The Canadian Nurse Volume 70

The
.....1
Nurse

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<< .

January 1974 Q

THE
PROBLEM-
SOLVING
TECHNIC:
I SIT
RELEVANT
TO
PRACTICE?

ISS MRA LOYER
158 GUIGUES 5T
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UVHITE
SISTER

WHITE SISTER'S
NEWEST LINE OF ACTION

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Style No. 42318
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Tricot knit
Sizes 5-15
White only
Price about $29.00

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Tricot knit
Sizes 3-15
White about $25.00
Slue about $27.00

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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
COMMUNICAnON 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
va riety.
Little. Brown July 1973 $6.25
LEADERSHIP TECHNIQUE IN EXPECTANT
PARENT EDUCAnON
2nd edition Clark
. . . Designed to equip the nurse instructor to con-
duct well planned educational sessions for pros-
pective parents.
Springer June 1973
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
EFFECnVE APPROACHES TO PAnENT
BEHAVIOR
Lipkin and Cohen
. . . How the nurse should approach an emotionally
disturbed patient when giving direct nursing care.
Springer June 1973 $5.50

. .. ..
,iéØJE

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TIle Body's Response
to TI'IUIII8: FrtctUfes

Recent releases
jor clinical
competence
o

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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
WINTERS' PROTECTIVE BODY
MECHANICS: A Manual for Nurses
Bilger and Greene
. . Concentrates on the physical and physiological
princip
es 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
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
Sutterfey 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
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, Gaffo 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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Please send me the booklsl whose numberlsl I have circled
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3 7 11
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Address Position

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Postal Code

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Books may be returned wIthin 15 days

D Use my Chargex number
D Charge and bill me

CN-1-74

,. .

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.

ALBERTA
CALGARY
The Bay
Simpsons-Sears
Vogue Dress Shop
EDMONTON
The Bay
Eaton's
Johnstone Walker
Rose Uniform Shop
Simpsons-Sears
LETHBRIDGE
Eaton's
Fays Apparel
LLOYDMINSTER
Ellen Rick Ltd.
Vivian Style Shop
MEDICINE HAT
Petite Style Shop
RED DEER
The Bay

BRITISH COLUMBIA
BURNABY
Simpsons-Sears
FORT ST. JOHN
Model Dress Shop
GIBSON
Goddard Fashions
KAMLOOPS
The Bay
KELOWNA
Sha-Dori Specialty
LOUGHEED
The Bay
PENTICTON
The Bay
PRINCE GEORGE
The Bay
REVELSTOKE
Revelstoke Co-op Associates
RICHMOND
The Bay
SMITHERS
Village Fashions
SURREY
The Bay
TERRACE
Terrace Co-op Associates
TRAIL
The Bay
VANCOUVER
The Bay
Eaton's
Jermaine's Ltd.
Miss K. Raynier
Rose Uniforms
VERNON
The Bay
VICTORIA
The Bay
Eaton's
Lady Mae Shoppe
S impsons-Sears

MANITOBA
THE PAS
Shirl's Boutique
PORTAGE LA PRAIRIE
Marr's Fashion

WINNIPEG
The Bay
Eaton's
Rose Lee Fashion Uniforms
265 Kennedy
837 Sherbrook St.

NEW BRUNSWICK
FREDERICTON
Levine's Ltd.
MONCTON
Eaton's
George Battah Ltd.
Simpsons-Sears
SAINT JOHN
Calp's Limited
Manchester, Robertson,
Allison Ltd.
Simpsons-Sears

NEWFOUNDLAND
CORNER BROOK
Sutton's Style Shop
ST. JOHN'S
The London, New York & Paris
Association of Fashions Ltd.

NOVA SCOTIA
ANTIGONISH
Wilkie Cunningham
DARTMOUTH
Jacobsons of Dartmouth
GLACE BAY
Ein's Ltd.
HALIFAX
Eaton's
The Robert Simpson Co. Ltd.
Uniform Shoppe
SYDNEY
Jacobson's Ladies Wear
Uniform Shop
330 Charlotte St.

LONDON
The Clothes Tree
1201 Oxford St.
Eaton's
Uniform Centre
Wellington Square
Uniforms Unlimited
723 Richmond St.
MISSISSAUGA
White Dove
58 Dundas St.
OSHAWA
Eaton's
Simpsons-Sears
OTTAWA
A. J. Freiman
C. Caplan Ltd.
Simpsons-Sears
Uniform World
226 Bank Sf.
OWEN SOUND
Sylphene's of Owen Sound
854 - 2nd Ave. E.
PETER BOROUGH
Uniform Shop
445 S1. George St.
Simpsons-Sears
RENFREW
Uniform World
170 Renfrew Ave.
ST. CATHARINES
Magder's Uniform Shop
40 Queenston St.
Simpsons-Sears
ST. THOMAS
Gerrard's Shop
639 Talbot
SARNIA
Uniform Shop
225 N. Front St.
Simpsons-Sears
SUDBURY
Eaton's
Uniform Centre
84 Elm St. W.
THUNDER BAY
Eaton's
TORONTO
Eaton's
Robert Simpson Co.
Uniform Specialty
1254 Bay St.
372 Queen St. West
Uniform World
641 Bay St.
WELLAND
Select Uniform Shoppe
179 King St.
WINDSOR
Adelman's Dept. Store
60 Pitt St. E.
Simpsons-Sears
Uniform Centre
324 Pelissier St.

ONT ARlO
BELLEVILLE
Jackson Metivier Uniform Shop
265 Front Sf.
Mcintosh Bros.
257 Front Sf.
BRAMPTON
Purple Pelican
Shoppers World Shopping Centre
BRANTFORD
Uniform Shoppe
37 King St.
CHATHAM
Artistic Ladies Wear
Uniform Shoppe
63 Fouth Sf.
117 King Sf. West
HAMILTON
Eaton's
Florence Nightingale Shop
156 James St. S.
Lockharts Ladies Wear
603 Concession St.
The G. W. Robinson Co. Ltd.
18-24 James Sf. S.
Simpsons-Sears
KINGSTON
Simpsons-Sears
Uniform Shop
20 Montreal St.
KITCHENER
Uniform Salon
332 King St. E.
Simpsons-Sears
U'ITU niiD III:'U'

WOODSTOCK
Gerrard's Shop
399 Dundas St.

.

PRINCE EDWARD ISLAND
CHARLOTTETOWN
Eaton's
Fashion Shoppe
141 George Sf.
SUMMERSIDE
Smallman's Ltd.

QUÉBEC
CHICOUTIMI
Spécialités Suzette Inc.
418 est. rue Racine
1 Place Saguenay
JONQUIÈRE
Corseterie Louise
444 St-Dominique
LAUZON
J. E. Paré & Fils
MONTREAL
Eaton's
Uniform Boutique
5729 Cõte des Neiges
575 Maisonneuve Blvd. W.
800 St. Catherine St. E.
QUEBEC CITY
Les magasins Mile Uniforme
1121 rue St-Jean
Lyne Enrg.
2461 boul. Ste-Anne
Place de I'Uniforme
2750 Chemin Ste-Foy
Maurice Pollack Ltd
750 boul. Charest
Le Syndicat de Québec
405 rue St-Joseph
Simpsons-Sears
STE-FOY
Jacqueline Thibeault
2700 Place Laurier
ST-GEORGES DE BEAUCE
Confection Simone
ST-HYACINTHE
Mme Rita Bibeau Massé
1665 rue des Cascades
TROIS-RIVIÈRES
Maurice Pollack Ltée

SASKATCHEWAN
PRINCE ALBERT
C.8. Department Store
PRINCE RUPERT
Fraser Co. Stores
210 - 3rd Ave. W.
REGINA
Eaton's
SASKATOON
Eaton's
Fashion Uniforms
150 - 2nd Ave. N.
Simpsons-Sears

MlHITE
SISTER
PROMINENT DEALERS
listed alphabetically by
geographic location

BE FIRST ON THE SCENE

The
Canadian
Nurse

ð

A monthly journal for the nurses of Canada published
in English and French editions bv the Canadian Nurses' Association

Volume 70, Number 1

January 1974

19 Guest Editorial ........,.............................................,.......... M. Lalonde

21 The Problem-Solving Technique:
Is It Relevant to Practice'? ..................................................... B. Geach

23 Electrophrenic Respiration
in QUddriplegia ................... R.G. Vanderlinden. L. Gilpin. J. Harper.
M. McClurkin. and D. Twilley

27 When You Visit a Sick Friend .......

2H I've Got a Wolf By the Ears ............................................... B. Hartley

32 Protecting Nonsmokers in Public Places .............................. S. Kessler

rhe vie,,' e"pre"ed in the ùlilorial and va...ou' article' arc Iho,e of Ihe .ltuhor, and
do nOI nece"arily repre":nllhe polieie, \11' vie", of Ihe Canadian Nur'e,' ^",u:ialion.

4 Letters 42 Research Abstracts
7 News 44 Books
37 Dates 49 A V A ids
38 Names 50 Accession List
41 In A Capsule 64 OITicial Directory

Exccutivc Dircclor: tlelen h.. MU!o.,allem_
hlitor: Vi
inia \. Undabur
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hlitors. Uv-t:llen I.ockeber
. ()oroth
S.
Starr _ l:ditori..1 A""I;II1I: Carol \, 1)..01'-
kin _ I'roduction A"i,tanl: t:lil.abeth \.
Stanton _ Circulation Managcr ßer
1 Dar-
li
_ Advcrtising M..nagcr: Geol'):ina Clarke
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tÙr \:'xdu,i\\:' puhlication. I h\.' \:'Llitur 1"\..,\..1"\\.....
Ihc right to 1l1"
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print" and graph, ..nd
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c (..lIli.llh.1I1 'ur'\." \...,cl\:laUon 197--1

. ,

Editorial I

"Have you got the Cps1" 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 bel ieve 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! - VAL
THE CANADIAN NURSE 3

JANUARY 1974

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 (Controlling 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 good.
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
u!\e of p.r.n. medication. which is
another type of restraint. I would like
to see more emphasis on recognizing
the signs of impending aggression and
methods of intervening before physical
restraint is necessary. Many nursing
<;taff miss behavioral cues that indicate
<tgitation; 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 departmeñt. 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 stafr. 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. -
Chadalllle Jallsoll, Reg.N., LOlldoll,
Olltario.

Author replies
There is no single right method that
everyone can use in dealing with a pa-
tient \\ho is out of control. Guidelines
that fÒlh)\\
oullll. theoretical know-
ledge require modifications for those
whose duty i!\ 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 understood. shows that someone is
in control and goes a long way to alle-
viate the patient's fears. I nvolving those
present - be they other patients,
protessional or nonprotessional staff.
and visitors - can sometimes be more
effective than any "crisis team:'
The second query. regarding a
patient with a weapon. is always ti'ight-
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. - Jeall A. Reid,
MOlltreal, Qllehec.

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
etting,
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

Rcgi,tcrcd Il\I"C
,
your community nccds
the henefit of your
skills and experience.
Volunteer now to
tcach 51. John Ambulance homc
mlr,ing and child care cotlrse
.
('(lntact your Provincial Headquarters,
St. John Ambulance.

to the tather. "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. Fowles, Vall-
CO/H'('/', R.C.

Student learns from article
I was very interested in the article by
rhora KlOn. "How we communicate
non verbally with patients" (Nlwember
1972). It is true that bedside manners
are important in communicating with
patients.
I was reminded of an unpleasanl
experience I had last year \\hen I gave
an injection to a patient for the first
time. I was read} to give the injection.
when the patient suddenly grabbed my
other hand and said. .. rhis is your first
time giving an injection. and -I do not
want to be pract iced upon."
I was ama7ed and asked him why he
said that. He replied, "Your looks re-
veal it. You are trembl ing and perspir-
ing profusely, and you look frightened:'
The instructor came and found us ar-
guing; I wa
been able to .convince the
patient to receive the injection. under
supervision.
I was so embarras
ed. I did not
know why I behaved the way I did, in
spite of le:lrning the right principles in
the classroom. However, that experi-
ence taught me a good le!\son. It also
showed the ditTerence between know-
ing something in theory and in practice.
No\\ I am a jun ior nursing student
and have given countless numbers of
injections to patients. I am glad I have
never experienced
uch embarra
!\ment
since. rhe artide in Ihe Callad iall
N /I,..\'e made nw more awarl.' of my ges-
tures and actions when I deal \\ilh pa-
tients. and helped mc avoid loss of
con fidence.
I highly recommend that every stu-
dent nurse read about the crfects of
nonverbal comnll.nication with patients.
I hope you will puhli...h morc articles
of this type, a... the} are interesting and
an' applicable to the practice of nursing.
cspecialJ} 1'01 student nurses who are
still learning the ba
ic principles in
nursing. - /Hdo .It'all L ^-1allalo,
School I
f N/lnillg. fhilippillt' Ullioll
College, Mallila. 9
JANUARY 1974

.

.

-

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Davolchanged suction instruments
jUst enough to make a big difference.

There's only one difference
between Davol instruments and
metal ones.
Davol made them disposable.
80 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.

BUILDING ON A CENTURY OF QUALITY
HEALTH CARE PRODUCTS

'11l1li<('

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

"J.:.. . .J 1874-1974

=

Who makes surgeons'
gloves for the giants
of skill who are
small in statu

and wear
size 5 1/ 2
,
.

.

t \

J ,\

I.
I
I

Perry!. . .Naturally! But why? -Because small in stature doesn't mean small in the
appreciation of proper fit and other features and benefits that have made Perry the
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Gloves, size 5112S have beaded wrists for added protection and strength, whisper thin
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don't have to wear size 5112, we'" send you the size gloves that fit you.

erry gloves
A PRODUCT OF
AFFILIATED MEDICAL PRODUCTS LIMITED
90 Commercial Ave., Ajax, Ontario

6 THE CANADIAN NURSE

JANUARY 1974

news

1
I

"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 four-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 prcsence 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 coordindtor. "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 tor consultation.
. Nurses do not write enough about
what they arc doing.
The conference was sponsored joint-
ly by the department ot 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 Uthe global
objectives of nursing education be
redefined in accord with the evolution
in nursing."
CNA directors decided at their
meeting in Septemher 1972 that it
might he timely to review nursing edu-
JANUARY 1974

.

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 hureaucracy. .1
heahh-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
Servicc Novemher 13-16. 1973. The
conferencc was sponsored jointly by
Health and Welfare Canada and the
Canadian Nurses' Association.
Ms. Frayne. an Ottawa writer and
hroadcaster, said the present system
of providing care is top-heavy. "1 f
the structure is simplified. perhaps even
those who administer it will have some
understanding of its work ings:' ...he
suggested.
Spea"ing about community health
eenters. Ms. Frayne mentioned the
Hasting's Report which. she said,
s"ined the issue of control and did
not deal with the need for "govern-
ment seed money" so a center could
hecome self-sufficient. "Control hy
the local community must be ensured
at the outset through conditions attached
to provision of puhlic funds:' she said.
Consumers arc taking an increased
intere...t in health costs. while cxamin-
ing the quality of care. Ms. Frayne said.
"We won't be content to pay high cosh
t()r indifferent care in the future:'
Another panclist. Yvonne Vanden-
engel of Montreal. deplored the fact
that phy...icians rarely ma"e house calb.
and suggested that RNs should fill thi...
gap. The nurse should diagnose the

ailment. referring patients with serious
illness to the doctor, Ms. VandenengcJ
said. She had some advice for hosp;tal-
based nurses who don't like ma"ing
home vi...its and prefer the hospital
setting. "Stay there,"' she said.
Nurses who make these home "isits
should have "peripheral vision." Ms.
Vandenengel explained. "Out {)f the
corner of their eyes they oh...erve. with-
out being noticed. They see the type
of home. the hahit... of the family-
anything that will shed light on the
health problems of the patient."
The tour-day national Conference
on Nurses t()r Community Service was
attended hy more than 200 health
profcs...ionals and their "clients." The
theme of the conferencc was "the ...hift
of nursing services from acute. curative
care in institutions to the promotion
of hcalth in the community:'
Keynote spca"er on the opening
day of the conference \\ as 1\'1arguerite
Schumacher. CNA presidcnt. Her topic
wa... "The Identity of Nursing in the
Electronic Age."

Panelists Set Forth Skills And
Knowledge Of Nurse Of Tomorrow
()f(aWlI - In reporting to the plenary
...ession on the sccond da" of the
national Conference on N'urses for
Community Service. held in November.
Denise Lalancette, nurse clinician,
University of Sherhroo"e Clinic. ...aid
shc was made uncomfortahle hv what
she had heard the day before. -
She \\ a... disturhed hy nurse.... hesita-
tion and reluctance to assume their
rc"'ponsihility to meet the need... 01
tomorrow: by the lac" of nurses' ser-
"ices in homes and disad"antaged
area...: h} their apparent content with
the "system" in that the} do not que...-
tion if u...crs lIl't'c1 their service... a... nO\\
offered: and hy their lac!.. of attcntion
to the individual nceds and comll)n of
patients.
M.... I alancelte felt rea......ured ho\\-
ever. \\ hen she al...o heard: .. rhere are
hcalth \\Ior"ers who clre ahle to care
for u... at a price \\Ie can pa}. 1 he} are
the nurse...... "We nurses must get going
and II.\(' our ..."ilk" she conclud\..x1.
Pamela Poole, re...earch consultant.
Health and Welf;lre Canada, \\a... the
fir...t paneli...t tl) ma"e projection... on
the "no\\ ledge and ..."ills for future
nUI...ing practice. Her... \\a... the general.
fin CANADIAN NURSE 7

news

and personal. view: "Our mandate of
physician'
help
r will change to that
of autonomous decision-ma!..er. The
nurse of the future will have a gr
ater
sense of being independently respon-
sible (0 the public he or she serve
than
to the agency."'
M
. Poole further foresaw a health
care system \\-here 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 thc needs of the people will
take precedence over th
needs of the
providers [of care)."
Projections were made for nun,ing
in ti.)ur areas: acute care nursing by
Joyce Bailey. specialty nursing practice
by Audrey Thomp
on. continuing
nursing care by Lorine Besel. and pri-
mary nursing care by Geneva Le", is.
Ms. Lewis, director of puhlic health
nursing, Onawa-Carleton health unit
envisioned the communitv nurse of the
future as a s!..illed he
llth educator
capable of supervising and counseling
the well individual from birth to lkath.
constantly alert to sign
of di

ase to
permit early intervention.
Ms. Besel, nursing director. Allan
Memorial Institute, Montreal.
tressed
that long-term patients need someone
to care lIhollt them. not just (or them.
"We must get away fronl the focus on
illness, when a patient is an interesting
case. We must fÒster an emotional
curiosity and be able to Wne in to the
patient's emotional experience as he
goes through the various stagö of adap-
tation to his ilIn
ss."
Ms. Thomp
on. director of nursing.
Reo Deer Hospital. and vice-president
of the Regi
tered Nurses' A

ociation
of Alberta, said that no basic nursing
Lxlucation program can provide a prac-
titioner with all that is needed tÒr con-
tinuing skilled practice and it is the
individual nurse who must be motivat
d
to constantly search for answer
to
prohlems that .Iri
e.
In her opinion. the nurse of the
future. even though a group memher.
will need to be self-directed, ahle to
ma!..e aulOnomou
professional deci-
sions. and he accountable for his or her
actions. This nurse", ill need to ta!..e 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 responsihility or direc-
tion over all those who deal with pa-
tients'!" she as!..ed. Ms. fhompson be-
8 THE CANADIAN NURSE

heves nursing may become extinct un-
less nurses have compassion for and
involvement", ith patients.
!'vh. Bailey. director of nursing,
Wellesley Hospital. Toronto. remindcd
the audience that care of the acutely
ill '" ill continue to be in an institution
with sophisticated procedurcs. ma-
chines. and qualified staff. The nurse in
this
ning must possess "the ability to
deal personally in a caring way with
the critically ill and an understanding
of th
depersonalization that can occur
in intensive care areas. Also important
will be a !lex ihil ity 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 he reached where
there is very linle left for nurses to do:'
she said. However. the future of nursing
and acute care nursing as a specialty
is "as hright and as exciting as we wish
to ma!..e it," she added.

Family Practice Nurse Role
To Be Tested In Urban Setting
Ottawa - "Il is in the urban, fee-for-
service. multipractice setting that the
acid test of feasibility of the attached
nurse practitioner waits:' Dr. Boyd
Sunie told those attending the national
Conference on Nurses for Community
Service, on November 15, 1973.
Dr. Sutti
is president of the Cana-
dian Puhlic Health Association and
professor of health care delivery at
Memorial Univcrsity, St. John's., Ntld.
He was a member of a panel discussing
the preparation of tomorrow's prac-
titioners.
Dr. Suttie outlined a demonstration
pn
iect in Newfoundland to measure
the impact on patient care. function
tran
lcrs, and costs, of introducing a
nurse to each of 10 urban general prac-
tices. "For us fl) have chosen the rural
or nllrth
rn scene IÌJr this project would
have heen 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 seeond-rate solution to
the problem of provision of primary
care in the ahsence or scarcity of phy-
sicians. and the expanded role nurse
has more to oller than that.
"The time has come. . . for the for-
malizing of the education and the utili-
Dltilln of the expanded role nurse. and
for a sound. scientitic eval uation 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.
"N ursing 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. N eylan. 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 l)O 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 he pre-
scribed.
Assessing the national scene in nurs-
ing education. panelist Dr. Bevcrly
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 011 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
heen the failure to differentiate clearly
hetween 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.

(COl/lilll/ec/ Oil pliKe 10)
JANUARY 1974

, .. ,
- - .--

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38480. THE CLINICAL NURSE SPECIALIST.
Edited by Joan Riehl, R.N., and Joan Wilcox
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news

I'
I
I'

and personal. view: "Our m
physieialÙ help
r will chan

of autonolllOU'i decision-ma
nurse of the future will have
sense of heing independentl
sible to the public he or she s
to the agency,"
Ms. Poole further ti.>resaw
care system where the nurse
munity service will be able to
will he concerned with healt
will nol be a separate indiv
prevention and another ti.>r c
said. "and the needs of the p
take precedence over the nee
providers [of care}."
Projections were made 1'0
in fi.1ur areas: acute care n
Joyce Bailey. specialty nursin
by Audrey Thompson. c
nursing care by Lorine Beset
mary nursing care by Geneva
Ms. Lewis, director of pub
nursing, Ottawa-Carleton he. ,
envisioned the community nurse of the
future as a s!..illed heîllth educator
capable of supervising and counseling
the well individual from hirth lo death.
constantly alert to signs of disease to
permit early intervention.
Ms. Besel, nursing direclor. Allan
Memorial Institule. Montreal. stressed
that long-tcrm patients need someone
to care aholll them. not just If)/' them.
"We must get away fronl the focus on
illness. when a patient is an interesting
case. We must fÓster an emotional
curiosity and be ahle to tunc in to the
patient's emotional experience as he
goes th rough the various stages of adap-
tation to his illness,"
Ms. Thompson. director of nursing.
Red Deer Hospital. and vice-pre'iid
nt
of the Registered Nurs
s' Association
of Alberta. said that no basic nursing
education program can provid
a prac-
titioner with all th.1t is needed for con-
tinuing skilled practice and it is the
individual nurse who must he 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 he sclf-direct
d. able to
make autonomous professional deci-
sions. and be accountable for his or her
aetions. This nurse will need to ta!..e a
stand on issues. to spea!.. out. and may
have to learn to lohby. she added.
"Docs 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 as!..ed. Ms. Thompson bc-
8 THE CANADIAN NURSE

L

lIeves nursing may hecome extinct un- of the practice of medicine." he said.
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Uttllll'lI - "It IS 111 the urban. tee-tor-
...ervice, 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 IS. 1973.
Dr. Sunie is president of the Cana-
dian Public Health Association and
proll:ssor of health care delivery at
Mcmorial University, St. John's. Ntld.
He '" as a member of a panel discussing
the preparation of tomorrow's prac-
titioners.
Dr. Suttie outlined a demonstration
pn
ject in Newfoundland to measure
the impact on patient care. function
transll:rs. and costs, of intnxlucing a
nurse to each of 10 urban general prac-
tices. "For us to have chosen the rural
or northern scene for this projcct would
have heen a mista!..e," he saiJ . . . . "To
have devoted our efti.>rts exclusively to
th
rural and northern areas could have
led to the recognition of the expanded
rok nurse as a second-rate solution to
the problem of provision of primary
care in the ahsence 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. scientitic evaluation of
her impact. . . . We are not just chang-
ing one role of the nurse. We are start-
i ng a chain of events that will change
the role and relationship of the physi-
cian and adjacent health professionals.
paJticularly in primary care - a chain
of events th,lt will change the patterns

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patient care will have to be developed.
Once these standards are accepted,
deficits can he assessed and programs
tor 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 nursc's role in prevention
and health maintenance; we have tocus-
sed our attention 011 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
hetween 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 trom 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.

(Contillued Oil PllKC' 10)
JANUARY 1974

Where can you turn when
you need up-to-date answers
to what's new-
s-I
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· 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 helping 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?

(Re..il prices shown)
39681. COMMUNICATION 1:'11 Nt.:RSING
PRACTICE. Eleano, C. Hein, R.N. Provides a
variety of approaches to more effective com-
munication in actual nursing situations. 55.95
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." SI1.00
39691. COMMUNITY HEALTH Nt.:RSING.
Kathleen Leahy, M. Ma,gue,ite Cobb, and Ma,y
Jones. A wealth of practical information on the
delivery of health care. Case histories show how
to bring nursing care into the community. 58.50
40131. CONCEPT FORMALIZATION IN
NURSI
G. The Nursing Developna.nl Confe,-
ence G,oup. A repertoire of professional con-
cepts for the nursing planner and developer. Ex-
plores future nursing roles. $7.95
64941. Nt.:RSING THE OPEN-HEART SUR-
GERY PATIENT. Mary Jo Aspinall, R.N., M.N.
Concise soft-bound handbook tells all about nurs-
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TRODt.:CTION TO OPERATlNG-
ROO
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Cornelia Be"" and Mary L. Kohn. Details sterile
technique, positioning and draping, your duties
and procedures at every stage of surgery. 58.95
60420. A MANIJAL OF CARDIAC ARRHY-
THMIAS. MichDel 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 NL'RSING TODAY. Joy
P,inceton Clausen, Ma,garet Hemp Flook, Bon-
nie Fo,d, Ma,ilyn M. G,een, and Elda Popiel.
Forty contributors provide c1earcut guidelines for
maternity nursing. Practical nursing know-how
and criSls-coping tips. $11.95

72990. PSYCHOSOCIAL ASPECTS OF TER-
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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. 512.50
73960. RESPIRATORY INTENSIVE CARE
NURSING: From Beth Israel Hospital. Sha,on
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. 59.95
64991. NURSE'S GUIDE TO CARDIAC SUR-
GERY A
D NURSING CARE/THE Nt.:RSE'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 coun' as one. 510.15
67180. PARENTS AND CHILDREN IN THE
HOSPITAL. Ca,ol Ha,dg,ove and Rosemary
Dawson. Successful new programs where mothers
live in and help care for their hospitalized chil-
dren. $7.95
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61910. MEDICINE: Essenttals of Cllnlnl p...,.
tlee. Cheste, Keefe" M.D., and Robe" Wilkins,
M.D. A complete guide to the art of making a
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detection and treatment of hundreds of clinical
illnesses. $12.50
64930. I'oURSI'G CARE OF THE CHILD
WITH LO:'llG-TER'\1 ILLNESS. Edited by Shi,-
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thinking on the exacting science and art of nurS-
ing chronically ill children. $9.95
64940. NL'RSING MANAGEMENT FOR PA-
TIENT CARE. Ma,jo,ie Be)'e,. and Ca,ole
Phillips. Techniques and keys for gelling more
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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? 58.95
67641. PEDIATRICS. Edited by Mohsen Ziai,
M.D. A major, 10000page medical guide on care
of the child from prenatal stages through ado-
lescence. Softbound. 511.50
68570. PHARMACOLOGY: Drug Aetlons and
Reac:tloDS. RUlh 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.so
72330. THE PSYCHODYNA
IICS OF PA.
TIENT CARE. Law,ence H. Schwa"l and Jane
Linke, Schwa"l. Focuses on people's reactions
- both 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 before, during, and after cardiac
surgery. The 2 books count as one. SIJ.4!
44460. EMERGENCY ROOM CARE, 2nd EdI-
tion. Edited by Cha,les Ecker, M.D. The guide
that will arm l. ou to cope with the emergenciC'
that crop up- rom cardiac and obstetrical emer-
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49360. FUNDAMENTALS OF CHE'\IOTHER-
APY. William B,ewste, P,att, M.D. E"ery chem-
ical and clinical aspect of drug therapy: indis-
pensable for today's nurse. 510.so
52230. HANDBOOK OF DRLG INTERAC-
TIOI'oS. Gerald Swidle,. Sets down the interac-
tions of more than 1300 drugs, telling which
other drugs must be avoided with a specific drug,
preferred methods of administering, danger signs.
515.00
J64OO. BLAKISTON'S GOULD MEDICAL DIC-
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current information: generic and chemical names
of the latest drugs, terms, diseases-from psychi-
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If card is missinll. simplv write
The Nurse's Book Society
Dept.: 6.108. Riverside. N J. OR01S
and indicate 3 books you want.

news

I COllI i 1111/,,1 f,.oll/ pll.l!l' 8 J

The annual meeting was held in
Montreal's Queen Elizabeth Hotel on
November 5. 6, and 7, 1973. At the
meeting. delegates reeleeted 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 Order of Nurses of Quebec.
Because the word "Order" appl ies
specitìcally 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 OM).
Delegates approved resolutions ask-
ing the AN P() 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 respectcd 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 carc of the chronically ill.
ANP() was as"ed, by resolution. to
make enquiries on the potential role
of the nun.e in acupuncture and to
participate in any Chinese-Canadian
group formed to study this subject.
I 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 5.ROO nurses participated in the
study.
The report says. "32.000 nurses
work illcgally each day... for daily
thcy perform acts for which they were
trained but which the law does not
recognize as an integral part of the
nursing role. ... The present study
concerns thc problem posed by the
"borderline act" in demonstrating. with
percentagc for cach procedure, the
broad responsibilities accepted by the
nurse. ..
The study i.. 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 Ll<;
"Every .lct the object of which is to
identify the health nceds 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

L.

The Flowers That Bloom In The OR, Tra La

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Nurses and technicians in the OKs 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 manul
lcture. Helen Ja"ab. h
ti. and Molly
Brewster, right, are shown in their tlowered headgear: they are nurses' aides in
the operating room 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 ANP() briefs to the parlia-
mentary commission studying the Bill

related to nursing. (News. June IY73,
page 10). The completed ANP() 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 lim its
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 FCG. 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 outpo
t nurse
may give oral medications without
a doctor's order.
In a report of AN P() priorities.
work inherent in the two pieces of
legislation. the Code of the Profes-

ions and the Nurses' Act. were iden-
tilïed. They are to develop ANP() by-
laws; set up a competency board to
evaluate mcmbers' professional "now-
ledge; develop a code of ethics applying
to the practice of nursing. a requirement
of the Professional Code (Bill 250);
and implement professional inspection
prowams to <;upervise the practice of
nur"lIlg.

Nurses Want Greater Voice
In B.C. Health Corporation
ViIl/COIn-l'r, R.C. - Directors of the
Registered Nurses' Association of
British Columbia (RNABC) have en-
IANUARY 1974

dorsed the establishment of an interim
nursing advisory committee to advise
the board of the ne\\ B.c. cm\\ n corpo-
ration on health. the B.c. Medical
Centre.
Matters on v. hich 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 RNABe and the Univer-
sit} of B.c. school of nursing \\ ill ask
J. V. Cristensen. chairman of the B.c.
\1edical Centre. to make the nursing
advisory committee an official com-
mittee of the complex.
The bill creating the crO\\n corpo-
ration for health v. as given ro) al assent
early in November I <)73. It gives the
health corporation the responsibility
to establish and operate in Vancouver
a provincial mcdical and health sci-
ences center: to establish training
..chools and courses tÌJr medical. dental.
and paramedical persons. for nurses.
and fÒr othcr persons in the health
field: to providc public cducation in
hcalth: and to carryon mcdical and
hospital research.
-I \\0 chief officcrs of the ncw corpo-
ration \\-ere recruited from Vancouver
Genera] Hospital. The corporation's
chairman. Mr. L hnstensen. was for-
merly chairman of thc VGH board: the
corporation president. who is the chief
administrative officer. is K.R. 'Weaver.
fÒrmer executive director of VGH.
fhe B.C. Medical Centre's profes-
...ional advisory comm ittee is made up
of 15 doctors plus one appointee from
RNASe. one appointee from each of
tv. 0 othcr professional groups. and a
health sciences student elected by the
student bod\, The RNABe board had
supportcd a'LBc proposal for a profes-
sional advisory board to "permit all
health professionals to have an equal
voice in cxpressing their views through
their chairman to the governing body:'

RNs And LPNs Come Together
In Three Manitoba Agreements
It'if/llipeg. Mall. - 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. Thc Selkirk
Nurses' Association was first. follow-
ed by thc Souris Rcgi'itered Nurses'
and Licen...ed Practical Nurses' Asso-
ciation. and the Pine Falls Nurses'
Association.
At thc annual meeting of the \1ani-
toba Association of Registered Nur'ies
held in Ma}. \IARN mcmbers accept-
ed a resnlution to "approve in princi-
ple the <\malgamation of thc thrce
nursing group... - registered nurses.
licensed practical nurses. and registered
psychiatric nurses - under onc Act. in
JANUARY 1974

such a manner as nUl} bc decmed in the
best intcrests of all group'" and thc
health care of people of Manitoba:'
The \tAR' Nl,It's of September/Oc-
tober I <)73 said: "The movement that
has taken place tov. ard the unification
of nurses over the past } ear and thc
resolutions passed at the \IARN annual
mccting intluenccd the deci'iion" to
include LPl':s in the Selkirk '\iurses'
Association.
The Provincial Staff Nurses' Coun-
ciL cstablished in 1<)70 by b}la\\- of the
t\1 '\RN Act. is made up of nurses who
are eligiblc for inclusion in collcctivc
bargaining units. elected by their pccrs:
the president of t\1-\ RN is not a mem-
ber of the Council cx oftìcio.
The Council is rcsponsible for as-
sisting local staff nurses' assoc iations
in collective bargaining. According
to a recent Council nev.sletter. separatc
negotiations havc becn held fix 14 of
I X
collective bargaining uni", bccause
cmplo} ers refuscd to negotiatc cen-
trail} .

Ont. Nurses' Association Formed
For Province-Wide Bargaining
Torollto, Ollt. - Last October 13. a
significant stcp toward province-wide
collective bargaining by nurses \\as
taken when the Ontario Nurses'Asso-
ciation (ONAI v.as formed.
Attending the founding meeting
were more than 300 reprcsentatives
from 85 independent nurses' associa-
tions. which are ccrtified as bargaining
agents for nurses employed in health
care institutions. publ ic health units.
visiting nurscs' organizations. and in-
dustry. Thcsc founding members adopt-
ed a constitution and electcd a board of
directors who will hold office until the
first annual meeting is held.
It is expected that the 100 indcpend-
cnt nurses' associations in the proVll1cc.
representing more than 10.000 nurscs.
will merge with the ONA. Some 35.000
to 40.000 nurses \\-ork in Ontario at
prese nl.
At its I <)73 annual meeting. thc
Registered Nurscs' Association of
Ontario passed a resolution endorsing
the establ ishmcnt of a separate central
vehicle for collcctive bargaining by thc
Nurses' Central Security Fund (in
which the 100 indcpendent nurses'
associations participate).
Ontario labor legislation appears to
prevent RN AO. as prescntly structured.
from becoming ccrtificd as a tradc
union because its membership is not
open to graduate nonrcglstered nurscs
who are now included in bargaining
units. and because some of its members
are in management positions.
Anne Gribben. director of RN o\(>'s
cmployment rel.!tions department.
explained. "By crcating a central body.

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Buy your regular mid-week day ticket any-
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We invite you to ski with us this season,
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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 DNA 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 DNA; when
this occurs, the other nurses' units will
be able to become charter members of
DNA.
DNA 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 13
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 techmques, and intnivenous ther-
apy.
Sixteen clinical experts from British
Columbia hospitals attended a work-
shop in October 1973 at RN ABC head-
quarters. Their services are otTered
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 "ervice will
be small in comparison to the big re-
turn expected in bette r patient care."

Government Council On Women
Disapproves Award To Nurses
Oltawa - The advisory council on the
status of women has expressed to Trea-
sury Board chairman C.M. Drury their
disapproval of the arbitration award
made to federally employed nurses.
(News, December 1973, page 7.)
The advi!>ory council, which met in
Ottawa on November 13 and 14, asked
Mr. Drury to reopen negotiations
with the nurses immediately. The coun-
1.2 THE CANADIAN NURSE

l

cil said, "The regional wage application
creates great discrepancies among
nurses pcrtorming the same tasks in
different parts of the country:'
The council was also critical of the
study of nursir'1g 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
teons 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 31, 1973,
Mr. Munro, the minister responsible
for the status of women, announced

It's Winnipeg In '74

ð

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 councilor 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 judgIllent 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 Jeltoid muscle
of the patient's left arm with a I 1/2-
inch needle. According to the evidence
given at the tr.ial, the patient did not
wish to lower hIs pants tor the 1M. After
the patient returned home from the
ut-
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

Dunng the trial, Ms. Wilcox de-
scribed in detail the technique she used
for giving an 1M injection. Several
expert witnesses testified that her metn-
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.
"N BARN is pleased that the case is
going to be appealed," Nancy Rideout,
NBARN'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. Onto - 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 lack 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
conti nued.
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
doT 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 oftwo 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. He describ-
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 resol utions approved by
OHA members was one that calls on
OHA to "take the necessary steps to
achieve policy changes which will
enablèqualified and experienced nurses
from abroad to become registered in
Ontario, based upon their nursing skills
and training."
Another resolution calls ìor studying
the Ho
pitals of Ontario Pension Plan
to establish the feasilibity of removing
discrimination because: " .. the
clau
es pertaining to benetït
in the. .
IColltitll/('d Oil f'l/1!(' I
)

Next Month
in

The
Canadian
Nurse

. A Diploma Is Not
An Oil Painting

. Ethics of Nursing Practice

. Clinical Laboratory Procedures

ð

Photo credits for
January 1974

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

Toronto Western Ho
pital.
Toronto. Ont.. p. 25

University of British Columbia,
Vancouver, B.C, p.
9

THE CANADIAN NURSE 13

1Â R.."". N.". PI
.. . .I'ooast
qu.III" $11'.....1 l"yl g,
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M_U Zl If* .pll.nIIDua. .hl". ,
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MRS. R. F. JOHNSI

lv'II'lr.
SUPERVISOR

IN

----

CHARLENE HAYNES

L

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,";r. t OHN, L.PN.

,,

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SRDUIlÐ I UTTERING PRlCU'
ftII J DESCRIPTION COlOi flNISW (

:) COLOR 'Enlmeli' l... hi'"'' 2l,,"
I ALL METAL rich, trim and 0 Gold [ 0 Duotone Does B g
ac:lue 0 1 Pin 2.25 1 Pin 3 OQ
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1- METAL FRAMED ClassIc 0 Gold Poh
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I 100 'SIRn; snow white DlaS!lc with 0 SII\ler frame
l_p".I

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onlv
I MDLDED PLASTIC .sllnPJ
.5>mart. 1 Does I Does
510 ( ooomicat WIU never discolor. not not
I Smooth rounded corners and edges. apply apply
I . QUANTITY DISCOUNTS: 1()'24 pins, deducl 10%;
I .Please Idd 25.. per Drderlar 3 pinS or lesi. 25.99 pins, 15%; 1000r more pins. 20%.
--------------------------------------.

---------------------

T .1Iar...
All ..tal
.....169

IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS!
Choose style you want, sl10wn left _ Print name land 2nd bottom left. Altach edra sheet for ad(hlional pms
hne if deslled) on dolted lines below Cileck otfJer mfo In HOTE SAVINGS ON 2 IDENTICAL PINS. _ . mare convenient.
boxes on chart, clip this section and attach to coupon spare in casl of loss.

P/U"ic
UlBiIiltI
5!i8

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l'1li"
,,1110

PLASTIC LAMINATE... slimmer,
t-roader. engraved thru surface to
! ntrastmg core color. Beveled
border matches lettering

AIIMlItti
P..,tIc
"'.510

MEDI-CARD SET HandIest reference
ever! 6 smooth plastic cards (3
" x 5Y.z") cram-
med with information, including Equivalencies of

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Blood Chern., Liver Tests, Bone Marrow, Disease
Incub. Periods, Adult Wgts.
All In white vinyl holder with gold stamped
caduceus. No. 289 Clrd Sit . . . 1.50 SI.
6 Dr more 1.25 'a. 12 Dr more 1.10 ...
Your initials lold-stamped on holder,
.dd 50. per lei.

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 2Y.z".x 4" x ]". Dial calibra-
ted to 320 mm., IO.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
Dermanent identification and
distinction. A wise investment for
a lifetime of dependable service!
No. 106 Sphyg. . . . 37.95 ea.

NURSES PERSONALIZED
ANEROID SPHYG.

CAP ACCESSORIES

I
.

_.-

CAP TOTE keeps your caps crisp and clean

while stored or carried. Flexible clear plastic, white
trim, zipper, carrying strap. hang loop_ Stores flat. Also
for wiglets, curlers, etc. 81,7" dia, 6" high.
No. 333 Tole. . 2.65 ea., 6 Dr more. . 2.35 el.
Your iniliall gold,"lImped, Idd 50. per Tole.

WHITE CAP CLIPS Kolds capl

firmly in place! Hard-to-find white bobbie pins,
......-::; enamel on fine sprin, steel. Eight 2" and eipt
3'/ clips included in plastic snap box.
No. 529 Clips. . . 3 boxes lor 2.25,
. 6 for 65, ea., 12 for 60.. ea.
MOLDED CAP TACS
_
Replace cap band instantly. Tiny plastic tac,
' _

dainty c.aduceus. "Choose Blad., Blue, White

Dr Crystal with Gold Caduceus; Dr all BI.ck. . -_. - -.::

(plain). The neater way to fasten bands. : -. U

.

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t::t:

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P....t. ':----.
;-

METAL CAP TACS Pair 01 dainl,
IA.lA..I jewelry-quality Tacs Witt! grippers. flolds cap
IWUI bands securely. Sculptured melal, gold finish.
... approx.
'J wide. Choose RN, LPN, LVN. RN

Ceduceus or Plain Caduceus. Gift boxed.
n M'O ..
No. CT.l (Specify Iniliall), No. CT-2 (PI.ln
t.:.V1.U Cad.) 01 No. CT.3 (RN Cld.) . . . 2.95 pro
SEL-FIX CAP BAND Blackwelvel r---..
band material. Self-edheslve. presses on,
. .
pulis oft; no sewing. Dr pinning. Reusable .
several times. Each bind 20" Ion,. pre-cut to \
popular widths: Y.z" (12 per plastic box) Y.z" .
(8 per box) %" (6 per box) I" (6 per ))bxl
Spectfy widttl under ITEM column on coupon.

. ...; B nd. . . ,.r bax 3 Dr more. .1.50 ea.
CROSS PEN --
. Ia,"G,.
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World-famous ballpomt, Witt!
,
scu
tured caduceus emblem. Full name - _

:
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ecuupOn). -c...-
No. 3502 Chrome 8.00 e.. No. 6602 12kt. G.F. 11.50 ...
TO: REEVES COMPANY, Box C . Atlleboro, Mass. 02703
ORDER NO. In rmDlmlmmmml
--

.
.
.
t

Use extra sheet for additional Items or orders.
INITIALS al deli red, _ _ _
(Good Idea. . . feJ distinctive identification)

TO ORDER NAME PINS, lill out all inlormalion in box lop
nght, clip out and attach to this coupon.

I enclose $ (Mass. residenls add 3% S. T.)
Sorry, no COD's Dr billing lerms .vaillble

L.

.
I S.nd 10 ..
· City
a . .

.

.

Street

.Stale .'

..Zip .........
. . ill

.

.

.

.

-- KELLY FORCEPS So handy lor
every nurse! 5Y.z" stainless steel, fully
guaranteed. Idesl for clamping off tubing. Your
own initials help prevent loss.
No. 25-72 Fo..ep.... 2.75 eo. 6 Dr more 2.50 U.
Tour Inltl.l. onlfaved. add 50. por I....p..

.

. ..

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aIS "

:l:
Y ) ed I
Free
Scope
Sack
\
- .I v.-.-

Free Initials and Scope Sack
with V1nU' own
Littmann" Nurteteope I
BRAND

Famous LIttmann nurses'
diaphragm stethoscope . . .
a fine precision ,"strumenl,
with high sensltivit, for
blood pressures, apical pulse
rate. Only 2 ozs., lits in
pocket, wilh gray vinyl anti.
collapse tubing, non-chIlling
epoxy diaphragm. 28" over.
all. Non.rotating angled ear
tubes and chest piece beau.
t,lully slyled in choice of'S
jewel-like colors: Goldlone.
Silvertone, Blue, Cleen, Pink.'
FREE INITIALS AND SACK!
Your ,"itials engraved FREE
on chest piece; lend individ-
ual distinction and help pre-
vent loss. Also FREE SCOPE
SACK included, worth $1.
(Free sacks nol personal.
Ized; add SO
if initIals de-
sired.) Note big savings on
Quantily orders.
No. 216 Nursescope . . . 13.80 ea. ppd.
6-11 . .. 12.80 ea. 12 or mOre. . . 11.80 ea.
Group Discounts
free Initials and Sack!
.IMPORTANT: New "MedallIon" styling Includes tubIng in
colors 10 match metal parts. If desired, add $1. ea, to
prices above; add "M" to Order (No. 216
) on coupon.
No. 223 Scope Sack only. . . 1.00 ea. ppd.
6 or more 75t ea. Gold stamped initIals, add 50t

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o Wh,le nO BI.ck
o Med. Gree ry: lö Dt<: Blue
OMed Blue White
DCccoa letters only

n I Pin .95 j 1 Pin 1.55
'î 2 Pms 1.65
2 Pins 2 60
Iwme n.mel Iwme fio!lmel

White
only

o Black 01 Pin 225 01 Pm 3_00
o D" Blue fl2 PinS 3.15 rJ 2 Pin!. 4.95
(Wm@' '1i'Jrn
J Is me "<'Im!'1

White
only

o Black [j 1 Pm .95 U I Pm 1.55
o Dk Blue 0

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3W' LISTER MINI.SCISSORS

tiny. handy. Shp Into undorm pocket or
purse Choose Jewelers Cold or gleaming
Chrome plite finish on coupon
BeL No 3500 Mini.Scissors . . . 2.75 e..
4W' or 5W' LISTER SCISSORS
As above. but larger lor bigger
s ChrCl11t finISh only
N. 4500 141'1"1 or No 5500 15V."1 Scissors. . . 2.75
5W' OPERATING SCISSORS _ .

Stamless steel. with sharp I blunt

'\
poinls Beauh!ully pOhshed flmsh. -

No. 705 DR SCII,Ors . . . 2.75 ea. - '7'
All scissors above: 1 dOl. Dr more (anr stylel . . . 2 00 ea. \.. .)
Your initials eneraved. add :iDe per SCISSOrs

CLAYTON DUAL STETHOSCOPE tIght.
weight Imported dual scope; highest sensitivity for apica
pulse rate. Chromed head tubes and chest piece with ,
11;'s" bell and I f." diaphragm, grey anti-collapse <@)j

tubing. 4 OZ., 29" long. Extra ear plugs and e D
diaphragm included.
mitlals engraved free.
No. 413 Dual SIelh . . . . . . . . 17.95 ea.
. JEWELRY NURSES CHARMS '1;,
.
Finest sculptured FistJer tharms,
"-oc.."'-J
Sterling Dr Gold Filled (specify under COLOR on couponl. i' .. ....
For bracelet or pendant chain_ Add to your collection! /' ("\ f

No. 263 Caduceus; No. 164 Cap; No. 68 J'! .. '1
Grad. Hat: No. B. Band. Scissors. . 3.49 el. (" íI '\
",II, I
_14K PIERCED EARRINGS

f7""" Dainty. detailed 14K Cold ceduceus. for on Dr off duty
'Ii wear. Shown actua1 SIZ
. Gift boxed for fflends, too. _
. No. 13/297 Ea",ngs . . . . . . . . 5.95 per pair.
PIN GUARD Sculplured caduceus, chained

to your professional letters. each with pinbackl

safety catch. Or replace either with class pin for ,

salety. Gold finish, gift boxed Choose RN. LPN
Dr LVN. No. 3420 Pin Guard. . . . 2.95 'a.
(1n
) ENAMELED PI NS Beautifully sculplured .tatus

insignia. 2-color keyed. hard. fired enamel on gold plate.
A Dime.siled. pin-back. Specity RN, LPN. PN. LVN. NA 01

::
. ;
5co

:
. Pin 1.95 88., 12 or more 1.50 ea.

..

Endura NURSE'S WATCH F,ne SWISS made
waterproof timepiece. Raised easy-to-read white numerals
and hands on black dial, luminous markings. Red sweep.
second hand. Chrome fimsh, stainless back Includes
black velvet strap. Gift-boxed, with 1 year guarantee
Very dependable. Includes 3 initials en,raved FREE!
No. 1093 Nurse. Walch. . . . .. . . . . . 19.95 ea.
. I . Prevent stains and wear! E[}

Smooth, pliable pure white vinyl. Ideal
low-cost group gifts or favors. ,.
No. 210.1. Iript), two compertments
with flap, gold stamped caduceus. . .
- 6 for 1.50. 25 Dr more 20. e.
o No. 79t lIeft) eeluxe Saver, 3 compt J J
chan,Re pocket & key cham . . . I
6 lor 2.98, 25 Dr more 35. la.

D Nurses' POCKET PAL KIT
. ,. Handiest for busy nurses Includes while Ðeluxe
:

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hanðsClme httle pen light .. all sil1Jer fmrstJed
o Change compartment, key chall'.
, No. 291 Pal Kil . . . . . . . . 4.95 '".
3 Initials enlraved on shears. add 50.. per kit.

Bzzz MEMO-TIMER TIme hot packs, heat '" ro ."",
lamps, perk meters. Remembar to check vital signs
ø " .,i
give medication, etc. lightweight, compact n Y.z" dia), ,
sets to bUlZ 5 to 60 min. Key ling. Swiss made.
,.
No. M'22 Timer. . . . . . .4.95 el. .... .'
3armore 3.95 ea.i6 or more 3.50 ea. .... ...

EXAMINING PENLIGHT
White barrel with caduceus imprint, aluminum
band and clip. 5" long. U S_ made. baUeries mcluded Ire-
- - placement batteries available any store). Your own hght. gift boxed.
No. 007 Penlipt. . 3.00 ea. Your Inlli.l. enlra'ed. .dd 50. per lip..

.. .- - .....-..........

Whittenton fåJhiollA
Uni/ofPt

New "Saucy" Bump Toe Moc
little fashion notches run around sole and
heel; latest bumper toe look with
=- big bold eyelets; sturdy extra hght
cushion crepe sole and heel; finest
long-wearing white glove leather
the ideal shoe to feel pretty
in uniform. Fit guaranteed
or return (unmarrE-dJ
for Size exchange
No. 854 Saucy Shoe
...16.95 pro

(

--

.,

MISS FIVE.
Umque smock style with a httle
I.rl look Generous patch pock-
ets. inner surgical pocket
Short sleeves 100% Dacron
Double Knit.
STYLE No. 4632
3/4.15116...21.95

,
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,

SIZES.
u.a;I-11
..C,..r(-l-l1 '

"'_.c...-

.REEVA
Young fresh multi-luck bib 2-
button cuff Gusset
. sleeves
130'7 0 nacron Double Knit
STYLE No. 4697
6.20.4 16 Petite... 22.95
141f2.26'h...24.95
15% Do<.on/25% Cotlon
STYLE No. 4797
6-2D. 4.16 Petite... 16.95
14%-26%.. .17.95

C
.1

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.GIBSON GIRL
Youthful hip nse WIlst, mini
soft shirred skirt. pleated
blouse. Inner surgical pocket
100% Polyester Warp Knit :t;.
sleeves.
STYLE No. 4624
314.15116... 18.95
60% Dacron, 40% Nylon cord

l'Es,:

e;:s.
314.15/16. .15.95

Famous
NLJRSE
J\.1:ATES &

hær

New "Kork
Featherweight Style
Extremely lightweight. . . '11lIth the new
"bottom" look Smlrt comfortable lace- it
up heel oxford. Thick Slm cork sole ..........
with Hil" cork heel (very sllp-reslstln" ','" )
outwears crepeJ. White washable

soft glove upper leather. tricot

V .
lined. arch vents fit guaran-

teed or return (unmarred)
for size eJichange.
No. 638 Kork.Lite Shoe \..
. . . 16.95 pro

IIUS:
AAorA 1-11
..r c: 4"J.11

__
I . er E: '.11

iliA

...

All-Weather NURSES' CAPE

St,y snug In cool weather dry IR the rain
Traditional Navy with Bught Red lining
flRest lallorlng of 65% Dacron polyester,
35
Q combad cotlon lepel trealed tOO'\.
Nylon Duralyn IInlng_ Sn.iP fasteners. arm
openings Matching head scarf SMALL (up to
34 busU. MEDIUM 135381 or LARGE 139421
specify Slle on coupon.
No. Ii58 Cape . . . . . . . 14.95 ea.
3 Sold Inltlall In collar. Id1l1.00 per cape.
t. U
_ _ .. b A lifetime of service
for visiting nurses! finest black
" thick
genuine cowhide. beautrfully crlfted with
ruued stitched Ind rivet construction
Water repellant Roomy mtellor, with snip-
m washable liner and compartments to
.

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" \
TWD ru
ed carrying straps. 6" x 6" x 12".
1 . r' Your Initials gold embossed fREE on top_ An
P'J
tf1dlßl value of superb quahty.

oJ 1M4t1 801 (with liner). . 37.95 ea.
Extr. liner No. 4415. . . . . _ . _ 6.95 ea.

t.

<CD

.

news

(Continued from page /3)
plan are discriminatory. in that the
residual benefits in event of the death
of the beneficiary are only paid to the
surviving spouse 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."

H.C. Labor Relations Act Gives
Govt. RNs Bargaining Rights
Vancouver, R.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-
gdge 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.
I n our discussions. I have explained
the Act and the 1TJethod 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 dgreements will
apply to each bargaining unit. First
there is to be a master agreement to
include all the terms anå conditions
of employment that are common to all
employees in the bargaini ng unit.
Nurses will then split to negotiate two
subsidiary agreements; one will be for
RNs and registered psychiatric nurses

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 organiLing
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
MOlllreal, 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 1974. By taking
a qualifying year. non nurses with a
B.A. or B.Se. 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 aJld development in nursing.
and one elective. which will be ph) siol-
ogy in most cases. The qualifying year
will also be offered in
eptember 11)74.
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.Se. (Nurs-
ing) program offered at MeGill. 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 t0i the expanded
function of nursing in any field. includ-
ing health centers and family pi act ice
units. The research option tocuses on
research in clinicdl nursing or in health
care provision .1I1d evaluation.
Dr. Moyra Allen, professor of nur!>-
ing. is directing the development of
ML-Gill school of nur!>ing's research
unit. The nur'iing facult) plans to pro-
vide demonstration projects in the
expanded function ot nursing.
'
THE CANADIAN NURSE 15

IE

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 ARITHMmC OF
DOSAGES AND SOLUßONS:
A Programmed Presentation

I n 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. I n addition to these standard fea-
tures this new edition conveys a wealth of new
infor
ation 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.l?,.
April, 1973. 3rd edition, 76 pages plus FM I-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-B i II i n gs

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 few. 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 I-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.IOphth.l, M.D.;
WILLIAM H. SAUNDERS, B.A., M.D.; CAROL FAIR
KEITH, R.N., B.S.N., M.S.; and ANORA W. PRESCOTT,
R.N. February, 1974. 3rd edition. aoprox. 448 pages, 6y," x
9y,", 357 illustrations. About $12.35.

A New Book!

FAMILY-CENTERED
COMMUNITY NURSING:
A Soåocultural Framework

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. QUINN, R.N., M.S.; with 40 cOl')tributors. October, 1973.
304 pages plus FM I-XVI, 6y," x 9y,". 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 L TO
86 NORTHLINE ROAO
TORONTO, ONTARIO
M4B 3E5

JANUARY 1974

THE CANADIAN NURSE 17

IE

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. Aprit,
1974. Approx. 240 pages, 5%" 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 et 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!

T reece-Treece

ELEMENTS OF RESEARCH
IN NURSING

This new book offers concise explanations for each
step of the research process. I t 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 I-XII, 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/L VN 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.

MOSBY

TIMES MIRRDR
THE C. V MOSBY COMPANY, L TO
86 NORTHLINE ROAD
TORONTO. ONTARIO
M4B 3E5

18 THE CANADIAN NURSE

JANUARY 1974

.

"'\
1f"ò'"

JANUARY 1974

Guest Editorial

The Honorable Marc Lalonde

Minister of National Health

and Welfare

I am grateful for this opportunity to
share some of my views with the reg-
istered nurses of this country. As
ministcr of National Health and \VeI-
fare. I have had occasion to appreciate
the contribution of nur!.es to health
care in Canada.
Two of the key attributes I 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 locus on a more p:>sitive
approach of health promotion. This
should result in a better halance between
prevention and cure.
Recently. my department !.tudied the
major causes of death and sickness in
Canada to identify better our main
health probkms. From this evolved a
conceptual framework that allow
a
more integrated approach to the
tudy
of the whole health lïdd; at the same
time, it provides us with potential Ii.)r
a broader spectrum of health-promot ion
activities. This framework. which we
call the Health Field Concept. has four
principle clements. human hiology. en-
vironment. life-style. and health-care
organization.

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, identilïed as the
environmenC 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-
cd food!.; drugs. or cosmetics; noise
and water pollution; cro\\-dcd cities;
and stresses of urban living arc part of
the environment from which individuals
cannot always protect themselves.
Life-style, the third clement. 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 smo"e. to overeat, to use alcohol
excessivcly, or to lead a sedentary life.
The life-style pursued by the individual
wilI affect the requirements for using
the health system. including its 1
lcilitie!.
and human resources.
The health-care organi/atlon, or
fourth element, is known to all of us a<;
the health-care sy!.tem and consist!. of
the quantity. quality. arrangement.
nature, and relationships of people
and resources. It includes hospitals
and extendcd-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 signitïcant cause of death as early
as 15 years of age. Respiratory dis-
eases and lung cancer accounted for
15 percent of deaths for men between
the ages of 55-70.
The morbidity in hospitalized pa-
tients corresponds to the aoove 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.

JANUARY 1974

The problem-solving

technique:

is it relevant to practice?

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 at
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 sol ution of the

· F.G. Abddlah et a/., Patiellt-Celltered
Approach(',
to N IIßillR, N.Y" Macmillan.
\%0. p. 10.
JANUARY 1974

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.CM., M.S.N.

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 !>Cope to clarify
this issue; but the presence of this
confusion suggests that, although the
technique is well established - among
educators, at least - it i!> not as clearly
understood as we believe. Perhaps the

.. F-.G. Abddldh. and E. I evine. Belter
Patiel/t Care ThrollKh NIIHill
R('.\('arch.
N.Y.. Mdcmillan. \965, p. 12.

confusion accounts, in part, for the
silence aoout 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 grddudte of the Univer!>itv
College Hospital. london. Engldnd. and
the Y die l'nivcrsity School of Nursing.
New Haven. Conn. She is A"i"tant Pro-
fessor at the Universitv of Connecticut
School of Nur,ing. W,lIlingford. Conn.
THE CANADIAN NURSE 21

docility; yet I have the feeling they are
horcd 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, I 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
intormation I 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 jW1ior, 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 !.peedy
reactions, I was consciously evaluating
the effectivene!.:> of my action to pre-
22 THE 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 oored 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-
mque.
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 iftheproblem-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

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 pulmondfY system is
intact. but the central control or Its
peripheral outt10w 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-Barré 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 sutfer
from a hypoventilation syndrome char-
JANUARY 1974

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.

acterized by cyanosis. hypoxia. hyper-
carbia. and re
plratory acidosis. espe-
cially during sleep when there may be
prolonged pericxJs 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-
type ventilator during
Ieep. This venti-
latory lli>
i
tance tends to maintain p02
and pC0 2 at the diurnal levels to \\ hich
they have become accu
tomed. 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 Jahlons"ï
/IIl/strateci
Dictiol/llry oJ Epol/\'II/ic SYI/clrome.\ (///(/
DiWII.H'.\ 11/1(/ their .\'I'fltmym.\ (W.B.
Saunders 19f191. "Ondine's cursc" is:
"Failurc of dUlOmatic respiratory func-
tion with dpned. especially evident
duri ng sleep. and retdined ability to
hrcathe on command, .Ondine's cursc'
is helieved to have heen eoined bv [ a
Dr.] Severinghdm. \\ ho relates it to the
legend of Undine. a water nymph. who
punished her mortal hushdnd hy depriv-
ing him of the ahility to breathe dUto-
maticall}. rhus. on falling asleep. he died.
not being ahle 10 rememher to hre.llhe."

atory failure is high cervical cord trau-
ma. Although fractures and even di
-
locations in the atlanto-axial (C I and 2)
region are not uncommon. mo
t ot
these injuries do not result in neurolog-
ical deticit. If the spinal cord is signif-
icantly traumatized above the origin

of the phrenic nerves. \\ hich arise from
the third. fourth. and fifth cervical
segments. apnea results immediatel)'
and the patient is dead on arrival at the
hospital.
With increased public a\..arenes
,.nd
training in the use of mouth-to-mouth
respiration. some of these victims \\ ill
survive in a state of complete quadri-
plegia and total dependenq on me-
chanical ventilation. This is a ne\\ prob-
lem; fortunately. hO\\ever. a new solu-
tion to chronic respirator) insufficiency
has recently been developed - electro-
phrenic respiration.

Historical development of EPR
In 1937. Waud reported that rabbits
could be maintained in .1 satisfactory
respiratory condition flU hours b)
rhythmic electrical stimulation of the
phrenic nerves.' Sarnoff (I94H) exper-
imented with
everal other
pecies and
noted that submaximal electric
timula-

'1 hc authors arc stdl'f mcmhers at the
roronto \Vestern Hospit.IL Il'ronto.
THE CANADIAN NURSE 23

tion of a single phrenic nerve produced
adequate gaseous exchange for at least
22 hours. 2 He coined the term "elec-
trophrenic respiration" (EPI{) 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. 3
His success led to the development of
suitable electrodes. radioreceivers. and
a pacemaker for EPR. In 196R he
reported using EPR to obtain ventila-
tory assistance in a case of hypoven-
tilation syndrome,4,5
In Novcmber 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 C I 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 tlaccid 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 spendi ng the rest of her
life in the respiratory unit of an acute
general hospital seemed unacceptable
on human itarian and econom ic
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 tirst 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 trans venous
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 I, 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 identitied.
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 thc 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, p02' and
pC0 2 . The tidal volumes measured on
each side are approximately 50U 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 nonnally
sensitive to elevated pC02. 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
adeq uate 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 J .)
The current output of the pacer is
measured in milliamperes and can be
adjusted for each 12-hour period of
pacing. The doctors initl..Jly 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

-=-

-

'

J "
--

I

..J

--

.

,

---

, .........
,

.

\.

Figure J: The patieflt with radiofrequenc)' phrenic nerve pacemaker, which is set
at 2.0 milliamperes and powereJ 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 nen-e.

a wall outlet; when she is in a wheel
chair. the unit is battery powered. In
the sitting position, more current is
necessary to provide adequate tidal
volwnes. Initially. tidal and minute
volumes were measured and recorded
every tive minutes: however. when
total EPR was established, these re-
cordi ngs 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 suctioning.

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 wa
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 po
itioned
with pillows and sandbags.
As the
ympathetic nervous supply
to the body was destroyed. there wa<;
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. RolI

of padding were used in the hands to
prevent finger contractures.
Placing the patient in the chair was
also a ditlìcult maneuver. A quadripleg-
ic chair with horizomalleg support and
head support was used; pillows
upport-
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 halt
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 lo
s
THE CANADIAN NURSE 25

during the tÏrst three months, until
the patient stabilized and started to
regain weight as fat. Urinary drainage
was accomplished by an indwelIing
Folcy 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 naturalIy
caused her a great deal of fear. anx iety,
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-
tivc 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 emotionalIy 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
table 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
rehabil itation personnel could work

toward a realistic vocational goal.
This patient wilI always require the
facilitie'i 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 I ips.
Devices for remote control of light
switches. television. doors. boo" pages.
and even a typewriter can he attached
to the wheelchair and allow the patient
a far greater range of independence.
Financial support fÖr this apparatus
has heen 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 chalIenge is great, but it can
be met by a competent and dedicated
team approach to the problem.

References
I. Waud. R.A. Production of artificial
respiration by rhythmic stimulation of
the phrenic nerves. Naturl' I
O:J550:
149. Nov. I J. 1937.
2. Sarnof( SJ. et al. Electrophrenic
respiration. Scil'lICl' IOX:4H2. Oct. 29.
194K
J. Glenn. W.W.L Remote stimulation of
the heart by radiofrequency transmis-
sion: clinical application to a patient
with Stoj"ö-Aùams synùrome. Nl'w
Ellg. J. ,\ll'd. 261: 19:9
X-51. Nov. 5.
1959.

. Judson. J.P. and Glenn. W.W.l . Raùio-
frequency elect rophrenic re'ipiration.
Long-term application to a patient
with primary hypovcntilation. JAAIA
2<U:I<UJ-.H. Mar. IX. I%H.
5. Glenn. W.W.L et al. Centrdl hypoven-
tilation: long-term ventilatory a
sist-
ance by raùiofrequency electrophrenic
rðpiration. A 1111. Surg. 172:755-7 .
.
Oct. 1970.
6. Glenn. W.W.L et al. rotal ventilatory
support in a quaùripkgic patienl with
radiofrequency electrophrenic respira-
tion. Nc'w Lng. J. Ml'd. 2H6:5IJ-I
.
l\lar. 9
1972. -

JANUARY 1974

I

,,<
I l
Jüø

.....

"00 BRING OR SEND YOUR
FRIEND A FEW FLOWERS----"

r

"00 MAKE YOUR VISIT SHORT---"

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.

(])

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

THE CANADIAN NURSE 27

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, Phormia (Act 11/ sc.2, 506-507)

Bonnie Hartley

I have systemic lupus erythematosus!
I am learning to live with it. but there
is much to learn if I am to keep the
"'wolf' subdued.
When I first learned the diagnosis.
I knew little about the disease. What
did the future hold for me? Could I
carryon 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. 1
Systemic lupus erythematosus ISLE>
occurs 6 to X times more frequently in
women than in men. and the peak
incidence usually begins between 20
and 40 years of age, although it ma)

I he author wa
with the department of
nur
ing L-ducation. I he Ho
pital fÖr Sic"
Children. loronto. Ontario. She i
pre-
sently employed hy Rycr
on Poly technical
In
litute 111 roronto. She ac"nowkdge

the a,
i
tance of Or. G Davie... Sunn}'-
hroo" \lcdical Centre. loronto. and the
department of medil:al puhlil:alion
. I he
Hospital for Sic" Children, Toronto.

28 THE CANADIAN NURSE

start as early a:-. 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 bu ilds
antibodies: but what causes the damage
in the first place remains a mystery. The
antihody most characteristic of SI E is
the lupus erythematosus II EI factor.
which promotes phagocytosis of nucleo-
protein. Many patients also have anti-
nuclear factors (AN Fl. antibodies that
react against the whole nucleus. nucleo-
protein. DNA. and histone.

How SLE begins
There is nothing characteristic about
ho\\ SLF begins. It can begin with
fever, malaise. weight hJss. and fatigue.
Arthritis is common but rarely produces
permanent deformity. The arthritis of
SLE frequently mimics rheumatoid
al thritis 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 he fore I had any
other symptoms.
Frequently. a "'butterlly" rash
spreads over the bridge of the nose and
flares out on the cheeks. A nineteenth
JANUARY 1974

century physician de
ribcd the skin
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 Ilush
but. as summer progressed. the rash
became deep red. Being a red-head
and pale complexioned. I was very
conscious of th.e 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 ('fc ).
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. I had
bilateral pleural effusions.
The problems of diagnosis are com-
pounded by !'.ymptoms 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 51 E. although they are
unusual. This and mental depression.
excitability. headache. forgetfulness.
or even a nervoùs breakdown can mark
the onset. When lupus attacks the kid-
ney!'.. nephritis or protein-losing
nephro!'.is results. Diagnosis is usually
confirmed by a kidney biopsy.
Several tests help to make a diag-
nosis certain. Blood tests for the IE
factor ma) occa!'.ionally be negative.
even -when the di!'.ease is present. If the
antinuclear factor is present in the
blood. it usually fall!-. when a remission
occur!'.. Mo!'.t patients with SI f also
have low serum complement levels
(normal I
O to 160). -which are closcl)
linked to renal disease. These slowly
ri'>C a!'. the di!'.ease is brought under
control. As well. mo!'.t SI E patient!'. have
an elevated erythrocyte 'iedimentation
rate. perhaps a'i high a!'. 100 mm/hour.
and normochromic anem ia.
1\.1an) factors. although not causes
JANUARY 1974

,þ .
-Ät/

r

-

.

.. A 1lIuJ/(gh I loo/..
'ery fmhiollab/e ill my large-brimmed hat alld .H'er.\ucÅerjacÅet,
I'd pnjer to lem'e them at hOlne whell it is 100 0 ill the shade.'''

of 5LE. 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 !'.ulfona-
mides. penicillins. apresoline. mezan-
toin. or hydantoin (Dilantin); and
emotion. Just as dt the time of diagno-
sis. the exacerbation is ushered in by
symptom!'. 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 u!'.ed.
Salicylates help to control joint s)mp-
toms. hut none of these drugs except
the !'.teroid!'. alter the course of the
disease. The latest treatment involve..

the use of immunosuppressive agents.
!'.uch as azathIOprine (lmuran) or
cyclopho!'.phamide (Cytotoxan). Fre-
quently. much of the treatment is direct-
ed at preventing further deterioration
of renal function.

Helping patient and family
What special challenges doe!'. the
patient with SI E present to the nurse'!
Symptomatic and supportive care are
.tlwa) s necessary in the acute stage.
but nurses should .tlso prepare them-
selves to answer the man) questions
the patient and his family will have.
The famil) has to cope with the acute
anxiety resulting from a serious illness
and the mood changes characteristic of
patients receiving 'iteroid therapy.
which may be inten..e and hard to live
THE CANADIAN NURSE 29

with. My doctor warned my family
\\ hat to expect so that my emotional
swings v.ere 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 dOlÙ
"now if I intimidated nurses because I
am a teacher of nursing or if the diagno-
sis of my disease scared them. In any
event. during my six wee"s in hospital
only two nurses ever ac"nowledged the}
knew what was wrong with me or had
any understandi ng of the long-teml
nature of the disorder and what it might
mean fÒr me. Luc" ify. the doctors were
willing to answer my many questions.
NtH\ that I am bac" at wor", man}
people tell me of patients \\ ith lupus
who are doing well.
I have lived with lupus for 10
months. I am not p<lstthe time of great-
est danger. The mortality rates arc
highest in the first year after diagnosis.
Of the patients who survive this first
year, lJU percent of the adults without
renal disease and XU percent of those
with renal disease will survive five ye.lrs
or more. In children the prognosis is
kss favorable. Patients with lupus
usually Jie of renal cause... central
nervous system complications, or in-
fections. 3 Generally. the easier it is to
induce a remission and the longer the
remission lasts. the beller is the pro-
gnosIs.
To reach her full potential. the nurse
must he prepared to clarify intt)rma-
tion the doctor gives and augment this
with the appropriate patient teaching.
She should "no\\ and make ",ure her
patient "nows that exposure to ultra-
\ iolet radiation can cause a sunhurn
and kad to an exacerhation. Outdoor
activities. such a!>. swimming. garden-
ing. sailing. or \Vater s"jing. should be
.!voided het\\een lJ.UU A.:\L and 4.00
P 1\1 true ,>un time. 2 The patient need
not give up all sports. but should prac-
tice them in the earl) morning or late
30 TH E CANADIAN NURSE

afternoon to avoid the strong sun.
Naturally, other torms 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 haby's cubicle. I
find it a nuisance to remember to turn
off these lamps when I am caring tor the
baby and harder still to remember to
turn them on again when I leave the
room.
When I walk to worl-., I cannot al-
ways avoid the sunshine so I use an
ultraviolet screening agcnt. Today's
fashions - the big hats, the long
sleeves, and the lightweight jackets -
favor the girl with SLE. Although 1100"
very fashionable in my large-brimmed
white hat and seersuc"er jac"el. I
would prefer to leave them at home
when it is 100 0 in the shade. Because
a tan is fashionable. I stand out from
my friends and co-workers.
H aseric" statcs, "A gradual return
to full, normal activities after an I F
nare [-up I is best, usually over a period
of several momhs." 2 1 will never torget
the overwhelming fatigue so frequently
a part of lupus. Some days my fatigue
was so great that even readi ng was too
much etlÙr\. I bec.mle discouraged and
depressed.
At lea!>.t eight hours sleep or more
each night is essential: during the tirst
few months after leaving hospital. a
daytime nap is advisable. Patients
need to he reminded that, if they feel
tired after some activity, the} should
have done less and "topped "ooner; at
fir"t. they "hould avoid heavy cleaning,
lifting of children and bas"ets of wet
wash, and long periods of ironing.
After three months' off duty. I
returned to wor" 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. \\ ithi n three
\Vceb. I was hac" to work full time.
Today. my energy level is just about
normal.
fhe nurse who cares for a patient

with SI E needs not only 'pecial know-
ledge. but alst) special fran"ness.
Although the whole question of preg-
nancy should be discussed thoroughly
with the doctor, sometimes the patient
turns to the nurse for further interpre-
tatiun. According tt) Roo" 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 ahout :n per-
cent, it increases either during the preg-
nancy or in the early postpartum
period. 4 Most physicians advise
against pregnane) if the "idneys are
severely affected.
The wise nurse will try to ma"e sure
the patient understands that imllluniza-
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 he
aware of the advantages of special
identification, such a!> a "Medic-Alert"
bracelet or nec"laee.
If the doctor fails to explain that the
Wassermann is falsely positive in about
I 0 to 20 percent of SI E paticnts, then
the nurse should do so to deereasc the
possibility that the patient will be
embarrassed by finding out later.

A way of life
Above all. the patient Illust under-
stand that continuous drug thcrapy will
become a way of life. He must ncver
fail to ta"c the drugs pre!>.cribed. and
he must "now the eftects and side ef-
fects of these drugs. \1edieal chec" -ups,
drug", and perhaps diet. too. hecom.:
the new direction.
I was pleasantly surprised at how
quidly I adjusted to my high-protein.
low sodium (I gram per day) die\. At
first all the fÒod seemed tlat: but now.
after 10 months. meals oncc again are
interesting and satistying. I find it
frustrating that quick toods that meet
my diet re!>.trietions .Ire unavailahle.
Salt - free preparations of condiments.
such as "etchup. pie"les. 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 stock a salt-free. crunchy-
style peanut butter and mayonnaise.
For me. the salt substitutes give ti')()d
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
ydlow 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 ot
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 visit...
to the doctor. the repeated and repeat-
ed blood tests and urinalyses require
much adjustment. So far I have been
able to SC:hedule 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 w ill also be antacids to prevent
gastrointestinal upsets. I mix Amph
iel
and Maalox. It's hard to remember to
tdke all these medicines regularly. as
JANUARY 1974

TABLE I

Frequency of Appearance of Clinical Symptoms

Symptoms Frequency U u Symptoms Frequency .
Arthritis 91 Pericard it is 33
Fever H4 Murmurs 2

Skin 76 EKG Changes IX
Renal 54 Adenopathy 46
Gastrointestinal 55 Splenomegaly 10
Pleurisy 49 Hepatomegaly 23
Plural Effusion 29 Central Nervous 30
System
Pneumonia 30

Adapted from Cecil-Loeh TextbooÅ of Medicine, /3ed., Philadelphia, n.8
Sal/nders. /97/, p. 8/8.

the activities of the day crowd in to
blot out such mundane matters.
Yes, there is much for the patient
\\ ith lupus erythematosus. The most
important is that he can I ive a produc-
tive, normal life. The "wolf' can be
held by the ears and subdued - al-
though rarcl) tamed.

D.S. cd. Int!>oo/.. 01 dalllatolos:.I'.
ed.
Oxford. Hhu:""ell <.;cientilïc Pllblica-
t ion
. 1972. p.1 061-11 '6. '"

References
I. Tumllity. P.A. S}'tenllc IUPll' el')the-
mato,us. III \Vintrohe. \J .:\1. et al Lxi.
HalTi.\(}II'.
prillciple.\ or i",ell/(/I lIIed-
icille. 6ed. I'oew Yor". \IeGr,l\\< Hill.
1<170. p. 1962-7.
2. Ha,,:ricl... J.R. and "-dlum. R.E. Prillla
I;',. pariel/t.\ with IlIplls ('/"ythelllato.\II.
.
Cleveland. Dep..trtment of DermalOl-
l)gy. Clevcldnù Clinic "ounù.ttion.
1962.
.'. Schur. Peter H. S},temic lupu
el)the-
mato
u
. III Bcöon. 1'.8. and I\IeDcr-
mott. \\' Lxi. Cecil-Loeh tetrhoo/.. 01
lIIedicille. I.'cd. 10l'Onto. Saunùcr...
1971. p. X 16-22.
4. Ro"dL
.R. IllPU' cl'}thcm,lto'l....
-.ckrodcrm.t and dcrmatomYlhiti,. I hc
"collagen"' or "connective-ti

ue" di
-
ea'>C. III Roo" Arthur and \\,il"in'on.

THE CANADIAN NURSE 31

Protecting nonsmokers
in public places

The issue of the rights of the nonsmoker
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. I 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

"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

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 Kcssler is program administrator
of the American Lung Association of
Southeast Florida. f'ollowing her gradua-
tion from the University of Georgia. I\ls.
Kcssler participated in the N rRDA carecr
developmcnt program in Virginia and then
wor\..ed as director of information for the
Gcorgia Lung Association. This article
is a condens.ltion of !\h. .....es"lcr"s presen-
tation at thc AI A's annual mceting in
New YOI'\.. City. N.Y.. U.S.A.

ministrator in smoking deterrent pro-
grams, I made an appointment to tau.,
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 flop 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 Americal/ LIII/M A .
.mcillrÙJ//
BIIlletil/.

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 phy!>iciam. 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
JANUARY 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 hazards of smok ing 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 inttTðtcd 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 I to ban
smoking totally in the auditorium. fhat
was our first real victory. It is signifi-
cant that the vote was 4 to I because
four of the commissioners \\-ere 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 a<;k for an ordinance against
smoking. An ordinance is enforceable.

A policy has much less weight; the
patrons are simply asked not to smoke.
I n 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
pI aces.
Understandably. the committee
couldn"t come up with Madison Ave-
nue-type slogans the fir!>t 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 "Plea<;e don"t !>moke.
People are breathing" done by GASP.
We reproduced this poster plm, two
others: "In consideration of others,
please don"t smoke" and "Enjoy clean
air? Hide your a<;htrays." Copies went
to physicians, and citizen volunteers
also distributed them in public places.
An envelope accompanied each piece.
Floods of reque!>ts 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

ociatiof'
Disease þ..ss Cþ..RD
RespiratOry E.\\QUE.\\E.
SN\O\ZE. RS SMO\(\NG...............
fOf\ NO'-
,- L1AN\( YOU "'AI'- ,-0 SEE
rt ..''-'ILE I ..
O ..r> O c,-OR.
,-I-IE 0
'/OU \,/ISI'-
o V'JI-I

OSPI'- AL.
,-1-1 M" cl-ll L,
N'- Of
GIN fRO M'/ BAB'/.
'/OU I-IOLO
O V'JI-IILE
MEE1'I NG .
OOUR\NG ,-I-I\S

EA,-\NG.
o V'JI-I\LE \ AM
M'/ I-IOME.
o IN CONcERT.
oUR\NG '-\-I
CE. SI-IOV'J.
O ERfORMA
P ,,^,-OR.
E ELEv"'"
o \NS\OE ,-1-1
'/ OffiCE.
O AT M ROoM.
oV'JoEO
o \N ,-I-I\S cR

for thcm!>clves within a short time.
Out of the committec itself came
an equally succcssful item: a smo"er'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 homc." "sit-
ting next to me," "in this concert," "in
the office," "in the restþlurant," 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 i!> being allowed at. . . ,.. and there's
a blan" 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 a!> 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 of the 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 dccided 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 intorm
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
objectivc. For instance, wc wcnt direct-
ly to thc head of a local health depart-
ment to Ict 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 pcrson.
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 publ ic 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 "eep in mind in
conducting a "rights of thc nonsmo"cr"
campaign. I've put down all thc suggcs-
tions I can thi nk of and some things you
should watch out tor.
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 that' 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\'. ho'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 fam il iar 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 turni ng 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.
.; 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. I f 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 smo"y hou
cs, it'" hard to throw
stones.
v Always precede your appearance
at hearings with many letters.
v Tell the newspapers what you're
gomg 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."
" You can expect strongly negative
reactions from some governing bodies
to the proposition that they ban smoking
in their building or public facilit).
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.
" 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.
" 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 "new
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 smo"e from be-
ing a serious health hazarù. 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 he carried out by dIlY
association in the country. This is one
problem that is not endemic to only
one particular pan 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! 'Þ

THE CANADIAN NURSE 35

The
Canadian
Nurse

50 The Driveway, Ottawa, K2P IE2, ant.

ð

Information for Authors

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The Canadian Nurse and L'infirmière 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.
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tion to readers; and presentation. A manuscript accepted
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Webster's 7th College Dictionary are used as spelling
references.

References, Footnotes, and
Bibliographv

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
consecutivelv in the manuscrIpt and listed at the end of the
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 bibhography 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 Ilf
publication, and pages consulted. For magazine references,
list the author's full name, title of the article, title of mag-
azine, volume, month, year, and pages consulted.

Photographs, Illustrations, Tables,
and Charts

Photographs add 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
identificaticn of persons. The consent of persons photo-
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
OFFICIAL JOURNAL OF THE CANADIAN NURSES' ASSOCIATION

dates

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 minimum 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 1 X8.

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 Ed ucation 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., NW., Atlan-
ta, Ga. 30309, U.S.A.

April 5-6,1974
Annual Stewart Rt::search 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. 12Oth, 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 1 08, 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: BL Bible, Ph.D., Dept. of Rural
Health, American Medical Association,
535 N. Dearborn St., Chicago, III.
60610, USA.

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.

June 16-21, 1974
Canadian Nurses' As-
sociation annual
meeting and conven-
tion, to be held in the
Manitoba Centennial
Centre Concert Hall,
Winnipeg, Manitoba.

ð

April 25-27, 1974 lune 17-19, 1974
British Columbia Operating Room Emergency Nurses' Association of
Nurses Group, fourth biennial institute, Ontario, third annual conference, Royal
Hotel Vancouver, Vancouver, B.C. For Connaught Hotel, Hamilton, Ontario.
further information and advance regis- For further information, write to: Ms.
tration, write to: Ms. Jean Lowery, 1/1 - Jean Grote, 137 Duke St., Apt. 4, Ham-
7151 Cambie St., Vancouver, B.C. ilton, Ontario L8P 1 X8.

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 Red!. For further information,

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
Waggoner's Lane, Fredericton, Ne

Brunswick. \ow
THE CANADIAN NURSE 37

names

Nancy Garrett has
left her position at
CNA House in Ot-
tawa to work in a
less frigid cI imate.
She has acccpted a
two-year assignment
with a team from
Harvard University
to work in Yaoundé,
the capital of Cameroun.
Under the auspices of the Ccntre
univer
itaire dcs sciences dc la santé.
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
nl<lternal and child health component
to the center.

?

.;!>
.."

Ada McEwen, national director. has
announced the appointmcnt 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 Rcsp iratory
Diseases Associa-
tion. Her new responsibilities include
the identification of educational needs
of VON staff and the devclopment of
programs to mect thcm.

.....

,

I

Dawna Sedun (Reg.N.. Hosp. for Sick
Children, Toronto) has been appoint-
ed infant nutrition/family planning
specialist with Wycth Ltd.
Ms. Sedun was re-
cently employed as
a medical represent-
ative with a major
pharmaceutièal
company in the T 0-
ronto area. In her
new position she
will be responsible
. for maintaining liai-
son be
w.een Wyeth Ltd. and ho
pital
and clime pasonncl who deal with
infant nutrition and birth control. She
will be located at the company's cxecu-
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
hrooch.
Dr. Girard. who recently retired as
dean of the faculty of nursing at the
University of Montreal. has acccpted
an appointment on the teaching staff
of the school of nursing at the Univer-
sity of Moncton, Moncton. N .B.

Appointments and reinstatement
to the
nursing faculty of Mount Saint Vincent
University, have been announced.
M. Marguerite Muise, B.Se.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 S1. Vincent's
Hospital. Ottawa.
Judith Arlene Allan, B.N.. is nursing
instructor. She was formcrly 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 publ ic
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 fÌ,)r several years. then was asso-
ciate director of nursing education at
Western Memorial Hospital. Corner-
brook, Newfoundland, before joining
thc un iversity 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.Se. (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 ANP() arc. 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, Vlontreal; honorary secretary.
Pierrette Boucher. Montreal; honorary
treasurer. Claire Royer. Sherbrooke.

......
--

J

-

\ '

Nicole Du Mouchel. who was chosen
by the Association of Nurses of the
Province of Quebec to rcpresent nurses
on the Interprofcssional Council of
Quebec. has been elected secretary to
the council. Ms. Du MouehcI is the
executive director and secretary-regis-
trar of AN P().

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.,
Regind Grey Nuns school of nursing.
Regina; Dip\. 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 puhlic 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-
fÜrd Health Region for two years prior
to her present appointment. She suc.
ceeds Muriel Niblett who rctired in
November. Ms. Niblett (Reg.N.. Este-
van General Hosp. School of Nursing;
Dip\. Public Health Nursing, U. of
Toronto) worked in Saskatchewan. in
the Mayo Clinic. Rochester, Minn.. and
JANUARY 1974

....

,

j.

-":Þ

4
;
--

!>
n
d in the Canadian Arm\' o"erseas
hdor
joining the ,talloI' the \V

hurn-
Estc\ an H
alth Region as a puhl ic
health nurse.
She \\ ill li\
in \\ e\ hurn and hope,
to tra\ el. -

G. Margaret Clark is the ne\\ director
of nursing at Joseph Brant \1cmorial
Ho"'pital. Burlington. Ontario. Th

form
r d ir
etor \\ as Betty Davidson.
\1.... Clark has becn \\ ith the ROF"
Victoria Hospital in Ñtontreal for sev-
eral

ars. her most recent position
th
re ha" ing heen director of nursing
and principal of the 'iChllol of nursing.

Barbara E. Burke,
R.'\;.. B.i\.. \1.Sc.
(AI. \\as reeenth
appointL"d dir
ctoí'
of nursing at thL"
V ietori a G
neral
Hospital. Victoria.
B.C The form
r
dir
etor of nursing
at Doctors Hospital
in Toronto. \Is. Burke had until 11.)72
nhlde \tomreal and district her ha...e.
She has heen on the nur,ing facult" of
0<1\\ son College. \\'estmouiit: a...sistant
director of nu'í-sö. I akeshore General
Hospital in Pointe Claire: charge and
senior ,taffnurse \\ ith the Victorian Or-
der of Nup;es in I aSalie and \Iontreal.

".

J

-...;.

-

On the occasion of the 40th alll1i\ er-
sarv of the school of nursing. celehrat-
ed ãt its fall comocation. the-Universit"
of OWI\\ a conferred honorar
degreé!>
on Sister Madeleine de Jesus (Corinne
f. Lat1,unmel and Isabel Black.

r--.. \

..

Sr. M. de Jesus

..,

Isabel Black

Sr. Madeleine de Jesus. prolessor
emcritus. was recogni/ed fÒr her work
as the first director of the ...chool of
nursing. a post she held from 11.)33 until
her retirement in 11.)61.
:vIs. l3I,ICk. principal nur...e-consul-
tant \\. ith the röearch and aIMI)' sis
division of the Ontario ministr} of
health. \\.J,S given recognition Ilx her
work in nursing development in Can-
ada. She is the author of ...e"eral puh-
lications dealing \.. ith the availdbilit} of
clinical nursö and nur...ing education.

JANUARY 1974

Penelope lessop,
Reg.,.. B.Se'\...
ha...-been appointed
nurs
clinician. am-
hulaton care J
-
partme;n. SI. Jo-
seph's Hospital.
Hamilton. Her ex-
perience a... assistant
director. staff edu-
cation. at the Kingston G
neral Hos-
pital and as clinrcal and classroom
teacher ..t SI. \1 al) . s Scholll of Nursing
in K itchener j... h
ing put to good USL" in
h
r nL'\\ position. \\.hich she finds
"
\
iting and r
\\arding."
\"- fes...op is co-author. \\ ith Fran-
ce... HO\\ard. of "Prohkm-orient
d
charting a nur,ing \ ie\\ point"
(Cwulll. ,Vllne. August. IlJ73 I.

...

--

\

)

eN.A.M. Stokvis (S.R.J\.. S.C\1.I ha'
been appointed director of the SI. Boni-
face General Hospital school (If nur...-
ing. \\ innipeg.
Ms. Stok" is. \\ho \\as horn III Hoi-
land. studied nur.,ing in England. Ha
career th
re included \\ ork \\ ith the
British Red Cross rehahilitation unit.
röearch. and tutoring in mid\\ ifcr

Since coming to Canada. :\Is. Stok vis
has heen engaged in supervision and
teach ing. her mo"t recent association
being with the \1etropolitan General
Ho...pital in \\ ind!>or. Ontario, as clini-
cal instructor of obstetrical nursing and
assi!>tant director of nur;ing education.

Lucille E. Notter, Ed.D.. R.:'\.. has
retired as editor of .\'lInillg Rewa"c".
She has also heen editor of th
lilt('/"-
lIatiollal .Vllnillg Illdex.
Concurrent \\ ith Dr. '\otter"s r
tir
'
m
nt is the reka...e of her n
\\ hook.
L IIden/ellldillg VII/'\illg Rewa"c",
puhlished hy the Spring
r Puhli,hing
Co.. Ne\\ York Cit
. Other puhlished
\"or'" include Prt}fl'.uiOlIllI Nllnillg.

Elaine McClintock \\as appoint
d chair-
man llf the health ...ciences depal1nwnt
01 SI. I awrence College. Brock\ ilk.
\\hen the Gen
ral Ho...pital school 01
nursing. of\\.hieh she had h
en dir
ctor.
\\ as oflïeiall} tran...lár
d to th
eolkg

\b. \1 cCI inhH:k
H.Sc.i\.. is a IlJ74
candidate for a
master.... d
gr

in

ducational admin-
i...tr.ltion from
üu

n's l'ni\
rsit\.
Kingston. Prior io
joinTng th
Brock-
\'ill
Gena.11 Ho...-
pital ...chool of nursing in IlJt10. she had
h
en .1 ...t.11l nur"'
\\ ith th
\ ictorian

......

'

Order of :'\urs
s in 13roek\ille. Her
prCs
nt r
sponsihilitiö. in addition hI
nursing. include the allied health plO-
gram... of h
ha\ ioral "cienee and child-
èare \\ ork
r.

S
\
ralne\\ appointm
nt... to the facuh

ofnursing.! ak
h
aJ Uni\Cfsit}, 1l111l1-
der Ba\. Ontario. ha\ e h

n .lnnoune
d.
Marjorie Wallington, R.\:., B.S
.:'\..
\1.Sc.:\.. assi...tant prokssor and acting
chairman of th
facuh\. has \\ ork
J in
roronto for se\ eral \
;Irs - as instruc-
tor. then clinical nurs\,' "'pL'Cialisl. at the
I oronto Generdl Ho...pital. and a... IlIlr...-
ing C(ln...ult.UlI \\ ith th
ministl'\ of
h
:llth of Ontario. -
Margaret Drummond Page, Reg.:"..
H.Sc.:--':.. \1.P.H.. a......i,tant prokssoL
ha... for thc pa't t\\ 0

ar'" hc
n IlUr,ing
consultant \\ ith the Ontario ministn of
h
alth. ronmto. Prior to this sh
\\ ;,rk-
ed in I hunder Ba\ (Port AJlhurl in th

ar
as oh\dfare a;ld puhlic h
alth.
Carolyn Wojtysiak Adams, 13A
;\Iurs., :vI.Sc.N., special lecturer, com-
pkt
d graduat
studies in nursing atth

Uni\ er,it\ of \\
...t
rn ()ntarill during
the past ýear.

0('

--.
- --

'"

-

-
-

...

\

---
II .If
I il/iall Hrudie

Catherille Allan

Catherine Brcwer Allan, R
g.'\...
B.Se.N.. M.S.. lecturer, is returlllng to
th
facult\ of I ak
h
ad l ni\
;'it\
aft
r comp.kting her ma...ter"... d
gr
e iíl
puhl ic h
alth nur,ing at the Uni\
rsit

of \1 in ne...ota. \1inneapl l li....
Lillian Gallan Hrudic, R
g.:'\.
B.Sc.N.. special lecturer. ha
been
a t
acher at' I akdl
aJ R
gional School
of
ur...ing IÙr the pa...t I\\
'
ear.... Prior
to thl'" sh
\\ as on th
t
aching stallllf
St. Jos
ph'... schllol of nUl ...i
lg. Port
-\rthur.
Elizabeth McNaught McCowatt,
S.R.
.. S.C:\L B.ScN.. sp
ci.lliectur-
er, ha, taught at the Lakehead R
gional
5.:hool llf '\iur...ing. For '
\
ral -\
ars
...h
\\ork
d at St. Jos
ph'... (j
íleral
Hl"pital in ! hunder 13a
. fir...t on ...tall.
th
n as a t
.leher of ohst
trics in th

Illl'pit.tl"s ...chool of nursing.
Elaine Petcrs Mullen. R.:\.. B.Sl.".:\.,
...pecialkctUi
r. ha... \\ork
d in \\ inJ...or
and D
t((lit .IS a Ill
dical-,.,urgical in-
StluctOr. She has mor
r
n:'lil\ h

n
clinical a......i...t.lIlt at the Uni\er
...it\ of
\\
...t
rn ()ntario -.chool 01 nUl''''lI1g 111
I olldon. Ont.lrio.
THE CANADIAN NURSE 39

names

p
ciali
t in ps)chiatric nur
ing at

kMast
r l1niwr...it) !\1
dical C
ntr
.
D. Joan Eagle, B.Sc.N.. \1.N.. as-
sl'ciat
professor.
chool of nursing.
and coordinator of pediatric care.
Hamilton G
n
ral Hpspital. has been
on the faculty of Md\1aster University
...chool of nursing for s
veral )
ars.
Mary Fawcett, B.Sc.N.. lecturcr.
has. since ll}tJ I. been with the faculty.
on an intermittent basis.
Agnes Griffin, 8 .Sc. N.. lecturer.
has operated a group home in which
th
Children's Aid Soci
ty has placed
)oung girls on a t
mporan basis.

:vkl\1aster l'niversity ...chool of nurs-
ing has announced new appointm
nh
to its facultv.
Marilyn - Booth, B . Sc. 1\ '. Icctur
r.
worked for two years as a public
health nurse in Etobicokc. fÒllowing
graduation from McMaster Univcrsity

Olga Darcovich, B.S.;-.J.. M.A., a
-
sistant prolL>......or. \\ as recently din ical

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regular
and 24-hour
colleclors
In newborn
and
pedialriC
sizes

40 THE CANADIAN NURSE

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easily. . . every time. . . Hollister's popular U-Bag
now has become a complete system. Now, for the
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I

Now the U.Bag 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 U.Bag system.

HOLLISTER LIMITED. 332 CONSUMERS RD., WILLOWDALE. ONT,

Edith Murray, B.PT..I'v1.Sc.. assistant
professor. was previously as...i...tant
professor inth
departm
nt of rchabili-
tative medicine. Cniversity of Sas-
katchewan.
Cornelia P. Porter, 8.S.N.. M.N.Ed..
assistant profcs
or. has wor"ed in
various capacit ies at th
Pediatric
Continuity Clinic of the University
of Rochester.
Marilyn A. Ray, B.Sc.. M.Sc.. as...is-
t
lIlt p
ofe
so
, has held teaching po
i-
lions III medIcal-surgical nursing and
maternal-child nursing at the University
of California school of nursing. Sa;,
Francisco.
Marjorie E. Shaw, B.Sc.N.. lecturer.
has held various positions with the
Montreal Children's Ho
pital. most
recently ...ervi ng a
home-care coordi-
natoI'.
Cecily Margaret Smith, R.N.. B.A..
M.Ed.. lecturer. has been a teacher
at SI. Joseph"s Hospital ...chool of nurs-
ing in Hamilton.

Grace E. Terry, B.Sc.N.. lecturer.
has relUlll
d to the facultv after an
ab
ence of 1\\0 veal'S. during which
he
wor"ed as staff í1Urse. then head nurse.
at S1. joseph's Hospital in Hamilton.

Helen Gary, R.N.. BSN.. a head
nurse at St. Paul's Ho
pital. Vancouver.
was the r
cipi
nt of the I nno\ative
Nurse Award in recognition of her
project on pnmary nursing care con-
ducted at that hospital. This award was
established to give recognition to
Greater Vancouver District registered
nurses who have implcmenkd methods
to facilitate patient car
. and to offer
financial support to\\,ard organiJ:ing
,md implementing such methods.

lean Laing of foronto was elected pres-
ident of the Ontario Occupational
Health Nurses" A
sociation at its an-
nual meeting. She suec
eds Patricia
Ewan of Niagara falls.
Dorothy Schwah of SI. Catharines is
first vice-president and Gail Pearson
of Guelph, secretary,

Roy Harding (R.N., 51. Joseph's Hos-
pital school of nursing. Victoria; Dipl.
Nur
ing Service Admin., Dalhousie
U., Halifax). is earning his M.D. at
Dalhousic University.
Mr. Harding's professional exper-
ience has included that of "medic" on
an off-shore oil rig. where he looked
atier the general health of the rig's
pcrsonnel and rcndered emergency
treatment ",hell n
eessarv. H.: was. lor
two
ears. chairman of "the ...oeia! and
economic \\elfare committee of the
Registered N ur
es' Association of Nova
Scotia. '.,.;.
IANUARY 1974

in a capsule

Hepatitis from clams
A lettcr to the editor of the Journal (
r
'hc A maimll Med ical A ssoÔatioll
(Oct. :!l), IlJ73) tell
how five of six
per
ons \';ho ate clams at a family reun-
ion became ill with hepatitis.
Apparently it i
not enough merely
to steam clams until they open, u
ually
\';ithin the first minute of steaming.
The t\';o ph)'sicians who wrote the
article advise that inadequately
team-
ed clams may indeed transmit hepatitis,
and that illadequate probably means
failure to steam the clams "for at \cast
4 to 6 minutes:'

Health, health, health
A major ne\';, prime time TV
efles
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 povert} famil} will be
of particular concern to the producers.
The overall objective of the series
is to get people to- improve the level ot
their own health and that of their
family. Health is closel) related to life-
style and the individual has much great-
er power than most people realize to
maintain his or her own health and
to prevent illness.

Have wheelchair, can travel
r he 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.
The Wheelchair Traveler, which is
described in the September IlJ73 issue
of CA.R. Scope (published by the Ca-
nadian Arthritis and Rheumatism
Society), is the name 01 a guide that
li
b all the information available on
facilities at each hotel ,U1d motel. res-
JANUARY 1974

taurant, L)r 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 Womell at J1;orÁ,
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 retirt>ment pensions. The

l
I
v \

,
'.. "
...I.
.il!',
..". ...,

.";.. '--
CC)

legislation. which was expected to go
before parliament b) the end of IlJD.
would give pensions to mothers. mar.
ried or not. who have had no regular
paid wor" and have devoted them-
selves fully to their family duties. Ac-
cording to infonnation from the Minis-
try of Lahour. more French ....omen
between 20 and :' 5 years of age wor"
outside than inside the home.
In England. women in the puhlie
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 \\ ith domes-
tic duties.
'

".'.... I '
...
f. .

...
.li.
)c.,.J
J........ __,..! I

-

"Look! They have twu more traps set...

THE CANADIAN NURSE

41

research abstracts

Th!: fÒllowing arc abstracts of studi!:s
selceted from the Canadian Nurs!:s"
Association Repository Collection 01
Nursing Studies. Abstract manuscripts
ar!: pr!:pared by th!: authors.

kezala, Wilton S. Till' COI1!/iJrt (d' pa-
liel/I,\ il/ lractiol/: a de.\cripIÏl'e sludy.
Montreal. P.O.. ILJ72. Thesis (J\;1.Sc
(Appl.)) McGill U.

"I his s\Ud} d!:seribes th!: behaviors of
patients who were immohilized in
traction in a gen!:ral hospital. Its pur-
pose \\as to ascertain the rdative lk-
grees of comfort or discomfort these
patients had. ComlÙrt was eonceptllal-
i/L'd as a state of being r!:vealed through
the patient'.. heha" iors in 1\\ 0 respects.
the amount of ph} sical restlessness h!:
exhibited and the nature of concerns
he expre...sed'
The method used in investigating
patients' hehavior... was direct oh
erv,
-
tion. Data collection \Va... carried out at
various times of the day. and all pa-
ti!:nts on one \\ard \\ho were in traction
\\L're t1b...!:rved more than once during
the investigative period.
fhe findings r!:vealed the 1'0110\\ ing.
I. Some degree of phy...ical restless-
nes... !:xist!:d in all patient.... and it ap-
peared to have three main compo-
nents. physical movement. change of
focu... of activit}. and behaviors indica-
ti"e of pain.
2. Almo...t without exception theo;e
three a...pects of restle...sne...... co-vari!:d.
rhat is. continuous physical movement
was associated with frequent changc
of activity and numerou... pain hehav-
iors. Converse!}. in freq uent physical
mov!:ment. in frequent activit} change.
and few pain behavior... t1ccur!:d to-
geth er.

J. Patient... exhibited varying degree...
of phy...ical restle...sne....... as de...cribed
bv behaviors related to the above
three factors. What \\a:-- prnbahl} ...ome
kind of continuum from a very high
to a very low degre!: of restlessne...s
was conceptuali/ed in the three cate-
goric... of high. mt1derate. and low re...t-
'Ïcs...ncs.... AI; clevakd hed and ...kdetal
traction tended to he as...oeiated \\ ith
a high degrec of restlessnös.
4. Pati!:nts who were verv restlc...s
and were therefore in pain g;lve ...peci-
fic instructions h1 the Ilur...es ahout how
to handle their (patients') injured limhs.
42 THE CANADIAN NURSE

Nurses usuall) responded to the pa-
tients' ilhtructions. and patients appear-
ed relie\ed
5. Vcr) rest Ie...... patients appeared
to heeome less rest Ie...... \\ hen the}
\\ere \\ ith their relatives. hut this did
not ..eem to occur when they were with
others.
h. Patients sought advice from nurses
and fnml Idlow patients concerning
pain and their treatm!:nt. When they
received the advice, thcy used it to
COPL' \\ ith their pain and di..comfort.
7. Vcr) restless patient-. and )ounger
patients appeared to hL' concerned with
the immediate recovery in hospital.
whereas th!: les... restless patients and
older patients. except those who were
in ...ke!etal traction. appeared to be
eoncellled \\ ith the later (ultimate)
rL'covery at homL' and ahout their home
alfairs.
On the ha...is of the...e findings it was
...een that patients in traction experience
varying degrees of phy...ical. a... well as
PS) chologieal. com fort and discomli.1rl.
To reduce patients' discomfort would
thercli.1re require nurses to recognize
the contributing factors outlined in this
study.

Macdonald, Myrtle I. 11Ie cirCUmSlal/-
ces ill II'hicll posloperali\'e palÙ'Il1S
al/d llIeir mtrseS delermil/l' I/eed .lin'
(/11 (f/w/gesic Montreal. P .0.. IlJ71.
fhesis (M.s.:. (Appl.)) MeGilll!.

rhis s\Ud) was undertaken to discover.
I. the circumstances under \\ hich nur...es
perc!:ive thc possihility of patients
having pain. 2. the fÙcHu.... nurses con-
,ider \\hen determining the need for an
analgesic. J. the factors pati
nts con-
...ider \\ hl:n deciding to ask tor some-
thing li.Jr pain. and
4. \\hether there is
delay in GilT) i ng out requests of pa-
tients li.Jr analgesics.
Data \\ere collected hy participant
ohservation in threl: ...urgical units.
All postoperative patients and nur
es
involwd in decisions about analgesIcs
during the ohseJ\'ation period... Wl:re
included in the sample. fhe sample
con...istcd of 94 instances. 72 of giving
and 22 of not gi"ing analgesics to JX
patients. .
Findings ,hm\ that there were lour
ways that nurses perceived the pos...ibil-
ity of the patient needing an analgesic.
I. perceiving e" idence of pain firsthand

while the patient was moving or being
moved. 2. receiving rl:ports of pain or
ITquests for an analgesic from the pa-
tient. J. anticipating pain through
knowledg!: gain!:d lïr...thand in previou...
nur
ing interaction. or through formal
and informal reports. and 4. anticipating
need Ii)!" an analgesic through theore-
tical knowledge and routine practice.
Decisions by patients' nurses to give
or withhold analgcsics 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.
f ven whl:n they were at the hl:dside.
"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 tl)Cu
ed on the routines of
giving medications. If they anticipated
pain. they ohtained further information
hy going to the patient or his nursc. It:
on thl: other hand. the patient's nursc
r!:quest!:d 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 a..k for an analgesic. The cal!
light was used onl) four tim!:s hy pa-
tients during the observation period
and ne\er hefore the fifth po...topera-
tivc day.
Decisions to ask IÒr an analgesic
\\ere hased on a numbl:r of the follow-
ing factors. the previous advice of
doctor or nurse. a desire for rcst or
sleep. the steadiness and/or sevcrity
of pain in comparison with other exper-
iences of pain, the nced to be brave,
the fear ofaddiction. and the knowledge
of other ways to cope with pain. fo
weigh a numher of thesc factors and
then wait IÒr a nurse to comc into thc
room took as long as two hours.
fhe u...e of analgesics to promote
movement was not undcrstood hy pa-
tic Ills. for analg!:sics wcre ctmsidered
to have a sedative effect oppo...ite
to the ohjective of movement.
fhl:re' were 12 cascs of unreported
pain noticed by nurses, all occurring
after the second postoperative day.
Nurses' criteria ti.lr assessing pain
JANUARY 1974

aftcr thc ..ccond da\ \\ ae \ ague. fhe\
m i....ed and/or III 1,interpreì
d ..om

nOI1\ erhal ..ign.. of pain. The) had
difficult) desnibing pain. and thc \\ ord..
u..cd implied as,umption.. a.. to
etiolog).

Carleton, E. Gail. Relaliol/Ships he-
III'eell 1/I111/1IITied l1/olhen alld Iheir
lIell'horll ÌI
flllll\ ill hospital. 'Vlont-
real. P.Q..llJ71. Thöis( \1.Sc.( Appl.))
McGill U.

L'..ing qualitative research methods.
this dcscriptivc study \\, as designed to
investigate interaction hCI\..een un-
married mothcrs and their infant!, as it
occurrcd during thc time cach inl
lIlt
\\,as hcing fed hy hi.. mother. Partici-
pant ohscrvation was the approach uscd
to collect data during thc fir,t feeding
period on postpart.7.n da} one. and
during onc fecding period on cach of
the four suh..equent postpartum da) s
IÒr each d\ ad.
The stúd} \\as conducted on thc
35-hcd obstetrical unit of a 266-bOO
general hospital.
The ...unpk includcd lJ unmarried
mot her.. and their ne\.. horn infant...
Both mothers \\, ho \..erc planning to
\..eep their inl
lI1ts in their 0\\ n care and
tho..e \\ ho were placing their inl
lIlts
for adoption \\ere included in the
sampk. the relevant critaion heing
that the mother \\,as fccding hcr infant
during the live-thl} ho"pitalization
paiot\.
Data anal) sis began carl} in the
period of data collcction. Through thi..
joint process the specitic research
question \\,as fÖrmulated. and. lata.
a cla..silìcation system \\ a, evolved.
L'sing thi.. cla....ification s) stem. the data
from
5 feeding periods of
5 minutes
\\,cre analyzed.
Fl}Ur pattern.. of mother-infant rela-
tion..hip.. \\ere identified in the data
and döcribed in detail. Thcsc pattern..
could be di..tingui..hed from one anoth-
er III that t\\O of the pattern, were
eharacteri7ed b) thc di,'enified beha...
ior.. of mothers and inl
lIlt.. (changing
fmm day to day), while thc othcr
t\\O
patterns \\ ere charactcrized b} 11011-
dil'l'n!/Ïec! heha\ ior.. of mothers and
infant.. (much the s.lme from da) to
da}).
Of the t\\,o nondiversified patterns.
one \\ as remar\..ahk for the ph) ..ical
closcne.... bctwcen mother and infant
and the passivity of each ovcr the five
da}s (close-pa.Hi"e patlall): the ..ccond
\\as remar\..ahk for the ph}sical di,-
tancc het\\,een mother and inl
tnt and
the relative activil\ 01 each ovcr the
five days (di.\{CIIlI-aé-ti,'e patlem).
The 1\\0 diver..ilìed pattern.. could
be diflerenti.ned from each other h)
JANUARY 1974

the progre....ion of the heha\ ioral
change.. oh..cr\etl. One of them \\,a..
mar\..
ed h\ the fluctuating naturc of
hoth moth
r and infant heha\ iors from
da) to da) UTl/ell/aliOI/ patterll!. In
contrast. the other pattcrn had a rela-
tivel) ..mooth progre....ion of change..
fmm da\ to da\ - graduall\. a hala;'Íce
\\ a.. ach ic\ cd" \\ he'í-c thc "i nfant \\ as
alert .lIld ..uc\..ing \\ell and the mother
was anticipating his necd.. and re..pond-
ing to them .dlccti\eI) (dC'l'e1opl1/el/tal
patterll).
\\ ithin the limits afthe small sample.
the findings of this ..\Ud} indicate that
patterns of mother-inl
lI1t relation..hip..
cannot be differentiated on the basis of
cthnicity of the mother, nor on the
ba,is of \\, hether she plan.. to rear the
infant herself or relinquish him II.}r
adoption. There arc. hm..e\er. implica-
tions that ..ome features of the close-
pa..sive pattern and the fluctuation pat-
tern ma} bc ..pecific to teenage moth-
ers. For this reason. further re..eareh
is indicated to study a large sampk ot
hoth married and unmarried mothers
to identil} the existence of the..e and
other patterns of mother-infant rela-
tion..hips developing OWl' the lir..t
live thl)" postpartum.
Thi.. ..tud} also raises other que..-

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tion.. II.}r nur,ing re..eareh. I <\re there
identiflahle n..7r..ing care need.. of
mother-infant d)ad..
di'pla) ing each of
the fÒur pattern.. of rd.ltion..hip'! 2. Arc
there "peeilïc pattern, of interaction
hel\\een mother.. and nur..ö. \\hich
coe\ist \\ ith ..pecilic pattern.. of mother-
infant re!.ltion..hips'.'
. HO\\ are nur..e..'
hehavior.. alleeting the indi\ idualmoth-
er-infam d}ad.. th
t display a particular
pattern of re!ation..hip'.'

II

Furnell, Margery D. Aclole.\('el/t (11.'-
p/'e.\.\ioll 1I1lc! illle/'pe/'.\(Jl/C/llwhCll'ior.
Vancpu\'er.B.( '.llJ73.The,i..C\1.S.7'J.)
L. of British Columbia.

:1

Adolescents ma) he particularly vul-
nerahle to depression. \ et public health
nurses \\or\..ing \\ith large groups 01
ado\öcents are often unable to recog-
nile depressed }outh... due to the lac\..
of simple. re!iahk screening tool... Thi..
cxplorator
..tud} \\as undcrta\..en to
gain information that could be u..ed
to dL'\ elop such a \001.
Specilicall). the 1<}lIlming question
\\a.. po..ed. "Are there modes of relat-
ing interpersonall) that can he used to
distingui..h the highl} and moderatel)
depressed adole'Cent from the non-
deprösed adolc..
ent"" The ans\\ er
\\as 'ought from inl<mnation ohtained
from ad7}lescent ..elf-reports on Bec\..'s
Dcpres..ion Irl\entor) and an adapted
and pretested II.}rm of :\k:\air and
Lorr'.. I nte rpcr..ona I Behavior Il1\en-
tOJ'}. rhcse i 11\ entorie.. \..ere adm inis-
tered to 25 adolescents \\ ho attended a
treatment center I<}r adolescent.. \\ ith
emotional prohlems and 77 randomly
..elected adolescents \\ ho attended I<Hlr
Catholic high ..choob in Vancouver.
Adolesc
nts \\ere classified as non-
depres..ed. modcrate!} depressed. and
highl}' depressed on the hasis of their
..core, on lkc \.. -., Depression Ill' entor).
A n anal.. si.. of \ariance \\ as carried
out todi..ct)\er iftherc\\asa ..ignilicant
dillerence in intcrper..onal hehavior
score.. 01 nondepressed. mpderately
depressed. and highl) deprösed ado-
Ic,cents. A simple regression anal}'sis
and a multiple step\\ i..e regre....ion anal-
}si.. \\as done to ..ee if there \\a.. a
sign ilïcant correlation het\\ een an}
interpersonal beha\ ior categories that
could di..tingui..h het\\een the non-
lkpre,",ed. n
oderatcl
depres..ed. and
highl} depre....ed .ldole..cenL
The fmdings ..upported the o\erall
conclusion. adolescent... \\ ho exhibit
mistrust. competition. and detachment
mo..t of the time or all of the time and
exhihit dominance onl\ some of the
time. or not at all. ma\" he nwderatel\
or highl} depres..ed adl)Ie'Cents. -
I he lïndings did not support the
generall} held thesis that supressed
hostilit) is an impollant factor in the
depre....cd pep.,on. "'""
THE CANADIAN NURSE 43

boo ks

Emergency Medical Guide, 3ed.. by
John Henderson. 651 pages. To-
ronto. McGraw-Hili Ryerson. 1973.
Reviewed bv Nicole Marcha/.., Direc-
tor, Nation(/l De/Jclftment (
r Family
Health, Canadian Red Cross Sol'Ìety,
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
boo" is neither a first aid book nor a
medical textbook; it is rather"a view in
depth of many pressing medical prob-
lems which could face a person at some
time."
The result is a un ique product. not
concise enough to ...erve 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 dctinite medical model (...igns.
symptom.... treatment) and I wonder if
it were written tin in-between groups
such as medics or physicians' assistants.
Ten chapters arc 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 N icl-
son method.
Experts have practically abandoned
the teaching of the latter two (especially
Holger Nielson) because. except in rare
cases. mouth-to-mouth remains the
simplest and most efficient technique of
artiticial respiration.
The technique of external cardiac
massage is described and. although this
is a dangerous procedure. the author
docs 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 th ird 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
bro"en 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
hook. along with emergency child birth.
The author seems to think that pail)-
ful menstruation is a medical emergency
and has listed a series of exacises to
improve po...ture and develop pelvic
...tructure for the young woman. Also
thrown in as a bonus arc basic home
nursing techniq ues. a schedule for ac-
tive immuni7ation 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 docs not see'm to contain inaccurate
facts and could he interesting tin an
individual who feels quite nostalgic
ahout not having trained as a medical
doctor.
This hoo" would not be convenient
tor a true first-aider nor for professional
workers in hO'ipital emergency wards.

Psychiatric Nursing, ged.. by Margue-
rite Lucy Manfreda. 557 pages.
Philadelphia. F.A. Davis Company.
1973. Canadian Agent: McGraw-
Hill Ryerson. Scarborough. Ontario.
Reviewed bv Jean Forrest, A .\'So-
l'Ìate P/'(
f'es.\or, Faculty (
r Nursillg,
The University (
r Western Ontario,
Londoll, Olllario.

The ninth edition of this boo" reviews
the current field of mental illnes... and
psychiatry as an introduction to psy-
ehiat ric nursing. Psych iatric care today
indicates intervention by a variety of
health professionals. This book includes
a rather limited description of a team
approach for the individual's care.
The need... of each individual req uir-
ing psychiatric care arc indicated in
Unit 5. but arc not followed through
in Unit X to a sufficient degree. The
medical model. used by this author. is
increasingly under consideration and
question as a method of practice tin
other members of the health team.
As memhers of the team. nurses
must assess the behaviors. thought....
and feelings that have brought the
individual fin professional help. either
voluntarily or involuntarily. By care-
ful assessment, the nun,e can e...tablish
therapeut ic nursing in collaboration
with other members of the psychiatric
health team.
Unit X is focused on the behavior
and nursing care of patients. By using

the medical model as the basis tin
discussion of nursing care. there is
limited reference to the current nurs-
ing modalities now being described in
the literature.
Nurses arc 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 hy therapeutic use of self and
a variety of techniques permits the
individual to move to more acceptable
behavior.
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 PsychiatrÙ' Nursing
should include a broader base and
clearer discussion of current nursing
practice related to the modalities now
being described in the nursing liter-
at ure.

Foundations of Pediatric Nursing, 2ed..
by Violet Broadribb. 500 pages,
Toronto. Lippincott. 1973.
Rel'ieU'ed h)' Carolvn Roberts, As-
\';stalll Pro/i.'s.\or, Faculty of Nurs-
ing, University (
r Weste/'ll 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 cd ition considerably.
Ms. Broadribb purports to have pre-
pared a book on pediatric nursing that
prov;..lcs a basis from which a student
.. . . . can build to the depth and breadth
she needs and desires. The emphasis is
011 getting started.... The student
needs practical help as well as broad
guidelines." Thus. th
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 boo" has much to recommend it.
The text is supplemented by illustra-
tions. tables. and case studies that
facilitate aClluisit ion of the material.
On the whole. the material is current
(Co,,/ill/I/'tf 0" f'age 4(,1

JANUARY 1974

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.

I

Saves
you tiIl1e
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
III diapers. And when less
time is spent changing
linens, those who take
care of babies have
more time to spend on
other tasks.

KeelJS
him drier

, 3(J""
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.... "...í, II

Pa 'I)
e1"8.

,

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"

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Plloenll . CiAWILI[

CAR.IU

books

(Col/tiuued /;'011/ pllge 4-1 J
and retlecb area!> of increased concern
in pediatrics. such as drug ahuse. neo-
natal intensive care unit--.. the
tages of
grief. and the concept of prespeech
training for infants with cleft palates.
The text is mosl explicit in what to do
and how. over a broad range of s\..ills
from Apgar scoring to the use of a uri-
nometer.
The author states .. . . . no attempt
is made in this boo\.. 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 psychoJynam ics without clinical
appl icat ion.
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 cJition, 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 pdges. To-
ronto. Lippincott. 1973.
Reviewed by Mary tl/et/ Dris('()l/,
Staff Nurse, St. Joseph's Hospital,
ScÚt/t John, New Brut/swick.

In the preface the author states. "the
purpose of this second edition is to
present the latest inti.>rmation 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 purpose.
In the chapter. "The Family and
Pregnancy." she ha!> given necessary
46 THE CANADIAN NURSE

attention to the possible effects a preg-
nancy can have on the entire famil).
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 ris\.. arc
well presented; however. the author

xpresses some questionable views.
in this day and age, in relation to the
social conditions that may cause an
expectant mother to be considered high
ris\...
The title of this boo\.. 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.
Re\'iewed hv MJ. Mildred Morris,
Assistall1 PI:(
re.uor, School (
r Nurs-
it/g, Ut/Í\'ersity (
r Vuay,'a, OUmm,
Ot/tario.

This book is designed for anyone who
counsels those who have a problem
pregnancy. It may be used a!> a training
manual or as a resource. Several authors
h.lve contributed to this excéllent wor\...
The specific techniques the counselor
needs to be nondirective and nonjudg-
mental arc 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-

elor's goals must be focused on the
examination of alternatives and on the
decision-ma\..ing process. rather than
on attempting behaviorarchange and/or
tension reduction. By accepting and
understanding the client's situation, by
providing information. and by enabling
her to face the decision-ma\..ing 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 ma\..ing.
The fÖlIowing chapters deal with
the alternatives in continuing the preg-
nancy and the abortion alternative.
However. the deci!>ion is not treated
as absolutely final.
In the second chapter. the role of the
male partner is further emphasi7ed. In
counseling for keeping the pregnancy.
the areas deserving concentration arc:
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-
plan:1ed pregnancy and their possible
solutions arc treated at length. The
alternatives of \..eeping the child or

placing him for adoption are fuiiy ex-
plored. No pressure fÒr either alterna-
tive. but as free a choice as po
sihle.
i
the main objective in counseling.
The abortion alternative is presented
in great detail in the third chapter. The
three sections ma\..ing up this chapter
discuss abortion counseli ng, medical
aspects of abortion, and the changing
abortion laws. Abortion counscling
means working with a woman who has
made a responsible decision to see\.. an
abortion. 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 rcliable tÌJnn of contraception that
is acceptable to her. The concluding
chapter
contain information that will
guide the counselor in helping his
clien!
to avoid future problem preg-
nanCies.
This boo\.. is highly recommended
for anyone who counsels persons who
have a problem pregnane}. It should
enable coun
clor!> 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 L.
Pohl. Ill) pages. Dubuque, Iowa.
Wm. C. Brown Company. 11}73. Ca-
nadian Agent. Burns & MacEachern.
Don Mills. Ontario.
Re\'ieU'ed hy /:". Mary BI/::::.ell, As-
sociate P/'(
fés.\()r, School (
r NI/rsing,
McMaster Uni\'('/"sity. Hamilton,
()t/lario.

rhis book, which is an outgrowth of
the author's re!>earch for her doctoral
degree, is intended to assi
t nursing
practitioners who desire to impHh'e
their teaching ability. In this ne\\, edi-
tion. references at the eonel usion of each
chapter have been updated beyond
IlJ60. A new chapter on evaluating
teaching and learning, plus addLd em-
phasi!> on the period of convalescence.
is indeed val uable.
The objective of the bou\.. is achiev-
ed. Conteil\ is built around the exam ina-
tion of principles of learning and teach-
ing with emphasis on teaching a!> the art
of helping people learn. Factors affect-
ing teaching and learning arc described.
Chapter!> deal ing with suhject matter.
methods of teaching, and teaching
materials arc up-tn-date and explicit.
The infÖrmation on planning for teach-
ing and evaluation provide good exam-
ples fÒr the reader.
(Co//ti//ued 01/ fluge -IX)

,ANUARY 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.

Critic-al
Illei(lCllts
ill

llrH. 1.

"

"

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
th
system, Editors' overviews precede each section, offering useful reading suggest-
ions derived from experience with prior "critical incident" volumes. It provides a bene-
..;ial 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. Corsini, Ph.D., Research Affiliate, School of Pub-
lic Health, University of Hawaii, Honolulu.
369 pages. $11.85. Published June 1973.
r-----------------------------------------,

W. B. SAUNDERS COMPANY CANADA, L TD.I
L
) 833 Oxford Street, Toronto, Ontario M8Z 5T9 :
Please send me for: I
o my personal library _ for classroom adoptIon I
School
Positio n I
1696 Bermosk & Corsini: Critical Incidents In Nursing $11.85. :
Name Address I
Provo I
L _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ .!:
1.:!.4-1

JANUARY 1974

THE CANADIAN NURSE 47

books

(('''lIlilllled ',..,11/ pag.. 461

One of the strong points of the book
i
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 tlJr both nursing studenb
and tÒr graduates who are interested in
improving their teaching. This revised
boo\.. is a valuahle addition to the other
cight books in the Foundations of
N'Ursing series.

International Directorv of Nurses with
Doctoral Degrees. 106 pages. New
Yor\.., American Nurses' Foundation.
1973.

The American Nurses' Foundation puh-
lished its first Directory of Nurses
lI'ith t'amed Doctoral Degree.\ in 1969.
Thi
was a follow-up to the list com-
piled by Amy Frances Brown for an
appendix to hcr Research ill Nursillg
(Philadelphia. Saunders. 195X). Both
these I ists. and the 1970 and 1971
supplements to the AN f- Directory,
were national compilations for the
United State
.
Canadians will be particularly
pleased that the ANF has made this
1973 cd it ion international. Canada
is next to the United State
in haviLg
employed 'Å'ithin her borders the most
nur<;es with earned doctoral degrees.
that is. of the 55 nurses with carned
doctoral degrees \\or\..ing outside the
United States. 2X arc in Canada. We
must admit. of course. that Canada,
as a neighhor of the United State<; with
ready aece<;s to the many American
institution
offering doctoral degrees
in fields of interest to nursing. is in "a
most favored country" position in this
regard.
The nursing profession hegan to loo\..
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 progre
s in both is being made.
Dr. Bro\\n listed 109 American
nurse
. dnd the 1973 Directory'
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 editi(;Jl. This is
urely a bindery
oversight since the Preface and "A W on.1
48 THE CANADIAN NURSE

About the Entries" on page ix ma\..es
the intent to cover only earned degrees
quite clear.)
The entries in the Director} include
more information than in previous
Directories. The data on clinical inter-
est areas. wor\..ing experience. and
current employment status and field
extend its usefulness tlJr employers and
research departments seeking personnel
with special qualifications. For exam-
ple, an individual whose doctoral
!>t

ies 10 years ago were in a specific
chl1lcal area may have proceeded in
administration or teaching and the
cI inical 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
ti)r this Directory must generally have
been good. Of the two Canadians who
are missing from the listing, one is no
I
mger actively in the nursing profes-

Ion and the other was on sabbatical
leave out cf the country at the time of
the survey. To balance this lo
s. two
others shown as employed in Canada
arc not. we suspect, Canadian citi7ens!
Three indexes that are new features
of the 1973 Directory extend its use-
fulness. The tigure quoted earlier of
nurses with earned doctoral degrees
employed beyond the United Sates
were from the I ndex 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 Su
ject of Doc-
toral Dissertation. and by Field of
Doctoral Study are indicators of areas
of research helpful for research workers
and prospective doctoral candidates
loo\..ing ti.Jr new channels of investiga-
tion, and for historical and trend
studies.
The American Nurses' foundation
has malic a splendid contribution to
the tools of nursing research with this
collection of all health science and
research libraries serving nurses.

A Very Private Malter: The Ostomy
Handbook by Edith S. Lenneberg
and Miriam Weiner. :!X pages. Los
Angeles, Calif.. United Ostomy As-
sociation. 1973.
Re\'iewed hy Gellevie\Je fllO"'p.
(}",
ElI1erostolllal TherapisT. St. Joseph's
Gelleral Hospital, nll",cler Bay.

This boo\.. was written with not only
the nur
ing 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-

tanding of the various types of "stlJ-
mas" and problems that may etrect the
patient after this type of surgery.
One of the prime o
iecllves IS to pre-
sent the suhjeet to the reader so he may
understand the extent of the problems
involved and the need for specialized
services ti)r complete rehahilitation.
The authors also explain that these ser-
v ices arc not only necessar} for the
patient with reccnt surgery. but also tl)r
patients who hdve had this handicap
tor many years. This type of rehabili-
tation is an ongoing process.
The boo\.. 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 tind clear. I 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 ICeling 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
scldolllmentioned 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 boo\... 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 un iy ue hasic boo\.. rei ated to ostOIll y
care. It offers a complete understanding
of the word "stoma" and all the com-
pi ications 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 hy the text. The boo\.. would
definitely be useful in teaching those
who arc involved in managing the pa-
tient and the patient. who must he
given tool<; to help himself.
As a reference boo\.. tl)r any individ-
ual who may he in need of intormation
or see\..ing assistance, it is excellent. ,.;
JANUARY 1974

A V aids

o A series of tapcd television pro-
grams on "The Canad ian \\ oman."
produced in 1972 by
me 75 Montreal
women and telecast on a Montrcal
cable station. arc nol.I. available at no
cost tor shOl.l. ing on cable stations
across Canada and to women's groups.
There are t\\O 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 '\ we A. 1355 Dorchester
Blvd. W.. Montreal. Deposits of $10
per tape. plus shipping chargcs. are
required for the Montreal source.
These 25 taped programs can be
viewed on any hut Portopak projectors.
Included in the program series are the
subjects: women in the family; cons-
ciousnes" raising; feminism; scxualit)
of women. in two parts; women. the
Native experience; women as artists;
the prostitution of women; womcn 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 vie\\point of the la\\, in two parts;
communal living. the psychology of
women, III three parts; women from
the vicwpoint of the church; and wo-
men from the viewpoint of politics.

o "Learning to Nurse," a series of
videotapes for use in the teaching of
nursing. is available from Videotape
Research Program. School of Nursing.
ÑkGill University. 3506 University
Street. Montreal 112. Quebec. The aim
of each tape is "to demonstrate cvery-
day. ordinary behavior and perfÖrm-
ance of people." These tapes. made
for demonstration purposes in a rc-
search pn
iect. arc for sale only.
The tapes avail.lblc arc: 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 (10 min.).
and Suctioning an Infant in Respiratory
Distress (7 min.); A Child with Dia-
betcs: A Comparative Study in Three
Families (2X 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 II1ness - Part A (27.5 min.). Part
B (31.5 min.), Part C (19.5 min.); and
The Aged in Hospit.d (40 min.).
JANUARY 1974

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British Columbia hospitals located in communities with fcw doctors can call on
the Mobile Instructional Resources Centre - a fancy name fÖr a continuing
education program set up in a bus. The Universit) of British Columbia's
division of conti nuing education in the health scienccs bought the bus. \\ hich
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 sl ide projectors. t\\O TV sets. an autotutor. and a cartridge
movie pn
iector. 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 '\iurses' Association of British Columhia has donatcd SH.OOO
toward purchasing and producing A V materials and has allocated S5.000 to
the end of 1974 1'I.)r developing instructional packages. The A V material used
in this continuing cducation program is being constantly updated.
----

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THE CANADIAN NURSE 49

AWARD OF MERIT
o On October 25. 1973. the First
Canadian Festival of Institutionally
Produced Instructional Media and
Canadian Education Showplace pre-
"ented The University of Western
Ontario in London with an Aw,m.1 of
Merit tix the entry E\lIl1/ifllltio/l (
r 1I
N l'l\'bvrfl.
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. \-?

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

Tropical
Diseases
and
Parasitology

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 shmild be addressed to. The Libra-
ty. Canadian Nurses' Association. 50
The Drive\\ay. Ottawa. Ont. K2P IE2.
No more than thn'l' titles should be
requested at anyone time.

BOOKS AND DOCUMENTS
I. Ad"lr "lid cl,ild c",.I'; II dil'lII II/>p/'tJlld, 10
IIunill}.!, ny Janet I\liller Harner et al. 51.
I oui
. I\losny. 197.'. XI-Ip.
2. Alienl/ai,'(' 10 iU'liluliollll1 UII'/' I",. olt"'''
AII/<'I'iulI/.': I'racticl' al/(l plallllillg. A ('(II/{;"'-
ellce I'l'POI'I, edited by Eric Pfeiffer. DUr-
ham. N.C.. Center for the Study of Agmg
and Human Development. Duke Univ.. 1973.
197p.
3. Le., lI.uell/hiée.' dé/ihérllllies (dllIlS Ie.' coo-
pé/'{/Ii,'e.,), par Claude Béland. Ville 1\10nt-
Royal. P.Q.. Editions Robel. 1969.20Xp.
4. ßcf"/I'i",' II/odi/iclllioll 111/{1 I(,e ullnillg
pmn'.u, by Rosemarian Berni and Wilbert I .
Fordyce. St. Louis. Mosby. 1973. 135p.
5. Call1ldillll Hmpillli A.'.'O/'Ílliioll ol1ìu' 111/{1
IIs.,odalioll direclo,.y, 11)73. Toronto. Cana-
dian Hospital Association. 1973. Mp. R
6. Clllllldillll Nu,..\(,s' A.,.\/J/'Íalioll ,lal/'II//'lIls.
Ottawa. Canddian Nurses' Association. 1973.
1 vol.
7. nil' dilliClI1 /lPP,.ollch 10 I(,e palie/ll. by
William 1 . Morgan and George L. Engel.

roronto. Saunder
. 19ó9. 31-1p.
X. ClilliclIl //l'urolo}.!y. ny Francis I\liehael
I-or
ter. 3ed. SI. I ollis. \Iosby. 1973. 20Xp.
9 COlI/lIIUllity (,1'11111, - ,lra/('}.!Ù" .to,. "/"'"<:1'.
Pllpe,.., p,.es('lIled al 1(,(' /I)/Z l'L'giolllll II/eel-
ill}.!' o{ II" Co II 11";1 0/ /1'''"1' 1/(,11111, Agell-
cin 1111.1 CO'" 11/1/111/" HIIIII(, -'e/'l'in', (,eld
ill Alllllllic Cil", \../.. l\'o"(,lI/hlT 17-1l!, "",I
0"1/,,.,. I ('X".,, [)eCI'II""''' II-I:!. New '\- 01'1..
National I eaglle for Nursing. Oept. of Home
Health Agencie
and Community Health
Services. 1973. 76p.
10. COlllrol/ill<: 111.. "1'1'",,1 or ill/(T/iOIl: "
p,.ogn/ll/ll/l'd 1I/"'.'l'l11l11ioll, by Helly :\lclnnes.
St. I ollis. !\1o
by. 191-'. Illp.
II. 71/(' .IllY ('((H' I,oo/-.., by Barb Cameron el
al. Toronto. Canadian Women's Educa-
tional Press. 1972. 4Rp.
12.01"''''01''''''111' ill 111.. cO'T('('liol/.\ {ìdd ill
C""lIdll. Ollawa. Canadian Criminology and
Corrections Association. JYI). )4p.
13. Di,.eclon' ,!r CIIH".,. ",ohilily oPI>tlrtulli-
lit" ill IIlInillg. Prepared by C,trrie H. I en-
burg. Walter L John
on ,md Jo Ann T.
Vahey. New '\-orl.. National League for
Nursing. Div ision of Research. 1973. 21 Xp.
1-1. D,.ug, , d..",ol/." dol'lon 1111.1 di-",,,.\(', by
Perry A. Sperber. SI. I ollis. \\'an'en H.
Green. 1973. 294p.
IS. flt''''''III., "r ,.e.' (,,,,.<1, ill II IIn illg , by
Eleanor Walters Treece and Jame
Wil-
liam Treece. St.1 olli
. Mosby. 1973. 2X-Ip.
16. 1-."'lIluIII iOIl o{ g,.",IIIII/," 01 "'.w/'ÍII/..
.leg,..... IIlInillg p,.ogra",.,. by 1\1 ildred I.

Nursing
Faculty

Program
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.

Take our special course In Iropical diseases
and relaled subJecll. Thla equips you 10 lunctlon
intelligently 81 8 nurse In 8n environment where
luch dlleasel pose a heallh problem.

pen to graduat" nurses currently registered in
their own province or slale Comprehensive 16
week course commenCes in September and
February Train In modern, equipped cenlre Wllh
attraclive accommodalion lor living in localed
in Melropolltan Toronlo

For information write to:

Co-ordinator.

e

.

..II .
health institute

I;"

..

4000 Lealie Street, 'Mllowdale,
Ontatio, Canada.

50 THE CANADIAN Nl.!RSf

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

JANUARY 1974

.1
.If
f
. A
r

Montag. Ne.... York. publi,hed for the Dept.
of Nur,ing Education h} Teachers College
Pre". Teacher, College. Columbia Univer-
,ity. 1')72. lOOp. (Nur,ing education mono-
graph, no. 13)
17. Fouudaliol/.l or I'..diall'ic uunillg, by
Violet Bmadribb. :!ed. Toronto. Lippincott.
1973. 500p.
II!. Gmlll.' alld /11\'(11'11.' gUll/(', 1<)73. Ottawa.
:l.ledical Re,earch Council. 1973. ó3p.
I '). fill' gl'oup IIppl'Ollcll ill lIunillg pl'actic..,
b} G....en D. I\larram. SI. louis. Mo,by.
1973. 2:!Op.
20. Iflllld"oo/.. !;". lIunillg lIide.'.
vi-.ed. :\Idbourne. Ho'pital, and
Commi"ion for Nur,ing Aide
Schools in Victoria. 1973. 310p.
:! I. 11I!;'Clioll: p/'(Telllio" IIl1d C 01111'01. by
Haine C. Duba} and Reba D. Grubb, SI.
I oui,. :l.lo,by. 1973. I óOp.
:!:!. Il/te"''''li",,,,1 dil'ectol'Y ,
! "W'.,C'.' lI'ill,
doclowl degl'ee.\. Ne.... York. American
Nurses' Foundation. 1973. 1U6p.
23. I"II'(/\'e"ous IIIeelic(/(iol/.l; a Iwnelhoo/.. fol'
''''I'.'e.' IInel olhel' allieel heallh pel'"onnel, by
Betty L Gahan. St. Louis. Mosby. 1973.
176p.
2-1. 11I1I'oduClioll 10 clillical lIunillg, b}
\lyr.l E,trin I evine. :!ed. Philadelphia. Da-
vi,. 1')7]. 5 15p.
25. II/tl'odllclol'Y ",lIlen/il,' lIunillg, by Do-
ris C. Bethea. 2ed. Toronto. Lippincott.
191.'. ::!76p.
26. \Ic'",oil'e 'Ul' Ie pl'ojel ell' I'èr:/('",..nl 1110_

JOed. re-
Charities
fraining

difìc",1 Ie I','gl"",,'111 ,'II "('I'lu de la loi 'Ul'
1<'.\ .\t'/Tic...\ d.. .\illllé el /('., .'en'ice'.' .'odllux.
Montreal. Fédération de, Admini,trateur,
ue, Service, de Santé et ue, Services \OCiaux
du Québec. 1973. 54p.
27. Alicl'o"iology: III"ol'alol'Y III "" uIII lIud
II'OI'/.."OO/... by Alice I orraine Smith. 3ed.
St. Louis. :\Io,by. 1973. l7:!p.
21( Nunillg ill Ihe .\tTel/tie.\; .\('Ie('(eel I'ead-
illg., Ihlll pl'e.\t'1I1 "olh Ihe o/c1 ali<I Ih.. lIell"
lI'ell</.' I" h..lp C'I','(/(e betteI' lIunillg (<U'C' f;".
palielll.,. Compiled by Anne K. Roe and
I\1ary Sherwood. Toronto. Wiley. 1973.
32lp.
:!9. P,'ople cllld idea.,. ,'IIunilll! III li/e.'lel'lI.
I <):!O-I<)7U, by Hendrick Overduin. London.
Ont.. Faculty of Nursing. University of
Western Ontario. 1')70. 150p.
30. l'el'.'p''Cli,'"., iu l"'IIIall de \. "'''1'111 ,'111;
"unillg Ihl'"ugllOuI Ihe IiI<' c:\'C-{e. by Dori,
Cool. Sutterly and Gloria Ferraro Don-
nelly. Toronto. Lippincott. 1973. 331p.
3 L The pmclicc of III"lIIal hea/tll nUl'sing:
II C,WllllUllily appl'ollch, by Arthur Jame,
Morgan and Judith Wil,on Moreno. Toron-
to. I ippincott. 1973. 2 II p.
32. l'I'ecisi"" joul'ullli,,": II /'('pm'lel'\ il/tl'''-
dUC'ti,,1I I" ""dlll .,d"II,'e ",elllOd." by Phi-
lip Meyer. Hloomington. Ind.. Indiana Univ.
PI'.. 1973. 342p.
.'3. PI'iucipln or illlt'I"in' ('(1/'(', by E.R.J.
Emery et al. Lonuon. Engli,h Univer,itie'
Pr.. 1973. lóXp.
34. PI'iudple.' of III ic/'()"i,,{og\, , by Alice I 01'-

Request Form
for "Accession list"

r.line Smith. 7ed. St. 1 oui,. \lo,b\. 1')73.
681p.
3.
. 1'I'"ble", I,,'..gll""n ali<I """rri,," COIIII-
,dillg. hlited by Rohert R. \\ ihon. S,llud.
N.C.. Famil} life Publicalion,. 1')7'. 120p.
36. Relldillg' iu gel'olll"logy. ed ited by V irgi-
nia ;\I. Brantl and Si,ter Marie Ra}mond
Hro"n. St. I oui,. \Io,by. 1973. 117p.
37. R'p"I'1 1<)73. Otta....a. Canadian C"mi-
nology and Correction, A"ociation. 1973.
I vol
3K R"I'''I'I 1<)71-73. Otta.....I. Intern.llion.ll
Development Rc,earch Centre. I ')73. IO-Ip.
39. I'{,e lelld,illg lì",clioll "f lire lIunillg
pracliliollel', b} \largaret I. Pohl. 2ed.
Dubuque.lo....a. Bro....n. 1')73. 12')p.
40. 7 eXlb""/,, "r p..dillll'ic IIIInilll!, b} Doro-
thy R. Marlo..... -led. fomnto. Saunder,.
1973. 77óp.

PAMPHLETS
41. Aid I" II". I"'",allilin IIl1d \(willl \(';"11-
cn. Otta....a. Canada Council. 1')73. 17p.
-12. flit, ('''''e of Y"ul' ('o{"\to",,. by John
Cedric Goligher and \Iurid PolI.lrd. 2ed.
london. Hailliere. frndall. IQ7'. 'Ip.
4.:\. 1\1111111111 0/ COlllillllillg /1111 \ ill!! cdunlf;"11_
Vancouver. 13.<.. Univer,it} of Hriti,h (0-
lumbia. 197'. Xp.
4-1. ,\'lIr.\;'lg ('llllclIl;on (Illtl rCI!;\lral;oll:
,lali,lind I'ep 0 1'1 , I <)7:!. fo!'Onto. College
of Nur,e, of Ontario. 197' 'Xp.
-I
. Ref'orr 1<)7:!. loronto. C.tnadi,tn \len-
tal Heallh A'\()ci.ltion. 1973.

In decubitus
ulcers

CANADIAN NURSES'
ASSOCIATION LIBRARY

Send this coupon or facsI'11I1e to
LIBRARIAN, Canadian Nurses' Association,
50 The Driveway, Ottawa K2P 1E2. Ontario.
Please lend me the fOllowmg 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.

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, l20North Queen Street.
Toronto, Ontario M8Z 2E3.
Suppliers of Alpha-Keri.. therapeutic bath
oil, and Keri'" Lotion, all over body lotion.
"T.M. Auth. User

Request for loans will be filled in order of receipt.
Reference and restricted material must be used in the CNA
Ii brary.
Borrower '. .....,............. .......... ......... .......... ........................ .... .......
RegistratIOn No. ........................................................
Posi tion ....... ......... ............. ........ .............. ........ ......................

ß

---------------

--
---

c

D YES. please contact me to schedule a viewing of
Westwood's in-service film on decubitus ulcers.
Westwood Pharmaceuticals Toronto Ontario M8l 2E3

Name

Area code_ Telephone No._

Title

Address... .... ..... ......... ...... .... ..... ....... .... ........ .., ..... ....... ... ...... .........

Date of request ......

Institution

Address

JANUARY 1974

City

Province

Poslat Code

THE CANADIAN NURSE 51

COriGidin'D '

DESCRIPTION:
Coricidin 'D': Each white, coated
tablet contains:
2 mg chlorphemramine maleate US.P.,
390 mg acetylsalicylic acid,
30 mg caffeine and
10 mg phenylephrine.
Available in blistersoftz
and 24, and botdes of 100 tablets.
Coricidin 'D' Medilets: Each orange-
pineapple-flavored multicolored tablet contams:
0,5 mgchlorphemramine maleate U.S.P.,
80 mg acetylsalicylic acid and
2,5 mg phenylephrine HC\.
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:
Administerwithcaretopatients with hyper-
tensIon, cardiac d,sorders, 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
anti histaminic 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 I Medilets: 7 to 1 2
ars: 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. Lir
1it treatlj1ent to 3 days. The recom-
mended dosage should not be exceeded
except on a phys,lcian's advise.

Detailed information is available on
request.
SCHERING CORPORATION LIMITED
Pointe Claire, Quebec H9R IB4

52 THE CANADIAN NURSE

accession list

46. Occ"palio"al linl aid, by SI. John Am-
bulance Association and Brigade. I.ondon.
I\lacmillan Journals. 1973. 43p.
47. Sla/c""'111 of hdll:r nmlill"illg cd"ca-
lioll '/"1' I'('gi.H('I'cd 11 "/'.\c,,. Edmonton.
Alberta Association of Registered Nurses.

GOVERNMENT DOCUMENTS
Callatla
4K Depl. of Industry. Trade and Commerce.
Rcpo'" 11)70 "f /"c A-li"i.,Il'/' ,!f... ,,"d<'l'
III<' CO/poraliol/.' ali<I Laho"r Vlliol/.' Rcll/l'I'"
Act. Ottawa. 1973.2 vols.
49. Dept. of the Solicitor General. The gene-
ral prograll/ ./i,,' I"C tll'\"dop"Il'III ,d' P-\\'-
c"ialric sl'/Tices ill .Ii'tleral cO/Tl"l'/iollal scr-
I'icn ill Callatla. Ottawa. Information Cana-
da. 1973. óOp.
50. I.abour Canada. Laho"r OI
r:'lI/i::alioI/.I
ill Callatla. 11)72. Ottawa. Information Ca-
nada. 1973. 147p.
5 L Stat 1st ics Canada. AtlI'allC<' .,Iali.,/in or
('tI"cmioll /973174. Ottawa. Informatio
'
Canada. 1973. 39p.
52. Statistics Canada. AIIII"t/1 l'l'l,orl '11' 110-
lilìt/f>le diwt/w." 11)72. Ottawa. Information
Canada. 1973. 44p.
53. -.Ct/ll/ldiall ,,"i,'cni/in t/II</ collcgc.I,
11)73. Ottawa. published jointly by... and
AUCC 1973. 51:'ip. R
54. -.Ft/II "IIroIIl/CIII ill I",it'er.,ilit'.\' ali<I
wlll:!!"s, 11)71/72. Ottawa. Information Ca-
nada. 11)73. 15:!p.
.
5. -.lIo"I'i/ul .,Iali,,/in /1)71: "0/. 7, Ho.I'
I,ilt/I illdict/lor.\'. Ottawa. Information Cana-
da. 1973. 151p.
:'ió. -.t/l.l/r"C/io", all</ dclilli/iol/.I ./i,,' I"e
t/IIII"al 1'1'1"1'11 of Iw.'pital.,. by... and Depl.
of Nat ional Health and Welfare. Ottawa.
57. Statistique Canada. Direc/ÍI'e.I' de déjìni-
liOl'.I 1'0"1' Ic rt/ppor/ d'uctil'ilé tle.I II,ipiIU"X,

par. . . et Ministère de la Santé et du Bien-
étre social. Ottawa. 1972.2 vols.
:'ilt -. SIt/li.Hill"" de /'ell.\{'igllcII/elll-l'.llill/t/-
lio".I, /1)73174. Ottawa. Information Cana-
da. 1973. 39p.
Vniled Silltes
59. National Institutes of Health. A hiblio-
grllp"y (II' C"ille.\{' sO/ll'n'.,' Oil /IIedicille 1111<1
I",blic "elllih ill the l'eop/l".1 Rep"blic ,!f
Olillt/: 11)60-/1)70. Washington. U.S. Govt.
Print. Off.. 1973. 486p. (U.S. DHEW Pub-
lication no. (NIH) 73-439)
60. National Library of Medicine. Biblio-
g/'//ph.\' "I' t"e his/ory "I' ",,'dicille, 110. 6.
11)70. Bethesda. Md.. 1973. 21)5p.

STUDIES DEPOSITED IN CNA REPOSITORY
COLLECTION
Ó I. Em/,,"tioll de I'<:f.f(-t .\I,,' I'lll/xiété pré-
hrollclw.lcopie. d',,11 II/,,,Ie dïl!/"rll/atioll ré-
pOll/llllIt u"x lI11<'.\'1;''''' de cliellts IIo.lpitali-
,IÓ, par Maria Da Encarnacao Serralheiro.
Montreal. 1970. 141p. (Thèse (M.Nurs.)-
Montreal! R
ó2. Hellit" cllre ill CIII/ada: a COII"l/l'lItllry,
by H. Rocke Robertson. Ottawa. Informa-
tion Canada. 1973. 173p. (Science Council
of Canada. Special study no. 29)
ó3. 1.1 red Ii,,' dllllg{'/'; U IlIId,' ,
r t"" \'OII/alic
/'{'uctiol/.\ or r..dlwired c"ildrell 10 illlles.I,
by Elinor Bridget Leslie Peer. Gainesville.
Fla.. 1973. 30p. (Thesis (M .Sc.N .)- Florida)R
64. N"rse aide similarit}' to patient and feel-
illgs or "dp/e.I.II/l'.I'.I. by Charlotte Tramblay.
Cleveland. Ohio. 1971. 38p. (Thesis (M.Sc.N.)
-Case Western Reserve)R
ó:'i. N /II'.\{'.\" perceplu",.' ,!f thâr hO.'pital'.1
orgalli::utiOlwl clW/'//cl{'/'i.'lin. by Audry
De Block. Milwaukee. Wisc.. 1%9. 70p.
(Thesis (M.Sc.N.)- Marquette) R
óó. A .'/IITe.\' ,,1' CUlllldiuII .Ic""ol" or ""/'.Ii",!!
10 det<'l'II/ille /11l' illslr"ctioll alld cli"ical
experiellce pr()\'ided ill mental retardation.
by Elsie I.E. Pearen. Vancouver. B.C.. 1973.
!!7p. (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 tor 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 I January 1974, the charges
for photocopying periodical articles
will be:
10 cents per page
Minimum charge per article $1
i.e., the charge for a request tor
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 tollowed
by the CNA Publ ications Order De-
partment, charges under $5. must be
prepaid.
Photocopying of books and docu-
ments will not be done.

JANUARY 1974

classified advertisements

ALBERTA

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 1CO. Tele.
phone: 578-3691.

REGISTERED NURSES required immediately for 72-
bed accredited. active treatment hospital. Also 1 Rlt.
tor 50.bed Nursing Home. AARN-AHA contract In
force Refund of lare after one year of service. Apply:
Director 01 NursIng. Providence Hospital. High Prai-
rie. Alberta TOG 1EO.

BRITISH COLUMBIA

REGISTERED NURSES AND LICENSED PRACTICAL
NURSES WANTED FOR FULLY ACCREDITEO HOS.
PITAL EXPANDING TO 190 BEDS IN JANUARY 1974.
GENERAL DUTY POSITIONS IN MEDICAL-SURGICAL
PSYCHIATRIC AND ICU-CCU AREAS MUST BE
ELIGIBLE FOR B C REGISTRATION BASIC SALARY
1973 - 5672 00 (NEW CONTRACT BEING NEGOTIAT-
ED). APPLY. DIRECTOR OF NURSING. ST. JOSEPH'S
GENERAL HOSPITAL. COMOX BRITISH COLUMBIA
V9N 4B1.

ADVERTISING
RATES

FOR ALL

CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additional hne

Rates for display
advertisements on request

Closing dale for copy and cancellation is
6 weeks prior to 1st day of publication
month.
The (anodian Nurses' Associafion does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they are interested
in working_

Address correspondence to:

The
Canadian
Nurse

ð

SOTHE DRIVEWAY
OTTAWA, ONTARIO
K2P 1 E2

JANUARY 1974

I I

BRITISH COLUMBIA

HEAD NURSE required for Obstetrical-Gynecological
Nursing Unit (IncludinQ nursery) In 230-bed active
treatment hospJlal In Okanagan Valley of British
Columbia RNABC contract In eltect. Apply to. Direct-
or of Nursing. Penticton Regional Hospital, Pentlcton,
Bntish Columbia.

WANTED HEAD NURSE for 5-bed Intensive Care
Unit In Okanagan. Duties to commence February 1st.
1974. Eligible for B.C. registration. Preparation ancJl
or previous experience in I.C.U and Administration.
Salary and benefits In 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
allendlng staff. Experience of training desirable.
Must be eligible for B.C. Registration. Nurses
residence available. Salary 5687 per month starting.
Apply to: Director of Nursing, Mills Memorial HOSPI-
tal, 2711 Tetrault SI.. Terrace, British Columbia

EXPERIENCED NURSES required In 409-bed acute
HOspital with School of Nursing. VacanCies in
medicel, surgical, cbsletric, operahng room. pediat-
ric and Intensive Care areas. BasIc salary $672.-
$842. B.C. Registration required. Apply: Director
of Nursing. Royal Columbian Hospital, New West.
mmster. British Columbia

GRADUATE NURSES for 21-bed hospital preferably
with obstetncal experience. Salary in accordance
with RNABC. Nurses residence. Apply to: Matron,
Toflno Genera' Hospital, Tofino, Vancouver Island.
British Columbia.

NURSES REOUIRED 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 41-beo
hospital, located On the Alaska Highway. Salary and
personnel policIes on accordance wIth RNABC
Accommodation available in residence. Apply:
Director of Nursing, Fort Nelson General Hospital,
Fort Nelson. Brollsh Columbia.

GENERAL DUTY NURSES REOUIRED 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 5672 - $842 per
month. Policies In accordance with RNABC Contract.
Residence accommodation avaIlable. Apply to:
Director of Nursing. Powell River General HO
:)ltal
5871 Arbutus Avenue, Powell River. Brollsh Columbia.

WANTED: GENERAL DUTY NURSES for modern 70-
bed hospltat, (48 acute beds - 22 Extended Care)
located on the Sunshine Coast, 2 hrs. from Vancou-
ver. Salaries and Personnel Policies In accordance
with RNASC Agreement. Accommodallon available
(female nurses) In residence. Apply The Director
of Nursing. St. Mary's Hospital, P.O Box 678. Se-
chell, Brotlsh Columbia.

II

BRITISH COLUMBIA

EXPERIENCED GENERAL DUTY NURSES lor modern
10.bed hospItal with doctors offices In hospital.
Situated beautiful west coast of Vancouver Island.
Accommodation S50.00 a month. Apply Admlnlstra.
tor. Tahsls HospItal Bo. 399 Tahsls British
COlumbia

GENERAL DUTY NURSE wanted for 87-bed modern
hospital. Nurses Re.sldence. Salary 5646.00 per
month lor 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 Mayor this year. Residence accommodaltons
available. RNABC pohcles In effect Apply to
Director of Nurses. SI. John HosPital Vanderhoof
Bntish Columbia

MANITOBA

D.O.N. required for 58.bed Personal Care Home
a new facility. Excellent salary and fringe benefits
Will credit for past experience Must be bilingual
and have experience In geriatrics For further in-
formation write to Administrator. Foyer Notre Dame
Inc. Notre Dame de Lourdes Ma""oba ROG 1MO

TWO REGISTERED NURSES are required by Baldur
District Hospital for general duty Duties to commence
In early 1974. Attractive residence In 16-bed hOSPital
Sal ary based on Government scale with conslderalton
fOr experience For further information contact Mrs
K Gordon. Director of NursIng, telephone 535-2373
Baldur District Hospital Baldur Manitoba

Required ImmedIately - 3 REGI STERED NURSES and
3 LICENSED PRACTICAL NURSES for a new 50-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

NOVA SCOTIA

REGISTERED NURSES (3) for general duty and (1)
wIth Operating Room experoence requored for 22-bed
hOSPital In Sheet Harbour. Nova Scotia (situated on
the scenic Eastern Shore). Apply to Administrator
Eastern Shore Memorial Hospital Sheet Harbour.
Nova Scolla.

ONTARIO

Apphcatlons for the position of' NURSING ADMINIS-
TRATIVE SUPERVISOR and HEAD NURSE for the
Paediatric Oepartment of a 14:> oed General Hospital
are now being accepted. Preference will be given to
applicants with formal preparation In Nursmg Servl( .
Administration. but those with administrative expe r
lence will be considered Completely furnish d apan
ments with balcony and swimming pool adjacent ''''I
hospital and lake are available and the loca n IC
within easy driving distance of American and Cana-
dian metropolitan centres Apply Director of Nur! ng
General Hospital Port COlborne Ontario

SUPERVISOR OF PUBLIC HEALTH NURSING: for
progressive Health Unit with ger. alllc program
Nursing degree essential supervIsion and adm
Iratlon preferred Excellent personnel polici :II Appl,
Dr V Soudek. Medical OfflL'r of .. 'allh Lf' s
Grenville & Lanark District Health Unil Box 130
Brockvllle, Ontario

THE CANADIAN NURSE 53

ONTARIO

REGISTERED NURSES lor 34-bed General HospItal.
Salary $646. per month to $756 plus experoence al-
lowance. Excellent personnel policies. Apply to'
Dorector 01 Nursirg Englehart & DIstrict HospItal
Inc., Englehart. Ontario.

REGISTERED NURSES required lor a new 79-bed
General Hospital in bilingual community ot North-
ern Ontario. French language an asset, but not
compulsory. Salary IS $645. to $758. monthly wIth
allowance for past expenence, 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, Onl.

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 Nursmg. Bmgham Memorial HospItal. Matheson,
Ontaroo Phone (705) 273-2424

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS lor 45.bed Hosplta!. Salary ranges
mel ude generous experience allowances R.N. S
salary $645 to $745 and R N A s salary $445. to $530.
Nurses residence - private rooms with bath - $40.
per month. Apply to The Director 01 Nursing, Gerald-
ton Dlstroct HospItal, Geraldton. Ontaroo.

REGISTERED NURSES and REGISTERED NURSING
ASSISTANTS lor held hospItal In Northern Post 01
James Bay: Fort Albany and Attawaplskat Salary
scale according to prevIous expenence plus North-
ern Al1owance. 4 weeks vacation after one year and
18 sick leave days per year. Traveling expenses paid
to a maXImum 01 $90.00 lor Fort Albany and $11500
for Atlawapiskat upon employmenl. v;)callOn and
termination Roommg available In nurses. reSidence
with meals. accommodationS at the hosplta1. French
language an asset. but not compulsary Apply to
James Bay General HospItal POBox 370. Mooso-
nee Ontaroo P01 1YO

REGISTERED NURSES lor General Duty and I.C.U.
- C.C.U. 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. Ontaroo.

OPERATING ROOM TECHNICIAN required lor lully
accredIted 75-bed HospItal. You wIll be In the
VacatIonland 01 the North, midway between Thunder
Bay. Ontano and Wmnipeg, Mamtoba Basic wage IS
$4/1.50 with consideratIOn tor experience. Wnte Or
phone the Director 01 Nursing, Dryden DIstrict
General Hospital. Dryden. Ontaroo.

pUBLIC HEALTH NURSES (QUALIFIED) FOR GEN-
ERALIZED PROGRAMME ALLOWANCE FOR EXPER-
IENCE AND lOR 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

RESEARCHERS (Ph d preferred) m the health held
To study developmenl 01 the expanded lunctlon 01
nursmg In new types of health selVtces descrip-
tion evaluation To study problems of family health
c\nd health practices relevant to nurSing and health
serviCes Apply Dlreclor School of Nursmg McGIll
UmverSlty Montreal Quebec H3A 2A9

54 THE CANADIAN NURSE

I f

SASKATCHEWAN

REGISTERED NURSES are required by a 228-bed
regional hospital located close to numerouS resort
areas. Salary and benehts according to SRNA con-
tract. For further information contact. Personnel
Director. Victoria Union Hospital. Prince Albert.
Saskatchewan.

UNITED STATES

R.N:s - SOUTHERN CALIFORNIA - ImmedIate need
eXists for medical-surgical units. Orientation and In-
serVIce program. Excellent salary. lull paid benelits.
We will assÎst you with your H-1 visa for immigratIOn
An intertm permit may be obtained trom the Ca\ifor-
ma 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 Streel. Los Angeles. Caillor-
nla 90017 (213) 482-8111 ex 287

MONTREAL
NEUROLOGICAL
HOSPITAL

A Teaching Hospital
of McGill University

requires

Registered Nurses
for
General Duty
PrevIous experience In neurological nursmg not
required. Active inservice education programme.

Apply to:
The Director of Nursing,
Montreal Neurological Hospital
3801 University Street,
Montreal 112, P.O.

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 lBO.bed accredited hospital is
sItuated at SI. 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. livmg
accomodations suppl ied at low cost. PUBLIC
HEALTH has challenge of large remote areas.
Excellent personnel benefits include liberal
vacatIon and sick leave. Salary based on
Government scal es.
Apply to:
INTERNATIONAL GRENFELL ASSOCIATION
Assistant Administrator of
Nursing Services,
St. Anthony, Newfoundland.

THE CAPTAIN WILLIAM JACKMAN
MEMORIAL HOSPITAL

LABRADDR CITY

require the following nursmg 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 cl erk

Applicants should apply in own handwriting to,

Director of Nursing
Captain Wm. Jackman Memorial
Hospital
410 Booth Avenue
Labrador City, Newfoundland

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

GENERAL DUTY
NURSES

- for 360.bed acute general hospItal
- clinocal areas include, - Medicine, Surgery,
Obstetrocs, Paedlatrocs. PsychiatrY, Rehabill.
tation, Extended Care and Coronary Care
- B C Registration preferred but not manditory
dunng inotial employment
- Personnel policies In accordance with
R NABC C ontr act.

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

Startong 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
Onentatlon and Staff Development Program
Windsor offers cUltural and educational oppor-
tunities including Unoversity and Community
College.
WE ARE PEOPLE HELPING PEOPLE
in the rapidly progressing specialty of chronic
care and rehabliltatoon. We offer
- a challenge
- Job satisfactIon
-a happy environment
Apply to,

Director of Nil'sinll
3177 Riverside Drive E.,
Windsor, Ontario
NBY 452

JANUARY 1974

ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO.

REGISTERED NURSES

630-bed fully accredited Hospital provides
experience in Emergency, Operating Room,
Post Anaesthesia Room. I ntensive Care Unit,
Orthopaedics," Psychiatry, Paediatrics, Obste-
trics and Gynaecology. General Surgery and
Medici ne.
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 aftèr 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 POSnl0
: Considerable pa
t
involvement in community care facilitie,
\\<ill permit the succes,ful dpplicant to
develop new consultative ,ervices. The
aim is to assist in the operation of re,i-
dential rest homes. pe"onal care home
facilities. and supervisory and educa-
tional facilitie
for children up to 15

ears of age. The po,ition \\<ill involve
the co-ordination and motivation of a
'mdll
taff conducting initial. continuing
and annual visitations.

THE APPLlC\
T: Will have a un i-
ve"ity degree in the 'ocia! o,çiences and
may have taken relevant po,t graduate
training. Considerable experience in
institution
and facilities listed above.
preferably in an administrative. consult-
ative or supervisory capacity is required.
THE SALARY: $9X6 to G;llX5 per
month.

THE \PPUCATIO
S:
lust be ob-
tained from and returned along \\ ith a
detailed re
ume of education and exper-
ience to the Director of Personnel Ser-
vice
. 453 \\'est 12th Avenue. Vancouver
10. B.C.. as soon as po"ible. Please
quote competition P-x9XX.

HUMBER MEMORIAL
HOSPITAL

Telephone 249-8111 (Toronto)
200 Church Street,
Weston, M9N-1 M8, 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.

THE CANADIAN NURSE 55

MISERICORDIA HOSPITAL
EDMONTON, ALBEUA
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 ANO
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 Brihsh Columbia reqUired.
Contact:
Registered Nurses' Association of B.C.
2130 West. 12th Ave.,
Vancouver 9, B.C.
for details.

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, Sas::.
692-1841

56 THE CANADIAN NURSE

McMASTER
UNIVERSITY
School
of Nursing

Nurse laculty members including an Asso-
ciate Director. reQuired lor July. 1974 by a
progressIve School 01 Nursing. The School .s
an Integral part 01 a newly developed Health
SCiences Centre where collaborative relatlon

ships are fostered among the various health
professions.

ReQUirements. master s or doctoral degree
preferred. with clin1cal speclahst preparation
or expenence and/or preparation in teaching.

Salaries. commensurate with education and
expenence.

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 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 t-IURSING
Montreal Children's Hospital
2300 Tupper Street
Montreal 108, Quebec

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 I icensmg in Quebec
not appl icabl e to Canadian citizens.
Applications and enquiries should be sent to:
DIRECTOR OF NURSING
6875 LaSalle boulevard
Verdun 204, Québec.

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 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 01
the position; personnel policies in line with
mdustry 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

REG ISTERED 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 1CO

JANUARY 1974

.

I:XCITEMENT IN NURSING
plus
rHE MAGIC OF ARIZONA
Jlessionalism in a perfect settmg Jom
1m in a new, modem. fully accredited
I with services focused on care of adult
s. Openmgs all shifts for RNs and LPNs.
opportunities also for mterested or
nced ICU-CCU Nurses.
our nursmg Units are m.the.round
II ng our giving mdlvlduallzed patient
located in a delightful retirement
nity near Phoenix. Arizona. This IS the
t safest. resort area In the U.S. You
joy the advantages of a large metro.
area with none of ItS probl ems.
ke the opportunity to give you all the

I:
Welch
tant Director of Nursing
ER O. BOSWEll HOSPITAL
Box 10
:ity, Arizon a.
An Equal Opportunity Employer.

GENERAL DUTY and
NSIVE CARE UNIT NURSES

lur 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-ordinate a two year registered nurse
diploma programme, this IS a new programme
planned to start in the fall of 1974 m a
growing commumty college.
QUALIFICATIONS: Masters degree m nursing
or equivalent experience in nursing educa.
tlon knowledge of current nursing praclices
administrative experience helpful
Salary commensurate with educalion prepara.
tlOn and experience, attraclive fringe benefits
and relocation allowance.
Apply in writmg immediately statmg qualiflca.
tions, experience. references and date avaIl.
able tl'
Dr. FJ. SPECKEEN, PRINCIPAL,
COLLEGE OF NEW CALEDONIA,
2001 CENTRAL STREET,
PRINCE GEORGE. B.C.

1;.'

JANUARY 1974

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

--------------------------------

liD\
\Uf

The Montreal General Hospitol
1650 Cedar ....venu.. Montreal 109. Qu.b.c

PI.as. t.1I me about hospital nuning und.r Qu.bec's n.w conc.pt of Social and
Preventive Medicine.

Nom.

....ddr...

Qu.b.c languag. r.quir.m.nll do nat apply to Canadian applicantL

L_______________________________

I

THE CANADIAN NURSE 57

MISERICORDIA HOSPITAL
EDMONTON, ALBEUA
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
T5 R 4H5

VANCOUVER
GENERAL HOSPITAL

requires

REGISTERED NURSES
FOR REGULAR ANO
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.
2130 West - 12th Ave.,
Vancouver 9, B.C.
for details

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, Sas:;.
692-1841

56 THE CANADIAN NURSE

McMASTER
UNIVERSITY
School
of Nursing

Nurse laculty members. Including an Asso.
ciate Director. reQuired lor July. 1974 by a
progressive School of Nursing. The School IS
an Integral part of a newly developed Health
SCiences Centre where collaborative relation-
ships are fostered among the Vanous 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
expenence

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 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 t-IURSING
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 01
graduates for our medical, geriatr
children's services.
Nursing assistants with experience or
graduated. Psychiatric nursing backgro
preferable but not essential.
Language requirement for licensing In (
not applicable to Canadian citizens.
Applications and enquiries should be sent
DIRECTOR OF NURSING
6875 LaSalle boul evard
Verdun 204, Québec.

REGISTERED NURSES
AND
REGISTERED NURSING ASSISTAt

required for a 104.bed active treatmel,. t"_O
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 mil es 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 responsibil ity 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 1CO

JANUARY 1974

EXCITEMENT IN NURSING
plus
THE MAGIC OF ARIZONA
For professionalism in a perfect setting, lOin
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 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 O. 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
Cont ract.

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 I s 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. attracllve fringe benefits
and relocation allowance.
Apply in writing immediately stating qualifica-
tions, experience, references and date avail.
able tC'
Dr. F J. SPECKEEN, PRtNCIPAL,
COLLEGE OF NEW CALEDONIA,
2001 CENTRAL STREET,
PRINCE GEORGE, B.C.

1;.'

JANUARY 1974

Everyone Knows
Where We Are!

J
I

Where Are You?

Come and nurse in exciting Montreal at -

The Montreal General Hospital

a teaching hospital of McGill University

--------------------------------

liD\
'U i

The Montreal General Hospital
1650 Cedar Avenue, Montreal 109. Quebec

Please tell me about hospital nursing under Quebec'. n_ concept of Social and
Preventive Medicine.

Name

Addre..

Quebec language requirements da not apply to Canadian applicant..

L_______________________________J
I

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

w:_

BRISBANE, AUSTRALIA

REGISTERED NURSES

Applications are invited from Registered Nurses to fill
vacancies on the staff of the Royal Brisbane Hospital,
Brisbane, Queensland. Australia. Its associate, the Royal
Women's Hospital, invites applications from Registered
General Nurses desirous of undertaking 12 months' mid-
wifery training course.
Wages and conditions are in accordance with Nurses
Award (Queensland). Uniforms are provided and laundered
free of charge; nurses' swimming pool and tennis courts
are available. Accommodation at a reasonable charge is
available for applicants wishing to 'live in'.
Royal Brisbane Hospital and Royal Women's Hospital,
Brisbane together with Royal Children's Hospital, Brisbane
form a major teaching hospital complex of approximately
1700 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. Challeng ing 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
R.N.'s B.S. degree
R.N.'s B.S. degree & one year's experience
A ten-percent shift differential is paid for evening or night shift work.

$845/mo. USA
$845/mo. USA
$888/mo. USA

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 SN3

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 RN.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 N5W 5H1
Closing date for applications: 31st January 1974

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Jewish G
!1..
!lJ' Hospital
A modern 700 bed non-sectarian hospital which has general and special services.
Active In-Service Education Programme, including Planned Orientation Prog!"dmme.
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
THE CANADIAN NURSE 59

JANUARY 1974

ROYAL VICTORIA
HOSPIT AL

MONTREAL, OUEBEC

invites applications from

REGISTERED NURSES

for

GENERAL DUTY

Inservice 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

Montréal112. P.O.

TORONTO
GENERAL HOSPITAL

Invites applications Irom

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 CENERAL HOSPITAL
101, College St.,
Toronto, Ontario,
M5G 1L7.

60 THE CANADIAN NURSE

.-

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
K1 Y 4E9

Q

ORTHOPAEDIC 6<: ARTHRITIC
HOSPITAL
'VI

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.

JANUARY 1974

DALHOUSIE UNIVERSITY

SCHOOL OF NURSING

FACULTY POS,ITIONS 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

's;

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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

IANUARY 1Q74

NURSING
ADMINISTRATOR

A V AILABLE
A challenge in the Community Nursing Education
Prog ramme
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

WHEN
Begins July 1,1974

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 (Ioc. 427)

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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 Plasltc Unit, Coronary Care, Intensive
Care and Neurosurgery Units and an active Emergency Department
. Obstetrical Department - participation in "Family celltered" teach.
ing program.
. Paediatric Department - participation in Play Therapy Program.
. Orientation and on-goirc 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.

THL CANADIAN NURSE 61

PROVINCE OF BRITISH COLUMBIA
requires
REGISTERED NURSE -
HOSPITAL CONSULTANT
(I NSPECTOR-HOSPIT ALS 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.

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
procla iming 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
438Y2 College St.
Burlington, Vermont
05401

FORMATION CENTER
4 Toronto Street,
Ottawa, Ontario.
K1 S ON2

62 THE CANADIAN NURSE

BORED?
RESTLESS?

- Stimulating General Duty activities in
a 675 bed hospital- on a unit of your
choice
- Leisure time activities that are interest-
ing and exciting

Apply to:
Director of Nursing
Regina General Hospital
Regina, Saskatchewan

JANUARY 1974

I nd ex
to
Advertisers

January 1974

Oavol Canada. Ltd. ................................................ 5
Holl i...ter Limited ..... ....... .................... .......... ....... 40
International Health Institute ............................... 50
J.B. Lippincott Co. of Canada Ltd. ........................ I
Mont Sutton. I nc................................................. II
C.V. Mo...by Company. ltd. ..................... 16. 17. I X
The Nurses' 8001-.. Society...................................... l)
Perry Rubber Company......................................... 6
Procter & Gamble ................................................ 45
Reeves Company............................................ 14. 15
W.B. Saunder... Company Canada. Ltd. ................ 47
&:hering Corporation Limited ............. 52. Cover IV
Westwood Pharmaceuticals .................................. 51
White Si...ter UnilÙrm. Inc. ...... 2. Cover II. Cover III

tin'''' i \i ilK l\1wws:a
Georgina Clarke
The Canadian Nurse
50 The Driveway
Onawa K2P I f2 (Ontario)

A tln.'rfi.\Ù1K Repn'S('1lTlif/ "Ö
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003
h.'k'phone. (215) \1Ilh\,,) lJ-14lJ7

Gordon Tiffin
2 Tremont Crescent
Don Mills. Ontario
I dephone. (416) 444-47J I

Member of Canadian
Circulations Audit Board Inc.

BEl:]

JANUARY 1974

Serve Canada's
native people

6.

....

.

-

----

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1 ...
.
j

.

In
a well
equiRped
hospital.

I . Health and Welfare Sanlé eI B.en.être social
Canada Canada
,---------------

I Medical Services Branch I
I Department of National Health and Welfare I
I Ottawa, Ontario K 1 A OK9 I
I I
I Ple...e send me informuion on hOsPital I
I nursing with this servIce. I
I Name: I
I Address: I
City: Pray: _

_______________J
THE CANADIAN NURSE 63

...-

PROVINCIAL ASSOCIATIONS OF REGISHRED NURSES

Alberta
Alberta Association of Registered Nurses.
10256-1 I2 Street. Edmonton. T5K IM6.
Pre.
.: A.J. Prowse; Pre.
.-Elect: D.E. Huff-
man; Vke-P/"('.
.: A. Thompson. I. Walker.
COII/II/ittee.
- Stl(l1" Nur-'l'.
: C. Asp; N.W.
ElIu('.: W. Mills: N
R. P/'((l'tin': A. Clark;
Supen'. Nur.n'.
: J. Smith; Pmjl.(.t Din!('. N,w.
ElIu('.: M. Moncrieff. Pml'. O,ffil'e Stl(IT-
Puh. Rei. O,ffin"': A. Shaw; Ell/ploy. Rei.:
Y. Chapman; Ant. Ell/ploy. Rd. O,[(il'(,/,:
R.R. Donahue; N
R. Sel'l'. Cmm,lt.: 8. Sel-
lers; COII/II/. Adl'Í.mr: H. Coller; R"Ri.\trar:
A.R. McKinnon; Ex('('. S('('.: H.M. Sabin;
O.lTin' MWIlIR("': M, Garrick.

British Columbia
Registered Nurses' Association of British
Columbia. 2130 West 12th Avenue. Van-
couver. Pre.
.: G. LaPointe: Vin'-Pn'.\.: T.
Duck. R. Macfadyen. COII/II/itt('e.
- N.
R.
ElIlIl'.: J.K. Griffith: N.I'R. Pmctin': E.H.
Dancer; SoC, & Enll/. W('
r: B. Archer. Stl!l1
- En'('. Din'('.: F.A. Kennedy; ReRÌ-\'trar:
H. Grice: A.ut. R('RÌ-\'t,.(//.: J. Small; Din'c.
&111('. S,"T.: C. Kermacks; A.ut. Din'(', Edm'.
Sel'l'.: J. McCullagh; Din'('. N.W. Sel'l'.: T.
Schnurr; Di,.,!c. Pe".
ol/l,d Sal'.: N. Paton:
A.
M. Din'('. Peno""d Se/'l'.: (Plan'II/('IIt
Sel'l'.): F. MacDonald. (Li,h",' Rd.): G,
Smale; Din'('. COII/II/. Sel'\'.: C. Marcus:
Lihm/'iall: J. Molson: Adll/ill. A.ut.: D. St.
Germain.

Manitoba
Manitoba Association of Registered Nurses.
647 Broadway Avenue. Winnipeg. RJC OX2.
P/'('.
.: F. McNaught: Pa.w P"('.
.: E.M. Nu-
gent; Vin'-Pn's.: R.G. Black. L. McClure.
COII/II/itt(.(..
- N
R.: A. Croteau. M. Swe-
dish; So('. & Emil. We({.: A. Daniels: LeRÌ-\'I.:
O. McDermott: Brd. l
r Exalll.: O. McDer-
mott: Fillalll'e: K. DeJong: P"l
(e.
.
. Sta.lT-
Ell/ploy. Rd. Adl'i.
.: J. Gleason: Pllh. Rd.
O,[(ic('/': M. Paynter; ReRi.
tm": M. Caldwell;
COlltill. Edllc, Adl'i.
.: H. Sundstrom.

New Brunswick
New Brunswick Association of Registered
Nurses. 23t Saunders Street. Fredericton.
Pre.
.: B. LeBlanc: Pa.vt P"e.
.: A. Robichaud;
Vke-Pre.
.: S. Cormier. R. Dennison; HOll.
Sec.: S. Robichaud. COIIIII/itt(.(..
- NW.:
Z. Hawkes. S. MacLeod; N
R. A.ut. COII/II/.:
J. Sherwood: LeRi.
/.: K. Wright: Exe('. Se('.:
MJ. Anderson; Liai.
oll o'llìa,': N. Rideout;
CO/wilt. So('. & EnJ//. W('({.: G. Rowsell;
ReRi.
,,'(//': E. O'Connor; A.
.
t. Ere('. Sec. &
ReRi.
t"(I/': M. Russell: &llIc COll.llllt: A.
Christie.

Newfoundland
Association of Registered Nurses of New-
foundland. 67 Le Marchand Road. St. John's.
Pre.
.: E. Wilton: Pa.w P"('.
.: P. Barrett: P"e.
.
Ðect: F. Bouzan; Vin'-Pn'.
.: E, Summers.
J. Nevitt. COII/II/itt('e.
- Nw. 1::<111('.: E.
64 THE C ANADI N NURSE

Gardner: N.\R. S('/"I'.: J. Pawlett: Soc. & En"'.
We
{.: W. Williams: Exec Sec: P. Barrett.

Nova Scotia
Registered Nurses' Association of Nova
Scotia. 60J5 Coburg Road. Halifax.
Pre.
.: M. Bradley: Pa.
1 Pre.
.: J. Fox: Vice-
Pr('.\.: Sr. M. Barbara. G. Smith. C. Butler:
Rel'ord. 5f.'c: Sr. M. Gillis: Erec, S,.c: F.
Moss. COII/II/ittee.\- N.w. Edll('.: T. Blaikie:
N.
R. Sen'.: S. MacDonald: Soc & EnJ/l.
Weir: G. Murphy: Alfl'i". N
J!. EdIlC.: Sr. C
Marie; Adl'i.
. N
R. Sen'.: J. MacLean: Eli/-
ploy. Rd. O,lfin'r: M. Bentley: Pllh. ReI. OOì-
n'r: D. Miller: Adll/ill. A.\,".: E. MacDonald.

Ontario
Registered Nurses' Association of Ontario.
JJ Price Street. Toronto. M4W I Z2.
Pre.
.: W.J. Gerhard: Pres. Elect: N.M. Ma-
rossi. COlI/lI/iUl'('S - 5f.)('io-EnJ/l. W df: C,J.
Seppala: N\R.: G.L Schmidt: &III('(/t"r: C,J.
Faulkner; Adll/ill.: M.L. Peart: Exec. Direc.:
L Barr: A.w. Exec. Direc.. D. Gibney:
Din'c. Ell/ploy. ReI.: A.S. Grihben; Dire('.
P"'
'('.
.
. Del'd.: eM. Adams: ReI!. Exec.
Sec: M.I. Thomas. F. Winchester.

Prince Edward Island
Association of Nurses of Prince Edward
Island. 188 Prince SI.. Charlottetown.
Pre.
.: E. MacLeod: Pa." Pre.'.: C. Carruther
:
P"('.
. Elecl: B. Robinson: Vice Pr,..\.: S.
Mulligan: Exec, Sec.-ReR.: L. Fraser. COII/-
II/itt('e.
- Nw. Edllc.: D. Sawler; NW.
Sell'.: J. Peters: Pllh. Rd.: H. Wood: Fillall-
n': C. Carruthers: Le!:i.\'l. & By-Ll/II'.\: Sr.
M. Cahill; Soc & Emil. We(f.: M. Babineau.

Quebec
Association of Nurses of the Province of
Quebec. 4200 Dorchester Blvd.. W.. Mont-
real. H JA I V2. .
P"('.
.: R. Bureau: Vke-Prn.: S. O'Neill.
J. Pinkham. (Eng.). P. Proulx. Y. I ePage.
(Fr.): HOIi. Trea.\.: C. Royer: HOll. Sec' P.
Boucher. COII/II/itt""x- N.
R. &111('.: G. Al-
Ien. D. Lalancette. Nw. S,.n'.: J. Had,well.
R. Dionne: P,.,
'{'s'\. SI"T.: S. O'Neill. P. Mur-
phy: School l
" N\R.: R. Atto. C. de Villiers
Sauvé: LI'Ri,
/.: 1\1. Masters. C. Bélanger:
Sec. R('!:.: N. Du Motlchel: PilI>. Rei. o.tfil'(,/,:
M. Jean.

Saskatchewan
Saskatchewan Registered Nurses' As
ocia-
tion. 2066 Retallack St.. Regina. S4T 2K2.
Pr,..,.: DJ. Pipher; Past Pre.'.. E. Linnell;
Pre.
. Elect: J. MacKay: I'in'-Pr,..\.: Sr. B.
Bezaire. S. Rhoden. COlllllliuel',,'- NW.:
I. Watson; Chapter.,. & PI/h. Rei.: R. Leding-
ham; Soc. & EnJl/. We(f:: G. Hutchin,on:
Exec. S('(,.: A. Mills; ReRi.w'ar: E. Dumas:
Pllh. 1t!f<VIII. Ofjìcl'r: B. Schill: N'R. Cal/.\lIlt.:
R. Mireau: As.w. ReRi.'tm,': J. Passmore.

-

ð

Canad ian
Nurses'
Association

Directors

President
................ Marguerite E. Schumacher

Pre
ident-Elect. ...... Huguette Labelle

1st Vice-Pre,ident.. Beverly Du Gas

l\1emher-at-Large ..... Glenna Rowsell

Member-at-Large .. K. Marion Smith

1\'lember-at-Large
.............................. Deni
e Lalancette

Member-at-Large ..... Roberta Coutts

A.J. Prowse ............................. AARN

G. LaPointe .......................... RNABC

F-. McN aught .......................... MA RN

B. I eBlanc ............................ NBARN

E Wilton ................................. ARNN

\1. Bradley............................ RNANS

W. Gerhard ............................. RNAO

E. MdcLeod ............................ AN PEl

R. Bureau ........... ................... ANPQ

OJ. Pipher ............................... SRNA

Executive Director

........................... Helen K. Mussallem

JANUARY 1974

r ./
j .... "ROYALE CORDED" "ROYALE RIB" t!:i
' \ - - The soft and fluid
\.
Professional
different styling for the
shirtdress professional girl
'/1'
",
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--

Style No. 1412
IJL Sizes 6-16
Jf White Style No. 1301 \
$18.98 Sizes 8-20
Blue, Yellow White only
I $19.98 $23.00
I, ,\
JYALE RIB" . "ROYALE CORDED"
lUtifully detailed With delicate
ss for a stitching to add a
eer girl touch of delight
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i)ì ß "ROYALE OXFORD" \..

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cc Odl'C ';2.

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The

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February 1974

....1..
:;A
Nurse

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A
ROSS CANADA

C -:; NURSING
TEXTS

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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, manaqement 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 $9.95

STUDENT WORK MANUAL IN
CRITICAL CARE NURSING
Lippincott 1973 90 pages $3.75

*

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CI<fIICAl

I'!' NUPSIN

tlill

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

CD

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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, deve:opmental 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
Notter
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-

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

............
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Please send me the book/sl whose numbers(sl I have circled
1 5
2 6
3 7
4

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.

FEBRUARY 1974

Name
Address
City

Province

Position
Postal Code

o Payment enclosed (send postpaid)
Books may be returned within 15 days

o Use my Chargex number
o Charge and bIll me

CN-2-74

THE CANADIAN NURSE 1

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THE

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1'RAO!E""" NO US...., Of''' . c:.utAOA MAOf IN U

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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. CN-2, 7912 Bonhomme Ave. . St. Louis, Mo. 63105

The
Canadian
Nurse

ð

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. MacDougall

22 Ethics of Nursing Practice ..................................................... M. Allcn

24 When You Visit a Sick Friend ......

25 Clinical Laboratory Procedures ............... E.M. Watson. A.H. Neufeld

I h.: vi.:", .:xpr,:"ùl In Ih.:
xlilorial and variot" arlicl
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do notn':c.:"aril
r.:pr.:,.:ntlh.: polici.:, or vi.:v" ofth.: ( anadian '\1111"':" '\"o.:iati.lI1.

4 Letters 51 Rescarch Abstracts
7 News 54 Books
45 In a Capsule 6U Av Aids
46 Dates 61 Accession Li'it
47 Names 79 Indcx to Advertisers
49 Ncw Products XU Official Directorv

E- xc'cutiw Dir"Clllr: lIeI"n "'. .\lu"aU"m.
hillor '\ i
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Starr. I clitorial \"I,t,n1l' Carol \. 1)\\01'-
I..ill . Produclion ..\"i'tanl tJi/ahclh .\.
Stanton. ('Irculatlon :\I,lI1ag"r. ""r
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log....thl..r \\ilh rl"g.'lratloJ1 llul11h... o r In .1 pro-
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P\.'ll. t..I(Juhlt.. -'p.ll..l."l1.
on onl.' ,ilk 0' unrukd papl.'r k.l\ Ill!! \\ Il.k
margil1'. \1anu,..:npt' .Ih.' .u..TI.'ptl.'d lor fI.:\ 11..'\\
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"\du'I\\: puhh..:.ltllm. I h...' ...'duol I...........rh
till.: fight (0111.11...1...' thl' u,u.1I clhtoll.d l..'h.,llgl."
Phologr .Iplh (glo,,
prll1hl .lIld gr.lplh .lIld
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Driv"""v. 011.1",1. Ontario. "21' II :!

C (".IIMd..I11 'lII'I.... \.......J\:I.IIIOIl It) .J

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 1933 to 1944.
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 is the 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.'
"Si nce 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."

-VAL.

* 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 Morton.
.. fhe pandemic intluenza of 19 I X." 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 epidem ic.
I 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 nw mother in
farm operations. suddenly"arrived home
very ill and reported having to clo
e
down his work because 70 to XO percent
of his men were ill.
Within a week our two hired men
and the family. except my mother and
mvscI f. were ill. Outside chores. cook-
ing. caring fÓr the sick. and so on were
left to us. Within another wee"- I sud-
denly became ill: although not acutely
sick, I
pcnt nearly three month
recov-
ering. Mother worked outside. cooked.
and cared for the sick without help.
Every household in the community
and village was stricken and deaths
occurred daily. My t
lther 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 nigh!-
he visited at all hours. How he survived
only God knows. He was concerned
about my mother, who never seemed to
rest. He tinally organized a makeshift
hospital and moved our two hired hands
there.
When my father began to improve
and felt he should relieve mv mother of
the outdoor chores. my mother - usu-
ally a placid soul -locked him in the
house while she carried on with the
chores. I can still recall his ranting over
the fact that mother had defied him.
My 1
lther said his frequent hot
whiskey toddies 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. Sa/lders,
Maid.weJ//e, SasJ..wdlel\'l/ll.

I was particularly interested in the
article concerning the influenza epi-
demic of 191 X. 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 11u and the illness
of another. A few days later my brother
wa
in bed with the 11u and
oon con-
tracted pneumonia.
I ahoo had a mild case of the 11u.
o
was confined to bed. I was too voung
to realize how ill my brother w.
\. My
chief thought wa
that his entrv into
the army h
ld been postponed. "
This article brought back memories
of m)' parents' days of worry. and made
me realize how serious the t
lmilv situ a-
tionmight have become. Becausé of the
illness. mv brother's induction was
postponcd to November I I. and his en-
tire four months of army service were
spent in Boston harbor. instead of in
France! - Ed/la Frye, Verlllolll.

Second-class nurse
I am getting tired of being considcred
a second-class nurse because I work in
a home for the aged. I think it is time
to do
omething about this.
Regi
tcred nurses in Canada who
work with the aged are not giving them-
selves a chance. They have allowed
them
elves 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
mcan 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 om:
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.

Rcgi
tcred ",1r'C
,
your community necds
the henefit of yoU!
skills and experience.
Volunteer now to
tcach St. John Amhulance home
nur
ing and child care courses.
('ontad your Provincial Headquarters,
St. John Ambulance.

There is another hlcet to thi
argu-
ment - our patients, them
elves. Arc
they not the ones who
truggled through
a depression and helped

in a w.;[.'!
To many of these old folks. whose rela-
tives arc 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 thcv
have dared to grow old'! Of course not!
But they arc being deprived because
good nurses. who are particularly suit-
ed to .caring for thy aged. are being
lured mto 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 arc letting our patients down. too,
because we are implying they are not
important enough to fight for. or to care
for. They deserve the best we can give
them. ----;- Patricia M. Briggs. SRN, SCM.
Reg.N., Londo/l. Ontario.

Letter must be answered
fhe letter "Nurses should not n:tire"
(December 197.\ page 4) must be
answered.
I was out of nursing for ]0 year
and
have been back for two. I must admit
th,lt at first it was grim. You need a
brave director of nursing and a long
sufferi ng head nurse. Medicines are
all new. Intensive care units did not
exist. but it is ama7ing what docs come
back.
About five or seven years ago. one of
the hospitab in my city had a refresher
course, but I wa
unable to attend. This
winter. SI. Lawrence College is giving
a IS-week refresher course.
I certainly resent being told to qep
down to a registered nursing assistant
po
ition. I was a good nurse <lI1d still
am. although in a limited capacity.
Since I graduated. I have never given
up reading 711e Ca/laclia/l Nun/!. There
arc also many good nursing texb. which
nurses can borrow from their hospital
to answer their many questions. - J.
N/!LIIlIa/l, Ki /lgsfO/l, Omario. 1;]
FEBRUARY 1974

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s have pull-on elastic waist. Visit or phone your nearest Eaton's Store.
:handise available at or through Eaton's stores and Catalogue Offices across
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puffed sleeves, round collar and button front. Sizes 3 to 15. In white, 34.00; pink, 35.00.
2. Polyester and nylon tricot rib kmt with button front jacket, pintuck detail at cuffs
and waist, action sleeves and pockets. Sizes 8 to 18. In white, 30.00.
3. Polyester and nylon shirt look with patch pockets, drawstring waist. short sleeves,
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EATON'S

New... ready to use...
"bolus" prefilled syringe.
Xylocainè100 mg
(lidocaine hydrochloride injection, USP)

For 'stat' I.V. treatment of life
threatening arrhythmias.

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o Functions like a standard syringe.

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o Calibrated and contains 5 ml Xylocaine-.

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6 THE CANADIAN NURSE

Xylocaine
100 mg
(lidocaine hydrochloride Injection U.S P)
INDICATIONS-Xylocaine administered Intra-
venou
lv is specifically indicated In the 3Lute
management oft I) ventricular arrh) thmias OCLUf-
ring during cardiac manipulation. 'iiuch dS cardia,"
surgery: and (2) life-threatening arrhythmias. par-
ticularly those which are ventricular in ongin. such
as occur during acUle myocardial infarction.

CONTRAINDICATIONS Xylocaine i. wntra.
indicated (I) in patients with a known history of
hypersensitivity to local anesthetics of the amide
type: and (2) in patienl'ii \\'ith Adams-Stokes syn-
drome or \\ith severe degrt:es of sinoatrial. atrio-
ventricular or intraventricular block.

", ARNINGS-Constant monitoring with an elec-
trocardiograph is essential in the proper adminis-
tration ofXylocaine intravenousl\'. Sign
of exce...
sive depression of cardiac conductivih. 'iuch as
prolongation of PR interval and QRS complex
and the appearance or aggravation of arrhythmias.

hould be followed by prompt cessation of the
intravenous infusion of this agent It is mandator)
to have emergenc\' resuscitative equipment and
drugs immediately available to manage pos\;;ible
adverse reactions involving the cardiovascular.
respiratory or central nervous systems_
Evidence for proper usage in children is hmited.

PRECAUTIONS-Caution should be employed
in the repeated use of Xylocaine in patients with
severe liver or renal disease because accumulation
may occur and mdY lead to toxic phenomena. since
Xylocaine I
metabolized mainly in the hver and
excreted by the kidney. The drug should 31\;;0 be
used with caution in patients with hypovolemia
and 'ihock. and all forms of heart block (see CON-
TRAINDlCATlONS AND WARNINGS)
In patients with sinus bradycardia the adminis-
tration ofXvlocaine intravenously for the elimina-
tion of ventricular ectopic beats without prior
acceleration In heart rate (t=.g. by Isoproterenol
or by electric pacing) may provoke more frequent
and serious ventricular arrhythmias.

ADVERSF REACTIONS Systemic reactions of
the following types have been reported.
(I) Central Nervous System: lightheadednes,.
drowsmess: dlzLmess: apprehension: euphoria:
tinnitus: blurred or double vision: vomiting: sen-
sations of heat. cold or numbness: twitching.
tremors: convulsions: unconlliiciousness: 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 procainamidc or between
Xylocaine and quinidine.

DOSAGE AND ADMINISTRATION SinRle
Injection: The usual do
e is 50 mg to 100 mg
administered intravenouslv under ECG monitor-
ing. This dose may be administered at the rate
of approximately 25 m@: to 50 mg per minute.
Sufficient time should be allowed to enable a slo\\
circulation to Larry the drug to the sÎle of action
If the initial injection of 50 mg to 100 mg does
not produce a desired response. a second dose mav
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 expenence with the drug is limited.
Continuous Infusion: Following a smgle injection
in those patients in whom the arrhythmia tends
to recur and who are incapable of receiving oral
antiarrhythmic therapv. intra\'enous infusions of
X)locaine may be administered at the rate of I
mg to 2 mg per minute (20 to 25 ug/kg per minute
in the average 70 kg man). Intravenous mfusions
ofXvlocaine must be administered under constant
ECG monitoring to avoid potential overdosage
and toxicity. Intra\'enous 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 antiarrh)thmic agent for
maintenance therapy.
Solutions for intravenous infusion should be
prepared by the addition of one 50 ml single dose
vial of Xylocaine 2"J 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 rer mmute
will provide I mg to 2 mg of Xylocaine HCI per
minute.

FEBRUARY 1974

news

Nursing And Health Is Theme
Of 1974 CNA Convention
()(tl/l\'(/ - Th
theme of th
'<)74 CNA
ann ual m

t ing and conv
nt ion \\ ill
b
"Nursing and H
alth'" It will be
held in Winnipeg at the Manitoba
c
nt
nnial center. June 16 to 2L 1<)74.
Registration will begin on Sunday.
June 16. at noon. An interfaith church
servic
\\ ill he held at 1600 hours. and
the opening ceremony at 1<)30 hours.
follO\\ed hy a reception.
\10nday. June 17, will he a husiness
s
ssion with reports from the ex
cutiv

dir
ctor. special committ
es on the
testi ng s
rvice and on r
search. finan-
cial rcports. and th
r
port of the com-
mitt
e on nominations. At the Monday
night di nner. ther
will he a presenta-
tion to nurses to he honored.
Two panels on nursing and health
will h
presented on Tuesday. June I K
In th
morning. a panel will discuss
New Work Relationships: th
afternoon
panel \\ ill fixus on N
w Structures in
H
alth Care Deliwry. An open forum
\\ ill 1'0110\\ th
second panel presenta-
tion.
Wednesday morning. June IY. th

Canadian Nurses' Foundation will hold
its annual meeting. Also on Wednesday
morning. CNA voting delegates will
choose CNA officers for the biennium.
\\'
dnesday altermxlIl is free time.
Thursday, June 20. is the second day
d
vot
d to th
topic of Nursing and
Health. In the morning. a panel on
Personal Attitudes and Professional
Image is sch
duled. to be followed hy
an l
pen forum. Multiple sessions arc
on the program for Thursday afternoon.
ind ud ing cI i nical topics. current re-
search in nursing practice, relicensing
and continuing education. special il'a-
tion in nursing. and experiments in use
of hospital nursing manpower.
A g
neral husiness session is sched-
uled for the morning of the final day of
the annual m
eting and convention.
Friday. June 21
rhe ne\dy-clected officers \\ ill he
installed at 1400 hours: the president" s
reccpt ion 1'011 ows.

NBARN Requests Govt. Attention
To Pension Plan Discrimination
Fredericto/l, N.R. - Last December.
th
New Brunswick Association of Reg-
i
tered Nurses sent telegrams to the
FEBRUARY 1974

federal government requesti ng that it
give priority to the removal of discrim-
inatory aspects of the Canada Pension
Plan (cPp).
Bernadette LeBlanc. NBARN presi-
dent, explained that nurses in the prov-
ince are deeply concerned about the
unfairness of the Cpp's henefit paid on
the death of a female contributor.
"Although male and female contrib-
utors are treated alik
as far as pay-
ments are concerned, the spouse 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. N BARN's
membership is <)9.7 percent female:
64.4 percent of these members arc mar-
ried contributors.
The association's action followed a
me
ting of its executive committ
e.
Accordi ng 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

Vi/l/lipeg, Ma/l. - The Manitoba As-
sociation of Registered Nurses (I\tARN)
is conducting a province-wide survey
to determine the numher of nurses who
would return to active practice if re-
fresher programs were availahle in
centers throughout Manitoha.
The need
fÒr such a survey arose
because many Manitoha hospitals.
especially in rural areas. are having
difficulty in ohtaining sufficient nursing
staff. I\1ARN believes there arc a num-
ber of registered nurses who haw been
out of nursing fÒr several years and
who would return to active nursing if
refresher programs \\ere available.
I\tARN is distributing a questionnaire
across the province via its members. as
well dS through community newspapers.
The questionnaire a..,ks fÖrmerly aetive
regist
r
d nurses to indicate their prcf
erence of 100 centers at \\ hic h refresher
programs could be held. the preiCrred
time of year for a course. and whether
the RNs would be pn:pared to \\ork
full- or part-time after completing the
program. .
Marlene Caldwell. I\tARN registrar.
said. "Refresher programs thus far
have not heen av,lIl,thJc 111 rural cen-
ters. This has meant that som
fÒrmer

nurses. particularly in rural Manitoba,
becau
e of family responsibilities. have
heen unahle 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 con'iider
returning to active practice:'

Nursing Committees Set Up
By BC Health Corporation
Va/lcouver, H.C. - A nursing advisory
committe
, recomm
nded by the direc-
tors of the Registered Nurses' Asso-
ciation of British Columbia (RNASe),
has heen established fÒr the new pro-
vincial crown corporation on health.
called the B.C. Medical Centre. (Ne\\ s,
January 1974. page 10).
Patricia Wadsworth, director of pa-
tient scrvices at Vancouver General
Hospital. \HIS named chairman of the
committee by the Centre's administra-
tion. The RNASC named Audrey Mur-
ray, director of nursing at SI. Paul's
Hospital. Vancouver. to be vice-chair-
man.
The RNASC has he
n given the op-
portunity to appoint two more repre-
sentativcs to the Centre's professional
advisory committee: it already has one
appointee. RNABC president Geraldine
l aPoint
. The other two named to [he
committee arc Thurley Duck. RNASC
first vice-president. and Kirsten \\ eh-
her. assistant professor at UBe school
of nursing. The protCssional advisory
committee at the B.\'. Medical C
ntre
takes the place of the medical advisory
committee th,lt i.. usual in hospitals.
Th
B.C. Medical Centre has ,lIso
e..tablished a nursing task committee
to act in an advisory capacity to th

planning and building committee. one
of the C
ntre"s six m,
jor committees.

SRNA Recommendations Concern
Nursing Role In Health Ce.nters .
Regina, Sas/... - rhe nursll1g role 111
Saskatche\\an's community health and
soci,d eenters should be devdoped 111
consultat ion \\ ith the Saskatchew,1Il
R
gistered Nurses' Association. and
the department of publie health should
mak
consultation services on nursing
matter.. available to nurses employed in
the...
centas.
TH E CANADIAN NU RSE 7
.

news

(COIl/ i I/I/I'd li'olll fllI,!!1' 7)
These two recommendations. ap-
proved at a meeting hdd November
1-3. 1973, by the SRNA council. will
be communicated to Health Minister
W.F. Smishek.
SRNA supports III 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 the
e centers
re.ceive no orientation on the concept
01 the centers, on the preventive care
role. of the nurse. or on community
nu rSlllg.
. There are no written policies per-
taining to nursing practice in the cen-
ters.
. No mechanism h.1S been established
to allow nurses. physicians. and board
members at the centers to meet annually
or semiannually tì.)r educational pur-
poses and program planning.
. Advisory boards. as suggested by the
department of public health. have not
been establ ished.
. No criteria have been developed to
cover the ()B-call function of nurses III
the centers.
SRNA will also urge that standards
officers with the Saskatchewan Hospi-
tal Services Plan make the same visib
to community health centers as they
make to hospitals.
The association's nursing consultant
has visited tive of the existing centers
to obtain intì.mllation about the com-
munities' plans Iì.)r their centers and the
role and functions of the nurses em-
plo)ed 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 c1 inical portion of the
course within one and ()Be-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 hy SRNA before they are eligible
to practice. At present. a correspond-
ence refresher course is availahle
th rough the extension department of
the U. of Saskatchewan. Regina.
SRNA's standing committee on nurs-
a THE CANADIAN NURSE

ing requested the counci I to <Ippoint a
consumer to the committee. It wa

agreed that the Sa
katchewan branch
of the (\msumers' As:-.ociation of
Canada be asked to name a per
on to

erve on thi
committee.
A motion to disallow smoking dur-
ing SRNA council meeting
was also
approved.

leDain Report Explains Reasons
Behind Nonmedical Drug Use
Ottawa - The crucial factor in using
an opiate narcotic. such a
heroin. Iì.)r
the first time is access to the drug. '"It
is a combination of a person being
psychologicall) or socially vulnerable
to heroin use. and receiving encourage-
ment or per
ua
ion from another per-

on on whom one feels :-.omewhat de-
pendent. . .,'" says the final report lIf
the Commission of Inquiry Into the
Non-Medical Use of Drug
.
This 114X-page report wa
released
to the public last Dcccmber. four and a
half years after the five-member com-
mission wa
appointed by the federal
government. Gerald L cDain, dean of
Osgoode Hall Law School in Toronto.
was the chairman.
I n 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 1474 annual meeting and con-
vention of the Canadian Nurses'
Association wi 11 be held June 16-
21. 1974. in the Concert Hall of the
Manitoba Centennial Centre. \\ in-
nipeg, Manitoba. The opcning
ceremony will be held on Sunday
evening. June 16. .1t 1430 hours,
tì.)lIowed by d recept ion fÒr the
member
, students. and guests
registercd fÓ. the meeting. An
inter-
faith church service will
be held on
Sunday afternoon at 1600 hoUl
.
Busines
and special interest se
:-.ions
w ilI commence at 0400 hours. \1on-
day June 17. continuing dail) and
concluding on Friday afternoon.
June 21. Students enrolled in schools
of nur
ing in Canada n1a) register as
ohservers at the annualmceting and
can participate in
pecial intere
t

essions anl! social events. - He/ell
K. ,\1u.Ha1/e/ll, Ereclllh'e Director,
('WIlIl/ÙIIl Nunes' A.\SoÓatioll.

However. Illany other faetors that
contribute to nonmedical drug use are
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 com lort and pleasure.
Modern advertising encourages the
notion that there is no reason to put up
with di
comfort. '"
Although the report :-.ays that
ome
forms of nonmedical drug use seem to
have levelled off and eve.
decreased in
certain ca
e
. 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
indi
criminate. chronic multidrug u:-.ers
who encourage the spread of harmful
drug use;
. A marked increase has occurred III
experimental and dependent use of
the opiate narcotics; and
. Hallucinogen users have become
more sophisticated in the abilit) to
avoid acute adverse reactions.
As for treatment of drug dependence.
the commission considers the outlook
discouraging. "Efforts to promote
ab
tinence in drug-dependent individ-
uals by long periods of contÏnement
in prison or hospital settings have yield-
ed poor results in the long run." Al-
though the comm ission released its
report on treatment earlier. it devotes
one section in the tinal report to opiate
maintenance and a shorter section to
the therapeutic community.
The adverse effects of Impnson-
ment of drug offenders are described
and suggestions made. "Prison i
in
many ways a finishing school for crim-
inals. ... It i
difficult to think of a
better way to train people tì.H crime
than to bring all the criminal t)-pes
togethcr in one long live-in seminar
on crime. There would be. on the con-
trary. every interest in trying to keep
them a\\<ay from one another. . . .
"These adverse effects. . . are par-
ticularly retlected in the treatment 01
drug offenders. . . . There is consider-
able circulation of drug
within penal
institution
.. . . offenders are reintÖrced
in their allachment to the drug culture,
and. . . in many cases they are intro-
duced to certain kinds of drug use by
pri
on contacts." says the report of the
LcDain COlllmi
:-.ion.
In its conclusions and recommenda-
tion
fÒr control of the drug user. the
commi
sion strongly recommends
against extending the offence of sim-
ple posse
silln. ':"We believe that we
should gradually withdraw from the
(COI///lII/(.tI,,,, fllI):1' 10/
FEBRUARY 1974

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Next Month
in

The
Canadian
Nurse

. Cholera Epidemiology
and Control

. Poor Baby: The Nurse
and Femini
m

. Adjusting to Imminent Death

. A Volunteer Nurse
in Israel

ð

Photo credit for
February 1974

Public Relations Dept.. Cit} Hall.
Montreal. Quebec. cover photo

10 THE CANADIAN NURSE

news

(Co"l Ú/I//'d /i'OI" (J(/g/' 81

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
"IDA.
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 oi all kinds...,
including specialized methadone units
and therapeutic communities. but a
considerable increase in the number
of probation officers and llthers cap-
able of assisting with the task of social
rehabilitation. "

MARN Approves $40 Daily Fee
For Private Duty Nurses
Winnipeg, Man. - rhe directors of
the Manitoha Association of Registered
Nurses (:\t<\RN) recently approved a
fee increase to S-lO for X hours' nursing
care by RN
in private practice.
The new rate \\-as effective January
I. IY7-l. It replaces a fee of
31 fÌJr X
hours. which has been in effect fix 2
years. The new houri) rate will be
S 7 ..'i0 for periods of less than -l hours.
The increase brings salaries of the
self-employed nurses into c1o
er align-
ment with nurses employed by health
care institutions. \t<\RN says.

New Labor I.egislation In Ntld.
Limits Right To Strike
SI. John's, N.tld. - With the recent
passing of a controversial bill in the
Newfoundland House of A
òembly.
"trikes by public service employees
who are classified as "essential" are
illegal.
The draft legislation. which was
passed in October IY7J after much
debate and amendment. governs collec-
tive bargaining with respect to certain
employees in the provinee'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 relationsJ hoard sh.1I1
request the employer of employees in
the unit to. . . provide the board and
the bargaining agent with a statement

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, sakty. or
security of the public or otherwise in
the publ ic interest."
David Sparkes. employment relations
officer for the Association of Reg-
istered Nurses of NewfÖundland, 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
es
ential. then a strike would be com-
pletely ineffective and meaningless."
Another objectionable feature of this
legislation, M r. 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
Fdll/onlon. A/ta. - Nurse-midwives in
Western Canada have fÖrmed an a......o-
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-
trea
urer; and members-at-Iarge Jose-
phine Bertrand. St. Walburg
Sask..
and Ytiriam Roberts. Drayton Valley.
Alta.
The association adopted the state-
ment of the role and functions of nurse-
midwives delineated hy the Registered
Nurses' Association of Ontario (News.
July IYD. p.12) and supported b) the
Canadian Nurses' Associ.Hioll (News.
Deccmber IYD. p.7). Two ad hoc
committees were named by the new
a
soeiation: the constitution committee
is chaired b) Judith Friend. Edmon-
ton. and the continuing education com-
mittee is headed by \1ary McLees.
Calgary.
One o
iective of the western mid-
\\ ives a
sociation is to promote up-
grading of nursing care in all areas
of the maternit) cycle in Canada hy
working toward continuing education
fÖr nurse-midwives and by acting as
a resource for nurses in oh
tdric,d or
puhlic health 11llr
ing.
rhe group is aiming for a national
organization of nurse-midwives. a pre-
requisite for adm ission to thc I ntcr-
national Congre

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FEBRUARY 1974

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FEBRUARY 1974

THE CANADIAN NURSE 11
.

1

have to be a communist to love your
brother. It comes from the Bible."
Speaking at the opening of the OHA
convention, held October 2() to 31.
1973. the executive director of the
Rehabilitation Institute of Montreal
left the impre:-.sion that Canadian:-.
could learn from the Chinese people's
"acknowledgement of the inadequacies
of health care there. the modesty. . .
concerning m<
ior advances, the zeal
of pursuing plans for further imp.ove-
ment. and the complete subordination
of individual goals 10 the success of
group effort. . . . '.

news

(('oll/illlll'd 1;'0111 I'"ge IV)

You don't Have To Be A Communist
To Love Your Brother, OHA Told
Toronto, Ollt. - After a recent trip
to China as leader of a Canadian med-
ical delegation. Dr. Gustave Gingras
told men
bers of the Ontario Hospital
Association October 2(). "You don't

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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 objections to grown
men being paid $40,000 or S50,000
per year to playa boy's game on ice or
on a football tÏeld. "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 puhlic 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 criti
ally 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 rehahilitation cen-
ters have one or mure 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 eaeh decubitus
ulcer costs the tax payer $1 ('-000 to
$15,OOO'!""
As an authority on rehabilitation,
Dr. Gingras emphasiLed that the needs
of the many Canadians who are over
65 "far exceed those of our young popu-
lation:' The health profession.he said,
has to "combat the deplorahle 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
()l1awa - A nurse consultant with the
American Cancer Society cautioned
nurses October 13 to avoid acting in
ways that could make a patient
ear
death feel he is no longer useful.
Instt:ad of referri
g to death by
euphemisms. if it is mentioned at all.
(COII/illlled Oil flage 151

FEBRUARY 1974

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result of this superior
containment, shirts,
sheets, blankets and
hed pads don't have to
he changed as often
as they would with
convc
1tional cloth
diapers. And when less
time is spent changing
linens, those who take
care of babies have
more time to spend on
other tasks.

. d

Po
Þel's

,

....

\

'""

..

\
'

...

PROCT.ER II GAMIILE CAR.HZ

R_ Nama Pins.. .11_

uallty, IIIIoIrUSt styling.
wIth salaty c'a.ps. Naw
opt,ona' D........ finish wIth
contrasting utln ....kl'Ound
and polished .....s tar I

tf{.
.Jtr
MRS. R. F. JOHNSON
SUPERVISOR

CHARLENE HAYNES

-\1
'

--

'OHN, L.f?N. l\

NURSES PERSONALlZED
. . 05eJù . pe.R
ANEROID SPHYG. _.-

.

A superb instrument especially I
designed for nurses! Imported from pre-
cision craftsmen in W_ Germany_ Easy-
to attach Velcro cuff. lightweIght, com- /
pact, fits into soft sim. leather zipperec
case 21,7" x 4" x 7". Dial calibra-
ted to 320 rom., 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
tlermanent identification and
distinction. A wise investment for
a lifetime of dependable service!
No. 106 Sphyg. . . . 37.95 ea.

:' / Duty

free

CAP ACCESSORIES
____,
CAP TOTE keeps your caps crisp and clean __
while stored or carried. flexible clear plastic, white
trim, zipper I carrying strap, I1ang loop. Stores flat Also --
for wiglets. curlers. etc. 81,7" dia_. 6" higl1.
No. 333 Tote. . 2.65 ea., 6 or more. . 2.35 ea.
Your initials gold-stamped, add SOli! per Tote.

WHITE CAP CLIPS Holds caps
.
flrmly in place! Hard-Ia.flnd white bobbie p
ns.
"-. - enamel on fine sprin, steel. Eight 2" and eight
..
3" clips included in plastic snap box
No. 529 Clip. . . . 3 boxe.lor 2.25,
\:' 6 for 65. ea., 12 for 60, ea.
MOLDED CAP
4
Replace cap band instantly. Tiny plastic tac, - ...

dainty caduceus. -thoose Black, Blue. White _
or Crystal wit" Gold CeduceUSi Dr all Black ,- - -'.. -.

(plain). The neater way to fasten bands. : . -. ---f

':'
:r
t ::t
1

'pi/s
t5 perset.
o:-- .' \

r::'N'I .,., METAL CAP TACS Pair of dainty

, jewelry-quality Tacs wit" Rnppers. holds cap
(illRI bands securely. Sculptured metal, gold finish,
... . approx.
" wide Choose RN, LPN, LVN, RN
po ...... V..- Caduceus or Plain Caduceus. Gift boxed.
ntvF.f1 .t{
No. CT.1 (Speclly Initial.), No. CT.2 (Plain

-vLU L"'" Cad.) or No. CT.3 (RN Cad.) . . . 2.95 pro
SEL-FIX CAP BAND Blackvelvet :-----..
band material. Self-adl1esive, presses on, L 1
.
pulls ofl; no sewing. or pinning. Reusable ,... __
several times. Eacl1 band 20" long, pre-cut to \
popular widths: 1/4" Cl2 per plastic box) 1,7"

p:c

y b
t

J:r

É
o:
I
;n

u

B nd. . . ,er box 3 or more. .1.50 ea.
CROSS PEN - -.....;
'""'''
' ,J(a
"''' ro '
World-famous ballpoint, with
, .
scu
tured caduceus emblem. Full name _
::
III:

e:v

.(ili

::
:r:

:e
ouponJ.

No. 3502 Chrome B.OO ea. No. 6602 12kt. G.F. 11.50 ea.
.. I .

ORDER ND.

CDLDR I SIZE QUANT. PRICE
I

ITEM

.
I
.
t

INITIALS as desired, _ _ _
(Good idea. . . for distinctive identification)

TO ORDER NAME PINS, fill out all inlormatiDn in box top
right, clip out and attach to this coupon.

I enclose $ (M.... resIdents add 3% S. T.)
Sorry, no COCos or billing terms available

Send to .....

Street

,

...;-Btm

r---------- --------------------------.
IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS!
I Cl100se style you want, sl10wn left. Print name (and 2nd bottom left. Attacl1 extra sl1eet for additional pinS. I
I line if desired) on dotted lines below Cl1eck otl1er Info in NOTE
AVINGS ON 2 IDENTICAL PINS . more convenient, I
I boxes on cl1art, clip this section and attach to coupon spare In case of loss. I
I LETTERING,______________________ 2nd LlNE,________________1
I STYLE DESCRIPTION METAL "HAL I'
OCL

UNO LUTEalNC "ICES' I
I filO. COLOR fiNISH (Pbstiel COLOR Elliraveill1 LI., Elllrøtd 2 lines I
I ALL METAL... nch, trim and 0 Gold 1 0 Duolone Does I 0 Black 0 I Pin 2.25 0 I Pin 3.00 I
. . ;
c::.
o

I

mooth 0 Silver IS

:

hed a

y IS

I
:ue 0
s

sn;:e
0
:;
esn:;e

Does I DWhlte
o

c:1 0 1 Pin .95 0 I Pin 1.55
not 0 Med. Green . ue 0 2 Pms 1.65 0 2 Pms 2.60
apply 0 Med. Blue White CYme name) (yme namel
OCoroa lettpr.. only
White I 0 Black 0 1 Pin 2.25 0 I Pin 3.00
only 0 Ok Blue 0
P
.. '
;e
0 2

s n

White I 0 Blacl< U I Pin .95 LJ I Pin 1.55
only 0 Dk. Blue 0

n

e
0 2
ins 2
e

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

..lIrtII
tit
..161

.

PLASTIC LAMINATE . slimmer.
broader: engraved thru surface to
)ntrastmg core color. Beveled
border matches lettenng.

..

METAL FRAMED. . ClassIC 1 0 Gold
::OSlli!n. snow.whlte clashc with 0 Silver
MOLDED PLASTIC 5..m..,le,smcut, DO.::5
onomlcal Will never discolor. not
Ie ply

IIIPlease add 25_ per order for 3 pins Dr less.

MEDI-CARD SET HandIest refer.nce
-' ,
-,
. - "', ,""",.

med with mformatlon, IncludmK EQuIvalencies of \. ,
Apothecary to Metnc to Household Meas., Temp. ,_... .....
oC to of, Prescrop Abbr., UrmalySlS, Body Chem.. \ 1 \
Blood Chern., Liver Tests, Bone Marrow, Disease
Incub Peroods, Adult Wgts
j I
AU In wl1lte vinyl holder with Kold stamped l
_
l
caduceus No. 289 Card Set. . . I_50 ea.
"'S
6 Dr more 1.25 ea. 12 Dr more 1.10 ea.
Your initial. gold..tamped on holder,
add 50. per set.
./' KELLY FORCEPS SO handy for

every nurse! 51,7" stainless steel, fully
=+

6 guaranlead. Id.al for clampmg off tubIng YOUI
. own Imtlals help prevent loss.
. eA R No. 25-12 Forceps. . . 2.75 ... 6 Dr more 2.50 el.
Your Initials enrraved, add 50tl per forceps.

. ...

Your
Initials

l:
.
ed "
Free
Scope
Sack

,

þ

Ii

-

1

Free Initials and Scope Sack
with V1nß' own
Littm
IJNJj NurteteOpe I
Famous Littmann nurses'
diaphragm stethoscope . . .
a fine precision instrument,
with hIgh sensilivity 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
lubes and chest piece beau-
tifully styled in choice of'S
jewel-like colors: Goldt.ne,
Silvertole, 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 SOt if inllials de-
sired.) Nole big savings on
Quanl,ly orders.
No. 216 Nursescope.. .13.80 ea. ppd.
6-11 . . . 12.80 ea. 12 or more. . . 11.80 ea.

Group Discounts
free Initials and Sack!

oIMPORTANT, New "Medallion" styling includes lublng In

colors 10 malch melal paris. If desHed, add $1. ea IO:J
plOces above; add "M" 10 Order (No. 216
) on coupon.O
No. 223 Scope Sack only. . . 1.00 ea. ppd.
6 or more 75
ea. Gold stamped initials, add 50

.,..
. 1,;., ......

1.-.. rl ..:.. _ .... --(-

Does
not
apply

Polished
frame
only
Doc

not
.,

3V." LISTER MINI.SCISSORS

'tmy, handy, shp mto uniform pocket or
purse Choose Jewelers Gold or gleammg
Cl1rome plale fmlsh on coupon
BeL No. 35DD Mini.Scissors . . . 2.75 ea.
4V." or 5V." LISTER SCISSORS
As above. but larger for bigger JObs Chrome finish only
No 450014%") or No 5500 (5'/2"1 Scissors. . . 2.75
5'12" OPERATING SCISSORS _ .

Stainless steel, with sl1arp/blunt ._

-'"
pornts Beautifully polished finish

No. T05 DR Scissors . . . 2.75 ea. -
All scissors .3bowe: 1 dOl. or more lany style) . . _ 2.00 ea.
Your Initials engrawed, add 50c per scissors.

CLAYTON DUAL STETHOSCOPE light.
weight imported dual scope; highest sensitivity for apical
pulse rate. Chromed head tubes and cl1est piece with ,
Jl/," bell and F/s" dlapl1ragm, grey anti-collapse .....-.. tri..

:

g
O

'c
u

J
;
oE

I
i

r :

:v:
dfree. @ ty
No. 413 Dual SteU1. . . . . . . . 17.95 ea. ree
JEWELRY NURSES CHARMS 'Q,
Fmest sculptured Fisher cl1arms,

}
Sterlmg or Gold Fillea (specify under COLOR on coupon"
.. ..
For bracelet or pendant cham. Add to your collection! I
t:'\ f ;
No. 263 Caduceus; No. 164 Cap; No. 68 J""
=
;.; N
.4BKB;
Ê
C

0
..Ë:

GS {
f\
-"
!:;'t'J Damty. detailed 14K Gold caduceus. for on or ()fl duty
.. "s.u wear. Shown actual size. Gift boxed for fnends. too.
If No. 13/297 Earrings. . . . . . . . 5.95 per pair.
PIN GUARD Sculptured caduceus, chained

f:
rC:

eò
io;:
lal

t:

he

rth w

st
rna;

safely. Gold finish, gift boxed. Choose RN, lPN
or LVN No. 3420 Pin Guard. . . . 2.95 ea.
(,.IDì ENAMELED PINS Beautifully sculptured slatus

I insignia, 2-color keyed, hard.fired enamel on gold plate.
I.'m\ . O,me.sized, pin.back. SpecIfy RN. LPN, PN, LVN, NA. or
(!F,
:. ;
5co

. Pin 1.95 ea.. 12 Dr more 1.50 ea.

.

Endur3 NURSE'S WATCH Fine Swiss.made
waterproof timepiece_ Raised easy.to-read wl1lte numerals
and hands on black dial, luminous markings. Red sweep.
second l1and. Chrome fmist!. stainless back. Includes
black velvet strap. Gift boxed, with 1 year guarantee
Very dependable. Includes 3 initials enaraved FREE!
No. 1093 Nur.e. Watch. . . . . . . . . . . 19.95 ea.
. · .. Prevent stains and wear! ïJ
@. smooth'PliablepurewhiteVinYI'ldeal
low-cost group gifts Or favors. .,.
I No. 21D.E (right). two compartments
wltl1 flap, gold stamped caduceus. . .
6 for 1.50. 25 or more 2D. ea.
'- 0 . MI. 191 Deft) Deluxe Saver, 3 compt.
. '-../ change pocket & key chain . . .
6 for 2.9B, 25 Dr more 35. el.

D Nurses' POCKET PAL KIT
,::) .. Handiest for busy nurses. Includes white Deluxe
Pocket Saver, wltl1 5" Bandage Shear (botl1 sl10wn
opposite page), T ri.Color ball-point pen, plus
U . \ . handsome IlttI. pan light. . . all silver fInished.
o Change compartment, key chain.
, No. 291 Pal Kit . . . . . . . . 4.95 .a.
3 Initials enaraved on shears, add 50, per kit.

Bzzz MEMO-TIMER TIme hot pa<:ks, heal. dJ "
lamps, park meters. Remember to check vital siJns
. , ,.
give medication, etc. Lightweight, compact n 1,7" dlaJ,

sets to bUll 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.

D ) EXAMINING PENLIGHT

White barrel with caduceus Impnnt, aluminum
A.
".}, band and chp. 5"' long, U.S. made, battenes mCluded Cre-

...... placement batteries available any store). Your ownligt!t, gift boxed.
No. 001 Penliaht. . 3.98 ea. Your Initials IInaraved, add 50, per IIKht

"""--". . ___--.ttlme_.

Whittenton /åðhionJ
Uni/ornt

,

.REEVA
Young fresh multi-tuck bib. 2-
button cuff Gusset
4 sleeves
100% Dacron Double-Knit
STYlE No, 4697
6-20,4.16 Petite... 22.95
14V,.261,7. . . 24.95
75 0 0 08cron/25% Cotton
STYlE No. 4797
6-20,4.16 Petite... 16.95
14';'.261,7 . . . 17.95

..

.1

.

MISS FIVE.
UniQue smock style with a little
girl look Generous patch pock-
ets. inner surgical pocket
Sl10rt sleeves. 100% Dacron
Double Knit
STYLE No. 4632
314.15/16...21.95

\

r-

...
.GIBSON GIRL
Youthful high rise waist, mini
soft shirred skirt. pleated
blouse. Inner surgical pocket
100% Polyester Warp Knit %
sleeves
STYLE No. 4624
314'15/16...1B.95
60% Dacron, 40% Nylon cord
Jersey, short sleeves.
STYLE No. 4824
3/4.15/16.. .15.95

(

(

Famous
NURSE
MATES'"

hoer

New "Saucy" Bump Toe Moc
Little fashion notches run around sole and
l1eel; latest bumper-toe look witl1
n -- b1i bOld eyelets; sturdy extra light
, cushion crepe sole and heel; finest

long.wearing wtlite glove leall1er
"'\... .. '- . _ the ideal sl10e to feel pretty
... . '- in uniform. Fit guaranteed
.' Dr return (unmarred)
SIZES: '-
forsizeexcl1anRe.
UorA;a.11
B, C, D or f; 5-11 . No. 854 Saucy Shoe
1S,Ic"""'_
1 -.....,... ..,.... ...16.9Spr.

New "KorkPLit
Featherweight Style

II

: cõm

h

: I

:. /
up l1eel oxford. Thick sim. cork sole "'"'-I;... "C..
with II/s" cork heel (very slip resistant,
. _ ;J

outwears crepe). White washable 'V).' '?
soft glove upper leather, tncot

/ " .
Imed, arch vents. Fit guaran- ._
teed Dr return (unmarred) "=
for Silt exchange. I
I SIUS:
No. 638 Kork-Lite Shoe
....0' .. loll
. 16.95pr. rs,.u,.IN.......1 .
':r.::f5:;:

All-Weather NURSES' CAPE

é@Æ ..;

'ì:'
' 1.
'\ "

Stay snug in cool weather, dr
in the ram
Traditional Navy with Bnght Red hnrng
Fmest tallonng of 65% Dacron polyester,
35% combad colton. Zepel treated 100%
Nylon Duralyn hnrng. Snap fasteners. arm
openings. Matching head scarf SMAll (up to
34 bust). MEDIUM (35.38) Or LARGE (39-42)
. specify size on coupon.
No. 658 Cape . . . . . . . 14.95 ea.
3 GOld Initials on collar, add 1.00 per cape.

NU
_
: '... A lifetime of service
for visiting nurses! Fmest black
" thick
genuine cowhide, beautifully crafted with
ruued sfltched and rivet construction.
Water repeUant Roomy Intenor. with snap.
In washable tlner end compartments to

organize contents. Snap strap holds top

open durini use. Name card holder on end.
Two ru..ed carrYing straps. 6'f . 8" . 12".
\ :

:t

:

s
:I
e eo

:

:

t

top. An
No. 1544-1 Bag (wIth liner). . 37.95 ea.
Extra liner No. 4415. . . . . . _ .6.95 ea.

\ .

news

(COllltI/lH'cll;'OIl/ I'llge J:!)
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 hy the universi-
ty's school of nursing and the Canadian
Cancer Society.
Patients have "a curious way of meet-
ing our expeetations:' she said. "I l' 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. Barcklcy told her audience that
one of the bonuses of nur
ing i

eeing
"the heigh\!-. of nobility that our fellow
human beings. under the greatest ima-
ginable stress. can and do reach."
In the cancer situatio;l. there are
many way!'. 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. deper!'.on-
alizing them. . . ...
She suggested that nurses "can en-
courage t
lmilies to turn to patienb for
advice. Unable to serve those the) love.
the patient
then have a scnse of still
being needed and wanted. Through
prescrving the role for the patient that
was alwa)s important to him. we make
it possible for him to die with dignity:'
In M!'.. Barckley's opinion. what
nurses say to patients i
never as im-
portant as what the) let patient!'. tell
them. She also places more importance
on the feeling with which communica-
tion i
made than on the words.
In her conelusion. the speaker point-
ed out that one of the chief ta
ks in
nursing "is to help patients, threatened
by physical suffering .lIld inner tur-
moil, to maintain their individuality."
She said nurses
hould rem em her that
many patients meet death \\ith a digni-
ty that enriches the lives ot everyone
around them.

Hospital Launches Campaign
To Help Victims Of Child Abuse
/"orOI/IO, (JI/I. - A new campaign to
save victim!'. of child ahu!'.e and help
their familie
has heenlaunehed h\ The
Ho!'.pital 11)1' Sick Children. in co
lper-
ation with the Catholic and Metropol-
itan Children'!'. Aid Societies.
Any nurse or doctor who <;ee!'. a case
of suspectcU ahuse 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 informalIy with
the families involved. Instead of making
accusations, they wilI 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 facil it ate the referral of famil ies
to many of its services, which include
day-care centers and visiting home-
makers.
In 1972, the hospital treated 100
abused children, five of whom died;
the Children's Aid Society investigated
15.000 possible cases of neglect or
abuse.
Dougléls 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
ih power to "break this vicious cycle,"

U.S. Nurses Will Show Muscle
When ANA Forms Political Arm
1\.1Imas Cil\', Missouri - The Ameri-
can Nur!'.es: Association i
estahlishing
a nonpartisan. political arm that will
enable nur!'.es to exercise more pol itical
intluence nationalIy.
fhe purpose of thi!'. new unit i!'. to
educate nurse
and other per
ons on
pol itical is!'.ues. help nurses and others
organi7e tÌ1r effective political action
and for carrying out civic responsibili-
tic!'.. and rai!'.e fund!'. tl)r 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 "ideaexchange"
page.
Put your ideas on paper now!
Forfurther information write:
Editor, The Canadian Nurse,
50 The Driveway,
Ottawa, K2P 1 E2.

THE CANADIAN NURSE 15
.

o

MONT SUTTON commands the highest peak
within a radius of 100 miles of Montreal.
20 miles of trails and slopes, 6 modern 0
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 tlckels 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, Québec
Tel.: (snow reports). . (514) 866-7639
(514) 866-7718
Accommodation .... . (514) 538-2646
Office, . . . . . . . . (514) 866-5156
(514) 538-2545

16 THE CANADIAN NURSE

news

didates who have supported issues im-
portant to nurses. fhese arc areas not
open to ANA.
The unit will not lobby or take its
own po
ition on issue
. but will be
guided in its actions by .'\NA policies.
Although ANA will provide some of the
financial
upport. eontri but ions arc
also expected from interested individ-
uals. The organiL<ltional details have
not been announced yet. but some
ANA board members arc expected to
be on the unit's board of director
.
For some time. legally
parate.
political action arm
have been working
with state nurse
' as
oeiation
in Cali-
fornia. Colorado. and \Va"hington.

St. John Ambulance Offers
Bursaries For Master's Study
Ottawa - St. John Ambulance offers
one or more bur
aries of $1.000 from
the Margaret MacLaren Memorial
Fund. awarded annually. to experienced
registered nurse
fÓr 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 7 L2.

New Nurse Practitioner Program
Begins At U. Of Saskatchewan
Regil/a, SaSh. - A ne\\ nurse practi-
tioner program begin
March \. 1974
at the University of Sa
katchewan'"
college of nur
ing in Sa
katoon. The
program will prepare experienced
nur
es to give primary medical care
in rural communities that arc without
re
ident doctors.
To begin. only four nur
es will be
admitted to the program. which eon-

ists of a six-month training course and
two years of service in one of four com-
munities. fhe training program i

de
igned to prepare the nurses to as-
sume an extended and independent
role as member
of the health care
team.
When the nur
e practitioners com-
plete the two-year employment period.
the program will be evaluated and a
decision made about whether to expand
it. The Sa
katehewan government is
financing the training course and the
employment program. A committee

respon
iblc for the program eonsish of
repre
entative" from the Saskatche\\ ,Ill
Regi
tered Nurses' Association. Sas-
katche\\an Medical A
"ociation. col-
leges l)f nursing and medicine at the
Saskatoon campus. and provincial
department of public health.
The four rural communities chosen
as demonstration areas - Marylïeld.
Leroy. Fox Valley. and \kadow Lake
- arc repre
entative of comll1unitie

that have difficulty obtaining primary
medical care. Community health and
social centers arc operated by the Mary-
field and Lerov eommunitie
.
All four núrse practitioners will be
employed by local boards in the com-
munities and will \\ork elo
ely with
doctor
in nearby centers. The nurse
who serves the Mcadow Lake area will
also
erve fÒur other areas on a visiting
basis. fhcse nur
e
will be the health
workcr
of lïr
t contact. pro" iding
initial a
ses
ment and screening pa-
tients. giving immediate treatment li.Jr
minor condition
and emergcncy treat-
ment when necessary. and referring pa-
tient
to doctors lix further treatment.
fhe colleges of nursing and medicine
at the U niversit\ of Saskatehe\\ an arc
cooperating to gi"e the training PIO-
gram. Four major courses m<lke up the
curriculum; they include theory and
practice. as \\ell a
a period of supervis-
ed experience \\ ith a phy
ician. The
cour
es relate to diagnosi
. management
and treatment of disea
e. counseling
and teaching health maintenance. and
ethics. roles
and rclationship
.
N urscs interested in receiving further
information or in applying to the pro-
gram
hould write to 1V1s. i\1.E. Craw-
ford. Associate Professor of Nursing,
College of Nursing. University of
Saskatchewan. Sa
katoon S7N 0\\ O.
Pn:fcrenee in
electing candidates will
be given to nurse
\\ ith experience in
a rural setting and in publ ic health. \d

Going
on
Vacation
?

YOU'LL ENJOY IT
MORE IF YOU +
GIVE BLOOD
BEFORE YOU GO.

FEBRUARY 1974

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....

j

o

o
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o

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· Gives relief from itching
· Supplements natural skin oils
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· Is economical

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FEBRUARY 1974

ruE CANADIAN NURSE 17
.

The Davol story on suction catheters
begins at the end.

At the end of our catheters, you'll
find an exclusive anti-traumatic tip
that's extra gentle to sensitive
mucosa.
It's a big difference, and one that's
made us the number one supplier of
plastic and rubber catheters.
But it's not the only difference.
Our latex catheters are easy to
insert. And they're the softest
catheters made.
Our plastic catheters have a
special slip finish that slides easily
through endotracheal tubes.
All have raised control vents to
BUILDING ON A CENTURY OF QUALITY
HEALTH CARE PRODUCTS

keep exudate from contaminating
fingers.
And all are packaged individually
in see-through, peel-back packs, and
are also available in cath/ glove kits
and tracheal suction trays, and as
our innovative Cath 'N Sleeve.
No doubt about it. Davol makes a
lot of difference. And that's where
our story really begins.
Davol Canada Ltd., 1033 Range
View Rd., Port Credit, Ont.,
L5E-1H2 (416)274-5252

DO 1874-1974

-

Can you see an analogy between the
suburban housewife, who has been
saving for an original oil painting to
hang above her tireplace. and the nurse.
who studies and works diligently until
graduation day when she receives her
diploma or degree'?
The housewife finds the painting
she wants at a price she can afford.
she completes the transaction. and
hangs her treasure to be admired t'ör-
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-
thelcs.'i deserved. Although less preva-
lent than formerly. the belief still exists
<lmong 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 regulation

to be considered when assigning duties
for today and planning for tomorrow.
For many of us, this routine remains
FEBRUARY 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.

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 docs this lackadaisical attitude
toward continuing education exist on
a continent where nurses call thcm!-.elves
professionab"! In part. it exist... becau!-.e
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. \ldcDougali. a graduate of SI.
:\Iartha'
Ho
pitaJ
chool of nur
ing.
Antigoni
h. Nova Scotid. and the po
t-
grdduate clinical cour
e in ps\chiatric
nursing at the Allan I\lcmnridJ Institute.
I\lontreal. received a A.I'<. trom I\kGill
University. She says, 'The article i
the
re
ult of three }edr
' experience in in
er
vice education and of nUmerou\ di
euv
sion
with colleague
- nur
ing st,llf dnd
nur
ing admini
tr,ttor'. :\h \lacDougali
ha
recentl} ,Iccepted ,I po,ition with the
department of natiûndl health dnd welfare
to work in public health in Inuvi". 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 staftìng? 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 a

tatistics do not
differentiate between number of nur
-
ing hours and number of intelligently
spent nursing hours. Educational pro-
gram
arc luxury item
to be encour-
aged only when time allows some en-
richment of our job satisfaction.
If you doubt this, try to tell bu
y.
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

'orkshop. 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 I ives. between the ages of 20 and
60, working. Wouldn't patients benefit
if nurse
were more proticient in their
work and enjoyed it no less'! If we
believe that we ourselves and our pa-
tients would benefit from inservice
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 inservice educator.

Responsibilities of the director
First and foremost among the re-
!-oponsibil ities of the director of nurses
and her associates is active involve-
ment with the inservice educator in
setting up the programs. The resultant
programs will better reflect the priori-
ties and interests of both teaching and
administration. An inservice program
designed wholly by administration, or
wholly by teaching, will bc incomplete
and biased toward one set of priorities
or the other. The most direct ways in
which the director can show her support
arc by advertising the existence of such
program!-' to potential employees and
hy reminding newly hired employees
that attendance will be encouraged and
supported. She can also give evidence
of support by attending herseU'. If shc is
too busy to participate, can junior staff
members be criticiLed for not attending
for the same reason'!
The policy of the director, which is
conducive to the sueccssful function-
ing of an inservice program, could be
derived from the following values.
. Recognition that stimulation of
curiosity is a human need as basic as
arc 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 h..s been made for meeting the
need for stimulation, without symp-
toms that accrue from prolonged bore-
dom. Some of these symptoms are:
an entrenched helief in the validity of
nonchange, 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
establ ished 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 inservice educa-
tion programs cannot be successful
unless Iu policy of reimbursement fÓr
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 thcm. This replacement can be
provided by having head nurse ..nd
supervisory personnel take their turn
replacing junior staff on the wards ..t
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 df
their implicit message to staff: We are
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 nurscs and an ongoing
evaluation of formerly used methods,
a considerable amount of anxiety is
elicited from all membcrs of this
profession. Anxiety in the graducites
from the newer programs takes thc
form of wondering if they will be ..c-
cepted by graduates of the more tra-
ditional ..nd work-oriented schools.
Graduates of the latter schools wondh
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 lesscn them by bring-
ing groups together. She can best do
this by stressing the fact that wisdom
is derived from both tÒrmal study and
life experience, and that neither is
complete without thc 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
grad uates I ike 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, pcrhaps reluc-
tantly, and listen. But. if the educator
is skillful enough to eI icit 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 thcse initial reluctanccs 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
arc.
. Prohlem soh'il/g. Individuals are
most willing to learn what they need to
know at a particular time. An inservice
educator must realize she has an ohliga-
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 presencc. She will never
be ablc to identify areas of contlict if shc
remains closeted behind a desk in her
office.
Her availability to staff on the wards
will sharpen her perceptions ahout
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

r

A DIPLOMA IS NOT

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 inscrvice
educator. will provide more learning
than a situation in which the educator
gathers pcople together to say "this is
your problem. and this is my solution."
. 1
/lII/Ilil/g fàr procedures. All of us
experience some anxiety at the pros-
pect of breaking with established policy
and emb.lrking on a new course. How-
ever. the earlier people are consulted
and the more time available for accept-
ing .lI1d working out these feel ings. the
greater is the chance of success lor the
new program. The inservice educator
must. therefore, be prepared to inform
staff of changes in procedure or the
IIltroduction of a new operating policy.
To do this successfully, she mu<;t her-
FEBRUARY 1974

A N 0 I L P A I N T r N G!

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.
. Reil/forcell/cnt of old II/literial.
Knowledge and techniques previously
learned and not used frequently arc
likcl) to be ignored or forgotten. There
are several areas of learning in this
category that must not be fÖrgotten.
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 th.m do their colleagues
in a general hospital. A general review
for all nurses in this category. conduct-
ed at rcgular intervals. must be part
of an inservice education program.
. GCl/cral still/ulatiol/. rhis last area
is fourth in order but not in importance.
We would be dull indi\ iduals 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.
infÒrmed. 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 examinatiun of the cultural
background of patients whose culture
is different from ours.

Conclusion
I believe that within a fe\', years
inservice education tÙr nurses will no
longer be considered a luxury fÒr 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 optim istie'! 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 peuple
from various schools leads to sharing
and sharing leads to mutual problem
solving.
In addition. nurses arc becoming
more realistic business people \',ho
know that annual increments and the
ProSPL'Ct of job security. bal ring some
accident. arc not enough. 111l:y <II e no\',
beginning to demand less tangible
benefits. like job satisfaction. rhis ...al-
isfaetion comes m.tinly frnm challenge
and from creative involvement \', ith
their work. In an effort to achiew thi...
challenge and involvement, nurses .Ire
demanding continuousl) plOvided op-
portunities to learn. to quest ion. and
not to be relegated to a niche defined
on I} by their initial qualifications and
years of service. For these nurses. .111
inserviee program, ba...ed on coopera-
tion between education and adminis-
tration and IÙunded on the pI inciples
outlined. will become as integral a
part of their working day as the
collee
break ;

mE CANADIAN NURSE 21

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 undertaken
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
bccdme increasingly aware of the

hanging 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 i
professor of nursing. in
chdrge of the re
earch unit in nursing and
health. School of Nur
ing. I\h:(jill l'ni-
ver
ity. She i
a graduate of the Montreal
General Ho!-'pital ...chool of nursing. Dr.
Allen received a B.N.. I\IcGill Univcr...ity:
M.A.. University of Ch,c.lgO: 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
dre 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 al/ 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.
o To whom lI/ll I responsible? This will
determine
1.-'hat should be done and,
FEBRUARY 1974

therefÒre, lilY course ofllction.
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 hersel f because she is being pulled or
pU'ihed into action on two sides and
from opposing torces. Somewhere in
this conflict the nurse fecls she ought to
do something, but she is being pressed
toward 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
responsible to the hospital and ward
doctor with reference to the patient or
to the patient"s own doctor \\ho is an
outsider not on the staff of the ho!'>pi-
tal'! The outside doctor is concerned for
his patient"s welfare and requires
inti.,rmation on the plan of treatment
and the patient's progress.
What i!'> my responsibility to a co-
wor"er. a nurse who is ta"ing drug!'>'! I
wish to protcct her and prevent anyone
from "no'Wing but I have a responsibility
to the institution. too.
As a scho(,1 nurse, what is my res-
ponsibilit) to a teenager who is ti.mnd
to be ta"ing drugs or is in nl'cd of an
abortion'!
Am I responsible to bapti/e a sic"ly
newborn, ,I!'> indicated b) hospital
policy. or not to bapti/e him. o'Wing to
the critical nature of his condition'!
Am I to call the clergy for a d}ing
paticnt. according to hospital policy.
or to assess the need., of the patient
and to follo'W them'!
What is my respon!'>ibil ity to the
paticnt who is having an abortion
(consent signed by the dl'ctor) and to
the husband who should legall) "now
and agree to the abortion. although the
hlhband i!'> not the father of the child'!
\Vhat is my responsibility to the idea
of one doctor-one patient ver!'>us the
real situation: three doctors caring tÓr
one patient. preoperativel}. during the
oper,nion. and postoperativel) '!
FEBRUARY 1974

01 ÁnoH' what should he done, hut
what course (
r lIction should ItaÁe?
A small number of responses con-
cerned themselves with a problLill with-
in the selL the individual "new she
should act in a certain way and she
either did act in that way or did not. or,
in some cases. she withdrew from the
situation. In no case was there conflict
within the person as to what should be
done. N ur<,es described thc following
situations as raising ethical problems.
A sterilization procedure is frequent-
ly carried out fÓr women who are said
to be intolerant of the pill. However.
the nurse discovered that they were not
intolerar
t of the pill; th is reason was
given so that the procedure could be
charged to hospital insurance.
Reporting of medication errors is
not possible because many of the errors
are made by blac" nurses. Blac" nurses
cannot be reported because the nurse
reporting 'Will be said to be discriminat-
ing ,md will be called up by the Human
Rights Commission.
Nurses are a'i"ed to add the drug to
IVs to initiate an abortion. ( fhe nurse
decided she would nurse these patients
but she would not initiate the abortion.)
Nurses are as"ed to teach birth con-
trol.
Of all the respon!'>es thdt were for-
warded. onl} three nurses experienced
eth ical problems related to the negation
of the human person or to inhumanity
in dealing with patil'nts. These ex,lmplcs
centered around the harassment of the
agcd and chronically ill in an institu-
tion. the battering of bahies in an infant
ward. and the destruction of the fetus
in !'>urgical abortions.
DIn gcncral, the quality (
r ('tIrc i.\
l/Il.\at i.
/àctory. Whllt ('tin I do?
Other problems related to difficult
situations in which d \\hole group ot
pcople and. in 'iome instances. the
institut ion a!'> a whole was described b)
the nur!'>e as sanctioning and condoning
factors that produce exceedingly poor
care for patients; for example, dirt.
filth. coc"roaches. inadcquate linen

uppl). 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 contlict 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 'W ith
the eth ic of the individual versus the
ethic of the group. with the problem of
life .lnd death. such as maintaining lite
lor long periods in nonresponding
individuals. euthanasia. or with the
ethical considerations experienced in
nursing patients with organ transplants.
In real it). it wlHlld appear that
nurses seldom experience ethical prob-
lems. In the first instance. the nurse.
if she "new how to determine to \\ horn
she 'Wa.'i responsible, 'Would then "nO\\
\\ hose direct ive shoul d be fÓllowed. In
the second instance. the nurse believes
that !'>he "no'Ws what the ethical
behavior !'>hould be; the problem lies in
hO\\ to get other people to behave in
this ethical fashion.
'

I he ,Iulhor an,.I}LeU the material recei\úl
from re
ponucnt" ,II1U a"umc,. f,'r thi,
rea,on. full re"p,'n,ihilit
tor thc content
of thi" allicle.

THE CANA IAN NURSE 23

When you visit a sick friend__ ___

--

è
I
I
li

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

"00 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)

Rl'I'i
ed hy A.H. \elddd, M.D., Ph.D.. F.C/I

In laborator) mcdicinc, approachcs and
tcchniqucs arc changing morc rapidl)
than in am othcr branch of mcdicinc.
At prcscnt: automation and thc increas-
ing usc ,)f various t) pcs of data proccs-
sing unfortunateh tcnd to automate thc
patient ao; \\cll.- In addition. highl)
spccial iled units and scrvices. \\ hich
are coming into bcing at an incrcasing
tcmpo. are also hcavil) dcpcndcnt on
laboratory data. Thcsc includc intcn-
sive care: cardiac un its. hem od iah sis.
opcn hcart surgcr). organ transpldnts.
and so on.
It is. therctÙrc, pertincnt that thc
medical team. especialh the nup,ö.
have a better undcrstandi ng of the sig-
niticancc of o;pccilïc labor.uory data 'io
thc \\clfare of thc paticnt. rhcrcforc,
thc 1()lIm\ ing condcnsed information i"
prcscnted.

A numher of changes. additions. and
deletions have agailï hecn nccessar)
Seq uencc jo; based on the usual adm inis-
trative arrangements in the laboratOJ).
The ordcr. ho\\cver. is not nccessarily
the order of importdnce.
Hcmatolog)
Blood Ban"
Biochcmistr)

Function test<.
M icrobiolog)

- se
um and plasma
- unne
- cercbrospinal
Iluid
and im e"tigations

Tests identified by proper names
The use of a man's name lor labor-
mon tests lÎ.Jrtunateh is on the \\ ,1\
out: along \\ ith outm
xlcd tests. Htm--
ever. son1e still persist and tho".: most
commonl) used 1'0110\\ .
R(,lIce-Jo/l('.\ pro!eill - the ahnormal

FEBRUARY 197..

protein found in the urine of about
50 percent of patients \\ith myeloma
RodelllsJ"y IIl1i! - thc amount of phos-
phatasc rcquircd to libcratc I mg.
of pho"phoruo;; tCO;1 rcsult for al"al ine
or acid phosphatascs (SCC alst) Sigma)
Cool/lhs - a tcst used in prcgnant
\\omcn and ne\\ horn infant" reldti\ e
to Rh o;ensiti/ation; also used in
hemol\ tic anemias. and so on.
DIIJ"e --a method I()r dctcrmining thc
blecding timc of a paticnt

I\a//Il- a töt for s)phili"
Killg- -'lrll/.HrOllg IIl1i!- an amount 01
phosph,ltase rcquired to liherate I
mg. of phcnol: test rcsult for al"alinc
or acid phosphatases
Lallge's Colloidal (jolcl- a tc"t on
C.S.F. as an aid in diagnosis
\.1o.\('lII/wl - a t\\ o-hollf specific gr,l-
vit) volume tc"tl()r e\ aluating "idne)
function
Papallicolaoll - ,I tcchnique for ident-
il
ing cancer cells
Palll-R/IIlIId/- d serol,)gic,11 te"t t(JI'
infectious mononudco':-is
R/llI/ple-Leedc - not a 1,lhur,ltor) tc,,\.
hut ,I method to dctermine capillar)
fragilit) b) inllating a hlood pres"urc
cuff and counting thc petechi,le in
a cireum"cribcd area of s"in
Schillillg - a radioi"otope te"t I()r
pcrniciou" ,lIlemia

Dr. \\ .It''OIl. 10lmerh Prok",nr and He,ld
nl P,llh,)lt)gic.11 ( hemi"lr\ .lIld Seninr \,-
,nciale in :\Iedicine. I acull\ ,)t \JediclIle
l nihT,il\ nt \\ e,lcrn OIlI,II'in, .lIld Cli-
nic,1! P,(lh,)lngi'l ..II \ icwri,1 H,,,pil..ll.
died J une
(). 147
. Dr. 'eutcld. Prote"
,nr I--me,itu,. I .ICUIt\ ,.1 :'\Iedieine. lini-
\ er,"\ 01 \\ e,lern Ont.lri,), ,uecceded Dr
\\ .,"on .r- Plofe",,,' In I YhO

TIn CANA IAN NURSE 25

Sigma - the amount of phosphatase
required to liberate I mg. of phos-
phorus: test result tix al"aline or
acid phosphatases (see abo Bodan-
!'>"y)
Wa.uermallll - the original test fÒr
s) phylis
.
It ntergrell - a technique for perfÒrm-
ing the R.B.C. sedimentation rate
Widol - a serological test for typhoid
and paratyphoid fever!'>
Wimmhe - a special tube for deter-
mining red cell volume and sedimen-
tation rate
Zi('h1-N('e1
ell - a stain for acid-fast
bacteri a, usually for tubercle bacill i

Abbreviations and symbols
ABO - the main blood group syslt:m
Ac. - acid
A.C .D. - anticoagulant used in pre-
serving blood (acid-citrate-dextrose)
ACTH - adn:nocorticotrophic hor-
moll\.:
.\.F.B. - acid-fast baccilus: a char-
acteristic "taining quality of the tu-
bercle bacillw.
AII...- al"aline
B.S. - blood sugar
BSP - bromsulphalein: a liver func-
tion test
B.T. - bleeding time
Bl'N - blood urea nitrogen
C. - centigrade
Ca - calei'úm
cc. - cubic centimeter (not used now)
CI- chlorine
C.P.h.. -thc enLymc creatine phos-
p ho" i nase
Cr- chromium
C.S.F. - cerebrospinal tluid
Cu - copper
C.\.I. -cell \olume index
Difl'. - diflì:rential:used \,ith reference
to a smear of blood or C.S.F. to de-
term ine the types and percentage"
of white blood cells present
E("(; or FKG - electrocardiogram
EnT.\ - an anticoagulant. frequentl)
used in blood samples ti,r hem atology
EE(; - electroenceph.tlogram
Eos. - eo!'>inophil: a variety of white
blood cell
E.S.R. -er)thn>cyte !'>edimentation
rate
.... - Fahrenheit
F.B.S. - fasting hlood !'>ugdr
Fe - iron
FSH - follicle stimulating hormone
of the pituitary gland

. - gram
G..\. - ga!'>tric analysis
(;C - gonococcus. causative organism
of g0710rrhca

GI - ga"trointestilMI
II &. F'=- hematoxylin amI eo"in stain:
u"ed in the preparation of patholo-
gical matcrial fÒ, examination
1711C - 17-hydroxycorticoids
HCG - human chorionie gonadotro-
26 THE CANADIAN NURSE

phic hormone. present in pregnancy
(pregnancy tc!'>t) and malignant tu-
mors of the tcstcs
H
- mercury
H
h. - hemoglobin
5HIAA - )-hvdroxvindoleacetic acid
Ht. - hematoérit -
ICDII - isocitric dehydrogenase. a
tissue enzvme
Ig -the hlt;od immunoglobulins. such
as IgA. IgG. IgM. etc.
III - international unit
I.\'. - intravenous
K - potassium
17KS-17-"clOsteroids: urinary hor-
mones from the adrenal cortex and
teste!'>
L. or I. - liter
LnH - lactic dehydrogenase, a tis-
sue en7yme
L.E. - lupus erythemah,,>u!'>
L
mph. -I) mphocyte, a type of white
blood cell
MeH - mean corpuscular hemoglobin
:\ICH( - mean corpuscular hemoglo-
hin concentration
\IC\ - mean corpuscular volume
mEq./I. - milliequi\ alent per liter
m
.- milligram: see Weights
ml.-millilltcr. Iii 000 part of a liter:
apptoximately thc same as cc.. but a
more exact expression of measure-
mcnt
mOsm - milliosmole. 1/1000 part of
an osmotically active unit per liter
I\I
elo - myelocyte. the forerunner of
the granular !eu"ocyte

- nitrogen

a -- sodium

eut. - neutrophile. a variety of\., h ite
hlood cell
'I)
- nonprotein nitrogen
O 2 - oxygen
Osm - one osmotically active unit
(molecule or ion) per liler
P..\. - pernicious anemia
Pap stain - Papanicolaou stain tix
cancer cells
PHI - protein-hound iodine. and esti-
mation used in connection with thy-
roid function
pCO 2 - partial pressure of carhon
dioxide
pH - a symbol used to express acid-
ity and al"alinity
1)1. Ct. - blood platelet count
1)0 2 - partial pressure of oxygen
P.S.I). - phcnohulphonaphthalcin
kst. a method for assessing "idne)
function
R..\. - rheumatoid arthritis
R.B.L - red hlood ccll count
Rctic - reticulocytc. a young R.B.C.
RF - rheumatoid factor. pre!'>enl 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

S<;OT - serum glutamic-ox,lIacetic
transaminase

(;PT -serum glutamic-pyruvic
transaminase
S.G. - specific gravity
T 3 - an ill I'itm test for thyroid func-
tion
T 4 - a test fì.,r thyroxine. lhe thyroid
hormone
T.P.I. - Treponema pallidum immo-
bilization. ,\ specific test of scrum
for syphilis
TSH - thyroid stimulating hormone of
the pituitary gland
l'.- unit. a comparative weight mea-
sure
L..\. - urine analysis
l'r.Ac. - uric acid
\'DRL - tlocculation test for syphilis
\ M.\. -\anilmandelic acid. a test for
adrenal medulla function
W .B.C. - white blood cell count
Weights - I "g. "ilog. 10 3 g,
I g. gram
I mg. mill ig. 10- 3 g.
I mcg. 111 icrog. I U -6 g.
I ng. nanog. 10- 9 g.
I pg. picog. 1lJ-}2 g.
".R. - Wassermann reaction

FEBRUARY 1974

Determination

Autohemolysis

Bleeding time
(Duke)

Blood volume

Carbon mUlloxide
hemoglobin

Clot retraction

Coagulation
(clotting time)

Coagulation
factors

Differential
White ceIl count

FI:BRUARY 1974

Hematological Values

Most hematological allaly.\es are carried Ollt Oil blood collected âther ill (/ potassium-
amllollium oxalate or ill EDT A. t.'xceptiolls to this are the prothrombill alld partial
thromplostill time, collected ill fluid af/ticoagulallt, alld the LF preparatioll Oil dotted
blood. Usually fi'tJ/1l 3-7 mi. is adequate for allalysis.

Normal Values

Clinical Significance

0.5-3.6% without glucose
O.I-OJV( with glucose

differential te'it for
certa in anemias
(spherocytoxic)

1-3 min.

prolonged when platelet<;
reduced (as in thrombo-
cytopcnia purpura)

60-90 ml./kg.

increased in polycythcmia
vera: dccreased in dehy-
dration. shoc,," hcmorrhagc,
postopcratively, ctc.

none

in carbon monoxide poison-
ing or intoxication (car
exhau!'>t. etc.)

complete and perfect
in 24 hours

delayed and imperfect in
th rom bocytopen ia purpura
(platelet detìc iency)

!'\-IS min. (test tube
method); 1-5 min. (capil-
lary tube method)

prolongcd in hemophilia.
also aftcr heparin ad-
m i n istr at ion

"'actor VIII deficiency
Factor IX deficiency
other Factors

classical hcmophilia
Christmas disea'ie
other coagulopathie!'>. usu-
ally chronic

Mature neutrophils
52-7OCh ; 3.000-6J)()0/cu.mll1.
Young neutrophils
3-5 c (; 150-400
Eosinophils
I-4Cfc ; 50-400
Basophils
0-1.5 (( ; 15 -I 50
1 ymphocites
20-35 r ( (up to 50( ( m
childrcn) 1.500-3,000
monocyte!'>
2-6( ( : 100-600

increased in manv infections:
decreased in agr.;nu JoC) tosis

incrcascd in many aIlcrgic
condit ions

increascd in lymphocytic
lcukcmi.l. infectious mono-
nucleosi s. .md w hooping cough

THE CAN
IAN NURSE 27

Determination Normal Values Clinical Significance
and Notes
Fibrinogen 200-500 mg./ I 00 ml. decreased or prolonged in
Fibrindex -less than severe liver disease and
60 sec. 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- 120-240 mU'/1 Os R.B.C. Familial hemolytic anemia
6-phosphate (primarily in Negroes)
dehydrogenase)
Hematocrit Male. 40-547c decreased in the anemias; in-
Female. 37-47l',{- creased in polycythemia
and hemoconcentration
Hemoglobin Adult male. decreased in the anemias;
14-17.5 g./IOO ml. increased in polycythemia
Adult female: and hemoconcentration
12-15.5 g./IOO ml. (shock, burns, myocardial
Children. infarction)
11-13 g./IOO ml.
Infants (I day to 2 decreased in hemolytic
weeks). 15-22 g./ I 00 ml. disease of the newborn
( erythroblastosis)
Hemoglobin electro- HgA - about Y5 ri hemoglobinopath ies
phoresis HgA2 - <:3 r ,f (sickle cell anemia,
HgF -< 2C;;" (50-YW
in the thalassemias, etc.)
newborn )
Iron 60-150 mcg./IOO ml. increased in hemolytic
anemias. hemochromatosis,
high intake; decreased
in iron dctìciency
anemIa
Iron binding 220-400 mcg./1 00 ml. increased in iron detì-
capacity ciency anemia and late
pregnancy; decreased in
hcmolytic anemia, P.A.,
hemochromatosis
L.E. preparation none positive in lupus
eryth em atosi s

28 THE CANADIAN NURSE

FEBRUARY 1974

r

Determination Normal Values Clinical Significance
and Notes
Mean corpusclar 27-32 ng./IOO ml. increased in macrocytic
hemoglobin anemia {e.g" pcrnicious
anemia}; low in hypo-
chromic anemia
Mean corpuscular 33-3R 17i same as above
hemoglobin
concentration
Mean corpuscular 80-94 cubic micra same as above
volume
Partial thromboplas- 0.34% a test for hemophilia-
tin time (PTT) 60-70 sec. li"e states
Paul-Bunnell negative a test II.)!, infectious
{heteroph ilc monocucleosis
antibodies}
Plasma hemoglobin 0-4.0 mg./IOO ml. increased in hemolytic
anemia and other hemor-
rhagic processes (mis-
matched blood. etc.)
Plasma iron incorpor- 75% and over in 7-10 decreased In hemolytic
ation ( 59 Fe) days anemia; a measure of the
rate of formation of red
blood cclls
Plasma iron turn- 0.061 mg./day/g.Hg. important in study of
over (59Fe) iron metabolism
Plasma volume 34-60 ml./kg. decreased in hemoconcen-
tration; increased in
'>ome with hypertension.
Pagers disease. and some
other clinical conditions
Platelets 150.000-450.000/cu. mm. decreased in thrombocyto-
penia purpura and other
clinical conditions
Prothrombin time 12-16 sec.. reported mainly used in control 01
with control anticoagulant therapy

FEBRUARY 1974

mE CArMDIAN NURSE 29

Determination

Radioiron clearance
(59Fe)

Red blood eell
count

Red blood cell
volume (1311)

Red cell fragil ity
(osmotic fragility
test)

Red cell survival
test (with 51 Cr)

Ret icu locytes

Schilling test
(radio cobalt
Vitamin B 12)

Sedimentation rate
(Westergren)

Total body water
(tritium space)

30 THE CANADIAN NURSE

Normal Values
and Notes

Clinical Significance

T! -120m in.

decreased in iron defi-
ciency: increased in
hemósiderosis and apl as-
tic anemia

Adult male.
4-5 million/cu.mm.
Adult female:
4-5 million/cu.mm.
Infants.
5-7 million/cu.mm.
at birth. gradually
decreasing to adult
at 15 years

decreased in the anemias:
increased in polycythemia
and hemoconcentration
(shoc,," burns. myocardial
infarction)

2Y-33 ml./"g. in males
20-26 ml./"g. in
females

decreased in blood loss;
increased in polycythem-
ia vera and hemoconcen-
tration

hemolysis begins at
0.43'.:( NaCi
hemolysis complete at
0.34-0.3
.f NaCl

fragility increased in
hemolytic jaundice; de-
creased in obstructuvc
jaundice

Half-life: 25-35 days

decreased in hemolytic
anemias: a test for life
span of the red blood
cell

0.5-1.5(/( of all red
blood cell.,

increased in pernicious
anemia following Vita-
min B 12 therapy and in
hemolytic anemias: de-
creased in aplastic and
pernicious anemia

I {)l 'c and over
(urinary excretion)

this is a specific test
for pernicious anemia

\1ale: 0-9 mm./hr.
Female. 0-20 mm./hr.

increa<;ed in infectious
and intlammatory dis-
eases

50-7W I of body weight

increased in edema; de-
creased in hemoconcen-
tration (burns. shoc".
etc.)

FEBRUARY 1974

Determination

Values

Clinical Significance

Vitamin BI2

;>150 pg./ml.

increa
ed in acute and
chronic Iculo.emia. infec-
tious hepatiti
. liwr
cirrhosis: decrea
ed in
the anemias. malabsorp-
tion. malnutrition}

Blood Bank Values

Determ ination

Values

Clinical Significance

ABO groups

0-45 q of population
A-40 c e of population
B-IOC. of population
AB-5 c e of population

e
scntial to determine
he/ore blood transfusion

Rh groups

o - Rh pos. X5 c(- of pop.
d - Rh neg. 15 c { of pop.

important in pregnancy
The Rh neg. mother \\ ith
a possible Rh pos. fetu

mightlcad to er}throblas-
to
is fetalis: abo in
person
recelvlIlg re-
peated transfusion

Rh phenotypes

o cau
es most diffi-
culties in transfu-
sion: other" <C E)
may cause difficul-
ty in cros
match

difficulties are piclo.ed
up in d cros
match: in
rare instance
no cross-
match pmsible and then
blood l11u
t be given \en

IO\\ Iy with clo
e oh
er-'
vation

Cros
match

match ABO group: in
the Rh group. D:d

ö...ential in order to
eI im in ate transfusion
reaction

Antibody screen

screening procedure for
other Rh phenot) pes and
other blood grollp
-
:\1. KclL etc.

al11e ,I" Rh phenot) pe
:
abo in lì.ll'en
ic p.tth-
olog)

Coomh
te"t

a te
t for Rh anti-
bodies

Rh neg. mother \\ ith Rh
po
. fctlls ma
1I:,ld to
increa
ed antiblllh to D.
Fortunatelv thi
C
1I1 nm\
be climinaied b\ tre.tt-
ing mother al p:trturition
\\ith high titer ami-D
serum

FEBRUARY 1974

THE CANADIAN NURSE 31

Determination Normal Values Clinical Significance
and Notes
Cold agglutinin
\\hen present. these ag- essential to identify;
glutinatc patient's this can be cither re-
red cell!'> versed or weakened by
warming the blmx! to
37 0 C
Amniotic tluid test for several chell1i- in the Rh mother, tests
anal)'ii!'> cal s (b il irubin. etc.) will !'>how whether fetu'i
is Rh neg. or Rh po...;
also for genetic dis-
orders

Biochemistry, Blood Plasma or Serum Values

In the lIIl!iority (
fl/(lspitals. all hiocllellli.Hry analyse
are clI1Tied Olll Oil serulII. 1I0H'e
'er,
sOllie hospitals still use oxal{/fed Mood .IiJr allllllonict, BUN, glucose. and N PN. A 1II00IIlts of
Mood Il'l/uired .If)r the analyses range .Ii-tJln 5 -10 1111.

Determination Normal Value Note Clinical Significance
Aldola
e 3-X U ./ml. increased in viral
i hepatitis. progres-
I ...ive mu!'>cular dystro-
phy, myocardial in-
farction
Ammonia 4X-115 mcg./IOO ml. te!'>t must be increased 111 severe
nitrogen done ill1ll1edi- liver diseasc and
atcly bleeding into gastro-
intestinal tract. es-
pecially from e...opha-
geal varices
Amylase 60-160 Somogyi do not draw increased in acute pan-
U./100 ml. during or creatitis: also in
just ti.)lIow- pdrotiti
. pcrti.)J'ared
'ing 1.V. peptic ulcer. abdom-
glucose or inal trauma. after
after adm in- morphine. etc.
istration of
morphine
Ascorbic acid 0.6-1.2 mg./100 ml. blood must be low in scurvy
(Vitamin C) placed in a
tube surround-
ed by ice and
sent immedi-
atelv to the
lab/;rarory

32 THE CANADIAN NURSE

FEBRUARY 1974

Determination Normal Value I Clinical Significance
Note
Bicarbonate see pulmonary func-
tion
Bilirubin (Van 0.1-0.8 mg./loo-mt. increased in jaundice;
den Bergh latent jaundice 0.5-
test), total 2.0; clinical jaundice
above 2.0
Bilirubin, 0-0.2 mg./100 mt. increased in obstruc-
Direct tive jaundice
Calci urn 9-11 mg./100 mt. low in hypoparathy-
or 4.5-5.7 mEq./l. roidism, sprue, and
steatorrhea; increased
in hyperparathyroidism
and some bone diseases
Ceruloplasmin 35-65 IU/mt. decreased in Wilson's
disease
Chlorides 96-105 mEq./l. decreased in vomiting,
starvation, and after
gastrointestinal
surgery
Cholesterol Adults: 150- increased in hypothy-
275 mg./100 mt. roidism, diabetes, and
Children: 100- nephrosis; also in
225 mg./100 mt. hyperlipidemia, in
Infants: 70- hypercholesterolem ia
125 mg./IOO mt.
Chol ine'iterase 0.62-1.26 decreased in hepato-
U./mt. cellular jaundice, ad-
vanced cirrhosis, after
hepatotoxic agents:
familial
Copper RO-120 decreased in Wilson's
mcg./ I 00 mt. disease (hepatolentic-
ular degeneration)
Creatinine 0.7-1.4 mg./loo mt. impairment of urine
flnmation or excre-
tion (renal and/or
pre-renal)

FEBRUARY 1974

THE CANADIAN NURSE 33

Determination Normal Value Note Clinical Significance
Creatine phospho- 0-20 IU/ml. increased in muscle-
kinase (CPK) wasting disease, mus-
cle trauma. C.Y. ac-
cident. severe mus-
cular exercise
Glucose (fasting) 70-100 mg./100 ml. up to 140-160 increased in diabetes
after meals mellitus. Cushing's
disease; decreased in
hyperinsulinism.
fasting
Growth hormone male. 0-8 ng./ml. used with increased in acromeg-
female: 0-30 ng.lml. challenge aly. pituitary giant-
Child: 0-10 ng./ml. dose of in- ism, and related con-
suI in or ditions; decreased in
child. 0-10 ng./ml. arginine hypopituitary states
17-Hydroxycorti- 5-25 mcg./IOO ml. heparinized increased in Cushing's
costeroids blood disease, moderate in
(cortisol) infections. burns.
surgery; decreased in
Addison's. etc.
Insulin 4-24 mc. U.lml. usually with insulin resistant
glucose tol- diabetes; presence
erance of an insulinoma
hocitric dehy-
drogenase (lCDH) 50-260 U ./1 ()() mt. increased in diseases
of the liver
Lactic dehydro- 200-450 u.lml. test for the increased in myocar-
genase (LDH) five isoen- dial infarction, li-
z
mes will ver diseases. pulmon-
gIve more ary infarct, etc.
specific in-
formation
Lipase 0.2-1.5 U./ml. increased in acute pan-
creatitis. etc.
Lipoproteins 300-800 mg./iOU ml. consists of differential diagnosis
four frac- of hyperlipoprotcin-
lions: chylo- emias (five types)
microns. beta. pre-beta.
alpha

34 THE CANADIAN NURSE

FEBRUARY 1974

Determination Normal Value Note Clinical Significance
Magne
ium 1.3-2.5 mEq./l. draw in poly- decreased in unexplained
ethylene tube tetany and in marked renal
insufficiency
pH see pulmonary func-
tion
Phosphata
e. 0.13-0.63 Sigma increa
ed in c..IIlcer of
acid U/100 ml. the prostate with meta-
0.1-0.R Bodansky stases of bone: also in
U/IOO ml. hemolized serum
1-4 King-Armstrong
U/IOO ml.
Phosphatase. O.R-l.3 Sigma test for the increased in h)-perpara-
alkaline U/IOO ml. IsoenLymes thvroidism. bil-
1-4 Bodansky may be more iai-y obstruction. rick-
U/IOO ml. specific ets. active bone depoo;-
3-13 King-Armstrong it ion (excess osteo-
U/IOO ml. blastic activity>
Child: 2.R-b.7
Sigma U/IOO ml.
Phosphorus. adult: increased in severe
inorganic 2-4.5 mg./IOO ml. nephritis. sometimes in
child: ricl,ets: úecrea
d in
4-6.5 mg./IOO ml. conditions in \'.hich
serum calcium is
elevated
Phosphol ip ids 150-300 mg./IOO ml. important in relation
to disorders involving
1
1t mdaholi'm
Potassium 3.5-5 mEqA serum must be increased in renal
separated from failure and se\ere
the cells w ith- Addison's disease: de-
in one hour creased in diabetic
comJ.: especiall)- im-
pmtant for patienb
on hemodial)- sis
Protein bound 4-X mcg./I ()O ml. decreased in dcbilita-
iodine (PBI) ting ,lIld febrile ill-
ne
ses: increased in
h) penh) roidism. preg-
narK) . oral contr,lcep-
tives. and iodine-con-
taining drug

I

FEBRUARY 1974

THE CANADIAN NURSE 35

Determ ination Normal Value Note Clinical Significance
Proteins. adult: decreased æ, a result
by. electrophor- of marked and prolong-
eSls ed albuminuria. ncph-
Total 6-H g./100 ml. ritis. livcr disease.
Albumin 3.2-5.6 g./l 00 ml. starvation causing
Globulin 1.2-3.2 g./I 00 ml. edema; increased in in-
Alpha I 0.1 -0.4 g./I 00 ml. 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./100mJ
Globulin
alpha 1 0.12-0.32 g./lOO ml.
alpha 2 0.25-0.4 7 g./I 00 ml.
beta 0.17-0.61 g./lOO ml.
gamma 0.4-1.41 g./l 00 ml.
I year.
AI bum in 4.0-5.0 g./l 00 ml.
Globulin
alpha I 0.15 -0. 35 g./l 00 ml.
al pha 2 0.5 -1.11 g./I 00 ml.
beta 0.52-0.H3 g./IOO ml.
gamma 0.45-0.66 g./100 ml.
over 4 years:
Albumin 3.7-5.5 g./lOO ml.
Globulin
alpha I 0.12-0.3 g./100 ml.
alpha 2 0.35-0.95 g./100 ml.
beta 0.47-0.92 g./IOO ml.
gamma 0.53-1.2 g./IOO ml.
Rheumatoid negative increased in rheumatic
factor (RF) fever. rheumatoid
arthritis. lupus: and con-
ditions with immuno-
logic stimulation
Sodium (Na) 133-14H mEg./l. increased after ex-
cess intake of NaCI
hy patient with im-
paired kidney func-
tion: decreased in
vomiting. GI dis-
orders. tube drain-
age (postop). diabetic
coma. Addison's dis-
ease
T3 25-35/', uptake decreased in hypothy-
roidism. pregnancy.
after oral contraceptives;
increased in hyper-
thyroid ism. nephrosis.
liver disease. after
coumarin drugs. sali-
cylates

36 THE CANADIAN NURSE

FEBRUARY 1974

...

Determination Normal Value Note Clinical Significance
T4 5.S-12.3 mcg./IUO ml. more specific measure
than above
Thyroid binding 10-26 mcg./100 ml. as above; also cret-
globulin (TBG) inism. etc.
SGOT 10-50 Karmen U/ml. increased in myocar-
Transam inase (3-20IU) dial infarction. in-
fectious hepatitis.
muscle-wasting
diseases
SGPT 5-35 KU/ml. increased in acute
T ransam inase (3-1R IU) hepatitis, cirrhosis
in relapse. less in
myocardial infarction
Triglycerides 50-150 mg./IOO ml. increased in hyperlip-
idemia (diabetes. xan-
thomatosis. biliary
cirrhosis. etc.)
BUN (Urea 9-20 mg./I ()() ml. decreased in malnutri-
nitrogen) tion. pregnancy; in-
creased in nephritis.
urinary tract obstruc-
tion. congestive heart
failure. shock
Uric acid 2.5-7.5 mg./I 00 ml. increased in acute
gout. nephritis. leu-
kemia. frequently in
myelomatosis
Urine Values
Determ inatio n Normal Value Specimen Note Clinical Significance
Required
Aldosterone 2-20 mcg./24 hr. 24 hr patient hyperaldosteronism in
must be hypertension
on spe-
cial diet;
ke
p
urme
bottle
cold

FEBRUARY 1974

THE CANADIAN NURSE 37
.

Determination Normal Value Specimen Note Clinical Significance
Required
Amylase 60-225 Somogyi U.I random increased in acute
I 00 m I. pancreatitis. paro-
titis. peptic ulcer.
abdominal trauma
Calcium 50-300 mg./24 hr. 24 hr. paticnt increased in hyperpara-
on spe- thyroid ism. myeloma-
cial tosis with bone metastases
diet
Catechol am i nes up to 100 mcg./ 24 hr. patient must increased in adrenal
24 hr. be off cer- medulla tumors and
tain medica- those of neural or-
tion. hyper- Igm
tensive drugs.
tetracycl ine,
epinephrine-
like. etc.
Chloride,; 170-250 mEq./I. random important in control-
ling saline adminis-
tration
Copper up to 70 mcg.1 24 hr. preserve In increased in Wilson's
24 hr. polyethy- disease
lene bottle
Copropor- 50-160 mcg.1 24 hr. preserve In increased in the
phyrins 24 hr. polyethy- porphyrias
Child: lene bottle
0-80 mcg.
Creatine 50-100 mg./ 24 hr. prc!>erve In used in the study of
24 hr. toluene muscle diseases
Creatinine 0.X-I.5 g.1 24 hr. preserve in normally excretion
24 hr. toluene constant; altered in
certain muscle dis-
eases

38 THE CANADIAN NURSE

FEBRUARY 1974

Determination Normal Value Specimen Note Clinical Significance
Required
Estrogens ovulatory 24 hr. preserve in Increased in tumors
cycle. polyethy- of the ovaries; de-
4-64 mcg./24 hr. lene bottle; creased in ovarian
normal male. keep cool and pituitary mal-
4-25 mcg./24 hr. function
prepubertal
male and female.
4-25 mcg./24 hr.
postmenopaus-
al.
0.5 mcg./24 hr.
pregnancy (3rd
trimester):
26-60 mg./24 hr.
Follicle before puberty. 24 hr. important in
Stimulating less than 6.5 the investigation
Hormone (FSH) Mouse U./24 hr. of endocrine dis-
after puberty: turhance:"
6.5-52;
after meno-
pause.
96-600
17-hydroxy- female: 5-18 24 hr. preserve in important in the in-
corticoids mg./24 hr. polyethy- vestigation of adre-
male: 8-25 lene bottle; nal and testicular
mg./24 hr. keep cool malfunctions
5 -hydroxy- 60-1 60 mcg./ 24 hr. patient must increased in carcin-
indole- 24 hr. avoid eating oid tumors
acetic acid bananas dur-
(Serotonin) ing collec-
tion
17-keto- under 10 yr.. 24 hr. preserve In important in the in-
steroids 0-4 mg./24 hr.; polyethy- vestigation of endo-
10-15 yr.: lene bottle; crine disturbances
3-10 mg./24 hr.; keep cool (adrenal. testes)
Adult female.
2-17 mg./24 hr.;
Adult male:
3-23 mg./24 hr.
Lead 0-0. I 2 mg./24 24 hr. preserve III increased in lead
hr. polyethy- intoxication
lenc bottle
O'imolality 500-H50 mO
l/ random concentrating and di-
(Osm) kg. water or 24 luting ahility of the
hr. kidneys

FEBRUARY 1974

THE CANADIAN NURSE 39
.

Determination Normal Value Specimen Note Clinical Significance
Required
Potassium 25 -100 mEq./l. 24 hr. varies with useful in the study of
dietary in- renal and adrenal dis-
take turbance, water and
acid-base balance
Pregnanediol female: 24 hr. preserve In increased in corpus
3-10 mg./24 hr. Eolyeth y - luteum cysts and some
male: ene bottle; adrenal cortical
0-1.5 mg,f24 hr. keep cool tumors; decreased in
threatened abortions
Sodium 130-260 mEqA 24 hr. varies with same as potassium
salt intake
Urea 8-15 g./24 hr. 24 hr. preserve In important in the
nitrogen tol uene investigation of
metabolic disturb-
ances
Uric acid 0.4-1.0 g./ 24 hr. preserve In useful in the inves-
24 hr. toluene tigation of metabol ic
disturbances
Urohilinogen Qualit.: Random preserve increased in liver
Pos. in I :20 or 24 with sod. diseases and hemoly-
Quant.: hr. carbo un- tic jaundice
0.2-3.3 mg./24 hr. der pe-
troleum
ether

Cerebrospinal Fluid Values

Test Normal Value Clinical Significance
Color and appearance clear and colorless; may cloudy, turbulent. or gros-
be slightly blood tinged sly purulent in meningitis;
from needle trauma; no bloody or yelIow when hem-
clot orrhage involves CNS
Pressure 7-15 mm. Hg. (100-200 mm, increased in meningitis,
of water), patient lying down; edema of the brain. hemor-
15-22 mm. Hg. (200-300 rhage, neurosyphilis; de-
mm, of water), patient sit- creased in shock, dehydra-
ting up; tion, and spinal canal
Child: 3.5-7 mm. Hg. (50- block
100 mm. of water), patient
lying down

40 THE CANADIAN NURSE

FEBRUARY 1974

Test Normal Value Clinical Significance
CeIl count 0-5/cu.mm.; all lymphocytes increased in the various
types of meningitis, polio-
myelitis, neurosyphilis.
and encephalitis; pus celIs
predom inate in the acute
bacterial processes. In-
creased lymphocytes in
tuberculous meningitis. po-
liomyelitis. and neuro-
syphilis
Glucose 45-80 mg./100 ml. 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 neurosyphil is.
Proteins 15-40 mg./IOO ml. increased in those condi-
albumin 52% tions with an increased cell
alpha I 5% count (see above); increased
alpha 2 14% in spinal cord tumor and
beta 10% infectious polyneuritis
gamma 19%
Chlorides 120-130 mEq./l. increased in urem ia; de-
creased in tuberculous
meningitis
Colloidal Gold 0000000000 abnormal forms in meningi-
test tis, and syphilis. Examples:
555554321000. paretic-type
curve; 0244310000. luetic- or
tabetic-type curve;
0000245520. mcningitis-
type curve
Bacteriologic neg. important in differentiat-
examination ing between bacterial.
viral. and other cau.,es
of meningitis
Serologic tests neg. for syphilis
for syph il is

FEBRUARY 1974

THE CANADIAN NURSE 41
.

Function Tests and Investigations

Tests Principle Normal Value Clinical Significance
a.c. - p.c. per:.on's abilit) a.c.. 70-100 mg./ a screening tcst for
blood to handle diet- 100 ml. diabetes mell itus,
glucose ary carbohydrate p.c.. less than Cushing's syndrome,
150 mg./IOO ml. etc.
Glucose a test of ability blood glucme not for diagnosis IJf
tolerance to store and util- to exceed 150 mg. diabetes melIitus.
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 t ,hr..
I hr., 2 hr.; oc-
casionally 4, 5,
or 6 hr. test
required
Intravenous eliminate possi- blood glucose same as for glucose
gl ucose hility of impair- returns to nor- tolerance
tolerance ed absorption mal fasting
from the intes- within 1- t
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./IOO ml. ful in Addison's
mote withdrawal one hr. after disease
of glucose from ingestion of
blood stream. glucose with
Dose. 0.25 U./ 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./100 ml. in hypertension; mar-
(angiotensin sin control of kedly influenced by
II) aldosterone se- physical activity
cretion and salt intake
Kidnev function, based on abili- morning specimen valuable in renal dis-
diurnal varia- ty of kidneys S.G. 1.023 or case, especially slow-
tion to concentrate higher Iy developing chronic
unne discases
Moscnthal test ability of kid- night specimcn same as above
neys to concen- not to exceed
trate urine af- 575 ml.. S.G.
ter a test meal >1.0 I H; day spe-
cimens S.G.
varies hy <J points
or more, reaching
1.020 in one or
two specimens

42 THE CANADIAN NURSE

FEBRUARY 1974

Tests Principle Nonnal Value Clinical Significance
P.S.P. excretion normal kidn
- 30-5OCé excreted test tor renal tubu-
rapidly and in 15 min. lar function
efficientl}
excrete the dye
Creatinine rate of elimi- 80-160 ml./min. test tor glomerular
clearance nation of cre- function of the
atinine b" the kidneys
kidneys
G I absorption triolein is di- >8lk in the 4th. malfunction of bile
test 125) gested by pan- 5th, and 6th hr. and pancreas; dis-
triolein creatic lipase eases of liver and
and absorption is pancreas
facilitated by bile
GI absorption absorption re- same as above diseases of the liver:
test 125 I quires presence with triolein test
oleic acid of bile eliminates diseases of
the pancreas
Xylose tolerance xylose is ab- I he 29-49 useful test tor GI ab-
sorbed bv dif- mg./ I 00 mL sorption in absence
fusion míd not 2 hr.: 20-60 of renal disease
metabolized \\ hen 3 hr.: 8-16
given b} mouth 5 hr. urine
4-8 g.
ACTH stimulation ACTH stimulates >8-16 mg./24 hr.; diseases of the pitu-
the adrenal cor- also blood 17HC itary and adrenal
tex to secrete cortex
corticosteroid"
Congo red amyloid tissue pre- <35( , retention amyloid disease prim-
ferentially ab- ary and secondary
sorbs the dye.
Given LV. and mea-
sured serially in
hlood
Gastric function acidity of fa'>t- fasting: 5-100 mL diseases of the
ing content: ser- 1st hr.: 30- 300 mL stomach
ial samples after titratable HCI
test meal (with female: 0-25
or without his- mEq./l./hr.
tamine) male: 0-48 mFq
Maximal gastric modification of female basal: diseases of the
secretion above to create 0.5-2 mEq./I.; stomach
a max imum res- post-hist. 10-
ponse: with large 24 mEq
dose of antihis- male basal: 1-3
tamine folkmed mEq./I.: post-
by large dose of his!. 10-30 mEq
histdmine
Gastric function pH of gastric sam- as above. but more
(recent trend) pic,> under contin- precise data
uous aspiration;
intubation under
radiological con-
trol: can be com-
hined with secre-
tin stimulation
- -

FEBRUARY 1974

THE CANA
IAN NURSE 43

Tests Principle Normal Value Clinical Significance
Pulmonary function blood must be drawn 18-25 mEqA complete investiga-
HCÜ3 without stasis from tion of acid-base
(hil:arbonate) tournique balance; will estab-
pH dra\\ n in a spec;al lish the relative
7.35-7.45 contributions of
syringe without respiratory and non-
stasis respiratol) factors.
pO as ahove 90-110 mm. Hg. thereby indicating
2 necessary therapy to
pCO
restore balance
as above 35-45 mm. Hg.
B .E. (base calculated from 10 (:t2)
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 tcst in certain dis- sodium 10-80 increased sodium
eases of the pan- mEq.n. and chloride in the
creas there is chloride 4-60 sweat in fibrocystic
excess secretion m Eq ./1. diseases of the pan-
of sodium chlor- creas (mucoviscidosis)
ide in the sweat
Fecal fat most dietary fat 1-7 g./24 hr. increased amount io
is digcsted and ab- 7-25% (dry sprue, steatorrhea.
sorbed; increase weight) etc.
in fecal fat is.
therefore. signif-
iCJnt
Fecal to establish pres- reported <is differential diagno-
bacteriology ence of abnormal "normal flora" sis in diseases as-
bacteria in GI 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-
GI tral:t; speci- ported
men must be fresh

Clinical mil:robiology is a specialty
that includes bacteriology. mycology.
parasitology. and virology. It is most
essential that sterile techniques be fÒI-
lowed for all specimen collection. con-
tainers used. and transport to the lahor-
atory: the slightest contaminent may
well II1valillate the result.
Bacteriology: I n the laboratory most
specimens are cultured on various
media. depending 011 the presence 01
suspected organisms. They are sub-
sequently identified and subjected
to various te,t-., such as antihiotic
sensitivity. etc.
h 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 ta
several weeks for growth and identi-
lïcation.
Parasitology: With increasing travel
and temporary residence ahroad, just
about all human parasitic infections
are being seen in Canada. In general,
specimens. especially stools. must be
delivered to the laboratory in as fresh
a state as possible.
Examples of medically important

parasites are as follows:
. Prot070a-amoebic dysentery.
malaria
. Platylhelminths - tapeworm. schis-
tosomiasis
. Nemathelminths-round worms.
pll1worms
. Arthropods - scabies. body lice
Vimlogy: 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. {;:;
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, I have a
problem with the \ertical 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.. Cherr\' Hill, ^'.J."
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 i

ue of What's Ne>>', pub-
lished b) The Hospital for Sick Children
in Toronto.
"No recent issue has rou
ed staff
passion and fury ao; the great tobaceo
vendetta. When a box of exploding
cigars was left in the doctors' lounge.
administration decided the time had
come for action.
"Consequently. effective Janual) 30.
1974. segregated dining will be intro-
duced to the cafeteria. The Non-Smok-
ers' Preserve will scat 2:-:0 in thc center
and north sections. Black-lunged
lunchers will bc confined to 124
eats
in the south (bring your compass). Signs
will be po
ted. and the admini
tration
hopes all will cooperate. Suspected
intiltrators will be a
ked to submit to a
nicüti ne-stain finger inspection."

Comment on "consumer"
Thoo;e who object to the expression
"dclivel) of health eJre:' believing the
\\ord deliven' is best lIsed \\hen refer-
ring to milk. are no doubt beating
their brlms ahout the use of the \\nrd
COII.\Wller when talking about those
who require or \\ill require health care.
FEBRUARY 1974

These persons will welcome the word

of Dr. E. Gra
Dimond, provmt for the
health sciences at the Universit) of
\] is
ouri.
Writing in the October 9. 1973 i

ue
of Saturda\' Re\'ind World, Dr. Dimond
sa)s. nAs' alwa)s, there will be tho
e.
both on the medical faculty and among
the public (now reterred to. digestivel\.
.IS health consumers) . .. n .

Warning to farmers
An article in the :-.Jovember 1l)73 i

ue
of the American Lung Association
Bulletin tells of a disease called "farm-
er's lung," which is traceable to expo-
sure to moldy hay.
This is one of the hypersensitivit\
diseases. which are "due to a pulmonar}
reaction to an organic (usuall) vege-
table) dust inhaled b} persons sensitized

t',
.'"
;..
I' " "if-:'
-:"'''/ -......ø
.
.'.#i

.
. "." t.

. . . to the dust by pre\ ious exposure to
it. ..
The article also notes that the disease
"occurs four to eight hours after expo-
sure to hay that has become mold\
during storage in poorly ventilated
barns or bins. The first symptoms are
chills and fever, cough. and shortness
of breath. A
a rule. the acute stage
subsides in a week or 10 days.
me-
time
to recur."
According to thi
article. there i

no specific treatment. although
teroid

are prc
cribed in some cases to reduce
intlammation. The bC'it treatmcnt io;
prevention. the article note
.
Because of heav\' rain
in 1l)73.
fam1ers are \\arned to take the utmo
t
precaution to mJke
ure that hav and
other fa. m products are protected" from
dampness \\ hen the
are stored in barn,
and bin
. i7

....:.:
\ ....
.

.'

... .
",

,
(
i

"I don" know - she claims to be someone's an""

THE CANADIAN NURSE 45
.

dates

March 2, 1974
One-day clinical nursing session on
"Shock: Pathophysiology, Therapy
and Nursing Care," Cody Hall, Univer-
sity of Toronto. Fee: $12.00. For further
information, contact: Faculty of Nurs-
ing, Continuing Education Program,
U. of Toronto, 50 St. George St.. To-
ronto, Ontario M5S 1 A 1.

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 1A1.

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 M4W 1 Z2.

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,
Bayshorelnn, 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.Q. H4W 1W3.

June 16-21, 1974
Canadian Nurses' As-
sociation annual
meeting and conven-
tion, to be held in the
Manitoba Centennial
Centre Concert Hall,
Winnipeg, Manitoba.

ð

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 1 X8.

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-

riQ

FEBRUARY 1974

names

. ....

.. ...

','\,... .

J

Eli;:,ah('tf1 Boargouill

Paul BOIII'Kouiu

Elizabeth Johnson Bourgouin and her
husband. Dr. Paul Bourgouin. have ar-
rived in I ndonesia to serve for two years
with r.1EDICO. a service of CARE. They
are stationed at a hospital complex in
Surakarta (Solo). Central Java. as part
of a 15-member CARE-
IEDICO 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 M f'DICO. he worked in Maria
in the Gaspé.

Dorothy Wyatt (B.A.. B.Ed.. B.N.)
was elccted mayor of SI. 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 new director of
nursing at the North Okanagan Region-
al Ho
pitals. a tri-hospital complex
comprising Vernon Jubilee Hospital.
Armstrong-Spall umeheen Hospital.
and Enderby and District Memorial
Hospi tal.
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. ll. of
Saskatchewan, Saskatoon. SasJ....) work-
ed in various capacities at the Moose
Jaw Union Ho
pital 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
i.ncl';lde pro
oting and developing
famIly planmng 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 ehild-care supervisor in
the children's inpatient unit <It Royal
Ottawa Hospital.

E.A. Pattinson is director of the extended
care department of the Burnaby Gen-
eral Hospital. Burnaby, B.C She was
appointed 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. Servo 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:

......

] ')
JII/ial/a La;:arul.

...
Barry Olwl/

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.

..

-
-

\,'

.
:'9-'

1;'
Billie I'urcell

Pat RoddlCI.

Billie Purcell (R.N.. Edmonton Gen-
eral Hosp.. Edmonton; B.N., McGill
U., :\1ontreal) 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 mcdical-
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.,
__ w..... Alberta Hosp..
"" .
'. Edmonton: B.Se.N.,
Ý U. of Alberta. Ed-
.. l' \ 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 worker.,. It is
signiticant to note that a nurse has been
chosen for this coordinating position.

--
-

Lucille Carber is the public health/hos-
pitalliaison nurse in the Prince Edward
Island Department of Health. A grad-
uate of Dalhousie University school ot
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 \\ith the Roben Wood Johnson
Award. This award of 5 LOOO 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

Vivian B. Kirkpatrick was recently ap-
poi ntcd 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

by the faculty as most likely to m_ake
a substantial contribution to the held
of health services administration.
Ms. Harrison (R.N., Misericordia
Hospital s.::hool of nursing, Montreal;
B.Sc.N., and M.H.S.A.. U. of ,'\Iberta)
is a former director of nursing adminis-
tration at the Misericordia Hospital,
Edmonton.

NDYlI

HOllister's comolete
U-BÄG
system

regular
and 24-hour
collectors
in newborn
and
pediatric
sizes

48 THE CANADIAN NURSE

gel any Inlanl urine sDeclmen when YOU wanlll

The sure way to collect pediatric urine specimens
easily. . . every time. . . Hollister's popular U.Bag
now has become a complete system. Now, for the
first time, a U.Bag 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.

I

Each U.Bag 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 - hypo.aller-
genic adhesive to hold the U-Bag firmly and comfort-
ably in place without tapes - complete disposability.
Now the U-Bag 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 U-Bag system.

HOLLISTER LIMITED. 332 CONSUMERS RD., WILLOWDALE. ONT.

State Research Hospital in Illinois.
More recently, Dr. Kirkpatrick
organized the school of nursing and
later taught psychiatric nursing at
Laurentian University in Sudbury.

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-
vel stoke 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 Qucensway
General Hospital, Toronto.

Marlyn Andrews, (R.N., St. Michael's
sehool of nursing, Dip\. 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 Edmon-
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 Oftï-
cer Sister. Also active in the Registered
Nurses' Association of Nova Scotia,
she was president in 1951)-61 and was
the recipient of a lite memhership in
the association in 196X.
Jean Nelson, director of nursing at
Camp Hill Hospital, was admitted to
the Order of St. John in the rank of
Servi ng Sister. She was with the Royal
Canadian Army Medical Corps as
nursing sister during World War II,
and prior to her present appointment
was assistant director of nursing at St.
Anne de Bellevue, Quebec, Department
of Veterans Affairs. <;J
FEBRUARY 1974

new products

{

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

New lightweight cast
It might have heen a dull
ummer fur
four-)'ear-uld Pierre Martin. if he had
heen burdened ",ith a heavy plaster
ca
t. \\ ith the ne\\ I ightcast I I. avail-
ahle throughout Canada from Charles
E. Frosst
& Co.. restrictions to his
normal activities were cut to the
minimum. In addition to being thin
and light, thi" east is strong and dur-
able. is water immersible. and dries
quid..I)'.
For further information. write to
Charles E. Frosst & Co., P.O. Box
217. Pointe Claire. Dorval 700. P.Q.

New rescue system
The new Bradford Casualty Carrier is
a multipurpose rescue and evacuation
system. It may be used as an amhulance
streteher or as a rescue stretcher to suit
all conditions. rhe carrier makes it
possible to move a patient from an
accident location to the amhulance.
hospital emergency, hospital trolley.
or x-ray bed ",ithout creating additional
trauma or discomfort.
The Bradford Casualty ("arrier can
serve as a rigid ambulance stretcher
with backrest, in place of a "hasket -
typl' litter." or as an enveloping stretch-
er for difficult extrication prohlems. It
ma) he lifted in a horizontal position tu
he hoisted by a helicopter or crane or
in a vertical position for extremely
difficult rescues. A patient can he
carried through holes 25 inches wide.

....

.AI

r1í
.,., ';
:11
,
\ -: -

Chilcl\ Mitt

FEBRUARY 1974

\\
,
, J
..
'";.;

if:. , .:
,. ""-
. ,,-

k-
.'þ
.
..

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t

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. ,... ..}
'"' '9., ;q
- " ,
...
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.......
,.:;---""

....

'"

..
,"'
-,
R I .'.
t ,,\-,'"
. ""'"

..

Liglllll'eighl CWI

This produet is availahle from Safet)
Supply Cumpany.
14 King Strcet
East. roruntu. Ontariu.

Chi;d's mitt
rhe P('
e) Cumpany recentl) introduced
a child's mitt that i
de:-.igncd to keep a
)uungster from putting his hand duwn
his throat or using hi... lincers.
rhe hack 1.11'
the mitÌ IS m..de of
Posey ßreezeline dacron me
h. \\hich
gives full vision uf the hack 1.11' the h.lI1d.
The palm is rilled \\ ith Inil iant pul) e
-
teL For mure infol mat ion. \\, rite to F nn:-.
& G ilmol e I td.. 10.\_\ R.lIlgevic\\ Rd.,
Port Credit, Ontariu.

New tricyclic antidepres!>ant
Anafranil (domipr.lmine) is a ne\"
tril'ydic antidepre,"sant that is potent
and rapid acting. An..rranil h.l:-. :-.hu\\n
excellent re...ult<; in the treatment of
depressive ill ncs:-.. according to Geig)
Pharmaceuticals. It provides a distinct
threc-fÒld action, relieving the total
...)mptom complex 1.11' depre

ion

through elevation of muod. remlSSlun
of so'matic symptoms. and alle\ iation
of anx iet).
Anafranil is available as a sugar-
coated, 25 mg. pale yellow Ientic
I.lr
tahlet. It cumes in hottles 1.11' 50 and
500. :\10re information i
availahle
from Geigy Pharmaceuticals. Dun al.
Quehec.

Literature available
A ne\\ 40-page guide de
crihing nearl)
300 ...il icone products and their appli-
cations is available from DO\\ Curning
Silicones Inter-America Itd.. I lïppet
Ruad. Downsvie\\, Ontario :\DH 5 L
.
rhis hrochure. entit!ed "A Guide to
Dm\ Corning Products," i
organi/ed
fÒr select iOIl 1.11'
il icone product
hy
indu
try cla
:-.ilï
at iun. I'here are
X
product groups. ranging from ruhher
compoum,h tu p(J\\der treatment:-.. de-
fo.ll11ers and luhricant
. Thl'se produet
group:-. .Ire cro:-.
-indC\eJ to II.) industr

classifications. \\ h ich inelude appl i-
ances. chemical proces...ing, rubher. and
equipment.
THE CANADIAN 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 Safety Belt 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. #5163-4532, $21.00.

\

--

l .

'.... "

The Posey Foot-Guard is designed
with a rigid plastic shell providing
support and synthetic wool liner to
prevent pressure sores on heels and
ankles. The Posey line includes
twenty-three rehabilitation products.
#5163-6410, $15.00 ea.

'-

.

",

The Posey "V" Safety Roll Belt se-
cures under the bed out of the pa-
tient's reach, yet offers maximum free-
dom to roll from side to side and sit
up. This belt is one of seventeen
Posey safety belts which insure pa-
tient comfort and security. #5163-
1131 (with tie ends), $9.90.

.
,

4

k-

I.
l'

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, 11.'
, .' r
,,""ì ' !

r.-;-- J
, \.
, , .

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.'

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'f"
.

The Posey Body Holdermay 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. #5163-1731 (with
ties), $5.10.

<

'; '.
,..,. .

....

,\1\\
The Posey Houdini Security Suit,
constructed of cool breezeline mate-
rial, is virtually impossible for patient
to remove yet provides security with
comfort. There are eight safety vests
in the complete Posey line. #5163-
3412, $15.00.

Send for the free all new POSEY catalog - supersedes all previous editions.
Please insist on Posey Quality - specify the Posey Brand name.

50

THE CANADIAN NURSE

Send your order today!
POSEY PRODUCTS
Stocked in Canada
ENNS & GILMORE LIMITED
1033 Rangeview Road
Port Credit, Ontario, Canada

new products

The following sections of the bro-
chure give data on the applications and
characteristics of each product group.

t the end is a list of applications

n
exed . to the appropriate product
mformat Ion.

Treatment for menopausal symptoms
Ortho Pharmaceutical (Canada) Ltd.
has developed a programmed method
llf oral treatment for the menopause.
wh ich 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 disconti nued until
the first day of the next month.
Program tablets are available in
three different color-coded packages,
according to required strengths tÒI
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
arc signiticantly reduced at the onset of
menopause.
Estrogen-relatn.l symptoms include
depression. adverse skin effects, hot
tl ushes. 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 Lakeshore Road East,
Mississauga. Ontario L5E 3B6. Includ-
ed in this tray service arc dishes. bowls
and lids. tlatware, napkin. nonwoven
fabric tray cover. and individual poly
bags for disposing of each service.
Iso-Pak components. which are
ED.A. approved. insulate foam to
hold tood at a maximum eating temp-
erature. The foam withstands tem-
peratures from minus 40 degrees
fahrenheit to I X5 degrees fahrenheit
without distortion. and can be used in
microwave ovens. fhe Iso-Pak bowls
and dishcs do not absorh liquids. are
firmly rigid tllr eas
handling. and give
no odor or taste to food.
All the items neeessar
for the tray
service are in one box and the trays in
a second box. {;:;
FEBRUARY 1974

research abstracts

Mooney, Sr. Mary Margaret. A cOlllpar-
ati\'l' stlldy (
f IlllneS' recordillg (
f
allalgesic therapy. Cleveland. Ohio.
1972. Thesis (
I.s.
.) Case Western
R esen e (' .

A review of the literature re\ealcd 3
consistenc) of expectation as to the
content of nursing notes. Included in re-
corded nursing observations are nota-
tions <IS to the kind and amount of anal-
gesic. the time of administration of
p.r.n. analgesics. descriptions of the
patienfs pain, and notations of patient
response to analgesic therapy. It is
proposed that certain approaches to
recording nursing obsen ation, promote
the inclusion of more expected content
than other approache... to recording
nursing observations.
This stud\ considered \\hether the
use of a prZ)blcm list as a guide for
recording nursing observations con-
tributed to the inclusion of more ex-
pected and recommended content than
\\ as included in nursing notes \\ hen
such a problem list \\as not used. Pa-
tient age. patient ,ex. length of hospi-
talization. length of postoperative
period. t)pe of service. and the occupa-
tional status of the recorder of nursing
notes \\ ere other variables considered.
The nursing notes from the patient
record of 100 medical-surgical adult
patients in three Clevcland hospitals
\\ ere anal)zed for expected content con-
cerning the ,ldministration of p.Ln.
analgesics. fhe 11111m\ ing h) potheses
\\ere tested and conlirmed.
I. The administration of p.Ln. anal-
gesics is recorded \\ ith significantl)
greater frequency in problem-oriented
nursing notes than in nursing notes
that are not problem-oriented.
2. Descriptions of pain cxperienced
b) the patient immediatd) prior to or at
the time of administration of p.r.n.
anal gesics arc recorded \\ ith sign ilicant-
I) greater frequency inprohlem-oriented
nursing notes than in those that arc not
problem -oriented.
3. Patient response to p.r.n. anal-
gesics is recorded with ,ignificantl)
greater frequenq in problem-oriented
nur,ing note, than in those that arc not
pnlblem-oriented.
fhe conclu,ions a... as,essed in this
,tud\ \\ ere that:
· pr
lblem-I'riented nursing notes arc
more likel) to contJin expected content
FEBRUARY 1974

than non problem-oriented nursing notes
. e:\pected content in problem-oriented
nursing note... of surgical patients is
more likely to be recorded concerning
the administration of parenterall) ad-
ministered analgesics than concerning
the administration nf orall\ administer-
ed analgesic... J
. the response of male patients to anal-
gesic therap) is more likel) 10 be re-
corded in the nursing notes than the
response of female patients. irrespec-
tive of \\ hether or not the nursing notes
arc prohlem-oriented
. expected content concerning the ad-
ministration of p.r. n. analgesics is
morc likel\ to be recorded in the nur...-
ing notes '01' patients \\ho hale been
hospitalized ...ix da) s or less than for
tho,e hl'spitalized seven days or more.

Robinson, Leola Anne. IlllimllatÙm
lItili
ed hy del'ell ('lIrdia
' patie/lts
alld the relatioll.\hip (
,. this ill-
.!c1nlllltioll to progress (!Iia discharge.
:\1ontreaI. Que.. 1 1 )73. Stud\ (I\1.Sc.
(Appl.)) \1cGill U. -

This stud) used qual itative re...earch
techniques to examine the inrÓrmation
u'ed h) II cardiac patients in assessing
their illness situations. Each patient
\\ as visited throughout a period of ho...-
pitalization. and at least t\\ ice after
discharge. Follo\\-up medical-record
data \\ere al...o obtained for all patients.
The data revealed six sources 01
information used by patients. Three
of these were external to the patient\
personal experience: the health team.
the public media, and others \\ ith heart
disease. The other three ...ources \\ ere
internal to the patienfs personal exper-
ience. past illnesses. ph)siological feed-
back. and factors in one's life situatinn.
The summ,ltion of all the informa-
tion accumulated by each patient in-
dicJted the information hase for that
patient, This information hase rcsulted
in the patienfs vie\\ ing the ill ness in a
particular \\ a). fhree "vie\\ of illness"
categories \\ere identified. optimi...tic,
uncertain. and pessimi...tic
The vie\\ of illnes, a patient po...,cs...-
ed \\as po...itivd) associ,lted with his
progress t\\O to Il'ur month, after dis.
charge. That is. patients with an opti-
mistic vie\\ of their illness did \\dI. and
patients \\ith a pessimistic or uncertain
vie\\ of their illne...s did poorl).

The findings of thi... stud) suggest
that it \\ould be helpful for the health
team to be a\\are of the information
hase a pat ient possesses. In th is \\ ay.
health team intervention can be directed
more readily to\\ard the specific needs
of each patient. Patients \\ ith an opti-
mistic vie\\ of their illness mal onl\
need straightfof\\ard guidelin
s and
instructions. Patients \\ Ith uncertain or
pes...imistic vie\\s of their illne...s require
more than this.

Clements, Dianne B. Loss: a II/q;or COIl-
l'e/'.\atiollal thell/e of the elder/,'.
'\lomreal. Que.. JI)7j. Stud\ ('\1.Sc
(Appl.)) \1cGill U. -

fhe purpose of th is research \\ as to
stud) S) stematicall) thl' theme of 10......
donlinJnt in the cOI1\'er...,ltion of the
elderly. This \\a... done to determ ine
patterns of cOl1\ersation about loss and
predict \\hat groups of people would
talk about particular losses.
Unstructured inter\ie\\s \\ere car-
ried out \\ ith 24 peopk het\\cen the
ages of 65 and XX) cars. The ana" sis of
the COI1\ ersation... re\ ealed IÏ\ e "nwlor
themes of loss: lo,s of sdL los.... of
others, loss of home. loss of acti\ ities.
and loss of health. These major Ip"
themes \\ ere related to sdeetCli demo-
graphic variahles and COI1\ ersational
characteristics. fhe researcher dis-
covered that pepple \\ ho t,llked about
a particular kind PI' los... had ccrtain
characteristics in common.
Those \\ho talked most ahl'ut their
o\\n death. I os... of self. \\ere in the older
age group nf the "',Imple leightie, and
late se\entiesL and talked about a large
numher nf lossc,. The com ers,l\iO
l'"
\\ere either vel') short or \el) long.
\\ idO\\.... \\ ho \\ere alsp in the old
r
group and talked ahout multiple losses.
tended to talk mo,t ahout the Ip...... 01
others.
fhose \\ ho h,ld either li\ed nn one
farm all of their li\e, or :.ad been born
in Europe talked about the 10" pf their
homes or the los, of their nati\ eland.
Tho...e in till' youngcr age group
(...ixties and earl) ,e\entie,) talked
about le\\ er lo......es and IIICused on 10......
of acti\it). fhe )ounger pepple \\ho
mentioned fe\\ Ip,ses. hut \\ ho ,11-.0
talked for rclati"el) ,hort period"
fÒcu...cd on los... of health.
The...e findings ma) lead nur...c... to
THE CANAglAN NURSE 51

research abstracts

question some of the hasic assulllptions
that guide their nursing care of the
elderly. Further qualitative re
earch
i
needed to obtain a more complete
and detailed picture of the importance
of lo

to the elderly and the role of
the nur
e in helping these people
cope \\, ith the <lging proce

.

Reighley, Ronald S. The (,(l/Icer1/.\ e.'-
presscd hy patiellt.\ with cardiac
('(mdiliollS dl/ring the /ïnt 13 da\'Sor
IIO.\'pitali:.atiou aud till' resfJol/.\
'.\' (Ù
health 1\'()/"J..e/"'\ and other patient.\
to thne concern.\'. Montreal. P.O..
1<)71. Stud) (M.Sc. (Appl.)) Mc-
GilllJ.

rhls
tUdy. uSll1g qualitative research
methods. was de
igned to inve
tigate
the concerns expres
ed h) 3X patient

\\ ith cardiac conditions during the
fir
t 13 days in hospital. and the res-
ponse, made b} hospital personnel
,1Ild other patient
to the
e concerns.
Se\en categorie
of concerns and
five eategori

of responses \\ ere
identified from the 11.f incidents ex-
trapolated from the data. rhe re
pon
e

to the concerns expressed by patients
\\ ere anal} zed in terms of the crfect
they had on the expressed concern.
Re
pon,es that allowed JiJr a re.,olu-
tion or Ic,sening of a concern \\ ere
termed facilitative. and respon
es
eon,idered not to as
ist q.r to Icssen
a concern \\erT termed nonfacilitative.
rhis stud\ found that nonfacilitativc
rc"pon
es predominated for lJ of the
13 da\ s. rhe greater proportion of non-
facilitati\e re
ponse
\\ ere demonstrat-
cd during the fir
t four da}s l)f hospita-
I i/ation. and only on the twelli.h day
did facilitative rcspom,es exceed the
nonfacilitative responses.
rhe findings indicated that the
t) pe of concern expre

ed b} a patient
\\ ith a cardiac condition. during the
first 1.\ da)s of hospitali/ation, i
clo
e-
Iy related to the numher of day" "pent
in hospital.
It \\ as tiJund that a strong rdation-
.,hip existed het\\een the categol'} of
personnel making the respon
e and
the t} pc of re
pon.,e given in re"ponse
to a patient's cxpres
ed concern.
rhe finding that the concern
of
patient
\\ ith cdl'diac conditions tend
to be "da)
pecilïc" ,uggöh that pa-
tient education could he geared to Ihe

hanging cOI.Kern pattern. Such a pro-
Ject could torm the ba
is of further
research.

52 THE CANADIAN NURSE

11le great variatil)(1 of re
pon
es h}
hospital personnel suggests an area
for further research to ascertain the
difll:rent frames of rell:rence being
usnl h)' the health \\orkers giving eare

McMahon, Sister Mary. 4 stl/dy to
identU."" the concerns or I//Other.\,
the strategie,\ wed to e.'press thell/,
awl the nl/rsing imelTl'ntion elicited
hy thel/l a.\ re\'eall'd dl/ring the hath-
iug (
r the hahy. Montrea I. Oue..
IlJ72. Stud) (M.Sc. (Appl.)) Mc-
Gilll'.

This
tud}' wa
designed to identify
the eoncern
of mothers in relation to
the care of their babies during the post-
partum hospitalization period.
In this study, concern rcfer
to any
interest. worry, or de
ire to know exhi-
bited by the mother during the bathing
ot the baby.
By means of the participant-observer
role, data were collected at the time the
mothers were bathing their intants. This
was a return bath, since mo
t mothers
in the sample had been given a bath
demonstration the previous day. The

amplc included 36 mothers - 26
primIpara and 10 multipara.
Mothers' concerns fall into six cate-
gories and the}' use four strategie
to
express them. Five categories of nursing
intervention are employed to re
pond
to the mothers' eoneern
.
Analysis of the data in relation to
the three variablc
, Illothers' concerns,

trategies used to express them. and
nursing intervention. reveals that two
interaction patterns emerged from the
data.
Pattern I: When mothers arc con-
cerned about the procedure and the care
and condition of the baby, they use the
qrategy of inquiry. and the nurses
re
pond by giving directions, infomling.
or approving,
Pattelï/ II: When mothers' concerns
are in the area of the baby'
behavior.
their own performance. socializing, and
compari
H1 with sibling
they u
the
strategies of commenting to the nurse
or commenting to the baby. The nurses
primarily do not respond but. on occa-
sion, giw approval.
Findings reveal that:
I. Mothers' greatest eoncern
dre
with the procedure OX percent), care
and condition of the baby (2X percent),
and baby's behavior ( I () percent),
2. Mothers use the
trategies of in-
quiry (37 percent), commenting to
the nur
e (29 percent), and commenting
to the baby (2lJ percent) most frequent-
ly.
J. 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 X percent of the cases they do
not re
pond at all, and in 17 percent of
the cases they inform.
5. Nur
e
do not respond to mothers'
concerns 36 percent of the time, and
give infÒrmation in 3 I percent of the
ease
.
These findings suggest that when
mothers inquire about their concerns.
they arc more likely to obtain a response
than when they comment to the nurse
or to the baby.
The lìnding that the mother's 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 tor the baby. It could also sug-
gest that the mothers arc 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 intluenee the
nurse ha
in this
ituation.

Tremblay, Charlotte. Nurse aide sim-
ilarity to patil'1If and feelings (
l
IIClple.Hl/l'.n. Cleveland, Ohio. \<)71.
Thesis (M.S.N.) Case Western Re-
serve U.

rhe present study was to investigate
the relation
hip between the perception
of similarity of the nursc aide between
her
clf and the terminally ill patient.
and the nurse aidc'
fceling
of help-
lessne
s in caring li)r the terminally ill
patient in nursing homes.
Subjects for the present study were
30 female nurse aides worki ng in three
nursing homes. rhe criteria ti)r inclu-
sion of nur
e aides were that they had
given care to one of the women patients
for at least 15 day
and that they knew
how to read and to write.
rhe hypothesis statcd that there is
a relationship between the perceived

imilarity of the nurse aide between
herself and the terminally ill patient.
and the nurse aidc's feelings of hclp-
Ie
,ne
'.
A Pearson product moment correla-
tion eoefficient was computed to de-
terminl' the extent of relationship
between these variables. The obtained
correlation of + .3X wa
significant at
the .05 level on a two-tailed test.
The h) pothcsis \\ as supported. This
meant that \\hen nur
e aides perceived
them
elves as being more similar to
thl' pal ients. nu rse aides reported feel-
ing
of hclpfulne
s. and ",hen nurse
aides perceived themsclve
as being
lös similar to the patient
. nur
e aides
reported feeling
of helplessness.
The investigator concluded that
inserviee education in regard to the
FEBRUARY 1974

varia hie... in thi., ,tud) may he helpful
to nurse aide, \\ho arc \\orking \\Îth
terminall) ill patients innur,ing home....
Research i... needed to e'\pltJre more
fully the relation...hip hel\\een the per-
ceived ...imilarih of the nurse aide...
hetween themseives and th
' term inal h
ill patients. and the nurse aiue'; rccÍ-
ings of helplcssnc....... Such re...earch
could enable nurse... to formulate plan...
to help nur.,c aiues feel more helpful
in caring tÒr term in all) ill patient....

Kravitz, Mona B. Jo/...illg bel,m'iOllr 011
orthopedics - a descriptil'e stlidy.
M,)ntrcal. Que.. 1973. Stud\ (\1.Sc.
(Appl.l) McGill L'. -

This descriptive study \\ as to generate
useful knO\\ ledge ahout joking in the
subo;tantive context of orthopedic pa-
tient care.
Joking beha"ior \\as defined as an)
statement or action that evokes laugh-
ter in the subject or listener.
Participant observation permitted
exploration of some of the suhtle nu-
ances of interaction among patient... and
between patients and nurses. Written
records aIlo\\ed the researcher to learn
something about \\ hat patients \\ere
like prior to hospitalization. their prog-
ress in hospital. and the beh aviors on
which nurses focused in \\ ritten reports.
The sample consisted of 24 ortho-
pedic patients on bed rc...t. Patients in
the immediate postoperative phase
were excluded. Patients were observed
on at least t\\O separate occa,ions. The
average hours of observation per pat ient
were 1.75. All hut one patient \\ ere in
four-bedded rooms.
As some patients joked during the
observation periods \\ hile others did
not. a category set was thus identitied.
Jokers and NOII;o/...en \\ere among the
patient, observed. and a number of
differences were observed between
them.
I. Jokers demon.,trated considerahle
verbal anu social skill in interaction...
with others. This was not evident in
the nonjoker group. Interactions ob-
served bet\\ een nur,es and jokers \\ ere
suggestive of a sharillg (?t' uhat it lI'a.\
like to llline and u'hat it l\'ll
li/"'(' [(} be
nlined. Little interaction \\a... ob...erved
between nonjokers and nurses and non-
jokers anu other patient....
2. Joker... tendeu to he in rooms
where other occupants joked. '\1on-
jokers tenued to be in rooms where
other occupants did not joke. In their
spdre moments. nur...es tended to gr dvi-
tate to rooms characteri7ed b) ajoking
climate.
J. Jokers diu not tend to complain
of pain and minimi.red other ph) ...ical
and p...ychological d i.,com forts. Non-
FEBRUARY 1974

jl)kers appeared to be preoccupied with
...uch discomforts.
4. \lore non jokers than jokers re-
ceived tranquilÌiLers uuring' ho"'pitali-
7ation,
5. :\1ore jokero; \\ere gainfull) em-
ployed prior to hospitaliLation than
nonjokers. \1any nonjoker... were social-
I) ueviant \\ ith respect to problems of
alcohol ism. retardat ion. mental illness.
and criminal activity.
6. Joker... focused on lik outside
hospital - their \\ork and recreational
acti vities. Nonjokers did not.
Variables that did not discriminate
bet\\een jokers and noniokers \\ere.
fever. diagnosis. :o.urger). tÌ-action. anal-
gesic and sedative medication. length
of stay. previous hospital experience,
la'
g.uage, age. sex. religion. and ethnic
orrglll.
A perceptioll wa., conceptualized a...
a judgment hy a person of another's
characteri...tics or attrihutes. A total of
II I statements were collected and cate-
gorized along the dimension of IlI/neS'
perception. !\: inet) -four (X5 percent) of
them \\ ere ohtained from \\ ritten re-
corus. and 17 ( 15 percent) from verhal
remarks made by nur...es ahout patients
in casual convcrsation. Items were

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as...igned to t\\O categories. the .,ocial
nature of the patient and the progre....,
he \\ a... making in ho"'pital. :\urse...tenu-
cd to perceive joker... a... soci.tble anu
progre,...ing \\ell. and nonjoker, a... un-
...ociable and not progressing well.
A total of 42 statements nldde bv
patients about nurse, and/or nursing
care \\ere considered as indice... of pat-
terns of patiell1s' perception. Jokers
tended to perceive nur...e... as ...ociahle.
efficient. but busy, Nonjokers tenued to
percei\'e nup,e... a... unsociahle. ineftÏ-
cient. and bus).

Bhusari, Marjorie. A \tlidy of
Hrategies and slih.\('lf/i('111
ol/1co/lle.\ ill a p.\)'chiatric
\h1Jltre.11. Quehec. I (r I.
(\'1.5c. (Appl.)) \1cGill L'.

111/ r.\ /II,!.!
patiem
\eftillg.
Stud)

In nur
ing \\e ha"e little de...niptih:
e\ idenn: on \\hich to h.lse hoth practice
and teaching. of ho\\ nur...e... practice.
or of h(m patients hehave in respon...e
to their nur...ing, This is a de.,eripti\e
study of the rdation...l1Ïp... among nur...-
ing ...trategie... and sub.,equent paticnt
outcomes.
:\. nur.,ing .,trateg) \\ as defined a...
a verhal or nOI1\ erhal nur'\e heha\ inr
performcu \\ hile nur.,ing a pati.:nt. anu
a patient outcome as a behm ior occur-
ring in response to a nur.,e ...tratcg
.
The ...tUlh \\ as conducted h\ the method
of groundeu theol'\. D.lta \\'ere collect.:d
h

participant (;b...en ation of inter-
action... het\\een
l) patient... and 13
nur...ing ...taIT. in a ...hort-term p...)ehiatric
...eui ng.
'\n7Ih.,i., re\caleu that nur...e ...trat-
egie... \\- ere not ljual itat i\ eI) uifll:rent
from patient l'lItcome.... Six .,uch ...trat-
eg) anu outcomc t
pc... \\ere identilïeu.
a\ oidance. p()\\er-prote.,t. hargaining.
illiorming. inquir). and aCljuie.,cence.
Both nurse... and patient... u...ed inform-
ing. inljuil'). and P(1\\ .:r-protc...t .,trat-
egie... more frelju.:ntl) than the) did the
remaining three. Characteri...tic panel'll"
llf relation...hip... \\ere identilïed anll)J]g
.,tratcg
t
pc... and outcome I) pc.... IlK'
\ ariou., qrategie... of nur.,e... and p.ttienlS
\\ere conceplUali/ed a... falling along a
...inglc control-compliance conllnuum
extending from a\oidance to acquie.,-
ccnce.
rhe finding., .,ugge...t "e\ eral area.,
for .,Uh.,L'l.luent de...crrpti\e re
earch.
I. hm\ .,trategie... anu oulcome., arc
affected h) .,eiíing. t
pe of illne.,.,.
...tage of illnc....... or the e'\p.:cted COlli ,e
of illnc.......
2. the di.,co\ er
01 conceph and
h
pothe...e... rele\ anI hI the area of
control.
3. the effect... in pr.lctice of teaching
nur...ing a... inljuir). that i.,. a" a continu-
ing inljllir) into \\ hat OCClll.... ...uh...
.lju'-.nt
to particular 1lI11,.,ing .tct.,. .:
THE CANAQIAN NURSE 53

books

The Crisis Team: A Handbook for the
Mental Health Professional by Ju-
lian Lieb. Ian I. Lipsitch. anu An-
drew E. Slaby. I X6 pages. Hagers-
town. Maryland. Harper and Row,
1973.
Rl'I'Ù'ln'li hy Philip /-. T. COI\'l'/' ,
(ormer A ssistafll Director (
( Nursing
Sen'icc, Queell Strl'l't MClltal Health
Cell1re, {orollto, ()ll1ario.

In this expensive paperback. the organ-
izational structures required to support
a multidisciplinary team's work in crisis
intervcntion MC plainly stated and
described. Because it is aimed at prac-
tically anyone interested in this work.
psychiatrists or clinicians familiar with
this aspeet of psychiatric care will tind
The Crisis ream somewhat repetitious.
Nev\'comers and trainees. on the other
hand. \\ill find thc book a helpful walk-
through of how to set up and run a suc-
ccssful crisis intervention center.
The varied readership at which this
hanubook is aimeu somewhat blunts
the two major elements. fhe review
of crisis intervention as a technique
is too briefly outlined to provide a
complete grasp of the real nature of the
worL and the clinical casc histories.
\,hile numerous. arc too sketchy to be
proper models for emulation.
In addition. the descriptions of the
structure and functioning of. a unit as
an organization would need furtha
amplil
cation to be really helpful. How-
ever. ample references on crisis inter-
vention methodology arc provided, anu
careful reading will sort out the form
of organiLation the authors recommend.
rhe 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
addres:, where more eopies of the forms
could be obtained, as they are com-
pre hensive. scl f-explanatory. and adapt-
ahle to a variety of settings.
Crisis intervention is an essential
p<lrt of modern. community-oriented
p"ychiatric 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
qual it ies needed for successful perform-
54 THE CANADIAN NURSE

ance arc not restricted to doctors. this
book encourages nurses or other profes-
sionals to accept an active role in the
organization and pr,wision of a com-
plete eri"is intervention service.

Midwifery by Jean L. Hallllm. 15::!
pages. London. English Universities
Press. 1972. Canadian Agent. Mus-
son, Don Mills. Ontario.

Rel'iel\'ed hy ,\;J.1'. ,\;Jilt/red Morris,
A ssislallt Prt
f'e.,.'or, School (
( Nun-
illl<, Ullivcrsity (
( Ottal\'a, Ottal\'a,
Oll1ario.

This text is part of a modern nursing
serics designed for student midwives
in the United Kingdom. The author
stresses that childbirth is a natural phe-
nomenon. and states: "U nnccessary
interference with nature can cause much
harm:'
Further. the author deplores undue
haste in the management of labor. She
gives as examples
thc use of an episio-
tomy except in an emergency. oxytocics
ro hasten placental separation, anu the
Brandt Andrews method to deliver the
placenta. However. in North America
thcre is general acccptance hy nurse-
midwives of the use of midline episio-
tomy where indicated; these indications
arc broad compared to those listed hy
Hallum. such as prevention of a severe
pcrinealtear.
Careful proofreading would have
elim inated distracti ng typograph ical
errors. ti,r instance on page II. 510 gm
is given as the weight of the non-
pregnant lIterus. and on page ::!9. chro-
nic villi. Generally. this work seems
oversimplified; the physiologic hasis
1'01 treatment is not generally stah:d.
hut rather information is presented
without explanation. However, the good
line-drawings add to the reader's unuer-
standing. The lIse of rhetorical ques-
tions hreaks the continuity of the
material and. at times. the author secms
\0 he "crmonizilll
.
One wonuers
why a treatment re-
garded hy North American and Euro-
pean authorities as heing of historical
interest, the use of Willet's forceps to
apply traction to the fetal scalp in the
management of marginal placenta pre-
....i<l. is incluued in a basic text.
An excellent summar) of the train-
ing programs for miuwives in the UK

is included. which should interest
nurses and nurse-midw ives in other
countries. The use of thi" \\ork as a
reference for Canadian nurses and
nurse-mid\vives is limited. since mater-
nit) care here. particularly management
of lahor. is di fferent from that descrihed
hy the author.

The Interpersonal Basis of Psychiatric
Nursing hy A. H. Chapman and E]/a
1\1. Almcida. 5lJ
pages. Ne\\ Y 01'''-
Putnam's. IlJ'::!. Canadian Agent.
:Vlacmillan. Toronto.
Rn'icl\'ed I", A1(/r
arct R. Wehh,
IllSlrt/clor, .\cl!ool ;
( N IIni IIg, Ulli-
\'enily o((ì"gary, ('/lig/lry, Alla.

This text meets the ohjective set forth
hy thc authors. it is a "'clear. compre-
hensive texthook of psychiatric nurs-
ing:' The book covers all aspects of
psychiatric nursing. ranging flOm its
heginnings in the nineteenth century
10 the present. As well. sections are
included that are not typically ll1und
in ps)chiatric nursing texts. such as
di"cussion of common ènll1tional proh-
lems found in medical and pediatric
nursing. and the nurse's role in psychiat-
ric research.
This is a valuahle text Iì.>r under-
graduate students. and one thl:) would
USè in all areas of nursing. Each chapter
is summarized hy a list of the important
nmcepts presented in that chapter: a
fairly extensive glossary of psychiatric
terms is included at the end of the hook.
Unlike many of the current ps}chiat-
tric nursing texts. this book still relàs
to patient... as diagnostic entitie
rather
than in hehavioral terms. However.
includcd \\ithin each patiènt classili-
cation is an e'\tensive description of the
nursing care required b) these patiel1ls.
Of particular interest is a chapter deal-
ing with the assessment of the ps)chiat-
ric patient. An a.,...e,smènt fr;lIl1e\\orh
is outlined. indicating the various wa\s
in which each memher of th
' healíh
team. such as the nurse. the p"ychol-
ogist. and thc ps}chiatrisl. contribute
to thè tÒrmulation of the p"ychiatric
diagnosis.
As well as hcing useful for the un-
dergraduate student. th is hook would
unlk)l(htedly he a valuable refercnce
"ouree Illr nursing libraries.

(Continued on page 56)
FEBRUARY 1974

.
.

.
.

E

.

51

I

INSTRUCTOR'S NOTE: To receive a com-
plimentary copy for firsthand evaluation,
write to the Textbook Department, men-
tioning your position, course, and enroll-
ment.

FEBRUARY 1974

New 6th Edition!
NEUROLOGICAL AND
NEUROSURGICAL NURSING

Carini-Owens

Highlighted by extensive revisions, this new 6th edition appears as 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; 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 $11.85.

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. Januarv, 1974. Approx. 240 pages, 8" x
10",266 illustrations in 234 ECG tracings. About $7.10.

.

I

new Mosby nursing books
accelerate student
achievement

...

MOSBY

TIMES MIRROR

THE C V MOSBY COMPANY. L TO
86 NoRTHLINE ROAD
TORONTO. ONTARIO
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New 3rd Edition! labunski et al

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 I-VIII, 7%" x 10W'. Price, $6.25.
THE CAN DlAN NURSE 55

books

(Coll/illllt" li'olll!'agt 541

Childhood Learning, Behavior and the
Family by Louise C. Taichert. 112
pages, Ne\\ Yor\.... Behavioral Pub-
] ications. 1973.
Re\'iewed hy ClIthrYlI GlwlI'ille, As-
sociate Profl'Hor, ,'\,1cMaster 1I 11 i-
I'ersi ty School (
r Nllrsillg. Ilamiltoll,
01ltario.

This boo\... presents a neurodevclop-
mental-family approach to understand-
ing and managing childhood learning
and behavioral problems.
The neurodevclopmental approach is
based on the assumption that. although
the ch ild and his fam il) are separate
systems. they must be viewed together
as a functional unit. Such an approach
provides fÒr a process-oriented. non-
catagorical assessment of the child's
devclopmental levc\ and how this is
inlluenced by many variables \\ithin
the family system. fhese variables could
be. communication patterns. norms.
values. and roles. fhis approach is
quite different from the traditional
meuicalmoucls. which tend to empha-
sile diagnostic labels and management
of the child in isolation from the towl
family.
The first t\\O chapters present a
historical review of critical issues of
ehildhood learning and behavior. whieh
extends beyond the nature-nurture con-
Ilict. Critical phases of learning as des-
cribed b) Eri\...son. Piaget and Freud
are compared. 1 he author not onl)
identifies specitïc learning problems.
but abo describes th.
learning process
involved in achieving academic las\...s,
Chapters three

ld four focus on
behavioral evenls occurring as the child
\\ith specific learning diso
ders and his
familv interact with each other. Pat-
terns 'of communication within a dosed
family system and a dysfunctional
famil) system are examined and cases
cited as exampk
s.
As the treatment anu management of
childhood learning and behaviZml1 prob-
lems are described in chapter five.
continuous emphasis is placed on the
signitìcance of early detection of high-
ris\... children.
Chapter six describes how the neuro-
developmental approach to learn ing anu
behavioral problems is made operation-
al through the use of gestalt-oriented.
conjoint. family therapy. Cases are
presented to illustrate the therapists'
tas\... in helping the chilu and his family.
This boo\... is excellent for anyone
\\or\...ing with childn:n and their fami-
lies.
56 THE CANADIAN NURSE

t

'''''' "
"" :J
"
""'- "
.,.... :;

Go..... r

""'(fri.

'C

IEt.,
"

I'C"' '" r"

Perspectives in Human Development;
Nursing Throughout the Life Cycle
by Doris Coo\... Sutterley and Gloria
Ferraro Donnely. 331 pages. New
York. Springer. 1973. Can:.!dian
Agent. Lippincott. foronto.
Rel'ieU'ed hy Raymolld M. Ihomp-
.\IJI/, Assi,\tWll PrOfl'\'Sor, UlIÎl'ersit\,
(
r British CollI>>ll,jo School (
r NUI'.
-
illg, VallCOlIl'er, B.C.

rhe authors of this publication have
used systems theory for presenling a
multidiscipl inary view of man. fhe
boo\... is intended to meet the learning
needs of freshman nursing students.

Eight life processes form the frame-
\vor\... tiJr the presentation of content.
An attempt is made lo demonstrate
the relationship among the processes.
thereby credting a multidimensional
view of man. Olher content areas of
panicular note are related to systems
theory. clwironmental factors inlluen-
eing man. and the profession of nursing
vicwed as an open system. fhe treat-
ment of the content is of sufficient
breadlh and depth to be stimulating
tÒr the beginning IlUr"ing student.
Cases are used to 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 fc\\ of the cases pose problems
and could be used as a basis for further
discussion; otherwise the use of the
cases for lhis purpose is extremely
limited.
An extensive number of tïgures and
tahlcs provide the reader with vast
amounts of data in an organized. use-
ahle format. Of particular note are the
\\hipple Age-Ponrait Summaries that
permit the reader to rake a theory. such
as hic\...son's. and identify behaviors
characteri/ed in lhat theory. A few
of these tabks and figures are complex
and appear superfluous to the purposes
of the boo\....
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
arc for p.::rioJicab. which is interesting
because these publ ieations are the
source of much of the up-to-date infor-
mation. Also of note is a uearth of
nursing references. particularly \\hen
excellent ones relevanl \0 some areas.
such as systems theory. do exist.
Although the publ ication is for
nursing and is relevant to nursing. there
is a lim ited attempt to demonstrate for
the intended audienee 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 boo\... may well serve as one
item in the data base needed for the
effective use of the nursing process.
The chief value of this hoo\... is as
a reference in obtaining a brnau. inte-
gratcd view of man throughout the life
cycle. Because of its particular frame-
wor\... t{,r the prcsentat ion of content.
il may be difficult to use this success-
fully as a text in a curriculum lhat uses
a diflerent system model.

Industrial Mental Health and Employee
Counseling, edited by Robert L.
Nolanu. 432 pages. New York,
Behavioral Publications, 1973.
Reviewed hv Rachel Aim Gow.
Industrial Ni,rsc, Air Canada, To-
romo I nterflat iOflal Airport.

"A problem employee is one who does
not eontorm to the social-vocational
role expected of him at his place of
employment." This boo\... is concerned
with the problem employee. Its purpose
is to provide the reader with a com pre-
hen
ive view of what various compan ies
and individuals have uone to understand
/Co,,/il/{It'd 0" {Jllg<, 5X)

FEBRUARY 1974

A New Book!
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.

Mcinnes

By BETTY MciNNES, R.N., B.Sc.N., M.Sc.IEd.1. July, 1973. 112 pages plus FM
I-XII. 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.. B.S.; and REBA D. GRUBB, Medical Writer. August,
1973.160 pages plus FM I-XVI. 6" x 9", 40 illustrations. Price, $5.15.

.
.

 SICS
EY.N.

.

.
.

...

new Mosby nursing books
initiate professional
awareness

MOSBY

TIMES MIRROR

THE C V MOSBY COMPANY. l TO
86 NORTHLINE ROAD
TORONTO. ONTARIO
M4B 3E5
A New Book! Gahart
INTRAVENOUS MEDICATIONS-
A Handbook for Nurses And Other Allied Health Personnel
In this unique new volume, the author presents the complete, specific, stat
information designed to aid you in the administration of all LV.
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

FEBRUARY 1974

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. 118 pages plus FM I-X. 6" x 9". Price, $4.15.
THE CANA
AN NURSE 57

books

(Col/ti/ll/C'c/ f,.o/ll I'"ge 56)

and deal effectively with problem
employees.
The book is divided into tïve parts;
each part is a collection of papers by
academic, medical. and industrial
experts.
Part I concerns mental illnes
, hO\\
it effects productivity and efficiency,
and the economic consequences of job
disruption. An interesting chapta
deals with identifying emotional di
-
turbance in persons seen in industrial
clinics.
A recent study tì.)und 15 percent
fewer industrial clinic patients than
patients in a general group medical
practice were considered b) nonpsy-
chiatric phy-;icians to have an emotional
problem. The author feels thi
coulu
be attributable to the fact that employ-
ee
in these companies were initially
screened th rough job interview
and
phy
ical examinations.
Where companies encourage health
care by partial subsidy of good in sur-
dnce coverage and where a company is
supportive of employees with emotional
problems by eliminating stressful
on-tne-IOD 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 hit
forgetful. a bit
uspicious, a bit compul-
sive. irritable, and angry. and still be
very much a normal person," These
anu other traits arc discussed in Part
I L 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 I II deals with the multiple
approaches to employee counseling.
from the role of the psychiatri
t in
industry. through the value of clinical
counseling. to the role of the pa
tor
in employee counseling.
Part I V has four ch apters deal ing
with the mental health of supervisory
and managerial personnel. the impact
of their problems on the organiLatiÒn,
and the care that must be taken in
dealing with the problems of people
at this level.
Part V is composeu 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, anu interesting to read.
It eould be a val uable reference tÖr
any occupational health cI i nic, for
college
tudents in personnel or indu
-
trial management, or management
personnel and industrial training in-
structors.
Although the book deals exclusively
\\ ith 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. 19X pages. New York.
Springer, 1973.
Reviewed by Christina I. Mihoski,
Teacher. Nursing Program, Confed-
eration College, Thunder Bay, Om.

rhis book deals with behaviors tì.1Und
in per
ons with various health problems.
which makes it more versatile anu
worthwhile than a basic text related
specificalh to psychiatric problem
.
The authors recognize the need for
all health workers to develop mean-
ingful anu as
ertive intervention to meet
a dienfs emotional needs. It is pointed
out that m<iny' health workers avoid
patients with emotional needs as the
worker is not sure of what to say or
do. With thöe two premises in mind.
the authors have prepared a short man-
ual that describes problem behavior,
discus
cs the dynamics i nvol\, cd, and
suggests approaches suitable tì.)r use
in any ho
pital or community setting.
The book is divided into two sections.
The short, tïrst 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 im.portant as studying
and understanding the patient, since
the health worker is 50 percent of a
one-to-one rei ationsh ip.
It also establ ishes that the health
\\orkcr cannot begin to understand
and help the patient until she has
understood and dealt with her own
fedings appropriately. Many examples
illu
tratc that. too often. the nurse's
conclusions about a patient arc colored
b) her own per
pectives and do not
accuratel) re!lect the patient's needs.
The chapter dealing with crisis
inh:rvention provide-; a broad over-
view of crisis points in lite, as seen
from a maturational outlook (the stress
time
of growth and development!. It
might have been auvisablc to delineate
between the normal development.,1
crisi
, such a
weaning or puberty, and
the accidental type of crisis. such as
loss of a joh, illness, or being a victim
of a disaster.

In the longer, second section of the
boo", 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
anu 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-
ualthat coulu 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. ill us. by Jane SulIivan. 95
pages. New York, Springer, 1973.
Rniewed by Kay Dejong, Inservice
t.'dllcatio" Instructor, St. Bon
face
Gl'fllnil Hospital, Winnipeg, Man-
itoba.

As happens so often in this rapidly
changing world of health care, the
specialty world for which a book was
originalIy 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 Learner
," in which the
author assumes that the nurse to whom
her book is directed is "idealIy" a nurse
who works in an leu or ecu. 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.
(Colltil/I/eel Oil (Jage 60)

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, 6%" x 9%",13 illustrations. About $6.30.

A New Book!
BEHAVIOR MODIFICATION
AND THE NURSING PROCESS

Berni-Fordyce

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, 5%" x 8W'. Price, $4.15.

BASICS
BEY · I

.

...

new Mosby nursing books
enhance interpersonal
perception

MOSBY

TIMES MIRROR

THE C V MOSBY COMPANY, l TO
86 NORTHLINE ROAO
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., MS.; 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!
NURSING AND THE PROCESS
OF CONTINUING EDUCATION

Popiel

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 I-XX, 6Y," x 9%". Price, $7.30.

FEBRUARY 1974

THE CANADtAN NURSE 59

books

(Co/lti/l/led /;'0111 page 58)

The division of the boo\... 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 CV p's will tind the
entire program necessary and benefi-
cial. The author has repeated many
questions several different ways; this
ma) stimulate learning in the young
student. but may not do the same for
the RN who wishes to review CVP.
The objectives. generally spea\...ing,
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 goillg to be
used by a large number of people. Its
spine may not stand the stralll

There are areas that \Ve fÓund 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 mar\... 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 claritied whether tlush-
ing is accomplished by gravity !low of
IV solution or by forcing tluid under
pressure through the tubing. Gravity
tlow would probably not dislodge a
wcll-formed clot in the evp catheter.
but tlushing with a pressure device
could. resulting in the death of a pa-
tient. due to an embolus.
The procedure for removing the
CVP catheter has not been included by
the author.
Although the author has recommend-
ed the book for both grauuate!-. anu
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
"<;tandard" of \...nowledge and perform-
ance of CVP mea<;urement.

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 Columhia
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 boo\... 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 moditication. Of par-
ticular value is their frequent use of
examples of patient situations, describ-
ingobservable 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 detaileu. 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
arc 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 III
the last few ehdpters of the book, III
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 problcm-
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 shoulu allay the
fears of those who view behavior mo-
dification as a covert manipulation of
patient behavior.
The book itself takes the fonn 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 arc interested in
applying a well-defined methodolog)
for nursing intervention, rQ

AV aids

DATA BANK SERVICE
o The University of Southern Cali-
fornia is otfering the N ICEI\I Update
Subscription Service to upuate and
supplement all previous NICEJ\I in-
dexes. NICEM has published 14 com-
prehensive volumes dealing with non-
book media. The subscription sèrvice
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-volul11e set
to find new titles in all the media and
all subject areas, and abo helps those
who only need access to one media
volume, such as the Inuex to 16111m
Educational Films.
For more information, write to the
University of Southern California,
National Information Center for Edu-
cational Media, University Par\..., Los
Angeles. California 90007, U.S.A.

AUDIO CASSETTES
o 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 Ij>ro
lcms. 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 tive presentations:
the uses anu abuses of moral stages;
the uses of psychology in contlict reso-
lution in a university setting; exploring
values for career decision making: a
computer-based system of interactive
guidance and information (SIG I); a
signiticant change in direction: its im-
plications for psychological measure-
ment; and four talks on the contribu-
tion of measurement to self-under-
standing.
The Proceedillgs 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
Tcle-Film Enterprises, Toronto. Ont.
Among these films, The Heart A !tack
(25 min.. color) explores the nine risk
factors of heart disease: high blood
pressure. cholesterol level, excess
weight- overnutrition. sedentary living,
stress. age. diabetes. and heredity;
The Heart: Counteratlack (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 FUllctiollillg Struc-
l/Ire, Part I (30 min., color) covers
aspects of the living cell as pan of the
proeess of I ife 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 IlIflillCY (20 min., color) examines
the infant's early development.
Films on abortion and acupuncture
anesthesia are available from Cinema
Images, a division of International
T dc-Film Enterprises. 221 Victoria
St.. Toronto. Ontario M5B IV5. 'G'

accession list

Publications on this list have been
received recently in the CNA library
and arc listed in language of source.
:\I.lterials on this list, cxcept refer-
FEBkUARY 1!Í74

ence items, may be borrowed by CNA
members, schools of nursing and other
institutions. Reference IRI tlems (ar-
chive books and directories. almanacs
and similar basic books) do 1I0t go out
on loan. Theses. also R are on Reserve
and may go out on Imer/ibmry loall
ollly.
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 I E2.
No more than three titles should be
requested at anyone time.

BOOKS AND DOCUMENTS
I. Areawide pIW/l/Ù/R for illdepell<lellt lil'illR
Ji)r older people. COllft.'rellce 01/ Gt.'rolltology,
2211<1, UI/il'enih of Florida, Feh. 6-8, edited
by Carter C. Osterbind. Gainewille. Fla..
University of Florida Pres
. 1973. 14:!p.
2. Bartlett',\ I/llji,,"ilill/ quotatioll.\. by I eo-
nard Louis Levinson. Chicdgo. Cov.les Book
Co.. 1971. 341p. R
3. Ba.çic 1i/Cl" of hody lI'att.'r al/d ion\, by
Stewart Marshall Brooks. 3ed. New York.
Springer. 1973. 117p.
4. Ba.\ic IlI/lllall (/IwtolllY ali<I pi,,' \t%g.".
by Charlotte M. Dienhart. :!ed. Toronto.
Saunders. 1973. 280p.
5. BaÜi lihmry lIIallaRi'lIIi'llI fi,r Itealth
"ciel/ce.\' lih/'{/rie.ç, by Ann L Schadp. :!ed.

:\Iadison. Wise.. University of Wi'iConsin
Extension. Depl. of Communication Arts.
1973. 304p.
6. Biller lI'age.ç; Ralplt Nada'" "lUdy Rroup
report Oil di.\i'a.\(' alld illjul\' Oil tlte joh, by
Joseph A. Page and Mary-Win O'Brien.
New York. Grossman. 1973. 314p.
7. Cal/adial/ gOl't.'rI/I//l'l/t prORI'l/lIIl11e.\ alld
"en'ii'i'.\; Ro\'erlllllellt orR(llIi
lIti,,". Sepl.
1973. Don Mills. Ont.. CCH Canadian
Limited. 1973. 1 vol. R
8. Critical illcidellt.\ ill IIursillg. Edited by
Loretta Sue Bermosk and Raymond J. Cor-
sini. Toronto. Saunders. 1973. 369p.
9. Deci"ioll mll/..illg ill lite corOllal)' ('arc Ullit;
a mtllllwi alld 1I'0r/..boo/.. for IIurse.\, by Wil-
liam P. Hamilton and
Iary Ann Lavin.
SI. Louis. Mo
by. 1972. 1
Op.
10. Dictiolllwire pratique de thél'llpi'lIIique
",édicale. par Léon Perlemuter et al. Paris.
Mæ-son. 1972. 1200p. R
II. Directory (
f ill/ulihrary 10111/ policie.f
alld plwto('op\'il/K serl'ice.. ill Call1ldillll li-
hl'llries. Compiled by the Committee on the
Directory. . . , Information Services Section.
Ottawa. Canadian Library Association. 1973.
S8p.
I:!. E\'(lIuatioll ill the cOllti/wUIll (
f medical
educatiol/. Philadelphia. National Board
of Medical Examiners. Committee on Goals
and Priorities. 1973. 94p.
13. Forlll al/(l fill/clioll of II'ril1ell IIgreemel/1.\
ill tlte clillical educatioll (
f healtlt profe.ç-

Some nurses are just nurses.
Our nurses are also
COmmissioned Officers.

Nurses are very special people in the Canadian Forces
They earn an Officer's salary, enjoy an Ofhcer's pnvlleges
and live In Officers' Quarters (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
trammg with no loss of payor privileges. Promotion IS based on
ability as well as length of service And they become eligible for
retirement benefits (mcluding a lifetime pension) at a much earlier
age than In civilian life.
If you were a nurse m the Canadian Forces, you would be
a special person domg an especially responsible, rewardmg and
worthwhile Job.
For full mformatlon, wnte the Director of Recuitmg and Selec-
tIOn. NatIonal Defence Headquarters, Ottawa. Ontano KIA OK2

,>þ
'\.r

,

,'t
--:

- ,,-

Cet involved with the
canadian Armed Forces.

THE CANADIAN NURSE 61
"

accession list

,iOlwls. by Margaret L Moore et al. Thoro-
fare. N.J.. Charles B. Slack. 1972. II I p.
14. I tI ./i'rllltilioll de.' chac/"'lIn ell .'CÙ'IICl'.,
lIIedi..tlll's; COIII/Hl' rl'",11I d'lI11l' ltlhll' rOllde
orl:tllli"él' par Ie C/O/\1S lII'l'C /'a\\i.\l"'lCl'
de /'O,\1S d de {'VNESCO, Gelli'!'{. /0-/ I
'eplelllhre 1970. Genève. Organi
ation I\10n-
diale de Sante. 1973. 206p.
15. C'l'al adl'l'II1llrl" ill IIl1nÙ/K, edited by
Helen Wright and Samuel Rappolt. New
\ or". Harper and Brother
. 1960. 2XXp.
16. \1l'lIIhl'nhip dirl'clory. /973. American
I ibrary A

ociation. 1973. 21 Xp. R
17. 1",IU.\lrial III ell lal /1< allh al/{l l'lIIplm'l'l'
cOllmdillK, compiled by Robert L Noland.
Ncv. York. Behavioral. 1973. 432p.
I K A II ill1rodllCliolllo lI'or/..illK lI'ilh lhl' agillg
{'l'noll II'ho i' I'i.,"all\' 1I<lIldicappl'd. New
\ or". American Foundat ion for the BI indo
1972.51 p.
19. ,\ficro-Rohal: dic1iol/lwire dll Inlll{1li.,
pril/lordial, apr Paul Robert. Pari
. S.N.L
Le Robert. 1971. I 207p. R
20. .\ oi.,l'; all occllpaliollal I",:ard a ",I
pllMic IIl1i.mlla, by Alan Bell. Geneva.
World Health Organization. 1966. l3lp.
,World Health Organization. Public health
paper
no. 30)
21. ,vlll'.\{',' allllllllae jOllrnal, 1973. Winnipeg.
The Alumnae A
'>Ociation of Winnipeg
General Ho
pital. School of Nursing. 1973.
91p. R
22. flI<' IIl1nillg clillic., of Norlh AIIH'/ ica,
1'01. 8, 110. 3, Sepl. 1973. Toronto. Saundep;.
1973. p.375-570. (Contents. -Fmergency
nur
ing, -Maternal and infant care in high-
ri
" fam il ie
)
23. PO"/..l'l pal. A gHlphic- arl.' dig"'l ti".
I,rilllen alld {/{/I'l'rli.,iIlK I,rodllclioll 111"'/-
"Ken. ged. New Yor". International Paper
Co.. 1966. 190p.
24. I he prillcipll',' alld praclicl' 01 '"rKelY
Ie". IIl1nl'.' al/{l allied Im!le.\.\ioll,'. by Denis
I-rederic Elli
on Na
h. Sed. London. Ed-
ward Arnold. 1973. 9X7p.
2'i. P'yehologicalle.\ls: rlll'ir II\{' a",/I'alidil\'
ill sdec1illg calldidall'.' lor .,c/wo/., 01 IIl1nillK
ill ISl'lIl'I, by Rebecca Bergman et al. Tel-
Aviv. Tel-Aviv Univ.. Faculty of Continuing
:\Iedieal Education. Dept. of Nur
ing. 1973.
46p.
26. Reader ill IIIl'diml lihnlriall.,f1ip. Edited
by Winifred Sewell. Washington. CD.. NCR
Microcard Fdition... 1973. 3X2p.
27. {!//{'.'l '/;'1' lhe 01' lilll 11111. Procl'l'dillg' 01
lhl' "'/llualllled illK or A .\.\oc ia 110 11 or Vllin'r-
,ilie.' alld College., 01 Callada, TOI'OIIlo. Ocl.
3()-Nm'. 2, 1972. Ottawa. The A"ociation.
1972. 123p.
2X. Rl'fl'l'l'IIC<' hoo/.., ill papl'rhtlc/..: all alllwl-
aled gllidl, edited by Bohdan S. Wynar.
I ittleton. Colo.. Libraries Unlimited. 1972.
199p.
29. Rl'pOrl 1973. london. Royal College of
62 THE CANADIAN NURSE

Nursing and National Council of Nurses of
the l'nited I<..ingdom. 1973. 66p.
30. Reporl 01 lhe Calladiall Vllin'nily Nlln-
illl: Sllldl'lIl.' A.\.\ocialioll COlllál'IICl', Hali-
Iltx. rl'h. 9-1 I. 1973. Halifax. Dalhousie
Univer
ity. School of Nursing. 1973. 161p.
31. Rl'.'I' ira 10/"1' illll'II.,il'l' carl' IIunillg, .fi-Olll
Bl'lh Isra'" Ho'pilal, BO.'lOll, by Sharon
Spaeth Bushnell with 3 contributing authors.
Boston. Little. Brown. 1973. 3'i4p.
32. Saullden Il'.'I.' I;", sl'(t:l'nilllalioll l!f 111/1'.'-
illg COlllpl'1<'IICl', by Dee Ann Gillie
and Ire-
ne Barrett Alyn. 2ed. Toronto. Saunders.
1973. J92p.
33. A rl'xlhoo/.. lêJr IIl1nilll: ani.'lal/ls. by
Gertrude D. Chere
cavich. 3ed. St. Loui
.
Mosby. 1973. Hip.
34. The Vllin'nily l!f Ollall'a School l
f
Nllnillg 1933-1973. Ottawa. University of
Ottawa. School ofNur
ing. 1973. 145p. R
35. WOlIIl'lI ill lhl' In,r/.. "}ITl': procl'l'dillg\ l!f
a COl
lál'lIcl' spolI.",rl'd hy lhl' Dil'isioll of
Pl'nOIlIl'" P'yc1wlog\' oj lhl' Nell' YOI'/.. Slall'
P\\'chological A.\.\ol'Íalioll. NOI'l'mher, 1970,
.Vell' } or/... Edited by Mildred E. I<..atzell
and William C Byham. Nev. Yor". Behav-
ioral. 1972. X6p.

PAMPHLETS
36. Addrl's., lisl, 1973-74. Ottawa. Canadian
Medical As'>Ociation. 1973. '9p. R
37. Alllhulalory care: all al/lw1aled hihlio-
graphy ld' recell1 plallllillg lilerawre, by
Gerald 1\1. Richmond and W. David Helms.
Monticello. ilL. Council of Planning Libra-
rians. 1973. 37p. (Council of Planning Libra-
rians. Exchange bibliography no. 404)
3X. Call lI'e cOllquer nlllcer? by Clifton R.
Read. New York. Public Affairs Committee.
1973. 2Xp. (Public affair
pamphlet no. 496)
39. The Calladiall 'celie. Firsl El.,ie Sll'phell-
SOli ,\lelllorial Leclure deli,'erl'd hy Pro.fi's.,or
IIdell ,\t. Carp ell I{'/' 01 Facully of Nur.,ÙlR,
Vllil'er.\lly or Torolllo Oil Wedlle."lay, 141h
.\larch. 1973. Edinburgh. University of
Edinburgh. 1973. 15p.

...

114'"
0"
,\ 'AC,

4"

....

'I

LOWE "fl".ff

NO" HA ....\'! 1
hdd ugly \uperlluous hair.., was
unloved, . . discouraged. Tried many
things. . . even razors. Nothing was
satisfactory. Then I developed a sim-
pic. painless. ine'"pensive. nonelectric
method. It has helped thow...mds win
heauty. love. happiness. !\Iy "RFE
book. "What 1 Did About Super-
Iluous Hdir" explains method. ylailed
in plain envelope. Also Trial Offer.
Write :\Ime Annette I anLette. P.O.
Box (,10. Dept. C-376. Adelaide SI.
P.O.. roronto 210. Ont.

40. COlllprellell.,i,'e hl'allil plallllilll? hihlio-
gmphy, by Robert G. Dyck. Monticello. ilL
Council of Planning Librarians. 1973. 28p.
(Exchange bibliography no. 392)
41. Housillg: a lIalio1ll,'ide crisi" by Maxwell
S. Stewart. New York. Public Affairs Com-
mittee. 1973. 2Sp. (Publ ic affairs pamphlet
no. 495)
42. Tile N LN pre-Il/Ir.,illg alld Ruidallce exa-
lIIillalioll. 4ed. New York. National League
for Nursing. Division of Nursing Education.
1965. 37p.
43. NUl'.\illg paper.', "01. 5, 110. 2, Seplemher
1973. Montreal. McGill University. School
for Graduate Nur
es. 1973. 35p. (Contents
-Teaching as guidance of learning. -Group
method
and personal growth. -Identifica-
tion of learning needs by means of critical
events. -Concept teaching in nursing)
44. Regi.\I/'l/lioll eXall/illalioll policie.
. Fre-
dericton. New Brunswick Association of
Registered Nurses. 1973.
45. ReporT, 1973. Ottawa. Canadian Council
on Social Development. 1973. 24p.
46. SOllie .,lalisl"'S 011 haccalaureale al/{l
Iligller deg".e pl'OgralllS ill lIursillg 1972-73.
New York. National League for Nursing.
Division of Research. 1973. 17p.
47. S.\'/IlposiulII 011 Child Ahuse, Nell' York
Vllil'{'/'.\Í1Y Medi{'{/I Celllre, Nell' York. Jlllle
15, 197/. Edited by Aaron R. Rausen. Evan-
ston. ilL. American Academy of Pediatrics.
1973. p.771-812. (Pediatrics. v.51. noA. pt.2.
April 1973)
48. A syslemalic allal).'.\i,' of joh de.\Y:riplioll.\
fi}r lIu/'.\illg I//lllwgelll ell I: 11011' 10 produce
Ihelll, holl' 10 u.\e Ihem, by Bernard W. Steel.
Edgware. Eng.. B.W. Steel. 1971. 31p.

GOVERNMENT DOCUMENTS
Ca Illlll"
49. Commission de la Fonction publique.
Bureau des Langues. Rédaclioll admillisl/'l/-
lil'e. Ll.xique. ji'{/Ilçai.\-aIlRlai." allglai.\-f/'llll-
çais. 3éd. Ottawa. 1971. l72p.
50. -. Bureau des Langues. Rédaclioll ad-
milli.'l/'l/lil'e. Ottawa. 1971. 7 vols.
51. Conseil des Sciences du Canada. Ewdt,.,
sur cl'rlaill aspe{'/s de I" polilique de,\ riches-
.'es IIlIWrel1es, par W.o. Bennett et al. Ot-
tawa. Information Canada. 1973. 126p.
(It
Etude spéciale no. 27)
52. Economic Council of Canada. for the
Interdepartmental Committee on Candide.
CANDIDE lIIodei 1.0: .\lII'illg alld cOI/.\IImp-
lioll, by Thomas T. Schweitzer and Tom
Diedule. Ottawa. 1973. 73p. (CANDIDE.
Project paper no. 2)
53. Health and Welfare Canada. Halldhoo/..
Oil dl','elopmelll l!r cOlllllllmily ell/ergellcy
II'l'
f<m' ,\C'/Tin'.'. Ottawa. 1973. 47p.
54. Labour Canada. Del'elopmelll.\ ill lhe
ellaCllllel/l l/Iul adlllillislralioll of laho"r """.\
ill Callada. 110. I, J/Ille 1973. Ottawa, 1973.
ll'ip.
55. Manpower and Immigration. Offices
"hroad. Ottawa. 1973. 9p. R
56. Parliament. Senate. Special Committee
on Science Policy. Repo,." ,'ol.J, A gOl'ern-
1I/{'1I1 orgalli;:"lÙJ1l lor lhe .'el'elllies. Ottawa.

FEBRUARY 1974

Information Canada. 1973. I vol.
57. Public Service Canada. 111/plel1/elllatioll
repOlt Oil statlls of ",Ol1/ell report rl'COIII-
l1/ellllatioll.\ hy the Pllhlic Sl'n'iCl' COl1/lIli.\-
.\ioll. Ottawa. Information Canada. 1973.
58. Science Council of Canada. St/"l/tl'gÍl'\ of
tJt'I'doPlIIl'IIt . (tn' the Calladiall cOlllpllter
il/dll.\try. Ottawa. Information Canada. 1973.
80p. I Its Report no. 21)
59. Statistics Canada. AmI/wi .\"Iaril'.\ of
pllhlic health I1//nl'.\, 1971. Ottav.a. Infor-
mation Canada. 1973. 50p.
60. -. COlltillllillg l'dllcatioll; pt.I, dl'l1/l'II-
tan-.\l'colll(ary Il'l.ef, 1970-71. Ottav.a. In-
formation Canada. 1973. 79p.
61. -. Falllilv l'xpellditllrl' ill Callada, 1969.
Ottawa. Information Canada. 1973.2 \ols.
62. -. HlJ.\pital .\tatl.\11CS, 1'01.2 HOIpital
.\t'r\"Íces, 1971 Ottawa. Information Canada.
1973.207p.
63. -. Ho.\pital .\tatlstlCS, I'ol'} Ho.\pital
per.\ml/lei. 1971. Ottawa. Informatiop
Canada. 1973. 228p.
64. -.Hmpital .\llIti.\1io, 1'01. 4 haltlllt'('
.\'hl'et.\, 1971. Ottawa. Information Canada
1973. lOOp.
65. -. Hospital stati.\tin, 1'01. 5 Ho.\pital
l'l'l'IIl1e.\, 1971. Ottawa. Information Canada.
1973. 78p.
66. -.Hmpital .wat;..tin, 1'01. 6 Hmpital
expellditllre.\, 1971. Ottawa. Information
Canada. 1973. 249p.
67. -. IIIstmctim/tl1 media ill the lI11il'l'r;itil's

(
f the AtlalltÍl pro\'Í//( l'.\, 1971. Ottav.a.
Information Canada. 1973. 35p.
68. -. II/.\tructio//\ allli dl'fìllitio/l.\ (tn the
wlllllal relllrll of p.\\'ch Ílltl ic lI11it.\. Otta" a.
1972. 1 vol.
Mallitoha
69. Committee on Health. Education and
Social Policy. White papel "" health policy.
Winnipeg. 197'2. 3 vol
.
Olltario
70. Ministry of Labour. IIIIllI.\try-spo/l.\ored
traillillg prog/"l/lIIlIll'S ill Oll1ario. AllglI.\t
1968-JII1.\ 1969. Toronto. 1973. 78p.
71. - Lahollr I/",r/..l't n'fJ('/"il'IICl' oj penoll.\
who rl'cl'Í\'ed adl'llllt'(, II"ticl' of l'l1/plo\1/1('1/1
terlllillatioll. by Ian B. Mch.enna. Toronto.
1973. II p. I Employnrent 'information o,erie

no. 4)
7'2. \linistry of Social Development. Lqllal
opportllllity .I;lr "'0111('11 ill O/llario: a plt",
for actioll. Toronto. 1973. 73p.
73. Workmen'
Compen!>3tion Board. Al/lll1al
report. 1972. Toronto. 1973. 36p.
Ullitl'd Statl'.\
74. Library of Congres
. Subject Catalogmg
Division. SlIhjC'ct headillg.\ lI.\ed ill the dic-
tiollary catalog\ of tl" Lihmry of COIIgreH.
7ed. Edited by Marguerite V. Quattlebaum
Washington. 1966. 1432p.
75. National I n
titute
of Health. SOI'Iet
l1/edie ille: a hihlio[?raphy 0.1 hihliogmphie.\.
Washington. U.S. Govt. Print. Off.. 197.:'
46p. (DHE\\ Publication no. INIH) 74-5751

Request Form
for "Accession List"

76. Public Health Service. The hmlth COII-
.\('lJI/('IIn'\ of.\lIlo/.. Ùw; a report of Ihe SlIrgeoll
G(//<'Ial: 1971. Bethe
da. I\fd.. 1971. 458p.
77.- -. Di\i
ion of Nursing. Re.\('arch Oil
III1/'.\e .\taOillg ill I/(I.\pital.\; report of a COII-
f<'rellu, \la\' 1971. Bethesda. I\ld.. 1973.
I 87p. (DHI-'W Publication no. INIH) 73--B4)

STUDIES DEPOSITED IN CNA REPOSITORY
COLLECTION
7K A di\CII\\ioll paper Oil ""nilll! a\.\i.\ItIllH
ill C(//lIl/la. A report of a .\lIn'l'Y. Prepared
for the Canadian N ur
e
' As
ociation. by
Sl
ter \Iadeleine Bachand. Ottav.a. Can,ldian
Nur
e
' A
ociation. 1973. lip.
79. A I1/lIltidilll(,/l.\icmal (//1//1.\'\i\ 01 1'01('
p erc l'f'tio/1 ill a I1/l'lI1//1 h('{tlth \\'\telll. by
Beverley J. Riddell. Calgary. A.lberta. 1971.
70p. IThe
is (:\I.Sc.) - CalgarY)R
XO. R('\ollrce.\ for the preparatioll of 'mr.\t'-
leach('r.\ - e\'/""Ùlt/tiO/1 o( a .\itll/llioll. b}
Shirley Yvonne Alcoe. :-.Jev. York. 1973.
238p. rThesis- Teachers College. Colum-
bia) R
81. The roll' of th(' 'IIInl' (prof;'.\\iolla/l ill
Ihe adlllilliwratioll allli il1/plellll'IIlatioll of
patiellt care, by h.atherine I\lacLaggan. Nev.
York. 1966. 54p. R
82. SOl1/e COIICl'pt.\ of dru[?-rdatl'd f'tlliellt
cart a.\ I iewed hy Ihe lIIajor health (art'
profn.\iclll\ ill Olllario. by James Lyon :\lann.
Toronto. 1972. 246p. (Thesi
1\1.Sc.Phm.)
- Toronto) R 'G'

Tropical
Diseases
and
Parasitology

CANADIAN NURSES'
ASSOCIATION LIBRARY

Send this coupon or facsimile to
LIBRARIAN, Canadian Nurses' Association.
50 The Driveway, Ottawa K2P 1E2, Ontano.
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.

T.ke our specie. cour.. In troplce. dl......
and ralatad subjacts. Thla equip. you to lunction
Intelligently.. . nur.. In .n environment wher.
.uch dl....e. po.e a health problem.

Open to gr.due'e nurse. Currently rev.l.ered In
their own prov.nce or .t.te ComprehenSlye 16
week cour.. commences In September .nd
Februery. Tr.in In modern. equipped centre with
.ttrectlye .ccommodetion 'or living in located
In ....'roPollt.n T oronlo

Request for loans will be filled in order of receipt.
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For information wrlle to.

.

.

I;'

..II .
health institute

..

Addre ss . ................ .... ...... ......... .... ........... ....... ............ ............... ...

4000 Lealie Street, 'Mllowdale,
Ontatlo. Canada.

.....................................................................................................

Date of request ...................................................... .....................

FEBRUARY 1974

THE CANADIAN NURSE 63
.

classified advertisements

ALBERTA

DIRECTOR OF NURSING required lor modern 25-bed
Hospital on Highway 12, East Central Alberta. Please
apply to Administrator. CORONATION MUNICIPAL
HOSPITAL CORONATION. ALBERTA, TOC lCO. Tele-
phone 578-3691.

REGISTERED NURSES required lor 70 bed accredited
active treatment Hospital Full time and summer
relief All AARN personnel policies. Apply In wrlllng
to the Director of Nursmg. Drumheller General Hos-
pital. Drumheller Alberta

REGISTERED NURSES required immediately for 72
bed accredited. actove treatment hospital. Also 1 R.N
lor 50-bed Nursing Home. AARN.AHA contract In
force Refund of fare after one year 01 service. ApPly
Director of Nursing. Providence HosPital High Prai-
rie. Alberta TOG lEO

BRITISH COLUMBIA

HEAD NURSE required for an acute modern 35-bed
hospital. located In southern 8 C s Boundary area
with excellent recreation facilities. PosItion to be
fIlled by April. 1974 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
RA TES

FOR ALL

CLASSIFIED ADVERTISINC

$15 00 for 6 lines or less
12.50 for eoch additionol line

Rafes for display
advertisements on request

Closing date for copy and cancellalion is
6 weeks prior 10 1 Sf day of publicalion
monlh
The Canod,an Nurses' Association does
not review the personnel policies of
the hospitals ond agencies advertising
in the Journal. For authentic information,
prospective applicants should apply 10
the Registered Nurses' Association of the
Province in which they ore interested
in working.

Address correspondence to:

The
Canadian
Nurse

g

50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P 1 E2

64 THE CANADIAN NURSE

I I

BRITISH COLUMBIA

n
U 0'

r'

QfO
u

:::)tro,
aI2
Ó_
.,"JI
:fv

Ireatment hospital In Okanagan Valley of Brillsh
Columbia. RNABC contract In effect. Apply to: Direct-
or of Nursing. Penticton Regional Hospital. Penticton.
British Columbia.

OPERATING ROOM NURSE wanted for actIve mo-
dern acute hospItal Four Certilied Surgeons on
attending staff. Expenence of tralnmg desirable.
Musl be eliQlble for B.C Registrallon. Nurses
residence available. Salary accordong to RNABC
Contract. Apply to Director pf Nursong, Mills Mem-
orial Hospital 2711 Tetrault St Terrace, Bnllsh
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. B C. Reglstrallon required. Apply' Director
01 Nursing. Royal Columbian Hospital, New Wesl-
minster. Bntlsh Columbia.

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES required for small
upcoast hospital Salary and personnel policies as
per RNABC contract. Salaries start al $672.00 for
Registered Nurses, $577 75 for Licensed Pracllcal
NUrses. Residence accommodation $25.00 per month.
Transportatoon paid lrom Vancouver Apply to
Director 01 Nursing. St George s Hospital. Alert Bay.
Bnllsh Columbia.

GENERAL DUTY NURSES AND LICENSED PRACTI-
CAL NURSES for modern 130.bed accredited hospItal
on Vancouver Island Resort area - home 0' the Tyee
Salmon. Four hours travelling lime to city 0' Vancou-
ver Collective agreements with Provincial Nursing
Association and Hospital Employees Union. Resl'
dence accommodation available. Please direct in-
QUiries to Director of Nursing Services. Campbell
River & Di stnct General HospItal. 375 - 2nd Avenue.
Camobell River. British Columbia. V9W 3Vl

GENERAL DUTY NURSES for modern 41-bed
hospital, located on the Alaska Highway. Salary and
personnel policies In accordance with RNABC
Accommodation available In residence. Apply:
Director 01 Nursing, Fort Nelson General Hospital.
Fort Nelson. Brollsh Columbia.

GENERAL DUTY NURSES. lor modern 35-bed hospl
tal located In southern !:J.C. 's tJoundary Area with
excellent recreation facilities Salary and personnpl
policies in accordance with RNABC. Comfortable
Nurses's home. Apply: Director 01 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 accommodallon available. Apply 10:
Director of Nursing, Powell River General Ho$5ltal
5871 Arbutus Avenue, Powell River. Brollsh Columbia

I I

BRITISH COLUMBIA

EXPERIENCED GENERAL DUTY NURSES for modern
10-bed hospital with doctors' offices in hospital.
Situated: beautiful west coast of Vancouver Island:
Accommodation: 550.00 a month. ApPly' Admlnistra.
tor. Tahsls Hospital. Box 399, Tahs.s, 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.

MAN ITOBA

REGISTERED NURSES required lor an 11.bed hos.
pital at Notre Dame de Lourdes. Manitoba. E xcell ent
salary and will credit for acceptable past experience.
Please apply to' Admlnlslrator Notre Dame Hospital.
Notre Dame de Lourdes. Manitoba.

TWO REGISTERED NURSES are required by Baldur
D.slnct Hospital for general duty. Duties to commence
in early 1974. Attractive residence in 16-bed hospital.
Sal ary based on Government scale with consideration
fOr experience. For further .nformation contact: Mrs.
K. Gordon. Director of Nursing. telephone 535-2373.
Baldur Dislroct Hospital, Baldur, Manlloba.

Required Immediately - 3 REGISTERED NURSES and
3 LICENSED PRACTICAL NURSES for a new 50-bed
Personal Care Home. Salary 10 accordance with the
recommendations 01 the MARN. Apply: Director 01
Nursing. Swan River Valley Personal Care Home
Inc.. SWAN RIVER. Manitoba ROL lZ0.

NEW BRUNSWICK

REGISTERED NURSES required immediately for
general duty in 300 acllve treatment hospitaL Salary
5567 5658 per month. dependant on experience.
Excellent fronge benefits. Apply Personnel Director.
West Saint John Community Hospital. B3610. Postal
Stallon B, Saint John. New Brunswick E2M 4X3

Additional laculty member needed by July 1 1974 tu
coordinate and teach an Introductory course In in-
tegrated baccalaureate program. Recent master s
degree In medical and surgical nursmg required,
and some experience team teaching In integrated
programs preferred. The extras We have to off.er are
an exciting neW curriculum approach. a new. well-
equipped self-Instrucfional laboratory. and the ad.
vantages of living In a beautiful. small city. Address
Dean. Faculty of Nursing. The University of New
Brunswick. Fredericton. New Brunswick

ONTARIO

REGISTERED NURSES required lor a new 79-bed
General Hospital In bilingual community 01 North-
ern Ontaroo. French language an asset. but not
compulsory. Salary is $645. to $758. monthly with
allowance for past experience, 4 weeks vacation
aller 1 year and 18 sick leave days per year.
nused
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

REGISTERED NURSES lor 34.bed General HospItal.
Salary $646. per month to $756. plus experoence al-
lowance. Excellent personnel policIes. Apply to:
Director 01 NursIng Englehart & DIstrict HospItal
Inc.. Englehart, Ontaroo

HEGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS lor 45.bed Hosp,ta'. Salary ranQes
Include generous expenence allowances R N s
3alary S680 to S780. and R N A s salarv S
90 to S565
Nurses residence - pr.vate rOoms With bath - $40.
per month. Aoolv to: The Dorector of Nursing Gerald-
ton Dlstroct Hospital GeralOton. Ontaroo POT 1MO

REGISTERED NURSES FOR GENERAL DUTY. I.C.U..
C.C.U. UNIT and OPERATING ROOM lequored lor
lully accredited hospllal Startong sdlary 5697 00 WIth
regular increments and with allowance for expen-
ence Excellent personnel policies and temporary
res. dence accommodation available Apply to The
Director of Nursing Kirkland &. District Hospital
Korkland Lake. Onlaroo P2N 1R2

OPERATING ROOM TECHNICIAN requored lor lull)
accredIted 75-beo HospItaL You will be In the
Vacationland 01 the North. mIdway between Thunder
Bay, Ontano and Wmmpeg, Mamtoba. BasIc wage IS
$471.50 with conSlderalion tor experience. Write Or
phone the Director 01 Nursong, Dryden Dlstroct
General HospItal. Dryden, Ontaroo.

QUEBEC

RESIDENT CHILDREN S CAMPS IN THE LAUREN-
TlANS REOUIRE: GRADUATE NURSES for the sum
mer. Apply JewIsh Community Camps 5151 Cote SI.
Catherone Road. Room 203 Montreal Quebec H3W
1 M6 Ph one 735-3669

UNITED STATES

NURSING DIRECTOR: Laredo JunIor COllege at
Laredo. Texas. IS seekmg 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
tn educational administration. A very cnallengmg
program Salary open. Please contact Belty SchmIdt
Director Nursmg Education. Laredo Jumor College.
POBox 738. Laredo Texas 78040 512-722-0521 Ex.
46 (collecl)

NURSING INSTRUCTOR. Laredo Junonr College al
Laredo. Texas. IS seekmg nursing instructors for a
forward-movang. open-curriculum nursing program
which Includes three levels health assistant. licens-
ed vocatIOnal nurse and registered nurse Program IS
well establoshed. Masters Degree preferable A
very challengong program Salary open Please con-
'act Betty Schmidt. Director. NursIng Educatoon. La-

Junoor College. POBox 738. Laredo Texas

Monte Vista, COlorado requires REGISTERED
NURSES lor 50-bed hospItal Workong visa readily
available after January 1st 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 alter
5p m

TEXAS wants you! If you are an RN. expenenced Or
a recent graduate come to Corpus Christi Sparkling
CIty by the Sea a cIty bUilding lor a belter
future where your opportunities for recreation and
studies are limitless Memonal Medical Center 500-
bed general teachmg hospital encoureges career
advancement and provides an-service Orientation
Salary Irom S68200 to $94000 per month. com
mensurale with education and expenence Dlfferentl a'
for evenang shifts available Benefits Include holi-
days sick leave. vacations. paid hospltahzallon
t'Jealth hfe 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 POBox 5280
Corpus Christo Texas 78405

I I

UNITED STATES

ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO.

REGISTERED NURSES

630-bed fully accredIted Hospital provides
expenence in Emergency, Operating Room,
Post Anaesthesia Room I ntenslve Care Unit
Orthopaedics. Psychiatry. Paediatrics, Obste:
tries and Gynal:cology, General Surgery and
MedicI ne.
BasIc 2 week OnentatlOn Program and con.
tinuing Active Inservlce Program for all levels
of Staff.
Salary IS commensurate wIth preparatIon and
experience
Benefits onclude Canada PensIon Plan. Hospital
PensIon Plan. Unemployment Insurance.-
Group L,fe Insurance and O.H.I.P. (66.2/3 0 0
Basic Rate paid by Hospital). - Extended
Health Care Plan - Supplementary Blue Cross.
After 3 months. cumulative sIck tIme.
Rotatong periods of duty - 40 hour week-
10 Statutory holidays - 3 weeks annual vaca-
tIon aftër completion of one years service.
APPL Y:

ASSOCIA TE DIRECTOR
OF NURSING SERVICE

ST. JOSEPH'S HOSPITAL
30 The Queensway
TORONTO 3. ONTARIO.

HUMBER MEMORIAL
HOSPITAL

Telephone 249-8111 (Toronto)
200 Church Street,
Weston, M9N-1 M8, 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 pr"vided.
Competitive salaries offered to qualified personnel. Registered
Nurses are urgently required for temporary employment July,
August and September.

FEBRUARY 1974

THE CANADIAN NURSE 65
.

R.N.'s - SOUTHERN CALIFORNIA - Immediate need
eXists for medical-surgical umts Onentatlon 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 nursmg In California prior to licensing. Con-
tact. Personnel Director. The HospItal 01 the Good
Samaritan, 1212 Shalto Sireel. Los Angeles. Calofor-
nla 90017 (213) 482-8111 ex 287

PUBLIC RELATIONS OFFICER

Responsible for providing information services to
members of a professional association and the public
in support of the public relations objectives ofthe Asso-
ciation.
General duties indude 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 1 M6

THE
PEDIATRIC PAVILlDN
NURSING DIVISION
OF THE
LOS ANGELES COUNTY -
UNIVERSITY OF SDUTHERN CALIFORNIA
MEDICAL CENTER

invites Canadian Nurses interested in
comprehensive Pediatric Nursing to write
for more details about our hospital.
Starting Salary: $842 month
Pr0n7060nalOpportuni6es
In-Service 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.HN. or B.Sc. preferred). Annual salary
range $7056 - $1 0,512. 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 385
532-4441

66 THE CANADIAN NURSE

Applications are invited trom:

McMASTER
UNIVERSITY
School
of Nursing

PUBLIC HEALTH NURSES
NURSING INSTRUCTORS

lor

Nurse faculty members Includmg an Asso-
ciate Director, required lor July. 1974 by a
progressive School of Nursong. The School IS
an integral part of a newly developed Health
SCiences Centre where collaborative relatton-
ships are fostered among the various health
professions.

OVERSEAS APPOINTMENTS

(Minimum three-year term)

ReqUirements master s or doctoral degree
preferred. with cllmcal specialist preparation
Or experience and/or preparation in teachtng

Salaries: commensurate with education and
experience.

Further information and application
forms from:

Application, with copy of
curriculum vitae and two
references to
Dr. D.J. Kergin, Director,
School of Nursing,

The Division of Ministry Personnel and
Education
The United Church of Canada
85 SI. Cia ir Ave. East
Toronto, Ontario. M4T 1M8
Attention: Mrs. Jean Parker

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

FEBRUARY 1974

EXCITEMENT IN NURSING
plus
THE MAGIC OF ARIZONA

For professionalism m a perfect settmg, loin
our team in a new, modern, fUlly accredited
hospital with services focused on care of adult
patients. Openmgs all shifts for RNs and LPNs.
Great opportunities also for mterested or
experienced ICU.CCU Nurses.
All of our nursing units are in-the.round
faCilitating our glvmg mdividualized patient
care. Located m a delightful retirement
commumty 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 O. BOSWELL HOSPITAL
P.O. Box 10
Sun City, Arizona.
An Equal Opportunity Employer.

CLINICAL NURSE
SPECIALIST
FOR
MED-SURG
NURSING

REQUI RED IN 254-BED
ACTIVE CARE
GENERAL HOSPITAL

APPLY TO:
Director of Nursing
Moose Jaw Union Hospital
Moose Jaw, Saslt
692-1841

THE LADY MI NTO HOSPITAL
AT COCHRANE

invite applications from

REG ISTERED 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 1 CO

FEBRUARY 1974

1+

Public Service
Canada

Fonction publique
Canada

THIS COMPETtT/ON IS OPEN TO BOTH MEN AND WOMEN

REGISTERED
NURSES

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.

Department of
Veterans Affairs,
Camp Hill Hospital

Further information on duties and qualifications may be obtain-
ed from and applications should be directed immediately to:

Salary:
$6938 - $8308

PERSONNEL MANAGEMENT ADVISOR,
DEPARTMENT OF VETERANS AFFAIRS,
CAMP HILL HOSPITAL,
HALIFAX, NOVA SCOTIA.

Eff. December 31 n3
$7701-$9216

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.

ADMINISTRA TIVE
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

THE CANADIAN NURSE 67
.

REGISTERED NURSES
AND
REGISTERED NURSING ASSISTANTS

required for a ID4.bed active treatment plus
72.bed chronic care unit located at Haileybury.
The Tn-Town area consisting of New Llskeard,
Hatleybury. Cobalt all within 5 miles of each
other is located 90 miles from North Bay
with dally plane. tram and bus service to and
from Toronto etc. Beautiful recreatIOnal facil
Itles including curling, skatmg, skimg, sWim.
ming, boating, hunting, flshmg.
Salary fUlly appropnate to the responsibility of
the position; personnel policies m I me with
mdustry and hospital practice. Orientation
and In-Service Educational programmes are
provided.

Apply in writing to:
PERSONNEL DIRECTOR,
Temiskaming Hospitals.
Hailevburv, Ontario.

GENERAL DUTY NURSES

Required Immediately

. for 270.bed acute care general hospital
expanding to 370 beds
. clmical areas mclude: Medicine Surgery
Obstetrics Paediatrics Psychiatry Rehabilita-
tion Extended Care and Intensive and
Coronary Care
. Must be eligible for B.C. registration
. Personnel policies m 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

Startmg 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 oilers Cultural and educational oppor.
tunitles including University and Community
Collel!e.
WE ARE PEDPLE HELPING PEOPLE
In the rapidly progressing specially of Chronic
care and rehabilitation. We offer
- a challenge
- Job satisfaction
- a happy envi ronmenl
Apply to:

Director of Nursing
3111 Riverside Drive E.,
Windsor. Dntario
N8Y 4S2

68 TH E CANADIAN NURSE

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
!VIontreal Children's Hospital
2300 Tupper Street
Montreal 108, Quebec

DURHAM COLLEGE
OFAPPUED ARTS AND TECHNOLOGY

invItes applicants for

FACUl TV POSITIONS
in the Nursing Department

Qualifications:
- Registration In Ontario
- University preparation In Nursing education. bac-
calaureate degree preferred
- Minirrum of two years bedside nursing experience
Responsibilities:
- Classroom teaChing and dinlcal SUpervision.
Salary:
- Commensurate with preparation and experience
WIthin the CSAO range
Starting Date:
-August 1, 1974

Direct applicatIOns wIth
complete resume to:

DEAN OF ACADEMIC AFFAIRS,
DURHAM COLLEGE OF APPLIED
ARTS AND TECHNOLOGY,
BOX 385,
OSHAWA, ONTARIO.
L1 H 7L7

NORTH NEWFOUNDLAND & LABRADOR
requires

REGISTERED NURSES
PUBLIC HEALTH NURSES

International Grenfe!1 Association provides
medical services for Northern Newfoundland
and Labrador. We staff four hospitals, eleven
nursl ng statIOns. eleven Public Health units.
Our main 180.bed accredited hospital IS
situated at St. Anthony, Newfoundland. Active
treatment IS carried on m Surgery, Medicme,
Paediatrics, Obstetrics, Psychiatry. Also,
Intensive Care Unit. OrientatIOn and In.Service
programs. 40-hour week, rotating shifts. Livmg
accomodations suppl ied at low cost. PUBLIC
HEALTH has challenge of large remote areas.
Excellent personnel benefits mclude 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
Sed Modern Accredited Hospital
on Vancouver Island. Excellent
recreational facilities and within
easy reach of Victoria and Vancou-
ver.
Personnel Policies as per RNASC
Contract.

Apply:
Director of Nursing,
West Coast General Hospital,
814 - 8th Avenue. North.
Port Alberni, B.C.

GENERAL DUTV
NURSES

- for 360.bed acute general hospital
clinical areas mclude: - Medicine. Surgery,
Obstetrics. Paediatrics, Psychiatry, Rehabili.
tatlon. Extended Care and Coronary Care
B C. Registration preferred but not mandltory
dUring initial employment
- Personnel policies m accordance with
RNABC Contract

Please contact the:
Director of Nursing
Nanaimo Regional General
Hospital
Nanaimo. British Columbia

FEBRUARY 1974

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,---------------

I Medical Services Branch I
I Department of National Health and Welfare I
I Ottawa, Ontario K 1 A OK9 I
I I
I Please send me onformatlOn on career I
I opportunities In this service. I
I Name: I
I Address: I
City: Prov: _

--------_______J

1+

Public Service
Canada

Fonction publique
Canada

THIS COMPETITION IS OPEN TO BOTH MEN ANO WOMEN

NURSING ADVISORS

$13,542 to $16,642 (Under negotiation)

Ottawa

WIth

Health Programs
National Health and Welfare

Under the general dIrection 01 the Semor
Advisor. Health Systems. plans. organ.
Izes and directs the work of teams
composed 01 Federal/ProvIncial and
non-govemment professIOnals in analy-
sis of present and proposed health care
sub systems related to nursIng commu.
noty health care needs, resources and
programs; coordmates and directs a
Federal/ProvincIa] multidisciplinary
team m the condud of major studies
related to the total health care system
or major portions of It; coordinates and
directs the development, evaluatIon and
use of methodologIes related 10 utlllza.
tlon of health care facIlitIes and assess.
ment of present and future resource
requirements; provIdes professional
advlæ to the Assistant Deputy Minoster
the SenIor Advisor. Health Systems and
other Branch and Department officers
to assist In formulating departmental
attitudes and policies; participates In
departmental assIstance 01 educatIon of
health persomel on a national basIs and
performs related dutIes

- EligibilIty for reg'stration as I nurse In a province 01 Canada
- Badlelor's degree in Nursing
- Considerable elperlence in all fields 01 nursing adm,",strat,on

For the posrtlon with Health Program. knOWledge of the Englosh language IS essential. For the pOSItIon
wIth Canadian Penitentiary Se",ces, knOWledge of both the Englosh and French languages IS essentIal
For thIs lalter posItIon unlilngual persons may also apply on thIS competItIon They must however.
indIcate In wntlng. theIr wliiongness to undertake continUOUS language traIning at pUblIc expense for
a penod 01 up to twelve months Such training shall be undertaken ImmedIately at the tIme ot condoM nal
appOIntment. In or through the Publoc Service CommIssIon s language Bureau and at locat,ons
specIfied by the Publoc Service CommIssIon
The PublIc Service CommISSIon wIll seek evidence 01 the likely capacl1y ot un!llngual candIdates from
outsIde the Public Service to become bIlingual
Please apply on 'ApplicatIon for Employment'. Form PSC 367-401, avaIlable at Post Offices. Canada
Manpower Centers and offices of 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 OM7

Pfe.se quote compelillon number 73-166-02 on all correspondence.
Appolntmenb IS a result 0' thi. compel/lion are sublectto the provision. 0' the Public
Setvice Employment Act.

FEBRUARY 1974

THE CANADIAN NURSE 69
.

Canadian Penitentiary
Services Solicitor General

Under the direcllon ot the Director,
Medical ServICes. wdl assist in the re-
organIZation of the "tal nursing program
of the Canadian Penrtentiary Service to
provide nursing care to apprOJumately
7000 inmates in some 35 institutions:
advises the Director on the continuing
efficiency of the nursing services as relat-
ed to medIcal. psychlatnc. dental and
surgical care and nursing administratIOn;
assists In the development of training
programs of nursing staff and nursing
service pOlicies which will attract qualifi-
ed staff and promote maxImum ut,Ioza-
toon 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 nationa] and
provinCIal nursing associatIOns. federal
and provIncIal departments of Health.
hospitals and universities; other related
duties.

QUALIFICATIONS:

LANGUAGE REQUIREMENTS:

FACULTY
POSITIONS

Open tor clinical experts
to teach in lIIe
undergraduate programs.

COMMUNITY HEALTH NURSING
MENTAL HEALTH NURSING
MEDICAL-SURGICAL NURSING
OBSTETRICAL NURSING
and
CONTINUING EDUCATION

Personnel policies and salanes in acrord with University
schedule based on Qualifications and experience.

Apply in writing to:
RUTH E. McCLURE, M.P.H.
Director, School ot Nursing
University ot Alberta
Edmonton, Alberta
T6G 2G3

Wanted 'Dr 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
1::ìalary 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 1 EO.

INTENSIVE CARE UNIT NURSES

With preparation and/or expenence in Intensive and Coronary
Care Nursing, or mterestln training tor this Nursing Speciality
QUAUFICATIONS: Successful completion ot an approved basIc
course In Nursing. Active registration in New Brunswick. or
eligible tor same. Must be able to work rotating shift.
SALARY RANGE: $567 - $651! per month. Salary commensurate
with Qualitlcatlons and expenence.

REHABILITATION NURSES

With preparation and/or experience In RenaDilitatlon Nursing
QUALIFICATIONS, Successful completion ot an approved basIc
course In Nursmg Active registrallon in New Brunswick. or
eligible tor same Must be able to work rotating shift.
SALARY RANGE: $567-$65B per month. Salary commensurate
with Qualifications and expenence.

Excellent tringe benefits Three weeks vacation aller one year
service Insurance and pension programs 37'
hour week.

Apply to:

Personnel Director
WEST SAINT JOHN COMMUNITY HOSPITAL
B 3610. Postal Station B
Saini John. N.B. E2M 4X3

70 THE CANADIAN NURSE

2 L.P.N.'S
REQUIRED IMMEDIATELY

For a 58-bed Personal Care Home, a mo-
dern facility, 80 miles south west of Winni-
peg. Thriving community of 1500 people.
Living quarters provided. Will credit for past
experience. Excellent salary and fringe
benefits.

For further information contact:
Mr. René Comte
Foyer Notre Dame Inc.
Notre Dame de Lourdes,
Manitoba
ROG 1 MO
248-2092

DOUGLAS HOSPITAL
IN METROPOLITAIN MONTREAL
A multl.disciplinary psychiatric hospital with
1 lOa adult and 100 children's beds;

reqUi res

NURSING STAFF ON ALL lEVELS

We onvite enqUiries from registered nurses with
experience in psychiatric nursong 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 boul evard
Verdun 204. Québec.

DIRECTOR OF NURSING
REQUIRED IMMEDIATELY

For a 58-bed Personal Care Home, a mo-
dern facility, 80 miles south west of Winni-
peg. Thriving community of 1500 people.
Living quarter$ 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. RENÉ COMTE
Foyer Notre Dame Inc.
Notre Dame de Lourdes
Manitoba
ROG 1 MO
248-2092

REGISTERED NURSES

for

GENERAL DUTY

for
General or Specialized wards includ-
ing a.A. 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.

THE UNIVERSITY OF BRITISH COLUMBIA
SCHOOL OF NURSING

FACULTY POSITIONS

Rapidly developing new curriculum re-
quires ten senior faculty members with ex-
perience in all clinical areas as well as
in education, evaluation, curriculum dev-
elopment and research. Positions available
now.

Apply to:
Muriel Up richard, Ph.D.
Director
School of Nursing, IRC Bldg. No. 341
University of British Columbia
Vancouver, B.C.
V6T 1 W5

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.

FEBRUARY 1974

career opport__nity

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,
Supervisor of
Employment
Manpower Dept.

Box 2100,
Calgary, Alberta
T2P 2M5
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 - $8,268 - $13,440 per annum
Range V - $9,120 - $14,820 per annum
Range VI - $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

WE CARE

"ÎIiJ

J

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?

B:

- Stimulating General Duty activities in
a 675 bed hospital - on a unit of your
choice
- Leisure ti me activities that are interest-
ing and exciting

Apply to:
Director of Nursing
Regina General Hospital
Regina, Saskatchewan

72 THE CANADIAN NURSE

NURSING
ADMINISTRATOR

AVAILABLE
A challenge in the Community Nursing Education
Prog ramme
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
H4 B 1 R6
Tel. 514-482-0320 (Ioc. 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 In
atmosphere of medical excellence.

Please apply to:-

Personnel Office
TORONTO CENERAl: HOSPITAL
101. College SI.,
Toronto, Ontario,
M5G 1L7.

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 Ministry'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
H3A 1A1

FEBRUARY 1974

ASSOCIATE DIREC10R OF
NURSING-PATIENT CARE
VICTORIA GENERAL HOSPITAL

An exciting opportunity exists for a person with
broad knowledge and experience in nursing practice
and management with this leading 430-bed acute
general hospital in one of Canada's most beautiful
citið.
The Associate Director of Nursing will be responsible
for the performance of safe, efficient and thera-
peutically effective nursing care for patients.
This is a unique opportunity in that the Associate
Director of Nursing will be concentrating on patient
care matters rather than just administration. In
addition, this person will join a young management
team that is leading this hospital in a new phase
of its development.
Interested candidates should call or submit their
I!.sumes in confidence to Kyle R. Mitchell at:

""nl,ill

220 - 1155 West Georgia St, Vancouver 5, B.C.
604-685-0261

ROYAL VICTORIA HOSPITAL

THE CANADIAN NURSE 73

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

DALHOUSI E UN IVERSITY

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

74 THE CANADIAN NURSE

LAKEHEAD UNIVERSITY

REQUIRES A
CHAIRMAN, SCHOOL OF NURSING

An experienced academic administrator who can assume
responsibility for 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. AVRE
Secretary of the University
Lakehead University
Thunder Bay, Ontario
P7B 5E 1
Attention: School of Nursing Search Committee

ACCEPT THE CHALLENGE

ST. BONIFACE GENERAL HOSPITAL

Due to the expansion of our present program and
facil ities, 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 for:vard all
applications and enquiries to:

ASSISTANT DIRECTOR
NURSING SERVICE (STAFFING)
ST. BONIFACE GENERAL HOSPITAL
409 TACHE AVENUE, WINNIPEG, MANITOBA
R2 H 2A6

FEBRUARY 1974

NATIONAL HEALTH CARE
EVALUATION SEMINAR

THE RELIGIOUS
HOSPITALLERS
OF SAINT JOSEPH

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, concern&d with evaluating health care.
EXPENSES:
Tuition is $100. Lodgings will be arranged at the University
for $5.00/ day. Limited financial support is available.

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

For information and application forms, write to:
Mrs. Marilyn Janigan (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.

R.S.V.P. FORMATION CENTER
438V2 College SI.
Burlington. Vermont
05401

FORMATION CENTER
4 Toronto Street,
Ottawa, Ontario.
K1 S ON2

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Jewish G
!l
!
1 Hospital

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 ì:J
.

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 exp""r-
ience, liberal fringe benefits and scope for advancemen.

For an interview please contact:

PERSONNEL DEPARTMENT
QUEEN ELIZABETH HOSPITAL
130 DUNN AVENUE
TORONTO, ONTARIO
M6K 2R7
Tel.: 537-2411

D

ORTHOPAEDIC &: ARTHRITIC
HOSPITAL
'VI'V'

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.

76 THE CANADIAN NURSE

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-
elo r '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 Eglinton Avenue East
Toronto, Ontario
M4P 1 P4

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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 opportumties 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 DepartrJ12nt.
. Obstetrical Department - participation in "Family centered" teach-
i ng program.
. Paediatric Department - participation in Play Therapy Program.
. Orientation and on-going statt 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.

FEBRUARY 1974

SUNNYBROOK
HOSPITAL
is
PEOPLE
JOIN US

Write to:
Selection Officer
Personnel Department
SUNNYBROOK HOSPITAL
2075 Bayview Avenue
Toronto 315, Ontario

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
condudes 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 M5P 1C1

Sunnybrook Hospital
· a 1,200 bed University owned
teaching hospital with
opportunities for development
in modern specialty
nursing units.
· comprehensive range of
fringe benefits.

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FEBRUARY 1974

REGISTERED NURSES
Immediate Openings in all Services
Come wor\( and play in Newfoundland's second largest city!
Comer 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 Comer 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: $6,900.00 - 8,810.00 per annum
- Effective Apnl1, 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, three steps.
- Educational differentia/for B.N. and master's degree in Nursing.
- .80rt per shift for rotating evenings and nights.
- $2.00 per shih for Charge Nurse.
- $50.00 uniform allowance annually.
- 20 working days annual vacation.
- 8 statutory holidays.
- Sick Leave - 1

days per month.
- Accommodatiorl 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, 1974.
Services include Medicine, Surgery, Paediatrics, Obstetrics, Psy-
chiatry, CCU, and ICU.
Letters of application should be submItted to:
DIRECTOR OF PERSONNEL,
WESTERN MEMORIAL HOSPITAL,
CORNER BROOK, NFLD.

I

. competitive salaries.
. staff residence
accommodation with parkland
setting and excellent
transportation to
downtown Toronto.
. recreation facilities.

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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 SN3

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
R7 A 1 l7

78 THE CANADIAN NURSE

DO YOU
WANT TO HELP
YOUR PROFESSION?

Then li/l out and send in the lorm below

-----------

REMITTANCE 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 be1ow:

MEMBERSHIP (payable annually)

Nurse Member - Regular
Sustaining
Patron

$ 5.00
$ 50.00
$500.00

Public Member - Sustaining
Patron

$ 50.00
$500.00

BURSARIES $..
MEMORIAL $

RESEARCH $

in memory of .

Name and address of person to be notified of
this gift .....

REMITTER

(Print name in full)

Address
Position
Employer

N.B.: CONTRIBUTIONS TO CNF
ARE DEDUCTIBLE FOR INCOME TAX PURPOSES

FEBRUARY 1974

I nd ex
to
Advertisers

February 1974

Astra Pharmaceuticals Canada Ltd. ................................................ ...m....... h
Canadian Armed forces ............................................................................. 61
CI i n ie Shoenl akers ..... .............. ........................ ......... ......... ................... ..... m.. 2
DavI)1 Canada Ltd. ......................................................................................... I X
Holl ister Li m ited ....................................................................................... .....+X
ICN Canada Ltd. ........................................................................................... II
I nternational Health Institute ......................... ............................ ................... 63
Lanzette Prod ucts ...... ...... ............ ........... ....................... ................................ 62
J .8. Lippincott Co. of Canada Ltd. ......................................m...................... I
Monl Sulton I ne. ............................................................................................ I h
C. \'. Y10shy Company. Ltd. ............................................................. 55. 57. 51}
J .1'. Pose) ('ompan) . .................................................................................... 50
Procter &. Gamhle ......................................................................................... I 3

Reeves Cornpan) ..................................................................................... I..L 15
Will iam H. Rorer (Canada) Ltd. ................................................................. I 7
Sando/ ICanada) Ltd. ................................................................................... 12
Sehering Corporation limited..................................................... 7<). Covcr I\'
While Sisler UnifÒrm. Ine. .............................. 5. 9. Covcr II. Covcr III

Acll'crtisil/g Mwwgcr
Georgina Clarke
The Canadian Nurse
SO The Driveway
Ottawa K2P I E2 (Ontario)

4 cll'('Ylising RepreWn1l11/l'e.\
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003
I'dephone. (215) Mid\\a) 9-1'+97

Gordon Tiffin
2 Tremont Crescent
Don Mills. Ontario
T dephone. (416) 444-4731

Member of Canadian
Circulations Audit Board Inc.

I31!EI

FEBRUARY 1974

1-

, CoriGidin'D"

DESCRIPTION:
Coricidin 'D': Each white, coated
tablet cont,lins:
2 m
chlorphemramine maleate U.S P..
390 m
acetylsalIcylic acid.
30 mg caffeine and
10 mg phenylephrine
A vadahle In blIsters of [2
and 24. and bottles of 100 tablets.
Coricidin 'D' Medilets: Each orange-
pineapple-flavored multicolored tablet contains
O. j mg chlorpheniramlne maleate US P..
!<(1 m
acetylsalicylic acid and
2.5 m
phenylephrine HCL
A,all,lble in boxe< of 24 Medilets in a
ch,ld's protective package
INDICATIONS:
Symptomatic relIef of nasal congestion and
other discomforts associated with sinusitis,
colds and allergIc or vasomotor rhinitis.
CONTRAINDICATIONS:
Sensltl\'itv to any of the components.
patients receIving MAO inh,b,to"
PRECAUTIONS:
Admlnisterwith care ropatients with hyper-
tensIon. cardiac disorders. hyperthyrOidism,
diahete, mellitus and patients hypersensitive
to sympathomimetic compounds
Patients should he cautioned not to oper-
ate veh,cles or hazardous machinery until
their response to the drug has been deter-
mined Since the depressant effects of anti-
h,stdmlnes are additive to those of other
drugs affecting the central nervous system,
patients should he cautioned against drink-
Ing alcoholic beverages or taking hypnotics,
sedatives, psychotherapeutic agents or other
drugs \\',th CNS depressant effects during
anti histaminic therapy
Rarely, prolonged therapy with antihista-
mine-containing preparations can produce
hlood dvscrasias

ADVERSE EFFECTS:
Dn)" sines5, dizziness, nausea, Increased
Ittltah,hty or excitement may be
enClmnten.J

DOSAGE:
Coricidin 'D': Adutts: I rahlet every 4
hours. not to exceed 4 tahlets In 24 hours.
Ch,ldren 10 to [4 years' 1/2 adult d,.se'
under I (1 years' at discretion of physiCian.
Coricidin 'D' Medilets: 2 to 6 years
II 4 to I Med,lets ì to 12 yt',\ts: I to 2
Med,let'. Each dose may be repeated every
3 to 4 hours. but not more than 4 Medilets
should he given In one day to children 2 to
6 Yl'ars. and 6 Medilets to ch,ldren 7 to 12
years Li
it treatment to 3 days The recom-
mended dosage should not he exceeded
except on a physician's advise

Detailed information IS avaIlable on
req uest
SCHERINGCORPORATION LIMITED
Poinl" Claire, Quebec H9R r B4
I PMAC ]

PROVINCIAL ASSOCIATIONS OF REGISTERED NURSES

Alberta
'\thcrla ,\
.,ociation of Regl'telcd Nu"e,.
102
(' 112 Stleet. Fdmnnton. r
" 11\1(,.
1'1'('\.. A.J. Pro'A,e: I're'.-llecI: D.F. Huff-
man: I iu,-Pr('\.: A. Thomp,on. I. Wall-.cr.
c.",,,,,itte,.' - SII/If \'II/'\n: ( "'p: \ '.t:.
1..<1 lie.: W. 1\1 ilh: "-'-t:. I'ractice: \. Clark
SUP"/T \'unn: J. Smith: I'roje('/ Oire(. \ '-t:.
t:.luL. 1\1. \loncricff. 1'1'01' O/lìn SII/If-
I'ul>. Rd. Om( <'1': '\. Sha'A: Flllpl",'. ReI.:
, Ch,'pm.lJ1: -1.\\1. huplo"- ReI. Of/it cr:
R.R. Dnnahuc: \ 'g. Sen'. COl/.\ull.: H. Sei-
ler,: COIIIIII. Adl'i.'or: H. Cotter: R"t:/.,Imr:
'\.R. :\Ic"innon: Ü". .'iLc: H.1\1. Sahin:
OlliCL' \{(///(/t:,'r: 1\1. Galricl-..

British Columbia
Regi,tcred Nu"c
' '\,'>Ociation of Hriti,h
Columhia. 2\30 Wc,t 12th Avenue. Van-
couver. PI''''.: G. I aPointe: 1 ÙT-I'rn. r.
Ducl-.. R. M.lcfadycn. COllllllittee.'- 'I.\g.
f:.cluc.. .I.". Griffith: I\,'g. Practice: F.H.
Dancer: .\oc & FnJ//. It elt:: H. Archcr. SI,!Il'
- b:l'C f>in'c F.A. "cnnedy: Regi.\lrar:
H. G ricc: A.\.\t. Regi.'lrar: J. Small: Dir"
/..due. SnT.:L. "clmacl-.,: -1.\\1. f)ire(. hluc
Sen'.: J. :\IcCuliagh: f)ir('('. V'g. .\1'1'1'.: T.
Schnurr: lJiree. I'e/'\oll/wl Se/l'.: N. Paton:
-1 \\1. I>irec. 1'1'1'.'01111"1 Se/T.: (1'11/(,('111('111
SnT.): F. \lac Donald. (/',1/1>01' Rd.l: G.
Smalc: f)irec. COIIIIII. Se/'l'.' C I\larcu,:
1 il>raril/II: J. \lol'on: Adlllill. A \\1.: D. St.
Germain.

Manitoba
\lanitoha A

ociation of Rcgi,tercd Nu"ö.
('..J7 Rroad'Aay Avenuc. Winnipeg. K
( OX2
1'1'1".. F. I\IcNaught: 1'<1\1 1'1'0.: 1'.1\1. Nu-
gcnt: I in'.Pn'.'.: K.G. Black I. 1\1c( lure.
COllllllillee., - ,'I/'g.. A. Crotcau. 1\1. Swc-
di,h: SOl'. & l:.ám. We(l.: A. Danick le/!i,I.:
O. \lcDcrmott: Hi'll. of /:'\(/111.: 0 \kDer-
mott: FiliI/lice: ". Dejong: Pn!/l'.\\. Staa -
/'1111'10\'. Rd. Ad,'i.'.: J. Glea.,on: PilI>. Rei.
OUi""/': M. Pay nter: Ret:i'lrar: 1\1. Caldwell:
Co/llill. Edll(. Ad,'i.'.. H. Sund,trom.

New Brunswick
New Brun,'A icl-. A.,.,oci.ltion of Kcgi'1cred
N ur.,e
. 231 Saunder' Strcct. F rcdcricton.
1'1'('\.: B. I cHlanc: PI/.,I 1'1'('\.: A. Rohichaud:
I ice-Pre.'. S. COlmier. K. Denni'o(}n: /foil.
.\ec.: 5. Kohichaud. COlli III ill,'" , - ,'Ii \g.:
7. Ha'Al-.e,. S. /\lac( eod: N\<.:. Aul. COIIIII/.:
J. Shelwood. 1 egi.,I.: ". Wright: Lxee. .\1"
\U. Andc"on: Lil/i.'oll (Jf1Iu'/: N. Kideout:
COli \/III. .\oc & {-'COli. We(l.. G. Kow,ell:
Regi\lmr: F. O'Connor: A \.\1. F,,'(, Sn. ,I:.
Regi\lmr. 1\1. Ru.,.,ell: r.dll<. Co 11\ II II: ^.
Chri
t ic.

Newfoundland
A.,.,ociation of Kegi'itered Nu"e, of New
foundland. 67 I c :\Iarchand Koad. St. John'.,.
1'1'1'.'. F. Wilton: 1'(/.\1 1'1'1'.'.' P. Harrett: 1'1'1'.'.
f', cl: F. HOIlLan: 1 iu'-Pn',.: E. Summer-
J. Nevitt. COII/II/ill,'n - V\g. Ellie.: 1-.

80 THE CANADIAN NURSE

Gardner: N,'g. Se/'l'.:J. P,mlett: SOl'. & fcoll.
11.'11.: W. William
: [<;,I,'C Sl'C.. P. Harrctt.

Nova Scotia
Reg"tcrcd Nu"e
' ^'
ociation of Nova
Scotia. AOY' Cohurg Rn.ld. Halifax.
1'1'<'1.. M. Hr.ldlev: 1'''.'1 1'1'1'.,.: J. 1'0": I ice-
I'n".: Sr. 1\1. Harhdra. G. Smith. (. Butler:
flu 0/'(1. Su.: Sf'. \1. (jilli.,: FI('('. S..c: F.
I\ln.,.,. COllllllille('\ - \"g. I'd"e.: r. Hlaikie:
\"t:. .\"1'1'.: S :\l.lcDlII lid: \'"e. ,( 1"011.
II eU.: G. \Iurph}: Ad,'i,. .v ,g. I dill'.. Sr. C
Marie: -1d,'i,. \"... ,'it IT.. J. I\lacLcdn: Fm-
1'10.\. Rd. Oail'''/': \1 Bentley: Pllh. Rei. Otfì-
l'er: D. :\Iiller: Adlllill. A \\1.: F. :\lacDonald.

Ontario
Kcgi.,tercd Nu"e
' A.,.,ociation of Ontario.

3 Price Strect. Toronto. I\I..JW I L2.
Prn.: W.J. Gcrhard: 1'1'1'.\. necl: N.1\1. \Ia-
ro.,.,i. C"mmittee.' - Soâ,,-EulII. Wd/.: CJ.
Sepp.lld: \"g.: G.I . Schmidt: bllln/lor: CJ.
Faull-.ner: Admill.: 1\1.1 . Peart: Exec DinT.:
I.. Barr: A.'.II. E.\('c. Dirn.: D. Gibney:
Din'c. hllplo"- Rd.: AS Cìribhen: Direc
Prole.\\. f)('I'"I.' C.1\1. Adam.,: R"g. En'c
Sec: 1\1.1. Thoma
. F. WinchesleL

Prince Edward Island
A

ociation of Nu"c' of Prince Edward
(,land. I XX Prince SI.. Charlottetown.
Prn.: F. !\Iacl eod: Pa,l Prn.: (,. Carruthers:
PI'''' /-'I"CI. B. Rohin.,on: I iu' Pre.'.. S.
Mulligan: En'(. 'ie( .-Reg.: I . Fra,er. Com-
mitt""., - V'g. F.lllc.: D. Sawler; V,'g.
.'in,... J. Pctc,,: Pllh. Rei.: H. \Vood: Fill'lI/-
n" t. (aIrUlhc,,: Legi,l. ,I:. II\'-ll/I\'-': Sr.
i\1. Cahill: SOl' ,( 1....111. Welt:. 1\1. Babineau.

Quebec
A.,.,ociatlon of Nu"c, of the Province of
()uehcc. ..J200 Dorche,ter Hlvd.. W.. \lont-
real. H
^ I V2. .
1'/'(".. R. Hureau: I in'-Prn.: S O'Neill.
.I Pinl-.ham. (Fng.1. P. Proulx. ,. I ePage.
(I-L): HOIl. !re(/,\. (. Roycr: [foil. Sec: P.
HoucheL COIIIII/ill"", - ,\'.,t:. fdllc.. G. Al-
Ien. D. (.danccttc. N'g. S"/I'. J. Hacl-.'Aeli.
K. Dionne: P/,,,Ie\\. Sen'.: S. O'Neill. P. Mur-
phy; School 01 I\\g.: K. '\no. C. de Villie"
Sauve: 1 egi,l.. \1. I\la,ter,. (. BeI.mger:
.\ec R'g.' N. Du :\Iouchcl; Pllh. Rd. Officer:
\1. Jcan.

Saskatchewan
Sa
l-.atchc'Aan Kegi,terL-d Nu"e,' A.,.,ocia-
tion. 20(,(, Ket..llack SI.. Regina. S..JT 2"2.
PI< ,. DJ Piphcr: I',,'! Pre.'.. (C. Linnell:
r/'e.' Fle('/: J. I\lac"dY: Vice-Pre.'.: Sr. B.
BCLaire. S. Khodcn. COII/II/ illee,' - ,Y.W.:
I. W,,"on: CIl<lplen & Pllh. Rei.: R. I cding-
hart'!; SO(. & Fcoll. Wdt:: G. Hutchinson:
I.\el'. Sec. A. I\lil).,: R('/!i.'lr<ll: E. Duma,:
PilI>. IIII,,/'m. (.)!lìc<'r: H. Schill: N,/!. COI/.\IIII.:
R. :\lireau: A.'.'1. Regi.'I/W" J. Pas.,more.

ð

Canad ian
Nurses'
Association

Directors

Prc
ident

1\1 arguerile E. Schumacher

Pre.,ident.Flect.

. H ugucttc I ahellc

I ,t Vicc-Prc
ident.. Beverly Du Ga,

I\lember-at-1 arge ..... Glenna RO'A.,cll

I\!ember-at-Large .. ". /\Iarion Smith

/\I cmher -at-Large
.............................. Deni.,e I.alancette

I\lemher-at-1 arge ...... Koberta C'OUlb

A.J. Prow.,c ............................. AAKN

G. I aPolllte .......................... RNAB(

1-. I\lcNaught .......................... I\IAKN

B. LcBlanc ............................ NHARN

F. Wilton ................................. AKNN

1\1. Hradley ............................ KNANS

W. Gerh.trd ............................. KNAO

E. Mad cod......... .................. ANPEI

R. Hureau

.... ANP()

DJ. Piphcr ............................... SRNA

Executive Director

..................... Helen ". I\lus.,allem

FEBRUARY 1974

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42353 Style # 42411
Royale oxford tricot.
Sizes 5-15
White .............. $25.00
Navy................ 528.00
Style # 2857
Royale oxford tricot.
Sizes 6-16
White only...... $19.98

Style # 42353
'.:\ Royale rib tricot knit.
\\ Sizes 3-15
'White only...... $29.00

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'/'
MAIL ORDER DIVISION
372 QUEEN ST. W.
TORONTO M5V 2A3
Please send II mail orders to

SHOP IN PERSON AT OUR
NEW BAY STREET

CTfîDI:'

Howto1tatch"a cold.

--

Surprise a cold right at its onset with
Coricidin '0' for adults and Coricidin '0'
Medilets ,': for children, You can recom-
mend these products knowing they will
provide relief from aches, pains and
fever plus decongestant action;
Coricidin '0' and Coricidin '0'
Medilets contain Chlor-Tripolon;:
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.
Coricidin'D

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ee page 79.

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CAREER APPAREL

# 2342

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Sizes 8-18
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About .................................. 530.00

CAREER APPAREL AT FINE STORES ACROSS CANADA

ç:;

Recent releases
.for clinical
competence

CD

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

f7'\ 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

CD

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

CD 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

o

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

. 1'-

no BM,', Root-
"T_:

';

CD

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
va riety.
Little, Brown July 1973 $6.25

'\.-';:-""'''!ro. -

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-J

CD

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

CD THE PRACTICE OF MENTAL HEALTH
8 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

.....-
............

Please send me the book(s) whose number(s) I have circled
1 5
2 6
3 7
4 8

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.

Name
Address
City

Province

Position
Postal Code

o Payment enclosed (send postpaId)
Books may be returned within 15 days

o Use my Charge. number
o Charge and bIll me

CN-3.74

MARCH 1974

THE CANADIAN NURSE 1
.

e-J

THE

LINIC

T..ADfIol"t.lllII. IJII I I ....1 Of" . CAl\lAOA "AI

SHOE
p.k

@

SOME STYLES ALSO AVAILABLE IN COLORS... SOME STYLES 3%-12 AMA-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. CN-3, 7912 Bonhomme Ave. . St. Louis. Mo. 63105
2 THE CANADIAN NURSE MARCH 1974

The
Canadian
Nurse

ð

A monthly journal for the nurses of Canada published
in English and french editions bv the Canadian Nurses' Associalion

Volume 70, Number 3

March 1974

17 A Death At Home ............................................................. D. McNeil

21 Poor Baby: The Nurse and Feminism ............................... D.5. Starr

25 Cholera Epidemiology and Control.............................. l.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 h... 'I...", ""pl..."...d in Ih... ùlihnial and \;11'011' ani...!.:, OIl'" Ih,,,... of Ih,' allihor, and
do no. n....;...,,,,1'11
1'''' pr...,...nt I h... pul i... i..., or , i...", of I h... ( anad ian :-. III""'" \ "o...ial ion.

4 letters 41 Names
7 News 42 New Products
35 In A Capsule 46 Books
36 Dates 52 Accession list
38 Research Abstracts 72 Index to Advertisers

EX.:cUli,,' Dir':c!OL Udcn 11.. \Iu"all,'m_
l'd,1I1f' \ ifJ!inia \. I indahur
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- Suh\criplinn Ral'...: ('allad.1 Oil.: '':,If.
V1.\K). I""
.:ar'. ...II.IMI. I Or"I!!II' Oil':
':,If.
$6.50; Iwo years, $12.00. Single copIes.
$1.00 each. Mdke cheques or money orders
pa
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for \."xdu'l\ ,-a puhhc.IIIOI1. I h,-' ,-'dlll)1 r\......\..n_
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I'holograph_ I glo", prill'" ,lIId gr,'plh .111<1
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nor to mdi":.lt..: "k'"1I1\.' '-'.11\.', 01 puhlJ\..atUJll

P'''t.II;': "'lid 111 ,I,h "I third ,;I,,,, r.n.:
\IO'\, IIH -\1. P V 1'\'f'1II1 '\". 10.001-
50 1 h.: 1>"\\'''.1\. (In,,,,,,. Ollta"o. ":!I' II :!

MARCH 1974

c (.1I1.IlII.1I1 'UI...\.... \......II\.I.llIuli 197'

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: "00 not hope to con-
cil iate both r 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 In 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 husband's needs are more
important than a career's 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 soclety'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 would to share with fhe Callad iall
Nurse staff and rcaders the interest that
has been shown in my article "Control-
ling the fight/flight patient"' (October
1973).
. An excellent letter from a practicing
nurse was forwarded to me. Both the
lelter and my attempt to clarif) some
points were published in the January
1974 issue.
. I agreed to a request to reprim the
complete article in The A ustralasiall
Nurses Jourllal in 1974.
. In November IlJ73. I '" as invited to
participate in an inservice program with
the supervisor) nursing "talf at the
Royal Ottawa Hospital. My article.
plu" a videotape produced by the psy-
chology department at the University
of Western Ontario in London. were
part of an interesting program. fhe
videotape. which depicted visual meth-
ods and commentar) used by staff in
coping with heightencd anxiety in
patients. elicited both positive and
negat ive reactions hy those present. fhe
nursing department of the Allan Me-
morial Institute in Montreal has begun
taping some useful material in this
field. using equipment from McGill
Universit\ .
Person:.1 Iclters and messages have
surprised and flaltered me. The need
to communicate what we see as daily
routine activity in crisis situations is
topical. - Jeall A. Reid, Ottawa.

Article draws support
It '" as with real rei ief that I read
andra
Kessler's article. entitled "Protecting
nonsmo"ers in public places" (Januar)
IlJ74). As a nonsmo"er. I get tired of
all the stress laid on smo"ers' 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 slllo"e-Iïlled). I have been wor"ing
for a few months as an office assistant
in a new and modern YM-YWC'\ com-
plex. and have been appalled at the
amount of smo"ing around me. In all
fairness. I understand that smoking is
not allo,"ed in the health and physical
education department, but there seems
to be no restriction elsewhere. I wor"
in a small suite of offices, hous ing from
five to eight staff members at a time,
4 THE CANADIAN NURSE

most of whom smo"e in varying
amounts. By 5.00 1'.1\1. each da) I feci
overpowered by thic". smelly air. The
wal" home on city sidcwalb is fresh by
comparison.
For three months. I have made count-
less remarb - humorous. concerned.
or frustrated. Every comment is either
ignored or treated as a jo"c. The solc
result of three months of campaigning
is my refusal to allow an ashtray on
my des" while I am seated at it.
In summary. and in reaction to your
editorial, (January 1974). no campaign
is better named than GASP! - R,V,
Olllariu (llall/e withheld Oil request).

Surgery "in the second person"
Reading Margaret Guthrie's fran" and
perceptive article. "Cardiac surger)
in the first pers')Jl" (September I 'J73>.
was a truly movi ng experience for me.
as 9ne who had undergone the exasper-
ating procedure "in thl' second person"
with a husband who was a heart patient.
Unli"e 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 w ifc
of the patient and a registered nurse. As
an RN. I thought I could expect somc
response from the nursing staff regard-
ing my husband's condition.
1\1) experience. ho,"ever. \\as similar
to the impersl)nality Ms. Guthrie felt
,"hen she was first examined. fhis ma)
have been because I was regarded as
a potential IIlterkrence by the nursing
staff. The "ind of interaction that should
have ta"en place in the intensive care
unit did ta"e place with the staff of the
eoronar) care u nit. where my husband
and I were treated as individuals. I
will always be particularly grateful to
one Philippine nurse who was ahle to

Regi
tered nur
cs.
your community needs
the benefit of YOUI
skills and experience.
Volunteer now to
teach 51. John Ambulance home
nursing and child care course...
Contact your Provincial Headquarters,
St. John Ambnlance.

consider the situation from my perspec-
tive and helped restore my conlïdence
in mysel f as a nurse.
. Ms. Guthrie's description of the
traumatic move from ICt I to the ward
and the problems "he encountered there
elicited my sympalhetic response. This
transition ta"es place at a crucial time
in the patient's recovery. ,"hen a proper
understanding of his condition and
encouragement arc required. I found
there was inadequate briefing as to what
the patient should expect and insuffi-
cient consideration by the nursing staff.
I agree entirely with the suggestions
\1s. Guthrie ma"es in her conclusions.
and would add the following. the medic-
al and surgical teams should come to
some agree
ment on the best course the
patient should fÖllow with respect to
such subjects as activity and alcohol
consumption: those closest to the pa-
tient should he given some medically
infÒrmed advice as to what one may
expect to see in a patient's behavior
fÒllowing cardiac surgery. i.e.. severe
depression and personality change:
and there should also be follow-up
treatment fÒr patients who have had
major surgery. even if a relative of the
patient is an RN.
I am thanHul to Ms. Guthrie for
describing the patient's position so well
and for reflecting my own experience
in an honest and enlightcning way. -
Barbara A. Chandler, London, Ontario.

June reunion in Winnipeg
In conjunction with Winnipeg's centen-
nial celebrations. we arc planning a
large reunion of all Grace General
Hospital graduates. including those of
the 3-)ea
program from the last ..HJ
years and from the 1 X-month obstetrical
program prior to 193-1-.
Events from June 27 to 30. 197-1-.
will include an alumnae hanquet for
the 197-1- graduating class. graduation
exercises. a garden party and hmrs of
Grace General Hospital. and church
services at the Citadd.
As bOl)"ings might he heav) this
\ car. we \\ould li"e to hear from ollr
;lIulllnac by \pril I. Write to Brigadier
Frances \\'agner. Grace General Hos-
pital. 300 Booth Drive. Winnipeg.
\1anitoha R.U 3M7. - L Degen,
\e(T('tan', (ira('(' (;('//('/'al Hospital
N IIr,\cs' A IIII/I//a('.
'

MARCH 1974

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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
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Price?
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L5E-1H2 (416)274-5252

BUILDING ON A CENTURY OF QUALITY , ' C
. 0' 1874-1974
HEALTH CARE PRODUCTS
..... Ä ')

news

CNA Gives Over 100 Gift Copies
Of Biography Of Ethel Johns
Oflall'a, (Jw. - fhe Canadian '\Jur"es'
A",ociation has 'ent over 100 eopie"
of Walch-lire\ Oil II/(' II/ol/Illaill\: II/('
ht'e alld 1I.,.;lillgs (
f'/:'-1/u'l ]ohm, a" gifts
to national and international nur"ing
kadel'". rhe hiograph
of \,..,. Johl1"

editor of The Calladiall .'VI/r.\(' from
IlJ.
3to IlJ.+-L \\a" \Hill..'11 h) I\largaret
\1. Street. Valll:ou\er.
In Septemher IlJ72. CN '\ director"
agreed to "upport puhlieation of the
hool.. h) pun:ha"ing copie" to the value
of S 1.000. Gift wpie" of Wlllch
/irn
Oil Ihe mOl/lllaillS have heen "ent to
Fngli...h-"peal..ing. national nursing
assol:Îation" that arc memhers of the
International Cou nl:Ï I of Nurse" and
to honoraI') member". pa"t pre"idenh.
and director" of CN/\.. a... ",ell a" to
other leader... of the nur"ing profc""ion
in Canada and ahroad.
A revie\\ of W(/{ch
fires Oil II/('
mOlllllllim appears on page 44.

Quebec Association Name Change
Became Effective February 1st
MOll1real. (jlle. - fhe Professional
Code of the province of Quehec was
proclaimed on February I. 1974, so
the title for the Quebec nur"ing a<;so-
ciation is now: Order of Nurses of Que-
hec (ON()).
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-
hee when the Professional Code was
proclaimed law. (News. January 1974,
pp. 9-10.)

SRNA Rejects Setting Up Of Board
To Regulate Health Disciplines
Regilla, Sa.\/... - rhe Sasl..atehe\\an
Regi...ten:d Nur"es' A""ociation ha...
rejected thc e...tabl i...hment of a health
di
cipline" regulation hoard. as recom-
mcnded in the Md eod Report. v. hich
\\ a... commi",ioncd b) thc provincial
hcalth minister and rdea...ed 1'01 public
discu...sion in A ugu"t IlJ73.
rhc Md eod Report ad\ocate" con-
<;umcr participatIon on the governing
bodie" of profcs...ional a"sociation".
con'umer and practitioner repre...enta-
tion on health ,Id\ isor) and planning
hodie,. puhlic regulation of the profc...-
MARCH 1974

"Hark! Hark! The Lark At Heaven's Gate Sings"

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IlK Royal Winnipeg Hallet. thl: \\ innipeg S
mpht))]) Orche'tra. and lIther
rcno\\ ned cultural group" havc pla
ed tocapacit
audiences in thc conce
.t h;
11
of the Manitoha Centennial Centre in \\ innipeg. I he katured aUractu))] 111
the hall from Junc 16 to 21, IlJ74. \\-ill he the annual meeting and convention
of the Canadian Nurses' A<;sociation.

...ion" through .1 health di'clpline<; regu-
lation hoard compo"ed of lay per<;on".
decentrali7ation of health <;ervices, and
the de\e1opment of communit) health
and social centers.
rhe health di'cipline, regulation
hoard \\ould have thc po\\er to revie\\
and re\oke regulation" made h) indi-
vidual profc,...ions. It... ruling" \\(\llId
be hinding on the protCsslOns: there
is no provision for <lppeal. The board
\\ould he composed llf three to fi\ e hi)
memh........ appointed h
thL' Cnl\\n.
In ih initial re'pon"e to the report.
sent to Health Mini"ter W.F. Smishel..
on Deccmhl:r 21, IlJ73. the a...'ociation
said it ,trongl} reject... the e"tahl i,h-
ml:nt ot ...uch a health di'cipline" rcgula-
tion ho.u'd. SRN ,\ notc' that thc pre-
sent mechanism for review of proks-
"ional .Ict-.. reculat ion.... ,lIld h\ b\",-
h} the I egi,I"tive A,...cmhl) ha,,'heen
,ati,factol").
'iRN ,\ "tate, it-. helief that thl' nK'-
chani"m i" in the hest interest 01 the
peoplL' of S,lsLllche\\an and th.lt thc
rc"pon,ihilit\ lor rc\ il:\\ ...hould h..,

retained b\ the elected repre"entati\ c,
of thl: pro\'ince.
rhe nur"e,,' a'"ociation "UPPOrl'
the need to re\ ie\\ proks,ional aCh,
hut ,ee" thi...IT\ ie\\ a" the re"ponslhilit)
of the I egislati\e Å".....'mhl
. \lthough
it cndor,es the need for profc""ional
act... to "rdlect ni,ting "ocial nceds:'
it emphasl/es that ct
n'ultation \\ ith
the gOY erning hod) III' each proks...ional
a"sociation is imperat i\ e heforc an

re\ i<;iolh are made.
\RN.\ 'upport-. in principlL' con...um-
n participation on the governing hodies
of prok"sional .ls"ociation'. hut reject...
consumer palt icipat ion on prok,,,ional
as...ociations' di'ciplinar
ùlmmiuce".
"1î1i, I... the respon"ihilit
or the pro-
k...,ion ,lIld mcmher" ,hould be entitkd
to a peer re\ie\\:' the a""lIciation
'a) s. It aho note" in its respon"e that
th.....c nHI't he a general unlkr'tanding
and acceptance of the term "con'IIIlle..."
rhc SR N \ re,pon"c 'UPPOI t... the
concept of con"IIIller and practitillnèr
participation in detcrmining thc pri-
(Co"t ;'11/, d 0" 1'''':'' 15)
THE CANADIAN NURSE 7
.

news

Saskatchewan
urses Look To SU:'I.
For Bright Bargaining Future
Sll\/(aloon.
s/... -
urses In S.I
-
latche\\, an ha\ e established a prm ince-

Ide union. called the Saslatche\\ an
L'nion of ....ur
s (SL '). for the purpose
01 collecti\ e bargain ing for nurse-.. b

nur!>es.
-\t a meeting last J<lßu<lf). X9 nurses
representing .B staff nurse associations
and nurse groups in the prO\ ince \oted
in favor of setting up the union and
elected a 12-member bodrd of directors.
The organization's constitution di\ ides
the pro\ ince into ï geographical ho
pi-
tal regions and one nursing home
region.
-\ statf nurse association prO\ incial
steering committee
æ. established in
'-10\ ember 19-3. alter the Saslatche\\ an
Registered ","urses' As!.OCiation decided
against an) im 0" ement in collecti\ e
bargaining because of the Supreme
Court of Canada ruling ('e\\,S. Decem-
ber 19-3. page 121.
\L'
as set up to represent nur!>es
in an\ health care institution in the
prO\ lñce. \lembership in the union
ill
be b\ affiliation as a chartered. local
stalf- association or through direct
membership.
The
nurse
' union
ill .Ippl
.IS
soon as possible to the provincial
Labor Relations Board for certification
as the bargaining representati\e for
\ arious groups of nurses in SdSlatche-
\\an. This represents a change in
bargaining approach b) the nurses.
Pre\iousl
. independent bargaining
groups dpphed to the Labor Relation

Board for certificdtion: "'L' members
bel ic\ e that a central bdrgai ning organi-
zation.
hich can be certified æ. the
bargaining agent for aJl groups of
nur<oes.
ill exert more impact dt the
bargdining table.
SL"s board of directors accepted the
previous nur
s' prO\ incial negotiating
committee as a committee of the ne\\,
union. This committee has been
negotiating
ith the Sdslatche\\dJ1
Ho...pital Association since late ",0-
\ember 19"73 for a ne
contract for
ho<,pital nur..es. The pre\ ious contr.lct
expired at the end of 1973.
AI Shalansk
. formerl\ emplO\ment
relations officer for SR
-\. is a consul-
tant to SL '. \1af) Parche"sk), Sas-
katoon. IS the SL' president: Jeaf!
Hodgson. Rel!ina. is first \ice-presi-
dent (hospital groupl: and Geraldine
\.1ang. \1el\ ille. is second \ ice-presi-
dent (nursin/Z: home groupl.
8 THE CA'...ADIAN "'URSE

C
A
embership Continues To Groy,
Figures for 0-\ members in 1973. compared to 1971 and 1972 show an
mcr
of .nearh 5,000 in the past ) ear. o.A membershIp. by pro\-incial
asSOCiatiOn, IS.

Alberta
British Colwnbia
\.fanitoba
"' e\\ Brul1S\\ ick
.... e\\, foundland
"'ova Scotia
Ontario
Prince Ed" ard Island
Quebec
Saskatche\\ an
Total

1971
9, -S.t
I I. 90

5..l66
3J
56
2.243
5.072
11.5"79
725
32.198
6,0-5

.8 3

I'F2
10.261
12.530
5.719
-t.1
5
2.204
5.2-3
I I. x29
755
33,391
6.253
92.315

19-3
10,060
13.389
6.007
-t,339
2.4 2
5.263
13,183
803
35.196
6.4"'0
91.1
:!

labor Relations Board Approves
Central Union For Ontario I"urses
Toronlo ani. - The prO\ince-wl()e
collective bargaining unit for nurses in
Ontario "as approved b) the Ontario
Labor Relations Board at a hearing on
Janu3J) ).t. 19-4.
The 'urses' Association Halton
Count) Health Lnit applied to the
Labor Relations Board for apprO\al
to merge" ith the Ontario ",urses' A<;-
sociation (O'A) and became Local I
of the ne" association. The hearing
before the Labor Relations Board
as
held to pro\-e the
tus of 0' A as an
appropnate trade union.
When the O'A was formed in Octob-
er 1973. representatives of 85 of On-
tario's 100 indi\idual collecti\e bar-
gaining units for nurses indicated a
desire to merge "ith a central union.
(
e
s, January 1974. p. II).
The board of the Halton County
Health Cnit. emplo)ers of the nurses in
O'A Local I. introduced no eVidence
opposing ihe application "hen it "as
heard b\ the Labor Relations Board.
accordiñg to the Registered
urses'
Association of Ontario (R.....AO). But
counsel did cro
s-examme the associa-
tion "itnesses to make sure that all the
proper procedures for forming a ne\\
union and for transfer of bargaining
rights had been obsened
An R'AO report sa
s. "Apparentl

the L labor Relation
] Board
as well

dti..tJed
ith the evidence gi\en. The
certificate. . . was dated Janu3I)'
15th!", one day after the hearing.

Preparation For Disaster Nursing
Discussed By Nurses In N.S.
Halifax. X.S. -
urses working in
emergenc
health !>ervice<; at the fed-
eraJ and provincial government levels
met with faculty representati\es of
schools of nursing in ,,"ova Scotia on

Janu3T) 24. 19- -to to discuss the prep-
aration of nurses for a responsible role
in disaster nursi-g. 1ne meeting "as
held at the headquarters of the Register-
ed 'urses' As.sociation of '\0\ a Scotia.
A 19"72 Disaster \'ursing Stud). is-
sued b) Health and \\ elfare Canada,
sho"ed that 41.8 percent of teaching
staff in Nova Scotia schools of nursing
had recei\ed specific preparation in
di
aster nursing: this percentage "as
higher than in an) other province.
Follo
ing ....ova Scotia was \fanitoba,
"ith :!O.ð percent of nursing faculty
prepared. In 5 pro\-ince
. fe"er than
10 percent of the teaching staff in

hools of nursing had recei\ed such
preparation.
F. Lorraine Da\les. nursing consul-
tant to the emergency health sen ices
division of Health and \\ elfare Canada.
was invited by '-Iova Scotia to partici-
pate in the one-da) seminar. \,k Da\ ies
initiated the federa) go\ernment study
on disaster nursing and prepared the
report on iL
The Disaster \ursing Stud) pointed
to the continuing "need to provide a
federal course at the Canadian Emer-
gency Measures College in Arnprior.
l Ontario). where nurse educators can
be exposed to the total. broad concept
of disaster planning in Canada."
But this stud) noted that "the main
responsibility for emergency health
planning lies at the provincial Ie\el."
The federal emer2en
health -.er\Ïces
organization's prim
ta..l 'is to .ad-
\ ise and asSiSt the prO\ inces in meet ing
their plaMing objecti\ e5."
Christine Steele, nurslOg officer" Ith
the ""ova Scotia government's emer-
gene) health services division aoo
one of the participants in the Januaf)
seminar. sa)S she is encouraged b
the
response she is getting from nurses in
the province. who are recognizing more
and more that one of their prime res-
COlll,,1It
d Oil pag
10
\-\ARCH 19-4

EAS:: I'ìEc..3TE? E FO'"
N.
UAL MEETING. CANADIAN NURSES ASSOCIATION
Cen1ennIIII Cenn. _"

.June 16-21 1'174

I'8C8JIl aar.s.on can1 lilt
or m acco.....0d06..0 I!o . see ce.w d card

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IICJRSei ASSOaA T1OM - 50 e.e
- oaa.a - Canada K2ft 1E2

a's Friendly Peop
fret i
elc s YOa to inniPJg
art of Le ContL,ert"

news

Saskatchewan Nurses Look To SUN
For Bright Bargaining Future
SlIshlltoOfl, Sæ;h. - N ur
es in Sas-
"atchewan have established a province-
wide union. called the Sas"atchewan
Union of Nurses (SI 'NL for the purpose
of collective bargaining for nurses. by
nurse
.
At a meeting last January. H9 nurses
repre
enting .n staff nurse as
ociations
and nurse groups in the province voted
in favor of setting up the union and
elected a 12-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 Sa
"atchewan
Registered Nurses' Association decided
against any involvement in collective
bargaining because of the Supreme
Court of Canada rul ing (N ews. 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 b) affiliation as a chartered. local
staff association or through direct
member
hip.
rhe new nurses' union will apply as
soon as po
sible to the provincial
L.bor Relation
Board for certification
as the bargaining representative for
various groups of nurses in Sas"atche-
wan. This represent
a change in
bargaining approach by the nurses.
Previously, independent bargaining
groups applied to the Labor Relations
Board for certification; '-;UN members
believe that a central bargaining organi-
Lation. which can be certified as the
bargaining agent fÒr all groups of
nurses. will exert more impact at the
bargaining tabIe.
SLN's board of directors accepted the
previous nurses' provincial negotiating
committee as a committee of the ne\\-
union. This committee has been
negotiating with the Sas"atchewan
Ho'>pital Association
ince late No-
vember 1973 for a new contract for
ho
pital nurses. The previous contract
expired at the end of 1973.
AI Shalansky, formerly employment
relations officer for SRNA, is a consul-
tant to SUN. Mary Parchewsky, Sas-
katoon, IS the SL N president; J ear.
Hodgson, Re
ina, is first vice-presi-
dent (hospital group); and Geraldine
Mang, Melville, is second \ice-presi-
dent (nur
ing home group).
B THE CANADIAN NURSE

l

igur
mcre.
assoc i

Alber
Britisl
Manit
New I
Newf<
Nova
Ontar
Princ!:
Quebf
Saskat

Labor
Centra
Torant
collecti
OntarÌl
Labor Relatio,;; 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 I
of the new association. The hearing
before the Labor Relations Board was
held to prove the status of ON A as an
appropriate trade union.
When the UNA was formed in Octob-
er 1973, representatives of R5 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. II).
The board of the Halton County
Health Unit, employers of the nurses in
ONA Local I, 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 l Labor Relations] Board was well
satisfied with the evidence given. The
certificate. . . was dated January
15th!", 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. R percent of teach ing
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.R 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
ervices
organization's primary task "i
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-
(Colltillued 011 pllKe 10)
MARCH 1974

Annual Meeting and Convention
Canadian Nurses' Association
Manitoba Centennial Centre
Winnipeg, June IS-21, 1974

Canada's Friendly People Province
Welcomes You to Winnipeg
"Heart of Ü1e Continent"

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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
SUTrON 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 !reason.
MONT SUTTON INC. Sulton, Québec
Tel.: (snow reports) ... (514) 866-7639
(514) 866-7718
Accommodation . . (514) 538-2646
Office. . . , . . . . . , , (514) 866-5156
(514) 538-2545

news

(Col/tinl/ed FOil! fllI
e lÎ)
ponsibilities is to accept d 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 rand]
in participating in the campaigns lO
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, Melfi. - '"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 I. 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.
fhe number of increments is increas-
ed by the new agreement from I to 4
on December I. 1973, and a fifth in-
crement is added on January I. 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 wor" 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 m.ltron
of the home.
The Convalescent Home of Winni-
peg is a nonprofit organization control-
led bv a board of 20 women. I t is the
oldest personal care home in Manitoba,
established in 1883, according to a
Winnipeg newspaper.

Six Nurses' Associations Join
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 16 African
countrie
.
A federation of nursing as
ociation

in Commonwealth countries was tïrst
considered in June 1969. when repre-
sentative!> of 33 Commonwealth coun-
tries met in Montreal during the con-
gress of the International Council of
Nurse!> (lCN). The group appointed an
ad hoc committee, with member!> from
six regions of the Commonwealth, to
100" 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
(Conlill/H'd Oil f'''
(' J! J
IUAPrl-l1Q74

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LOOK FO
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HIS NEW LINE AT
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Next Month
an

The
Canadian
Nurse

. CNA Annual Meeting
and Convention Highlights

. Nurses "Break the Ice"
on the Sir John A. Macdonald

. Parents Make the Decisions

ð

Photo Credits
for March 1974

Manitoba Centennial Centre.
Winnipeg. p. 7
M iller Services Ltd.,
Toronto, pp. 19.21,23

J an O'Brien. photographer, and
Whitchorsc SllIr. \\ hitehor
e.
Yukon. pp. 2H-29

brael lnformatiun Ser\'lce.
Jcru
alcm. p.
2

Margaret M. Street and
Vancouver General Hospital.
p. 44

1'> Tuo::rA....IAnIAIIJ 1IJ1111...J:

news

(("oll/illlledfrOIll I"'R" 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 non nurse 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

..r.!h-.

IIJ

,

,

1 he 197-f annual meeting anò con-
vention of the Canadian Nurse<
Association \\ ill he held in Winnipeg
during the city"... centennial year.
Nurse
from acros
the country will
gather to deli herate. dehate. and
participate on June I ó to 21. \\ ill
you hlo\'\' in to help hlow l)ut the
candles on Winnipeg.... hirthda)
cake'.'

tion of
urses. Dr. Mussallem told The
Canadian Nurse: "There is no fonnal
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 CAA T Regents Set
Nursing Program Standards
Toronto, Onl. - Standards for nurs-
ing education programs in Ontario
arc now set hy the council of regents.
governi ng body of all colleges of appl ied
arts and tech nology (C AA T), becau
e
diploma nursing education has been
transferred from hospital. regional. and
independent schoob of nursing to com-
munity college programs.
Joan Macdonalò. executive director
of the College of Nurses of Ontario
((NO). told the directors of the Regis-
tered Nur
es' .\
sociation of Ontario
(RNAO) that the community college
regents arc "committeò to ensuring
that the nursing program... maintain a
...tandard which is at least as good as
in the past or even better." The College
of Nurses was responsihle for determin-
ing standards for diploma and degree
nur...ing education programs before
Sept em her 197
when the diploma
programs shifted from the ministry lIf
health to the ministry of education.
(Ne\\
, March IYD. page l-f.)
The council of regents agreed. M....
Macdonald said. to accept the standards
proposed hy the College of Nur
es, a

a hasi... I'llI' program approval. The
council of regents asked the CNO in-
spectors to continue assessing nursing
programs Il)r a
-year period. to en...ure
the maintenance of program qualit).
Thi
arrangement will he reasses...eò in
2 year....
A provincial advisory committee on
nursing. to make recommendations to
the co'Uncii of regent
regaròi ng initial
anò continuing approval ,)f diploma
nur
ing and nur...ing a
si
lant programs
in C -\A I . ha
heen estahli
hed. Repre-

entatioll on the aòvisnry comm ittee
includes 5 CNO members nominated
bv the council of the CNO; I member
eZlch nominated h) RNAO. the Ontario
A......ociation of Registered Nursing A...-

istanb. the ministry of health. ministry
(Coll/illu"d Oil IJ//Re 15)
MARCH 1974

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JEWELRY NURSES CHARMS

finest sculptured Fisher charms,

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Sterling or Cold fill.d (specify under COLOR on couponl., '..
For bracelet or pendant cham. Add to your collection! ^ f' 1f <
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o .. Handiest for busy nurses Includes white Deluxe
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Change compartment, key cham
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3 Gold Inilials on callar. add 1.00 per cape.
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news

I COlli illlled li'o1ll I'",!!e J 21

of education. Ontario Ho..pital A ""0-
ciation. Ontario I\kdic,11 A....ociation.
at the ( \ \ r L"ounci I of pre..ident-..
Thc Ontario
ur
es' Act regulating
..choob 01 nursing wa.. considered h)
thc government to hc inappl icahle
...ince. in it-. interpretation. there arc
no diploma schoob of nursing no\\ but
rather nur...ing program.. in collegcs of
applied arts and technolog).
The College of Nurses of Ontario
continues to have responsibility for
..citing standards for admission to the
profc
sion. The C "" r council of regents
requires as..uranee in \\riting from the
College of Nurses that graduates of
C A" t nursing program... \\ TII he cI igible
for recognition hy the CNO as the regis-
tering bod). before program.. arc ap-
proved.
I aura Barr. executive director of
R:-.J AO. told Ihe ClIl/lIe1 illll Nune: "The
RNAO mu...t reassess it.. role in nursing
euucation. We have establi"hed a ta..

IÌJrce to loo!" at the RNAO role and to
have a statement read) lor the annual
meeting in '\1a)
'The R ;\JAO nced.. to reassert itscl L"
Ms. Barr said. "A ...trongcr profc"sional
a"..ociation i... ah"olutcl\' e....ential. Wc
must establi..h principles on which
nur..e-Il:.tcher... can stand. The R:-.JAO
will be the \\atchdog for its members'"

.\1<\ , /'(';, r I, . I, olllitllll d li'oll/!,"!!!, 71

oritie... in health ...cn ice.. and in the
health ...\ ...tem at all Ie\ eb. It also
..trongl) '..upport-. thc \'d cod report
regard ing the nced to rcprescnt the
disalh,lnt,lged a.. \\'cll as the affluent
and m iddlc-das... con..unll:r on health
ad\ j'IH) and planning bodie....
'\RN \ doc.. not agrce \\ ith the propo...-
cd ratio (one-third ph)...icians. one-
thiru allied health personnel. lme-third
ht) men) for a health council to ad\ ise
the mini"h:r of he,lIth. lI1..te,ld. the as"I'-
ciation recomllll:nds that thc hcalth
practitioncr component be di..tributcd
in relation to the population \\ ithin the
health profc...sion.... ,\.. the large..t
group of health practitioner... in the
Pll1\ incl'. SRN \ hel icvcs it mu"t ha\ e
...ignificant n:pre...entation.
\R:"':.\ "Upporh in principle the re-
port's recommendation that communit)
health ,lIld social L"Cnters. a.. recom-
mended b) the Ha..ting... Report. be e..-
tahli..hed. pro\ iding the center.. in-
corporate a ..ignilïcant component of
prnenti\e health ...en ices. It ...a)s it
mll...t bl' imol\l'd in de\cloping the

nurse's role in such centers. (Ne\\ s.
February 1974. page 7).
rhe association endor...es the recom-
mendation that a regional health ...ys-
tcm he de\ doped in the prm ince as
long as it emph,l..i/es thc ,Idministra-
tion anu pro\ ision of coordlllated health
..crv iccs. Expanding ...uch a s) ...tem to
i nduue other services. ..uch as :-.ocial
...en ice.... euucation. and agriculture.
:-.hollid he uecided through 7. \otc by
the population in each region, says
SRN \.

Pill's Potential Not Achieved
Says Developer Of Contraceptive
(Ï/;mgo, III. - The pill has not aclHev-
ed its potential in the 22 years it has
bcen u..ed. ..,1\ s Carl Djerassi. Ph.D..
the man \\ ho
) nthesi/ed the IÜ...t oral
contraccpt ive.
Dr. OJ cras...i sa)" that "hypcrcau-
tion" on the part of fedcral authoritie...
has ...Iammeu the door shut on the in-
troduction of ne\\ birth control method...
aceordino to the J anuar\, 1974 i:-....ue of
PrislI/, published b) 'the Amcrican
!\1edieal As:-.ociation. ., ro me," Dr.
Djerassi ..aid. "the pill \\ a" only ,I
beginning - a vel') 1111 perfect begin-
ning." He expccted it \\ mrld lead to
other, better methods.
He finds that liS federal authorities.
responding to prcssure from legislator...
and "sensational press cm erage" of the
pill. ha\e impo...ed "uJl\\arrantcu h)-
percaution" on consideration of ,Ill)
ne\\ birth control method. He said.
'lhe amount of practical clinical re-
search in reprodueti\ c biolog) no\\
being done by the indu..tr) or in the
uni\ er...ities has gone do\\ n. and "'pec-
tacular ,Id\ ance... arc no longcr in the
cards. ..
Accordlllg to Dr. D.ler,I......i. accept-
ance of the pill b) almo...t e\ er) rei igious
and cthnic group mean.. that "\\omen
ha\ e come into control of their fenilit\
and hale been able to ma!..e a deci..ioil
that previously hau heen left to men
or chanec. :'\Jothing ha.. had a bigger
impact on the ema
lcipation of \\oñlcn
and on the tÒstering and ...timulation of
\\omen's righb."

In hi.. \ fe\\. the pill I" not the ulti-
mate answer to the world's rapid popu-
lation growth. rhe development of a
once-a
month. menses-inducing abor-
tifacient pill is foreseen by Dr. Djerassi.
A pill of this !..ind would be "the mOst
useful contraceptive and something that
would. by no means. ta!..e as long to
devcll'p ,IS an immunological contra-
ceptive. ..
I he ultimate concept \\ ould bl: the
ahilit\ to ..\\ itch on and 011 a \\om.ln's
fertil (t\. ..afch and con\L'n ienth. rather
than ríeg"till!.! naturc during tlíe mcn...-
trual n
de.
But Dr. Dier
.....i doe....Ù
thin!.. "'llCh.l techni4ue \\ill hl: l!c\clop-
cd in Ie...... than .
5 ) car...
THE CANA
IAN 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

Amyotrophic lateral sclcrosis was a
disease I had never heard about before,
yet I "new that very quic"ly it would
be affecti ng our I ivcs as the doctor told
my father. "There is no "nown cause:
there is no curc:' My fathcr was a strong
man who enjoyed life to its fullest. but
this disease was somethi ng in I ifc we
were finding hard to comprehend.
Tears filled father's eyes as he sat
across from me in our car one cold
Octoher day almost four years ago. It
was diftïcult 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 '\eriously wrong. as I \Vas
heginning a new life for myself away
from home at university. This was go-
ing to be my first encounter with death.
J was shoc"ed and frightened.
f'or several years my father had
noticed a wea"ness 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 earl} in IlJólJ. which in-
creased the difficulty with his left arm.
rhe doctors thought there could he an
impacted vertebra in the nec" causing
pressure on the arm. hut they were also
concerned that there might he some
other influencing condition.
A serics of x-rays and tests "ere
conducted in the fall of Il)6lJ to tl)
to establish the diagnosis. Electrical
analysis of the muscles of the left arm

MARCH 1974

showed a mar"ed deviation from the
normal wavy line. which causcd the
doctors a considerable amount of ex-
citement and concern.
It was two wee"s of anxious waiting
before my parents were told. The dlx:tor
was lJO percent sure of the diagnosis,
hut wished to do some further tests to
eliminate th
possibility of <I brain
tumor or a spinal lesion.
After further consultation. t
lther
was told that he had a form of progres-
sive muscular atroph}.
The doctor was most gracious and
"ind. He explained that thc 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 lite
expectancy after diagnosis of t\\O to
th ree ) cars.

A
I H< I w- ()l 11'1 01 the initial
shoe". m) parents spent some time
together discussing "hat thc} might
100" forward to and searching for in-
formation in thc MacA ."vIedical ."vIal/-
lIal about th
prognosis of the dj'ease
and the different things \Ve \\ould ha\c
to contend with.

I he aUlhor. curn:ntl) In I'uf't'pe. ohtained
her B.Sc.N degree from the l nivCI',il\ l,t
Sa,"alehew.1Il in :\la). 197
.
THE CANADIAN NURSE 17

Looking ahead "a
terriI') ing. but
\w all soon learned that any probkm
Imes much of its magnitude when it
is faced one day at a time. rtuoughout
the course of the illness. I marvelled
at my father'
continued determination
and joy of living a
his phy
ical
trength
deteriorateo with each week and month
that pa

ed.
The normal proce
s in dmyotroph ic
lateral sclero
i
i
that nerves in the
central spinal sy
tcm that control the

kdetal muscles arc damaged. fhese
nerves die. and all impulses to the
mu
eles arc cut off. As a result. the
muscles gradually ""aste away. begin-
ning ""ith the small. finer muscles.
The wasting began in my father's
left hand and arm and quickl) spread
to hi... right hand and arm. The wasting
of the muscles is acclllllpanied or pre-
ceded by a fasciculation of the muscle.
Soon my father could no longer hold on
to objects. bUllon or unbUllon his
clothes. or turn knobs on the radio or
television.
Wasting continued through hi
arms
and shoulders. and then plIJeeeded
dow nward to the muscle
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 ..J.O falls. somt-'
more
evere than others.

A s A I-A:\III Y. WI-' RFr\1 In. I) \\e had
two choices: we could squander
the time we had left together feeling

orry rÒr ourselves. or we could cherish
it. Wt-' decided we weren't going to
waste any time. Although it was most
difficult at times. something wonder-
ful happened to the relationship within
our family. We laughed more and had
a rich and deep fellowship together -
more sharing and doing things together.
My father helped u
reali/e that
much of the fun of I ife is lost when
people arc drivcn by desire for material
thi ngs. fhe material valut-'s that used
18 THE CANADIAN NURSE

to mean
o much became less important
to us. as people became more and more
so. With this came increasingly open
free communication within our famil)
and with friends. We realized that so
much around us is beautiful and won-
derful - even a drive around the park
became
omething special. M) father
wantcd to take in a
much as possible
before he had to leave it all.
We 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 the) really werc. 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 tile time it gave us to
di
cuss. plan. and prepare for the
future. We talked about life. and we
talked about serious illness and the
eventuality of death.
We tried to help one another face
the situation realistically without fear.
'VIy 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 ""hate vcr
wa
ahead.
We were continuall) amaLed by
father's sense of humor. He
eemed to
reach state
of euphoria where things
would strike hi m as highly amusing.
fhis 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
omething was bothering
anyone of the family.

A " rH I-' DlSI-' AS!:' PRO(j R ESSI-'I). the
muscles in father's neck graduall)
became quite seriousl) affected. Th is
meant verbal communie<lIion was
soon to be eliminated. It was difficult
wht:n he tïnall) reached this point. A

long as "e could talk together. things
didn't seem too bad.
\Ve were able to work out a form
of communication by
pelling out words
"hile tither was able to blink his e)es

and move his eyebrows to indicate the
kller
he "anted. This got to be frus-
trating at times when father ""a
trying
to tell us something and we couldn't
understand: but we had to communi-
eate.
Sitting III a "heelehair presemed
additional problems as hither was not
able to support his own head due to the
weakened neck musc1e
. My brothers
and an occupational therapist from a
local hospital worked together to de-
sign a head
upport "ith a sy
tem of
pulleys. .This allowed father a good
range of motion of his head and neck.
yet gave the support he net:ded for sit-
ting up. He was then able to be up lor
long periods and to read with the help
of an electric paper turner.
Eating and drinking became more
difficult with each meal. and we lived
daily "ith the fear of having father
choke to death. By J anuar) IY72 hc
was very thin and hungry. weighing
only 90 of his original 155 pounds. We
decided. with the doctors. to have a
gastrostomy done. fhe l;perat ion was
perfÒrmed 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
c hok i ng.
We talked about a tracheotomy and
the possibility of an artificial respirator.
but we felt we should do only what
would make I ife easier without undul)
prolonging it. This was father's deci-
sion as well as that of the rest of the
family.

W F WI-'RF I-ORTUNA rE as a fam-
ily to be able to keep our t
lther
at home throughout the course of his
illnes
. 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. Hoyer
hydraulic lift and swing. raised toilet
seal. and portable oxygen equipment.
A dll(\Or loaned us an electric suction
from his office.

MARCH 1974

\\
cOIl\
rtcJ our livingrooll1 into
fath
r'
h
Jroom. Thi
allo\\
d him to
h
a part l)f th
activiti

of the hou

-
hold.
rh
} \\
r
thr
e Jiftìcult )
ars, but
abo \
r) r
\\arding. Th
re \\
r
times
of discourag
m
nt.
\'
n tim

of
r

ntI11l:nt: thn
\\a
pain: and th
re
\\
r
long nights of
ilting h) rath
r's
...id
as h
...truggkd \\ ith th
la
t k\\
da)
and hours of hi
lik.
Hl.' died p
acefull) in August. IlJ7'!..
Th
re \\ as no struggle but. rather, a
peaceful ...urrender to a long battle.
:\1) mother and I ...at hy his
ide hold-
ing hi
hand. and I sensed that he felt
our pr
"'ence. We gath
red a
a family
- thae \\ a... nohody to hustk us .1\\ a).
Fath
r
eem
d tl) have a "mik of con-
t
ntml.'nt on hi... rüc
as we
at in the
li\ ingroom \\ith him.
It \\ a
hard to kt the ambulance
lake him a\\<I). His iIlI1l:

and dcath
had he
n a famil) affair. I \\ ish \w
could ha\
huril.'d him in l)ur 0\\ n
garJ
n. \\hich h
had lo\
d "'0 much
during hi
lik.
He is mi

d. Our r
membrance i

of a strong. activ
man who fac
d lik
courag
ou
l) and surr
nd
red this
lik a
\\
knl'\\ it \\ith a grcat dcal of
dignit). Hi
a
hc'" li
b
neath th
first
tree h
planted - a very tall. majestic
tree.
'

MARCH 1974

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THE CANADIAN NURSE 19

OPINION

A current TV ad depicts a man who
has a cold. A woman addresse
him
as "poor bahy:' and bring'i him a head-
ache-fevcr-
tuffy nose remedy; soon he
feels well enÔugh to take out the gar-
hage. A contrasting rv ad shows a
young woman surrounded by noisy
children at a hirthday party:
he. too.
feels unwell. No one "poor haby
" her;
she goes to the medicine cuphoard,
dose
hcrself with a headache remedy.
and carries on her ho
tessing. The other
women at the part} do not a
si
t her.
according to the ad.
Nurses
uller from the "poor baby"
syndrome. A predispo
ition 10 it i

indicated in the rea
on given by women
for entering a nur
ing program. "I want
to help peopk and take care of them
when they're sick:' A nurse expects to
subordinate her interest
to those of her
patients. Nurses carry the attitudc into
their private lives a... adult women. and
subordinate their interests h) tho
c of
hu
band, children. neighbors. or com-
munity activitie
and. in the work
world. to tho
e of doctor'i and of nur
es
above them in the nursing hierarchy.
Imperceptibly, 1ll1r
eS come to de-
pend on the maternal stancc for their
self-re
pect and self-image. They get
hooked on
e1f-deprivation. Women arc
20 THE CANADIAN NURSE

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.

the ones who make the coffee, takc the
minute
. do the errands. and put them-

e1ve'i - their gW\\ th and development.
their satisfaction
-last. Nurses. along
with others. have ahrogated their righb
and denied their intercsts as womcn.
A feminist is committed to creating
the equal it}. not the samenes
. of the
sexes in all the rights and responsibili-
ties of Ii IC. It is not surprising that
nurses are not notieeahly active in the
fcmini'it movement. Mostnur
e'" are ill-

u ited to the de hate and dem and
of a
pu
h for womcn's rights. and ill-equip-
ped to organi.te on hehalf of women''i
interöts.
Many nur
es have difficulty seeing
a place for themselves in the feminist
world. rheir reasoning goes. Since I
am part of a profession of women. therc
i... no question of women's right
. no
competition with men. But thcre's a
world of men and women around us. I I'
nurse
lift their
ights from the kitchen
'iink, the neatly made hed. and the pwb-

\h. Starr i, an a"i...tant cditor of 1]'<,
((/llI/elic/l/ ,\ 11/'\('. I hi... art ide i
h..sed on
a spcceh ,hc gav.: to thc Alumni A...soÒ<I-
tion of t he Univcr'iity of Ottawa School of
Nur...ing in Novcmher (')7 .
.

lem-oriented patient records. the need
for the feminist movement in nurses'
per
onal 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. Evcry 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.
rhese attitudes were, perhaps, under-
standable when most women devoted
their working lives to the home, and the
male wage-carner provided the family
income. roday. over ..J.6,OOO married
nurse
are employed full-time in nursing
and nearly 20.000 married nurses work
part-time. 1
Nurses consider a man unusually
under
tanding when he a
sists his wife
to attend univcrsity. hut a nurse is only
doing what i
expected when she helps
MARCH 1974

MARCH 1974

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THE CANADIAN NURSE 21

her hushand to go to schooL Examples
arc numerou
of the automatic prece-
dence given maJe
over femaks. Some
men ht;ld doors and chairs for women.
but this cannot be equated with the
educational and career opportunities
afforded to men .as their right.
Some Canadian laws restricting
\\omell"s activities have been rescinded
and others arc in the process of change.
When Hi" Maje
t):s Privy Council in
London overruled the Supreme Court of
Canada in I Y2Y. and ruled that the
word "persons" includes members of
the mak and female sex and that
women are eligible to bc summonsed
and hecome memhers of the Senate of
Canada. the legal way was cleared for
women to participate in Canadian pol it-
icallife.
The Royal Commis
ion on the Status
of \\/omen in Canada. whose report
wa
publishcd in IY70. made 167 re-
commendation
to ensure for women
equal opportunities with men. National
and provincial committees on the status
of\\onH:n arc prodding for implementa-
tion of these recommendation
.
Hut what ahout restraint
that arc
self-impo
ed'.' Appropriate behavior for
men and women toward each other and
tow,u'd their own sex i
learned from
early childhood. Little girls are made
of sugar and spice and all things nice.
according to the nursery rhyme. while
I ittle boy
.Ire constructed of nails and
snail... and PupP) dogs' tails. Even the
ingredient
of little boys arc active.
while ...ugar and spice ju
t sit there!
Rooks lix children emphasi7e an
active. prohlem-
olving role for mak

anu a pas
ive. dependent role for fe-
malc
. "Oh. oh! Ltx,k. look! See Dick
run! Oh. oh! Look. look! See Jane sit!"'
If the male is the active and dominant
one. he is important. females compete
for hi
attention and
pend time with
other femaJc
a... second-hest. The man-
\.\oman games \.\e play arc pan iall) the
re
ult of ideas implanted in mind
too
young to query the rationality of the
grown-up.... and partly the re
ult of
conll ict
aroused hy the hurgeoning
...exual ity of adolescence.
Alix Kates Shulman wrote about
relation
hips hetween adole
cent hoy

22 THE CANADIAN NURSE

and girls from a woman's point of view.
in an anicle entitled "The War in the
Ibel-, Sl.'at." 2 She
ay... the ohjeet of the
real-life dating game in the IlJ..J.O... and
'50s was. tl)r the hoy. sexual intercourse
and. for the girl. avoidance of vaginal
penetration without complete alienation
of the hoy. It was psychological war-
fare in the back scats of cars and in
other uncomfortable. unprivate places;
no one emerged unscarreu or victorious.
A current philosophy of sexual he-
havior i
that women should be as free
as men to select their partncrs and
to enjoy relationsh ips. freed by the Pill
from the deterrent fear of pregnancy.
Rut today's young adults arc the off-

pring of parents whose attitudes were
"haped by the war in the hack scat. A
double standard continues to be applied
to the behavior of men and women bc-
cause many can't shake free of their
guilty hang-ups.
As a result. women react to men by
a tea"ing. tlirting. advance-and-retreat
behavior that mitigates against honest
friend
hip
and inhihits a woman's
ability to do her best work and make
her maximum eontrihution in business
and profcs
ionallifc.
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.
\.\e support the present status of women.
including ourselve
. and fail to que,,-
tion or challenge our accorded statu
.
Phy II i
Chesler makes the frighten ing
point in her book. Womell lIlld MlId-
lleH,3 that male p
ychiatrists may diag-
nose a woman as mentally ill if she
reheb against m,lIe uomination.
A married woman in prc"ent-day
Wcstern society suffers a terrible eco-
nomic and social vulncrahility. She
can come to middle-age \.\ ithout know-
ing the particulars of the family's
busine
s and financial affair.... without
making major. long-range uecisions.
I I' she is kh on her own by ueath. deser-
tion. or divorce. she lacks neces
ary
information and experience.
Housewives. nurscs. and secretaries
arc all \ ictims of a fatal availahility.
The \\ illingness to accept rc
ponsihility
for the housekeeping. nurturing tasks

and a denial of self - an unselfishness
- lead to nonpermanent achievements.
Daily meal
mu
t be cooked. patienh
hathed. and kill' 1'" typeu: no one douhts
these ta
ks need to be done or that they
can be donc with
kill anu devotion.
Rut a job consisting of tasks in which
one worker can replace another. almo
t
without pause. docs not give the worker
power.
Nur...e" arc without open power. A

Virginia Cleland asked, "Just who
makes the reall) important decision

tÖr nurses and nur
ing?"4 A variation
of the man-woman game. the nurse-
doctor game. has bcen de
cribed many
timcs. The nurse who insinuates sug-
gestions into a conversation \\ ith a doc-
tor. in such a way that the doctor thinks
the ideas for hetter pat ient care origi-
nate with him. is playing the nurse-
doctor game.
A" women and nurses. we support a
role for the male as master and enemy.
loved and despised. whom women cajole
anu trick. cosset and cheat but. when
the crunch comes. to whom they defer.
Although we say "poor baby:' we arc
the poor babies.

Remedies
Here arc tïve remedie
for the poor
baby "yndrome: become aware. make
per...onal choices, change child-rearing
practices. support other womcn. and
work tl)r a two-gender nursing.
1'0 become aware. read. listen. and
look. A
the level of con
elOusnes...
ri
e
. so will the hlood pre
sure. The
numh
r of put-down
woml.'n take i...
incredihle! If a woman remarks on an
ad or a movie dim in ishing \\Omen. a
man will
ay "Oh. comc no\\. You
don't take that seriously'.' Where.... your
...en"e of humor ,"
Rdu
al to laugh off humor that
treats women as
ex ohjects can have
po
itive results. rhe Metric Commi...-
"ion tried to make Canadian
,1\\ arc of
metric measuremenh h) picturing a
scantilv clad female \\ith hu
L \\al
L
and hip circumference printed in cen-
timeters; the outcry of wom
n got Ihe
poster removed from circulation.
To hecome aware i
to become irri-
tated and fru
tr<lted. to hl.' forced to
MARCH 1974

reconsider per
onal relation,hips, and
to discover that
ome treasured child-
hood legacies arc sexist. It is sad to
realize that The Little Prince was a male
chauvinist to\\ard his Rosc.
A warcness of facts, trends, and
social nuance
is the fir
t 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. \\Ie can prom-
i
e that we will never again refer to
ourselves as "just" anything. just a
housewife. just a mother, just a nurse.
\\ e put women down when we u
e
helittling 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
suburhan housewilC, who became a
feminist organizer. said. 'Tm a woman
just as much a
a wellÜfe mother, inas-
much as we're assigned certain roles
b} ,ociety. Just because I'm middle
class doesn't mean I'm not oppressed." 5
Women who have children or work
with children w ill find their growing
awarene
s reflected in child-rearing
practice
. They will try to make <;ure
that little children arc treated a
per-
son
first. and persons of a certain sex.
second. In nonsexist nursery 'ichools,
little girl
will play with trucks and
little boys pour water at make-helieve
tea parties. Someday our society will
no longer a
sume that boys arc born
with.. mechanical aptitude that auto-
matically di
qualitïes girls from a range
01 hohbies and careers.
Another remedy is to have confidence
in women and support them in their
endeavors. Many women e
tahli
h only
,upertïcial rdation
hip
with other
\\omen. and ne'-'er discu
s important
matter
with another woman. Ideally, a
lawyer. denti
t. or doctor is chosen f{\r
her or hi
competence. I I' one ha, no
criterion or information, why not trust
a woman lawyer or denti,t! A \\omen's
center in your community can
ugge't
name
of.... omen profe....ionals.
Recome ,1\\ are of and support wom-
en who have accepted high office and
MARCH 1974

high re
pon
ibility in puhlic life. There
are seven women in the federal govern-
ment's 700 senior executives. Seven
isn't many among 700. hut 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
pres,ure 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 \\Oml'n can do
a good joh 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
halanced. It is good to have women
engineers, economist
. and veterinari-
ans; it is good to have mcn as nurses.
We don't need men so they can take
all the top nursing job
and replicate
the present. male-dominated society.
And not, as some have suggested. so

ociety .... ill perceive the male's nccd
for an adequate salary and so raise the
pay of all J1l1r
e
. One reason for hav ing
numhers of mCn in nur,ing is to help
hrcak down the old doctor{nur
c. male{
female ,tercotype and let doctors and
nur,es relate to one another as per...ons.
ti)r the betterment of patient care.

Rewards
At present. the rewards of a
uccess-
ful fcmini
t movement in which the
righb and interest-; of \\ omen arc
hI ought into halance \\ ith those of men
arc speculative. In ,ociety generally.
the interest, of \\omen and children
will hL' protected only as \\omen acceed
to po
ition
of inlluenee and decision-
mal... i ng.
N ur
e
' re.... ani.. ti)r pal1ieipating in
the fcm in i
t movement \\ ill he a more
nearl} autonomou
profcs...ion \\ ith
more open po.... er. I hi, mean, nur
es'
ability to help patient... will he magni-
lïed. through their dhilit) to get deci-
,ion, and plan
implemented. Another
re\\ ard \\ ill he attracting into the pro-
les
ion creati\e. thinking. compa....ion-
ate people of hoth sexe....
On a pcr,onal h.l,i" growth in he.
lie\ IIlg in her own right-. and intaesb
produce, a \\oman \\ho 'tri\es to rea-

li7e her O\\n potential. ....hatever it ma}
be. Simone de Beauvoir said it. "What
\'.oman e
sentially lacks today for doing
great thi ng, i... ti.Jrgetful ness of herself;
but to li.Jrget oneself it i, first necessary
that now and for the future. one has
found onesel f. ,. 6

Summary
The liheration of women will result
in freeing feminine qualities - the real
feminine qualitie
, such as compas
ion.
tendernes" empathy - in persons of
both
exe
. fhe tCminist movement's
message to the nurse is: Don't poor
haby another person and don't be a
poor baby yourself.

References
I. Canadi,\11 ;o-Jur,e,' A,..ocialll1n. COII/1I-
clown 1972. Ültaw.1. Canadian I'<urscs'
A "ociat ion. 1'J7 _
. p.1 2.
2. Shulm.lIl. Alix "-atcs. I'he War in the
Hack Seal. !ll<' A Iial/lic. 2.
O: I 50-".
J ul
1lJ72.
:\. Chc,lcr. Phylli... 11'01//1'1/ ancl ,\lacll/e.n.
l,arden Cit
. :-".'1.. Douhkda
. 1972.

. Cleland. Virginia. Sn di...crimin.ttion:
Nursing', \Jo,t Perva,ive I'rohkm.
AI//erical/ ./ol/rl/al (
,. .V"rsil/g, 71.S:
1542-7. Augu,t 1971.
5. Johnson, \' alcrie :\1 i ner. I'he Suhurhan
Housewife a, f-emil1lst Organizer. Sa-
I"rday .Viglll. July 1973. pp.15-X,
h. de Hcauvoir, Simone. Ihe S('('ond ,\)1' r.
Tran" H .1\1. Parshlcy. "Ic.... '\ 01'10.,
"-nopf. 1971. ?

1
...

"...

......

..

,

THE CAN DIAN NURSE 23

The
Canadian
Nurse

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ð

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24 THE CANADIAN NURSE

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The Canadian Nurse
OFFICIAL JOURNAL OF THE CANADIAN NURSES' ASSOCIATION
MARCH 1974

Cholera epidemiology
and control

Cholera has been endemic in the delta
of the Ganges River in eastern India
since the beginning of recorded history.
and has periodicalIy ranged over the
entire globe. Between the years I H 17
and 1923. 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
IlJ47. cholera was confined to the
endemic regions of South East Asia
from 1923 to 1959.
The seventh pandemic. which start-
ed in 1960. spread from a focus in the
Celebes Islands in what is now Indo-
nesia f Figure n. It was a long time
before scientists realized that the of-
fending organism was EI Tor vibrio.
not the classical Vibrio cholerae. B\
1963. the disease had extended north-
ward as far as Korea. China. and the
Philippines; by 1965. classical V.
cholerae in India had been almost
completely replaced by EI Tor vibrio.
In East Pakistan. however. the classical
V. cJlOlerae, serotype Inaba. remain-
ed predominant.
Since 1965. cholera has spread west
via West Pakistan. Afghanistan. Iran.
and Iraq. I n 1970 it struck Odessa and
Kerch on the Black Sea, the Middle
East. and North Africa. In August
IlJ70. EI Tor cholera Ogawa
erotype
was introduced into Guinea. West
Africa. where it had not been recogniz-
MARCH 1974

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.

ed since I XlJ4. Since then. the disease
has been reported by more than a d07en
West African countries.
Spread of cholera in Africa folIow-
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, intluence the effect
of the importation.
Official reports from these West
A frican countries indicated approx i-
matelv 2..J..000 clinical cases. \\ith over
3.000' deaths. It has been estimated.
however. that in reality more than
three-quarters of a million cholera
infections have occurn:d in "'cst
Africa since August IlJ70.
The summer of IlJ71 \Vas notahle in
three ways.
I. There was further extension of the
disease in Africd. affecting Hhiopia.
Somalia. and East Africa. t..) involvc

Dr. Oavies is Director. Hure.IUI)1 l'pidclll-
iolog}. I anorato)
(e11l rc fl'r Disease
('01111'01. H
'alth Proteelion Branch.
kalth
.\ \\ d lill C ( anad;1. 011;1\\ .1.

altogether a total of ahout 20 countries.
2. Mas
ive epidemics of cholera oc-
curred in refugee camps in West Bengal
and along the frontier of East Pakistan.
\\ ell over 20.000 cases and 3.000
deaths occurred in this area.
3. Cholera \Vas imported into a num-
her of Euroflean countries. including
France. Spain. Portugal. Sweden. and
the L'nited Kingdom. usualI) by return-
ing tourists.
In August IY7
. Italian officials
notilied the "'orld Health Org.lIli7a-
tion of an outhreak of cholera in t\\ 0
localities south 01 Naples. Several
hundred cases occurred hefore this
epidem ic \\ as hrought undcr control.
Epidemiological investigation tended
to confirm that inkcted shellfish \\cre
the sources of the epidemic.
Another notahle event in August
IY7.3 was the report of a single con-
firmed case of cholera in Port I avaca.
Texas. The source was never found
and there \\ as no spread of the disease.
I'his is the lirst recogni/ed case in
North America in over 50 \ cars.
Iîle ever-\\idening geographic dIs-
persion of thc disease raises the threat
of further importation intp the \mcri-
can continent.

Organisms
In man} respects. choler.. resembles
other enteric infections. but is cha-
THE CAN DIAN NURSE 25

racterized by its greater potentiality to
spread rapidly in receptive areas and its
ability in severc 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. cho[erae, biotype EI Tor, is the
predominant etiological agent in all
the countries affected except East
Pakistan. where classical cholera is
prevalent. More recently. thc cla
sical
type is again being isolated in neighbor-
ing West Bengal. India.
EI Tor is somew hat more resistant
than classical cholera and survives
longer in the environment. It is more
easily detectable in bacteriological
surveys of water and night-
oil 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
monsoon. In some parts of the Philip-
pines, cholera tends to reach its peak
during the rainy
ea
on. The cause of
these seasonal pattern!> is unknown.

Pattern of spread
Bad environmental sanitation. par-
ticularly a lack of adequate fresh water
for personal use. seem!> to be the
fundamental factor in the spread of
cholera. Provision of abundant amounts
of safe water for all pcrsonal use can
break this cyclc. leading to its control.
There are two main types of spread.
I. The cxplosive epidemic where a
common source or common vehicle.
such a!> water. i
implicated and an
explosive outbreak appears over a
short time. An example of thi
is the
Broad Street Pump epidemic in I X54.
identified by Snow. *

: John Sno\\'. SilO II , Oil ('!lo/era. I{cprinl-
Lxi IlJ.
6 CÙ.. ,,"cw York. H"fncr. IlJ65.
26 THE CANADIAN NURSE

2. By contrast, protracted epidemics
may occur with the appearance of only
sporadic clinical cases over a period of
time. I n these outbreaks the means of
transmission is not always well detìn-
ed. Contact spread has heen 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 occa
ional small explosive out-
breaks may be demonstrated in famil)
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 predom inant-
Iy 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
th rough the environment. As a rule.
infected individuals excrete vibrios for
several days. but a fe", chronic carriers
have been described. Maintenance of
iniection in communities is facilitated
by the presence of subclinical cases
and by the relatively brief immunity
following infection so that reinfections
from year to ycar are common.

Clinical picture
The spectrum of diarrheal disease
for wh ich V. cho[erae i!> 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 I U, and for E I Tor cholera,
perhaps as Iowa!> I to 50 or I 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
tlecks of tloating mucus), although it
may occasionally be cream colored or
even bloody. Soon after the onset ()f
diarrhea. the patient cedses to urinate
and exhibits moderate thirst. followed
by cramps in the muscles.
The massive gastrointestinal loss of
isotonic tluid of very low protein but
high bicarbonate and potassium content
leads to profound dehydration with
hemoconcentration, !>hock. hypokale-
mia, and metabolic acido
is. 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 mortal ity rates
of 20-30 percent tor cholera; however,
with adequale treatmcnt. including
correction of saline depletion and
acidosis. mortality should be almo
t nil
in all age groups.

Treatment
Treatment should be given immedi-
ately. It consists chietly of intravenou!>
tluids and electrolytes to restore the
circulation and to corrcct the dehydra-
tion, acidosis, and potassium loss.
Tetracyclines are valuable III !>hortenÎng
the period of diarrhea and eradicat-
ing the organism.
Chemoprophylaxis of contacts with
tetracyclines has a limited place in
controlling the disease becau
e of the
ri sk of developing drug-resistant
vibrios.

Cholera surveillance and control
Cholera can be introduced into an}
country despite immunization with
presently available vaccines and the
use of other preventive measures list-
ed under the International Health
Regulations. It should be recogni7ed,
however, that cholera can spread only
in areas with poor environmental
sanitation and personal hygiene and
with inadequate basic health
ervices.
The risk of further invasions is much
greater at present as cholera has be-
come endcmic over a wide area of the
world. Also. the E I Tor biotype. with
its high proportion of mild ca
es and
carriers. spreads more easil)' than the
classical hiotype.
The wide geographic dispersion of
MARCH 1974

FICURE I
Extension of Cholera, 1961-70

'}

SOllrcl':
J ee/..I\' Lpide/ll;ologiclIl R('('ord, 46 13JI Allg. 6. /97/. World Hellirh Association.

cholera in recent years and thc
magnitude of tourist traffic make this
continent morc vunlerable to the im-
portation of chokra. The risk of spread
of the disea.<;e 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 minimiled further
in such areas by ensuring the availability
of health per
onnel trained in epide-
miology. bacteriology. and treatment of
cholera; the existence of well-organiz-
ed laboratory scrvices' equipped with
standard diagnostic reagents and media
for diagnosis of cholera: facil ities tor
treatment. chemoprophylaxis. and
health education; and the existence of
personnel and equipment to improve
sanitation and water suppliö. The
stockpiling of rehydration tluid
.
lalx)ratory supplies. vaccines for select-
ive vaccination. ...upplie... tor disinfec-
tion of water. and antibiotics has been
recommended by the World Health
Organization in area... threatened b)
cholera.
The mo
t etlective ,1I1d long-lasting
way of making countries unreceptive
to cholera is by improving environment-
al
anitation and personal hygiene for
the inhabitant
. 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 ...uch as Canada. cholera,
even if importcd. has little prospect of
ötablishing ibelf.
During the past decade. only
ix
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
wuuld be a wise precaution, however.
fi.>r physicians to take measures to ex-
clude this disease by perfÒrming bacter-
iological tests on tourist... with diar-
rheal disea<;e who are returning to Can-
ada from countrie
where cholera has
been" problem.

Summary
Seven cholcra pandemics have in-
volved the globe since I X 17. The cur-
rent pandemic
tarted in Indonesia in
1l){lO and in ever-increasing waves
extended northwest to involve progres-
...ivcly China. I ndia. the Middle East.
Africa. and. a decadc latcr. Europe.
Simultaneously. the classical Vihrio

cho/erae was almost completely replac-
ed by the EI 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 bc 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
cyclc of transmi
sion from man to man
through thc environment. The funda-
mental factor in spread of the disease
is inadequate sanitation. particularl)
lack of adequate water supplies for
pcr
onal u
e.
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
.

S
t\lng
nar
s. huilding fire:-.. and
making lean-It'
ar
nl)t tasks usually
a

ociated \\ ith nur
ing. But thi
i

what northern health service (NHS)
nur
e
havc bc
n doing recently.
rh
Canadian Force, and NHS hav

h
en jointl) conducting a "survival in
th
north" -.
minar. Yukon puhlic health
Illlr

-' learn
d th

urvi\'al th
or) on

day and put it into practice the next.
"I t"s a very e-.sential part of a north-
an nllr,
'...training. I hope the program
\\ill h
held
\'
ry )
ar:' Yukon field

uper\'i,nr HeI
n \\illianh said.
\1s. Will iams said the tv. o-da)
cour,e \\ a'- a fir
t Iilr the nur:-.es and
i
som
thing Illll....

ha\e heen a
king
for.
N HS nur'e
are frcy u
ntl) called
upon to accompan) ,eriou...ly ill patient

on ,IiI' evacuation 11 ights. usuall) under
adver:-.e
onditions imposed hy an emer-
gency ...ituation and the har
h Arcllc
environm
nl. TherdÒre. instruction
\\a
nri
nt
d to\\ard air emergencic....
A )
ar ago. a nur
e \\l)rk ing in th

North\\c,t Territori
s died \\hen a
plane \wnt off cour
e and cra...hed.
M,. Williams said the accident had a
lot to do with setting up the seminars.
"1 think
urvival in the north is
som
thing that is on our mind
a lot.
e:-.peciall) for th
nursö \..ho 11)." she
...aid.
Hata Richter. a nursc in the 't ukon\
mo't r
mot
community. Old Cnl\\.
:-.aid the cour,c had reinforced the
thing' ,he had kml\\n a per:-.on should
do in an em
rgency situation.
"\r10,t of u... hav
it at the back 01
our mind. I h
pos...ihilit) of having to
:-.urvive in th
outdoors al\\'a)
cxi'h
\\h
n \\e'r
traveling."
Th
I I nu rsö from cach of the
Yukon'., nur
ing
tation
received in
-

\h. U'I!llen 1'- a reportCl' and photograph-
er \\ Ilh I Ill: Ii hild,,,1'''' 'i1"I'. \\'hllchOI,e.
) lI"on. I hi, arllck j, ad'lptcd from her
,lItlde that dppeared III J hI' II hilc!"'/'\I'
'i1"I'. '\olnemhcr 2
. I (r.
.

28 THE CANADIAN NURSE

Surviving in the bush

Ian O'Brien

tructilJll in huildi ng :-.helt
rs. living 1)ll
the land. search and röcu
procedures.
air signals. and th
psychology of sur-
\' ivaI. fhey huilt lean-tos. start
d lires.
and learned 10 set
nare, in the wood...
outside Whitehorse. in _25 0 F. weather.
"\\le hop
to make the nurses aware
that there i... a prohlem and get them to
develop a little int
rest so they will
read and practice survival techniqu
s
on their ov. n:' said Warrant Officer

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.

.......'"

'"

,..

I

11

!
I

.J

Boh Coopa of the sun. ivai training
school in Edmonton.
Hc said the group \\' as much more
enthusiastic than militar) groups he
lNlalI) teaches "prohahly because
they v. ant to he here:' He added that it
is not po...sihlc to teach all there is to
know ahout survival in two days.
For nurses unable to attcnd the
course. vid
otaped recordings of the
teaehi ng

ssions v. ill he distrihuted. 'if

.<I/Iff'

\

,

\

-
",'?

,

"

-
,

..,

,...... ';
..

."
,\
J.

c.
..

.....

iIi

.6
\;
'\. ..

JI

"

.
.

,.

.

..

.
..
" " .' 'I '
II
ft
, -' \ .. Gathered around the fi re, which can
t
>Of"
; be used for warmth and as a distress

. j signal, are some Yukon nurses and

,;;;., their Canadian Armed Forces instruc-
-::
tors.
-;
'\ >'
I

.

.. '\ ..
.
':
....- l
. .
1

, t
. /
>'\
.... "..
'..., -"1' , "

l .
II '\{
..f'. '- . . .-'

.,. ",'.1:-<
. ...
- \

... ,
..

.

'P '"
'\ ...
t
f
'-

,

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.

.

I"
.

.,
.
.--

-- ""..""

., .....- ..

,. ,. _1IIIL''fo (
, .....W!.,. '..
-
.. ,.

\

,

"'-
..r""'"

. # .

.... t.
p "
_:"t ." t
#.
'I
.. ..

10..... ..
iI\", '>:-'
. . r

"

. .

'Of ...< ..

.
..

,'. .
-"'JII
f...,..... J:;;,
.
, :r
{'

l

."
..
..

""h
..
t

I I , ('
1.1 , :e
, -." : .. ,
J
t
I
,
? ' .. '. .
.
. 'tL
- \ .

, J.. ,. 1 , '
J'
r
. \ l'
r

'J

Yukon field supervisor, Helen Williams,
helps construct a lean-to

J, ..

,,

,
.....
'...
.."
.,;", 4
. ...
40
\ :1 ..
.'. 14
.

.. --

MARCH 1974 THE CAf'tADIAN 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 IsraeIis by surprise in
October 1l)7J. normal life came to a
standstill. As so many civilians had to
rcport for military duty - men to the
front lincs and women to noncombat
assignments - essential services 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 reI Aviv from (lJó.' to
(lJó4. * she had lived in Israel during
her husband's two sabhatical years.
Thus the nun..e's husband and three
youngsters understood her decision to
offer whatever help she sould during
thc Israeli crisis.
On the night 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

I\h. Dwor"in is a graduate of the Carleton
University School or Journalisill. She i..
l.'Òitorial a..sistant. Ihi' CI/IUUIÙIII Nul'.\i'.

30 THE CANADIAN NURSE

-P
..

. ..
, .J,
.. ...
I .
,...
!- . .
\ f
.... 0,
f
--
...
...

RiHja Resnie" is a graduate of the Jew-
ish (ieneral Hl)Spital in :\Ionlreal. where
she wor"ed in the emergency dep.lrlment
from 19hO to Il)h.
. and again after her
return from (...rae\. She ha.. .11..0 wor"ed
part I ime in ..everal Ottawa hospitals.
MARCH 1974

thought she would join this team. which
had been requested by Israel. But thc
nurse from the Israeli Health Ministry
who met the volunteers at Lod Airport
in Tel Aviv decided otherwise.
Ms. Resnid 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
hrief but intense experience.

Treatment begins on the field
For many 'ioldiers wounded in the
Sinai or on the Golan Heights. under-
ground field hospitals - built in the
form of air raid shelters - provided
immediate cmergency treatment. Teams
of soldiers. who had heen tauglrt 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.
Followi ng these emergency proced-
ures. the sol iders 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 lobhy.
\>.hich had hecome an adjunct to the
emergency department. they rcex,lI1lÌned
the soldiers. cleansed their wounds.
,lIld gave further treatment and medi-
cation.
From the lobby. the men were ad-
mitted to one of lïve departments. gen-
eral surgery. orthopedics. ophthal-
mology. neurological. and hurn. 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 hcaring that young men who
had no history of ulcers developed
bleeding ulcers within two weeks
because of the immense tension the)
experienced.
As soon as active treatment was
no longcr necessary, the soldiers
were transferred to convalescent
hospitals. The aim of this was to pro-
vide a morc 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 describcd how the emo-
tional care provided by the nurses dif-
fered in wartime. "There was a remark-
able difference in the staffs attitude
toward thc patients. Under normal
circumstances. nursing carc is objective.
kind. and efficient. Now the care was of
a more subjective and maternal nature.
Th is continued in spite of the ver)
long working hours [12 to 16 hours a
day]. ..
She said everyone was emotionnally
involved with the patients. "If it wasn',
your brother who was wounded or kil-
led. it was your hushand:' 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, \1s. Resnick
noticed that all the nurses in the group
she wa.'> with were in tears hecause 0'
what they were seeing.
The staff-relative relationship \vas
also unique. Ms. Resnick pI,inted out
th,lt the staff had a tremendous feel ing
of empathy toward the patients' rela-
tives. Since all regulations governing
visiting hours were ignored. m,lI1)
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 al ive and
particularly grateful to the staff. ex-
plained the nurse. There was a mix.ture
of rei ief and grief.
A year of experiencc 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
<IS much as possible and listening to
them. she fÒund she was able to allay
their anxiety.

Didn't know what hit them
Each day Ms. Resnick cared tor
three patients. who ranged in age from
19 to 21 years. For these young men,
the first encounter with war was es-
peciaIl) cruel.
.. Razicl was one of the young men
on the Bar-l ev line [overrun b) the
Egyptians] when the war broke out.
Thcse men just didn't know what hit
them. This Il)-year-old. who was about
to be married, had onc lung pierced.
one testicle severed. and had to have
one leg amputated belo\>. the knee.
Because of severe shrapncl wounds.
one kidney was also removed. rhere
were periods when he hurst into tears
and \vhen he had feelings of hopeless-
ness."
Another of her patients was 21-year-
old Arid. an Israeli oflïcer who \>.as
vacationing in Europe when the war
began. He returned home immediately
and \vas sent to Sinai. There he sustam-
ed multiple injuries. including second
and third-degree burns on his shoulder
and back. Gangrene developed in one
leg.
Ariel kept dozing off. and \>.hile he
was asleep he would relive the baltle.
hollering out orders. \Is. Resnick also
recalled that hecause he \\ as so proud
and hi., burns \\ere so painful. he would
ask her if he could yell ever) time she
changed his dressings. rhis p,ltient''i
elderly mother never left the hospital.
THE CANADIAN NURSE 31

.,

l ',' ----
. . \ J . c "..-, '.',
, _ ' ..f \. _ " . .;-- . .. .--...
-.. -.. :
-...."" '

....
..: -"}" "". "".....
"
-
, ' :r'
;-;'....
::'".... ë'j...... ,,
.;.
"'-11' ...' 1''-." .....1""+....."'"

. 6 , '. ' .. .....' '"--' ) ''''' ",,'-
j> .,r' '"", : '....)

.... ......" "...
I' 4
..Ift )

. ,
':
,

.

. )

'

'.

,

,

.,..
-""

'.

--

."

þ

,..

j ....

11'

...

'f
. . .

,
.

"

\
\

-

-.

....,\
-

When \1
. Re.,nick arrived on the

urgical ward.
he found that the Kar-
dex system \\'a
not heing u
cd. which
made it difficult for those who wcre
unfamiliar with the patients' condi-
tions. She wa
the first one to introduce
the Kardex. The staff \\elcomed the
idea. "I helieve they will use it now.
she said.

Nurses come from other countries
About .
o nurse volunteers went to
hrad during the war. Ms. Resnick met
three non-Jewish nurses - from Hol-
l,lIld. S\\eden. and the United States
- who were also \\orking at Ichilov
Hospital. Another two volunteers,
both operating room nurse
from the
U.S.. i nsi
ted on being sent to a field
ho<;pital.
32 THE CANADIAN NURSE

_r

/

...

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"

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..... ,j
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;..
...:, ;.

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During thc time Ms. Resnick spcnt
at the Tel Aviv hmpital, the director of
nursing invited all the nurse voluntcers
t'Òr tea. This gave them an opportunity
to talk about their work.
Ms. Resnick. who had left Israel
in 1952 with her parents. found that
spcaking Hebrew was a great help,
though not essential. Most of thc sol-
diers spcak English and many nursing
dutiö can be done without knowing
Hebrew, she said. "Without the lan-
guage though, it was more difficult
fÒr the volunteer nurses to adjust, but
they were all strong willed."
The nursi ng 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 nurscs' aidcs do just
about everything an RN does, e'ven
administering medication and changing
I Vs. 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. Rcsnick 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-
lu nteered to act as messengers around
the hospitals or work in kitchens and
laundry rooms.
"Many persons volunreered 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
respond to anything light-hcarted:'
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, 'fd?
MARCH 1974

The hair dryer treatment
for decubiti

fhe article "Oecubitis ulcer manage-
ment - a team approach" (October
I YD. pp. 41-4J) \\hIS valuablc and in-
teresting:. fo motivate further discussion
of the subject and to ,upport the benefit
of continuity of daily care given b) the
same persons. the followi ng classilïca-
tion of ulcers and their treatment is
gIven.
Four general types of decubitus
ulcer. progressing in severitv. arc:
superficial, suhCUlancous. anoxic, and
prC
lIl\
rCI/(J/lS .
A superficial ulcer is a break in the
sk in that occurs if moisture is neglected
or if adjacent skin surfaces arc not
kept separated. These ulcers arc 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
h)drogen peroxide and exposed to
rapidly cm:ulating. warm air. A hair
dryer is placed on an uverbed table with
the air stream directed at the ulcer lix
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
decpa into the skin. Suhcutaneou'
ulcer., ma) be caused by pressure for as
short a time as 2 to 3 hours in a sick.
immobile individual. such as a patient
\\ it h a severe CV A or a fract u red hip.
Suhcutaneous ulcers usu.llly occur in
MARCH 1974

The author, who has worked in an extended care hospital for the past 10
years, describes the treatment of decubitus ulcers of varying severity.

Dorothy H. Denholm

the coccygeal area or over bony pro-
tuberances. such as the hip or anklc.
fhe treatment is irrigation-
prefer a bulb syringe with which a
gentle Ii.H'Cl
ma) he exercised. using
Eusor' I/.
strength solution: prone.
or at least semi prone position. while
under the hair dryer; gentle packing
in the open area. usuall) Sofra-Tulle
or iodoform dressing; and absorption of
a nutrient.
An ulcer of this type docs not take
more than a week or two to be free of
infection. but healing i!. slow unless a
local appl ieation of a nutrient is intro-
duced with the packing. M) favorite
kinds arc vitamin A and 0 ointment.
Gel fuam flakes. granulated sugar crys-
tals. or cod-liver oil packing. In patients
with dark complexions. cod-liver oil is
immediately beneficial. whilc in Cau-
casians the vitamin ointment or GcI-
foam is absorbed more quickly.
I often prevail upon our medical
stall to order ascorbic acid 100 mgs.
three times daily IÒr one week. as this
is a reducing agent and may be neces-
sary for healing. Elderly and sick pa-
tients arc often deficient in ascorbic
acid. General nutrition - calories.
protein' - arc important. In man)

Eu'ol 'olUlion j, madc wilh 'l.dium
h
pochloritc: full-'Ircnglh Sl.lulion IS
II. I::!:' percent a\ ailahlc chlol inc.

long-term patients. metabolism is slower
than normal. thus epithcl ialization takes
place fa!.ter if aided b) these nutrients.
Subcutaneous uleers gradually close in
from the edges to the center. finally
being covered \\ ith new epithelium.

Anoxic ulcers
Ulcers form soon after spinal cord
injuries. caused by damage done during
()r immediately after the injur). The)
occur on any weight-bearing protuher-
ence. or occasionally on a metatarsal
joint. The response b) the s)'stem is
called reactive hyperemia: a flare. or
vascular dilatation. is the response to
pressure .J.nd is indicative of marked
slowing of the circulation and preexist-
ing vasoconstriction.
Pressure causes h) pt.xi.1 (interference
in the use of oX)gen in the tissues).
which results in anoxia - litera II). no
oxygen in the ti!.sues. Unless immediate
allention is given to relieving the are,1
of \\eight. necrosis sets in belo\\ the
skin surface and spreads radially. un-
dennining the surrounding sl..in. A dry.

:\h. Iknhl,lrn i, a gradu,lte 01 \\ in nipeg
Gene....1 H,"pit,tI ,eho,.1 of nur,mg. "he
h,., worlo.ed at \1. \ it.tl ,.\tended Ire,lt-
ment Ho'pital in \\ innip'"!,!. \t,mih)h,1.
for the p,.,t I II ) e,lrs. I he ,ILII h"r e\pre'-
'e, her than'" to Dr. \1 '\,eWIll,tn. neul'l'-
I"g"\' tor hi' ,.-.slSt,IIlCe wilh th
' ,trtielc
THE CANADIAN NURSE 33
.

blac"
cab
nsue
. frequ
ntly with in-
kction untkr it: if th
infection is not
c h
ck
d. it ma)
nt
r th
t
ndons. and

\'
n the bones.
I n mo
t cas
s of p
r
ons \\ ith
pinal
cord injur).
o much att
ntion is giv
n
to oth
r a
p
cts of tr
atm
nt that it i

not r
alized that perman
nt damag

i
occurring. which may b
pr
v
nt
d
b)
a
ing th
\\ eight from any w
ight-
b
aring ar
a. rh
id
al tr
atm
nt i

pr
v
ntion:
om
advise hyp
rbaric
OX) g
n.
Anoxic ulc
rs can be tr
at
d with
compre

c
of half-str
ngth Eusol

olution. k
pt on for l)J1
hour. thr
e
times dail) and a dressing with an oint-
ment containing enLyme
- Ela
e or
Varidasc - gen
rously appli
d be-
t\\

n compress tr
atm
nts. The com-
pr
sses caus
the scab to
hrink from
the
dge
. As soon as it is po
sibk to
lift even a corner of th

eab. the depth
of th
ulcer can be irrigat
d and packed.
or Cicatrin powder blown under it. The

cab graduall) dries and can be dipped
back
ach day. thu
p
rforming a grad-
ual debridement. At thi
point. the use
of the hair dryer is beneficial as a dr)-
ing ag
nt and to
timulat
circulation.
Generous applications of nutritive
substances should now be applied:
granulated sugar acts as a gentle abra-
sive and. used with Gelfoam Ilake
.
bring
noticeable results. rhe
e should
be used for a period of about a week.
then vitamin A and D ointm
nt in-
creas
s granulation.
rh is tr
atment is long and not al-
way

ucces
ful. though man) ulcers
h
al completely. The g
neral condi-
tion of th
s
patients frequentl) pro-
hibit" surgical treatment. esp
cially if
the vitality of d.ny propo
ed donor ar
a
is lading. due to the individual's age
or disturbance of hi
c
ntral nervous
s) stem.

pregangrenous ulcers
Threat of gangrene is involved in
peripheral vascular disease, with the
occurrence of a th icken
d dark
cab.
u
ually on a heel. metatar
al joint. or
34 THE CANADIAN NURSE

even toes. Diabetic patients arc prone
to this t)pe of ulcer. and many individ-
ual, do not seck medical ad\ ice until
the ulcer i, advanced to the stage of
necrotic tis
ue under the scab.
In treatment. the prone position i
a
mu
t! 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 pati
nt sat up in a
chair for meals and vi
itors and lay
prone the rest of the time. A huge ulcer
on the patient's heel complete!) healed.
I n addition to the prone po
ition.
a Eusol soak h.:lp
th
ulcer. I hold
the heel in a small amount of half-

trength Eusol solution for about 10
minutes. th
n dress the ulcer with
Erase ointment and Sofra- Tull
. Again.
loosen an edge of the scab as soon a

pos
ible. Paint the scab, and as far
undcr it as po-.-.iblc. with tincture of
b
nzoin compound: this s,)on gives
the necrosis d "honeycomb" appearance
and the Cicatrin powder can penetrate
deeper. The same sequence of debri-
dement. hai r dryer treatment. and
nourishm
nt is used as described above
tÒr the anoxic ulcer.
These arc the various typ
s of ulcers.
or bed s,)res. that plagu
ever) h()
pital.

Purchased aids
Several aids. \\hich may be pur-
cha
ed. arc helpful in caring for p
r-
sons with decubitus ulcas.
An air mattr
ss with electric pump
allows pressure to alternate on weight-
b
aring area
. A fine. foam material.
adh
sive on one
ide. ma) be placed in
a hur
e
hoc
hap
around a pressur

area to prevent sk in breakdown. Mois-
ture cannot penetrate this and it can be
left on. even during a bath. It adheres
bett
r if th
area i
first painted with
tinctur
of benzoin compound. Such
material
hould be removed at lea
t
once a week and left off for a day or
two. as it inhibits washing and rubbing
of the area.

A portable hair dryer is an e
sential
piec
of equipm
nt.
Boots of a synthetic material resem-
bling sheepskin are made into a heel
covering. strapp
d o\
r the inst
p.
The
e offer good protection fÒr heels.
but patients often complain that the
boot
arc too warm. Sheepskin placed
ov
r the drawsh
et. large enough for a
pati
nt'
torso. is an excellent preventivc
measure. rhe natural oil in th

heep-

kin is of value. Sheepskin is apen
ive.
how
ver. and a v. ashablc synthetic
material is somclimes sub
[ituted.

Continuity of care
Continuit) of care - ,me nurse
doing the treating of bed
or
s day
after da) - is the most important and
most b
netlcial suggestion I can oller.
Only thi
nur

can recognize v. hen it
is prudent to mov
on to a more ad-
vanced treatm
11l and can quickly assess
the type of ulcer. Although ulcer treat-
ment is discouraging at times. it is v
r)
r
warding to the nurs
on the whole.
rh
main thing is lIl'\'cr to give up!

Bibliography
:\Iunro. Donald. "Ikd Sores." In ,\lot/em
,vel/rotoR.\'. edited hy
il1l
on I od,e.
pp. ó07-12. Bo
ton. I iuk. Bro\\n and
Com pan). 1')hlJ. g

MARCH 1974

in a capsule

"Up Canada"
rh!: Hous!: of Commons debates. as re-
cord!:d in Hallsard, can scarcely com-
p!:t!: \\ ith a Bob Hopc script. There ar!:
!:x!:!:ption
. ho\\ever. as this excerpt
from HallSanl reveals. (The speaker is
F. Ob!:rlc. MP fur Prince George-
Peace River.):

"Mr. Speaker. on January X. 1974,
the night before last, the government-

ubsidized national television network
aired a program called 'Up Canada: a
portion of v\hich was dedicated to a
soap opera called, 'One Honorable
M!:mher: It may be coincidental that
this program was followed immediately
by a program called. 'Some Honorable
Members: L and I am sure most hon.
members. appr!:ciate the media's re-
cognition of our presence here in Ot-
tawa, but we must object to the use of
the national network i'n creati ng a false
impression about our activities here.
"The scene in the opera showed one
hon. memb!:r from the we
t cua
t. whose
name and address were almo
t identical
with those of one of m) collcagues,
in bed with another member's secre-
tal'). rhe male actor wa
clad only in a
hlanket with which he protected his
vitals. and the female wa" devoid of
any clothing apart from false !:yelashe

and fingernails.
"An
argument en
ued in bed over
the arrival of the member's wife from
the \\est coast. The girl decided to 'spl it
the sheets' and she called a taxi which
was to arrivc in five minutes. As it
happened. the taxi was on the
pot al-
most immediately.
"I would expect, \1r. Speaker. that
th!: mini
ter re
ponsible fix financing
the corporation would make every ef-
fort to
top the continuation of this
exhilarating cultural experience so that
we do not create the impres
ion 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.
SOllie 11011. ^1emhers: Hear. he<lr!

Cancer of e!>ophagus
1'\\0 main ri,k ractor
predominate in
the cau
e of cancer of the csophagus.
"moking and high alcohol consumpllon.
In an article in la
t December's i

ue of
thL' JOl/mal (If tile 4111cricall 'I,,/edic al
.1.\\ociatÙ"" 1\\11 doctor
. r.
)nder
and" Mahuchi. r!:port tlMt thL' n
k tlf
MARCH 1974

devcloping cancer of th!: esophagus i

signifïcantl) higher among
moker
.
wh!:th!:r cigarett!:s. cigars. or pipes are
involvL'd. Serveral studie
have sho\\ n
that heav) alcohol consumption in-
cr!:ases the risk of smokers to develop
!:
llphag!:al canc!:...
In their artiele. Drs. Wynder and
\1ahuchi say that long-term nutrition-
al defïciency. particular!) chronic
dclïciencies of iron or any of th!: vita-
min B complex. can lead to esophageal
cancer without th!: added intluenc!:
of either tobacco or alcohol.
The rate of esophageal canc!:r is
higher in certain countrið than in
others. according to the i\JD
. France.
fÒr example. has a high rat!:. paral-
lekd by a high level of alcohol con-

umption; India and Ceylon also have
high ratö. probably a
a re
ult of the
"chewing of hetel and the general nutri-
tional deficiencies endemic in Asia:'

Traditionallv. there is Ie

drinking
.tmong Jewish- people than non-Jc\\s

perhaps not surpri
ingly. Jewish peo-
pic have a lower rate of esophageal
cancer. Seventh Dav Adventi
ts. who
arc forbidden to
nl(;ke and drink. have
accordingh lower incidence rates of
cancer of the csophagu
.
The nonfat, fat cookbook
A cookbook published by the American
Heart Association contains more than
SOO r!:cipe
. cho
!:n h\ the a

ociation'

nutritionists. which åre aimed at de-
creasing excess fat intake and replacing
saturated fats with polyunsaturated fats.
The 412-page hardbound book.
which give
traditional dishes from all
regions of the United States, is publish-
ed by David McKay Company Inc.
Thi
information appeared in th!:
September 1973 issuL' of the Americall
Jour/wi or Nunillg

,-

.....
'-

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-
......
\
.

. -
Ð
..,
A .
,

.

. .
.

(

"Whose idea was it to re-surface the slide?"

THE CA
DIAN NURSE 35

dates

March 18- June 28,1974
Four-month program in neonatal inten-
sive care nursing, to be repeated in
October 1974, will be conducted by
the nursing education department,
The Hospital for 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: $200. 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, Focthills 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 1 X8.

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 OA1.

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 Engl ish. No registration
fee. For further information, contact:
A.H. Gardner, Executive Director,
NBTRDA, P.O. Box 1345, Fredericton,
N.S., 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, S.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 Sf.. Ottawa, Ont. K2P 1 V9.

June 16-21, 1974
Canadian Nurses' As-
sociation annual
meeting and conven-
tion, to be held in the
Manitoba Centennial
Centre Concert Hall,
Winnipeg, Manitoba.

ð

MARCH 1974

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ù

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.

research abstracts

Tht: 1'0110\\ ing art: ab
tracts of studks

dt:cted fron; thc Canadian Nur
es'
A

ociation Rt:pository Collection 01

ursing Studie
. Ab...traet manuscript...
are prepan:d b) tht: authors.

Finch, Elizabeth. A stlle/y (
(tI/(' cOllcems
o(a/l/hlliatory pmiellts ill the hospital
C'/l/C'rgellcy roo/l/ a/l(l thC' profl'.niOlwl
rC'spo/l.\(' to tluHe COllcenlS. Mont-
rt:al. Qut:hec. I lJ7J. SlUt!) f M .Sc.
(Appl.)) McGill U.

fhi
"'lUd). u
ing qualitati\t: re
t:arch
mt:thot!
. identilït:d and cla

ilït:d tht:
ht:alth conct:rn
of ambulator) patit:nb
\\ ho IN: tht: ho
pital t:mt:rgenc) room
a
a primal') carl' ct:ntt:r. and tht: rt:...-
pOlht: stratt:giö of prok...
ionab inh:r-
acting \\ ith Iht:m.
D,
ta \\ I:I'l' colkeled b\ oh
t:r\ ing
palit:nt-nur...t:. patit:nt-doétor intt:l:-:'
aClions. and h\ tht: use of unslructurt:d
inkn ic\\.... Thl'
amrk consislt:d of
-'0 palit:nb. Il) mak
and II fcmak
.
In th i
...t ulh. conct:rn rt:fcr
to an\
hdla\ ior nhiblted h) the patient during
hi
...Ia\ in tht: t:mt:rgt:ne\ room Ihat
\\ ould ï"ndicalt: an intt:
t:
ll;r unl'asint:

rdalt:d II) hi...
Iall' of ht:alth or Iht: con-
dilion

urrounding it. Profc...
ional
re"'ponst: i... dl'lï nt:d a
all\ statl'IlIt:nl or
action on thl' pari of " ní.lr
l' or doctor
rdatl'd to Iht: t:xpn:...sion or rl'...olution
of patit:nt
' conct:rns.
Patit:nb t:xprö
ed a total 01 I.n
concern...
O to nurse
and doclor
.
till' rt:IlIaindt:r 10 tht: rt:
t:archt:r. Con-
ct:rn
of
) IlIp\l1Il1al ic di
coml'ort werl'
t:xprt:
"'l'd mO...1 frt:quenll) (5 :-'.Ó4 per
ct:nt) and profö
ionab concentralt:d
Iht:ir dli.Jrh on diciting and rc
olving
tht:
t: concerns (5:-' tlf the 70L

Approximatd)
O pt:rct:nt 01 con-
cI:I'n
\\ t:re rdatt:d to t:mngt:llC\ hl'alth

t:n'jce and ...oeial and eco
omJc ...itua-
tion. and Ihe maioril\ of tht:...e wI:I'e
diÒIt:d h\ the re
èarclíer.
Anal) ':i... of prorc

ional re
ponse...

ho\\ed a 10lal of 2
S rt:
pon
e... madt:
10 70 concern
. \\ith a mt:an l)f 3.97
röpon
e
pt:r conct:rn.
Mort: rt:"'pon
t:
\\ere madt: 10 facil-
itate t:xpre

ion of concern ( I -' X I than
wcre madt: 10 lacililatt: rt:
olulion of
conct:rn (I 19 L Ft:\\ rt:
pon
t:
\\ erc
inhihilon ,21 ). Doctor
madt: mort: than
1\\ ice th
Illlmht:r of re
pon
t:
than
nur"'e
(19
10 S)I. Rt:...ponding ...tra-
38 THE CANADIAN NURSE

legit:
of nur
t:s maini\ wert: to facilitatt:
n
prt:s
ion ofconcern
Inquiring \\ a
the
...trategy mo
t frequt:ntly u
ed by both
rt:
pondenb.
Bt:C<IU
t: of ib ready aeces
ihility 10
the cOIllmullit\. Ihe emt:rgt:llCV room
slall ha
a uniqut: opportul;it\ ío ...1lJ(h
community ht:alth needs and to exper-
iment with health care practice... de-
signt:d to meet thme need
. Finding...
fr
)(ll thi

Iudy providt: a ba
is I
r
experimenlation of this nature.

Funke, Jeanette and Irby, Margaret
Imle. A stlldy (
( predictil'e criteria
ill re/atioll to /Ilothaillg hC'hll\'ior.
Dt:nver. Colo.. I Y7 3. Study (M.s.
(Nurs.)) U. of Colorado.

Predictive criteria for as
essing pott:n-
tial mother-child rt:lations have been
"udied but have not ht:en sufficiently
researched to be I'd iable for all pOpl
-
lations. ThercfÒre. the two-fold purpo
e
of th is study was: I. to asses
the rda-
tionship bet\..een the answer
from the
predictive questionnaire and the sub-
sequent per Il)fm anct: of mothering
beha\ ior. and 2. to develop a useful.
rdiablc tool that can he used succes
-
full y to predict inadequate motht:rs.
The target population was thc pre-
natal cI inic patients at a county general
hospital in a large metropolitan area.
The re
earch de
ign 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 prcdictive of futurt:
mOlher-child rdationships. rhese pre-
dictive scores were then compared with
a hehavioral <Isse
sment tool that a
sess-
ed the perfÒrmance of mothering be-
havior four to six weeb postpartum.
The results of this study indicate that
the following questions
Ire prt:dictive
of maladaptive mothering behaviors:
I. When you were a child: (a) How did
your parents discipline you'! (bl Did
you think the wa) your parenb disci-
plined you was the best way'! 2. When

omcthing you try to dll docsn't work
out the \Va) you want it to. what do you
do'! 3. When you fi rst kit movemcnt.
how did it make you feeL' 4. HO\\ do
you plan 10 discipline your bahy'!
SlUdy re
ults of the hehavioral assess-
ment tool indicated a higher frequency

of maladaplive mothering behavior in
the following behavioral catt:gorie
.
feeding. moving and holding. verbal
and nonverhal communication. and
touching.
The researchers hope that. with
further development of the
e toob,
inadequate mothering behavior can be

uccessfully predicted and evalualed.
Having accomplished this. the ba
ic
foundation will be laid for providing
nursing intervcntion for tho...e mother...
predicted to have poor mother-child
rclation
.

Christensen, Patricia Anne. ]JIC' lu}\tilC'
hchCII'ior o( 1I prillligrCII'ic/a. Pilh-
burgh. Pa. rhe
is (M.N.) U. of Pilt
-
burgh.

Thi
stud\ \\ as undcrtaken tll idelllif\,
the fccling
about
elfa
reflected in th
'
ho
tile behavior of a sdected prim i-
gra\ ida. Tht: hehavior \\ a
exam ined
for indication of a reaction to preg-
nancy. evidence of variation in in-
tensity. and e\ idenct: of change.
A hostile primigravida \\as cho
t:n
fur the study. the ba
i
of the
ekcti(1n
being "inapf1ropriate attire." I he
tud)
extended uver two monlh
. Initial
contact \\-jth thc subject occurred during
her Ihirty-Iïr...t \"eek of pregnanc).
fhc clinical setting for the
tudv \\as
the anlepartal clini2 of a large." uni-
\ersily-aITiliated. \\omen's ho
pital
in a mid-ea
tern city in the l 'nited
States.
During data collectil'1l. the \\- riteI'
functioned a
a participant-oh
ef\er.
gathering data in free a
sociation inter-
view
that \..ere terminatt:d h) the suh-
ject. Following each interview. the
uata were recorded. interpreted. and
analyzed. The focu
of the ...tudy emerg-
ed on completion of data collection.
The data were then reinterprt:led,
Pregnancy was a time tl)f thl

primigravida 10 experience fccling

of douht and hate ahout her
clf a
a
person. a woman. and a mother-to-he.
ScI f-hate was expre

ed in pn
iected
hO
lility and
clf-depreciation.
The hostiJc hehavior of this primi-
gravida could not he identified a
a
specific reaction to pregnancy. Ho\\--
evcr. it was identified as a reaction to
one component of pregnancy. that 01
MARCH 1974

chiluhearing. rhis primigra\ iua had
fantasies that her \\orthless self would
he retlecteu in the child she bore. The
hostilJt
expressed as a reaction to the
rear of chiluhirth uecreased as clarifi-
cation of the fear occurreu.
The intensit} of this primigraviua"s
hostilit) \ aried As ,hpects of herself
\\ ere unveiled. she experienced acute.
o\emhelming hostility that \..as project-
eu out\\aru. A less intense hostilit\ \\as
apparent fÒlhm ing the episoués of
acute hostilit\. While the intensit\ of
her hostilit) -\\as uecrea'iing. this' pri-
migra\ iua cIarilÏeu her feelings of self-
dOllbt. -
This primigrm ida's hostile heha\ lor
anu 'ielf-douht changed 0\ er time. rhe
episodes of acute hostilit) decreaseu
and the components of her ...elf-hate
changed. rhere \\ as mo\ ement from
e"pr
ssing self-hate as a \\(unan. a
person. and a mother-to-be to express-
ing an increaseu self-esteem for herself
as a \\ oman and nl\1ther-to-be.
Concomitanth. there \\ as a mo\ e-
ment from rejeéting her identitv a'i a
\\oman tlmard ide
l\it\ ing herself as
a \\oman. anu e'\pres...íng -herself as a
\\ oman. Simultaneoush. there \\ as a
decrease in expression
of self-uouhl.
rhe change in her feelings ahout her-
...elf ...lTm:d to hl" related to Ihe \erhal-
i/ation of her hostilit). \\hieh appear-
ed to ...en e as a catharsis anu as a
means of gaining perspeclive about \\ hl)
she. as a \\(unan. \\as anu \\ ho ...he, a...
a \\ llln.ln. \\ i...hed tl) hecome.
Feelings of shame \\ere experienced
concom itantlv \\ ith feel ings of uoubt
and hate. Tlie feeling... o( shame and
...elf-hate ma\ ha\ e - motivated this
prim igl a\ ida io become someone other
than \\ ho ...he percei\ed herself to bc.

Robertson, Carolin{'. A slIldv COIICl'rll-
illg chile/rell with 1I termflllll illllen
1I11e/ their rdlltiollship to others \\'!Úle
ill hmpital. Montreal. Que.. IYT.!..
rhesis (\1.sc. (App\.)) McGilll '.

I his descriptive 'itud). carried out in a
pediatric setting. examined the hehav-
ior... of 12 children \\ ith a terminal ill-
ness. and those of thc mothers. nurses.
...tudent nurses. and others \\ ith \\ hom
thc\ inter.lcted.
ï-I1C pu rpo...e 01 thl' stuU) \.. as to
idcntit\ the nature of these children's
re!atio
lships \\ ilh others in the hospital
situation.
rhe data consisleu of the interaction
sequcnccs \\hcre the child or adult ini-
tiatcd the con"crsation and had a rcsult-
ing rcsponse. f he content of the inter-
.Iclion and the outcomc of each se-
qucnce \\ere alsl) considered.
It \\ a.. found th,1t the children began
the interaction \..ith thc adults ab
)ut
MARCH 1974

half as frequcnt!) as the .Idul", heg,1Il
it \\ ith them. The most frequent eI iciting
behavior'i of thc chiluren \..ere dcmanu-
ing (42 percent) and protesting (24
percent). \\ hile the adults commcnceu
interaction hy inquiring (n percent)
and informing (2X percent).
When children began the interaction.
the common pattern \\ as a dem and h)
the child. \\ith a cooperating response
hy the adult. This accomplished thc
child's ohjective. The most frequent
pattern fÒr adults began b) inquiring
and the rest of the sequence developed
in the same \\ a\.
The child-niother relationship \"'IS
typically a cooperating-cherishing
dyad. Children gained their objectives
\\ ith their mother'i in X4 percent of the
sequences.
rhe child-nurse rel,nillllShip \\as
characteri/cd by the nurse using "in-
forming"" some\\hat more with the chil-
dren than the rest of the group. She
was also the most frequcnt confidante
of the child on the topic of loss of his
mother. The children talked about loss
as much as they did about pia).
rhere \\ere t\\O distinctive charac-
teristics of the child student nurse rela-

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tionship. I he ...tuuent u...cu "inquiring""
a... eliciting beha\ ior more Ihan amone
eI...e. She ,11"'l) cooperated \\ ith the éhild
almost as Illueh as uiu the mother.
rhe chilu's relationship \\ ith others
appe,lred least cIosc of all. Although
others uscd Ihe "enjo) ing" re...pon...e
mosl \\ ith the child. he uid not do so
\\ ith them. The pattern of helM\ ior that
leu to t he outcome of \\ Ilhdr,1\\ al. al-
though infrcquent. occured mosl oftcn
\\ ith others.
There is a hint of regression in the
frequent use of uemanding and protest-
ing b) these children. Hm\e"er. it can-
not be stated that the group under stud}
shO\\ cd a demonstrahle difference to
other groups of hospitali/cd children.
TherdÒre. it is sugge'ited thai further
stud} of such a group he done. through
observation of the heha.. iors \\ hile at
hospil,tl and at home. to disemer if the
frequenq of demanding and protesting
differs in the t\\O situations.

Olofinboba, lola. COllcems of e/illhctÙ
childrCI/ alld pan'lIls (d' e/iahetic
childrcl/. :\1ontre,11. Que.. IY7J.
The
is (M.Sc. (App/.)) ;\kGilll

This stud
employed qualitati"e re-
search Illethods 10 in"estigall' the con-
cerns that diahctic children and parents
of diahetic children hm e in rdation to
diabetes mellitus. The aim \"as to gener-
ate "nO\\ ledge that might shed "ddition-
allighton t';e needso!'\oungdiabeties.
rile sample consisted of ì 6 uiabetic
ehildrcn \\ho \\ere intervie\\ed and 16
parents \\ ho \\ere observed \\ ith their
children during their visit \\ ith the
doctor. The d..lta consisted of verbal
cxpre....,ions. and these \\ ere ,lIlal}led
according to their contents and lilcu...
of concern.
Findings \"ere as 1'0110\\ s.
I. All children indicated that ha.. ing
diabetcs did not hother them. The

focused on the "normal"' aspeci of thei'r
life situ,ttil)n more than Iheir uisease
process. The conclusion \\ a... th,1\ the

found diabete... relative!) unprohlem-
atic.
=:!. Children g""e various re.lsOlh li)r
not feeling hoìhered h) Iheir disea...e.
Among these \\cre. the) did not look
differcnt: thl') \\ere as .Ictive as their
fricnd...: Ihe) de.. i...cd mC,IIl'" of coping
\\ ith their prohlems.
J. All p,lrent... \\ erc concerned ahout
management of the diabetic rl'gimc.
The} -Iendeu to emphasi/e the di';,ease
proce...... 0\ cr thl" child's "nolll1al"' I ill:
situ.ltlon.
4 \i1ost parenh ...tre...sed the degree
of cooper,ttion recei\ cd from Iheir
children in 10110\\ ing the prescrihed
regime. :\0 relationship \"as indic.tted
hel\\een numher of prohlems and the
THE CANADIAN NURSE 39

research abstracts

child's coopcration or lack of coopcr-
ation.
Two hypotheses were generated:
. I\.now led ge dcrived from direct exper-
ience with diahetcs and its inherent
problems and solutions results in a
focus of concern on thc "normal" life
"ituation and a response characterized
by l1exihility regarding the therapcutic
regime (i.e.. diabetic children).
. Knowledge derived from inuireet ex-
perience with diabetes results in a focus
of concern on the disease process and a
rcsponse char.lcterized hy inl1exibility
regarding the therapeutic regimc (i.e..
rarents).
ImplinllÙms arc. I. There is a need
to encourage thc diahetic child to take
a more active role in his carc. 2. Parents
net:d help with developing criteria for
assessing cooperation and crises so that
minor departures from the diabetic
regime are not perceived as 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-
ihility on tlH.' part of parents and health
professionals.

DeMarsh, Kathleen G.; Anderson, A.I.;
Poole, Pamela E. A stltdy (
( the e..f

fi'clS (
( a specUìc illSen'ice edltc(/-
timl program .f(JI' registered Illirses
Oil patiellf we(((/re and hospilllI
operatioll. \Vinnipeg. Man. Research
Project (National Health Grant No.
607 -21-1 ), Health Sciences Centre.

This project was concerned with the
cfkcts of a specific inservice education
progl am for registered nurses on pa-
tient welfarc and hospital operation.
1'\\0 surgical wards of comparahle size
on the same 11001' of a large teaching
hospital were involved. one as the
experimental and the other as the con-
trol ward. 1 he pfl
iect used a "hefore
and after" design that provided ti.Jr the
samc tïve-month data collcction periods
in each of three years and two scven-
month intervals when nurses on the
experimental ward participated in d
planned inservice education program.
Each \\-ard was compared to itself
ovcr the three time perious on all
measures except mobility of auxIliary
staff and incidence of absentet:ism.
I n these instances the two wards were
comparcd \\- ith each other.
The findings indicate that the spe-
40 THE CANADIAN NURSE

cific inservice education program tÙr
registered nurses did not inl1uence drug
use. However, there were signitïcant
decreases in the number of day
pat ients
remained on intravcnous tlLuds post-
operatively and in thc amount of intra-
venous l1uius consumed by patients on
the experimental ward. rhese decreases
were rel1ected in per uiem costs and
in the use of goods from the central
supply room,
here a steauy decrease
in costs occurred over the three time
periods.
1 evine tuhes were removed earlier
each year on the experimental waru.
and one surgeon was intluenced to
changc his routine orders for cholc-
cy.;tectomy paticnts.
Awareness of the individuality of
pat ients was sign i ficantly increased in
more than half the I X nur<;es exposcd
to the inservice cducation program. A
changc in nurse hchavior hecause of
this was evidenced by thc positive
change in the patients' assessment of
their care over the three time periods.
Differcnccs in staff mohility and in
pattcrns of ahscnteeism suggest that
the mil icu of the expcrimental ward
\\- as morc conducivc to joh satisfaction,
hut the findings on the latter are in-
conclusive.
Somc differences in paticnt and nursc
pcrccption of what is important. and
of thc care that is providcd. are reveal-
ed on comparing responses to matched
items on thcir respective inventories.
Also. some intcre"ting qucstions are
raised concerning thc potcntial ability
of nurses to indi'v idual i7e care, and thc
possihility of measuring this potential
in applicants prior to thcir admission to
schools of nursing.
Copies of this
stud} may hc ohtain-
ed hy writing to Kathlcen G. DeMarsh,
Vice-Prcsidcnt, Nursing. Health Sci-
encesCcntre, 700 William Ave., Winni-
peg. Man., R3E OZ3. Each copy costs
$3.50.

Christensen, Judith C. Saline ahortion:
a study (
f female hehm'ior ill (/ crisis
situatioll. Montreal. Q uc.. 1972.
Thcsis (M.Sc. (Appl.)) McGill U.

This study, set in the maternit} unit
of a large gencral hospital. used quali-
tative methods to cxamine the bchavior
amI certain attitudes of a group of
women during their hospitalization to
terminai.e a mid-trimestcr pregnancy by
means of 20 pcrcent hypertonic saline.
A serics of four visits madc to most
of the 21 women included in this study
were timed to coincide with what seem-
ed to he the most critical periods of the
process: admission. injection. labor and
delivery, and the postabortion pcriod.
As data collcction progressed, a set
of questions was formulated, which

dcterm lIlt:d the nature of the sub-
sequent analysis. The analysis is a gen-
cral 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 tht: pregnancy'!
. What kinds of behaviors emerge
during the stagcs of the abortion pro-
cess'!
. \Vho does the woman inform about
the pregnancy and hcr desire for abor-
tion'!
. What is the woman's altitudc toward
tht: product of conception'!
. What is the woman's attitude to futu rt:
use of a contraceptive dev ice'!
It soon became eviJent that ohstt:t-
rical history was an important distin-
guishing feature. This was choscn as a
simple dichotomous classification
scheme for organization of the findings
in answer to the research questions.
Multigravidas tended to be oldcr. were
more likely married, had young chil-
dren at home. were usually receiving
financial assistance from the state,
kncw less about the det:1Î1s of the ahor-
tion sequence, expcrienced a shorter
labor or no labor at all. and required
les
sedation.
Most othcr generalizations derived
from the data refer to the group as a
whole. For example:
. \\-'omen undergoing abortion b\
means of saline injection tend to be
generally subdued' and submissive
during thc 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 whcn a
problem is obviously developing.
. Women often weep during the injec-
tion procedure. but become increasingly
composed after thc needle is inserted.
. Bchavioral cues that lahor has com-
menced arc an important indicatIon of
the kind of analgesic required to re-
I ieve d iscom fort.
. Delivery of the fetus is not a painful
or cxtremely distressing experience.
. Only selected persons in the woman's
fam ily and group of friends arc inform-
ed of the prcgnancy and wish fÒr
ahortion.
. Depersonalization of the fetus. cvi-
denced by the frequent use of "it" a
a
term of rcference, is common.
. Women may. or may not. ask to see
and/or know the sex of the fctus. The
most common timc fÒr this request is
at the time of abortion.
. Most womcn undergoing dcctive
ahortion have not uscd any fÒrm of con-
traception previously.
. Most women will agrce to u
an oral
fÒrm of contraccption after the abor;-
t
n. W
MARCH 1974

names

Margaret M. Street, author of Wa[('Il-
Fires Oil tile MOl/lllail/.\', has h
l:n
awarded the Dr. Walter Stewart Baird
Memorial Medal. This honor wa
con-
ferred on Ms. Street by the president of
the University of British Columhia fix
her outstanding work in the history of
health sciences.

K. Marion Smith, assistant dirl:ctor of
nursing at Surrey Ml:morial Hospital.
has been appointed to thl: new position
of associate executive director of thl:
Registered Nurses' Association of
British Columhia. effective February
15. IlJ74.

A former honom!}
secretary of the
RNASe. Ms. Smith
has heen active on
numerous assocla-
tioncommittees. She
is a memher of thl:
task committee to
develop criteria for

taffing th
operat-
ing room and was chairman of the com-
mittee on mandatory registration. which
recommended lay participation on the
association's board of directors and
stand ing comm ittces.
Ms. Smith is serving a two-year
term as one of four members-at-Iarge
on the Canadian Nursl:s' Association
board of directors. representing the ar
a
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 IlJ5X until IlJól. serving
as flying officer in Ontario. Lahrador.
and Alherta.

"

-- ,.,
'
'
--"

-..-
.

:_-'

Irene MacMillan is ins
rvice director
at the New \\, aterfÙrd Consol idated
Hospital. New Waterford. N.S.
Ms. MacMillan
earned h
r R. N. at
the Nl:w \\ aterford
General Hospital
school of nLIP..ing.
returni ng a ICw ye.lrs
later to hecome
night supervisor
there. After the ho<,-
pital was ren,lIl1ed
the Consolidated Hospital. Ms. 1\1,IC-
Millan was. for several years. its even-
ing and night supervisor of nurses.
MARCH 1974

--

.....

""""=>

Dorothy McClure
(Rl:g. N.. Victoria
Ho...pital School of
Nursing. london.
Ont.: B
Sc.N.. U. of
Wötern Ontario.
london: :vt.Sc.N.,
Boston l'., Boston)
has be(:n appointed
director of the
school of nursing at Lamhton College
of Applied Arts
and fechnolng). S.rr.
nia. Ontarill.
M.... McClurl:.... nur...ing e"periencl'
includes several years on the nursing
staff of Victoria Hospital and West-
minster Hospital. London. and Sunn)-
brook Hospital. Toronto. and t\\O Yl:ars
with the North Atlantic freaty Organ-
ization/Royal Canadian Air Force in
France. She \'-as a puhlic health nur...e
<it Norfolk County Hl:alth l'nit and
Brant Countv Health l'nit in Ontario.
Ms. :\1cérurl: taught at Hamilton
Ci.. ic Hospitals sc hool of nursi ng. \\ here
she \\as activelv il1\'ohed III developing
and implementÍng the curriculum for the
t\'-o-)ear program. More recently. Ms.
McClure \'-as an as...istant proICssor at
\1cMaster Universit\ \'. here she \\as
responsi hie t(lr coordi nati ng the Year
I nursing cour
e in the baccalaureate
program.

.
,.

-or

. .

,

'\
-.".. .

\

\ ^.
'It /"

r he current slate of officers of the
Ontario Occupational Health Nursl:s'
Association i... a... foHm\ s.
Prl:Sident. Jean Laing (Nursing Sa-
vice Supervisor. Bell Canada. rOfOnto):
past prl:sident. Patricia Ewen, (Ahitihi
Prlwincial Papa ltd.. 1l1Orold): 1st
vice-pre-ident. Dorothy Schwab (Fos-
ter-Wheeler Co.. St. Catharines): 2nd
vice president. Joan Subasic (L'ni..ersit

Hospital. london): sl:cretary. Gale
Pearson (St. josl:ph's Hospital. Gudph);
and trl:asurer. Barbara Bollis (\\olvl:rinl:
fuhl: ltd.. London).

Kerry Marshall, currentl) din.'ctor of
nursing at the Bdlevilk Gl:ncral Hos-
pital.
Ikllevilk. Ontario. has hel:n
ml:dical-surgical ...upervisor at thl:
rnronto Gl:neral Hospital and statf
nurse and supl:rvisor at thl: Ro) al \' ic-
toria Ho"pital in :\lontrl:al.
Ms. Marsh,11I (Reg.K, Toronto Gen-
eral Hospital school of nursing: B.N..

:YkGill ll.) \\as. in IlJ73. granted a
diploma in health administration from
the Uni vcrsity of Toronto. t('r \\ hich
shl: conductl:d a survl:Y on .. Profc......ional
nursl:s' altitudes to physicians and the
pasonnd in ho...pital departments."

Carol Koester of Rl:gina has been named
the consumer reprl:sentati ve on the
Saskatchewan Regi'itered Nurscs' A...-

ociation standing
committee on nurs-
IIlg.

\1s. K.oestl:r has heen active with the
Regina and provincial hranches of the
Canadian Association of Consumers tÒr
more than 10 years. and is a past pres-
ident of the provincial branch.
A graduate of the Uniwrsit) of
Sas"atchl:wan. Saskatoon Campus.
holding a bachdor of arts degree and a
hachel
'r"s degree in educ.rtion. Ms.
KOl:Ster is currl:ntly opaating a private
nursl:ry school tÌlur days ,I \\I:e".

Sister Joan Carr, (R.!"... B.Sc. (Elem.
Educ.). B.SeN., M.Sc.N.), is the new
director of nursing education at the Ha-
lifax Infirmary.
Active in the Registered Nurses'
Association 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 memher of curriculum council.

Louise Beaton \'.as appointed regional
nursing 'iupervisor for thl: Prince AI-
hert Health Rl:gion in PI ince Alhl:rt
S,lskaskatchl:wan. .

Ms. Ikaton (R.N.,
SI. Paul'... Hospital
school of nursing.
Saskatoon; Dlpl.
P.H.. B.Sc.;\:.. L'. of
S as" a t c hew a n.
Saskatoon) has bcen
a clinical instructor
.\ \\ ilh the Saskatoon
\.--,., City Hospital. and
puhlic health nursl: \\ ith the Saskatoon
Cit) Hcalth Oep,1( tmcnt and \\ ith the
Victorian Orda of Nurse.... Prior to her
currl:nt ,Ippointment. I\ls. 81:,lIon \\ as a
puhlic health nursl: in thl: S,lskatoon
Rural Hl:alth Rl:gion.

THE CAN DIAN NURSE 41

...

'"

..

new products

{

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

\

\ I I
1
H H
\1
:\:;

, h
'. \\ I l ,
..
2011 '"
't'

'"

,

,,
.

" ,,

""--

'-

C,rClllllci.I'Wf/ I ray

Blood Collel'ling Needle.I'

Circumcision tray
fhe Holli
ter circumcision tray puts
cverything at the ohstetricialÙ finger-
tips for quick circumcision in the deli-
very room. nur
ery. or physicidn's
oflïce. Contents, ",h ich are guaranteed
sterile, include prep sponges and
fenestrated drape (in seq ucnce of use).
Plastihell circumcision device with
ligature. and all instruments. The tray
eliminates costly preparation tillle and
the chance of finding an instrument
dulled by previous use. Single-use
instrument'i are designed specilïcall)'
for the three-minute circumcision
procedure.
This tra)' is supplied by Hollister
Limited. Tn Consumers Road. Wil-
Jo\\dalc. Ontario.

Blood collecting needles
The ne\\ Jdco Disposable Blood Col-
lecting Needles. Safc I and Safe II, have
heen designed i'l,I' patient 'iafety and
fÓr the safety of technicians. Bleeding
thumbs are eliminated with the ...arc
puncture-re"istant package.
42 THE CANADIAN NURSE

According to the company. the triple-
beveled needle point and exelusive
micro-bonded siliconized needle
reduces patient pain to a minimum.
Needle "spinout" is prevented hecause
the threaded metal hub locks firmly
onto the needle holder. On the multiple-
sample needle, the resiliencv of the
valve permits repeated draws without
leakage.
Three needle siles are available.
For further information, write to
Arhrook Lid.. Peterhorough, Ont.
KlJJ 7BlJ.

Ventilator control system
The Life Systems Division of Bourns,
Inc. has introduced the Model LS125
Ventilator Control SYstem. This unit
provides volumetric íimit 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 flow capabilitie'i
of the ventilator used, without impair-

ing any of the control functions of the
ventIlator. including dssist. 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
audihle and visual signal.
The Model 1 S 125 is pi aced in the
pneumatic line hetween the ventilator
and the patient "' ith no functional
mechanical interconnection with the
ventilator. hence its intCfchangeahility
with any I PPV. Mechanical support is
provided hy accessory mOllnting hrack-
ets. and inten:onnecting tuhing for
various respirators is ava
ahle.

There are two Canadian distrihutors
of this system. E-I-L Inc.. 1565 Lou-
vain SI. \\., Montreal II. Quehec: and
Mid-Canada Medical. 12-t-t Alhert
Street. Regina. Saskatl:hewan.

New approach to ileostomy
The Swcdi...h International Pn:ss
Bureau reported 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 outtlow
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 tÖr
the removal of the colon and creation
of an artificial opening into the ileum.
The newspaper Svensk,a Dagbladet
first reported this new method.

Literature available
A bulletin (no. 51-215) on Dow Corn-
ing's new Silastic contour design
mammary prosthesis is available from
Dow Corning Silicones Inter-America
Ltd., I 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) fÒr an
augmentation.
The shape of this prosthesis is not
new when it is compared to prior seam-

less contour design, but its envelope is
thi nner. 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 norm al breast.

Lumex. 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 Li
'i/1g CO/1(f(J/.tah/y with Your
Ileostomy, a hooklet publ ished by Sister
Kenny Institute. M inneapol is. M inne-
sota. This revised edition contain-;
photographs of step-by-step proced-
urcs. as well as current eq uipment
information. Techniques that enahle
the patient to care for his ileostomy
with maximum ease are described.

A discussion of necessan adjust-
ments is included. There aré seciion"
on topics. such as sk in care. general
Care and bathi ng. physical acti\ ities.
clothing. daily I iving. and travel. A diet
guideline for the patient to folio\\< dur-
ing the first six weeks following surgery
is provided. An information form IÖr
ordering suppl ies - to be completed
by physician and patient - simplifies
this task.
This manual. which was \\ ritten hy
a nurse, mav be obtained from the
Puhlication Óepartment. Sister Kenn)
Institute. I XOO Chicago A\ enue. \lin-
neapolis. Minnesota
55404. U.S.A.
Prepayment of $1.25 pcr copy is re-
quested on orders under '&5.

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
toam. 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 availahle from Fnns
and Gilmore Limited. 1033 Range-
view Road, Port Credit, Ontario. 'Î:-!

\ I
" \\ /
- "
- '.
.

f Introducing an
""/! _ --: ex
m
1y useful new
., ø medical mstrument.
Although the 'BIC 4' colour pen may 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 'BIC 4' colour pen is only $1.29, And our almost
as useful 'BIC 2' colour pen is 79<I: Both come in Fine or Medium points
and are available everywhere.

M
étG
Fine

MARCH 1974

fJ: (B i C)

I

l

-'

couleurs
colour pen

1231.H74.?

THE CANADIAN NURSE 43

books

Watch-fires on the Mountains: The
Life and Writings of Ethel Johns,
by Margaret M. Street. 336 pages.
Toronto. University of Toronto
Press. 1973.
Re\'ieH'ed by Je(111 E. Hac Gregor ,
LihrarÙlII, Natiollal Sciellce Lihran',
Ottawa, andformer Associate/:.{Iit(;r,
The Canadian Nur
e.

Every profession numbers in its ranks
tho
e. 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 indebtcd to her biographer - her-
self a distinguished Canadian nur"e
- 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 anl)ther mik"tonc in Canadian
nursing history - the Golden Jubilee
of the UBC School of Nursing. Ms.
Johns was its tirst director.
Painstakingly researched and record-
ed with warmth and understanding. the
story of this eventful life gradually un-
folds in a serie
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 arc douhly appreciated.
Thc littk girl who ...ailed from Eng-
land in l,lJ2 to join hcr parents in
Canad,\ had a!l'cady learned much sdf-
reliance. The subsequent mne years on
the Wabigoon Indian reserve \\-ere 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 da!>hed hopes
for additional tÌJrmal 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 Nur'ie
. The year wa
I XlJ9. and
Ethel Johns was launched on her varied.
sometime" controversial. career.
In the years that opened bctore
her. she was to become known as nurse
educator. lecturer. administrator. edi-
tor. <lnd author. She was to he held in
high e'iteem fÒr her fore"ightcdne...".
sound judgment. and integnty. Her
opinion.. and advice were to be sought
both wi-thin and outside her own pro-
fession. She was a vi!>ionary who saw
JIJI TUJ: rAI\JAnlAIIJ 1IJ111l4;;1=

.
-

:-

...

Ethel JO/JIlS, circa 1919.
nursing not only as it was. but as it
could be. Consequently. the causes that
she championed were onen 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 di rection.
Concern fÒr the protection of the public
and her profession prompted her sup-
port of nurse registration. Her convic-
tion that tho"e slated fÒr nursing leader-
ship required advanced learning won
her enthusia!>tic efforts on behalf of
university programs. She foresaw a role
for an auxiliary group of nursing atten-
dants who could free the professional
nurse fÒr more difficult and highly
'ik illed 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 fÒr her by her father. and her
own continuing thirst for knowledge.
Her appointment as editor of TIle
Calladiall 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
the 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 format III which it i" pre"cnted.
There is a need tor 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 St
art M. Brook!>.
124 pagcs. Saint Louis. '\1osby.
IlJ73.
RnÙ'II'ed !>\. Richard 1. Boz\'llsJ...i,
\,1asta, NlII':
illg Program, COIÙ('da.
atio/l College, n/lmda Bay, Olll.

fhis thin. wire-bound "self-kamer" i!>
intended to he u"cd with any "tandard
texthook of introductory microhiology.
The usc of this paperhack is threcfÒld.
to provide the instructor with a skeleton
for his notcs; to provide the stuuent
with a simple format for review; and
to help the student \\ ho is learning thc
subject for the firsttimc.
. fn this seconu euition. all the intor-
mation ha" bcen upuated and stream-
lined. Thc intcrest of tcaehcrs anu
studcnt!> has heen kept in mind; many
of thc changes were prompted hy "ug-
ge"tion" and constructive criticisms.
- Thi" ""elf-learner" is contemporary
(ColIl/lllled Oil l'lI1:e 461
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 scienæs.
Topics include: developmental differences; immunizations; vital signs;
lab procedures; environmental standards; assessment of growth and
development; common illnesses; and nutrition. By PEGG Y 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..4., R.N.; with a special unit on
Legal Aspects by ROBERT G. BOWERS, B.A., J.D. July, 1973. 312
pages plus FM I-XII, 7" x 10",62 illustrations. Price, $9.45.

,
,

MOSBY

TIMES MIRROR

THE C. V MOSBY COMPANY L TO
86 NORTHLINE ROAD
TORONTO. ONTARIO
M4B 3E5

MARCH 1974

VITAL SIGNS
OF NURSING
PROGRESS...
NEW BOPKS
FROM MOSBY

CLINICIAN
INTERVENTION
ASSESSMENT
PRACTITIONER
ICU
CCU
PRIMARY
PSYCHOSOCIAL
COMMUNITY
MO 81 LlTY
REVIEW
RESEARCH
CHALLENGE
O.R.
EDUCATION

THE l.ANAOIAN NURSE 45

books

rCO/lli/llll'd/;'01I/ ""KC 44)
wiih the needs of nurses who are requir-
ed to upgrade their education. A well-
organized tl:xt. it graduall) develops
the learner's knowledge of the subject
with a simple to complex approach,
to give the student a general under-
standing of microbiology.
Lnderstanding of new content i!.
reinforced by a repetative and progres-
sive use of term inology and facts in
structuring thc questions. Answers
are given in the margin opposite the
question; a mask is provided with the
test to cover the answer(s).
fhis "self-Iearner" is divided into
three major parh. Part I deals with the
general pri nci pi es of m icrob iology. such
as the various microorganism!. and
their charactcrist ics. Part II fam il iarizes
the student with medical microbiology.
dealing with such topics as infection.
immunity. diagnosis, and diseascs
caused by the various classifications of
microorganisms. Part III provides' the
student with an understanding of
sanitary. industrial, and soil micro-
biology.
The apparent intent of thi!. program-
med text is to provide a general know-
ledge of 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-
/lied Introd IICt io II to Microhiology is
that it ranks among the better program-
med texts.

Dr. Turtle's Babies by William John
Turtle. 31R pages. Toronto, W.B.
Saunders Company, 1973.
Rn'iewed bv Barbara G. Brown,
Assislallt P/'(
fessor, Facility (
fNlIrs-
ill.'?, 11Ie Ulliversity (
r Western 011-
tario, London, Ollll/rio.

Dr. furtlc. 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 hook. an outgrowth of a
discussion group !.eries for expectant
parents. is Dr. Turtle's attempt to give
parents a clear. beforehand picture of
how bahies grow, develop, and behave,
and to help them under!.tand 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
fundamentab are divided into four as-
pects: six major areas of responsibility
46 THE CANADIAN NURSE

in care and handling of a baby; tech-
niq ue of feeding; specific problem!. 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 responsibility.
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 tcchniques 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 Ihat
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.
I n the second part of the book the
author has taken the fundamentals
dealt with in the first part and applied
them duonologically to the care and
rearing of an infant from birth 10 one
year. fhe 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 a!. a guide tor 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 b) Debra P. Hymo-
vich and Martha Underwood Bar-
nard. 462 pages. Toronto. McGraw-
Hill. IlJ73.
Reviewed hv Jallet C. Kerr, A ssis-
tant Prore
sor, School of Nursillg,
Ulliversity of Calgary. Calgary,
A Iherta.

This volume of original contrihutions
by some 34 authors represents an im-
portant contrihution to the literature
relating to health care and families. It
cuts across mueh of the current theOl}
arising from various disciplines con-
cerning the family and applies this to
health care. In so doing. it is unique
because it provides a com prehensive

reference on the subject. not previousl)
available for nurses in practice and
nursing students.
Part one of the three-part book pre-
sents concepts. which relate to the hl-
mily. from a number of disciplines,
including nursing. medicine. law. socio-
logy, economics. and anthropology.
Significant aspects of this section of the
book indude the account of the histori-
cal development of t
lmily nursing and
family medicine.
In Part two the tixus 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 tamily 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 ill ness.
fhis boo" will undoubtedly prove
to be a useful and exciting tool for
nurses interested in providing improved
health care for families. However. the
author!. have intended that their book
be used more widely and it is certain
that this volume will provide a valuable
referencc fÒr the health professions
generally.

Principles of Microbiology, 7ed., and
Laboratory Manual and Workbook,
by AI ice Lorraine Sm ith. 681 pages.
St. Louis, Mosby, 1973.
Reviewed by Jean Jenny, Instructor,
University of Ottawa, School of
Nursing, Ottawa, Of1lario.

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 inuTIu-
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,
rCOllli/lllCd Oil paKl' 4[1,)
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 I-XI V, 6" x 9", 10 illustrations in 10
figures. Price, $6.05.

New 2nd Edition! CRISIS 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 non-technical 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, 6'/:," x 9'/:,", 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 I-XVI, 6'/:," x 9'/:,': 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 I-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
I-X, 7" x 10", 36 illustrations. Price, $6.30.

,
,

MOSBY

TIMES MIRROR

THE C V MOSBY COMPANY l TO
86 NORTHLINE ROAO
TORONTO. ONTARIO
M4B 3E5

MARCH 1974

VITAL SIGNS
OF NURSING
PROGRESS.. .
NEW BOOKS
FROM MOSB

CLINICIAN
INTERVENTION
ASSESSMENT
PRACTITIONER
ICU
0
CCU
PRIMARY
PSYCHOSOCIAL
0 COMMUNITY
MOBILITY
.
REVIEW
RESEARCH
CHALLENGE
O.R.
EDUCATION

THE CAN
IAN NURSE 47

books

(Co/lfi/ll/I'd/i''''/I f'1IJ:1' 46)
and hou
ehold 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 tïve. the largest. present
a
roster of significant pathogens
r;d
parasites. Material on the venereal dis-
eases has been augmented. presumahly
to _reflect current epidemiological
trends. The maior infectious diseases
are dealt with cornprehensively, making
this text an excellent reference source
for graduate nurses.
Unit six relates to the microbial
presence in everyday life. A survey,
it mcludes the latest mformation on
immunization and emironmental san-
itat ion.
Also available is a Wicmbiology
Laboratory ManITaland Workbook hy
the same author. It is designed to he
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 exerci
e
are descrihed. covering
such subjects as cultivation of bacteria,
sources . of infection, phagocytosis,
anaphylaxis. and te!>ting the efficiency
of sterili7 ation procedures. It is a
good hasic 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
hy Jacques E. Rioux and John Col-
lins. Eds. .no pages. Laval. Presses
de rUniversité Laval, 1<)73.
Reviewed bv Mav Toth, Lecflfrer,
Matemal-Cliild Nursing, School (
r
Nursing, McMaster U ni\'ersity, Ham-
ilton, OTllario.

Thi!> hook is bilingual. The editors
were directed to produce it by the
Canadian Fertility Society. They sug-
gest that the hoo" will he 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

=
GIN. -
.
(- S'
\ ,.,,
,

""" " ,'c
v "
'" 'J Ik Z
.
..."'"
. ( ) G

í

-'I f
."..... .. Y
""'...

Q H'c. ..
c

ception, intertil ity, contraception, abor-
tion, sexual behavior, and sex education.
There is a liberal supply of diagrams
and charts throughout the text.
The amount of bihliographic mater-
ial offcred varies from author to author.
For example, there were only two rc-
ferences given in regard to the hormon-
al methods of hirth control.
The section covering the anatomy
and physiology of the genitalia and
conception is easy to understand and
well supplicd 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 arc devoted to the male sexual
response, no space is devoted to the
female scxual response.
The section on reproductive failure
IS helptul. Many possible problems,
and tests to aid in the diagnosIs ot
problems. are cited. The technical as-
pl'Cts of investigative procedures are
discussed in several instances. There
is a periodic attempt to consider the
psychosocial aspects of care.
Thc section on reproductive control
is gcnerally adequate. The authors of
the chapters on !l'Ds and steril ilation
are, perhaps, rather conservative in
their approaeh to the use of these meth-
ods. Long-term effects of sterili7ation
are inadequately eovered.
The section on sexual hehavior is
useful hut too hrief. It is not free from
villue judgments. The one on sex edu-
cation in schools i!> extrcmely valuahle.
rhe authors combined medical and
educational theory. fhe result is a
usahle study of the suhject.
The text could he a useful reference
fÒr health-care pract itioners and student
practitioners, if it is kept in mind that
the need for hrevity has necessitated
s"imming many suhject area!>. It is cer-
tainly useful to h,lve material on infer-
til ity and contraception in the same
text. practitioners and learners would

he wise to use additional reference
material in most areas.
The fact that the text is bilingual
is hoth 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 L Phillips and Mary K. Feen-
ey. 354 pages. Toronto. Saunders,
1l)73.
Re\'iewecl by Joan Royle, Me MaSTer
L'ni\'eniTy School of Nursing, Ham-
ilton, (}fI(lIrio.

As the title implies, this hoo" is intend-
ed to help the student recognize and
descri he the common disorders of the
cardiac rhythm.
The authors hegin with a brief re-
view of the emhryological development
and clcctrophysiology of the human
heart. The scction on the standard elec-
trocardiogram and lead ...ystem pro-
vide!> the hasis for interpretation of
arrhythmias.
The major portion of the boo" 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 hy the use of actual patient
histories and tracings and hy the many
practical points the authors share from
their experiences. Many test tracings
throughout the text provide the rcader
with feedback on his comprehcnsion of
the text.
Scdions on electronic paccma"ers
and cardiac drugs provide a basis for
(Co/lfi/ll/I'd 0/1 f'1IJ!1' 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., M.S.N.; and ZEB L.
BURRELL, Jr., A.B., M.D., F.A.C.P. June, 1973.360 pages plus FM
I-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 proædures. By ALICE MOREL, R.N.; and GILBERT
J. WISE, M.D., F.A.C.S. May, 1974. Approx. 144 pages, 6'Jf." x 9t4",
172 illustrations. About $10.00.

New 2nd Edition! MATERNITY NURSING. Presenting the entire
maternity cycle as a normal physiologic proæss, 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, conæption,
fetology, labor and delivery, and the newborn infant. It reviews
techniques and proædures 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.J. October,
1973. 194 pages plus FM I-VI/I, 7%" x 10'/:,", 37 illustrations. Price,
$5.55.

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.
SAKAL YS, M.S. May, 1974. Approx. 176 pages, 5'/:," x 8W'. About
$4.75.

,
'.'

MOSBY

TIMES MIRROR

THE C V MOSBY COMPANY L TO
BS NORTHLINE ROAO
TORONTO. ONTARIO
M4B 3E5

MARCH 1<J74

VITAL SIGNS
OF NURSING
PROGRESS.. .
NEW BOOKS
FROM MOSB

CLINICIAN
INTERVENTION
ASSESSMENT
PRACTITIONER
ICU
CCU
PRIMARY
PSYCHOSOCIAL
COMMUNITY
0
MOBILITY
REVIEW
RESEARCH
CHALLENGE
O.R.
EDUCATION

THE CANA IAN NURSE 4<J

books

(Col//il/lli'd li'"," pm:i' 411)
understanding the treatment of various
arrhythmia
.

The authors have collected and or-
ganized a vast number of electrocar-
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 \\ ishing to
increase her skill in recogni7ing and
de
cribing cardiac arrh)thmias will
find this a valuable reference book.
The author
do a good job in delivcr-
ing what they promise. a plan for ac-
quiring
kill in the electrocardiogra-
phic interpretation of thc heartbeat. A
major criticism of scope lie
in the
authors' failure to di
cuss vector ana-
lysis and to provide sufficient depth
in cardiac physiolog) and clectrophy-
siology to enable the reader to under-
stand the pathophysiological proces;;es
underlying thc arrhythmias.

Leadership Technique in Expectant
Parent Education, 2ed.. by Anne L.
Clark. 118 pages. New York. Spring-
er. 1973. Canadian Agent. Lippin-
cott. Toronto.
Re\'iewed by Catherine McCqffrey.
Lecturer, School of Nursing, The
Universitv (
r Manitoba, Winnipeg,
Manitoba.

The main purpose of the book is to
provide a guide for the bcginning
in
tructor and to help her develop
skill in using the group leadership
method to conduct parcnt education
cour
es.
Further objectives identitied are.
to encourage 'thc nurse instructor to
develop her own teaching style. and
to keep abreast of current research
and practices in parent education.
One partiéularly interesting piece
of research is in the area of "reaction
to the state of pregn.lIlcy." Some reports
indicated that up to X5 percent of
women were unhappy upon first dis-
coveri ng that they were prcgnant. It
was found that many women do not
like to be pregnant and may resent it.
This response seems to be especially
relevant \\ hen one considers ho.... socict)'
view... pregnancy. Society make
thc
assumption that every pregnant mother
(married) wants her baby.
One item. \\ hich was difficult to
grasp in terms of feasibility. was that
of "employmcnt" of thc expectant
mother. The book
tates: "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 perm itted to do so." I wondered
ho\\ many expectant mothers have this
choice. especially in the present time
of intlation and world tensions.
I strongly recommend thi
book to
those concerned with parent education.
The value of
uch a book lies in its
variety of applications. Not only is it
an excellent guide ti.)r the beginning
instructor. but It has great potential for
teaching at all levels. For example. the
benefit of such a book. incorporated
into the teaching of baccalaureate stu-
dent
. 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 benetit of this
book is the concise form of its presenta-
tion. which provides accessible material
to all readers.

Controlling th(' Spread of Infection:
A Programmed Presentation by Belty
Mcinnes. III pages. St. Louis. Mo
-
by. 1973.
Re\'iewed h\' J('{II/ Shea, reacher,
Department - (
r Nursing, Humher
College (
r Applied Arts and Tech-
nology, Rexdale, Ontario.

The author states. "the purpose of this
book is to present. primarily to nursing
students but also to othcr 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
et-up. The answer(s) fÒr
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
sect ion. The author states that "sterile"
masks and cap
must be worn in the
operating room: this is incorrect.
Part II - Asepsis - co"ers asepsis
in general; mcdical asepsis. with con-
siderable stre
s on handwashing; and
surgical a
epsis. including methods of
stcrilization. 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 thi

book provides a good basic understand-
ing of the fundamentals of microbiology
and control of infection. There is some
repetition from Part I in Part II. and
from Part 11 in Part 111. 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 stud)' frames are used through-
out the three parts. nece
sitating appli-
cation of the principles to practice. This
book is appropriate for beginning nurs-
ing studenb and other allied health
workers who arc concerned with the
spread of infection but who do not re-
quire knowledgc in depth. The section
on surgical asepsis could be omitted
ti.)r workers not requiring this infor-
mation.

Rehabilitation Nursing: Perspectives
and Applications by Victor A. Chris-
topherson. Pearl P. Coulter and Mary
O. Wolanin. 51'6 pages. New York.
McGraw-HilI. 11)74.
RI'\'iewed hy Olga Greenwell, Head
.'Vurse, S/llIlighne.uy Hospital, Van-
co//\' ('/". B. C.

It has bccn rewarding to read a book
that has so clearly done what the editors
sct out to do. Their objective was to
providc a single volume to u
e as a
reference work for personnel practicing
in i
olated area
with limited library
resources. or tÙr those with limitell
readi ng time. The book is concise.
easily read. and highly instructive.
fhere arc 74 articlcs. called readings
in this volume. culled from various
journals published over the past \0
years. The authors arc mostly nurses.
ph)
icians. physical therapists. or social
science personnel. Although emphasis
has been placed on rehabilitation. the
diseu
sion of nursing care planning and
asse;;sment will be enlightening to
nurses working in any field.
The infÒrmation runs the gamut
from pediatric
to geriatrics. amputa-
tions to drug abuse. alcoholi
m to CV As.
and many more. One area that is fre-
quently neglected but is \\ell covCfed
here is sexualit). The book provide
a

eries of readings on sexuality that not
only confirm that it is a real and dis-
tressing problem for both stall and
patient. but also give some do\\ n-to-
earth advice on how to deal with the
problem in general and ho\\ to go about
gelti ng help for the patient.
A unique facet of this book is that
many of the contributors were patients
(Col/ti/lllt'd 01/ I"'):t' 51)

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 examination
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 I-XII, 7%" x 10'/:,". Price, $11.05.
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 I-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. SCHUL TZ, 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.; PA T S. 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 I-XII, 6" x 9". Price, $5.80.

,
"

MOSBY

TIMES MIRROR

THE C V MOSBY COMPANY L TO
86 NORTHUNE ROAD
TORONTO. ONTARIO
M4B 3E5

MARCH 1974

VITAL SIGNS
OF NURSING
PROGRESS...
NEW BOOKS
FROM MOSBY
0
CLINICIAN
INTERVENTION
ASSESSMENT
PRACTITIONER
ICU-
CCU
PRIMARY
PSYCHOSOCIAL
COMMUNitY
MOBILITY
REVIEW
RESEARCH
CHALLENGE
O.R.
EDUCATION

THE CANAOIAN NURSE 51

themsdws in the sellings they descrihe.
These particular articles offer an insight
and immediaC) that brings home their
me
sage \\ Ith darit). They will
timu-
late
taff in even the most efficient
rehahilitation selling to look over their
program
for improvements. For exam-
ple. the author of Reading 25 describes
how he. a C\- ,\ \\ith visual-auditory
disturbances. could have heen spared
much anxiety and trauma if a lillle
thought had becn given to his bed pla-
cement in the ward.
"I was one of those unfortunates:'
he writes. "whose unimpaired left
ide
visual-auditory fields were focused on
a blank wall. ... Even the patient in
th.e bed to my right was unseen. I! was
frightening to feel isolated in a room
full of patients who. due to blatant cir-
cumstances. also ignored my allcmpts
to
ocialize. Even the most casual lan-
guage stimulation wa
absent while I
was in that 'dead' corner except during
the visitations made by my wife."
This boo". easily read and highly
instructive. will provide techniques
and
timulation for nurses in any area.
I! should be forgiven the few lapses
into jargon that require a second reading
here and there. 'f;J

accession list

Publications on this list have been rc-
eeived recently in the CNA library and
are listed in language of source.
Materials on this list except referellce
items may be borrowed hy CNA mem-
bers. schonb of nursing and other ins-
titutions. Rcfáell(,c (R) itcm.\ (archive
books and directories. almanacs and
similar basic hooks) to IIOf go out on
loan. rheses. also R. an: on Reserve
and may go out on Illtcr/ihrary 10illl
ollly.
Requcst for loans should be made on
the "Request Form for Accession List"'
and should be addressed to: The Li-
bran. Canadian Nurses' Association. 50
Thc briveway. Ollawa. Onl. K2P IE2.
No more than three litles should be
requested at anyone time.

BOOKS AND DOCUMENTS
I. rhl' ANA ill WasllÍllgtoll, by Julia Thomp-

on. h.ansas City. 1\1 issouri. American
Nurses' A
sociation. 1912. 147p.
:!. A f\' A d illical se.Hio//.\ ,'I A /)/el'/('(II/ Nu/'-'I's'

a residential conference on:

-I.\.",cia , tioll /<;71. New Yor". Appleton-
Century-Crofts. 197
. :!J7p.

. Til/' A/J/ericall Heart A.\.\o('Íatioll coo/..-
"oo/... by the American H earl Association.
New )01'''. DaviiJ McKay. l<n
. 41:!p.
4. Ad/J/illi.\terillg IIlInillg .\t'/Tin', by Marie
DiVinccnti. Boston. I ittle. Brown. 1912.

40p.
5. Adll/i.\.\ioll (
I patiellt.\ to hospital, by
Howard Baderman et al. London. King
hlward's Hospital Fund for london. 1973.
51p.
Ó. Alfied /J/edical educatioll directory, /973.
4ed. Chicago. American !\Iedlcal Associa-
tion. Council on I\ledical hlucation. f 973.
4:!
p.
7. Architecfllral ha,.ri,.,..\ to the physically
di"ahfed. by Sue-Anne h.ir"land. Toronto.
Canadian Rehabilitation Council for the
Disabled. 1973. 54p.
H. Cart de ga,.,ler le,\ e/((;/)/t.\, par Thérèse
Grenier-Forest. J\lontréal. Editions du Jour.
1973. 179p.
9. 8,,1;,,-e addictioll: holl' to hell' yomh, by
Florence I ieberman ct al. New) or". Behav-
ioral. 1973. 131p.
10. rhe hiologic age.\ o.f 11/(11/ (i'o/J/ ((Jl/cep-
tim/ through old age. Edited by David W.
Smith and Edwin L. Bierman. Toronto.
Saunders. 1973. :!llp.
(Colltillued 01/ page 54)

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52 THE CANADIAN NURSE

MARCH 1974

New...ready to use...
"bolus" prefilled syringe.
Xylocainê100 mg
(lidocaine hydrochloride injection, USP)

For 'stat' I.V. treatment of life
threatening arrhythmias.

\

o Functions like a standard syringe.
@
o Calibrated and contains 5 ml Xylocainé.

o Package designed for safe and easy
storage in critical care area

o

The only lidocaine preparation
with specific labelling
information concerning its
use in the treatment of cardiac
arrhythmias.

\

,

+.1-
<"0

.
"'0
o
."

an original from
.\.S T I
.'

MARCH 1974

Xylocaine'F' 100 mg
(lidocaIne l1ydrocl1londe inlection U S.P )
INDICATIONS-Xylocame administered intra-
venously is specifically mdlcated In the acute
management or(l) vcntricular arrhythmias occur-
ring during cardiac manipulation. such as cardiac
surgery: and(2) life-threatening arrhythmias. par-
ticularly those which 8rc ventricular in ongin. such
as occur during acute myocardial infarction.

CONTRAIII,DlCATIONS-Xylocaine is contra-
indicated el) 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 essential in the proper adminis-
tration ofXylocaine 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-Caulion 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
andshoek, and all forms of heart block (see CON-
TRAINDICATIONS AND WARNINGS).
In patients with sinus bradycardia the adminis-
lTation ofXvlocaine intravenously for the elimina-
tion of ventricular ectopic beats without pnor
acceleration in heart rate (e.g. by isoproterenol
or by electric pacing) may provoke more frequent
and senoUs ventricular arrhythmias.

ADVERSE REACTIO"lS-Syslemic reaclions or
the followmg types have been reported.
(I) 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 sensilivity
between Xylocaine and procainamide or between
Xvlocaine and quinidine

DO"AGE AND ADMINISTRATlOII/ Songle
Injeclion: The usual dose is SO mg to 100 mg
administered intravenously under ECG monitor-
ing. This dose may be administered at the rate
of approximatelv 2S mg to SO mg per minute.
Sufficient lime 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 expenence with the drug is limited
ConlinuoulIJ Infusion: Followin! a single injection
in those patients in whom the arrhythmia tends
10 recur and who are mcapable of recelvmg oral
antiarrhythmic therap)'. intravenous infusions of
Xylocaine may be administered at the rate of I
mg to 2 mg per minute (20 1025 ug/kg per minute
in the average 10 kg man). Inlravenous mfuslOns
ofXylocaine musl beadmmislered underconstanl
ECG monitonng to avoid potcntlal overdosage
and toxicity. Intravenous inCusion should be ter-
minated 8S soon as Ihe patient"s basic rhythm
appean to be stable or at the earliest signs of
toxicity. It should rarely be necessd.ry to continue
intravenous inCusions beyond 24 hours. As soon
as possible, and when indicated. pallenls should
be changed to an oral antiarrh)thmlc agcnl for
mamtenance therapy.
Solutions for intravenouli IOCuslon should be
preparcd by the addition of one SO ml sm!le doc;e
vial of Xy)ocaine 2f.4. or one 5 m) Xvloeame Onc
Gram Disposable Transfer Svnnf!:e to I litcr of
appropriate solulion. This will proYlde a 0.1""
solution
thai IS. each ml will contain I mg of
Xvlocaine HCI. Thus I ml 10 2 ml per minUie
wdl provide \ mg \0 2 mg of Xvlocaine HCI per
mmute.

THE CANADIAN NURSE 53

accession list

(CO/lfilllled li'olll page 51)

I 1. Ihl' cardiac arrh\'lhlllll/.'. by Brendan
Phibb
. 2ed. SI. Loui
. :\Io..by. IY13. 20:'p.
12. Carl' or The ,'-'TOIII\' IJ//TieIlT. bv Virginia
Vu"ovich and Reba D. Grubb. SI. Loui...
!\lo
b}. I Y73. I3Hp.
13. CaTalogll1' de .fillll' <'1 d'w//lio-\'i.'"d.,.
1973. Otta"a. Con..eil canadien pour la
cooperation internation.lle. 1973. ó2p.
I.t. (;/1alo.<:II(, ol'.fillll' Oil lI'orid dl'l'eloplII('1/1
1973. Olla"a. Canadian Council for Inter-
national Development. 1973. ó2p.
I:'. CI illi('al a.'-'L".\Il/eIlT 1;'1' Tfle I/u/'.\e p/'//c-
TiTioll/,/,. by William C Fo,,"e.. and Virginia
"'. Hunn. 51. I oui... 1\10..by. 1973. 190p.
I ó. COIITelllpol'llry i.'.'/II'.' ill Calladiau lall'
'''1' lIur.\/'.', b} 5hirlev R. Good and Janet
(. "'err. :\Iontreal. Holt. Rinehart and Win-
..ton. 1973. 19
p.
17. CurricululII lJ//i1dillg ill lIunil/g; a 1'1'0-
c/'.\s. b} Em Olivia Bevi... St. Loui... 1\10..by.
I Y73. 172p.
I K Day care, [troll'il/.<:, karl/il/g, caril/g;
l/aTÍ/"Il/1 guidelil//'\ I,,,, The de\'elop1/1el/1 01
da,' care .I/'/Tin', Ii". childrell. OtHt"a. Cana-
dian Council on Social Developmenl. 1973.
:':'p.
19. Di.'Tril>uTiol/ or lu'alTh 1/1111IPOII'('/'; al/ 1111-
/I/ITI/1ed hihliogl'llphy prepared by Fllen Sax.
l\1anpo"CI' Distribution Project. Ne" Yor".
National Health Council. In3. 2óp. R
20. Falllily I,'alll/il/g il/ The edl/
'/I1iol/ I
r
11111'.'/'.\ al/d 1/1idll'i"I'.', Edited by lily \1.
Turnbull and Helena Pi7ur"i. Geneva. World
Health Organization. 1973. :,Op. .World
Health Organization. Public health pape,..
no. :'3)
21. Guide 10 The healTh ('//re lield, 1973.
Chicago. American Ho..pital A..
ociation.
I Y7 3. 5H
p. R
22. H('/IITh .,('iel/(,(" educaTiol/. Price ..chedule.
Toronto. Mediascience Ltd.. 1973. I vol.
23. Il/1rod ucTory cOII('/'pT.' il/ ('01/11111111 icaT iOIl
proc<'.\.\/'.' , b} Robert O. Reid. Toronto. Her-
"eley Studio. 1973. ó:'p.
2
. I a jeUI/I'",e eT la drogue; raPI'orr I/'TIII
GrouI'e d'e11lde de /'0 \IS. Genève. Organi-
..ation I\londiale de la Santé. 1973.
Xp. lit..

érie de rapport.. technique
no. 51ól
25. ,\ledical curl' alld 1/1edical cal'(,; pro.'pe/'1.'
101' TIll' orgal/i:aTÍ/1II alld lill//ll/'ÍI/g or pel'-
.\/II/al h('/lITI, care .\/'/Tin'.'. Spyro.. Andreo-
poulo... editor. Ne" Yor". IY72. 251p. (1\Iil-
ban" i\lcmorial I-und. Quarterly. v.50. no.4.
pl.21
2ó. ,\1m !> \,\. cOl/(prelr/'li.\il'L' /'(,\,Ù'II' 01 IIl1/',-
iI/g. Xed. SI. I oui... i\lo..by. 1973. ó
5p.
7. .'Vu/'\illg a/1/1 Tfle pro('e.\\ or comillllillg
edu///TI/II/, hy Fld.1 S. I>opiel. SI. I oui... :\10"-
by. 1973. 2
Xp.
2H. I a 1,lallilicaTi/J// dn .\0 ill , par Dolore..
1:'. I ink et Dori.. I . Carnevali. rraduction
revue par Cecile Boiwerl. :\lontreal. Re-
nouve.lu Pédagogique. 1973. 2
óp.
54 THE CANADIAN NURSE

29. P,'yclriaTric I/unillg, by I\larguerite I UC}
:\I.mfreda. ged. Philadelphia. Davi... 1973.
5:'7p.
.HI. P,yclrology a' al'plied T,' lIunil/g. by An-
dre" i\1cGhie. óed. Fdi nburgh. Churchill
I iving
tone. 1973. 292p.
31. ReporT Or Tire allll/Il/lllleeTillg 01 Tire A\\o-
daTiol/ or Regi'Tered Vu/'.\('\ 01 Nell:f,ullld-
lalld. SI. John.... 1913. 5
p.
.'2. Re.,ulT/I1s lil/a!.l de /'I'Tudl' ,ur /'aeTl'
Í/(Iirllli/'/' dall.' In dif1ál'lI(\ cl'lITrl'.' de ""'TL'
de la pI'lJl'ill('/' de (}lIehec 1971-73. I\lont-
real. '\..sociation des Infirmièrö et Infir-
mier.. de la Province de ()uéhec. 1973. H2p.
n. RL'\'ÌL'II' I
r Tealll IIlInil/g, by I aura I\lae
Dougla
s. SI. loui
. \Io..hy. 1973. 131p.
(1\Io..by'.. comprehen
ive review
erie..)
3.t, Serial IJ//Micl/Tiom; ThL'Ír place alld
Trl aT1/1ellT il/ lil>/'//rie., , by Andre" Delbridge
O
born. 2ed. rev. Chicago. American I i-
brary A....ociation. 197 3.
3-tp.
35. A .'T/III\' or e('ol/wl/in ,
r group pl'lleTice
III Sa.,ÁaTelll'lIall, by Donald O. Ander..on
.md Anne OJ. Crichton. V.mcouver. H.C.
Univer..ity of Hriti..h Columbia. 1973.2 vo!...
3ó. Tl'llil/il/g or Tire 111'1'.11' pl'llcTiTiolll'r; a di-
lIinti al/d .\laTi.'Tical /111l/ly.' i., , hy Dori.. :\1.
Storm... North Haven. Conn.. Connecticut
Health Service.. Research Series. 1973. IOHp.
IConnecticut Heahh Service.. Re..earch
..eries no.41

7. La TI'III/.'fJll/'ell(,(' dL .\Oi. par Sid ney \1.
Jourard. Traduit de I'américain par Scrge
Baron et al.. qui ont .Üouté un addendum ..ur
la p..ychologie humani..tique. Quebec. Fdi-
tion.. Ste-I-oy. 1972. 291 p,

K WaTclr-lires oil Tire 1110 Ul/Tail/.': TI/I' 1(';-
al/d II'r;Til/g.' 01 Erlu'l Joi/ll.'. by \largaret :\1.
Streel. Toronto. University of Toronto. 1973.
33óp

PAMPHLETS
39. B/lsic li.\1 o(guidl" /lIId illl"1'//1/1TÙ'1/ SoUI'-
('('s lor pl'o/l'.\.\ioll/ll /11//1 pl/Tiellf." libr/lries
ill h/J.\piTal.,. compiJcd b} Council of National
L ibrary Association
. Joint Commillee on
I ibrary Service in Ho..pital... Xed. Chicago.
American Hospital A....ociation. 1973. 27p.

O. Beyol1d /'/J//t1iCT or (,oll/pl'oll/isL': 1/111/1/111
pl'ogl'es.' , L'I/I'irOllll/I'I1T/l1 proTecTiou /11//1 The
UlliTed N/lTiol/s De\'e!OPII/I'I1T Progr/luI/IlI'.
Ne" Yor". l'nited Nation
. 1973. 39p.

\. ßyl//ll'\ /I.' III///'I/ded \I/lY 1973. Ne"
YorL National I eague for Nur..ing. IY73.
29p.
-t2. Col/ege edUC/lTioll: Áey To /I pl'o/n.,i/J/1/I1
('/Ire('/' il/ II1/I'.\TUg 1971-73. Ne" '1'01'''. Na-
tional I c.lgue for Nursing. [)cpt. of Hacca-
lauredte and Higher Degree Program... 1973.
23p.
-t3. Cou'TiTuTioll /11//1 byl/lll'.' /I, (I/IIel1dl'd
1973. Geneva. I nternat ional Council of
Nur..c... 197.l. 21 p.
-t
. A guidl' To II/eTric (,oll"I'I'.lio" (SII I\lont-
real. A
"oci.llion of Hl1..pital.. of the I)rovince
of Quebec. 1973. 33p.

5. -1 Joil/T .'l//Tel/l/'//1 01 TII/' -111//'/'inll/
,\'u/'\n' ,-J ,.",d/lT;oll /11//1 (/u' AI/1/ ric/lII S('hool
Ift'/lITh ,-J.,-,o/'Í/lTio". RI'/'/J//TII/I'/"//lTÙJ//' 01/
I'duc/lTioll/l1 p/'('p/lI'llTioll /I"d dl'lilliT;Oll 01
TII/ e\'palldl'd roIL' /II"/li/llcTiol/.' or Tfll' .,dl<",1

I/unl' pral T/11<//1er. "'an
a
City. No.. Amer-
ican Nurses' A....ociation. 1973. 6p.

ó. A II/uITi-l/aTio"al .'Twl\' of Thl' illTe/'l//I-
TÙJ///Il lIIigr/lTiol/ I!I phvsici/ll/.' alld "/11'.\/'.'.
Geneva. World Health Organization. 1973,
17p.
-t7. Nunillg 1/IIiT.'. 11'/11'/'-'. a/1(1 1'/1 Til'l/T I}('d-
1'001/1.\: liTera11lre I'e\'Í1' II' /III/I /II/1/OT/lTl'd bil>-
liog/'//phv, by Shevra 1.. Martin. Washtng.
ton. D.C. Gordon A. Friesen International.
1973.
3p.
-tHo Pro.<:I'IIII/., /lccI'ediTed (or p1/h/ic he/llTh
IIul'.\i1/g prep/l/'//Tio1/. 1971-73. Ne" Yor".
National Ledgue for Nursing. Dept. of Bac-
calaureate and Higher Degree Program
.
1973. Xp. R

9. ST/Illd/lrd., 01 pl'llc1i('l'. "'an..a.. City. 1\10..
American Nur
e
' A..sociation. 1973. 5
part...-Ntll...ing practice.-Community heallh
nur..ing practice.-Geriatric nllI...ing practice.-
\Iaternal child health nur
ing practice.-
P
ychiatric-mental health nllr
i ng practice.
50. I hl'l'e c/Il/I/el/J:L'S To Thl' IIunillg pwk'-
,i,,". 'ie!ecTl'd p/lpNS }i-olll Thl' 1971 ANA
cO""ellTiol/. h.an..a
City. 1\10.. American
Nur..e..' A....ociation. 1973. 32p.

GOVERNMENT DOCUMENTS
C/lII/ld/l
51. Dept. of National Health and Welfare.
Trl'1//I, /II L'Íg/lrl'((1' (,,,".'UlllpTio". (;I/l/ld/l
19:!O T" 1970. Ollawa. n.d. pam.
52. fconomic Council of Canad.1. ,-JIII/u/ll
1'/'\'iI'II', /973. Olla"a. Informalion Canada.
I 973. 2 I I p.
53. Health and \\ clfarc Canada. /Ji.'/I.'T('/'
uunil/g <Tudy; /I /'('1'01'1 To {-'II/I'I'gl'un' f/c/lITh
SI'J'I' , icL'.\ prepared by 1-. IOITdine Davie...
Olla".I. 1972. Hp.
5
. Health and Welfare Canada. \'uTriTiol/:
/I u/lTiou/l1 prioriTy. ,-J reporT I". NuTI'iTio/1
C/lII/ld/l To The /)ep1. 01 ,V/lTioll/l1 HI'/lITh /I/1d
WeN"I'e. OIl.lI'a I nformat ion Canada. 1973.
152p.
55. I\linistry of State for Science and Tech.
nology. Tire II/irl'ol'ed .'peCTrUII/; /I collL'cTio"
,d' },l'pOI'1.' Ii,,' TITe II0ll-.,L'ÍI'IITi.'T alld /",//-/'11-
Ri"e('/' /ll>ouT /lchie,'el1lL'I1T., il/ C/lI1/1di/lll
.,cie"n' /11//1 (('cI1l1ology. OIl.lI'a. Information
Canada. 1973. HOp.
:'ó. National I ibrar} of Canada. RL'porT
1971/73. Olla"d. 1973. ó7p.
57. Stati..tic.. Canada. /Io'piT/l1 i1//liC//Ton,
J/lIIU/lI'y-JUl1e, 1973. Ollawa. Information
C.mada. 1973. 192p.
5H. . /1",piT/l1 'T/IT i.'T in. ".1 Ho'piT/l1 />I'd"
1971. Olla"a Information ..mada. 197
.
195p.
GI'I'/IT BriT/lil1
59. Joint Hoard of Clinical Nur..ing Studie...
london. 1973. OUTlille cUI'riculuII/ ill /lc/'Í-
t!t'II! (II lei elJu'rgC'/1l y 11111".\;11.': for .\({lll' rl'gi.\-
T('/'('d 1//11'.11'.<. 19p. (Cour..e no. 19X)
MI. . 01l1/i1//' ('url'iculuII/ i" I//I"/II//'/'d
f'-,.\'/'himl'i(' IIunillg 1;'1' 111/1'.\/'\ 01/ Thl' I'('gi.,-
TI'I' lor II/(,1/T/lll/ur.\(" or Thl' rl'giMI'I' 1,,1' II/II'.'e.'
01 The IIIL'''T/II/,' 'u/>lIol'I/1/I1. lOp. (Cour..e
no. X201
ól. .OuTli"L' curriculuII/ iu I>dll/l'Íour
II/",Ii/i(,/lTio1/ ill III(,IIT/Il II/II/di< /II' Ii,,' rl'gi,-
T(,/,I'd IIunn. 12p. (Cour..e no. 7001
MARCH 1974

fl2. - . Olltlille cllrricllium ill child ali<I ado-
l('Sccllt IJ.lychiatric IIl1l'Sillg 1,,1' regi.\tered
11111'\('.\. II p. (Course no. flOO)
fI
. - Olltlille curricllium ill gelleral illtell-
si,'" carl' lIunill
lor \tate ellrolled IIl1r.\('s.
12p. (Course no. 115)
fl4. - Outlille cllrricllillm ill operatillg
def'artmellt lIur,\ill
li,r .\1ate regi.\fered
IIlIr.\('s. l-tp. I( our
e no. 17(1)
65. . Ol/tlille cllrricllium ill \I,ecial alld
ill1ell.\ÍI'e l/1/r.\illf: carl' "I' the l/('II'borll. 12p.
(Course no. 401 J
66. -. Ollllill" CII/TiclIllI1II ill -,pe";ld (//1<1
illtell.\i,'e IIl1nillg care of Ihe lIel\'lmrll .Ii",
state certi/Ïed midwi,'es, .\tate regi.\tered
IIl1l'Se.\ or regi.\(<'I'ed ,\Ícf.. childrell's IIl1r.\('s.
l.tp. (CoUl',;e no. .tOO)
Olltario
67. Depl. of Health. Directory I!I mll'sir,g
pe/'.\ollllel ill charge ,!r o.l1icial pllMic health
IIl1nillg .\('/Ticl'.\ ill Olltario. Toronto. 197
.
4p. R
6!( M i ni
try of I abour. Research Branch.
('ollectÍl'e bargaillillg prm'i\ÍolI.\ ill Olltario
mllllicipal a
reelllel11s. Toronto. 1973. II
p.
Vllited Sw(('"
fl9. Departement de la Santé. de )'I-.ducatlon
et du Hien-être. Callcer et .\oim illfirmi<'l'.\,
1/1(/11111,1 de /'iIl.lirl/1ihe ,'isiteu\('. Revu en
1955. Traduction par 1\1. Jean-Rodolphe
Bordua
. New York. Dép<lrtement de la
Santé. 1955. X!!p.

70. National In
titutt" of Health. "oreigll
trailled physiciam Imd Americall medicille,
by Rosemary Steven
and Joan Vermeulen.
For
ale by U.S. GOVI. Pri nl. Off.. Washing-
ton. D.C. 1972. 170p. IDHEW Publication
no. (N'IH) 7J-325)

STUDIES DEPOSITED IN CNA REPOSITORY
COLLECTION
71. The C;'TII1I1.\/all('('.\ ill I\'hich f'o.\(of'eratin'
f'atiellt\ alld their 1II1I'SI'.\ det<'l'lIIille lIeed {tn'
(/II (/III/Ige.\ic, by Myrtle I. Macdonald. Mont-
real. 1971. tl7p. IThesis IM.Sc.IAppU)
I\IcGill)R
72. The com.li,,'/ of patiel11S ill /ractioll: a
de,\(Tipti,'e .\tlllly, by Wilton S. "-e7ala. Mont-
real. 1972. fl7p. {Thesis (:\1.&,( Appl.)J
\lcG if)) R
73. The cOlln'rm expre\.\ed hy patiellt.\ with
ca/'lliac cOllditioll.\ durl1lg the }i/'.\t thirteell
day.\ ,d' ho"piwli::utÍlm alld the rl'.\polI.\('\ of
healtll l\'odel'S al/(l other patiellt.\ to the.\('
COII(,('''''.\, by Ronald S. Reighley. Montreal.
1971. IThe
i
(I\1.Sc.1 Appl.lJ - McGill) R
7-t. IlIfi"'lIl1/tioll IItili::ed hy de,'ell ('(mliac
patic'IIl.\ al/(l the rdatÍl",.\hip ,,1' thi.\ illforma-
tioll to pmgre.\.\ a.lier di\('lwrge. by 1 eola
Anne Robin
()n. MOn! real. 1973. 53p. (The-
sis (1\I.Sc.(Appf.)) - McGill) R
75. I 1'.\ r(,l/lllIIi.\.\ioll.\ 111/11-' 11'\ é('ole.\ d'illnr-
miÌ'/'I'.\ ca/lI/dielll/('.\cfi'llI/çai.\('s, par Soeur
Rita Gagne. Montréal. 1957. 40p. R

Request Form
for "Accession List"

76. Relatiollship.\ hl'1l\'eell Ufllllll/Tied moth-
el'S alld their IIell.horll illflll/t.\ ill hospital
by E. G,\ÌI Carleton. Montreal. 1971. flXp.
(The
is ( M.Sc. (Appl. II - I\IcG ill J R
77. .\It/ill" abortioll: a .\tudy of.li-rl/ale hef"/I'-
io"r ill 1/ nisi.\ .\irtll/lioll. by Judith C. Chri
-
tensen. Montreal. 1972. lOOp. (ThesisIM.Sc.
IAppl.)) - I\IcGill) R
7!!. A .\tlldy to determille if 1/ IIeed eÜ.\1.\ for
a /'I:fj'('.\ller c.mr.\(' .1"1' ill-a('(Ì\'I' 11111'.\('" wi.\h-
illg to refllrll to a('t;.'e IIl1nillg, by :\Iona E.
Ca!lin. Montreal. Association of Nurses of
the Province of I)uebcc. 19f17. 1 flp. R
79. rI .\tlldy to filld Ollt why /'('
i.\1er('(11I111'.\('\
ill ,Vell:/iJ/lI/llIllI/d are illaui"e ill II II r.\ÍIIg.
by Dawn Hanson et at. St. John's. Memorial
l'niver
ity of Newfou'ndland. 197
. 2f1p. R

AUDIOVISUAL AIDS
XII. Association de
Médecins de langue
française du Canada. I\lontréal. 1973.
SOllomed. -,<,ric' I, fW. 7. - Cote A. I. i\lasse
au
ein. 2. Coliques du jeune bébé.
. Phlc-
bites. - Cote B. I. Fndomelriose.
SOllmllec/. ,\Nie I, I/O. 8. -Cote A. I. Hypo-
glycemiant
oraux. 2. Alcoolisme. - COle H.
I. Ocytociques. :!. Rhill.ite ,
Iergique. J. Im-
pui
sance
eJ\uelle organique.
S(/I/(//I/ed, .\érie I, I/O. IJ. - COle A. I. Syphi-
lis. 2. Hypothyroidie. . Cute B. I. StJabi
me
chez I'enfanl. 2. Voix rauque. 3. Hemor-
ruides. 9

In deeu bitus I 1
ulcers &l r

,

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\
/

,
./' '- ,4-
i \ J -,. ri .,

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8
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I "'_'
"I
r

CANADIAN NURSES'
ASSOCIATION LIBRARY

Send this coupon or facsimile to:
LIBRARIAN, Canadian Nurses' Association,
50 The Driveway, Ottawa K2P 1E2, Ontario.
Please lend me the following publications, listed in the ..............
....................................................... issue of The Canadian Nurse,
or add my name to the waiting list to receive them when
available.
Item Author Short title (for identification)
No.

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, 120 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

Request for loans will be filled in order of receipt.
Reference and restricted matenal must be used In the CNA
Ii brary.
Borrower .............. ................................................................... .....
Registration No. ..... ........ ...........................................................
Position ............................................................... .......

8

---------------

--
-
-

c

D YES, please contact me to schedule a viewing of
Westwood's in-service film on decubitus ulcers.
Westwood Pharmaceuticals Toronto, Ontano M8l 2E3

T\I.lme

Area code_ Telephone No._

Addre ss ,.. ...... ................ ...... ..... ........ ..... ... ... ..... ....,........ '" ....... .....

Title

Institution

....- ..
..... .... ...... ...... .... ... ........ ....... ............ ...... ........ .... ..... ... ...... ......

Date of request .................................... .......................................

Address

THE CANADIAN NURSE 55

MARCH 1974

City

Province

Postal Code

classified advertisements

ALBERTA

REGISTERED NURSES required lor 70 bed accredIted
active treatment Hospital Full time and summer
rellpf All AARN personnel policies Apply 10 wnting
to the Director of Nursing. Drumheller General Hos-
pital Drumheller Albert;:t

REGISTERED NURSES. We need you lor our summer
relief program Come and Jom uS for a three or four
month period You can gain a great deal of clinical
experience dunng 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
wflte to Personnel Department. Red Deer General
HosPital Red Deer Alberta.

ImmedIate openings lor TWO GENERAL DUTY
NURSES. Salary In accordance with AARN 5625
5750 30.bed achve accredIted hospital 80 mlle<
from Edmonton Accommodation available Apply
D"ector of NurSing. Daysland General Hospital
Daysl and Alberta TOB 1 AO

BRITISH COLUMBIA

HEAD NURSE reqUIred for an acute modern 35-bed
hospital. located In southern BC.s Boundary area
with excellent recreation facilities. PosItion to be
lolled by Apnl 1974 Salary and personnel poliCies
In accordance wIth the RNABC Apply by March 31,
1974. to Director 01 Nursing Boundary HospItal
Grand Forks British Columbia

ADVERTISING
RA TES

FOR All

ClASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additional line

Roles far display
advertisements On request

Closing dale for copy and cancellalion is
6 weeks prior to 151 day of publication
month.
The Canadian Nurses' Association does
nol revIew the personnel policies of
the hospifals and agencies adverlising
in the Journal. For authentic information,
prospeclive applocanls should apply fa
the Regislered Nurses' Associalion of the
Province in which they ore interested
In working.

Address correspondence to:

The
Canadian
Nurse

fj

50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P 1 E2

56 THE CANADIAN NURSE

I I

BRITISH COLUMBIA

HEAD NURSE reqUired Apnl 1 1974 for a very aClive
.i5-bed Acute Care Umt - compnslng Paediatric
Medical I C U Surgical and OBS servICes PrevIOUs
Head Nurses experience essential SUite available 10
Nurses Residence Apply to D"ector of Nursing St
Mary's Hospital. Sechelt Bntlsh ColumbIa

OPERATING ROOM NURSE wanted for active mo-
dern acute hospital Four Certified Surgeons on
attendmg slaff. Expeflence of training desirable.
Must be ellQlble lor B C. Reglstrallon. Nurses
residence avaIlable. Salary according to RNABC
Contract Apply to Director pI Nursing. MIlls Mem.
onal HospItal. 2711 Tetrault St. Terrace Bntlsh
Columbia

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES requ"ed for small
uPCoast hospItal Salary and personnel poliCies as
per RNABC contract Salanes start at $672 00 for
RegIstered Nurses; $571 75 for licensed Pracllcal
Nurses Residence accommodation $2500 per month.
Transportation paid from Vancouver Apply to
Director 01 NurSing. St George s Hospital Alert Bay
British Columbia

GENERAL DUTy NURSES lor modern 30.bed accre.
dlted hospital Salary and personnel policies In ac-
cordance with RNABC Apply D"ector of NurSing.
Chetwynd General HospItal POBox 507 Chetwynd
British Columbia.

GENERAL DUTY NURSES for modern 41-Deo
hospital. located OP the Alaska HIghway Salary and
personnel pol iCles In accordance with RNABC
Accommodation available in residence. Apply
Director 01 NursIng, Fort Nelson General HospItal.
Fort Nelson. Bntish Columbia.

EXPERIENCED NURSES reqUIred '" 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. B.C RegIstratIon required Apply Director
of Nursing. Royal ColumbIan HospItal. New W-est-
minster, Bntlsh Columbia.

EXPERIENCED GENERAL DUTY NURSES reqUired lor
151-bed Hospital BasIc Salary $672 5M2 per
month. Policies In accordance with RNABC Contract.
Residence accommodation available. Apply t(.l
Director 01 Nursing. Powell River General HOSPital
5871 Arbutus Avenue. Powell River Bntlsh ColumbIa.

EXPERIENCED GENERAL DUTY NURSES for modern
10-bed hospItal with doctors offIces '" hospItal.
S,tuated beautrfuJ west coast of Vancouver Island
Accommodation $50.00 a month Apply Admlnostra
tor. Tahsls Hospital Box 399 Tahsls Bntlsh
Columbia

GENERAL DUTY NURSES required lor an 87-bed
acute care hospital '" Northern B C Residence
accommodatIOns available RNABC policies m effect
Apply to Director of Nursing Mills MemOrial Hos-
pital Terrace. Bn..sh Columbia V8G 2W7

NURSES REOUIRED 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

I I

MANITOBA

DIRECTOR OF NURSING reqUIred Immediately for an
11.bed HospItal. a modern lacliity 80 miles south
west of Winnipeg Thnvmg commumty of 1500
people livIng quarters provided Salary scale 59.120
10 680 per annum Will credit for past experience
For further mformatlon contact AdmlOlstrator Notre
Dame Hospital Notre Dame de Lourdes Mamtoba
ROG 1 MO. Telephone 248-2092

1 REGISTERED NURSE - 1 LICENSED PRACTICAL
NURSE required for small active treatment hospital
General duty live out Apply giVing experience and
references. to Director of Nurses Hartney Medical
Nursing Unot Hartney Manotoba ROM OXO

REGISTERED NURSES reqUired ImmedIately for a
Communoty Health Centre In Leaf Rapids. Manotoba.
salary range 5720 $835 monthly For lurther Infor.
mation and to apply please contact Michael Hoare
Leaf Rapids Health and Social Development Centre
Leaf Rapids. Manitoba ROB 1 WO

REGISTERED NURSES reqUired for the 101l0w,"g
positions In a 68-bed acute care general h05pltal
Night Supervisor. Operating Room Supervisor Ex.
perlence essential. General duty nUrses In Pedlatnc
Department Remuneration for past experience Shift
dIfferential Salary '" accordance wIth M H S C ap-
proved rate Apply 10 Adm'nlsrralor Sre Rose Gen
eral Hospital Stp.Rose.du.Lac Manitoba ROL 1S0.
ReqUired ImmedIately - 3 R'EGISTERED NURSES and
3 LICENSED PRACTICAL NURSES for a new 6O-bed
Personal Care Home. Salary In accordance with the
recommendations of the MARN. Apply Director 01
Nursmg. Swan River Valley Personal Care Home
Inc.. SWAN RIVER, Manitoba ROL 1l0.

NEW BRUNSWICK

WANTED: TWO REGISTERED NURSES. GENERAL
DUTY required for 17-b.....d active hospital. modernly
PQUlPPI '1 Also ONE REGISTERED NURSING ASSIS-
TANT. GENERAL DUTY. For further ,"formatIon con.
tact The Administrator Albert County Hospital
Albert New BrunswIck EOA 1AO

NOVA SCOTIA

SENIOR FACULTY poslflon open basIc reqUIrement
Bachelor of Nursing Responsible for pediatric as-
pect of an Intergrated 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 lor 34-bed General HospItal.
Salary $646 per month to $756. plus experience al-
lowance Excellent personnel policIes. Apply to:
Director 01 Nursing Englehart & Dlstnct Hospital
Inc., Engl ehart. Ontario.

SUPERVISOR OF PUBLIC HEALTH NURSING for
progressive generalized publIC health program Salary
adlustment lor expenence Salary range 512000
514000 Car allowance $6000 + 12 a mIle Apply
Dr H H Washburn. MD. D P H Medical Oflocel of
Health Haldlmand-Norfolk Health Unot Box 247
SImcoe Ontallo N3Y 4L1

REGISTERED NURSES requ"ed lor a new 79-bed
General HospItal In bIlingual communoty 01 North-
ern Ontario French language an asset. but not
compulsory. Salary IS $645. to $758. monfhly wIth
allowance for past experience, 4 weeks vacation
aller 1 year and 18 sIck leave days per year. Unused
sIck leave days paId at 100% every year. Master
rotatron in effect. RoomlOg accommodations available
In town. Excellent personnel policIes. Apply to: Per-
sonnel Director. Notre-Dame Hosp,tal. P O. Box 850.
Hearst. Ont.

MARCH 1974

ONTARIO

REGISTERED NURSES FOR GENERAL DUTY. I.C.U..
C.C.U. UNIT and OPERATING ROOM required for
fully accredited hospllal Starting salary 569700 with
regular Increments and with allowance for experi-
ence Excellent personnel policies and temporary
residence accommodation available. Apply to The
Director of Nursmg Kirkland & Dlstnct HOspital
Kirkland Lake Ontario P2N IR2

REGISTERED NURSES; Experienced genera' duty
nurses required for 28 bed General Hospital In North-
West Ontario Monthly salary schedule under review
experience recognized Nurses Residence provides
Indl\lIdual self-contamed furnished apartments at
minimal rental rate. Apply to the Director of Nursing.
General Hospital. Mamtouwadge Ontano Telephone
8263251 (are" code 807).

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS for 45-bed Hospital. Salary ranges
Include generous expenence allowances R.N.'s
salary 5680 to 5700. and R N A s salary 5
90 to 5565
Nurses residence
private rooms with bath - $40_
per month. Aoolv to: The Director of Nursing. Gerald-
Ion District Hospital. Geraldton Ontano POT 1MO

REGISTEREO NURSES for GENERAL DUTY and lor
INTENSIVE CARE NURSING. Salary and benefits
comparative with other areas Includes 20 days Va-
cation shift rotation reqUired Residential accommo-
datron available Apply to Director of Nursing. Hunts-
ville District Memonal Hospital Huntsville Muskoka
Ontario

LAURENTIAN UNIVERSITY inVites appllcanls for
the 1974
75 sessIOn to teach m all clinical nursmg
fields In a School of Nursing offering preparation
toward a B Sc N Degree Opportunity to participate
In designing a new nursing curnculum In a young
and growmg university which serves North Eastern
Ontano_ Master s qualifications In clinical specialty
preferably. Salary and rank commensurate with
qualifications and expenence. Bilingual (Ef)Qllsh..:.
French) preferred Apply to MIss Alma E Reid
Actmg Director School of Nursing Laurentian Uni-
versity, Sudbury, Ontario

OPERATiNG ROOM TECHNICIAN required for fully
accredited 75-bed Hospital. You will be In the
Vacatronland of the North, midway between Thunder
Bay, Ontarro and Wlnnrpeg, Manrtoba. BasIc wage is
$471.50 with conSideration for experience. Write or
phone the. Drrector of Nursing, Dryden District
General Hospital. Dryden. Ontarro.

Overnight camp In Ontario (near Ottawa) reqUires
FULL-TIME NURSE from June 26 - August 14 1974.
For information contact D Eln Dar. 272 COd sell
Avenue Downsvlew Ontario M3H 3X2. Telephone
office area code (
16) 63'.2511 Evenings - (
16)
221 .2
22

SUMMER COED CAMP small famlly.type situatIOn
Northern OntaJlo appro)!. 80 campers ages 14 to 16
requires UNMARRIED RN-7 wks .June 24 to Aug 12
Health Centre accommodatron Wrrle Or phone CAMP
SOLELI M 588 Melrose Avenue TORONTO Ontario
M5M 2A6 or (416\ 781.5156

QUEBEC

REGISTEREO NURSE required for co-ed children s
summer camp In the Laurentlans (seventy miles north
of Montreal) from June 21 1974 until August 20 197

Call 51
.688.175J Or write Camp Maromac
548
8th Street Chomedey Laval Quebec H7W 2A

REGISTERED NURSES with experience required Im-
mediately for Nursing Stations In English speaking
villages on the North Coast of Quebec Transporta.
tlOn of patrents to hospital of Blanc Sablon by ambu.
lance helicopter Applicants must be registered or
eligible for registration m Quebec Salary as approved
by Q HIS Recogmtlon for experience AdditIOnal
Isolation allowance 525 weekly Residence accom-
modation m Nursmg Stallons 525 monthly Please
forward application and curriculum vitae to Louise
Gobeli Director of Nursmg. Notre-Dame Hospital
Lourdes du Blanc Sablon Cte DuplessIs. Quebec

IF YOU WANT TO FEEL LitlE A PERbON CONTRIB-
UTING TO THE COMMUNITY AND NOT JUST A
MEMBER OF IT we need GENERAL DUTY NURSES,
lor a modern progressive 255-bed General Hospllal
In the West end of Montreal Applications will be
welcomed at Queen ElIZabeth Hospital of Montreal.
Nursmg Personnel. 2100 Mar'owe Avenue. Montreal
260. Quebec.

MARCH 1974

I I

SASKATCHEWAN

COLLEGE OF NURSING. UNIVERSITY OF SAS-
KATCHEWAN. LECTURER or ASSISTANT PROFES-
SOR Faculty members required to leach in several
clinical nursmg fields maternal-child nursing
intenSive care nursmg and community nursing
Master s degree In clinical specialty preferred
Teaching responSibility In basIc B S N program and
the B S N program for registered nurses Apply to:
Dean. College of Nursing. Unrverslty of Saskalch.
ewan Saskatoon Saskatchewan S7N OWO by May
1.1974.

UNITED STATES

R.N.'s - SOUTHERN CALIFORNIA - Immediate need
eXists for medlcal-surglcat 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 Callfor-
ma Board of Nursing Education and Registration to
practice nursmg in California pnor to 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 requrres REGISTERED
NURSES for 50-bed hospital Working visa readily
available after January 1st 1974. Transportation one
way can be obtamed Please write directly to the
Admmlstrator. Monte Vista General Hospital Monte
""sta, Colorado 81144 or call Calgary 271.2502 aller
5p.m

RN's and LPN's - Unrverslty Hospital North, a
teaching Hospital of the University of Oregon Medical
School, has openrngs In a variety of HosPital ser-
vices. We offer competitive salaries and excellent
fringe benefits. Inquires should be directed to. Gale
Rankin, Drrector of Nursing, 3171 S W. Sam JackSOn
Park Road. Portland. Oregon 97201

TEXAS wants you! If you are an RN, experrenced or
a recent graduate. come to Corpus Christi. Sparkllilg
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 onentation.
Salary from $682.00 to $940.00 per month. com.
mensurate with education and experience. Differential
for evemng shifts. available. Benefits rnclude holi-
days. sick leave. vacations. paid hospitalizatIOn
health life Insurance, pension program Become a
vital part of a modern up-to-date hospital. wnte Or
call collect John W Gover. Jr. Director of Per-
sonnel. Memollal Medical Center POBox 5280.
Corpus ChrlSIr. Texas 78405

II

AUSTRALIA

WESTERN AUSTRALIAN SCHOOL OF NURSING-
PRINCIPAL Appllcalrons are invited lor the POSI-
tion Of PRINCIPAL of a new IndePendent school of
nursing The new school will be the first of ItS kind
m Western Australia and will be associated with a
mator teaching hospital of over 1.000 beds Add.lronal
clinical experience IS also obtamable at other
metropolitan and regional hospitals The School IS
designed to cater for 1.100 sludents and will be an
Independent orgamzatlon controlled by a Committee
of Management. The Principal will be chief executive
officer A new bUilding will be completed by April
1975 Nurse educaliOn programmes to be conducted
by the school will compllse the hospltal.based di-
ploma course In general nursing. nursmg aide trammg
and post graduate and post-registration COurses.
Candidates are required to possess a sound knowl-
edge of nursing principles and practices a higher
quallhcahon m education Or an allied subject to-
gether with admlnlstratrve experience Salar
: 513.160
per annum Memorandun of information IS available
on request Applications stating age quallflcallons.
eJtpenence and the names and addresses 01 two
prolesslonal referees together with a recent photo
graph should be forwarded to the Chairman. Interim
Committee of Management. Western Australian
School 01 Nursing c/o Royal Perth Hospital Perth
WESTERN AUSTRALIA 6000. The closing date is
22nd March. 1974.

FACUL TV
POSITIONS

Open for clinical elperts
10 teach in \he
undergraduale programs.

COMMUNITY HEALTH NURSING
MENTAL HEALTH NURSING
MEDICAL-SURGICAL NURSING
OBSTETRICAL NURSING
and
CONTINUING EDUCATION

Personnel policies and salanes in accord with Umverslty
schedule based on qualifications and experienC9_

Apply In wrlflng to:
RUTH E. McCLURE, M.P.H.
Director, School of Nursing
University of Alberta
Edmonton, Alberta
T6G 2G3

UNITED STATES

J

REGISTERED NURSES - A malor hospital In Central
Washington has opemngs for registered nurses In
medical surgical and critical care departments. Pro.
gresslve Inservlce department with contmurng edu
cation program with community college Excellent
opportunity to work in acute care hospital that offers
challengmg experience m all areas of nursmg Hos
pita' located rn rural type communrty located 1
miles from MIssion Ridge Ski Area Contacl Per
sonnet Department. Cenlral Washmgton Deaconess
Hospital Wenatchee Wasrungton 98801

REGISTERED

NURSES

positionS available immediately in a 500
bed active Hospital for the following
departments, -

MedicallSurgical
o bstetri cs/Gy neco logy
Psychiatry

Excellent fringe benefits.

Apply to:

Director of Nursing Services.
The Metropolitan Genèral
Hospital.
1995 Lens Avenue,
WINDSOR.
Ontario N8W 1L9

THE CANA IAN 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 conslstmg of New LiskearO,
Haileybury, Cobalt all within 5 miles of each
other is located 90 miles from North Bay
with dally 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.Servlce Educational programmes are
provided.

Apply in writing to:
PERSONNEL DlRECTDR,
Tømiskaming Hospitals,
Hailøybury, Dntario.

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

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:
Master's 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

58 THE CANADIAN NURSE

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 1 EO.

NURSING TEACHERS
REQUIRED

For our 2 year Diploma Program.
Nurses holding a degree preferred.
Duties to commence late August. Va-
cancies in Medical - Surgical Nursing
and Psychiatric Nursing.

Please apply to:
MISS C.H.A.M. STOKVIS
DIRECTOR SCHOOL OF NURSING
ST. BONIFACE GENERAL HOSPITAL
431 TACHE AVENUE
WINNIPEG, MANITOBA. R2H 2A7

GENERAL DUTY
NURSES

- tor 360.bed acute general hospItal
- cI mlcal areas Include: - Medicine, Surgery,
Obstetrics, Paediatrics, psychiatry, Rehabill.
tation, Extended Care and Coronary Care
- B.C. Registration preferred but not mandltory
dUring mitlal employment
- Personnel policies in accordance with
RNABC Contract.

Please contact the:
Director of Nursing
Nanaimo Regional General
Hospital
Nanaimo, British Columbia

GENERAL DUTY NURSES

Required Immediately

. for 270-bed acute care general hospital
exp-anding to 370 beds
. clinical areas mclude: Medicine Surgery
Obstetrics Paediatrics Psychiatry Rehabilita-
tion Extended Care and Intensive and
Coronary Care
. Must be eligible for B.C. registration
. Personnel pOlIcies m 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

with training in Midwifery and pre-
ferably with a.R. experience re-
quired for 20-bed hospital in Labra-
dor.

Apply to:

Director of Nursing
International Grenfell
Association
Happy Valley. Labrador

WANTED

DIRECTOR OF
NURSING

The James Paton Memorial Hospital Board IS
accepting applications from qualified nurses to
fill the position of Director of Nursing.
This IS a challengmg position In a modern.
ISO-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 nursmg staff of 120 as well as
a fully-qualified team of 16 physicians.
The
a'ary for thIS po SI'IOr. IS negotiable, on
the scale $11,109. - $14,171
Applications In wrltmg statmg age. educa-
hon. trainmg. experience and references should
be forwarded to.
The Administrator
James Paton Memorial Hospital
Gander, Newfoundland
A 1 V 1 P7

MARCH 1974

DURHAM COLLEGE
OF APPLIED ARTS AND TECHNOLOGY

in\lites applicants for

FACUL TV POSITIONS
in the Nursing Department

Oualifications:
- Registration In OntanO
- University preparation In Nursing ed.Jcatlon, bac-
calaureate degree preferred
- Minimum of two years bedside nursing experience.
Responsibilities:
- Classroom teaching and dintcal supervision.
Salary:
- Commensurate with preparation and experience
with,n the CSAO range.
Starting Date:
-August 1, 1974

Direct app/icaÐons with
complete resume to:

DEAN OF ACADEMIC AFFAIRS,
DURHAM COLLEGE OF APPLIED
ARTS AND TECHNOLOGY,
BOX 385,
OSHAWA, ONTARIO.
L1H 7L7

HEAD NURSE

WANTED
IMMEDIATELY

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 field is essential.

Apply in writing to:

Director of Nursing
Trail Regional Hospital
TRAil, British Columbia

MARCH 1974

Some nurses are just nurses.
Our nurses are also
COmmissioned Officers.

Nurses are very special people In the Canadian Forces
They earn an Officer's salary, enloy 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 payor privileges Promotion IS based on
ability as well as length of service And they become eligible for
retirement benehts (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 Olrector of RecUiting and Selec-
tIOn, NatIOnal Oefence Headquarters, Ottawa. Ontano KIA OK2

,
{

:

"'
E

.

Cet involved with the
canadian Armed Forces_

CLINICAL NURSE SPECIALISTS

- Cardiothoracic and Neurological Sciences -

An excellent opportunity for self-directing individuals who 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

THE CANADIAN 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
Reg i stration.

Apply with full resume to:
The Director of Nursing
The Doctors Hospital
45 Brunswick Avenue
Toronto, Ontario
I 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 1CO

60 THE CANADIAN NURSE

REGISTERED NURSES
GRADUATE NURSES

and

REGISTERED NURSING ASSISTANTS

required for

FIVE SUMMER CAMPS
Strategically located throughout Ontano
and near
OTTAWA. LONDON. COLLINGWOOD. PORT
COLBORNE. KIRKLAND LAKE
(accredited members - Ontano Camping
ASSOciation)
Applications Invited from Nurses Interested In
supervisory assistant and general cabm
responsibilities In the held of rehabilitation of
physically handicapped children
Apply in wrihng 10:
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.A. 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
Chilliwack 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 main I BO.bed accredited hospital is
situated at SI. Anthony. Newfoundland. Active
treatment IS carned on in Surgery, Medicine,
Paedlatrrcs, Obstetrics. psychiatry. Also.
Intensive Care Unil. OrientatIOn and In.Servlce
programs. 40.hour week, rotating shifts. LIving
accomodatlons supplied at low cosl. PUBLIC
HEALTH has challenge of large remote areas.
Excellent personnel benefits Include liberal
vacation and sick leave. Salary based on
Government scal es.
Apply to:
INTERNATIONAL GRENFElL ASSOCIATION
Assistant Administrator of
Nursing Services,
St. Anthony, Newfoundland.

THE SALVATION ARMY GRACE
GENERAL HOSPITAL
anvites applicalron for
REGISTERED NURSES
in the
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 for the position of
Director of Nursing Services for an active
222-bed general hospital In the Okanagan
Valley The position will be available on the
summer 01 197

The hospital has undergone a recent major
expansion and complete renovation and ope-
rates extended activation psychlatnc mten.
sive and coronary care programs
Applications should be In wrltmg provldmg
details of education expenence references
age and mterests. and be addressed to

Administrator,
Penticton Regional Hospital,
Penticton, B.C.

DIRECTOR OF NURSING

Applications are invited for this posi-
tion in a 167-bed fully accredited hos-
pital.
Individuals possessing a BSc in Nurs-
ing and experienced in Nursing Ad-
ministration who are interested are
requested to supply a short 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 1 KO

MARCH 1974

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VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA
fhe
Iaritimes' largcst tcaching hospital. has immediate
openings for Registcred Nurses. Certified Nursing Assistants
and Orderlies. Positions are available in Special U nits and
for general nursi ng duties. It is the principal adult teachi ng
hospital of Oalhousie University and also opcrates a large
school of nursing.
SAI ARY:
Commensurate with 4ualifications and experience.
SPECIAL LNIT NLRSES $8170-$9582
REGISTEREO NURSES $7816-$9229
CERT. NL RSING ASSISTANTS $5626-$7180
NURSING OROERLIES $4991-$6333
BENEf-ITS:
Full Civil Service Bcnefits. including three wceks vaca-
tion. four wecks after 5 vears of service and shift diffc-
rent ial. -
For further information and/or application forms. please
contact:
Pcrsonnel Office,
Victoria General Hospital,
Halifax. "Jova 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 throughout the year in a variety
of areas. If you are contemplating a change. write us indicating
your ar eas of interest and exp erti se.

Mr. R.E. Capstick
Manager, Employment & Staff Relations
McMaster University Medical Centre
1200 Main Street West
HAMILTON. Ontario
L8S 4J9

MARCH 1974

GOOD NURSING
POSITIONS
OPEN IN
SUNNY TEXAS

COME TO PRESBYTERIAN HOSPITAL
OF DALLAS

Presbyterian Hospital of Dallas in Dallas
Texas, has openings for both 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
HIE CANADIAN NURSE 61

SUPERVISOR OF NURSING REQUIREO FOR A
COMMUNITY SPONSORED HEALTH & SDCIAL
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 1WO.

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 dailv 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

62 THE CANADIAN NURSE

nurses

who want to

nurse

At '\ ork Central you can join
an active. interested group of
nurses \\ ho want the chancc to
nurse in its broadest sense. Our
I 26-bed. fully accredited hospi-
tal is YOllJ1g. and already expand-
ing. ;\iursing is a profession we
re
rect and
we were the first to
plan and dnclop a unique nurs-
ing audit system. I'here arc
opportunitie<; for gain ing wide
experience. tor getting to know
patients as well as staff.

Situated in Richmond Hill. all
the cultural and entertainment t
t-
cilities of Metropolitan Toronto
arc 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 arc needed and will be made
welcome.

Apply in person or by mail to the
Director of :\ursing.

YORK
CENTRAL
HOSPIT AL

RICH\10
D HILL
O:\TARIO

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
M
ci
, .
BasIc 2 week Onentatlon 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 0 0
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 community orientated General Hospital
with expandmg programmes Approximately
.100 nUrSI ng personnel
Duties will Include planning. dlrectmg 1m
plementmg and evaluating educallonal pro-
grammes for all levels of nursmg personnel
focusmg on the patient as a person. a mem-
ber of the family and the community
Salary and Frmge Benefits commensurate
Must nave
Masters Degree m Nursing
Expenence In contmumg education
Eligibility for Ontario Registration

Write:

The Director 01 Nursing
The Doctors Hospital
45 Brunswick Avenue, Toronto. Ontario
OR PHONE: 416-923-5411

MARCH 1974

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VICTORIA GENERAL HOSPITAL
HALIFAX. NOVA SCOTIA

The :\Iaritimes' large.,t ho"pital. has immediate openings for
Clinical Nursing Supervi"or,. It i, the principal adult teach-
ing hospital of Dalhousie Univcrsit} and also operates a
large school of Nursing.
SAI ARY: $1 1.5 nO - $\3.537
CI INICAI NLRSING SLPERVISORS
A I\la.,ters Degree is preferable but candidates with a
Bachelors' Degree would be given consideration, 3 years
experience. I of which was at the supervi,ory level is
required. Courses in Clinical Special it} Nursing. especially
in \lcdical or Surgical Nur.,ing would he considered.
BFNEFITS:
Full Civil Service Benefit.,. including three weeks vaca-
tion and four wed.., after five vears ofscrvice.
Competition is open to both n1en and women.
For further information and/or application form,. please
contact:
Personnel ültice.
VictorIa General Ho'pitdl.
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 from $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 OA1

MARCH 1974

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vvarm

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somebody
cares.

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---------

I I. f M I

.
__ '}.., edical Services Branch
I I'
' Department of National I
I" Health and Welfare
I , Ottawa, Ontario Kl A OK9 I
I I
I Please send me more mformatlon on nursing I
I opportunities in Canada
s Northern Health Service I
I Name: I
I Address: I
City: Prov: _

----------_____J
I .. Health and We/lare Santé e! B.en êlre socIal
Canada Canada

THE CANADIAN NURSE 63

Certificate In Tropical
Community Medicine & Health

This three.months course, held twice a year, is specifically designed
for non.physician 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 i,l these areas.
Participants are integrated with physicians attending the Diploma
m 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 sti{!ents.
A Cerllf,cate 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.
ponslbllity of the student. The School may be able to advise on ob.
taining accommodation.
A prospectus and application form may be obtamed from the Admm-
Istrative Secretary, The School of Tropical Medicine, Pembroke Place,
liverpooll3 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 knowledge of
French would be an asset.

Direct applications to:

GENERAL MANAGER
MONTREAL CONVALESCENT HOSPITAL
3001 KENT AVENUE
MONTREAL, QUEBEC
H3S 1M9

64 THE CANADIAN NURSE

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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 Umt, 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.
. Drientati on and on-goi'1l staff education.
. Progressive personnel policies.
The hospital IS located m 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 m
need m Africa, Peru and the Dominican Republic
proclaiming Christ's love by care and preventIOn.
teaching and development programs
to share their common hfe of prayer and work In a
spirit of openness to God and the needs of others

R.S.V.P. FORMATION CENTER
438V2 College SI.
Burlington, Vermont
05401

FORMATION CENTER
4 Toronto Street,
Ottawa, Ontario.
K1S ON2

MARCH 1974

2

DB or TB

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I\CCOMMODATION FOR 1974 ANNUAL MEETING CNA WINNIPEG MANITOBA JUNE 16.21

HOTEL RATES

ORTHSTAR INN
'88 Portage Ave.,
Vlnnipeg, Manitoba

3C OB8
-JOTEL FORT GARRY
Vinnipeg, Manitoba

3C OR3

$24 00 - $28 00

$30.00 - $34.00

$24.00

$30.00

VINNIPEG INN

Lombard Place
Vinnipeg, Manitoba

2B OY3

$23 00

$29.00

vices are progressive!

.R-Single Room DB-Double Bed TB-Twin Beds

eaistrants will make their own reservat,ons by wnt.ng directly to the above addresses.
300k early to aVOId disappointment'

REQUIRED
IMMEDIATEL Y

So

.

IS nursing

For a 58-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

at

For further information contact:
Administrator
Foyer Notre Dame Inc.
Notre Dame de Lourdes,
Manitoba ROG 1 MO
Telephone: 248-2092

The Montreal General Hospital

a teaching hospital of McGill University

REGISTERED NURSES

Come and nurse in exciting Montreal

for

GENERAL DUTY

r-------------------------------.

for
General or Specialized wards includ-
ing O.R. for SSG-bed hospital on Uni-
versity Campus.
Team or Unit Nursing
Liberal fringe benefits

!

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The Montreal General Hospital
1650 Cedar Avenue, Mantreal, Quebec HJG IA4

Please tell me about hospital nursing under Quebec's new concept of Social and
Preventive Medicine.

for further information please
contact:
Employment Officer, Nursing,
University Hospital,
Saskatoon, Sask.

Nome

Addren

Quebec language requirements do not apply to Canadian applicants.

L-----------____________________J
THE CANADIAN NURSE b3

MARCH 1974

Certificate In Tro

Community Medicine!

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 1
with the nature 01 Health Care practices and problem
Participants are integrated with physIcIans at!
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 stëöents.
A Certillcate in Tropical Community Medicine an
by the Incorporated Liverpool School of Tropical 1\1
tory completion of the course and examination.
The course lee is normally f 56.50 which
examination. Accommodation is an additional exp'
ponslbility of the student. The School may be at
ta ini ng accommodation.
A prospectus and application form may be obtai
Istratlve Secretary The School 01 Tropical MedicI
LiverpoolL3 5QA, England.
Early application lor 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.

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 knowledge of
French would be an asset.

Direct applications to:

GENERAL MANAGER
MONTREAL CONVALESCENT HOSPITAL
3001 KENT AVENUE
MONTREAL, QUEBEC
H3S 1M9

f.4 THF CANAntAN NURSE

- I................... _.......... ........... r-' .'__r_ w ...

. Orientation and on-goi'1l 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.

Þ1

Vim . " .
W

THE RELIGIOUS
HOSPITALLERS
OF SAINT JOSEPH

INVITE YDU

to share their 300 year heritage 01 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 prevenllon,
teaching and development programs
to share their common life of prayer and work In a
spirit 01 openness to God and the needs of others

R.S.V.P. FORMATION CENTER
438V2 College SI.
Burlington, Vermont
05401

FORMATION CENTER
4 Toronto Street,
Ottawa, Ontario.
K1 S ON2

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
IMMEDIATEL V

For a 58-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 1 MO
Telephone: 248-2092

REGISTERED NURSES

for

GENERAL DUTY

for
General or Specialized wards includ-
ing a.A. 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.

MARCH 1974

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Quebec's Health Services are progressive!

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nursing

at

The Montreal General Hospital

a teaching hospital of McGill University

Come and nurse in exciting Montreal

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The Montreal General Hospital
1650 Cedar Avenue, Monlreal, Quebec H3G IA4

Please lell me aboul hospilal nursing under Quebec's new concepl of Social and
Preventive Medicine.

Name

Addren

Quebec language requirements do nol apply 10 Canadian applicants.

L_______________________________J
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 M5P 1C1

WE CARE

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HOSPIT AL:
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,
NEW MARKET. Ontario.
L3Y 2R1
66 THE CANADIAN NURSE

Cheque out
a cri
plpd chid
lOday.

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See what yaur dollars can do.
Support Easter Seals.

UNIVERSITY OF
ALBERTA HOSPITAL

EDMONTON, ALBERTA

invites applications from general duty nurses

Opportunities for Professional development m
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

MARCH 1974

SHERBROOKE HOSPITAL

SHERBROOKE,QUEBEC.
invites applications from

REGISTERED NURSES
GENERAL DUTY

138-bed 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.

QA
ORTHOPAEDIC k ARTHRITIC
HOSPITAL
'V IV

43 WELLESLEY STREET, EAST,
TORONTO, ONTARIO
rJl4V 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

MARCH 1974

Join our team at
Sunnybrook
Medical Centre-
and grow!

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· 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

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THE CANAOV<N NURSE 67

OPERATING ROOM
NURSES

- required for 270 bed acute care
hospital
- expanding to 370 beds
- must be eligible for S. C. registration
Personnel policies in accordance
with RNASC 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 to
carry out a generalIzed programme In rural
areas of the province.
Applicants should have a baccalaureate de.
gree wIth a malor or a diploma In public health
nursmg
Salary and frmge benefits In accordance with
the collective agreement of the AssociatIOn of
Registered Nurses of Newfoundland and appll.
cants should be eligible for registration In the
aSSoCiatIOn
For application forms and/or further mforma-
tlon 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 qualified 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
V1 T 5L2

68 THE CANADIAN NURSE

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

MARCH 1974

The George Brown College of Applied Arts
and Technology

Requires

REGISTERED NURSES

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 Westem Hospital
and Nightingale into a division of the College. The division
will offer diploma nursing, affiliate and graduate programs.

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.

The appointment will be made no later than Septem-
ber 1, 1974.

For an interview please contact:

Interested applicants should forward resumes by
April 15,1974 to:

Director of Personnel,
P.O, Box 1015,
Station B,
Toronto, Ontario,
M5T 2T9.

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 6q
.

DIRECTOR OF NURSING

TORONTO
GENERAL HOSPITAL

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
Uni versity.
Qualifications
Ehglbl e 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.

Invites applications from

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS
FOR GENERAL DUTY

Salary: According to qualifications and experience.

- Superior opportunities for Professional Growth
and Development.
- Progressive Personnel Policies.
- Excellent opportunities for advancement in
atmosphere of medical excellence.

Please apply in writing with a resume stating full
details of education and experience to:

Please apply to:-

The Administrator
Abbie J. Lane Memorial Hospital
5909 Jubilee Road
Halifax, Nova Scotia
B3H 2E2

Personnel Office
TORONTO CENERAL HOSPITAL
101, College St..
Toronto, Ontario,
M5G 1L7.

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!JfJl Hospital

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

This 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 will have over-all responsIbility for a
staff of ten. and will answer directly to the association's
seven-member governing council.
Salary range: $15,000 - $17,000 per annum.
Qualifications: 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 - 1100 Broadway Avenue
Regina, Saskatchewan
S4P 1 E3

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 Nursmg
General & Marine Hospital
1201-6th Avenue West
Owen Sound, Ontario
N4K 5H3

HEALTH
SCIENCES
CENTER

WINNIPEG,
MANITOBA

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THIS 1345 BED COMPLEX WITH ITS SEVERAL AMBULATORY CARE
CLINICS. AFFILIATED WITH THE UNIVERSITY OF MANITOBA
CENTRALLY LOCATED IN A LARGE, CUL TURALL Y ALIVE
COSMOPOLITAN CITY.

INVITES APPLICA TrONS FROM
REGISTERED NURSES SEEKING PROFESSIONAL
GROWTH. OPPORTUNITY FOR INNOVATION, AND JOB
SATISFACTION.
ORIENTATION - Extensive two week program:.lt full salary
ON-GOING EDUCATION - ProvIded through
actIve in-service programmes in all patient care areas
opportunity to attend conferences, institutes, meetings of professional
association
post basic courses In selected climcal specialties
PROGRESSIVE PERSONNEL POLICIES
salary based on experience and preparation
paid vacatIon based on years of service
shIft differential for rotating services
to statutory holidays 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 R3E OZ3

MARCH 1974

THE CANA
IAN NURSE 71

I nd ex
to
Advertisers

March 1974

Astra Pharmaceuticals Canada Ltd. ........................................................53
Bic Pen (Canada) Ltd. ............................................................................. 43
CI inic Shoemakers.... ....... ..... .... ....... ... .... ...... .... ............................ ....... ......2
Davol Can ada Ltd. ............. ............ ......................................... .................. 6
Department of National Defence ............................................................. 59
Hall ister Limited......... ................... ..... .................. ......... ..... ................... 37
J .B. Lippincott Company of Canada, Ltd. ................................................. I
Mont Su tton I ne. ..................................................................................... I 0
c.Y. Mu
by Company. Ltd. .................................................. 45. 47.49.51
Procter & Gamble .................................................................................. 13
Reeves Company .............................................................................. 14, 15
William H. Rorer. (Canada) Ltd. ............................................................ 16
Rosehilllnstitute of Human Relations .................................................... 52
Schering Corporation Limited ................................................ 72. Cover IV
Westwood Pharmaceuticals ......... ..... ........n...... ......... ......................, ....... 55
\\ hite Sister Uniform. Ine. ................................... 5, II. Cover ll. Cover III

A eh'crt i.\;'IX MllIlliXa
Georgina Clad...e
The Canadian Nurse
50 The Driveway
Otta\\a i\.2P I E2 {Ontariu}

A clverfisinR RepreSenlallVeS
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003
I ekphone. (215) \1id\\a) lJ-14lJ7

Gordon Tiffin
2 Tremont Crescent
Don Mills. Ontario
1dcphonc. (416) 444-4731

Member of Canadian
Circulations Audit Board Inc.

GæE

72 THE CANADIAN NURSE

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.
A vailable in blisters ofl2
and 24, and bottles of 100 tablets.
Coricidin 'D' Medilets: Each orange-
pineapple-flavored multicolored tablet contains'
0,5 mg chlorphemramme maleate L' S P.,
80 mg acetylsalicylic acid and
2,5 mg phenylephrine HC\.
Available m boxes of 24 Medilets m a
child's protective package
INDICATIONS:
Symptomatic relief of nasal congestion and
other discomforts associated with smusitls.
colds and allergic or vasomotor rhinitis
CONTRAINDICATIONS:
Sensitivity to any of the components.
patients receivmg MAO mhlbltors
PRECAUTIONS:
Admlmster with caretopatlents 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 machmery until
their response to the drug has been deter-
mined. Smce the depressant effects of anti-
h,stamines are additive to those of other
drugs affecting the central nervous system,
patients should be cautioned against drink-
ing alcohohc beverages or taking hypnotics.
sedatives, psychotherapeutic agents or other
drugs wIth CNS depressant effects during
antihlstammlc therapy
Rarely. prolonged therapy with antihista-
mine-contammg preparations can produce
blood dyscrasias

ADVERSE EFFECTS:
Drowsiness, dizziness. nausea. increased
Irritability or excitement may be
encountered.

DOSAGE:
Coricidin 'D': Adults: I tablet every 4
hours, not to exceed 4 tablets m 24 hours.
Children 10 to 14 years: 1/2 adult dose:
under 10 years: at discretion of physician.
Coricidin 'D' Medilets: 2 to b years:
1/4 to I Medilets: 7 to 12 Y"ars: I to 2
Medilets. Each dose may be repeated every
3 to 4 hours, hut not more than 4 Medllets
should be given m one day to children 2 to
6 years, and () Medilets to children ì to Il
years. Limit treatment to 3 days The recom-
mended dosage should not he exceeded
except on a physician's advise

DetaIled mfurmatlon IS aVBllable on
request
SCHERING CORPORATION LIMITED
Poínte Claire. Quebec H9R IB4
I P......AC )

MARCH 1974

e 2465
yale Corded" Tricot Knit
s 10-20
te ............................ $26.00
ow.......................... 527.00

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\AKES IT EASY
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yale Rib" Tricot Knit
or Length
!s 3-1 5
te only
00

HOP IN PERSON AT OUR
BAY STREET STORE
IR WRITE TO OUR MAIL
DER DIVISION FOR A NEW
CATALOGUE

<'
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UNIFORM SPECIALTY
1254 BAY ST.
(Just above Bloor) TORONTO

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yale Oxford" Tricot Knit
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yale Corded" Knit
and Yellow
00

MAIL ORDER DIVISION
372 Queen St. W.
Toronto, Onto M5V 2A3
Please send all mail orders to
above address r phone 366-1414
for f;Jst sprv. c::p

I SCHERING

Howto1tatch"a cold.

"-
--

- urprise a cold right at its onset with'
Coricidin '0' for adults and Coricidin '0'
Medilet
,': for children. You can recom

mend these products knowing they will
provide relief from aches, pains and
fever plus decongestant action,
Coricidin '0' and Coricidin '0'
Medilets c
ntain Chlor
T ripolon::
one of the world's most widely used
antihistamines: phenylephrine, a
highly effective decongestant and acetyl

salicvlic acid for aches, pains and fever.
The adult form contains caffeine as a mild
stimulant to keep your patients on the go.
COriCidin'D

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MISS MRA LOYER
158 GUIGUES ST
OTTAWA KIN 5H9 00056886

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"""ITE
SISTER

WH ITE
SISTER

HAS THE
SIMPLE
DIFFERENCE

A) Style # 42871
"Royale Oxford"
Junior Length
Sizes 5-15

White only
About ................ 520.0

B) Style # 2358
"Royale Rib"
Missy Length
Sizes 8-18

White only
About ............................ $24.(

C) Style # 2456
"Royale Corded"
Sizes 8-18

White ................ about $27.(
Navy.................. about $29.(

CAREER APPAREL AT FINE STORES ACROSS CANADA

c:;

new Bookl
now Info.mation

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Serving the health professions in
Canada since 1897
J. B. Lippincott Co. 01 Canada Ltd.
75 Horner Ave.
Toronto, Ontario M8Z 4X7
Representing in Canada:
Little Brown and Company
Blackwell Scientific Publications Ltd
Springer Publishing Company, Inc.

New - Third Edition
BASIC PSYCHIATRIC CONCEPTS IN NURSING
This thoroughly revised edition provides sharper focus on the dynamics 01
the nurse's role and function, and is designed to lacilitate the student's
progress from the theoretical to the operational level. Proceeding Irom 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 sell 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 Health Center;
Charles K. Holling, M.D., Sf. 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, Sf. Louis;
William D. Snively, Jr., M.D., F.A.C.P., University of Evansvi/le School of
Nursing and Indiana University School of Medicine.

CURRICULUM AND INSTRUCTION IN NURSING
Nursing educators are keenly 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

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BUILDING ON A CENTURY OF QUALITY , ' C -v; . ."""" . 1874-1974
HEALTH CARE PRODUCTS
"'" A ')

KK'

The
Canadian
Nurse

ð

A monthly journal for the nurses of Canada published
in English and French editions by the Canadian Nurses' Association

Volume 70, Number 4

April 1974

21 CNA Ticket of Nominations

31 CNA Financial Report and Auditor's Statement

36 CNA Convention Program

38 Nurses Break the Ice . . . .

42 Maternity Patients Make Decisions

45 Idea Exchange

. . H. L. Brigstocke

.M.B. Ratsoy

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r.:p..:-..:nt th.: Pt-,Iici.:, or vi.:", ofth
Canadian '-ur,c,' \"ocialloll.

4 Letters 9 News
47 Dates 48 Names
50 Accession List 72 Index to Advertisers

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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 otherwise 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.)
Brief 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:

...,
t! q;
t
y

..

. \

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

APRIL 1974

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 Duff\'. Reg.N.. Ðo;ion.
Quehec.

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 eval'üation?
Some authors seem to use the term
"problem-solving" in somewhat the
same way as B.F. Skinner uses the term
"conditioning," in making reterence 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 s
econd is insight - the
discovery of meaningful means-end rela-
tionships. Translating this to classroom
activity. problem-solving can constitute a
fonn 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 tu 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-
soh ing technique to find the
answer. - Jane C. Halihurton, Director
of Education. Yarmouth Regional Hospi-
tal. Yarmouth, Nova Scotia.

Comments on problem-solving
Bravo to ,\ teacher who puhlicly I'C-
quests the help of clinicians in devel-
oping relevant educational content
("The Prohlem-Sob" ing fechnique. Is
It Relevant to Practice'.'" January
IlJ74). Educators "uch a" Barbara
Geach help hridge the practice-theory
gap by "tressing the interdependence
hetween the two worlds.
I feel. howevcr. that the request fÒr
documentation of the usefulne"s of
problem-solving per se may be un-
realistic Problem-solving is an ongoing
process and is thus dilTi
illt to de
crib

in writing. Nursing care plans and the
problem-oriented medical record show
the results of clinical problem-solving,
and clinicians such as Marlene Mayers
do write about the ellcctivene"s of
these tools. I wonder if Ms. Geach is
looking in the wrong place for valida-
tion.
Changing students' attitudes toward
this "cerehral activity" will be more
difficult than simply reassuring one-
self that it is a meaningful process.
Nur"e educatol"; may use the terminol-
ogy of problem-solving. hut it is my
concern that thi" complex process may
not be well understood hy them - a
complication that would profound I)
affect their tcaching of that process. I
suggest that the writer's appeal for help
"hould not onlv be directed toward
cl inician". hut ,
so to\\ ard researchers
\\ho arc stud) ing the proee"s of proh-
lem-soh ing. - Je.nie 1
lal1tle. As.\o-
ciate /'/"(!/l'.HOr, Ihe Unil'eni,y eJf West-
ern Ontario. London. Ontario.

Author replies
It was pleasing to get such a rapid

esponse to my article, although sadden-
mg 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
because 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-
sol ving." one must concl ude 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 descrihe 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 he
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
(Collllllu"d 0" flag.. f>)
APRIL 1974

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letters

(Contilluedfrom page 4)
in action. in many context!>. and
"operationalized" in tenns of the experi-
ence of clinicians. - Barbara Geach,
Assistant Professor, University of Con-
necticut, Wallingford.

Nursing journal is now quarterly
In 1973. NUl".\ing 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 nur!>ing 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. th
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. - Vi\'ian Geeza,
Managing Editor, School of Nursing,
McGill University, 3506 Universitv
Street, Mo/ltreal, Þ.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 "northem" 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 detennine
the number of credits allowed toward a
degree.
The nur!>ing 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 Platt, RN, Win-
nipeg, Manitoba.

Comments on gonorrhea
I read with interest the comments con-
cerning the international ,
mposium
on gonorrhea (Decem her Ilr .
. pages
15-16). Two statements concern me.
First. the Women's Self-Help Clinic
does not encourage women to treat
themselves. hut rather educates \\omen
ahout tlll:ir hodies and ahout health.
The ohiective is to prov ide \\ omen with
"nowledge ,0 that the) "nO\\ when to
see" medical attention and are able
to participate in the re,olution of an
illnes, stage. In this dinic. \\omen hdp
women. and a female physician is
always present.
Second. I stressed that the provincial
\ D Clinic in VancoU\er i.; one of the
few. if not the only. VD clinics run hy
nurses. We rely a lot on puhl ic health
nurses to carry out the \ D program IÙr
the rest of the province. hulli Rui-
terman, Di\'i
ion (
( V f) CO/lfrol, Ðe-
partme/lf (!( Hcalth SC/Ticn, VW/('O/l-
\'('1', Briti
h Columhia.

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 edch 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 mayor
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, SecretaI')' of State Depart-
ment, Ottawa. ?

Regi
tered nu"c
.
your community nec'Js
the benefit of your
skills and experience.
Volunteer now to.
tca,h 51. John Ambulance home
nu"ing and child care course
.
('on'aer your Provincial Headquarters,
S'. John Ambnlance.

APRIL 1974

& . . . . . . . . . ..

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surgery: and (2) life-threatening arrhythmia",. par-
ticularly thoilie which are ventricular in origin. such
as occur durmg acute myocardial infarction.

CONTRAINDICATIONS-Xviocaine IS contra-
indicated (I) in pallents with a known history of
hypersen\itivil} to local anesthetics of the amide
type: and (2) in patients with Adam<iò-Stoke<;; syn-
drome or with severe degrees of sinoatrial. atrio-
ventricular or intraventricular block_

"'AR:"tII"'IGS -Constant monitoring with an elec-
lrocardiograph is essential In the proper adminis-
tration ofXyloeame intravenously. Sign!!. of exces-
sive depression of cardiac conductivily. such as
prolongation of PR interval and QRS complex
and the appearance or aggravation of arrhythmias,
!hould be followed by prompt cessation of the
intravenous infusion of this agent. It is mandatory
10 have emergency resuscilative equipment and
drugs immediately available to manage pos...ihle
ddverse reacliuns mvulvlng the cardio\'ascular.
respiratory or central nervous systems.
Evidence for proper usage in children is limited.

PRECAl'TlONS-Cau'ion should be employed
in the repealed use of Xyloeaine in patients with
severe liver or renal disease because accumulation
mayoccur and may lead to toxic phenomena. since
Xvlocaine is metabolized main Iv in the liver and
excreted by the kidney_ The drug should also be
used with caution in patients wilh hvpovolemia
and shock. and all forms of heart block (see CON-
TRAINDICATIONS AND WARNINGS).
In patients with sinus bradycardia the adminis-
IratlOn ofXvlocaine intravenously for the elimina-
tion of ventricular ectopic beat.. withoUI prior
acceleration in heart rate (e_g_ bv isoprolerenol
or by electnc pacing) may provoke more frequent
and ...erious ventricular arrhylhmia...

AÐVERSE REACTIONS Systemic reactions of
the following tvpes have been reported_
(I) Central Nervous System: lightheadedness.
drowsiness: dizziness: apprehension: euphoria;
tinnitus; blurred or double vision; vomiting: sen-
sations of heal. cold or numbness: twitching:
tremors: convulsions: uncon
l.iousness: and respi-
ratory depression and arrest
(2) Cdrdiovascular System: hypotension: car-
diova...cular collapse: and brad\'cardla which may
lead to cardiac arre...t
There have been no reports of cross sensitivity
between Xylocaine and procainamide or hetween
Xylocaine and quinidine.

UOSAGE: A:-.iO AO'\1INISTRATlO"l Sin
le
Injection: The usual do..e is 50 mg to 100 mg
admimstered intravenously under ECG moni(Or-
ing_ This dose may be administered at the r3tc
of approximdtely 25 mg 10 50 mg per mlnule_
Sufficienilime should be allowed to enable a slow
,'irculation 10 I.:arrv Ihe drug to the slle of action
If the imtlal inJel.tion of 50 mg to 100 mg does
not produce a de\lred re"pon...e. a second dose may
be repedled dfler 10-20 mlnules.
NO MORE THAN 200 '\1G TO 300 MG OF
XYLOCAINE SHOULD BE ADMINISTERED
DURING A ONE HOUR PERIOD.
In children expenence with the drug IS limlled_
Continuou!t Infusion: Following a single injecllon
in those p3t1ents in whom the arrhythmia lends
to recur and who are incapa ble of rece)\ling oral
antiarrhythmic therapy. intravenou!rl infusions of
Xylocaine may be administered al the rdte of I
mg to 2 mg per minute (20 to 25 ug/kg per minute
in the average 70 kg man). Intravenous infusIOns
ofXyloeaine must beadministered under constant
ECG monitormg to aVOid potential overdo!itage
and toxicity. Intravenous infusion should be ter-
mmated as soon as Ihe Pdtiem's basic rhvthm
appears to be stable or at the earliest ...ign... of
toxicity. It should rarely be necessary to continue
intravenous infusIOns bevond 24 hours. As soon
as possible. and when indicated. palients should
be changed to an oral antiarrh)thmlc agent for
maintenance therap).
Solutions for intravenous infusion should be
prepared by the addition of one 50 ml single dose
vial of Xylocaine 2% or one 5 ml Xyloeame One
Gram Disposable Transfer Syringe to I liter of
appropTlate solution. This will provide a 0.1%
solution: Ihat is. each ml will con tam I mg of
Xvloealne HCI. Thus I ml to 2 ml per minute
will provide I mg to 2 mg of Xyloeaine HCI 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 held on February 6, 7, and 8.
They decided not to expand services and
activities to help attain a break-even
financial statement. Further adj ustments
were left to the discretion of the CNA
executive director, Helen K. Mussallem.
The directors decided that Count-
down would no longer be printed in its
present form by CNA, effective with the
1974 issue. CNA will continue to compile
nursing statistics until another agency
takes over publication of the data. There
will be no gap in annual statistics on
nurses.
Directors voted [0 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, [0 study the

problem of the foundation's finances.
(News, December [973, 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 lIS-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 TS 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
Geraldine LaPointe. Kamloops, B.C. The
testing service committee was asked to
make nominations from which the C\IA
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 S 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 ) ear. .. The commi!lee 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 OJA
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 C!\'A 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 C:'IIA board
meetings as observers.
Directors also apprO\ed a recommen-
dation reiterating that appointments to the
testing service committee are made by the
CNA directors. Jurisdictions (licen,ingl
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 he made for the College
of Nurses of Ontario. the major non-C\lA
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 pro\ ide fÒr one R'i
representative from each pnnincial
registering/licensing authorit
. plus a rep-
resentative from a nursing assisl,Int dU-
thoritv.
. Thãt the feasibilil) of engaging In a
building program to expand facilities of
THE CANADIAN NURSE q
.

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
C:"JA 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 nor 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 L attend CNA board
meetings as observers. Affiliate member-
ship st
tus will provide for mutual sharing
of infonnation 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 II out of 15 ad hoc
committee-working part) 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 C:\IA 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 re.mh'ed that
- this method of levying fees on the provincial associations be changed;
- the fee he 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 nUße 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 perfonning medical functions. particularly in
physicians' offices. without benefit of the appropriate fonnal 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 resoh'ed 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 nun.es 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
con;ention of CNA in Winnipeg. Ju
e 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 a'ñ opportunity to become more
involved in health education programs in
the communify. 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 infonnation
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

mm he \\orn. So. get your own co,tume
read}. but ma"-e su.:ë it'\ easy to pac"-.
Then. Tue
da\. we need good weather.
as a sun
et cruise is planned. Three river
boats are alreadv boo"-ed. 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 ha\e 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. Gennans. Uhanians. Irish. and
Jamaicans. If }ou 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.
Frida". 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 A venue.
Winnipeg. Manitoba.
R3C OX2.
Deadline for reservations is April 30.

One In Five Canadians Needs
Medic-Alert Identification
Tomll{{), 0111. - "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. 19June. 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. -
H elell K. MIt
.\'CIJlem, Secretan-
Tn'(/.wrer, Calladiall Nltrsn' Foltllda-
tÙm.

APRIL 1974

tion ha
110.000 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
m
dical history. the Foundation ,ays.
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 SI.. Toronto. Ont..
M5R 2N 1.

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Glysennid. . supplied in easy-to-take tablets.
Glysennid. . clinically proven, constant potency.
Glysennid. acts systemically to help re-establish nor-
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homes, institutions

Composition: Each tablet contains 12 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 ma)(lmum
of 5 daily if required.
Contraindications: Appendicitis Intestinal hemorrhage. ulcerative
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Supply: Bottles of 100 and 500 tablets
Full product ,"formation available upon request @
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THE CANADIAN NURSE 11
.

news

Internal, External Groups
Will Study CNA Journals
Otrall'll - Canadian Nurses' Association
(C:'IJAI directors asked an internal and an
external group to study the two CNA jour-
nals. The Canadian Nurse andL'i'!firmiè-
re canadie/lfle. 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, F10rita Vialle-
Soubranne, Montreal. and Judith Prowse,
Edmonton. to stud) 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, Ollt. - Beginning in September
1974, the postdiploma program in
psychiatric nursing will again be offered
at Ryerson Poly technical 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 RN,.
More infonnation about these programs
is available from the Chairman. Nursing
Department. Ryerson Poly technical Insti-
tute. 50 Gould Street. Toronto. Ontario
M5B I E8.

Master's Program In Nursing
Recommended For Atlantic Region
Fredericton, N.R. - 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 is<;ue 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 nonnal
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 nonnal. The scope of activities and respon<;ibilities 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, /974)

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 dunng part of the
program.
The A:-':-'lJciation of Atlantic Univer-
sities sponsored the study at the request of
the Canadian Conference of University
Schools of Nursing. Atlantic Region.
APRI L 1974

Your patients
will amaze
you . . .

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Your patients will be back to normal in no \.

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NOT SURPRISING. . . "
RETELAST is so comfortable and gives .. ., J
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dressing or traditional bandage. !

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eR CANADA PHARMACAL CO L TO.,
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UPON REQUEST

APRIL 1974

THE CANADIAN NURSE 13
.

tf/.1)
1) u rr
Mil

Reeyes Name Pin. , . , nne.1
quality, ....rtell stylinl,
.,Ih "'aty cla.ps. Na.
.ptllm.1 Duatana fin,sh .,Ih
c.nlrall,nlsalm backVOund
and ...I'shad edlu lar e
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'
,*
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/

MRS. R. F. JOHNSON
SUPERVISOR

N

CHARLENE HAYNES

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.
enamel on fine sprinl steel. Eight 2" and ei&11t
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No. 529 Clips. . .3 boxes for 2.25.
. 6f.r65< ..., 12 I.r 60. ...
MOLDED CAP y;4i
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band !Uterial, Self.adhesive, presses on, t -- 1
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popular widths: If." U2 per plastic box) 1,1" ....-
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B nd. . . ] .er box 3 or mare. .1.50 el.
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1 I I
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Use extra sheet for additional Items or orders.

TO ORDER NAME PINS. fill out all information in box. top
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caduceus. No. 289 Card Sit. . . 1.50 II. c'_
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odd 50. per .01.
.....-::;; KELLY FORCEPS Sa handy lor
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guaranteed. Ideal for clampmg off tubinl. Your
own initials help prevent loss.
eA.R N'.25-12 F....ps . . .2.75 ... 6 .r m." 2.50 0..
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with V-<<lW' own
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a I,ne precision instrument,
with high sensitivity lor
blood pressurJ!s, apical pulse
rate. Only 2 02S., fits in
pocket, with gray vinyl anti-
collapse tubing, non-chilling
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FREE INITIALS AND SACK!
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vent loss. Also FREE SCOPE
SACK included, worth $1.
(Free sacks not personal-
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No. 216 Nursescope. . .13.80 ea. ppd.
6.11 . .. 12.80 ea. 12 Or more. . . 11.80 ea.

Group Discounls include free Inilials and Sack!.;:
'IMPORTANT, New "MedallIOn" styling ,ncludes tubmg ,n?:
colors to match metal parts. If desired, add $1. ea. to"
prrces above; add "M" to Order (No. 216
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No. 223 Scope Sack only. . . 1.00 ea. ppd.
6 or more 75
ea. Gold stamped inilials, add 50

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As above, but larger lor bigger Jobs Chrome finish only
No. 4500 14'IJ") or No 5500 (5Yl") Scissors. . 2.15
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No. 105 OR Scisso". . 2.75 ... _
All sCissors above: I doz. or more (any style) .. 2.00 13.
Your Initials engrand, add 5De per SCISSOrS.

CLAYTON DUAL STETHOSCOPE tIght.
welgl1t imported dual scope; highest sensitivity for apica
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N.. 413 Dual Slelt1. . . . . . . . 17.95 ... ree
'JEWELRY NURSES CHARMS
.

Finest sculptured Fisher charms,? <
)
I Sterling or Gold F,lIed (spec,'y under COLOR on couponl. 1
For brace)et Of pendant cham. Add to your collection! .
t
ac-}
No. 263 Caduceus, N.. 164 C.p; N.. 68 ..f. ",-
Grad. HII, No. S. S.nd. Sciss.rs . . 3.49 oa. ('} f\
.1&-" 14K PIERCED EARRINGS

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Dainty, detailed 14K Gold caduceus. for on or off duty
wear. Shown actual size. Gift boxed for friends, too.
N.. 13/297 E."inis . . , . . . . . 5.95 per poir.
PIN GUARD Sculptured caduceus, chained

to your professional letters, each with pinbackJ

safety catcl1. Or replace either with class pin for
safety. Gold finrsh, gill bo,ed. Choose RN, LPN
or LVN N.. 3420 Pin Guard. . . . 2.95 0'.
(1mI' ENAMELED,PINS Beautilully sculptured status
\W1 insignia, 2.color ktyed, hard. fired enamel on gold plate.

. Dime.siled, pin-back. Specify RN, LPN, PN, LVN, NA, .r

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5co

:.;.. Pin 1.95 ea., 12 Or mare 1.50 la.

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Endura NURSE'S WATCH F,ne SWISS made
waterproof timepiece. Raised easy.to-rea
white numerals
and hands on black dial, luminous markmgs. Red sweep.
second hand. Chrome flmsh, stainless back. Includes
black velvet strap. Gift-boxed, with 1 year guarantee
Yery dependable. Includes 3 initials ena:raved FREE!
No. 1093 Nurse. W.lch . . . . . . . , . . . 19.95 ...
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Smooth, pliable pure white vinyl. Ideal
low-cost group gifts or favors. ?"
- No. 210.E (ripl), two compartments
with flap, gold stamped caduceus. . .
6 lor 1.50, 25 or 1I0re 20. ea.
o No. 1St Oeft) Deluxe Sa.er, 3 compl. J
change pocket & key chain . . .
6 lor 2.96, 25 or more 35. 0..

D ""' Nurses' POCKET PAL KIT
. J
' Handiest for busy nurses. Includes wl1lte Deluxe
'J Pocket Saver, wltl1 5" Bandage She
r (both shoWn
opposite page), Tn-Color ball.pomt pen, plus
handsome little pen light . . '. all silver finished.
o Change compartment, key chain.
" N.. 291 P.I Kil . . . . . . . . 4.95 ea.
3 Initials enlraved on shears, add 50, per kit
Bzzz MEMO-TIMER Time hot packs, heat . tb
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ital silns
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3 or mare 3.95 II.i 6 or mare 3.50 ea.

EXAMINING PENLIGHT
White barrel with caduceus imprint, aluminum
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. placement batteries available any store). Your own light, gift boxed
No. 001 P.nllpl . . . 3.96 ea. Y..r Initial. onfl'aved, add 50. per IIpl.

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,

news

(Conlllllledfromp<.lf!,e 121
Govt., Profession Urge MDs
To Provide Better VD Care
Otta\t'a - The Department of ;\iational
Health and Welfare. the Canadian
Medical Association (CI\I;\). and thc
Canadian association of French-lan-
guage physician
have sent a joint letter
to all doctors in Canada. urging each
to "'revie\\ your participation and your
performance as a physician in the con-
trol of venereal disease:'
The letter. which is termed "unpre-
cedented" by the C\I '\. asks doctors to
consult their peers in vo practice and
also recent issues of The Ca'llldia/1
Medical A ssoÒatio/1 ]ollmal (C\I AJ)
or other publications.
Enclosed in the letter to the doctors
is a recommended guide to the treat-
ment of venereal disease. The letter
say., that. if <In 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 ...urvey of \enercal disea...e
treated b) \1anitoba ph)sicians in
(lJ72. published in the January IlJ.
IlJ74 issue of l \I-\j states. "Notifica-
tion of disease to the public health
authorities is cxtremely limited and
therefore epidemiological measures
nece..sary for proper control are rarely
activated." This report also says that.
although a recommended and frequent-
ly revised schedule of treatment is mail-
ed to all doctors. "noncompliance with
the schedule is the rule rather than the
exception.
At the IlJ72 meeting of the general
council of thc Canadian \1edical Asso-
ciation. a resolution \\as passed call-
ing tor a review of vo therapy and
control programs. more effecti\e pro-
fessional education. and the report-
ing of all cases.

Sask. Labor Relations Board
Hears From Many Nurses' Groups
Regi/1a, SlI\Á. I a..t '\0\ ember. the
Sas"atche\\an R.cgi..tered Nurse....
A....ociation \Hote a
ktter to thl.' Sas-
katdle\\ an I aO\II' R.dations Board.
pOlllling out that becau..e nurst:s do 110t
..hare the ..amc intere..t \\ ith other
groups of emplo) ecs in health eare
agencies. the) constitutc 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
jun'eyors' par: 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 pertonns similar surveying duties. the directors of C\lA
passed a motion to convey to CCHA a belief in the principle that all members of a
surveyor team be given equal pay.

. EmluatÙm of nursing practice: The C\lA special committee on nur..ing research
offered to identify the means through \\hich a position paper on the what. why. and
how of the evaluation of nursing prdctice may be developed. dnd to nwnitor the
process. Directors accepted the offer.

. Three nurses to hl' honored: Three nurses will be honored at the (";\1-\ convention dnd
annual meeting to be held in Winnipeg in June. The) ",ill be pre<;ented \\ ith a gold pin
depicting the leaf and the lamp. \\ ith a ruby a<; the flame.

. Unemployment insurance: A study of the Unemployment In
urance Act (1971) as it
affects nurses \\ as mdde in re<;ponse to concerns expressed by provincial nur
es'
associations. CNA directors \\ill submit a brief 10 the f\linister of :\Ianpo\\cr and
Immigration to inform him of the diffïcultie
encoumered b
nurse, and to recommend
peninent changes in Sections
5 ,lI1d 40 of the Act.

THE CANADIAN NURSE 1')
.

Next Month
in

The
Canadian
Nurse

. Self-Help Clinic
for Women

. Wanted: A Definition
of Nursing

. Basic Physical Assessment

ð

Photo Credits
for April 1974

Infonnation Directorate. Health and
Welfare Canada. Ottawa,
pp.38-41

SI. Paul's Hospital. Vancouver,
B.C.. pp. 42-44

Telephone Pioneers of America,
Manitoba Chapter No. 50.
Winnipeg. p. 46

16 THE CANADIAN NURSE

news

bargaining unit; and that pa
t practice
in Sa
"atchcwan and other provinces
has heen for nurses to negotiate on their
own hehalf through a separate bargain-
ing unit.
SRNA'
letter also noted that too
many units in an agency could weaken
the bargaining power of the \ arious
group
t)f employees. and that employ-
er
cannot he expected to negotiate with
a large number of bargaining units. It
added that its main concern was to
ensure employees' rights, as guaranteed
b) the Sa
"atchew,1I11 rade Union Act.
Another brief to the board was

presented hy rcgi
tered <tnd graduate
nurses representing 41 staff nurscs'
association
and nur
e groups employ-
ed at 37 ho
pitals and four nursing
homes. This hrief supported the prin-
ciple of minimizing the numher of
bargaining units in ho
pitals. nursing
homes. and health care institutions to
a manageable level and pre
erving the
right of employee, to bargain collec-
tivelv through a trade union of their
own "choosing.
Briefs were also
ent to the board by
the Biggar StaffNur
es' Association. the
Swift Current Chapter of SRNA. a
committee of the Lloydminster Hos-
pital Staff NUr
es' A
sociation. 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, On!., K2P 1 E2.

Why not share your experience and thoughts with nurses
across the country?

"How's it going?"

APRIL 1974

where
ore
ou
" growing?

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APRIL 1974

CHILD HEALTH MAINTENANCE:
Concepts in Family Centered Care . .t- 4&.. .
Unique in approach, this new text focuses on normal growth '"
\\ :jfi.Þ'
and development, both biological and behavioral, from ;.,\;. ;'" .
conception through adolescence. Special attention is . '
afforded environmental and familial aspects of child health 1 ' , '\11
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'

Chinn

f

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!

By PEGGY L. CHINN, R.N., Ph.D. March, 7974. Approx. 608 pages,
8" x 70",274 illustrations. About $74.75.

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 datô, 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, 7974. Approx. 748 pages, 8" x 70",20
illustratIOns. About $5.20.

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THE CANADIAN NURSE 17

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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
I-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. 172pages
plus FM I. VIII. 7'/.," x lOW: 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-XII, 7" x 10", 62 illustrations.
Price, $8.95.

"

18 THE CANADIAN NURSE

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 1- 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.S.N.; 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 1- VIII, 7'/.," x
lOW'. 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.

F
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APRIL 1974

r
f Because profes
ional growth and development is such
an integral part of your life. we'd like to offer you an
I 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.
I we'll have a drawing " with one winner selpcted
from each province.
I MOSBY
I TIMES MIRROR
\
THE C. V. MOSBY COMPANY, l TO . 86 NORTHLINE ROAO, TORONTO. ONTARIO M4B 3E5
,------------- -

New 8th Edition! ORTHOPEDIC
NURSING. This new edition has been
completely revised to include current
information on hody mechanics,
behavioral aspects of rehabilitation,
metabolic disorders of bone, and ,otal
hip and knee jomt 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
MARJORIE GOULD. R.N.. B.S.. M.S.
April. 1974. Approx. 576 pages. 7" x
10".572 illustrations About $12.10. r-'
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
ail-encompassing presentation of drugs;
and in-depth treatment of broad topics
in the field. 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
$11.80.

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. (Ophth.J. 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 1- VIII. 6W' x 9W', 357
illustrations. Price. $12.35.
----...,

APRIL 1974

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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 I-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
mformation 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. MA THENEY, R.N., Ed.D.;
and MARY TOPALlS, 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 exam ined: 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 O. BEVIS, R.N., M.A. May. 1974. Approx. 184
pages, 6" x 9", 23 illustrations. About $6.25.

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ADDR ESS

CITY

PROVINCE

HOSPITAL AFFILIATION

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CN 4/74

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THF CANADIAN NURSE 19
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20 THE CANADIAN NURSE

New Volume IV! 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 I-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. í72 pages, 7"''' x
lOW', 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 well ness-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 I
XIV, 5W' x 8W'. 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 I-X, 5W' x 8W'. 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, 5W' x 8W', 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 I-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.
CHERESCA VICH, R.N., B.S., M.S.
June, 1973.442 pages plus FM I-XII, r
x 10", 179 illustrations. Price, $10.00.

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

MOSBY

TIMES MIRRDR
THE c. V MOSBY COMPANY, L TO
B6 NORTHLINE ROAD
TORONTO, ONTARIO
M4B 3E5

APRIL 1974

Canaoian Nurses' Association

TICKET OF NOMI NATIONS
Ripnnium 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,
Femande 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. Thorne

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: Followmg the filing of the "Ticket of Nominations."
Yvonne Chapman and Roberta Coutts withdrew. )

President: Huguette Labelle

o

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Huguette labelle. Reg.N., B.SeN.Ed.,
B.Ed., M.Ed., UnÏl'ersityofOttawa.

Present Positinn: Principal Nursing Of-
ficer, Health and Welfare Canada, Ot-
tawa.
APRil 1974

Association Activities: President-elect,
Canadian Nurses' Association, /972-74;
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; memher, ETV Nursing Educa-
tion Committee, Ontario EducaTional
Communications Authorit\', Ontario;
member, Board of Governors, United
Appeal Ottawa-Carleton.

In recent years, the Canadian Nurses'
Association has
tated 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
a!>sociation. to identify necess(lry 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 member!>hip.

. the development of standard
of excel-
lence for nursing practice and nur!>ing
education.
. the interpretation of the dynamic state
of the nurse'!> role.
. a review of the eXIsting framework for
basic and continuing nur;ing education in
the light of current developments.
. the development of additiondl bridge!..
with other groups for cooperative action,
. the promotion of nursing research:
thereby assi
ting nurses to become better
architects of the essential service that they
provide and of their 0\\ n futun:.

THE CANADIAN NURSE 21
.

CAN 01 DATES FOR PREc;l DENT - LECT

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Beverly Witter Du Gas. The VancOIH'er
General Hospillll: B.A., U. (!f British
Columhia: M.S., u. (?f Washington,
Seattle: Ed.D., u. o.f British Columbia.

Present Position: Director, Health Mal/-
power PIll1lf1inK DiI'i.Üol/, Health Mal/-
power Directorate, Departmenl of 'Va-
tÙmal Health aNd Welfare, Ottawa.

A Hol'iation Activities: 1st vice-president
CNA, 1972-74

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loan M. Gikhrist. The Wellesley Hospllal,
Toronto: B.N.. M. Sc (Applied), McGill
University, M(mtreal: completing Ph. D.,
McGill Unh ersity.

P, e
ellt Po.luio/1: Dil ector, School of
Nursi/1g, McGill Ullil'er.Üty, Montreal.

AS.\oCÙlfion Activities: memher, .Ipecial
committee on re.l-earch, C a/1adian
NUr
e.I' A.uoc;atio/1: chairman, commit-
tee on re.\earch and development, Order
(?f Nunes of Quehec: member (represe/1t-
22 THE CANADIAN NURSE

Probably never before III Canadian nurs-
ing has there been greater opportunity for
our national association to playa 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 maùe that affecteù
nursing. but in which nurses haù 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 accordt:lJ individual
nun,es in clinical practice. by the rapidly
growing number of nurses in senior
management position
in our health ser-
vices. and by the constantly widening
scope of activitit:s of our provincial and
national assOl:iations. 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 Canadi"n Nurses' Association
must be prepared to pia) its part as an
equ<1J member of the health team. We

ing Quebec Region), committee 0/1
studies, Canadian A.uol iatiol/ of U'';l'er-
sity Schools of Nursi/1g.

fhe role of an organiLCd 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
structure
for their attainment are
evolved. and individuals are prepared and
motivated to carry out responsive and
goal-orientt:d 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,
rt:sponslve to the human need of all
Canadians for health care.
To achieve health selvices that are
comprehensive in natule 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 Pdrt of nursing leadt:rs to acquire
vision and accept risk.
In accepting the nominatIon fÙr elec-
tion to the office of president-elect of the
Canadian Nurst:s' Association, I am

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 no\\- 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 a
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.

prepared to make a persona! and profes-
sional commitment to work with my
colleagues and others in moving to\\-ard
these goals.

APRIL 1974

CANDIDATES FOR VICE- PRESIDENT

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Margaret D. Mclean. Royal Victoria Hos-
pital. Montreal; B.SeN.. U. of Western
Ontario, London; M.A., Columbia U..
N. Y..- post-masters swdy in administra-
tion of schools of nurÚng and (
{ nursing
sen'tce.

Present Position: Director and Professor.
\1emorial Uni
'ersit\' of Nel\foundland
School of Nursing, St. John'
.

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Helen D. Taylor. The Montreal General
Hospital; B.N.. McGill U. Swdying for
;\1. Sc. (App.), McGill.

Present Po.\iTÏon: Director of Nursing.
Jewish General Ho.\pital, Montreal.

Association Activities: 1st
'ice-presidellT
A'\P(.!, /967-69; president A vPQ,
1969-71 ;."A hl/ard (!f directon /967-7/;
2nd vice-preÚdent 4VPQ, /97/-72; prni-
dt,nt, district / I, English chapter, ANP(.!,
APRIL 1974

AssociaTÏvn AcTi
'ities.- formerly on etecu-
tive vf HRV; Board of Ewminers. A 4R\;
chairman, C\ 4 nursing wn'ice commiTTee
/966-68, and /968-70; 2nd \'ice-
president eVA, /968-7(); has ser
'ed on
many other C\ 4 ad hoc and special
commiTTees; member, joint ad\'i,wry
council, Nursing Unit Administration Ex-
temion Course; mt'IIIher, planning com-
miTTee for first cOI!ference on ho.\pital-
medical staff relationships.

After mUl.'h thought I have al.'cepted
nomination for vil.'e-pre
ident of the
Canadian Nurses' A
sol.'iation.
I bel ieve the profes
ion of nursing has a
great opportunity to make its optimum
contribution to the well-being of indi-
viduals. families. and con
munities.
Nurses have said they are responsive to
the heahh needs of people. We must
reall} be so no" if nur
ing i
to al.'hieve
its potential in the health I.'are S) stem.
This will nel.'essitate great I.'hanges. but
the time is npe for the organized profes-
sion to respond 10 the health needs of the
people in helpful wa)s. \0 demonstrate
what eXl.'ellence in expanded nursing
practil.'e Cdn do. and to \\ork in 1.'01-
leagueship with uther heahh professionals

/971-72;
'ice-prnident cn, /97/-
73; 4,\P{! board (!{ ad\'Ïsers, counci I
on discipline, legislation commiTTee;
board (!{ directors, Anociation of Hospi-
tal Administrator.\, PnH';'ICI' (
{ Quebec;
wrI'eyor, Canadian Council on Ho.\pital
AClTeditaTÏon.

The important I.'hanges that are takmg
plal.'e in the distrihution of hedhh services
in Canada offer nurses an unparalleled
opportunity to pal1iÒpate at all levels in
the health Cdre s}stem. Man) exciting
challenges are before us as a group.
As individuals. we eal.'h adopt our own
commitment. but also learn to realize \\e
need each other to test and
hare I:ertain
ideds. The immediate future" ill demand
that \\e resolve long-standing problems
within our own profe
sion: at the Sdme
time \\e must press tu\\ard ne\\ avenues
of development. Critil.'al aredS mUst \.'lm-
stantl} be identitied and researl.'hed. Each
nurse has a pn,fessional rcsponsibilit).
and one nurse'
responsihility is not more
or less Importdnt thdn the other's - it i...
just different.
We have rel.'ogniLed th,lt our ap-
proaches must I:ontinudll) be addPtt:d to
so\.'Ïetdl needs and thaI we must share
\\ ith other professiondls. with a host 01
agenl.'ies. \\ ith government. dnd "ith one
another if \\e believe \\e l:dn determine

and consumer<; in the promotion. reten-
tion. attainment. and restoration of health
and well-being.
I am tr) ing to give leadership in this m
a universit) school of nursing b) working
with community nur
ing agencies and b)
planning a I.'ontinuing edul.'ation program
for nur
es in a provinl.'e. "ith the provin-
cial assol:Jation.
I would be hdpp) to be part of the
leadership team at the CN -\.

and live up to our own profes...ional mlö.
I believe. very simply. thdt all this l:an
better be al.'hieved b) "orlo..ing together
through the Canadian Nur
es' A .....ol:ia-
lion.

THE CANADIAN NURSE 23
.

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CANDIDATES FOR MEMBER-AT-LARGE, NURSING ADMINISTRATION

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Marguerite M. Bicknell. Misericordia
Hospital Winnipeg; B.N., McGill;
M.H.S.A., U. of Alherta.

Present Position: As.\'Ïstant Executive Di-
rect()r - NursÏ1I{<, Brandon General
Hospital, Brand()n, Manitoha.

Association ActÏ1'itie.f.' member of district
ami provincial committees, M.4RN; presi-
dent. district 2. MAR,V; memher of hoard
of directors, M 4RN.

The emerging. comprehensive health-
care systems are producing a spiraling
demand for more and more complex
nursing services in a wide variety of
service mudalities. In response to this
demand. pre!>ent 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 10 the per-
ceived roles and practices. I believe it is
equally essential that allention be directed
toward the development of organizational
frameworks wherein the nurses of today
and tomorrow can function etlectively.
Organized nursing services. in all practice
settings. must provide an admInistrative
structure whereby the distinctive con-
tributions. because of level of preparation
and competence. dre readily identifiable
and acknowledged in pmcitioners of
nursing.

/ l

Olivette Gareau. Ste-Justine Hospital,
Montreal, BN, M.Sc.A., McGill U.

Presellt Position: Nursing Consultant.
Community Health Directorate, Nati()nal
Health and Welfare, Ottawa.

Association Activities: memher o} board
of administration, ANN,). 1962-70;
chairman of district Xl, ANPQ.
1966-67; member (!{ executive council,
Canadian Puhlic Health Association,
1967-72; member 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 Nun,es' 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 th'ë
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 idea!> 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 infl uence
decision making at guvernment level.
whether obtaining grants for members or
defining policies on health services.
I am also convinced that nurse!> 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

I also believe in and suppurt 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 profes:-.ional association is abso-
lutely essential 10 guide the course of
nUPiing toward the!>e 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 reason!> that I am pleased
10 accept the nomination.

important role that the CNA will have 10
develop to promote u!>e 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 deci!>ion
making.
Such political .lction is essential if we
want to secure for nurses in the area of
administration a vOice in the development
uf future national policies on health
mailers.
I believe that my experience in Quebec
and currently at the natiOl1d1 level allows
me to make a contribution to the work
CN.... must assume in the field of nursing
care administration.

APRIL 1974

;0

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,

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-.
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..
;::=; ;;/7:,.

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.
I, -.;;:,

Fernande P. Harrison. Misericonlia 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
.4.4RJV planning convention committee;
member of registration committee
1969-70: member of .4.4RN nursing re-
search committee 1971-72

Th
provi
lon of health services in
Canada is undergoing rapid change. Nun,-
ing. as one of the health professional
group!>. has d critical role to play in the
planning. evaluation, and provision of
health services.
Stemming from m} belief that nurses
mu
t be involved at all decision-making
le..e1s in matters relating to health ser-
vice!>. I \\-ould con..ider ita privilege to be

associated with the Canadian Nurses'
Association when the future of nursing in
particular. and health care !>ystem in
general. has reached this crucial point.

..

,

-..

Margaret L. Peart. St. Joseph's Hospital,
Hamilton; cert. in nursing education,
U. of Toronto; art.. hospital organiza-
tion and mmillgement, CWllldian Hospital
Assoâation.

P,esellt Position: DirectOf (
f Nursing, St.
Joseph's Ho.\piral, Hamilton, Ontario.

Association Acti\'itÚ's. WI/AO board of
directors: 5tanding committees at pro\'in-
cial and national le\'els: chairman. ad-
minÜtrator committee, R.\.40; executi\'e
committee, R.V.40; memba oj R.v40 advis-
on' onfin(lnce committee; member, board
of directors, vU.V, Hamilton: nursing
advison' sub-committ('e, health science
dÏl'isio
, Humber College; member oj
council, College of Nune.\' of Ontario:
member of nursing committee, Catholic
Hospital Conference.
APRIL 1974

M} acceptance of the nomination as a
member-at-Iarge representing nursing
administration is based upon my sincere
interöt and activity in the affairs of
nursmg.
As the major part of my nursing career
has been in nursing administration,
change has been a key
word, and I well
recognize thdt the profession has yet
mdny changes ahead to meet with experi-
ence and wise decision". It would be a
challenge to participate.
The intluence of nursing administration
Cdn give great strength to the continued
progress of nursing in our society. I
helieve this can only be done positively
by those willing to develop and imple-
ment change.
I believ
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
hest pos..ihle care for our patients and
community. Today. no group can work in
i..olation.
I believe that this is a critical time
for nurses. It is vital that the voice and
identit} of nursing be recognized in the
design for the provision of health care.
With the introduction of technology and
ne\\ health \\ orker... the effect upon
nursing is alread} being fell. It is impor-
tant that the profession continue to have
dialogue with the dppropriatc group
.
M} present position, as the director of
a department of nursing. includes such
activities as the development of ..taff
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 intluenced 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

.,

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-..

Marilyn Smith Riley. Payz.ant Memorial
Hospital, Windsor, N.S.; B..V.,
Dalhousie U., Halifax, N.S.; M.Sc.N.,
U. of Western Ontario, London.

Present Position: Academic Coordinator,
hasic degree program, Dalhousie Uni-
I'ersity school of nursing:
Superl'isor, medical unit. Victoria Gen-
eral Hospital, Ha/
rax, NS.: and COll.m/-
tant, Nursing, Nom Scotia Health Ser-
I'ices and Insurance C ommissio/!.

Associatio/! Actil'ities: recordinR secret-
ary, necwil'e, R'\.4VS 1966-68; member,
special commillee on /!ursing research,
R....ANS; chairman. commillee safe prac-
tice of nursing, RNANS; member, curricu-
lum council. RNANS: coordinator, annual
nursing seminar, R.VANS (/97/-72, 1972-
73); memher, CVF h()ard.

I believe nursing !>ervice 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 neeù for a chdnge in
philosophy of administration in nUf',ing.
We must recognize the tremendous pote
-
tial \\e ha"e 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 gi"e 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 \\hil:h all
nurses in Canada Can be heard-.

CANDIDATES FOR MEMBER-AT-LARGE, NURSING EDUCATION

".. -
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......"

A
\

Sister Joan Carr. B.Sc.(E/.Ed.), Mount
Sainr Vincent U.. Halifax, N.S.;
B.Sc.Nursing, Mount Saint Vincent Uni-

I'ersit\. and Ha/
fa r Infirmary: M.S.,
Boston Unil'ersin'.

Present Position: Director, Ha/
lax In-
fìrmary school ()f nuninR, Halifar. Nova
Scotia.

Association Actil'ities: chairman, Il/lrsinR
education committee, Cape Breton-
Victoria branch, RNA^JS: prol'incial
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 m}
philosophy of nursing and. more pre-
cisely. my philosophy of nursing educa-
tion.

J..->

.
<
..

Myrtle E. Crawford. ReRÏ1ll1 Grey Nuns'
Hospital; B.S.N., U. of Saskatchewan;
M.A.. Teachers College, Columhia U.

Present Position: Associate Prc
fes.wr
f
Nursing, Unil'ersity ()f Safkatchewan,
Saskatoon, Sask.
26 THE CANADIAN NURSE

I firmly believe that the nurse. irrespec-
tive of her immediate position. has a vital
role - that of service 10 others. Educa-
tion is the area of nursing I am engaged in
at present. It is my conviction that quality
of nursing I:are is a goal set early in the
"learning of nursing." and a goal 10 be
aimed at during the pral:tice of nursing.
I belie"e 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 nursi
g needs to be an
exchange of ideas.
spirations. and tal-
ents of thinking people, We need to hold
strong convictions of our beliefs in what
our role is in the health care svstem and to
have the courage of our con
ictions. M)
concern for nursing has prompted me to
allow my name to stand for nomination.

Association Actil'ities: memher of Sas-
katchewan Registered Nurses' As.wcia-
tion council 1960-63, 1965-67; president
SRNA 1963-65; hoard of directors, Cana-
dian Nurses' Association, 1963-65;
memher (
f I'arious CNA committees; con-
sultant to SR,VA committee on legislation
aflll bylaws; U. of Saskatchewan Senate,
1962-68; chairman, adl'isory commillee
to the nurse-pratitioner proRrwn (new
program to be gil'en hI' the ColieRI' of
NuninR ).

I am pleased. but also a bit apprehensive.
to accept the nomination for member-at-
large for nursing education. This is an
important and e
xciting time in the de-
velopment of nursing as a profession. and
if one feels strongly about the way in
whil:h nursing should develop. then one
<;hould be willing to commit oneself to
intluence the cou
se of events. However.
it is also somewhat frightening to take the

responsibilit} for recommending future
courses of action in the field of nursing
and health I:are. because there are s

many contlÏl:ting opinions and viewpoints
regarding the direction \\ e should take.
The Canadian Nurses' Association.
representing a large body of health
workers. should be intluential 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.
I believe that nursing !>hould break new
ground and should accept additional
responsibility in the provision of health
care. Nurses should nor wait for events to
happen or be led b} others. but rather
should be leaders \\ho cause things to
happen. There is enough diversity within
nursing that it should be possible to do
(his while continuing to provide the
nurturing and I:aring aspects of nursing.

APRIL 1974

"..

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Denise lalancette. Hnte{ Dieu de Gaspé,
Gaspé, Quehec; B.Sc.N., Marguerite

d' Y mH'if{e Institute, .\1ontrelll: M.S. In
Nursing. Boston U.

Present Position: Clinical nUrse - mat-
ernal and child care, U. of Sherbrooke
Clinic. Sherbrooke, Quehec.

As.mciation Activities: French-spea/...ing
co-president, committee on nursing edu-
cation, .4NPQ; member of CN.4 committee
on nursinR education; memher-at-Iarge,
nursing education. Canadian Vurses'
Association.

I believe in the importance of both basic
and continuing education for nurses.
especially at ; time when we hear so
much about expanding the role of the
nurse.
My purpo",e in accepting nomination
for a position I 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'
AssoÓation.

.---

-""""'-.,.

\

\...

Shirley M. Stinson.B.sc. in Nursing, U. of
Alherta; M.N.A., U. of Minnesota;
Ed.D.. Columhia U., N.Y.

Pre.lent Position: Joint Appoimment:
Pn
fesWlr, School of Nursing, and Did-
Úon (
r Health Services Administration,
U. of Alherta; and Graduate ProRram
Coordinator, School of Nursing, U. of AI-
herta. Edmollton.

A.\'.\ociation Actit'ities: chairman, Cana-
dian Nunes' Fmwdation scholanhip
selectio1l!J committee, 1971: chairman,
re,wlutÙm,\ se.uion, fint natiollal confer-
ence on mining research, 1971; chair-
man, Alherta Association (
f Regi.l'1ered
Nunes ad hoc committee on the Alherta
legil/ati\'e committee 011 occupations;
memher, special conference (
f past pres-
id"n1l and Canadian Nurses' Assocwtion
committee chairmen to discuss the struc-
lure andfwH'tiom ofe",.4. 1i;71: memher,
CN.4 .\pecial COf/lfmttee on nursl/lg re-
APRIL 1974

search: member, health committee for the
ECOllomic C oUflcil of Canada's national
ecof1!omic outlook cOf!ference.

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 ir. relation to nursing educa-
tion matters. and actively ensuring that
the C:'IIA identifies central nursing educa-
tion implications of trends within nursing
and health care delive!)' in particular, and
within societ} in general.
Some of the central beliefs ] 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 le!>s
concerned with our developing identical
nursing education and service standards
acms
Canada than I am with id(>ntifrinR
and comf1!unicarinR the similarities and
differences.
. The more we are able to envision
. 'llUrsing 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 permit 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 also value,
develop, and use inTuitive 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 fonner: 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 ] feel I can ask
some of the main questions. questions
which would, I hope, help the CN....
fonnulate sensible policies and take prac-
tical actions in relation to nursing educa-
tion in Canada.

THE CANADIAN NURSE 27

"...

-'.

Joyce Nevitt. B.SeN., McMaster U.,
Hamilton, Ont.; M.A., Teachers College,
Columbia U., New York.

Present Position: On sabbatical leave
from Memorial U. of Neufoundland
(Assoc. Professor).

Association Acti
'ities: second
'ice-
president, Association of Registered
Nurses of Nellfoundland; past president,
Nellfoundland-Labrador branch of the
Canadian Public Health Association;
member of several committees and of
council of 4R.VN; member, CWllIdian
Association on Gerontology.

I believe the time has come when the
nursing profession must concentrate on
patterns of education that will not onl}
prepare nurses for immediate service to
patients. but will also prepare nurses who
will recognize and accept continuing
education as a personal respom,ibil ity.
Teachers must see themselves as
guides and co-learners with students,
rather than as purveyors of knowledge. If
we teach only what we know, we teach
for the past: but if we teach students how
to learn and how to ask the right
questions. then we teach for the future.

Roles are changing. and it is imperative
to define clearly these roles and provide

the appropriate educational experiences to
prepare nurses to fill these roles. The
focus should be. not on what nurses want
for their- own satisfaction and
tatus
alone. but on what patients need from the
profession. We need to recognize that
nursing includes not only skillful hands,
but also the educated hearts and minds of
nurses who can readily identify oppor-
tunities for health teaching as a means of
promoting and maintaini;g health where
ever the patient-nurse contact is made.
If elected, I would like to encourage
seminars, debates, and discussions aboLut
nursing education acroo;s the country. and
to ask all who teach o;tudents of nursing to
contribute to a national dialogue. I see the
role of the member-at-Iarge 'ãs being one
of facilitating action by those most
closely involved in the education of
nurses.
In summary, we ought to ask: What
does the public need of us? How shall we
prepare to meet the need?

.

"

Anne Thorne. Saint John General Hospi-
tal, Saint John, N.B.; B.N., McGill;
M.Ed., Teachers College, Columbia U.,
N.Y.

Pres em Position: Director, Saim John
School of Nursing, Saint John. New
Brunswick.

Association Activities: formerly: presi-
dent of Saint John Chapter, New Bruns-
wick Association of Registered Nurses;
member of council and chairman of
nursi/lg education committee, NRARN;
member, /lursing education committee,
Canadian Nurses' Association: member
of Still1\' committee on nursing education
for New Brunswick. Presently: chairman
of ad hoc committee to e
'aluate
graduates of O1'o-year programs from
outside of North America who seek
registration in N.B.
28 THE CANADIAN NURSE

I am pleased to accept a nomination to
become a member-at-Iarge for nursing
education on the CanadÜîn Nurses' As:
sociation board of directors. My reasons
for accepting this nomination are as
follows:
I believe we are at the crossroads in
tenns of decision making on the direction
of educational programs for nursing for
the future. The age of community health
centers (or services) is upon us. We must
listen to consumers of care, and to
employers of nurses, in shaping the
programs for the future. No teacher or
administrator of an educational program
can work in a vacuum in planning a
program. If we prepare nurses solely for
the practice of today, we fail in our
efforts. We must continually have our
eyes on the future of the service of
nursing if we are to develop viable
educational programs.
Perhaps I should warn the electorate
that, although I shall try to keep an open
mind to potential future needs, I currently
object to the recent push toward the
"ladder concept" in nursing programs. In
no way do I now see the two years of a
diploma program as being similar or
equal to the first two years of a bac-
calaureate program in nursing. To me. the
"ladder concept" is in direct antithesis to
the concept of two levels of workers in
nursing. If we find, through evaluation
of practice. that the idea of two levels is
unworkable. I shall be prepared to look at
various alternatives.
For the moment, I feel we need to
explore the petfonnance of graduates of
diploma and baccalaureate programs of
nursing - in prdctice - to detennine the
effectiveness, and differences, of each. If

each is unique in tenns of what is offered.
we should know this. We should know
how diploma and baccalaureate graduates
can work together in providing nursing
services now and for the future. If the
difference between the two is negligible,
we should again review our philosphy.
At least two provinces are currently
evaluating the practice of nursing as it is
petformed in settings that are using the
two levels of nurses in their respective
roles. The results of these studies. along
with continuing consultation with con-
sumers and employers. will shape our
direction for the future.
An opportunity to serve the CNA as a
memher-at-Iarge will permit me to apply
experience gained in education for nurs-
ing to current and potential issues. Much
can be accomplished in improving nurs-
ing services through cooperative efforts
of educators. practitioners, consumers,
and employers.

APRIL 1974

CANDIDATES FOR MEMBER-AT-LARGE,NURSING PRACTICE

-,

Ai>

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lorine Besel. St. Boniface Hospital, Man-
itoba: B.N., McGill U.; M.s.. Boston U.

Present Position: Director of Nuning,
Royal Victoria Hospital, MOlllreal, and
Assistant PTl
fessor, School of '\luning,
\1cGill U.

Association ActÏ\'ities: president, English
Chapter X I, 4 VPQ. 1967-70: member of
board oj management. A VPQ, 1 967-7Ò;
member (
f the department (
f national
health and lI'elfare task force. 197/;
member, ach'ÏsOl
\' committee to 4 \PQ
board (
f managemelll; member of "ario/t!,
C\'4 ad hoc committees: CNA represenra-
tÏ\'e 011 national committee of mental
health professions, 1972.

1\1) reasons for accepting the nomination
are hopefully pure and certainly simple: I
am concerned and I care about patient,>
and nurses.

;

Doris Hynes. Ha/
fa'f It{firman, Hu/
fax,
'110m Scotia.

Present Positinn: Staff Nurse, medical-
surgim/llll;t, Sf. John's General Hospi-
tul, St. John's, Newfoundland.

As.wciarion Acti,'ities: acti,'e mc'mber,
Association of Registered Nurses of New-
foundland.

I accept this nomination. knO\\ ing there
are thou
ands of nur
es like myself who
feel [hat the practice of nursi
g is not
mere!) ajob but a privilege.
I think we must retain a fe\\ old-
fashioned ideas \\ ith the newest scientific
facts. For instance. that super new seda-
tion is very effective. but the patient md)'
have a more restful night if the bed sheet
i
tight, or if he is propped up on his
pillow. An intercom \\ ill save time. but it
takes the presence of someone nedr to
soothe a frightened patient.
The pace of life today i
very last. The
shortdge of hospital beds demand
that
ru,>h. Howe\er. I still believe \\<e must
have time to listen to our patients.
Patients are individuals and we mu...t take
that into con
ideration.

As a nurse, I know m) Iimitallons. I
can remember I also carr) out doctor
'
orders. We are tedm members \\ ho do our
best to promote good health no\\ and in
the future.
In addition to this. if the best of
medical and nursing skills are not effec-
tive, there are us';ally relative... around
\\< ho need emotional ...upport at this
difficult time in their Ii\es. I don't think
that as nurses \\ e can ignore them.
treating them mere!) a... part of the
hospital furniture.
The roles 01 a nun.e are numerou.... I
feel \\e must take advantage of eve!)
opportunit) to update our skills and
knowledge - not e\er)one ha... the
privilege of ...pending ...everal year> of
concentrdted
tud\ at univer
itv. But
there are ah\ ays opportunitie
to gro\\ in
thi... profession.
If I can repre
ent the nurse at the
Pdtient's bedside, I seek the nomination.

CANDIDATES FOR MEMRER-AT-LARGE SOCIAL AND ECONOMIC WELFARE

"rI

A;

......

../'

Glenna S. Rowsell. St. Jolm's General
Hospital, St. Jolm's, Newfmwclland:
dipl. clinical supen'i
ion and dipl. nun-
APRil 1974

ing education and administration, U. of
Torolllo; dipl. public hmlth nursing, {f.
of Ottawa.

Prese1l1 Position: Employment Relations
Officer, Nell' Brun.\ wicÅ Association of
Registered Nurses, Fredericton.

Association Activities: sust(llntng
member, 4RN.V; College of Nurses of
Ontario; director, Canadian Nurses' As-
sociation board; member of Canadian
Nurses' Foundation board of directors.

I accepted the nomination as the Canadian)
nurse
' Assm:idtion mcmber-at-Iargt"
(...ocial and economic \\elfare) on the c,,,
board of directors bel:ause I felt the need
to assist in the completion 01 ta
J...s

already in progress during the 1972-74
biennium.
\\ e also have to continue to establish a
comprehensive understanding of the com-
plex field of social and economic \\dfare.
Social emphasis on health and \\e!fdre is
expanding so rapidly that C'\" must conti-
nue to reexamine its goals to prO\ ide lor
greater participation. to act as a lobbyist.
and to speak for nurses at allle\ds.

THE CANADIAN NURSE 29
.

-

E. Margaret Bentley. Royal Victoria Hos-
pital, lv[oflfreal; diploma, public health
nursing, Dalhousie University, Halifax.

Present Position: C01zsultllnt, Social and
Economic Welfare, Registered Nunes'
Association of Nova Scotia, Halifa.\.

A.uociatimz Activities: consulTllnt to llnd
secretlll)' of the R^' 4.V5 committee on
social and economic welfare; memher et
officio of mrious R'y4,v5 ad hoc commit-
tees; six yellrs on the board of directors
and immediate past presideflf of the Public
Health Association of No va Scotia.

As consultant in social and economic
welfare rRNANSI over the past six years.
and having worked in puhlic health and
emergency health nursmg. I have noticed
how poorly and inadequately nurses
communicate with each other and with
the communit\' in general. Thev do not
express their- \ie
s or beliet's often
enough. and especially not in the places
where their voices are most likely to be
heard and heeded.
Since the organization of collecti ve
bargaining for nurses in Nova Scotia in
1968 and our efforts to educate nurses on
the legal aspects of their work. we have
seen that our members have become more
comcious of the importance of speaking
out and involving themselves in the
matters that concern them. Through briefs
presented on their hehalf. liaison with

-

...

"

,"'

..

lean E.C. lewis. R.S.CN., Alder Hev
Children's Hospitlll, Liverpool, England;
S.R.N.. Sefton General Hospital. Liver-
pool; community health administration,
Live/pool.

Present Position: Director, Public Health
Nursing Division, Departmem of Health,
Pro
'ince of Ne

foundland, St. John's.

Association Acth'itzes: past president of
the Association of Registered Nurses of
Ne"loundland; member of various com-
mittees of ARN,V: chairman of AR'V,v fi-
nance c(JI1zmittee, social & economic
we(fare committee; pllSt president of the
St. lo/m's chapter oj the 4R'v.'V; former
memher oj the CVA committee on social
30 THE CANADIAN NURSE

and economic welfare; former chllinnan
of the CNA commitzee on legislation:
execwive member of the Ne

foundlllnd-
Labrador branch of the Canadian Public
Health Association; member of the Roml
College of Nursing, Englllnd.

Every individual. in this day and age.
should have .m opportunity to determine
and improve working conditions and
economic standards. This can be achieved
on an individual basis through negotia-
tions or whatever processes may be
appropriate. and availahle. at the time.
Having been a member. in the past. of
the Canadian Nurses' AssociatIOn com-
mittee on social and economic welfare. I
have subscribed to the beliefs of the CNA
on this subject.
Nurses. and the nursing profession.
have the right and responsibility to define
their functions. as well as emphasizing
that the bæ.is to the provision of a high
quality of nursing care is the adequacy of
nursing staff. conditions of work. and an
environment conducive to efficiency and
individual satisfaction.
The local and provincial needs of
nurses are immediate. which has resulted
in many more nurses becoming infonned
and involved in the collective bargaining
process in order to meet these needs.
I believe that the CNA must continue to
set goals; exert it!> energy in research. as it
relates to the general social and economic
welfare of its members; recommend
changes; and initiate appropriate action

resource personnel. educational work-
shops and meetings. I feel that we have
made a start toward becoming a unified.
decisive group of professional people.
The day has long passed since one
person. such as Florence Nightingale.
could make headway through sole effort.
Nurses must work and stand to!!:Cther. it is
my sincere hupe that I can oft
r stimulus
and leadership to nurses to encourage
them to become more vocal and more
involved in both the world of nursing and
the world in general. One thing is certain:
If we do not speak and act on our own
behalf. we will be left with but two
choices - one of no change <ind one of a
change imposed by others than ourselves.

that will have far-reaching effects both on
a national owd provincial level.
My willingness to accept nomination is
becduse of mv concern for the social dnd
economic weÍfare of nurses both provin-
cially dnd on a nationalleve!.

APRil 1974

CNA Financial Statement

CANADIAN NURSES' ASSOCIATION

STA TEMEf\1 OF INCOME AND SURPLUS

Year Ended December 31,1973
(with comparative figures for year ended December 31, 1972)

Revenue:
Membership fees . . . . . . . . . . . . . . . . . . . . . .
Subscription

Advertising
Sundry income. . . . . . . . . . . . . . . . .
Government grant re National Conference
on Nurses for Community Service - net.

Expenditure:
Operating expenses:
Salaries .............
Printing and publications
Döign and graphics
Postage on journal .
Computer service. . . . . .
Committee meeting
'"
Tran
lation services. . . . . . . . . .
Commission on advertising sales ...........,.......
Affiliation fee
- I .CN.
- Canadian Council on
Hospital Accreditation

Consultant fees
Staff travel ...
Office expem,e . . . . . ..
Books and periodical!-. .
Legal and audit .....
Building services .
Sundry .. . . . . . . .
Furniture and fixturö
Landscaping and improvements
Depreciation - CN.A. House

Nonoperating expenses:
1972 convention .
Canadian Nurse
' Foundation
- admini
lration .......
- grant to Röearch Fund

Loss before item
below . . . . . . . . . .
CNA Te
ting Service - per statement
Investment income

Nel income for year
Surpl u
at beginning of year
Surplus dt end of year

APRIL 1'174

1973

$ 830,736
43.978
264,594
II. 934

2,552
1.153.794

529.808
212.666
I I. 708
116.170
18A89
11,281
1.309
25.714
40.464

5.000
7.825
16,547
30.574

.108
5.mO
67.974
7.929
6.970
345
31.867
1,165,778

1972

$ 789,620
42,310
256.943
12.232

I. 10 1.105

494.480
210.136
12.649
117.7m
20.861
19.122
2.663
23,675
37,156

9.339
13.5g8
32.174
7.068
4.677
72.562
4.035
5.344
III
31,867
1.119,210

3,103
4,334 3.488
2 , 000 2 , 000
6 , 334 8 , 591
1 , 172 , 112 1 , 127 , 801
(1 8 ,3 18 ) ( 26,696 )
40.397 84.745
51.968 39 , 766
92.365 124 , 511
74.047 97,815
874 , 027 776 , 212
5 941<.074 S 874,027
--
THE CANADIAN NURSE 31
.

CANADIAN NURSES' ASSOCIATION

BALANCE SHEET

as at De(,ember 31, 1973

(with comparable figures for year ended December 31, 1972)

ASSETS

Sundry Assets
Marketable securities - at cost (quoted
value $15,170; 1972 $16.453) ...............
Loans to member nurses plus accrued interest

1973 1972
$ 6.859 S I R6.R93
720,46(} 566.538
47.IR4 30.288
16.930 14.770
9.660 9.537
801 , 093 808 , 026
3.779 3.779
_ 6,759 6 , 714
10.538 10 , 493
55 I. XOO 5R3.667
......... . I I
-S5T:ROf 5R3.668
S 1.363.432 '51.402.IR7
- -

Current Assets
Cash in bank .........................
Short term deposits plus accrued interest ............
Accounts receivable ...................
Membership fees receivable ..........
Prepaid expenses . .

Fixed Assets
CNA House - land building - at cost
le
s accumulated depreciation on building
Furniture and fixtures - at nominal value. . . . .

Approved on behalf of the Boarù:

MARGUERITE SCHUMACHER
HELEN K. MUSSALLEM

PresÙkllt

Executive Directnr

32 THE CANADIAN NURSE

APRil 1974

CANADIAN NURSES' ASSOCIATION

BALANCE SHEET

as at December 31, 1973

(with comparable figures for year ended December 31, 1972)

LIABILITIES AND SURPLUS

Deferred subscription revenue. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1973 1972
$ 23,654 $ 37,236
28,000 29.706
79 , 800
51,654 146,742

Current Liabilities
Accounts payable and accrued liabilities. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Deferred membership fees. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Mortgage Payable - 6 I % due 1976 - payable in
monthly instalments of $3.548 to include
principal and interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . .

363,704
948.074
$ 1,363,432

381.418
874,027
$1,402,187

Surplus. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

We have examined the balance sheet of Canadian Nurses' Association as at December 31,
1973, and the statement of income and surplus for the year then ended Our examination
included a general review of the accounting procedures and such tests of accounting
records and other supporting evidence as we considered necessary in the circumstances.

In our opinion. these financial statements present fairly the financial position of the
Association as at December 31, 1973, and the results of its operations for the year then
ended, in accordance with generally accepted accounting principles applied on a basis
consistent with that of the preceding year.

GEO. A. WELCH & COMPANY, OlTAWA,
CHARTERED ACCOUNTANTS

January 31, 1974

APRIL 1974

THE CANADIAN NURSE 33

CANADIAN NURSES' ASSOCIATION TESTING SERVICE

STATEMENT OF INCOME

Year Ended December 31, 1973

(with comparative figures for year ended December 31,1972)

Revenue:
Examination fees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Interest earned . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Sale of computer program . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ..............

Expenditure:
Salarie
..................................................,..............".
Boarù and committee meetings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Item writing . . . . .. .................................,..... _ . .. .... ,........
Operations (data processing, printing,
warehousing) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . .
Consultants ......... . . . . .. ...................... . . . . . . . , . . . . . . . . . , . . .
Rent.. .. .. .,.. .. .. .... " . . .. .. .. .. . ,.. .. . . .. .... .. . . .,.. . . .. .... ., " .... ...
Tran!>lation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Office supplies and st:nionery . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Postage and expre!>s . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . .
Telephone and telegraph .. . . . . " ...........................
Staff travel .. . . . . . . .. ..................................................,.,..
Equipment maintenance and rental .................... . . , . . . . . . . . . . . . . . . . . . . . . . . .
Books and periodicals .......... . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . , . .
Furniture and fixtures
Miscellaneous

Net income for year.

34 THE CANADIAN NURSE

1973 1972
$287,950 $318,498
2,895
2 , 078-
290 , 845 320 .5 76
115,435 96,192
26,074 24.662
18.853 27,801
62,915 64,034
450
7,805 7,525
3,370 4,430
3,835 2,835
3,993 1.134
2,418 2,584
2,204 1,385
1,089 529
786 268
2,169
1 , 221 283
250 , 448 235 . 831
$ 40.397 $ 84.745
---

APRIL 1974

.

Annual Meeting and Convention
Canadian Nurses' Association
Manitoba Centennial Centre
Winnipeg, June IS-21, 1974

.1

r-

t

.....

Canada's Friendly People Province
Welcomes You to Winnipeg
"Heart of the Continent"

-

...
, I

-

CANADIAN NURSES' ASSOCIATION
Annual Meeting & Convention

Program Highlights

Manitoba Centennial Centre Concert Hall
June 16-21, 1974

Theme: "Nursing and Health"

Sunday, June 16
15:00 hours - Registration

Monday, June 17
08:00 hours - Registration

16:00 hours - Interfaith service

09:00 hours-

General session
Address - Marguerite E. Schu-
macher, President
Report- MARN arrangements
committee:
Margaret R. Swedish

19:00 hours - Opening ceremony
Chairman - Marguerite E. Schumacher,
President
Representative of the Province of Man-
itoba
Representative of the City of Winnipeg
Representatives of ICN, WHO, ANA

Roll Call

Reports

- Executive Director
- Special Committees:
Testing Service
Nursing Research

Welcome - Manitoba Association of
Registered Nurses
Keynote address
20:30 hours - Actors'showcase

21 :00 hours - Reception - Host: Manitoba Provincial
Staff Nurses' Council

- Committee on Nomina-
tions
Nominations from the floor (voting dele-
gates)
Report - Treasurer

36 THE CANADIAN NURSE

APRIL 1974

Report - Auditor
Appointment of auditor

19:00 hours - Dinner
Host: Manitoba Association of Regis-
tered Nurses
Place: Minto Armouries

Tuesday, June 18
08:00 hours - Registration

09:00 hours - NURSING AND HEALTH: CHANGING
WORK RELATIONSHIPS
Chairman - Alice Baumgart
. community participation
. interaction among the health profes-
sions: nursing, medicine, social work
. legal implications

11 :00 hours - Discussion

14:00 hours - NURSING AND HEALTH: CHANGING
STRUCTURES IN HEALTH SERVICES
Chairman - Nicole Marchak
. a provincial approach
. innovative nursing projects
. community planning

15:00 hours - Discussion

18:00 hours - Riverboat excursion

Wednesday, June 19
09:00 hours - Canadian Nurses' Foundation - annual
meeting

09:00 hours - Voting - Election of CNA executive
committee

12:00 hours - Recreation and sightseeing

18:00 hours - Folklorama

Thursday, June 20
08:00 hours - Registration

09:00 hours - NURSING AND HEALTH: PERSONAL
ATTITUDES AND PROFESSIONAL
IMAGE
Chairman - Roberta Coutts
. the nurse and her own health
. self-image and the nurse
. dynamics of effective representation
. student expectations
. client reaction

11 :00 hours - Discussion

11 :30 hours - Presentation to outstanding Canadian
nurses

13:30 hours - MULTI-SESSIONS
1. Research in nursing practice: defining
the problem
2. Trends in nursing
3. Towards a definition of nursing prac-
tice
4. Initial assessment in acute illness:
when minutes count
5. Care in renal failure
6. The process of concept definition and
concept operationalization in research
(videotape)
7. Nursing perspective of the treatment
of drug addicts in a penitentiary

Friday, June 21
09:00 hours - General session
Chairman - Marguerite E. Schumacher,
President
Report of Resolutions Committee
Report of Scrutineers

14:00 hours - Installation of officers
President's reception

Coffee served daily from 10:30 to 11 :00 hours.

All events held in the Manitoba Centennial Centre Concert Hall unless otherwise indicated.

Lunch recess at 12:00 hours daily.

Exhibits open at 09:00 hours daily, Monday, June 17 to Thursday, June 20.

In keeping with the theme, "Nursing and Health," fitness tests will be conducted daily; results available during the convention.

APRIL 1974

THE CANADIAN NURSE 37

"

....

Nurses break the ice

\,

\

,
\

.

Nursing aboard an icebreaker in the Arctic may not be every nurse's idea of
"heaven on earth." Yet the RN who served on the John A. Macdonald says
she'd recommend it to anyone who wanted "to stand on her own two feet and
make decisions."

t

Hilary Brigstocke

,

Because of the shortage of doctors and
male nurses available for duty aboard the
federal government's icebreakers on
their annual cruise in Arctic waters,
female nurses have, for the first time,
been employed as medical officers aboard
these vessels.
This past summer, three nurses - Bar-
bara Lord, Carol Beazley. and Helen
Doyle - served aboard the icebreakers
John A. Macdonald, Louis St. Laurent,
.md Labrador, respectively. They were on
contract to the department of national
health and welfare, which is called on by
the ministry of transport (MOT) to supply
medical personnel for these long cruises
that last anywhere from two to three
months. The idea is to "show the tlag."
as it were, in Canada's remote northern
areas; act as icebreakers; and "mother"
!.upply vessels bringing stores to remote
stations, such as Eureka on Ellesmere
Island.
The 18,000 horsepower Macdonald,
one of the biggest icebreaker;, in the
world (she helped the large US tanker
Manhattan on her successful negotiation
of the Northwest Passage to Prudhoe Bay.

\
\

Mr. Brigstockc is Media Coordinator
(Health). Information Directorate, Health and
Welfare Canada

38 THE CANADIAN NURSE

Alaska, in 1969). reached the inner limits
of Greely Fiord in northern Ellesmere
during her stay north of latitude 65.
On a cold. grey Sunday dawn in
mid-November, the Macdonald returncd
to MOT marine basin in Dartmouth, Nova
Scotia, having been away some two and a
half months. In an interview with the
master, Captain G.S. Yarn. and Ms. Lord
soon after docking. I was able to get some
idea of the problems facing a female
nurse, the only woman among a crew of
some 96. Ms. Lord, recruited in Ottawa
by the medical services branch of the
department of national health and
welfare, is a registered nurse with
experience in northern nursing at Inuvik
in the western Arctic and at Moose
Factory, Ontario. She joined the
Macdonald on contract at Resolute Bay,
Northwest Territories.
Nurses who serve on these "cssels
supervise and direct the clinic and ensure
"adequate and competent" medical care
for the crew and passengers. (The clinic
on the Macdonald, in contrast to the St.
Laurent, was quite small for the size of
the ship.) The nurse is under the authority
of the ship's master and accountable to
him.
The extent and type of treatment
rendered on board is governed by what is
required at the time, the resources
available, and the experience of the
APRIL 1974

. I

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The icebreaker John A. Macdonald about to berth at the ministry oftransport's marine basin, Dartmouth, Nova Scotia, on a
cold, windy November day. The ship spent nearly three months in Arctic waters.

individual nurse. All serious cases are
evacuated to shore facilities after
emergency care has been provided.
The RNS have to ensure that there is an
adequate supply of e!.sential medication
and first-aid equipment aboard, maintain
a record of any narcotics or controlled
drugs, and keep medical records for all
the ship's crew. On the cruise they may
have to provide emergency treatment to
persons on other ships in the area. This
happens frequently. particularly if the
icebreaker is escorting !.upply vessels.
The nurses may also assist \\ith
patients at fedeml government nursi ng
<;tations. subject to the ship's itinemry.
They hold sick pamdes daily, and, if
reque!ooted, accompany the ship's master
on his routine in!oopections. An additional
duty is to write reports or make
APRIL 1974

observations. when warranted. on the
sanitary conditions aboard the ship. This
includes food !.torage and garbage
disposal.
Ms. Lord. who was given a large and
well-appoi nted cabi n aboard the
Macdonald (some nurses are not so
lucky), said it was a worthwhile
assignment and could be recommended to
anyone who wanted . 'to stand on her own
two feet and make decisions."
The cruise was not without incident.
For instance, on Friday September 14,
1973, the first engi neer had a severe gall
bladder attack; throughout the day his
condition worsened. The ship was in high
Arctic waters at the time. Ms. Lord
attended the patient day and night and
was in regular consultation with a doctor
on shore via mdio.

On September 15. Ottawa arranged for
an ice reconnaissance aircraft to be
available at Resolute on Corn\\allis Island
to tmnsport the patient to hospital at
Frobisher Bay. hundred.. of miles to the
south. Nurse Lord accompanied him all
the way to Frobisher. arriving there at
2240 hour.. Greenwich Mean Time that
night. She then flew back to Resolute at
0433 hours GMT the next day and embark-
ed on the Macdonald at daylight. What-
ever earlier misgivings she had about
being the only woman aboard ship disap-
peared for she wa.. welcomed back and.
in the eyes of the crew. was accepted as
someone who had proved herself in an
emergency.
There were other incidents where Ms.
Lord had to fly by ship's helicopter to
treat the crew members of supply ves
els
THE CANADIAN NURSE 39

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Ms. Lord packs a memento, given to her by the ship's crew, before she disembarks
at Dartmouth, Nova Scotia.

being esconed by the Macdonald. Four
crew members were evacuated to shore
hospitals after examination.
Much depends on the attitude of ships'
masters. Many of them would prefer a
doctor aboard. Life on a ship is very
much a man"s world, where discipline has
to be enforced. The masters also like
someone who is experienced to deal with
a surgical emergency and who can, if
necessary, carry out an operation aboard.
In Captain Yam's case, there appeared to
be a keen appreciation of what the nurst:
was trying to do.
Not so with all ships' masters, it
seems. Some of them are sailors of the
"old school," men who have sailed in
Nonh Atlantic convoys and who may not
have too much confidence in a woman
being responsible for the health of the
crew. They feel that the men may take
advantage of her femininity and that she
is not strong enough to deal with the
malingerers or seasoned "Ieadswingers. ,.
Funhermore, an attractive young nurse
among all those men could create
problems of discipline.
40 THE CANADIAN NURSE

The crew, for thei r pan. might be
reluctant to consult or be examined by a
woman, panicularly if they have venereal
disease. Funhermore, embarrassment on
both sides could occur from the U'ie of
rough language, pan of the vernacular in
the daily life of the ship.
Again, a young nurse could have a
difficult time if she did not make it clear
to all concerned that she was appointed as
a medical officer by her depanment and
should be treated as such. Much depends
on her personality. experience. and
deponment aboard ship. She is not a
ship's mascot. She represents the
department of national health and
welfare.
Ms. Beazley, on the St. L(jurent, is
reponed to have said in an interview with
the Dartmouth Free Press, "A medical
officer's duty is to care for the physical,
mental, and emotional well-being of the
men." For many of the younger men, this
was the first time they had been away.
Emotional problems that occur when men
are cooped up in a ship for three months
at a stretch are considerable.

A prerequisite to all voyages is, as
already mentioned, the checking by a
nurse or physician of all medical stores to
see if there is an adequate supply. Also, if
there is time, all crew should undergo
regular routine medical examinations.
with a mandatory x-ray. Because of quite
a large turnover in the immediate weeks
before sailing, examinations are some-
times not carried out and men are signed
on who are liable to hean attacks and
stomach ailments. which result in their
being evacuated later during the voyage.
The same could be said for teeth. Ms.
Lord said that the condition of the crew's
teeth left much to be desired and that
some form of oral examination and
treatment <;hould be completed before
embarkation. Perhaps the attitude of some
masters is that a man can still work with a
toothache, and that the boatswain, with a
pair of pliers, can solve a lot of problems.
However, the question remains: What
type of health services is required aboard
these ships'? For instance, if a doctor can
be persuaded to take two and a half
months off his regular practice, for a fee
of $1,500 a month. will he have enough
to do on the ship? Some retired
practitioners would welcome a chance to
have such a trip in a remote and exciting
pan of the world, where they have time
for reading, writing, and photography.
There are some who want to go for
different reasons, however, and careful
selection is essential. On the other hand,
one can argue, with some justification,
that the presence of a doctor is a luxury.
Most emergencies that do occur - and
what happened on the Macdonald is a
good example - could be handled, some
say, by a paramedic or sick-bay
attendant. Others argue that a nonhern
nurse with clinical experience could fill
the bilL Under the present contracts,
nurses like Ms. Lord get $700 a month
with ovenime, subject to the master's
discretion. Her gross income was about
$1,200 a month.
George Dunn, a nursing officer with
many years experience in the depanment
of national health and welfare and with
the Royal Air Force in peace and war, has
served as a medical officer aboard a
number of icebreakers on nonhero
cruises. This year he was on the CCGS
APRIL 1974

Narwhal, which wa.. employed on
hydrographic work in James Ba
. He
treated one case of acute muscular spasm.
which wao; "difficult."' but nothing that
he could not handle. He believes much of
the medical \\ork abodrd these ships
could be dealt with by a nurse practitioner
or someone who had clinical experience.
ratherthan "classroom" experience.
It remains to be seen whether doctors
or nurses are the answer for these kinds of
duties in northern regions.
In some instances a paramedic (and
here the connotation is not confined to the
male sex) could provide the answer.
However. what ma) be needed is a
balanced selection among all three
categorie.. of health \\orkers - doctors.
nurse'. and paramedics. In deciding upon
a suitable candidate for the post. a
number of factors would have to be borne
in mind' the size and makeup of the
crew. duration of the crui se. the length
of loss of contact \\ ith and distance from
the neare<;t land-based facilities.
availability of communications. the
number of "upply ships the icebreakers
may be escorting. and so on. It should be
remembered that \tOT requests the
department of national health and welfare
to provide a medical officer on board
vessels destined for extended northern
cruises or when they have a crew of
bet\\een RO and 100. In addition. DNH\\ is
responsible for the health of the
government per..onnel on board
Undoubtedly. there will be a continuing
and cooperative examination of the joint
responsibility for health on these
icebreakers, The emergence of new
health disciplines. such as clinicall)
oriented nurses and dental therapist!>.
trained to fumi!>.h services to relatively
isolated ..egment' of the Canadian
population. may eventually provide the
answer to the problem of meeting the
health requirement" of the crews.

Barbara lord, a registered nurse who
acted as medical officer for a crew of
96 men aboard the ministry of
transport'<. icebreaker, lohn A Mac-
donald, disembarks at Dartmouth,
Nova Scotia.
APRIL lqì4

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THE CANAOIAN NURSE 41

Maternity patients
make decisions

In the postpartum program at St. Paul's Hospital, Vancouver, mothers and
fathers make the decisions in learning to parent their newborn babies. The
nurses' role is chiefly to make nursing judgments about the degree of assistance
and support the parents need.

M. Bernadet Ratsoy, B.Sc.N.

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42 THE CANADIAN NURSE

I

In January 1971, the maternity
departtnent of' SI.' 'Paul's Hospital.
Vancouver, initiated a new program to
provide a postpartum period free of
physical complications for the ohstetric
couple (the mother and infant), and
progressive adjustment to a positive and
independent parental role for the mother
and father.
We recognize the patient-mother as a
per!ooon ahle to make decisions, and her
husband or mate as her source 01
problem-solving assistance. The nurse -
teacher and supporter - complements
their roles; she does not attempt to control
the patient's behavior.
Although the parents are encouraged to
function independently, nursing
judgments are made about the degree of
assistance or support needed. Assessment
and appropriate nursing intervention in
relation to the mother'" and infant's
physical condition remain the most basic
responsibility of the nursing staff.
Nursing staff provide regular
monitoring of the physical conditions of
mother and infant. without interfering
with family activities. For example, the
Ms. Ratsoy is maternal-child health coordi-
nator at 51. Paul's Hospital. Vancouver: she
is a graduate of the Edmonton General
Hospital school of nursing dnd the University
of British Columbid.

The author, right, with mother and
baby.

APRIL 1974

infant'
weight. temperdture. and so on.
are recorded on the night tour of dut)
"hen most infants dre in the nurser
.
Our
i
not a rooming-in program.
There is no '-mu
t' dbout \\hen the
infant i
"ith the mother. no
cheduled
feeding time
. or an) other routines
that chdracterize rooming-In program
.
The central nurse!) provides ,upervised
infant care "hene\er the parent
"ish.
:\lother
mO\e in and out of the nur
ery
picking up equipment and supplies for
infant care or feeding their infants under
supervision of the nurse. The nursery
all 0\\
a röpite from the re
ptJn
ibilit) llf
the infant and ha
proved to be a necessa!)'
contribution toward a rested and contented
mother.

Physical facilities
The delivery suite is de
igned to alllJ\\
mdximum participation by the father or
other ..igniflcant person; It providö
pri\acy and comfort "ith nur
ing dnd
medical a,si
tance at hand.
The po
tpartUJn unit is decomted a, an
ãwmge famil) nught decorate it, home.
A fe" bedrooms are furnp,hed in
. 'contempomr) ho
pital" for immediate
postoperati\e patient care. other"lse the
room.. are furni
hed dS ordwdr)
bedrooms.
Lounges provide a small librdry.
telephones. the ubiqUitous televi
ion
et.
and comer
for quiet conversation. A
dimng room encoumges mothers and
fathers to eat together. This room is also
u
ed for group
e
sion
. T dck boards
displa) pertinent articles that the parent'
may read at their leisure.
Snacks. juices. cold drinks. Lonee. and
tea dre always available to the parents.
These service
entice parents to mO\e
about the unit. getting refreshmenh for
themselves. and getting to kno" the unit.
Ñlothers and fathers meet other mothers
and fathers. exchange chi Id-care hint,.
and fonn long lasting friendships. while
learning and gaining support from each
other. It is not unusual to find ne" friend

playing bridge \\ith two infants nearby in
their mobile bassinets.

Learning
An important dSpect of professional
nursing input is the assessment of
progress in the establishment of a healthy
mother-child relationship. Relationships
thdt are not developing are ea,) to
recognize in a situation where the
mother's lack of initidtl\e toward
APRil 1974

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Lila Morrm'\i head nur
e of the unit demonstrates some infant-care tasks as the
parents look on Tealhing is done on an indivIdual basis when the situation is
appropriate or when the parent!> request such a!>sistance.

imohement "lth her infant I
obvious.
Le
s obI. iou
but sti II recogni7able is the
nature of the father s involvement "ith
his infant.
Parent
wIllingly ds,ume the learner
role "hen their lack of knowledge cause

them no embarrd
sment. :\10thers set their
own learning ta,b. a
in the case of the
mother \\ ho ..trrange' to have her infant
stay \\ith her overnight so she will "know
how the baby acts during the night."
The nursing
taff pro\ ide the
infonn..ttion. ..upe" i
ion. and support
needed for learning. The parent
provide
their own moti\ation to become "good"
parents. and support edch other During
the hospital stay. the parents have
opportunities to practice being parents.
through Infant care tash. For example.
both mother and nurse contribute to the
infant's daily record. A "orhheet is
attached to the baby'
bassinet; mother
and nurse each record the feeding
amounts. emesis. regurgitation. stools.
and voidings with which she has been
imolved.
Intant care during the day i
carried out
in the mothe"
bedroom. unles,
circum,tance, dn not allo". The mother

IS never made to fed ..he muo;t assume all
self- and infant care. but care is carried
out "here
he can view the proceedings
becau
e she is interested in learning and
because thi
i
her infant. Our intent is to
stimulate learning and encourage contact
bet" een mother and infant.
The degree to "hich father becomes
involved with infant-care tasks depends
upon his interest and his concept of the
male role. His frequent and lengthy visits
allow a great deal of sharing of the
problems and decision making of
parenthood. Di'icussing a problem and
arriving at a decision together spreads the
responsibility for the decision made and
lessens the lonely responsibilit
some
mothers feel to" ard child rearing.
Usually the mother is able to provide
for her own postpartum h) giene if she is
taught how to do so. Each task is
demonstrated and a return demonstration
is requested by the nurse. These tasks of
self-care are planned so they can be easily
carried on after discharge. "ith no
significant changes in equipment or
method.
Emphasis is placed on the mothers
need to remain healthy, mentdll
and
THE CANA[)IAN NUR
E 43

physically: She must pay attention to her
own needs so she can meet her infant's
needs. If the parents are convinced of this
and have confidence in their skills as care
givers and decision makers. the problems
of excessive fatigue and fceling
of
inadequaq that lead to postpartum
depression may be avoided.

Visitors
The subject of VIsitors in a
family-centered maternity care program
raises concerns related to disturbance.
and spread of infection. Neither of these
concerns has affected our program
significantly.
Visiting is regulated b) the parents
themselves. A limited number of passes
arc given to the father for distribution. In
this way, the hospital assumes
responsibility for limiting the number of
visitors so the parents need nO\. and the
father assumes the responsibility for
disseminating information about the
regulations and giving passe
to the
invited visitors. As time passes. we find
that fewer people arrive to visit without
having been invited by father or mother.
On Sunday afternoons. other children
in the family are invited to \isit with their
mother in the lounge. The infant
are
taken to the nursery during visiting times
and visitors view them through a window
in the traditional manner.

Outcomes
SI. Paul's family-centered maternity
care program has been functioning for
three years and the appropriateness of the
decision to institute such a program is
constantly reinforced.
Safet) during the postpartum
hospitalization. the first objective. has
been maintained at least as well a
in the
previous program. The establishment of
risk evaluation * has raised the level ot
awareness in nursing staff and contribute

to anticipatory care. both in the intra- and
postpartum periods.
The objective of progressive parental
independence is difficult to evaluate but
we have gained a number of impressions
related to our success in meeting this
objective. An evaluative research study
will be undertaken in the near future.
Through the weekly prenatal tours of
SI. Paul's obstetric facilities. we have

"The Goodwin high ri
k sc('ring ...ystem IS
used at 51. PdUr... Ho...pital.
44 THE CANADIAN NURSE

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Parent!> include their infants in many of their activities. These situations generate
feelings of control and self-confidence in the parents.

discovered that the consumers of obstetric
,ervices are beginning to shop around for
the agency that provides the program they
desire. Some parents have changed
physicians, and others inquire for names
of physicians attached to SI. PalJl"s to be
eligible to use the ho'pital faci lities.
A
a response to the demonstrated wish
to use SI. Paul's
ervices. and to reduce
the upheaval involved in a change of
phy,ician once pregnancy is well on in
gestation. the hospital administration ha

agreed to accept applications for
temporary obstetric privileges from
physicians. not attached to SI. Paul's
Hospital. whose patients want to take part
in the program.
The parents using SI. Paul's continue
to be dmwn from an area larger than the
immediate community. Some have corne
from the state of Washington to take part
in the program.
Public health nurses making
postpartum visits indicate that mothers
whose childbirth experience has occurred
at St.Paul's are calm and confident in their
responsibilities and roles as mothers.
Physicians have said that the mothers
telephone them less frequently about
concern
such a, infant behavior and
feeding. When the mothers do telephone.
it is for good reason. such a
the baby's
diarrhea and vomiting.

Summary
In the St Paul's Hospital
family-centered postpartum program.
parents are recognized as persons willing
to assume responsibility. able and willing
to make decisions regarding their
responsibilities. The nursing staff assist
the parents to dSSume their responsibility
and also provide opportunities for parents
to practice problem-solving during their
hospital stay.
We believe that if a mother and father
have indication from others that their
roles as parents are important and
prestigious, requiring preparation. we
will foster confidence and positive family
relationships. Out of sharing. confidence.
and control grow positive feelings about
childbearing and childrearing that
ultimately enhance the growth and
developmental potential of the infant.
The nurse's role has changed from the
tmditional provider of care. The parents
are members of the health care team and
work alongside the nurse to meet the
objectives of the program. the parents'
objectives.
The program is our interpretation of the
community's expres,ed need, for a
chi Idbirth experience that maintains the
umbrella of safety for mother and child,
a<; well as allows. even encourages, the
magic surrounding childbirth.

APRIL 1974

Diet club

Peggy Lock

The diet club held at our clinic began as a
public service to our largely rural com-
munity. in response to requests made to
the clinic doctors and mvself for ad\-ice
on dieting and exercise. Ít took the form
of "eekly "talk and coffee" se!>!>ions
"here guests. on some occasions. gave
talks on exercises or demonstrated
make-up and foundation gannents for the
ladie!>.. A modest fee of one dollar per
year covered incidental expenses.
For the most part. the members talked
about problems of obesity and how to
solve them.
To lose weight. the club members
needed a reali!>.tic. inexpensive pro
Jfam
that could easily be included in everyday
family life. Our guide became the Cana-
dian Diabetic Diets. based on the ex-
change s) stem. As these diets are com-
pri!-.Cd of ordinary food. they were easily
adapted to our needs. For those who felt
cheated because they could not have
desserts. we had copies of diabetic
desserts run off as recipe books. and
induded recipes for
uch things as low-
calorie milhhake!>.
Because I have frequent contact with
the members as a nurse at the clinic. I led
the group at the start. but encouraged the
members to lead the discussion!>. and take
charge of the meetings. I followed their
dietary patterns closely during the first
month to a!>certain the members' need!>.
and problems.
Entertaining dnd restaurant meals
sho"ed up as trouble spot!>. The "bor-
rowing" sy!>.tem for "eekends. whereby
nothing "ould be eaten all day in order to
have a big meal and several drinks in the
evening would result in zero weight loss
for that week. even though the week it!>elf
had been a good one.
Because so many were patient!>. at our
clinic. no phy!>.ical examination had been
required of our members. \\ e therefore
based the number of calorie!>. allowed on a
person'!> activity, body type. de!>ired
weight. and estimated caloric expenditure
for a day. Thi!>. proved difficult. as most
people considered themselve.. to be more
active than they really were.
APRIL 1974

Each person was to try to lo!>.e between
one to two-and-a-half pound!> a week. As
a pound of body fat i!> 3.500 calories. * at
least 500 fewer calories per day must be
ingested to lose one pound a week. That
meant that the a\-erage dail) intake of our
club members was to be between 800 and
1.000 calories.
We counted calories - e\-ery
day - every "eek! When going over
members' accounts for the week. I could
see if caloric intake had been adequate
and if appropriate food had been eaten.
A!> it ..eemed important for members not
to divulge their actual weight. only the
"eekl) "eight loss or gain was posted in
the office. Thi!> "as reminder enough.
Our first few !>.ession!> were devoted to
Canada's Food Rules. proper eating
habit... various diets available. avoidance
of hidden calories, and the value of
exercise. We taught a !>.et of exercises. but
encouraged walking. swimming, and
other sports d!> an alternative or supple-
ment to exercises that could be boring.
maintaining that any activity using up
calories is of value in weight reduction.
Good progress was made during the
first two months. Then a "eight plateau
was reached. depression hit the group.
and some members dropped out al-
together. Ho"ever. by the fourth month
efforts "ere rewarded: clothes that had
ju..t hung in closets could be worn again.
fatigue had lessened.
Once May brought good weather, peo-
ple became too bu!>y on their fanns and at
home to attend the weekly meetings
regularly. We then ended the !>.eason with
a IOVv-caloric banquet that "as well
attended.
Of the 52 people initially registered
with our club. 40 remained with the
program. Together. they shed more than a
million calorie!>.. or 372 + pounds. an
average "eight lo!>.!>. of o\-ër nine pounds
each.

* JCdn \1a
cr. íh er....eight, Cw/\e.\. Cost all"
COlltrol, :'\Icv. York. Prenticc-H,.II. 14('R.
p.71.

Pegg) Lod.. d grdduate 01 the L'ni"e,...ity 01
Albcna School 01 Nur...mg. i... clmic nur
lor d
group of fdmil
prdctirione..... .It Cochranc.
Albend.

idea
exchange

Houses for
psychiatric day-care

Beverly P. Hanna

At Lions Gate Ho...pital. t\\ l) home...
are used tix the ps)chiatric da) center.
In the smaller hou...e i... the intcnsi\e.
in...ight-oriented program; the struc-
tured. heha\ ior-oriented program. and
the medication and/or rmlintenance
program arc located in the lareer hou'e.
rhe patient.. use thc hou...e... \-Ionda\ to
Frida\. 7 hours a da\; SC\ cral e\ enílH!'
a \\ed... folh1\\-up arid rdati\ co,' groups
meet there.
Ille three treatment program' arc
h,l,ed on \ariou, form... of group thera-
p) - \erhal (using dialoguc. ps)cho-
drama. and role pla)ingl: nOll\erhal
(u...ing arl. music. and mo\ ement): ac-
ti\'it): including \\ork pn
iect.... sports.
and games: ,lIld rdati\ es' group' .lnd
indi\ idual famil) the rap) . Although
much of thi, the rap) can he done in a
hospital setting. \\e prefer a llnuse fÒr
m.tn\ rea'Olb.
H
cause the da\ center loob like
an ordinar) hou...e. ihe patient-. ,lIld their
rdati\c... arc Ie" a\\are of. and Ie,...
anxit)u... ahoul. attending a ho...pital
facilit\. Patient... often fed the\ arc
comin-g to cia...... or group. rather than [()
a hospital.
.-\ hou...e meet-. our goal of heing a
communit\-oriented t
lcilit\. ;1\ailahk
anJ reachIng out to tho...e -\\ ho do not
need or ma; nllt \\ant ho'pitalil'ation.
In addition. man) parts ot the program
arc lös e\pensi\ e than the) \\ oilid be
in a hospital sett ing.
Facilitie... neee...sar) for the d,l)
center pwgram - group room.... inter
\ ie\\ J'l)oms. \\ ,I...hroom. kllchen. office,.
.tIld ,I \ ard - ,Ire ;tlread\ a\ ailahle in
a hou;e. O:cllpational therap) equip-
ment and a l:arpentr
,hop \\ ere added
to the larger hOIl...e. fhe onh facilit\
nù:ded "wside the hOIl'e, i...-the ho
.
pitaf g)mnasium in the \\ inter month,.
rh..' ho'pit,tI diet I..itchen 'upplie' a
noon meall1f ...and\\ iche,. 'oup 01 salad.
,lIld des,ell. \\ hich is tralhpol\ed b) u,
from the ho!>pitaL It aho !>upplies
THE CANADIAN NURSE 45

idea
exchange

.;om
of thc food fÓr the on
hot mcal
pr
par
d wed..l y hy thc paticnh. We
gro\\ some vegetahles in our o\\'n
garden.
Wor" j, an integral part of both the
insight- and thc beha\ ior-oriel1lcd prn-
gram:o.. Thcre are dail} duties. such as
washing dishc'. collecting the lunches.
clean i ng up. ,illS\\, ai ng t he phone. and
loc"ing up at night. Wee"'y duties
include complete housecleaning: yard-
\\01'''- such as mo\\, ing. ra"ing. planting.
and s\\'eeping: and coo"ing thc \\ce"l y
hot mcaL
:VI ajol worl.. projects, such a:o. ma" ing
drapes. building furniture. repairing
and painting the house. are also part of
thc program. The hospital maintenance
department perfÒrms an) major struc-
tural changes and electrical or plumb-
ing tas"'. but minor repairs are done by
the patients.
In insight-oricmed treatmel1l. the
\\01''' program emphasi7cs interaction
and learning: thc patients assign and
supervise .lll work. fhey then discuS'
the expaienc
of heing in authority or
bl.'ing under thl.'ir peers in authorit},
In thl.' bchavior-orientcd program.
the focus is on learning ne\\ practical
living and \\'or"ing s"ilb hy planning
and implementing work pn
iech as a
group.
It 'l:cm:o. thl:rc i, .l \\, arml.'r ,ensl.' of
bdonging and of sharcd responsihility.
kit h} staff and patil.'nts ali"e. for" fhe
Hou'l.'," Thc "graduates" fcell.'omfÓrt-
ahle dropping
in fÓr lunch to let us
"now thl.'} are doing well or to n:qul."t
additional hdp and advice.

I he author graduated Irom the \ anl:l'U"er
(Jeneral Ho'pnal 'l.'hOl,J of nur'lIlg in
I')h
. and ha' \\'or"ed in maternit\. P"'I-
,urgel). ,Ind difterent area, ofp",chiatric
11l1l'''ng. as \\,ell as \\,Ith the '\kohnl and
Dlug \ddlctll'n I ollndalion.
h. 1I,Inll.l
" prc'enIJ} head nurse 01 thc p'\Chlalnc
da\ celller al I lon' (,ate Ilo'pilal. ,,"orth
\ .oIlC' 1[1\ er.

46 THE CANADIAN NURSE

Just breathe for help

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Hospital patients \\ ho arl.' almost total-
ly paral}zcd can no\\, summon help h)
using a hreath-operatcd l.'all "" itch.
C) Briggs. a memher of the rele-
phone Pioneers of America and an
emploYl:e of the \1anitoha relephone
System enginecri ng department. heard
ahout a paralYl'ed patient in Transl.'ona.
:vJanitoha. who had difficult) contact-
ing the 11lIrsing station \\ hen she needed
hdp.
Since she was ahle to turn her head
about three inchcs to the ,ide. C\
thought he could de\- ise a "hlow" "'\ itcÍ1
fÒr h
r.
Using the small diaphragms from
inh alators. his exp,,'rimcntatil'n resulted
in t\\, 0 t) pes of pneumatic ,\\ itch -
one \\Ìth a ren\ rela,. the other acti\-at-
cd b) the light spring pile-up. ßoth
could he tied intl' a hospital eall s)stem.
ro activate thl.' pneumatic ,\\ itch.
a patient needs onl} tl' hll'\\' into the
plastic tubc housing the s\\'itch. rhis
pushes the diaphragm against the reed
rda) or spring pile-up. thus dl'sing

the circuit and signaling the nur,ing
station. The unit is placed \\ ithin a few
inche, of the patient's mouth.
\ he fir';! wl'r"i ng model of the hreath
:0.\\ itch. presented to the Par" \1anor
Personal Care Home in Transcona h,
the \1anitl'ha relephonc Pil'neers. wa
'
u'ed b) hlith Chl)don. a paralYl'ed
pat ien!.

Component!.
I he essential parts of the hreath
S\\ itch are: pld'til.' tuhing. \\ ith I 8"
inside diameter. to fit over diaphragm
outlct and of sunï
ient length tl' readl
the patient's mouth: exhalation mani-
tÒld for extension tuhe 11 056.'1: small
mouthpiece: telephone rehl) spring
pile-up: insulator material. \\ ith thread-
ed holes; machin
scre\\s I I 4" X sil'e
of threaded holes ahove: and electric
cxtension \\ ire.
The plastic tubing. the exhalation
manifold \Ùr extension tuhe r056J.
and the small mouthpiecc arc hospital
inhalation eq uipmenl. a\ ailahlc through
the catalog of lkllllC'tf 1cc('\soriC'\ alld
R C'plan'/1//'1ll I'ar!.\.

Assemb;y
\1oUI1l the 'pring pile-up on the
insulator hoard \"jth tension on springs
at I'em. Drill tuhe to match the threaded
holes on in'ulator hoard. and mount
the hoard \\ith the I 1,4" machillL'
Sere\\ ,. Adju,t the height of th
spring
pile-up. dose enough to the diaphragm
'0 that onl) slight pressure is nceded
to ma"e the Cl'lltal.'h. Attach thc electric
extension \\ ire to the spring end, and
\
ir
to the 24- volt ho'pital indicator
') ,tem. I he unit ma) he ,u'pended
Ileal' the outlet.
A I!OoSe-nl'c" Illa, he used for the
SUPPl
.t of the plastic tuhing to I..l.'ep
the Illouthpiece near the patient's
mouth. <.d

\ddilionaJ dL'I,lil, Illd} he l'htained frolll
I red Shac"cli. <";ecrdar}-I rea,!!re!'. \I,tn-
iloha ('hapter. I ekphone Pioneer, 01
'\merica.
Xl) I-'mpre" <";treel. Winnipeg.
\Ianitl.hd. IUC OA2.

APRIL 1974

dates

April 22-26, 1974
Five-day refresher course for obstetrical
nurses, University of Alberta School of
Nursing. Edmonton, Alberta. Registration
limited to 30 students who must be
registered nurses with S.C.M. or equival-
ent' . or 'have' è6;;plèted the 'ádvanc
d
practical obstetrics Course. Registration
fee: $25. For further information, contact:
Continuing Education for Nurses, 12-103
Clinical Sciences Bldg.. U. of Alberta.
Edmonton, Alberta, T6G 2G3.

April 29-May 1, 1974
Annual meeting and assembly of the
Catholic Hospital Association of Canada,
Chateau Halifax, Halifax. N.S.

May 1, 1974
New Brunswick Tuberculosis and Re-
spiratory Disease Association, in coopera-
tion with the Moncton Hospital. will be
sponsoring a one-day program on TB and
RD. Program to be held in the auditorium,
nurses' residence, Moncton Hospital. No
registration fee. For further information,
write to: A.H. Gardner, Executive Director,
NBTB&RD Association, P.O. Box 1345,
Fredericton, N.B.. E3B 5E3.

May 2-4, 1974
Vancouver General Hospital School of
Nursing. 75th anniversary. For further
mformation, write to: Ms. Eva M. Bowering,
Publicity Chairman, 286 Stevens Drive,
West Vancouver, B.C., V7S 1 C6.

May 9-10, 1974
'Cardiology 74" - two-day seminar on
study of the heart, Humber College, Rex-
dale, Ontario. This seminar offers an
advanced program for nurses and would
be of interest to doctors and paramedical
personnel. For more information, write to:
Mr. Bill Bayes, Humber Centre for Con-
tinuous Learning, Humber College of Ap-
plied Arts & Technology, P.O. Box 1900,
Rexdale. Ontario.

May 29-31,1974
Saskatchewan Registered Nurses' As-
sociation, annual meeting. Hotel Sas-
katchewan, Regina, Saskatchewan.
APRIL 1974

June 2, 1974
Final graduation ceremonies and alumnae
get-together. St. Paul's Hospital School of
Nursing, Vancouver. B.C. Interested
graduates may write to: Ms. D. McLellan,
. AI!J'Dl'Jae President. I 29-4550 Fraser
Street. Vancouver, B.C., V5V'4G8. ..

June5,1974
Workshop sponsored by Kent Chapter,
Registered Nurses' Association of Ontario.
Drs. Beryl and Noam Chernick present:
"Sexuality and Communication." Registra-
tion forms are available from: Ms. Edna
Dent, Kent-Chatham Health Unit. 435
Grand Avenue West. Chatham, Ontario.

June 12-14, 1974
Workshop for diabetic patient educators,
Geneva Park Conference Centre, Lake
Couchiching. Orillia, Ontario. Keynote

speaker: Dr. Martin M. Hoffman. Registra-
tion limited to 200. For further information,
write to: Canadian Diabetic Association,
1491 Yonge Sf.. Toronto. Ont., M4T 1Z5.

June 15-16,1974
Reunion, Holy Family Nurses' Alumnae,
Prince Albert, Saskatchewan. Registration
fee of $12 to be submitted by April 15 to:
Ms. Marie Church. 260-25th Sf.. West,
Prince Albert, Saskatchewan. S6V 4P3.

lune 19-21,1974
Canadian Association of Neurological and
Neurosurgical Nurses, annual meeting,
Sheraton Cavalier Motor Hotel. Saska-
toon, Saskatchewan. For further informa-
tion, write to: Ms. D. Ortynsky. 1914 Cairns
Ave.. Saskatoon. For membership infor-
mation, write to: Ms. J. Rapp, 112 Baseline
Rd.. Apt. 1010, London, Ontario.

Director of Nursing:
$12,600 - $15,200

The MINISTRY OF HEALTH'S Dr. Mackinnon Phillips Hospital. Owen
Sound, has an opening in June 1974 for a Director of Nursing Duties will
include planning, organizing and administering the global nursing program,
involving establishing and controlling personnel and fiscal and material
requirements to ensure, through delegation the highest possible quality of
nursing care in this 218 bed psychiatric hospital.
Qualifications: registration as a nurse in the Province of Ontario:
post-graduate certificate in nursing or hospital administration, preferably
with a bachelor of science in nursing: comprehensive knowledge of
psychiatric nursing and of hospital policies and administration; several
years experience In senior nursing administration.
Please submit resumes in confidence to; Hospital Administrator, Dr.
Mackinnon Phillips Hospital. Box 600. Owen Sound. Ontario, N4K 5R3.
This position is open equally to men and women.

Ontario
Public Service

Ontario

THE CANADIAN NURSE 47

names

Jean Reid herard joined the Canadian
Nun,t:
' A

ociatlOn rt:
earch unit (part
time). December 17. 1973.
A gradu.tte of Ed-
monton General
Hmpital
chool of
Nur
ing. Ms. Ever-
ard has had postgra-
duate training in
psychiatric nurs-
ing at the provin-
cial mental hospital
in Ponoka. Alberta.
and recel\ed a B.N. from McGill Uni-
\erslt) She has been nursing
upervisor
In the outp.ttient depdrtment and was.
mo
t re\..entl}. nur
e-in-charge of the
bnd therap) umt of the Allan Memorial
In
tnute. Royal Victoria Hospital,
Momredl

..;.

...-
..

Eileen M. Thauberger, a IlJ7(J graduate
lit thl (ne)
lIn,' School of Nursing,
Rl.!!ln,. I... the \\innel LIt the annual \\
B. S.lll\\lkr.... Cumpan) (',mada a\',alli.
I hI.... iI\\,lrd. a )car..... ....lIo'criptilJl]
to till.' .\lIning Cliniel (
f ^'()/th Alller-
ill/. " gi\ en to the
tudent in the final
)eal of the B.Sc.:'\ program at the
L n 1\ el...il\ 01 \\ ötel n Ontario. Llln-
don. \\ h
) ha... alt.Iined till' highöt
academiL ...t,lIlding for the second and
tlllrd )e,lrS lit the program.

lorine Be
el ha
been appointed director
of nursing, Royal Vlctona Hospital,
Montreal. Quebec.

Ms. Bese! (R.N., St.
Boniface Hospital

chool of nursing;
B.N., McGill U.,
Montreal; M.Sc.,
Bo
ton U.) was ma-
tron of Altona Hos-
pital. Altona. Mani-
toba. early in her
career.
EXl:<:pt for d year as head nurse in the
ps)chwtric unit of the Montreal Chil-
dren's Hospital. and time out for univer-
sit\ studies.
vh. Sesel has been as-
so
i"tt:d with the Allan Memuridl In.,ti-
tute .,mce coming to Montreal in 1957.
Her most recent position there was
director of nursing.
In dddition. Ms. Bese! was consultant
to thl. Mailllonidö Hospital and Home for
the Aged 0968-72). In 1967, she he-
carne a lecturer at the McGill School

- ...

-

----

48 THE CANADIAN NURSE

for Graduate Nurses. and in 197 \, an
assistant profes!>.or. a responsibility
she still carries.

Florita Vialle-Soubranne was appointed
associate director of the Order of Nurses
of Quebec in Februar} 1974.
Ms. Vialle-Sou-
branne, 'W ho ha<; just
returned from a
three-year sojourn
on the Ivory Coast.
has devoted most of
her nursing career
to education and
administration. She
has been on the fac-
ulty of the nursing school of 5t. Justine
Hmpital. Montreal; directOi of nur
ing
care at the SI. Eustache General Hospital
and at the lnstitute Albert-Prevost.
Montreal; and from 1967 to 1970 was
associate profes
or on the faculty of
nur
ing, Uni"er
it) of Montreal.
Ms. Vialle-Soubranne earned her R.N
at St. Justine Hospital school of nursing.
a baccalaureate at the Marguerite
d'Youville Institute, and a master'!>. de-
gree in hospital administration at the
Uni\ersit) of Montreal

.,,.
..a

Odile Larose has been appointed to the
staff of the Order of Nur!>.es 01 <.)uebu: a

nur,ipo consultant,

Ms. Latose IRN.,
Hotel Dieu Hospital
school of nursing,
Montreal: B.SL N ,
M. Nun.., U of
Montreal) hd., had
varied nursmg expe-
rience, !.ome con-
current with stud-
ie
: ob
tetrical and
po!>.tpartum care in a rural hospital.
teaching and clinical supersivion. part-
time responsibilities at an extended care
facility, and collaboration on an ONQ re-

earch project.

-

"

Nettie Fidler. former hedd of the Univer-
sity of Toronto's school of nursing, died
February 3, 1974.
Ms. Fidler held several administrative
positions in nursing: in the Ontario Red
Cross outpost hospital service, The
Toronto General Hospital. and the
Toronto Psychiatric Hospital She is

best known for her contribution to nurs-
ing education as director of the Metro-
politan Demonstration School of Nurs-
ing in Windsor, Ontario (1947-52),
then director of the University of To-
ronto school of nursing. a post from
which
he retired In 1962.
Ms. Fidler \l.a!. president of the Reg-
istered Nurses' A!.
ociation of Ontario
(1948-51): a member of the Dominion
Council of Health; chairman of the
Canadian Nursö' Association committee
on constitution. byla'Ws and legislation:
and a member of the nursing committee
of the World Health Organization. In
1941}. !>.he recei\ed the Florence Night-
ingale medal, an international honor.
Ms. Fidler 'Wa
co-author. \l.ith Dr.
r..enneth G. Gra). of Lem' and the Prac-
tice of Nunil/g

Hðter ). Kernen was dppolllted the first
dean of nursing at
the U niver
ity of
Saskatchewan, SdS-
katoon, in January.
She has been acting
dean since last
July _ when the

chool of nursing
1 at the Saskatoon
.. campu
was e1e-
\ ated to a profes
ional college.
Dean Kernen I R.N.. Regina General
Huspital :-.ch,)ol ot nursing: Cer\. Pub-
lic Health Nur
ing. McGill U.; B.Sc.,
M.A... Teacha
College, Culumbia U.,
Ne\l. York) joined the
U of Saskatche-
\..an III 1953 to develop the public
health nursmg content uf programs in
the
choul of nursing. She h.td formerly
been asso
lated with the Victorian Order
of Nurses, from being <,taffnurse in Win-
mpeg to being an aS
lstant superintendent
at national office in Otta\l.<1.
Having held office III man) nursing
and related associalIon!>.. I\h. Kernen is
currently d member of the joint committee
of the Canadian Nurse!.' A
sociation, the
Canadian Medical AssoL:iation. and the
Canadian Hospital Association; the ad
hoc advisory committee on health care
to the Department of Northern Saskat-
chewan: the committee un Clinical Re-
sources for Nursing Program
. Saskat-
chewan department of continuing educa-
tion: and the nursing advisory committee,
Victorian Order of Nurses.
(Continued on page 50)

"

'!"-

APRIL 1974

for relief of postoortum discomforts
only Tucks babies
tender tissues two ways
as a soothing wipe...as a cooling compress...and as often as she likes

Tucks medicated pads give your postpartum
patient more relief, more often than ointments or
aerosols because pads can be used more ways.
Cooling Tucks medication can be applied by
using the pad as a compress. Or the pad can be
used as a wipe to both soothe and cleanse. As a
wipe, it lets her avoid the mechanical irritation of
harsh, dry toilet paper. A Tucks pad under her
sanitary pad prevents chafing too.
Tucks medication gives prompt, temporary
relief from postpartum discomforts-the itching,
burning and irritation of episiotomies and simple
hemorrhoids. Its active ingredients are witch hazel
and glycerine-there is no "caine" type anesthetic

'(

in it. Your patient can have her own supply of
Tucks at bedside for self-administered relief with
minimum risk of over-treatment or sensitization.
In addition, Tucks medication is buffered to an
approximate pH of 4.6. This helps tissues maintain
their normal acid defenses. Prescribe Tucks pads
at bedside for soothing, cooling comfort from the
first postpartum day on.
Order a trial supply on your Rx. Write to:
IONi

A s

InternatIonal Chern.cat& NucJear CorOCXat:IOO
615 Montee de loesse
Monlreal377 Quebec

,

"

, ....

.
....

.. þ"

\,

't:'

40
T'-1ok.

W'"

POSEY FOR PATIENT
COMFORT. SAFETY. CONTROL

The new Posey Products shown
here are but a few of fhe many
producfs which compose the com-
plete Posey Line. Since the intro-
duction of the original Posey Safety
Belt in 1937, the Posey Company
has specialized in hospital and
nursing products which provide
maximum patient protection and
ease of care. To insure the original
quality product, always specify the
Posey brand name when ordering.

The Posey Safety Bar Kit with soft
padded bar provides a quick, simple,
and effective method of preventing a
patient from "scooting" forward in
any standard wheelchair. 8151 $29.85

'\

The Posey Foot-Guard with new
"T" bar stabilizer simultaneously keeps
weight of bedding off foot, helps pre-
vent foot drop and foot rotation.
6412, $21.00.

,

t,' ,-

.\

The Posey Houdini Security Suit,
constructed of cool breezeline ma-
terial, is virtually impossible for patient
to remove yet provides security with
comfort. There are eight safety vests
in the complete Posey line. 3412
$16.20.

,
..' .

"
",.
, '
"I ,,,

-

....
.,
II
I

t

,"

t/

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
complete Posey line. 1731 (with
ties), $6.00.

-...;:;;:

The Posey Finger Control Mitts
You can see the varied applications
of this Posey mitt. May be used to
prevent a patient from scratching,
picking, pulling out catheters, tV.'s,
ete. One size fits aiL Washable -
2816, $11.85 pro

Send for the free new POSEY catalog - supersedes all previous editions.

Please insist on Posey Quality - specify the Posey Brand name.

POSEY PRODUCTS Stocked in Canada

ENNS & GILMORE LIMITED

1033 Rangeview Road, Port Credit, Ontario, Canada

50 THE CANADIAN NURSE

names

(Continuedfrom page48)
The Manitoba A

ociation of Registered
Nurse
and Dr. Helen Gla

have an-
nounced the appointment of Florence
Strilaeff as research associate of a research
project to study '"the effect on the patient.
nursing per
onnel. students and their
teachers of the intermittent (variable)
nature of planned educational ex peri-
ence
."
After
everal years with Air Canada a

a stewardess on the Atlantic run, M
.
Strilaeff embarked on an intensive study
program. She earned her B.Sc.N. at
McGill University; B.A. at Sir George
Williams University. Montreal: and M.A.
from the School of Graduate Studie
,
University of Toronto.
Ms. Strilaeff ha
nursed at the Royal
Victoria Hospital. Montreal. and the
Montreal Neurological In
titute. She has
been a lecturer on the faculty of nursing at
the Univer
ity of Manitoba and wa
. for
several months prior to her current ap-
pointment. a member of staff at the
Canadian Nurses' Association. Ottawa. \-7

accession list

Publications on thi
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 institu-
tions. Reference (R) items (archive 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 Interlibrarv 101i1l 0111\-.
Request for loans should be made on
the" Request Form for Accession List"
and should be addressed to: The Library,
Canadian Nurses' Association. 50 The
Driveway. Ottawa. On!. K2P I E2.
No more than three titles should be
requested at anyone time.

BOOKS AND DOCUMENTS
I. L 'acupuncture. [' homeopalhie. ['o/ixolhemple er
les médecines nature/fes. plantes, dielerique.
thala-'Sotherapie, \'Oxa. Pdri
. Culture. Art. LO"lr
.
1972. 543p. (Le, grand, di<:tionnaires de la mai"m)
R
2. Aernhic.\, by Kenneth H. Cooper. Ne\\ Yorl...
Bantam Boob, 1968. 182p.
3. A,Uol'Í<ltL' degree edllct/tion .for 1111'"
illg - cllrrent iUlw, , /973. Paper< pre,ented
at the sixth conJerellce of the CUllllcil oj A "aciale
APRIL 1974

De
rt'e Progrll/Ill, AI/ahelll/. Cali}., Feh. 2li-\1ar
2. 1973. '-:e\\, York. NatiOl1.l1 Leagu
for Nur_ing.
Depl. of ...."ociale Degree Program
. 1973. 75p.
I PublicatIon no. 2-\-14(5)
4 Bas;" hookl (or I/Ilnill,
, a seleclli,' ofho"kl and
jOllrtl"/I 10 IIIpport COII/'le.1 lle"gnetl for ,,'hovls vf
I/Ulsil/g. OclOher 1973. Olin Milb. Om.. College
Bibliocenlre. 1'J73. 59p.
5. BII.IÍ<' p.\I'chimric I/II,..il/g, b} Susan irving
Toronto. Saundel'. 1'J7J. 319p.
6. Blllfdil/g >killl '" sen'e. Cbicago. American
Ho,pital A",>cialion. 1973. 5Xp. (Admini\trator

colledion. 1'J7))
7. A CIIl/adi"l/ c!trc'uor.\ 10 FO/lllc!lIt/lm.1 (/nd other
gramil/g lIgel/cies. 3ed. I:.dited by Alan Arlen.
OUa\\'a. As"'clatIon 01 lln"er
uies and Colleges 01
Canada. 1'J73. 161p. R
8. The Canadial/ sOllrce hook oj free edllcmional
lI/Cl/erilll,l. by Canadian EducatIonal Re
oun:e_ for
Teacher
. Calgary. Alta.. (
RT co 1973. 328p.
9. ClIwlog of Ihe Sophia F. Palmer Ml'm,mlll
Lihrar.\, AlI/ellClll/ Jvumal of Nursil/g COII/plll/\',
I\e... York 01\'. BO
lOn. Ma
\.. G.K. Hdll. 1973. 2
vols. R
10. COl/cept.1 il/ le(/deT.lhipforthe licel/sed pral1iCllI
I/unc', by EhLabelh Smilh and Barbara Huber. SI.
Loui\. Mo
bv. 1973. 205p
II. Currem cOl/cepts in cfimcal nllrsing, v.4, edlled
by Bdty S. Berger.-en el al. SI. Lou",. Mo\by.
I'J73.36Ip.
12. Cllrrem mcler 10 jourtlllis III educ'<I1Ùm: lInnual
cumulllllon, ".-1, 1972. Ne\\, York. Macmillan.
1')73. 2 pan
. R
13. o-\n \1. Approach It> curnculum. learnmg and
evaluatIon in occupational Iraining. by R. E.
Adalll
. 2ed. ()ua\\,a, 1973. 261p.
14. EconomIC l.h(.lrll(.'t'ri
/Ù

of (0111'1111.11;'" health
cemre.I: repvrt 10 Ihe COII/II/unin Hellith Cefllre
Projetl. b} .....P. Ruderman. Oua\\,a, 1'J72. 46p
15. ElCIlullIIVI/ oj eminmmefllal hellllh programl:
report of a WHO Sáel/IIJk GrollI'. Geneva. World
Hcahh Organl/atIon. ]'J73. 64p. (ft, Technical
repun ,erie, no. 528)
16. Glllc!e cle prnl/ier.I 10111.1, par Joel Hanley.
t-.lontreal. Le\ Edilions de I'Homme. 1'J72. 1,)lp.
17. Glllde medIcal 1'(/1' mol/ mec!eál/ dejll/mlfe, par
Maurice LauLUn. Montreal. l", Edilion, de
I'HoIIIIIIL. 1972. 165p.
18. The
II/c!l' 10 fCIIIl/fr- Ill". b} :'vlakollll C.
I\.ronb}. [oronto. n
\\' pre". 1972. 16Hp.
I'J. The hClf/cltc'<lpped child: ec!ucCl/iol/al (/1/(1
plW holvlilclli .
ui.Jclf/Cl' (or the vrgwI/c(/lir- lumc!-
IClli'ped. b} Agalha H. Bowley and L",lie Gardner.
.led. London. Churchill Llving\tone. 1972. 203p.
20. Jourtlal J'une inJìrll/iele, par George, Ra
.
Pari,. Edition Spécldle, 197.i. 233p.
21. The la... "lid Ih" III/He. by R,chard E.
Wakeford. Londun, E:.ngh,h Univcr,itle
Pres
.
1')73. HOp.
22. .\1<11ll1g,'melll of rel/lemel/l homes ami long-IeI'm
((Ire J"C/lill'-s. by Juhn H Cogge,hall SI. Luu",
Mo,by, 1'J73. 200p.

3. The mellllilll? oj hUlllall 111"1'11"'". hy Milia W.
lamb and Margareue L Harden Toronto. Perga-
mun Pre", 1')7]. 2
4p.
24. \1c'eling oj ,\tl/I/,I/<"I of He..lrh o( Amerin'.I,
SCII/t/(/gv. Chile. Vc/oher 1972. Propo.,als oj
change "",I "rcl/eglel of heallh }or Ihe decade
1971./WiO. PI. 3 Nu"m
, prel"",n(/T\' ...orkmg
do< """'11/. \Va_hlllgiun. D.C.. Pan American Heallh
()rgalliLatlOn. 1972. 55p.

APRil 1974

25.
/ellwl rewrdation - the lan' -li"ardianlhip,
by Barry B. S\\,adron alld Dunald R. Sulli\an.
Toromu. Natiunal InMilute on Menial Relardation,
1'J73. 23_
p.
26. .\1elhocl.1 of heallh care evalualion. Rea{lin.
'
"lid nerusel' dn'eloped for the National Heallh
Gram Health Care Enllualioll Seminarl. 2ed.
Ed;led by David L Sackell and Marjorie S. Basl..in.
Hamilton. OnL. Mc:'v1aMer Univer"ty. 1973. I vol.
27. Tile nen' aerahic.I. by Kennelh H. Cooper. I\oe\\'
York. Bantam Boob, 1970. 1'Jlp.
28. Nen Metropolitan cook hook. OUa\\'a. Mel-
ropolitan Life. 1973. 59p.
29. The Ne... York Time! el enda\' reader'.1 dictiol/-

lIn of misunderstood, misllled. mi,prol/ounced
words, ediled b\ Laurence Urdang. '\Ie\\, )orl...
Quadrangle Booh. 1972. 377p.R
30. Le nursil/g en matertlilf', par Con,l,mce Lerch
Tradult de I'anglai, par ... Polge d' ....uthe\llle el
R.H. Polge. SI. Lou;,. Mu
by, 197]. 35Hp.
31. NutritIOn: a hibliogmph\'. An al/I/"'<IIl'<I guitle
10 Ihe sollree> a..ailable <II Ihe BOidillg Grl'C'll ,\fath
Stience Library, by Dolor", A. June,. Blm ling
Green. Ohio. Bowling Green State l;mver-il}. Math
Science Library. 1973. 79p
32. PlIlient ('lire in el/dacrine probleml. by Rubena
T. Spencer. Toronto. S,lUnder,. 1973. 2.l0p. (SauII-
der
monograph
in dmical nur,in!! no. 4)

HOllister karaya seal apPliances

By preventing skin excoriation and simplifying
stoma care, Hollister's Karaya Seal appliances can
help speed rehabilitation. Applying one promptly
after surgery can prevent excoriation before it starts.
The Karaya Ring fits snugly around the stoma, keep-
ing irritating discharge away from the skin. Hollister
appliances are disposable, one-piece units. Also
available to the patient at authorized pharmacies
nationwide. Write for free evaluation kit.

S.I';
M'U

,

...

............

'-

helP your
ostomy patient
achieve
Sell-care
laster

.

THE CANADIAN NURSE 'j1

accession list

33. Thl' pharmacolngic ba
is of patienl care. by
:\1ary Kayc A
pcrheim, and Laurel A. Eisenhauer.
:!ed. Toronto. Saunder
. 1973. 5:!6p.
34 Phniologie appliquee à la médecine, par
Sam
on Wright. 12ed. Pdns. Flammarion
Mede,ine-Sciences. 1973. 606p.
35. Populalion probe: Call1ula, by Lorna R. Mar\-
den. Toronto.CoppClark. 1972. 179p.
36. The praclical nune in mpen'isory mil's, by
Mdrion K. SIC\ens. Toronto, Saunders. 1973. Dip.
37. La prb-ention à Ion?, lerme par la méthnde
nlLPHI. par N. Dalkey avec B. Brown, S. Cochran.
Paris. Dunod. 1912. :!09p.
38. Rehllilding Ihe professional in..tilllle. Ottawa.
Profð
lonal Institute of the Public Service of
Canadd. 1973. Sip.
39. Report 1972. New York. Milbank Memonal
Fund. 1973. 48p.
40. Reports prl'sellled durinK Ihe fifn'-Ihird ?,eneral
al1llllal meelill?" No.'. 1973. Montreal. Association
of Nur\ð of the Province of Quebec. 1973. SIp.
41. RicJwnl Asher tall-ing seme. A collection of
papers . edited by Sir Francis Avery Jones.
Baltimore. University PdrJ.. Pre's. 1973. 179p.
42. Secllrile d' emp/oi des peslicides; vin?,lième
rapport du Cvmile OMS d'nperts des InsecliCldes.
Gencve. Organisdtion Mondiale de la Santé. 1973.
60p. (It
Série de rappons technique
no. 513)
.n. Simple e,'e diagn(}.\Í.
, by Hector B. Chawla.
Edinburgh. Churchill Livingstone. 1973. 86p.
44. Le <OÙIS des IIwlades: pnnClpes ellechniques.
Montrédl. InstilUt Mdrguerite d'Youville. 1947.
814p. R
45. A S/Ill/\- vf risks, medical care, and infanl
mnrtalin, edited by Helen C. Cha'e. Washington.
American Public Health Association. 1973. 56p.
46. TllOm.<lm's con";..e medical diainnary. by Wil-
liam A.R. Thomson. Edinburgh, Churchill Living-

tone. 1973. 439p.
47. Tile unÍl'ersil\' and Ihe Canadian norlh; im'l'n-
IOn' of elaHes, research and .<pecial prujecls.
Ottav.a. Association of Universitie, and College, of
Canada. 1973. 300p.
48. The .\'Orkin?, mVlher, by Sidney Comelia Cal-
Idhdn. Nev. York. Macmillan. 1971. 264p.

PAMPHLETS
49. Communily heallh cenlre pmjecl: po.flllOn
paper for cvnsideralion by Ihe Canadian Public
Heallh Associalion. Toronto, 1972. I7p.
50. The cOllsultalion process in hi?,her educalion,
by Genrude Torres New York. Nationdl League for
Nu"ing, Council of Baccaldureate and Higher
Degree Progrdms. 1973. pam.
51. EducarivII for nunm?, rhe diploma way.
1973-74. New York. National League for Nursing,
Dept. of Diploma Programs. 1973. 30p. R
52. Faclurs delerminin?, Ihe numher of hour.< of
lahnr supplied h,' married women, by Sookon Kim.
Columbu\. Ohio. 1972. 25p.
53. Cmeralion lables of working life for men, 1940.
/950, and /960, by Howard N. Fullerton. 1972.
16p.
54. A ?,uide 10 seleai"e librar} sources in heallh.

52 THE CANADIAN NURSE

phnical etlucarimz. anti recrealioll. Bowling Green.
Ohio. Bov.ling Grecn State Uni\er
ity. 1973. 41p.
55. Cuitlelille
to l nlleclil'e hargaillÙzgfor ""r.1e.< ill
A IberIa. Rev. Edmonton. Albend As
ocidtion of
Registered Nurses. 1972. 39p.
56. Home heallil {'lire. New Ymk. National League
fm Nursing. Council of Home Heallh Agencie
and
Community Hedlth Services. 1973. pam.
57. The me.Jical sciellces; referellce sources. ?,ov-
emmelll llocumem, illtlnes anti IIunill?, jOllmals,
Bowling Creell Marh Sciellce Libran, by Kathleen
L. Pientd. Bo",'ing Green. Ohio. Bov.ling Green
State Unive"ity.
1dlh Science Library. 1973. 31 p.
(Bibliographic \cne\ no. 7)
58. \B
R\ 's re.'pome to Ihe report of Ihe Commi/lee
on nurse praclilioners. Fredericton. Ncv. Brunswid
A\sociation of Regi\tcred Nur\ð. 1973. 3p.
59. The IIursing alldil; a neceHily. HOII' .<half ir be
done? by Helen Bcnedikter. New Yor"- National
League for Nursing, Council of Hospital and
Related In
titutiondl Nur,ing Services, 1973. 23p.
60. A policy for heallh care. by V.L. Mdtthew
.
Toronto, Canadidn Public Health Associdtion,
1972. lOp.
61 Public Affair' Commlllee. Ncv. York. 1973.
Pamphlets.
no.497 Cleal/Sill?, ollr walen. by Gladwin Hill. :!8p.
62. -. no 498 Hl'al,h foods: facl.< alld fakes, by
Sidney Margolius. 28p.
63. -. no 499 The lie..' alcnllOlics: leena?,en, by
Jule\ Saltman. 20p.
64. Recommendaliolls for fillancing memal healrh
care in Ihe Ullited Swtes. A summary Sftllemellf from

FACELLE APPOINTMENT

o

G.G. MORRISON
Mr. Robert A. Graham, Vice President. Market-
ing of Facelle Company Limited, announces the
appointment of Gordon G. Morrison as Market-
ing Manager, Professional Products.
Mr, Morrison assumes the total marketing
responsibility for all Facelle commercial, indus-
trial. professional and hospital products as well
as export sales. He will report to the Vice
President. Marketing.
This appointment is part of a recent major
restructuring of the marketing management
organization at Facelle

Ihe repnrt of Ihe Alil'isory Pallel Oil Finallcillg
Memal Heallh Care. Chicago. American Hospital
AS\ociation. 1973. 26p.
65. Regitl1lali
aliOlI of heallh sen'ices: a Slalemem
fár cOllsideralion allhe JUlie 1972 policy hearillgs.
Toronto, Canadian Public Health Association.
1972. 4p.
66. Rl'f'OII I 97:!-73. St. LouIs. Mo.. Catholic
Hospital Association. 1973. 32p.
67. SClellce polin- and
Tl ill Callada; a paper
pre.<emed b\' Aurele Beallilles, Secrewry. Milli.<rr\'
of SWle for Scimce alld Techllolo?,y to C'llladian
A..sociarioll for Illformation Sciellce, Momebello,
M(/\'15. 1973. Ondv.a. 1973. 39p.
6X. A Ihree parameler model for birth projecliolls,
by A. RomaniuJ... Ottawa. 1973. :!6p.
69. The ,,'orkillg ;'ll/oors: alld Ihe greal oUldoors.
Semillar Saskalooll, Sask.. 1972. 18p.

GOVERNMENT DOCUMENTS
Callada
70. Commi"ion d'assurance-chômage. Rapporl
allll/lel. 1972. Onawa, 1973. 16p.
71. Con,eil des sciences du Candda. Les pOl{\'oin
publics el lïllIlOl'{J/Ùm illd/l.<rrieffe, par Andrew H.
Wil,on. Onawa, Information C.Ulada. 1973. 288p.
(It \ Etude spéciale no. 26)
72. Dept of Externdl Affair
. Diplnmalic corps and
consular alld nth", represelllaril'e.< ill Callada, Ocr.
/973. Ondwa.lnformation Candda. 1973. 81p. R
73. DepL of Ndtional Health and Welfare,
Commi
sion of Inquiry into the Non-Medical
U'e of Drugs. Filial report. Onawa. Informdtion
Canada. 1973. 1148p.
74. Hedlth dnd Welfare Canada. Callada healrh
mll1zpol1('rilJ\'elllOf'.\'. /973. Ondwa. 1973. 192p.
75. - Calladialls a.<k aholll child dm' care: a
bihliof!,raphy. Ondwa. n.d. 16p.
76. - Choo.<illg a da\' care sen-ice; Ihe day care
celllre. Onawa. n.d. 7p. (Bound with: Choosing a
day care service: the day care home)
77. -. Probahilill' lahle. of dealh.< m Ihe 1/('xr ren
,'ears; IIUlles and females a?,es 15-80, Camu/a,
/97/. Ottawa. 1973. 15p.
78. Law\. \tatutes, ete. Canadian bill of righls. An
al'l for Ihe recognilion anll prolectioll of human
righls wlllflllll/amelllalfreedol1ls. S.C 1960. <'.44.
79. -. Loi SilT la cllis.<e d'aide à la samé. S.R..
l'.H-4 et Règlemem. eftlhli par CP. 1967-257. CP.
/970-602, CP. /972-15.?7 Ondwa. Information
Cdnada. 1972.
80. Stdtistics Cdnddd. E.ltimllleS of families in
Call1llla, /972. Onawa, Informdtion Canada. 1973.
9p.
81. -. Mental h('(1frh .<taIÙ/ics /972: palienl
mo\'emenl. PrelimÙUlr\,. Onawd, 1973. pam.
82. -. SlarÙrics of pri\'(J/e eleml'nlary and secon-
dary .<chools, /972/73. Onawa, Information
Candda. 1973. I3p.
lB. Unemployment Insuranc!; Commi"ion. Report
1972. Onawd. 1973. 16p.
Ollfario
84. Dept. of Labour. Re\earch Brdnch. 01llario
coffeclil'e agreemellf erpiralions, /974. Toronto.
1973.4Ip.
85. Mini
tl) 0' Health. Research and Analysis
Division. MortalilY from mOlOr .'ehide rraffic
accidellfs, Onlariv 1966-1970. Toronto. 1973. 20p.
(Its Special repon no. 49)
Saskalchewan
86. Dept. of Public Hedlth. Reporl on Ihe slale of
APRIL 1974

suppl\' and de"",,,,1 for registered nurse. and
certified nursing a"ÜTam.' in Sa..karche,,'an. b\
.
Duane Adam'. Rcgina, 1970. 29p. R
United States
87. Dep!. of Juslice. Bureau of Narcolic
and
Dangerous Drugs. Reports /972. Vva,hington.
1973. 49p.
88. Naliondl Center for Health SldlÏ
tic
. Health
statistics rod", and romorrow.- a report oj the
Commirree ro Emluate the 'l!ational Cemer for
Health Staristics. Rockville. Md.. 1973. 24p. (Vital
and health slalistics serie
4. no. 15)
89. NdlÏonal In,tilUtcs of Health. Annual report of
internationaluctil'ities. /972. Prepdred b} Intcmd-
tiond! Cooperdtion and Geogrdphic Stud ie' Branch.
Fogal1y Intemationdl Cenler. Bethewa. Md., 1973.
SSp. (U.S. DHEW Publication no. (:'IIIH) 74-621
90. -. SratÜtical reference book of imernatÙmal
actMties. 1972. Prepared b} Intemational Coopera-
lion and Geographic Studie
Branch. FOgdl1y
International Center. Bethesda. Md.. 1973. 54p.
(US DHEVv Publicdtion no. (:'IIIH) 73-64)

STUDIES DEPOSITED IN CNA
REPOSITORY COllECTION
91. Adolescem depression and imerpersonal be-
hal'ior, by Margery D. Fumell. Vancouver. B.C..
1973. 132p. (Thesis (M.Sc.N.) - British Colum-
bld)R
92. Behlllior lIurses desire of pariem. a.1 cOI1\'e\'l'd
in the ",ard meeting in a ps\'chiatrÙ unir, by Agnes
M. Herd. \1ontreal. 1972. 79p. (The
i, CI.I.Sc.
(Appl.)) - \1cGill) R
'ß. Communicarion between relaril'e, patiem, and

lIune durillg the finr lilITlllg periOlI aj1er the
patient's etllergenc\ aclmisç;o1J tn all inlen
i\e ("lIre
unit. b\ Chr"tidnc Konrad. \lontredl. 1973. 103p.
(The,is (M.Sc. (Appl.)) - :l.1cGill) R
94. 4 comparatÍl'e sTIle'" of nune, recordillg of
lIIwlgelic themp\, b} Si,ler Mal) "1argaret
:l.loone\. Cleveland. Ohio. 1972. cl971. 66p.
(Thesis (M Sc. N.) - C d'e \\ c"crn Rcscrve) R
95. COllcerns etpressed b\ diabetic children and
parems oj eliabetic chiltirell, b} Jola Olofinboba.
:l.lontreal 1973. 40p (The
i, t:I.I.SL (Appl.)) -
:l.1cGiIlJR
96. The cOllcern.1 of mothen durmg the first ..eel..
fol/owing discharge of their ne..' bab\ from em
imelBi.'e ({Ire //lInen, by Judith \1al) Collinge.
'J5p. (The, IS (M.Sl'. (Appl.)) - \kGilI)R
'J7 CeJl/cerm of parents.. hell th,'ir child is admirted
TO ho'piral for eleail'e surgen, by Si,ter Joan
Kuffner. Montredl. 1972. 66p. (Thc,i, (M.Sc.
(Appl.)) - \tcGill)R
98. L 'etperience de ",ill, del dieml acl cemre local
de sen'ices c",,,,,,,mautaire.I. pdr Frdnçoise Berge-
ron. 136p. (Thè,e (\1. '\:u".) - Montreal) R
'J9. The hostile behlll ior of a primagrlll ida. by
Patricia Anne Chnstensen. Pitl
burgh. 1970. 42p.
(Thcsi, (!'II.N.) - Pit!\burgh)R
IIIU. All i""e,riRation of the lIutritÙm comem of
prenaral daHl'S ill AIIII Arbor, bv Bcn} Lou
Trimmer. Eileen KOller et .II. Ann Arbor. \lich..
1'J73. 25p. R
101. JoJ..illg behlll'iour Oil orthopedics - a de.lcrip-
ti"e \fIlCh. by M,>na B. Krdvilz. Montreal. 1973.
58p. (The,i, (:1.1 Sc. (Appl.)) - \tcGilllR
102. Loss. a major cOlII'ermtional theme of the

elder/\', b} Didnne B. Clement'. :l.lontredl. 1'J73.
53p. (Thesi, (\1.Sc. (Appl. II - \1cGiIlJ R
103. Sraff del'elopmem for nurses in hospITal situa-
tÙms in Omario, compiled by Jud} Dlck
on.
Toronto. 1973. 47p R
104. A sTlld\' concernillg children ..ith a terminal
il/llelS and their relat/IJ11\hip. 10 others .. hill' in
hospiral, b} Caroline Robemon. \Iontreal. 1'J72.
63p. (The
i
(M.Sc. (Appl.)) - McGilllR
105. A STIll'" of nursing straregies alld subsequem
patient ourcomes in a ps.\'chiarric serring, b}
Mdrjorie Bhu'dri. Monlrcdl. 1971 75p. IThe,i,
(\I.Sc. (Appl.)) - \1cGill)R
106. A srud\' of paill behm iour< ill pmtoperatÍl'e
patiellls, b} Sarah R Addi
on. \lontreal. 1'J72.
59p. (Thesi, (1-.I.Sc. (Appl.)) - \1cGill) R
107. A .,tud\' of predicri\'e crireria In reftllloll ro
motherillg behavior, b} Jeanene Funke and Mar-
garet Imle Irb}. DenIer, 1973. 56p.
108. A sllld\' of the concems of am bulat Or\' patiellH
in the hospital emergency room a",1 the profeSliVllll1
respollse to tho,,' COII"ems, b} Elizdbclh Finch.
:l.lontreal, 1973. 42p. (The
i, (:l.I.Sc. (Appl )) -
\1cGill,R
109. A stud\' of the effects of a specific ÙIIt'n Ice
educarion program for registered nurses Oil patient
welfare alld hmpiral operatioll. Winnipeg Health
Sciences Centre. 1973. 188p. R
110. A 'tud\' ro idemif. the concerns of mothers. the
strate.
ies used to etpress them, a",1 the IIIlrsillg
inten'emion elicited b\' them as rel'ealed durillg the
bathing of the bab\, b
Si,ter \ldry \k\lahnn.
:l.lontreal. 1972. 46p. (The
is (:l.I.Sc.
(Appl.)) - \tcGill) R

Request Form for uAccession List"
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APRIL 1974

THE CANADIAN NURSE 53

l classified advertisements

I

ALBERTA

REGISTERED NURSES required lor 70 bed accredited actIVe
treatment Hospital Full time and summer relief AU AARN per-
sonnel policies. Apply In writing to the Director of Nursing, Drum-
heller General Hospllal. Drumheller Alberta.

REGISTERED NURSES. We need you lor our summer rellel
program Come and iOln us for a three or four month penod. Yau
can gain a great deal of clinical expenence 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 wnte to'
Personnel Department. Red Deer General Hospital, Red Deer.
Alberta

OCCUPATIONAL HEALTH NURSE. The Red Deer Health
Unit. Red Deer. Alberta. requires occupational health nurse
for new Industnal health servlæ to be based In health unit.
Occupational Health Nursing Certllicate (O.H.N.C.) and/or
expenence in Industnal nursing preferred. Salary range as Red
Deer Health Unit schedule. based on qualifications and previous
expenence. plus usual fringe benefits. Application forms and
further details may be obtained from: Red Deer Health Umt.
4758 - 32nd SI.. Red Deer. Alberta T 4N OMB. Telephone
(403)347.1166

BRITISH COLUMBIA

DIRECTOR OF NURSING SERVICES. Applications are invited
for the pOSition 01 Director of Nursing Services in a 40-bed
hospital (25 acute and 15 extended care beds) on Salt Spnng
Island ,he position will be available on July 1sl. 197<f.
Applications should be In writing providing details of expenence.
qualifications and references to. Administrator, Lady Minto Gun
Islands Hospital, Ganges. Bntlsh Columbia VOS 1 EO.

ADVERTISING
RA TES

FOR ALL

CLASSIFIED ADVERTISING

$ J 5.00 for 6 lines or less
$2.50 for each addilional line

Rafes for display
advertisements on request

Closing dale for copy and cancellalion is
6 weeks prior 10 151 doy of publicalion
month
The Canadian Nurses' Association does
not review the personnel policies of
Ihe hospilols and agencies adverlislng
in the Journal. For authentic information
prospeclive applocanls should apply 10
Ihe Regislered Nurses' Ass06a1ion of Ihe
Province in which they ore interested
in working.

Address correspoodence to:

The
Canadian
Nurse

g

50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P 1 E2

54 THE CANADIAN NURSE

I I

BRITISH COLUMBIA

HEAD NURSE required for an acute modern 35.bed hospital.
\ocated in southern B C . s Boundary area with excellent recrea-
tion lacilities Position to be filled by Ap,il. 1974 Salary and per.
sonnel policies in accordance with the RNABC. Apply by March
31, 1974. to: Director of Nursing. Boundary Hospllal. Grand
Forks. Bntlsh Columbia

REGISTERED NURSES WANTED FOR FULLY ACCREDITED
HOSPITAL CONSISTING OF 190.BEDS. GENERAL DUTY
POSITIONS IN MEDICAL.SURGICAL. PSYCHIATRIC AND
ICU.CCU AREAS. MUST BE ELIGIBLE FOR B.C. REGISTRA.
TION BASIC SALARY 1973 - $672.00 (NEW CONTRACT
BEING NEGOTIATED.) APPLY. DIRECTOR OF NURSING
ST JOSEPH'S GENERAL HOSPITAL. COMOX. BRITISH
COLUMBIA V9N 4BI.

REGISTERED NURSES & GRADUATE NURSES required for
a new 41-bed Acute Care Hospital located 200 miles north of
Vancouver and 60 miles Irom Karnloops. B.C. limited lurnlshed
accommodation available. Apply to. Director of Nursing.
Ashcroft and Dlstnct General Hospital. Ashcroft, Bntlsh Colum-
bia VOK 1 AO

GENERAL DUTY NURSES lor modern 30-bed accredited hospl'
tal. Salary and personnel policies In accordance with RNABC
Apply: Director of Nursing. Chetwynd General Hospital, P.O.
Box 507. Chetwynd, Bntish Columbia

GENERAL DUTY NURSES lor modem 41-bed hospital located
on the Alaska Highway. Salary and personnel policies in
accordance with RNASC. Accommodation available In resi-
dence. Apply: Director of Nursinr:. Fort Nelson Genera' Hospital,
Fort Nelson Brihsh Columbia

GENERAL DUTY B.C. REGISTERED NURSES, fully aCcre.
dited 39.bed hospital Comfortable nurses residence. RNABC
Agreement In effect. Apply. Mrs E. NeVille, R N.. Director of
Nurses, Golden and Dlstnct Gene'al Hospital. POBox 1260
Golden. British Columbia.

GENERAL DUTY NURSES, for modern 35.bed hospital located
in southern B.C.-s Boundary Area with excellent recreation facI-
lities. Salary and personnel policies In accordance with RNABC
Comlortable Nurses's home. Apply. Director of Nursing. Bound.
ary Hospital. Grand Forks. Bntish Columbia

GENERAL DUTY NURSES for 360.bed acute general hospItal.
Personnel policies in accordance with RNABC Contract. Direct
inquiries to: Director of Nursing. Nanalmo Regional Genll3ral
Hospital. NanallTlO. British Columbia

TWO GENERAL DUTY NURSES with expenence In obstetrics
and O.A. required for a 21.bed hospital in the Southern Interior
of B.C. Living-in accommodation available. Salary as per
RNABC rates Moderate climate. good worl\lng conddlons and
recreational facIlities available. Apply. giving full particulars and
references in first letter to the Administrator, Siocan Community
Hospital, Box 129. New Denver Bntish Columbia

ExPERIENCED GENERAL DUTY NURSES reqUired for_
i
l-bed Hospital BasIc Salary $6/2 - $B42 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 Bnllsh Columbia

WANTED: GENERAL DUTY NURSES for modern 70-
bed hospital, (4B acute beds - 22 Extended Care)
located on the Sunshme Coast, 2 hrs from Vancou-
ver. Salanes and Personnel Policies 10 accordance
with RNABC Agreement. AccommodatIOn available
(female nurses) 10 residence. Apply: The Director
01 Nursing. SI. Mary's Hospital. POBox 67B. Se-
chelt, Bnlish Columbia.

EXPERIENCED GENERAL DUTY NURSES for modern
10 bed hospItal with doctors olhces In hospllal
Situated beautiful west coast of Vancouver Island.
Accommodation $5000 a month Apply Admlnlstra.
tor. Tahsls Hospital Box 399 Tahsls Bntlsh
Columbia

GENERAL DUTY NURSES required for an B7-bed

II

BRITISH COLUMBIA

acute care hospital In NOrlhern B.C Residence
accommodations available. RNASC policies In effect.
Apply to: Director of Nursing, Mills Memorial Hos-
pital. Terrace. Bntlsh Columbia VBG 2W7

NURSES RFOUIRED 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. CARl BOO MEMORIAL HOS.
PITAl 517 NORTH SIXTH AVENUE. WILLIAMS
LAKE BRITISH COLUMBIA

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES required lor small
uPcoast hospital Salary and personnel policies as
per RNABC contract Salanes start at $67200 lor
Registered Nurses. 557775 for Licensed Practical
Nurses. Residence accommodation 52500 per month
Transportation paid from VancoJ.lver Apply 10
Director of NursHlg St George s Hospital. Alert Bay
British Columbia

EX PERI ENCED NURSES required In 40g-bed aCUTe
Hospital with School of Nursing Vacancies In

edical. surgical. obstetric. operating room. pediat-
riC and Intensive Care areas BasIc salary $672.-
$B42. B.C Registration required Apply Director
of Nursing. Royal Columbian Hospital New West-
mmster. B,.hsh Columbia

GRADUATE NURSES lor 21-bed hospital prelerably
with obstetncal expenence. Salary in accordance
with RNABC. Nurses residence. Apply to: Matron.
Toflno General Hospital. Tofmo Vancouver Island.
Bnlish Columbia.

OPERATING ROOM NURSE wanted for aCTive mo.
dern acute hospital. Four Certified Surgeons on
attending staff. Experience of tralnmg desirable
Must be eloglble lor B. C Registration. Nurses
residence available. Salary according to RNABC
Contract. Apply to Director of Nursing, Mills Mem-
onal Hospital. 2711 Tetrault St. Terrace. Bntlsh
Columbia

NURSES - Come JOIn the southern sunny weather. Vacancies
aVailable In ICU. OR. surgical. general duty. etc 150 dilf US.
and Canadian hospitals In PacIfic coast from Bntlsh Columbia to
sunny State of Calilornla Starting salary $9.648.00 - $14.500
per annum. Work permits & other paper work for moving are
proVided free. Apply now: Phil can Personnel Consultants lid..
(Medical Placement SpecialISts). 5022 Viclona Drive. Van-
couver. B.C. Canada V5P 3TB Telex 0455333

MANITOBA

REGISTERED NURSES required for general duty In a 15.bed
hospital 500 air miles North of Winnipeg Thnvlng community of
2.300 young people Situated near large Hydro Electnc PrOJect.
Modern recreational facilities Dally Jet service to Winnipeg.
Thrice weekly train service. Hospital Includes medical. pediatric.
obstetrical and emergency facilities. Furnished accommodation
In Mobile Homes provided for single nurses. Salary range
$74700 to $891.00 depending on e.penenæ. Air transportation
paid from Winnipeg For further information contad. Mrs. E.
Johnson. Director 01 Nursing, Box 130. Gillam. Manitoba. ROB
OLO: Telephone' 652-2600

REGISTERED NURSES required for the following
positIOns .n a 68 ber! acute care general hospllal
Night Supervisor Operatmg Room Supervisor Ex
penef'\ce essentJat General duty nurses 10 Pediatric
Department Remuneration for past expenenci ShiH
differential Salary m accordance with M H S C ap
provpd ratp Apply 10 AdmlOlc;trator Ste Rose Gnl'1
eral Hospital Sre Ro'-:> du Lar Manitoba ROL 1S0

Requ. "lmed...tely - 3REGISTERED NURSES and
3 LICENSED PRACTICAL NURSES for a new 60.bed
Personal Care Home Salary In accordance with the
recommendations of the MA'1N Apply Director 01
Nursing. Swan River Valley Personal Care Home
Inc SWAN RIVER Manitoba ROL 1Z0

APRIL 1974

I .

1+

Public Service
Canada

Fonction publique
Canada

THESE COMPETITIONS ARE OPEN TO BOTH MEN AND WOMEN
Are you interested in working in the NORTH?
HOSPITAL NURSES
PUBLIC HEALTH NURSES
NURSE MIDWIVES
SALARY: $8,988 - $11,716
MEDICAL SERVICES BRANCH - INDIAN HEALTH PROGRAM HEALTH AND WELFARE CANADA

Nurses are needed at hospitals located at HODGSON and NORWAY HOUSE, Manitoba and NURSING STATIONS and HEALTH CENTRES at
various locations in Northern Manitoba, Northwestern Ontario and Saskatchewan.
The requirements include eligibility for registration as a nurse in a province of Canada, and preferably nursing experience in obstetrics or
midwifery for some positions or a Public Health Diploma, B.N. or B.ScN. degree. Knowledge of the English language is essential
Additional allowances are paid in isolated locations and extra salary for nursing specialties used in the performance of the duties.

GENERAL DUTY NURSES
SALARY: $7,826 - $9,440
TREATMENT SERVICES BRANCH - DEPARTMENT OF VETERANS AFFAIRS

The Deer Lodge Hospital at WINNIPEG, Manitoba requires General Duty nurses to identify the nursing needs of geriatric and chronically ill
patients; to plan and provide nursing care according to recognized standards and hospital policy; to assume responsibility for a ward or specialty
unit during evening and night hours; to direct and supervise the work of nursing auxiliaries and to perform other related duties. Knowledge of the
English language is essential.
The requirements include eligibility for registration as a nurse In a province of Canada and preferably with experience since graduation.
Resumés and enquiries about the above opportunities are invited by the:
PUBLIC SERVICE COMMISSION OF CANADA
504-266 GRAHAM AVENUE, WINNIPEG, MANITOBA. R3C OK6

Please quote reference number 74-W802 for the above positions and specify your areas of Interest and tocatlon preference.

REGISTERED NURSES
SALARY: to $8,543
(Dependent upon experience)
HEALTH AND WELFARE CANADA - MEDICAL SERVICES BRANCH

The Char1es Camsell Hospital in EDMONTON, Alberta, a 402 bed active treatment hospital, has an immediate requirement for nurses In the
areas of surgery, medicine. pediatrics. obstetrics and operating room. Knowledge of the English language is essential.
The requirements include eligibility for registration as a nurse in a province of Canada.
Successful candidates will be reimbursed for relocation expenses incurred in accordance with federal government Removal Expense
Regulations.
Resumés and enquiries about these opportunities are invIted by the:
DIRECTOR OF HOSPITAL PERSONNEL
HEALTH AND WELFARE CANADA - CHARLES CAMSELL HOSPITAL
12815 -115AVENUE - EDMONTON, ALBERTA - T5M 3A4.
Appointments as a result of these competitions lire subject to the provisions of the Public Service Employment Act.

APRIL 1974

THE CANADIAN NURSE 55

NEW BRUNSWICK

WANTED: TWO REGISTERED NURSES GENERAL
DUTV required for 1;" b L c1 d :IV_
hO
pltðl m ü l1tfnly
equ .,pec' AlSO ONE REGISTERED NURSING ASSIS-
TANT. GENERAL DUTY For further mtormatlon COn.
ract The Administrator Albert County Hospital
Albert New Brunswick EOA lAO

NOVA SCOTIA

SENIOR FACULTY position open basIc requirement
Bachelor of Nursmg Responsible for pediatric as
pect of an mtergrated program The pediatric pro
gram IS Interfaced with maternity and also with med
Ical and surgical nursing Apply to Director of Edu
cahon Yarmouth RegIOnal Hospital Yarmouth
Nova Scotia

Wanted. REGISTERED NURSE ADMINISTRATOR tor a
40-bed Nursing Home. situated In Caledonia. Queens Co.. N.S.
Living quarters proVided Salary negotiable. Apply to. MIss
Margaret WarrtJoldt. R N.. Administrator. North Queens Nursing
Home. Caledonia. Queens County. Nova Scotia

ONTARIO

SUPERVISOR OF PUBLIC HEALTH NURSING for
progressive generalized public health program Salary
adjustment for expenence Salary range $12000
$14 000 Car allowance $6000 + 12 a mile Apply
Dr H H Washburn. M D D P H Medical Olflcår of
Health Haldlmand.Norfolk Health Unit Box 247
Simcoe. Ontaroo N3Y 4L 1

OPERATING-ROOM STAFF NURSE required lor lully accre.
dlted 75-bed Hospital. You will be In the Vacationland 01 the
North, midway between Thunder Bay. Ontano and Winnipeg.
Manitoba. BasIc wage is $471 50 with consideration for
ex.penence. Write or phone the: Director of Nursing. Dryden
Dlstnct General Hospital. Dryden, Ontano

REGISTERED NURSES lor 34.beo General HospItal.
Salary $646 per month to $756 plus expenence al.
lowance. Excellent personnel policIes. Apply to
Director of Nursing. Englehart & District Hasp.tal
Inc.. Englehart, Ontario

REGISTERED NURSES requored for a new 79-bed
General Hospital In bllmgual 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
alter 1 year and 18 sick leave days per year.
nused
sick leave days paid at 100 0 /0 every year iJiaster
rotation In effect. Roommg accommOdations available
on town. Excellent personnel policies Apply to Per-
sonnel Director NOIrP-Dame Hos
lItal. POBox 850.
Hearst. Ont

REGISTERED NURSES' Experoenced general duty
nurses reqUlH.d for 28 bed General Hospital In North
West Ontano MOflthly salary schedult. under reView
expenence recognized Nurses ReSidence provides
mdlvldual self contained furmshed apartments at
minimal rental rate Apply to the Duector of Nursing
General Hospital Mamtouwadge Ontario Telephone
826 1251 I area rode 807)

Port Colborne General Hospital. Port Colborne Ontan( - This
modem 143.bed teaching hospital reqUires REGISTERED
NURSES lor all semæs Including Emergency Qperatlr'9 Room
and Cardiac Care Unot Completely lurnlshed apartment-style
residence. including balcony and sWimming pool facing lake
adjaCent to hospiTal Apply Director of Nursing General
Hospital Port Colborne Ontano

TWO REGISTERED NURSES, preferably fnends for gl
s
pnvate camp. ages 6 to 16. Camp located at Sundndge. Ontano
175 miles north of Toronto Dates of camp June 24 to Augusl
24 Salary for season. $700.00, room and board Wnte to Mrs
John W Gilchnst. 6.A Wychwood Pa
<. Toronto. Ontano M6G
2V5 Telephone 532.3403

REGISTERED NURSES AND REGISTERED NURSINC.
ASSISTANTS for 45.bed Hospita' Salar) "anges
Include generous experience allowances. R N s
saldry ,680 to ,ÎBO and R N A s salarv ,
90 to j6j
Nurses residence - pnvate rooms with bath - $40
per month. Acclv to The Director 01 NurslllQ Gerald-
ton Dlstnct Hospital Geraldton OntdrlO POT 1MO

REGISTERED NURSES and REGISTERED NURSING
ASSISTANTS for 83-bed Home for Mentally Retarded

56 THE CANADIAN NURSE

I I

ONTARIO

aTid PhyslcaUy Handicapped Children 40 Hour Week.
Accommodation avaIlable RN s salary $600- $720
and RNA s $520 $620
Ius allowance for expen.
ence Apply to Lakewood NUlslng Home. Box 1830
Huntsville. Ontano POA 1 KO

REGISTERED NURSES AND REGISTERED NURSING AS-
SISTANTS for a 41-bed Active Treatment Hospital. Excellent
personnel polioes plus e><penance allowance Apply to: Assls,
tant Director of Nursing Temlskamlng Hospitals. New Liskeard
Unot. New LiskearCI. Ontano POJ 1 PO

REGISTERED NURSES FOR GENERAL DUTY, I.C.U.,
C.C.U. UNIT and OPERATING ROOM required for
fully accreoited hospital Starling salary $697 00 with
regular Increments and with allowance for experi-
ence Excellent personnel policies and temporary
residence accommodation available. Appt
to: The
Director of Nursing. Kirkland & Dlstnct Hospital,
Kirkland Lake. Ontano P2N 1 R2

REGISTERED NURSES for GENERAL DUTY and lor
INTENSIVE CARE NURSING. Salary and benefits
comparative 'WIth other areas Ind udes 20 days va
catIOn shift rotation reqUired ResIdential accommo
dation avail able Apply to Director of Nursing Hunts
ville DistriCt Memorial Hospital Huntsville Muskoka
Ontano

PUBLIC HEALTH NURSES required for generalized prog.
ramme Salary $8.899-$11.379 Generous fringe benefits
Expenence recognized Apply to. The Director of Public Health
Nursing Northwestern Health Unit 15 Ocean Avenue West.
KENORA. Ontano. P9N 3W7

PUBLIC HEALTH NURSE (qualified) for generalized program.
Progressive Health Unit In Central Ontano. Attradlve salary and
fringe benefits Apply to Dr G.P A Evans Medical Offlær 01
Health. Watertoo Regional Health Unit. 850 King Street West,
Kltchener.Ontano

LAURENTIAN UNiVERSITY ,"vltes apphcants tor
the 1974.75 session to teach In all clinical nursing
fields In a School of Nursing offering preparation
toward a B Sc N Degree Opportunity to participate
In designing a new nurSing curnculum In a young
and grOwing university which serves North Eastern
Ontano Master s quahflcatlons In clinical specialty
preferable Salary and rank commensurate with
qualificatIOns and experience BIlingual (Engllsh-
French) preferred Apply to MIss Alma E. Reid.
Act.ng Director. SChool of Nursing. Laurentian Um-
verslty Sudbury.Ontano

QUEBEC

REGISTERED NURSE requlled lor co ed children s
summer camp 1M the Ldurentlans (seventy miles north
01 Montreal) from June 21 197
until AuguM 20 19n
Call 5H 688 175. or wnte Camp Maromac
5
8
8th '1tr
': Chomedt=")1 Laval Quebec H/W 2AJ

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
welcom
d at Queen Elizabeth HosPital of Montreal
Nursing Personnel 2100 Marlowe Avenue Montreal
260 OULbec

We reqUire Ine 5eIVIces of a GRADUATE NURSE lor a summer
position at the Quebec Camp for Diabetic Children Inc. In Ste.
Agathe.des.Monts. tor the penod extendmg from June 28th to
August 15th 1974 Salafles are based on current accepted levels
and loving accommodations and food are provided. Only bilingual
applicants will beconsldered. Enqulryshouldbemadeto: Dr. Mimi
M Belmonte, 2300 Tupper Street Room 448. Montreal. Quebec
H3H 1 P3

"NURSES FOR CHILDREN'S SUMMER CAMPS IN
QUEBEC. Our member camps are located In the
Laurentian Mountains and Eastern Townships. within
100 mIle radius of Montreal All camps are accred-
Ited members of the Quebec Camping Association.
Apply to Quebec Campmg Association 2233 Bel.
grave Avenue. Montreal 261 Quebec. or phone
489.1541

TRAVEL THE U.S.A. - .ee our ad page 64 thi.lssue.

MEDOX LIMITED

I I

SASKATCHEWAN

DIRECTOR OF NURSING requored lor lully modern 20-bed
hospital In North Central Saskatchewan Salary scale and fringe
benetlts as negobated by SRNA Near ProvinCial Park. Progres.
slve. modern community Administrative experience an assel
but not reqUired. Position available SepterrtJer 1 1974. Apply
to: Administrator. Porcupine Carragana Union Hospital, Box 70,
Porcupine PJaln Saskatchewan

COLLEGE OF NURSING. UNIVERSITY OF SAS.
KATCHEWAN LECTURER or ASSISTANT PROFES-
SOR Facultr members required to teach 1M several
clinical nursing heldS - maternal-child nursmg
lOt enslve care nursing and community nursing
Master s degree In clinical specialty preferred
Teaching responsibility In basIc B S N program and
the B S N program for registered nurses App1r to:
Dean College 01 Nursing UniverSity of Saskatch
!>Wan Saskatoon Saskatchewan S7N OWO by May
1.1974.

FULL TIME REGISTERED NURSE required for a 16-bed
hospital. To start Immediately. Accommodation in Residence.
Apply with relerenæs to' D. 0 N. Mrs. lIa Lellar Bengough,
Union Hospdal Dlstnct. Bengough. Saskatchewan SOC OKO.

REGISTERED NURSES are reqUired by a 22B.bed regional
hosprtaJ located close to numerOus resort areas Salary and
benefits accordIng to SRNA contract Contact the Personnel
Director. Vlctona Union HOSpttal Pnnce Albert. Saskatchewan,
for more Information.

UNITED STATES

R.N. s- SOUTHERN CALIFORNIA -Immediate need
eXists for medical-surgical Units Onentatlon and In-
service program Excellent salary. full paid benefits
We will assist you with your H-1 visa for Immigration
An Intenm permit may be obtained from the Califor-
nia Board of Nursing Education and RpglstratlOn to
practice nursing an California prior to licensing Con-
tact Per sonne' Duector The Hospnal of the Good
Samantan. 1212 Shatto Street. los Angeles Caltfor.
nla 90017 (213) 482.8111 ex 287

Mo "_ V'5ta Colorado reqUires REGISTERED
NURSES tor 50 beo hospital Workong visa readily
available after January 1st 1974 TransportatIOn one
way can be obtamed Please wrrte directly to the
Admll1lstrator Monte Vista Genera\ Hospital. Monte
Vista ColoTadO 81144 or call Calgary 271 2502 after
5 pm

TEXAS wants rou! " you are an RN. expenenced or
a recent graduate. come to Corpus ChTish SParkling
City by (he Sea a city bUlldong for a better
future where your opportUnilies for recreatIOn and
studies are limitless Memonal Medical Center 500-
bed general teaching hospital encourages career
advancement and provides lM.serVlce orlentallon
Sal ary from $682 00 to $940 00 per month com.
mensurate With educatIOn and expenence Differential
for evening shifts available Benefits Include holi-
days sick leave vacations paid hospltahzatlOn
health hfe Insurance pension program Become a
vital part of a modern up 10 dale hospital wTlte or
call collect John W Gover Jr Director of Per-
sonnel Memorial Medical Center POBox 5280
Corpus Chflslo Texas 78405

,,--

t ' l
;,

/'

APRIL 1974

REGISTERED
NU RSES

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 from $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 OA1

RN and RNA

Permanent or summer staff positions available
Active 250-bed General H()spital
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

1.'-
.r'
i.e..

-f '>

"

'\

,

(

THIS 1345 BED COMPLEX 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:.lt full salary
ON-GOING EDUCATION - Provided through
active in-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 holidays 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 R3E OZ3

APRil 1974

THE CANADIAN NURSE 57

REGISTERED NURSES
GRADUATE NURSES

dnd

REGISTERED NURSI NG ASSISTANTS

reqUir d for

FIVE SUMMER CAMPS

Strategically located throughout Ontario

nd near
OTTAWA. LONDON COLLINGWOOD. PORT
COLBORNE. KIRKLAND LAKE
accft:'dlt d members - Ontario Camping
Association)
Appllcðtlons invited from Nurses Interested In
supervisory assistant and general cabin
responsibilities 10 the field of rehabilitatIOn of
phYSI<Cdlly handIcapped chIldren
Apply in wrihng to:
Supervisor of Camping and Recreation,
Ontario Society for Crippled Children,
350 Rumsey Road,
Toronto, Ontario,
M4G 1R8. .

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.

REGISTERED NURSES

are invited to apply to this active
Regional Referral Hospital in the
B.C. Interior. The Hospital has 344
beds and an expansion programme
underway. All clinical specialties
are represented and provide op-
portunities for varied nursing ex-
perience R.NAB.C. Contract is in
effect. B.C. Registration is re-
quired.

Please address all
correspondence to:
Director of Personnel Services
Royal Inland Hospital
Kamloops, B.C.
V2C 211

58 THE CANADIAN NURSE

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

alary and benefits according to
RNAB.C. contract.

Please apply to:

The Administrator,
Burns lake and District Hospital,
Box 479,
Burns lake, British Columbia,
VOJ 1 EO.

FACULTY
POSITIONS

Open lor clinical experts
to teach in the
underuraduate prourams

COMMUNITY HEALTH NURSING
MENTAL HEALTH NURSING
MEDICAL-SURGICAL NURSING
OBSTETRICAL NURSING
and
CONTINUING EDUCATION

Personnel policies and salanes 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

THE LADY MI NTO 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 1 CO

NORTH NEWFOUNDLAND & LABRADOR

reqUires

REGISTERED NURSES
PUBLIC HEALTH NURSES

International Grenfell Assoclallon 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 m Surgery. Medicine,
Paediatrics, Obstetrics. PsychIatry. Also,
Intensive Care Umt. OrientatIOn and In-Service
programs. 40.hour week, rotatmg shifts. Livmg
accomodatlons suppl ied at low cost. PUBLIC
HEALTH has challenge of large remote areas.
Excellent personnel benefits mclude liberal
vacation and sick leave. salary based on
Government scales.
Apply to:
INTERNATIDNAL GRENFELL ASSDCIATlDN
Assistant Administrator of
Nursing Services,
St. Anthony, Newfoundland.

REGISTERED NURSES
ANO
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 Llskeard,
Halleybury, Cobalt all wlthm 5 miles of each
other is located 90 mIl es from North Bay
with dally plane, tram and bus service to and
from Toronto etc. Beautiful recreatIOnal facil.
itles includmg curling, skatmg, skIIng, sWim.
mmg. boatmg, hunting, flshmg.
Salary tully appropriate to the responsibIlIty of
the posit Ion, personnel policies m I me with
industry and hospital practice. OrientatIOn
and In.Servlce Educational programmes are
prov Ided.

Apply in writing to:
PERSONNEL DIRECTOR,
Temiskaming Hospitals,
Haileybury, Ontario.

GENERAL DUTY NURSES

Required Immediately

. for 270-bed acute care general hospital
expandmg to 370 beds
. climcal areas mclude: Medlcme Surgery
Obstetrics Paediatrics Psychiatry Rehablltta-
tlon Extended Care and Intensive and
Coronary Care
. Must be eligible for B.r. registration
. Personnel policies m accordance with
R NA BC COntract
. 1973 Salary $672 . $842.00 per month

Please contact:

Director of Nursing
Prince George Regional Hospital
Prince George, B.C.

APRIL 1974

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

(fruïrrn .

THE RELIG IOUS
HOSPIT ALLERS
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
438Y2 College SI.
Burlington, Vermont
05401

FORMATION CENTER
4 Toronto Street.
Ottawa. Ontario.
K1 S ON2

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. Mediæl Centre.

For further information, please write to:
PERSONNEL SERVICES
VANCOUVER GENERAL HOSPITAL
855 WEST 12TH AVE.
VANCOUVER, B.C.

APRil 1974

THE CANADIAN NURSE 59

EXPERIENCED R.N. 's

Required for a.B., Pediatric and
Medical/Surgical Wards. Salary
$820.00 per month with extra
allowance for experience.

For full particulars write:

Director of Nursing
Churchill Health Centre
Fort Churchill, Manitoba
ROB aKa

I

DIRECTOR OF NURSING

Individuals with B.Sc.N. and consider-
able experience in Nursing Administration
are invited to submit applications for a
challenging opportunity that is being made
available as a result of the planned
retirement by the present Director of
Nursing.
The hospital is a 495-bed community
general hospital with plans for expansion
to 750 beds and is located in the new City
of Misslssauga just west of Metropolitan
Toronto.
Reply in confidence to:
THE ADMINISTRATOR
The Mississauga Hospital
100 Queensway West
Mississauga, Ontario
L5B 1 B8

NURSING LIAISON

Required for Children's Rehabilitation
Program. Basic requirement is a degree in
Public Health Nursing plus experience in a
district unit. Past experience in a paediatric
or multi-disciplinary setting would be an
asset. The program is well established -
provides liaison with other health and
educational services. Opportunity for fam-
ily contact. Salary based on qualifications
and experience.
Apply to:
Mrs. P.C. Cox
Director of Professional Services
London & District Crippled
Children's Treatment Centre
385 Hill Street
London, Ontario
N6B 1 E4

60 THE CANADIAN NURSE

Nursing Sisters' Association
of Canada
Biennial Meeting
Wednesday, June 19th, 1974
Winnipeg, Manitoba
Mess Dinner

See you there!

UNIVERSITY NURSING
FACULTY POSITIONS

Maternity, Paediatric,
Medical-Surgical
Psychiatric

Master's degree and teaching experience
required. Excellent personnel policies and
fringe benefits Rank and salary commen-
surate with education and experience.
Positions available: Fall 1974.
Write to:

DEAN,
Faculty of Nursing,
University of Toronto,
Toronto, Canada.

THE LAURENTIAN HOSPITAL
SUDBURY, ONTARIO

is seeking a

DIRECTOR OF NURSING

QualificatIons:
registration as a nurse In Ontario
- vat/ed nursmg experience
- administratIVe experience at hIgh lellels
- 1'e bilingual
Preference will be given to candidates with a Master s or
B Sc. degree.
The Laurentian is a 420.bed general hospItal. scheduled
to open In 1975
Sudbury IS a hub city of 1 DO DO residents. situated 250
miles north of Toronto
Applicants who are not bIlingual must be wIlling to meet
thiS requirement at the expense of the hospital
Application and curriculum vitae are to be sent to:
EXECUTIVE DIRECTOR
LAURENTIAN HOSPITAL
1222 Pans Crescent
SUDBURY. Ontario
P3E 3A2

REGISTERED NURSES

The Red Deer General Hospital is
looking for nurses in several general
duty areas. However, we are espe-
cially interested in grads who have
experience in Intensiv'" Patient Care.
We have a very active 230-bed hospi-
tal in Central Alberta. If you are
interested in finding out more about
our progressive hospital contact:

Personnel Director
Red Deer General Hospital
Red Deer, Alberta

ADMINISTRATIVE
SUPERVISOR

With post graduate courses and ex-
perience relative to nursing administ-
ration. An opportunity to exercise
skills of leadership and to participate
in an ongoing progressive manage-
ment development program.
Applicant should be able to rotate on
night tour of duty.
Apply:
Assistant Administrator (Nursing),
York County Hospital,
NEWMARKET,
Ontario, L3Y 2R 1.

UNIVERSITY HOSPITAL
SASKATOON,SASKATCHEWAN

A 550-bed hospital located on the Univer-
sity Campus
reqUires NURSES for'

(1) New Born Intensive Care Unit.
(2) Medical Intensive Care Unit.
(3) Other specialized and general areas.
Excellent opportunity for development and
advancement in an environment of patient
care teaching and research.
For further information please contact:
Employment Officer, Nursing
University Hospital
Saskatoon, Saskatchewan
S7N OW8

APRil 1974

...:.

. ....::;,;

;
.. ...

.I
P I;

l

VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA
1 he :\Iaritimes' largest teaching hospital. has immediate
ope nings for Registered Nurses. Certified N ursi ng A
sistant

and Orderlies. Positions are aVdilable in Special L nits and
tor general nursing duties. It is the principal adult teaching
hospital of Dalhousie University and dlso operates a large
school of nursing.
SALARY:
Commensurate with qualifications and experience.
SPECIAl LNIT J\.LRSES $8170-S9582
REGISTERED
l'RSES S7816-59229
CERT. "'LRSING ASS1STA1\oT\ $5626-$7180
NLRSING ORDERLIES $4991-S6333
BEN F !-ITS:
Full Civil Service Benefits. including three v.eeks vaca-
tion. four weeks after 5 years of service and shitì diffe-
rential. -
For further information and/or application forms. please
contact:
Personnel Office.
\ ictoria General Hospital.
Halifax. Nova Scotia.

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VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA

Th.e .\1 aritime.s' largest h?spital. has immedidte openings for

hmcal
ursll:g Supervisors. It is the principal adult teach-
mg hospital ot Dalhousie University and al
o operdtes a
large school of N ursi ng.
SALARY: $11.560 - 513.537
CLINICAL NLRSI"'-G SLPERVISORS
A \Iaster's Degree is preferable but candidates v. ith a
Bachelors' Degree would be given consideration. 3 \ears
e'l.pe
ience. 1 of
hich was at the supen isory leV'eI is

eqUlre
. Courses In Clinical Specialit
Nursing. especiall\
In :\ledlcal or Surgical )\oursing would be considered.
BE
E!-ITS:
!-ull Civil Service Benefits. including three weeks vaca-
tion and four weeks after five "ears of service
Competition is open to both n
en and women:
I'or further information and/or application forms. please
contact:
Personnel Office.
\ ietoria General Hospital.
Halifax. Nova Scotia.

Th e h ea lTh care team

Join us at
Sunnybrook
Medical
Centre

,

\1

· 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

t
t

APRil 1974

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I

THE CANADIAN NURSE 61

DIRECTOR OF NURSING

Applications are invited for this posi-
tion in a 167-bed fully accredited hos-
pital.
Individuals possessing a BSc in Nurs-
ing and experienced in Nursing Ad-
ministration who are interested are
requested to supply a short 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 1 KO

RED DEER COLLEGE

requires

NURSING
INSTRUCTOR(S)

POSltion(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. KELL V
Director of Programs
Red Deer College
Red Deer, Alberta.

O.R. SUPERVISOR

required for a 268-bed, fully accre-
ditated hospital. The a.R. Super-
visor is responsible for the a.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.NAB.C. policies in effect

Apply to:
Director of Nursing
Chilliwack General Hospital
Chilliwack, British Columbia

62 THE CANADIAN NURSE

nurses

who want to

nurse

At York Central vou ean join
an active, interested group of
nurse
who want the chance to
nur
e in its broadest :-.ense. Our
I 26-bed. fully accredited ho
pi-
tal i:-. young. and already expand-
i ng. ;\; ursing is a profession we
respect and we were the first to
plan and develop a unilJue nur
-
ing audit system. I here arc
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
arc available a few milcs to the
South.. dnd the winter and
summer holiday and week-end
pleasures of Oiltario are easily
acees
ible to the North. I f you
arc really interested in nursing.
you are needed and
ill he made
welcome.

Apply in per
on or by mail to the
Director of Nur
ing.

YORK
CENTRAL
HOSPITAL

RJ('H\1()
D HII I.
ONIARIO

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:
Master's 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

NURSING SUPERVISOR

required immediately
for
Operating Room
and
Recovery Room
Staff responsibilities will include assessing
quality of Nursing Serviæ
and
assisting in the Planning of in-service
programs.
Baccalaureate Degree with broad nursing
experience.
Remuneration will be consistent with ex-
perience and qualifications.
Apply in writing sending complete re-
sume to:
Miss Phoebe Stanley,
Director of Nursing,
Stratford General Hospital,
Stratford, Ontario.

HEAD NURSE
OPERATING ROOM SUITE

For a 276-bed fully accredited hospital in a
university city of 60,000 population in
Southern Ontario. We require someone
with management experience and ad-
vanced preparation in Operating Room
technique and administration.
Excellent benefits and a salary commen-
surate with experience will be offered plus
extra for advanced preparation.

Please apply giving full resume to:

PERSONNEL MANAGER
St. Joseph's Hospital
80 Westmount Road
GUELPH, Ontario
N1H SH8

APRil 1974

g
1'111\ ,-

EMPLOYMENT
OPPOR TUNITIES

PROVINCE OF
PRINCE EDWARD ISLAND

NURSE IV'S
SALARY $9,252 TO $10,692
(EFFECTIVE APRIL 1,19741$9,715 TO $11,227
Sataty depends upon experience and qualtftcatlons.

"Director of Nursing" for a 75
bed special care hospital
Responsibilities for the nurs-
ing services offered by the hos-
pital.

"Supervisor" responsible to
the director of nursing of a 275
bed psychiatric hospital.
On an assigned shift, the
supervisor directs the adminis-
trative and professional nursing
services at the hospital.

QUAU FICA TIONS

RN, BSN, or recognized courses in supervision and/or administration and
have extensive supervisory experience. A special requirement is applicants
must be eligible for licensing to practice nursing on Prince Edward Island.
Application forms may be obtained by writing the Civil Service
Commission, P.O. Box 2000, Charlottetown, Prince Edward Island.

Cheque out
a cri
pled child
today.

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APRil 1974

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[ammunities.

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and Welfare Blen-êlre SOCial
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Canada Canada ..
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I Medical Services Branch I
I Department of National Health and Welfare I
I Ottawa. Ontario K 1 A OK9 I
I I
I Please send me more information on nursing I
I opportunities In this service. I
I Name: I
I Address: I
City: Prov: _

_______________J

THE CANADIAN NURSE 63

O.R. NURSES
S.C.U. NURSES
GENERAL DUTY
REGISTERED NURSES

Required for a 135-bed active treat-
ment hospital located in a modern
of some 6,000 people, just forty miles
south of Edmonton, Alberta's capital
and with easy access to lake and
mountain resort areas such as Banff
and Jasper.
Starting salary $665 - $830 commen-
surate with experience and qualifica-
tions. Excellent personnel policies
and fringe benefits available.

Kindly apply to:
Director of Nursing
Wetaskiwin General Hospital
Wetaskiwin, Alberta
T9A 1 V6

ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO.

REGISTERED NURSES

630.bed fully accredited Hospital provides
expenence In Emergency, Operating Room,
Post Anaesthesia Room, I ntensive Care Unit,
Orthopaedics, Psychiatry, Paediatrics, Obste.
tncs and Gynaecology, General Surgerv and
Medici ne
Basic 2 week Orientation Program and con.
tinulng 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. (66.213010
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.
tlon after completion of one years service.
APPl Y:

ASSOCIATE DIRECTOR
OF NURSING SERVICE

ST. JOSEPH'S HOSPITAL
30 The Queensway
TORONTO 3, ONTARIO.

64 THE CANADIAN NURSE

DIRECTOR OF NURSING

To assume the responsibility for the Direc-
tor of Nursing services in the present
90-bed accredited, active treatment hospi-
tal - and transition to a new 120 bed facility,
now under construction, to be completed in
1975.
A key administrative position for an indi-
vidual with demonstrated managerial abil-
ity and capable of maintaining good inter-
personal relationships at all levels.
Desirable Qualifications: Baccalaureate
Degree. with experience in administration.
Salary commensurate with education and
experience.
Send full resume to:
Administrator,
Payzant Memorial Hospital,
Windsor, Nova Scotia.

NURSE CLINICIAN

required for 40-bed Psychiatric Unit in
accredited gen
ral hospital.
Post graduate course in Psychiatry with a
minimum of five years' related experience.
Baccalaureate degree preferred.
Exællent working conditions and benefit
programme.

Please apply to:
Employment Supervisor
Belleville General Hospital
Belleville, Ontario.

R.N.'S - TRAVEL
THE U.S.A.

Registered Nurses required immediately in
modern hospitals in the U.S.A. Many hospitals
as well as cities to choose from, such as
Miami, Washington D,C., Philadelphia, San
Francisco, Atlanta and New York.
Arrangements for work permits and other
paperwork provided by us. Air fares advanced if
required and accommodation can be arranged
in the various cities. We can get you permanent
jobs or contracts to work your way around the
U.S.A. - 4 months, 6 months and 1-year
contracts. Medox has offices in Canada and the
U.S.A. to look after you. Why not travel the
U.S.A. with Medox Professional Nursing Ser-
vice?
Write Sheila Britten, MEDOX LIMITED, Suite
302, 3 Place Ville Marie, Montreal, Province
of Quebec, H3B 2E3, or call (514) 861-1728
and let us know your interests.

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 Speci
lty
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

This
Publicntion
is
\'Tnilnble in

II(
ROFOR.'I

,..from

,

Xerox
University
Microfilms

300 North Zeeb Road
Ann Arbor, Michigan 48106
Xerox University Microfilms
35 Mobile Drive
Toronto, Ontario,
Canada M4A 1 H6
University Microfilms Limited
St. John's Road,
Tyler's Green, Penn,
Buckinghamshire, England

PLEASE WRITE FOR
COMPLETE INFORMATION

APRil 1974

ASSISTANT ADMINISTRATOR
(NURSING)

Applications are invited for the position of Assistant
Administrator (Nursing) at Trenton Memorial Hospital. an
accredited 200-bed community general hospital located in
the Bay of Quinte region of Ontario, 100 miles east of
Toronto. Vacancy: May 1,1974.
The successful applicant will be a senior member of the
administrative team with special responsibilities for the
direction of the Department of Nursing and for other
important areas of management. The Hospital has a
progressive nursing service, is affiliated for RN and RNA
training and conducts an active in-service and community
education program. Apartment accommodation is available
near the Hospital.
Applicants should apply giving full details of education and
qualifications, experience, names for reference and salary
expectations to:

JOHN A. LUPTON
Administrator

TRENTON MEMORIAL HOSPITAL
Trenton, Ontario, K8V 5S6

Going away?..
Don't forget to be
a (f) Blood Donor
before you go !
BE A REGULAR BLOOD DONOR

APRIL 19ï4

GRADUATE NURSES

Require General Duty Registered Nurses for
Intensive Care and Operating Room Units. Must
be eligible for Alberta Registration. Salary to com-
mensurate with experience. $665. - $830.

Please submit resume and qualifications to:

Personnel Department
ROYAL ALEXANDRA HOSPITAL
EDMONTON, ALBERTA
T5H 3V9

ST MICHAEL'S HOSPITAL
Toronto, Ontario
invites applications from

REGISTERED NURSES

for

INTENSIVE CARE and "STEP-DOWN" UNITS

Planned orientation and in-service programme will enable
you to collaborate in the most advanced of treatment
regimens for the post-operative cardio-vascular and other
acutely ill patients. One year of nursing experience a
requirement.

For defaits apply fo.

The Director of Nursing,
St. Michael's Hospital,
Toronto
Ontario,
M58 1 W8.

THE CANADIAN NURSE 65

TH E HOSPITAL
FOR
SICK CHILDREN

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Situated inthe stimulating
atmosphere of downtown
Toronto,within walking distance
of the University of Toronto
The largest children's hospital on
the continent offers the
Registered Nurse opportunities
for development in our Nursing
Department, We have many areas
that will interest the Registered
Nurse who is looking 'or a
challenging career in paediatric
Nursing
Opportunities for employment in
Intensive Care, Renal Dialysis,
Neonatal Unit, Child and FamilY
Unit, Clinical Investigation
Unit, Operating Room, Cardiac
Surgery, Neurosurgery Isolation
and Orthopaedic surgery. We
have a planned orientation and
staff development programme

The majority of in-patient units
are working the 7 day fortnight
(12 hour shifts) Salaries are
commensurate with experience
and education. Excellent fringe
benefit programme, Current
registration in Ont, is required

Applications for General
Duty Positions are invited
PLEASE WRITE TO Mrs,C. MACINNES
The Personnel Co-ordinator
555 Universi ty Avenue
Toronto, Ontario, Canada
M5G1X8
TELEPHONE 366-7242 Ext.1528

66 THE CANADIAN NURSE

REGISTERED
NURSES

ASSISTANT
DIRECTOR
OF NURSING

positions available immediately in a 500
bed active Hospital for the following
departments: -

Applications are invited for the position of
Assistant Director Nursing for this fully
accredited 276-bed hospital (162 Active,
114 Continuing Care) in a university city in
Southern Ontario.
Under a new administrative structure, the
successful applicant will be a member of
the health care team within the Depart-
ment of Patient Services. Major responsi-
bility will be the administration and co-
ordination of nursing activities within the
Active Units of the Hospital.
Administrative education and experience
are essential.
Applications outtlnlng quatlflcatlons and ex-
perience should be forwarded to:

Medical/Surgical
Obstetrics/Gynecology
Psychiatry

Excellent fringe benefits.

Apply to:

Director of Nursing Services,
The Metropolitan General
Hospital,
1995 Lens Avenue,
WINDSOR,
Ontario N8W 1L9

Personnel Manager
St. Joseph's Hospital
80 Westmount Road
GUELPH, Ontario
N1 H 5H8

HUMBER MEMORIAL
HOSPITAL

Telephone 249-8111 (Toronto)
200 Church Street,
Weston, M9N-1 M8, 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 Developme('lt Programmes are provided.
Competitive salaries offered to qualified personnel. Registered
Nurses are urgently required for temporary employment July,
August and September.

APRil 1974

Q

ORTHOPAEDIC &: ARTHRITIC
HOSPITAL
'VI'V'

43 WELLESLEY STREET, EAST
TORONTO, ONTARIO
M4Y 1H1

Enlarging. Specialty Hospital offers a unique
opportunity to nurses and nursing assistants
interested in the care of patients with bone and
joint disorders.
Currently required -
Registered Nurses and Nursing Assistants for all
units
Clinical specialists for Operating Room, Intensive
Care, Patient Care and Education.

REGISTERED NURSES

Immediate Openings in all Services
Come wor\< and play m Newfoundland s second largest city'
Corner Brook has a populatIon of apprOJumately 35.000 . wnh a temperate climate In companson
wIth most 01 Canada Outdoor Irte IS among the "nest to be lound In North Amenca The aIrports
servIng Corner Brook are at Deer lake. 32 mIles away. and Stephenvllle. 50 miles away
Connecbons wnh these aIrports make readily avaIlable air travel anywhere In the wand
Present Salary Scale. S6.9OIJ.00 - 8,810.00 per annum
EffeclIVeApnl1, 1974. S7.452 00- 9.515 00 per annum
Effective September 1 1974. S7.652.00. 9.715 00 per annum
ServIce Credits. One step for two years expenence. maximum two steps Apnl1 sl
1974 - maxImum. three steps.
EducatIOnal dIfferential lor B.N. and masler's aegree In NursIng
.80c per shift lor rotating evenings and "'ghls
$2.00 per shift for Charge Nurse.
S50.00 uniform allowance annually
20 workJng days annual vacatIon.
8 statutory holIdays.
Sick Leave - 1 1/2 days per month.
Accommodation aVaJlablB
Two week oflentatlOl1 on commencement
Contmuing Staff EducatIOn program
At I1e present time. a majOr expanSion prOject IS .n progress to provIde regIonal hospotal
laCliltles lor the West Coast 01 the ProvInce. The Hospital will have a 350 bed capaCIty by
December. 1974. S9fVICes Include MedIcine. Surgery. Paediatncs. ObstetrICS.
Psychiatry, CCU. and ICU.
Lellers of applkallon should be submiltlJd to:

Director of Personnel,
WESTERN MEMORIAL HOSPITAL,
CORNER BROOK, NFLD.

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Jewish G
!lea
!f!' Hospital

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 SI. Catherine Road Montreal 249, Quebec

APRil 1974

THE CANADIAN NURSE 67

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 prelerred
- Minimum of two years bedside nursing experience.
Responsibilities:
- Qassroom teaching and clinical supervision.
Salary:
- Commensurate with preparation and experience
within the CSAO range.
Starting Date:
-August 1, 1974

Dlfect applications with
complete resume to:

DEAN OF ACADEMIC AFFAIRS,
DURHAM COLLEGE OF APPLIED
ARTS AND TECHNOLOGY,
BOX 385,
OSHAWA, ONTARIO.
L1H 7L7

DIRECTOR OF NURSING

Godench Psychiatric Hospital is an accredited 230 bed
active treatment psychiatric hospital, affiliated with the
University of Western Ontario. This modern hospital
overlooks beautiful lake Huron and is within short
driving distance of London and Stratford. The hospital
has specialized units of Alcoholic & Addiction,
Rehabilitation, Admission and Intensive Care,
Psychogeriatric. Extended Care and Child Care and
Family Centre. The program involves training of
nursing affiliates from community cOlleges and
training schools.
The successful Male or Female Applicant would
require Registration as a Nurse in the Province of
Ontario, completion of Post Graduate Course in
Nursing Administration, preferably a Bachelor of
Nursing Science, at least three years experience in an
Admimstrative and SUperviSOry Nursing capacity, with
the ability to set objectives, plan policies, co-ordinate
and analyze necessary needs within a multi discipli-
nary team approach to ultimate patient care.

ConfidentIal resume may be submitted to:
Goderich Psychiatric Hospital
Goderich, Ontario.
N7 A 3Y8

68 THE CANADIAN NURSE

THE CANADIAN
RED CROSS SOCIETY

invites applications for
the position of

NATIONAL DIRECTOR
FAMILY HEALTH

Position Summary
The position encompasses a broad range of
responsibilities including coordination and de-
velopment of family health services in the
provincial divisions as well as advising in relation
to other interests of the Society, nationally and
internationally.
Qualifications
The applicant is a Registered Nurse.
Qualifications are personal and professional
achievement including university preparation
(Master's degree in Nursing) and a high level of
energy and imagination.
Skills in inter-personal relationship, especially
the ability to communicate with a variety of
individuals and groups are essential.
Bilingualism would be an asset.
Apptications shoutd be sent with complete
resumé immediately to:
National Director of Administration
Canadian Red Cross Society
95 Wellesley Street, East
Toronto, Ontario M4Y 1H6

CLINICAL CO-ORDINATOR
for

OBSTETRICS
AND PAEDIATRICS

REQUIREMENTS:

. Registration in Ontario
. Advanced preparation, preferably
B.Sc.N.
o Leadership qualities
. Nursing experience in these areas

Interested qualified applicants please apply
to:

Director of Nursing
Peterborough Civic Hospital
Peterborough, Ontario

I

The School of Nursing
at the
Selkirk Mental Health Centre
is offering a
Post-Graduate Course
in Psychiatric Nursing.

Commencing September 9th, 1974
The Program is of nine months duration
and includes theory and clinical experi-
ence.
Successful completion of the program
leads to eligibility for licensure with the
R.P.NAM.
Prerequisite for enrollment - the candidate
must 'be a registered nurse in good
standing in the Province of Manitoba.

For further information please write not later
than June 17th to:

Director of Nursing Education,
School of Nursing,
Box 9600
Selkirk, Manitoba
R1A 2B5

SELKIRK COLLEGE
CASTLEGAR, B.C.

Selkirk College is a comprehensive com-
munity College located in a mountaineer-
ing and skiing region of southern British
Columbia.
The College invites applications for the
Chairmanship and Faculty Positions in
the two-year diploma program in Nursing.
Applicants for the positions must have a
minimum of a Bachelor's degree, prefera-
bly a Master's degree for the position of
Chairman, in addition to relevant Nursing
and teaching experience and must be
eligible for registr
tion with the Registered
Nurses Association of British Columbia.

Please apply to:
The Principal,
Selkirk College,
Box 1200, Castlegar, B.C.
V1N 3J1

APRil 1974

Assistant Director
of Nursing:
$11,100 - $13,000

The MINISTRY OF HEALTH'S Queen Street Mental Health Centre, a
C.HA accredited rapidly expanding 650-bed psychiatric facility in
downtown Toronto, requires an innovative and experienced indi-
vidual to assist with policy development, bUdget preparation and
monitoring, and overall administration of the nursing department,
which includes in-patient, out-patient and day treatment services.

Qualifications: B.Sc.N. degree and registration in Ontario sup-
plemented by administrative and/or supervisory experience, or an
equivalent combination of education and experience and demon-
strated interest in community mental health treatment.
Please submit resumes to: Personnel Officer, Queen Street Mental
Health Centre, 999 Queen Street West, Toronto, Ontario, M6J 1H4.

This position is open equally to men and women.

&?)
Ontario

Ontario
Public Service

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THE SCARBOROUGH
GENERAL HOSPITAL

-
"J

invites applications from:
Registered Nurses and Registered Nursing Assist-
ants to work in our 6S0-bed progressive, accredit-
ed, community-centered, active treatment hospital.
We oller 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-goire 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.

ROYAL VICTORIA HOSPITAL

Montreal is a fascinating,
bicultural city, but don'
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
H3A 1A1

APRIL 1974

/

THE CANADIAN NURSE 69

TORONTO
GENERAL HOSPITAL

UNIVERSITY OF
ALBERTA HOSPITAL

Invites applications Irom

EDMONTON, ALBERTA

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS
FOR GENERAL DUTY

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.

Superior opportunities for Professional Growth
and Development.
Progressive Personnel Policies.
Excellent opportunities for advancement in
atmosphere of medical excellence.

Planned Orientation Program,
In-service Education Program.

Please apply to:-

Salary commensurate with education and expe-
rience.
For further information write to:

Personnel Office
TORONTO CENERAL HOSPITAL
101, College st.,
Toronto, Ontario,
M5G 1L7.

EMPLOYMENT SUPERVISOR - NURSING
UNIVERSITY OF ALBERTA HOSPITAL
84 Avenue & 112 Street
Edmonton, Alberta

FOOTHILLS HOSPITAL

invites applications from graduate nurses eligible for reQ1stration who
enjoy nursing and
seek opportunities for personal
and professional growth

-
'tIll'

Foothills is a new 766 bed general hospital affiliated with the university of Calgary, situated in
northwest Calgary, fifty miles east of the rockies.

FEATURES

- patient and family - centred approach to health care by alileam members

:! t

-
-
-

- patient care departments in obstetrics, paediatrics. medicine, surgery,
neurosurgery, reactivation, psychiatry, intensive care
aJ
j - Centre for southern Alberta in neonatal intensive care. renal dialysis, and
I treatment of glaucoma, detached retina.

OPPORTUNITY

- for mdividualized orientation program
- for broad range of learning experiences and attendance al in-service educational programs
- to participate in planning your own program of growth
- excelleñt personnel policies
For appllcar/on form write to:
Ms. Paige Hegland, personnel officer,
Foothills Hospital, Calgary, Alberta, T2N 2T9

70 THE CANADIAN NURSE

APRil 1974

INSTRUCTOR
REQUIRED

for expanding 2-year
Integrated Diploma Program

Projected Admissions
for 1974-150 students

Total Enrollment - about 260

II

Requirements - Baccalaureate
Degree with at least one
year's
Experience in Nursing

Positions available beginning
in June 1974. Particular re-
quirements for those with ex-
perience and interest in Mat-
ernal and Child Health and
Psychiatric Nursing

For information contact:
Miss Anne Thorne,
Director,
Saint John School
. of Nursing,
Beaverbrook House,
Coburg, St.,
Saint John, N.B.

APRil 1974

ASSISTANT DIRECTOR
OF NURSING

Working below your potential? Interested in promoting new
concepts of care for chronically ill patients? We may have the
position for you!
Our 500-bed chronic, rehabilitation hospital has an immediate
vacancy for an Assistant Director of Nursing. The primary
daytime tour of duties include some administrative, supervisory.
coordinating and teaching activities.
The successful applicant must be a Registered Nurse with at least
five years' experience at the Head Nurse, supervisory level and
possess an Administration or Department Management Certificate.
Preference will be given to applicants with a B.Sc. in nursing and
those with teaching experience.

Apply in confidence to:
QUEEN ELIZABETH HOSPITAL
130 Dunn Avenue
Toronto, Ontario.

PH: 537-2411

Public Health Nurses:
$13,200 - $15,000

With the Health Promotion Branch, MINISTRY OF HEALTH, you will
develop and assess standards and guidelines for public health nursing
activities in the central Ontario region, and provide consultant and advisory
services to official and voluntary agencies. Location: Toronto.
Qualifications: must be registered as a nurse in Ontario; bachelors degree
desirable, but preferably a masters degree; public health experience at an
advanced level required; use of a car necessary.
Please submit resumes as soon as posssible to: Recruitment Officer, Social
Branch, File OB351 , Civil Service Commission, Parliament Buildings,
Toronto, Ontario, M7A 1Z5.
These positions are open equally to men and women.

Ontario
Public Service

Ontario

THE CANADIAN NURSE 71

CANADIAN INTERNATIONAL
DEVELOPMENT AGENCY
(CIDA)
PUBLIC HEALTH NURSE:
VIETNAM

CIDA is searching for an expert in public health nursing to
serve as part of a Public Health Field Training and
Demonstration Program (FTDP) in Vietnam's An Giang
Province. This expert will be involved in all phases of public
health administration at the provincial level in Vietnam but
more particularly in the planning and monitoring of activities
with a view to upgrading the health services of An Giang
Province so that it may become a suitable training ground
for health personnel from all over Vietnam. The incumbent
will work in close co-operation with the Provincial health
authorities and in a line position with other Canadian team
members.

DUTIES:

1. To assist in the determination of health needs and
objectives of An Giang Province so as to provide
guidelines for the expected performance of
graduates from the FTDP Program and to help set
objectives for the teaching program.
2. To seek out, report on and try to solve any
contradictions in the present health services delivery
of the National Institute of Public Health (Saigon)
particularly in the practical training program but also
with respect to development programs. indigenous
medicine and culture.
3. To assist in health field surveys.
3. To record and report on these surveys and to make
recommendations as appropriate on adjustments to
the program such as by revising bbjectives and
suggesting alternatives for follow-up activity.
5. To monitor and report the activities of health
personnel in the field and to proVide guidance to
those health personnel as warranted.

QUALIFICATIONS REQUIRED:

a) fully qualified as Public Health Nurse, preferably with
MPH or DPH degree
b) several years experience in public health field.
c) Canadian citizenship.
Interested and qualified candidates are invited to apply
to:

Mrs. Hylda K. Bateman
Head
Health and Social Development Section
Human Resources Division (M)
Canadian International
Development Agency
122 Bank Street
Ottawa, Ontario
K 1 A OG4

Nurses with a university degree and at least five years
experience but with qualifications differing from those listed
above are also invited to enquire about opportunities for
service with CIDA elsewhere in the developing world.

72 THE CANADIAN NURSE

I nd ex
to
Advertisers

April 197 4

Astra Phannaceuticals Canada Ltd. .. . . . . . . . . . . . . . .8
Davol Canada Ltd. ............................2
Facelle Company Limited ..................... .52

Hollister Ltd. ..
ICN Canada Ltd.

.51
.49
..I

J.B. Lippincott Co. of Canada Ltd.

C.V. Mosby Company, Ltd. .......... .17,18,19.20
Nordic Biochemicals ......................... .13
J.T. Posey Company ......................... .50
Procter & Gamble... .. . . .. .... . . . . .. .. . .CoverlV
Reeves Company ... . . . . . . . . . . . . . .. ....... 14, 15
Sandoz (Canada) Ltd. . . . . . . . . . . . . . . . . . . . . . . . . . .11
White Sister Unifonn. Inc. ... .5. 7. Cover II. Cover III

I dn'l'tisi n
MlII/(J
cr
Georgina Clarke
The Canadian Nurse
50 The Driveway
Ottawa K2P 1 E2 (Ontario)

Advt'rtisinR Rl'pu'sentallvn
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003
I ekphone. (215) "v1 id\\:I) l)-1-tl)7

Gordon Tiffin
2 Tremont Crescent
Don Mills. Ontario
T depholle: (416) 444-4731

Member of Canadian
Circulations Audit Board Inc.

1m:]

APRil 1974

./
UNIFORM- SP-EêIÂÚÿ

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.

A
I
#42440
'ale Corded"
I Jr length
I :; 5-15
e.......... 517.98
" Yellow
Blue ...... $19.98
B

#42878
'ale Oxford"
s 5-15
e only
)0

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· · · · "S SISTER ...."
. . . . . . . . ..
. . . . . . . . . . .. \

C
Style # 2350
"Royale Rib"
Missy Length
Sizes 8-20
White only
524.00

SPRINGTIME
WHEN THE DRESSING
IS EASY

1254 BAY ST.
(JUST ABOVE BLOOR)
TORONTO, ONT.

... . . . . . . . .
. OR SHOP BY MAIL
. MAIL ORDER DIVISION
. 372 QUEEN ST. W.
. TORONTO, ONT. MSV 2A3

Keeps
him 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.

f

Saves
YOU tiIlle
w'
Pampers construction
helps prevent moisture
from soaking through
and soiling linens. As a
result of this superior
containment, shirts,
sheets, blankets and
hed pads don't have to
he 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.

1......( /,1
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PROCTER. GAMBLE CAR.U!

The

.

..1..1..1
Nurse

NURSING CARE

.

A conceptual model

:\\oo\to a stateo,
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"e.
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May 1974 {;]

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Basic physical assessme
A self-help clinic
for women

- MIS S M

l1J Y E R
158 GU IGUES ST-
(iTTAWA KIN 5H9

C0056886

/'
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f''. SUPERBL'
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SINCE YOU CANT G(
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I
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LET OUR CAREER
I APPAREL SAY IT
I FOR yOU.....
II I
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......

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CAREER APPAREL

A) Style No. 2870
"Royale Oxford"
Sizes 8-18
White only
About ........ 527.00

"Royale Corded"
Sizes 8 - 18
Pale blue
About ........ $28.00

B) Style No. 42867
"Royale Oxford"
Junior length
Sizes 5 - 15
White only
About ........ $20.00
C) Style No. 42263
"Royal Spice"
Junior length
Sizes 5 - 15
White only
About ........ $28.00

CAREER APPAREL AT FINE STORES ACROSS CANADA

c:;

new nOOMS '74

CD il

,

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{(,

$

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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 LId
Springer Publishing Company, Inc.

New - Fifth Edition
FUNDAMENTALS OF NURSING
The Humanities and the Sciences in Nursing
The content has been thoroughly revised and reorganized, and much new
material reflecting current nursing concepts and practice has been
added. There is greater emphasis on a holistic approach to nursing
practice, and on preventive care. A major innovation is the inclusion of
the first application of systems theory to nursing care to be found in a
textbook on fundamentals of nursing. Systems theory is developed as the
basis for the nurse's responsibility and accountability, stemming from the
philosophy that effective nursing care results from the use of psychosocial
and biochemical knowledge to determine and provide individual care for
each patient; the nursing process system.
Elinor V. Fuerst, R.N., M.A.; LuVerne Wolff, R.N., M.A. and Marlene H.
Weitzel, R.N., M.S.N.
Approx. 450 Pages/Illustrated/May 1974 about $11.00
New!
CLINICAL PHARMACOLOGY IN NURSING
This entirely new text, by the authors of Pharmacology and Drug Therapy
in Nursing, is especially designed and prepared as an alternative for the
student or practitioner who needs to acquire quickly the kind of infor-
mation most immediately important to the planning and giving of nursing
care. Essential scientific background material, necessary for an under-
standing of the ways in which drugs of different classes are used in treat-
ing patients with various disorders, is presented clearly and concisely.
Data on the dosage, administration, adverse effects, indications and con-
traindications for specific drugs are presented in drug digests, at the end
of each chapter. Factual data and fundamental principles are, in addition,
presented in the form of detailed tables and summaries at the end of
each chapter. With 1973 edition of Nurses Guide to Canadian Drug
Legislation.
Morton J. Rodman, B.S., Ph.D.; and Dorothy W. Smith, R.N., M.A., Ed.D.
Approx. 700 Pages/ May 1974 about $10.50
New - Third 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 operationalleve!. 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 relation to interaction with peers, super-
visors. subordinates and patients; recognition of emotional problems faced
by all hospitalized patients.
Joan J. Kyes, R.N., M.S.N., Altoona (Pa.) Hospital Community Health
Center; Charles K. Hofling, M.D.. St. Louis University.
600 pages/May, 1974/about $10.00

Please send me the bookls) whose number(s) I have circled

2

3

Name
Address
City Province
o Payment enclosed (send postpaid)
Books may be returned within 15 days

Position
Postal Code
o Use my Chargex number
o Charge and bill me

CN'5-74

Keeps
him 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.

\0

Saves
VOll ti 111e
w'
Pampers construction
helps prevent moisture
from soaking through
and soiling linens. As a
result of this superior
containment, shirts,
sheets, blankets and
hed 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.

- _:fl::...------
, II
..

(
Þa , 'Pel's
f
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. \
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PROCTER. GANBlE CAR-UJ.

The
Canadian
Nurse

ð

A monthly journal tor the nurses of Canada published
in English and French editiom by the Canadian Nurses' Association

Volume 70. Number 5

May 1974

23 Behavioral Effects of Dialysis

17 Basic Physical Assessment. .. . . . ... ... ... ... .J.E. Fry. B. Majumdar

. . . .D. Walser

26 Wanted: A Definition of Nursing Practice

30 An Experimental Nursing Curriculum .......... .M. Uprichard

. . . . . . . . .Sr. M. Bachand

33 A Self-Help Clinic for Women. . . . . . . . . . . . . . . . . . . . . . . . . .A. Hall

I h.: \ 1':\\' l'''pr,:''.:d In Ih.: ,'(lito, ial and \ ariou, an,.:k, ar.: Iho',: of Ih.: author, and
do nOI n.:.:.:"arih r.:pr':":ll1lh.: pplici.:' or \ i.:,^' oflh,' ( anadian ;".;ur'.:,' \"o.:iation.

4 Letters 38 Names
7 News 39 Books
13 In a Capsule 41 A V Aids
15 New Products 41 Accession List
37 Dates 64 Index to Advertisers

Eo \.:eu'l\': Dlr.:ctor IId"n .... \Iu"all",".
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. 'nh'lriplion Rail"': (anad.a unt.:' \ car.
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$6.50. two years. $12.1)0 Single cop ie,
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C> { .1I1.IlII.1II 'ur...\..... \............1.1111111 )97'"

Editorial I

Having just read two biographies, one
of Jeanne Mance: the other of Myra
Bennett. ** I wonder why nurses don't
themselves record their adventures,
experiences, ideas; and not leave it to
historians or journalists to do it for
them.
Nurses do have stories to tell -
serious, humorous, learned - and the
book we are going to write some day is
a formidable task. But, let us start
recording snatches of day-to-day
events, or new developments in pro-
jects now underway.
We are too accustomed to receiving
impulses from the media. Let us send
a few messages too - on paper. How
easy it then becomes to communicate,
especially if sharing knowledge,
doubts, hopes with our peers.
Our country is large and this creates
a need for nurses to communicate, to
keep our profession informed about
what we, its members, are doing.
Naturally, this plea is made on
behalf of The Canadian Nurse and
L'infirmière canadienne: our forum for
innovative and original ideas; our
forum for sharing new or unusual
nursing procedures; our forum for
written "conversation", or an ex-
change of views, in either French or
English.
First, let us make sure what we say
is well said, logical, and readable.
Manuscripts are always welcome, but
so are plans for proposed articles.
Opinions are welcome also, but too
few are expressed. A letter to the
editor could be a start, as it involves
talking to only one individual, the
editor.
One final thought. Our journals have
only so many pages, and material has
to fit within their covers. What we
submit may have been said before,
may already be "in the mill," or may
need too much editorial help for the
time available to editors. We should,
therefore, not be disappointed if our
contribution is not accepted for publi-
cation, but should writè when again
we come across something worth
sharing.
As mentioned before: why wait for
biographers to tell our story, the story
we're living right now. - L.E.L.

. Atherton, William Henry. The saintly life of
Jeanne Mance. St. Louis, The Catholic
Hospital Association, 1945.
.. Green, H. Gordon. Don't have your baby
In the dory! Montreal, Harvest House, 1974.
THE CANADIAN NURSE 3

MAY 1974

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.

Note
"Ethics of Nursing Practice" (February
1974, p. 22) was a report prepared by Dr.
Moyra Allen based on responses to a
request of Canadian nurses for specific
examples of work situations presenting
ethical problems that they had encoun-
tered.
We did not endorse statements made.
but merely brought to light some of the
ethical problems that arose. They ap-
peared to be very few. Views expressed
were those of respondents and do not
represent our editorial policy.
One problem cited concerned the
reporting of medication errors. We apolo-
gize for the unfortunate inclusion of this
item in The Canadian Nurse, which sin-
gled out a particular group of nurses.
The quotation in the article also reflects
a misunderstanding of the work of the
Human Rights Commissions in Canada.
All provinces, except Quebec and Prince
Edward Island, have human rights com-
missions to administer provincial Human
Rights Codes. These codes prohibit
discrimination in employment (among
other areas) on the grounds of race, creed,
color. sex, marital status, nationality,
ancestry, and place of origin. The princi-
ple of the codes is to act for the best
interest of the total community and not to
protect anyone from dismissal for incom-
petence.
Following are letters received by the
editor up to press time.

Readers criticize article on ethics
I have concern about the article' 'Ethics
of Nursing Practice." There is a certain
lack of ethics shown by the author' in
reporting some of the incidents. If a nurse
has a problem within herself. this is not
allied to ethics in nursing, but to the
ethics of the nurse. The personal ethics of
nurses should be considered apart from
ethics of nursi ng practice.
The section that was most obvious and
distasteful referred to the black nurse and
the nurse's fear of reporting her because
of a possible involvement with the
Human Rights Commission. ] feel this to
be inflammatory and grossly prejudicial,
and the kind of statement that promotes
feelings of ill will between races. Even
though other nurses may not have had
difficulties, they will now anticipate
them.
The Human Rights Commission was
established to aid those who were the
object of discrimination, not to protect
4 THE CANADIAN NURSE

individuals from responsibility for their
actions because of their race and color.
As an employer of nurses of many
races and colors, I can only say that
anyone who has his facts correct and
documented should not have any fears.
Documentation should be done in any
case of disciplinary action. regardless of
color. Everyone has the right to seek
recourse for unjust treatment.
The person reporting this so-called
ethical problem appears to be prejudicial
to black people, and is using this as an
excuse to relieve her of her own respon-
sibilities.
I notice that The Canadian Nurse
abdicated responsibility for the content of
this article, but] am surprised it was even
printed. - Margaret Dowsett. Director
of Nursing, The Etobicoke General Hos-
pital, Rexdale, Ontario.

The Canadian Nurse printed an article on
"Ethics of Nursing Practice." As a few
concerned individuals, we are extremely
angry at this irresponsible reporting.
To publish such an article on the basis
of 22 responses from over 100,000
questionnaires sent out would imply that
the author is apparently irresponsible and
biased. It is of no statistical significance,
and the repercussions of this being pub-
lished in a nation-wide magazine
threatens the integrity and questions the
competence of the black nurse.
This article also challenges the integ-
rity of the white nurse who would
overlook the importance of reporting such
serious errors, using such an inapprop-
riate excuse.
It is a sad fact that at this time, there
appears to be stereotyping of groups of
people. - (Signed by 30 persons),
A/{incourt, Ontario.

I read with interest the analysis of" Ethics
of nursing practice." I would like to
comment on the ethical problem: report-
ing of medication errors.
Medication errors must be reported,
regardless of the person's color. creed,
class, or sex. As nurses, we cannot expect
to hide behind the mask of discrimination
to protect us from negligent nursing acts.
If a black nurse makes a medication
error, she ought to be governed by the
same code of ethics adopted by nurses in
Canada and other countries. All nurses
are aware of the standards of conduct,
based on moral judgments and values as
drawn up by the International Council of

Nurses. It is thus immoral to use dis-
crimination to violate the principles of the
code of ethics as applied to nurses.
When a nurse joins a professional
organization, she agrees to abide by its
principles and ethics. One statement from
the revised draft of the ICN code for
nurses states: "The nurse takes appro-
priate action to safeguard the individual
when his care is endangered by a co-work-
er." Medication errors are sources of
danger to the patient's well-being. A
nurse withholding such information is as
guilty as her colleague involved in the
act.
The purpose of the Human Rights
Commission is to investigate discriminat-
ory problems, not to advocate life-
threatening errors. I have had black.
white, and other nurses fill out medica-
tion error forms, without fear of interro-
gation from the commission.
With regard to ethics, emphasis should
be on patients' safety, rather than on
discrimination. Admitting medication er-
rors is not solely for the purpose of
reprimanding the nurse. It helps her
professional development. Perhaps we, as
nurses, need to examine ourselves, re-
view the ICN code of ethics, and develop
a philosophy of ourselves and nursing. -
Elfreda C. Bryan, Toronto, Ontario.

In her article "Ethics of Nursing Prac-
tice, ., Dr. Allen made a rather sweeping
statement that many drug errors are made
by "black nurses," as we are called.
I would like to ask how the author
arrived at this conclusion. She must have
carried out a complete survey throughout
Canada. Where are the statistics?
Twenty-two letters were returned. How
can the author base her statement on such
a number? What does "black" have to do
with a drug error?
Why should the reporter fear that she
will be called up by the Human Rights
Commission for discriminating against
"black nurses"? As a white Canadian,
she must know her rights. If she reported
the truth, there is nothing to fear; she
would have the facts to back up her
statement.
The purpose of the Human Rights
Commission is not to to uphold black
people in their mistakes, but to ensure
that justice is done. The commission is
not a "black organi7ation."
Dr. Allen's statement is erroneous,
unless she is prepared to produce figures
showing that "black nurses" make drug
MAY 1974

errors, compared with figures showing
that white nurses make the same or similar
mistakes in similar circumstances. A drug
error can be the administration of an in-
correct dose of a drug: the administration
of the wrong drug: an error in the route of
administration; and an error in the time of
administration, including the omission of
a dose.
This statement is not only vindictive,
but is also a form of subtle color
discrimination. Anyone who turns a blind
eye to a drug error is failing in her duty to
her people and to Canada as a whole, and
should be removed from her position
Such a person is an accomplice to every
drug error she fails to report.
In spite of such insults, I and others
like me will continue to do our work to
the best of our ability. My field is
pediatrics: I enjoy helping to save the
lives of young Canadians.
I know that discrimination will be seen
in many shades and colors. Believe me, I
have seen it. - G. Williams, RN, SRN,
SCM, Toronto. Ontario.

In the article "Ethics of nursing prac-
tice," a statement reads as follows:
"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...
will be call1ed up by the Human Rights
Commission. "
That statement in itself is a sign of
discrimination. Black nurses make many
mistakes, and so do white nurses. All
black nurses have good education, but
like other human beings, we make errors.
Why is nothing said of the few or the
many errors white nurses make?
I can imagine the effect this statement
will have on the public. Medication errors
should be reported, regardless of who
makes them, because it is the patient who
suffers. We are all here to save lives, not
to endanger them. I think we should not
be so race conscious, but should forget
the color of our skin and do what is right,
honest, and best for the patients. Few
mistakes or many can have the same bad
effect. - Ena G. Thorpe, RN, Hamilton,
Ontario

Survival course helps RNs
I read with interest "Surviving in the
bush" (March 1974) by Jan O'Brien, and
commend the author for this fine article.
I hope more features of this kind are plan-
ned for the future.
A similar group of public health nurses
in Saskatchewan recently undertook a
self-designed northern survival course at
La Ronge. This course was developed
primarily for public health nurses em-
ployed by Medical Services, National
Health and Welfare, who were in remote
or isolated communities throughout
northern Saskatchewan.
MAY 1974

The course included a realistic simula-
tion exercise intended especially to assist
public health nurses who travel by light
aircraft in distressing climates.
As conductor of the program, I must
compliment all the participants on their
initiative and enthusiasm. The simulation
exercise was conducted three miles north
of Lac La Ronge village in forest and lake
country. There was approximately 2 t
feet of powdered snow, with daytinu:
temperatures ranging from -20 degrees F
to -35 degrees F. The wind chill made the
exercise considerably more challenging.
Six volunteers remained outdoors
overnight, and although they were moder-
ately uncomfortable, they returned to the
classroom with their tasks completed.
The Report and Recommendations
on the Northern Winter Survival
Course is available on request to any
interested group. - Charles A. "Skip"
Brooks. Regional Health Educator, Sas-
katchewan Region, Medical Services,
Health and Welfare Canada. Regina.
Saskatchewan.

More about problem-solving
We felt compelled to respond to Barbara
Geach's challenge to clinicians regarding
the relevancy of problem-solving tech-
niques in clinical nursing ("The problem-
solving technique: is it relevant to prac-
tice?" January 1974).
Like any other skill, problem-solving
requires constant practice to maintain an
effective level of perfonnance. Nurses
must use the components of the technique
to arrive at valid decisions. The com-
bination of knowledge and experience
pennits the nurse to reach the point where
she accomplishes the skill quickly and
often unconsciously.
The trend in many nursing departments
is to alter the structure to one of
decentralization of authority. One impli-
cation of this is that the nurse must be
provided with an effective method, which
can be used quickly and efficiently to
make patient care decisions. The tech-
niques of problem-solving provide a
method for the nurse to examine the
consequences of her choice and actions.
As clinical nurse specialists, we con-
stantly use the problem-solving approach
when members of the health team consult
us. Although a great deal of this modeling
is invisible, one visible example we can
suggest is the process demonstrated when
we assist in the development of nursing
care plans.
Each day we assist staff to develop
plans based on their clinical findings. By
applying their specialized knowledge and
experience, they develop expected out-
comes and the related nursing action.
We do not take all the credit for
modeling this approach. Our experience
has taught us that many of the staff do use
the problem-solving approach. Where did

they learn this? We strongly suggest that
somewhere in their school of nursing
curriculum appeared the title "The
Problem-Solving Technique. It's Rele-
vance to Practice."
We use this approach and it works. It is
particularly pertinent to difficult decisions
that are resistant to ready solutions. Let's
keep teaching it and pushing it! It makes
people think. - Rosemary Powers and
Margery Sherlock, University Hospital,
London, Ontario.

Problem with part-time nursing
In reply to "Nurses should not retire"
(Letters, December 1973, page 4), I
heartily agree that nurses "hire a
housekeeper or baby-sItter and keep nurs-
ing one or even two days a week."
The problem seems to be that many
hospitals, having raised nurses' salaries,
refuse to hire regular part-time staff. This
leaves the married nurse no alternative
but to work full-time and, in many cases,
rotate shifts. This can create many prob-
lems at home, particularly for nurses with
young children.
As I have moved around Canada, I
have found this refusal is true of several
hospitals, many of which state they are
chronically short-staffed. Perhaps if some
hospitals were more lenient, many of us
would never retire. -Irene Manderville,
RN, Alberta.

More information needed
As I plan to do further research on the
1918 flu pandemic ("The pandemic in-
fluenza of 1918," December 1973), I
would appreciate hearing from anyone
who has anything to add: personal experi-
ences, little known facts, or any other
aspect of the subject. - Gladys Morton.
R.R.3, Wakefield, Quebec.

Have you worked in the north?
I am a writer presently doing research into
the life and work of the nurse in Canada's
north. I am most anxious to contact
nurses who have worked in northern
communities - with either the Indian or
Eskimo people - and who have available
diaries or letters telling of their experi-
ences.
I would appreciate hearing from any
readers who have such written records
and would be will ing to make them
available to me for study and making
excerpts. I would also be happy to receive
the names and addresses of nurses known
to have had northern experience, but may
be unaware of my appeal.
I hope my work will provide a reliable
documentation of the great contribution to
Canada provided over the years by our
nurses in the north.- Jo\' Duncan, R.R.
no. 3, High River, Albertã. <Q?
THE CANADIAN NURSE 5

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. .J 1874-1974

news

Nurses Featured On Program
Of CNA Convention In Winnipeg
Ottawa - Over 20 nurses will take part
in the program of the 1974 CNA conven-
tion to be held in Winnipeg. June 16 to
21. The names of program speakers were
announced recently. The program topics
were printed in The Canadian Nurse in
April 1974.
The Honourable Saul Miller. Manitoba
minister of health and social develop-
ment. will give the keynote address at the
opening session of the convention on
Sunday evening. June 16.
On Tuesday. June 18. a panel discus-
sion of "Nursing and Health: Changing
Work Relationships" will be chaired by
Alice Baumgart. Panelists include: Be-
verly May. a nurse who is chairman of the
provisory committee for the esta-
blishment of the West Island community
service center in Montreal: Mona Kravitz.
lecturer in the master's program at McGill
school of nursing. who is actively invol-
ved in the development of nursing in new
structures. including the West Island
center: Dr. Murray Katz. a family practi-
tioner in Montreal: Maria Gomori. direc-
tor of the social service department. St.
Boniface Hospital. Winnipeg: and Horace
Krever. professor of law. University of
Western Ontario. London.
The Tuesday afternoon panel on
"Changing Structures in Health Servi-
ces" will be chaired by Nicole Marchak.
national director of family health for the
Canadian Red Cross Society. On the
panel will be: Jean-Pierre Alix, research
associate in the department of behavioral
sciences. faculty of medicine. University
of Sherbrooke. Quebec. who will discuss
a province's approach to the subject. and
Dr. Lloyd Axworthy. director of the
Institute of Urban Stuäies, University of
Winnipeg. and a member of the Manitoba
legislature. who will discuss communit}
planning of health service structures.
Three nurses on the panel will discuss
innovative nursing projects. They are:
Janice Sherratt. Winnipeg YON. who is
involved with a not-for-admission pro-
ject; Darlene Flett. Ottawa, nurse-director
of a research project on health mainten-
ance for senior citizens: and Stephany
Grasset. Vancouver YON. who works as a
family nurse practitioner.
On Thursday morning. June 20. Ro-
berta Coutts, Montreal. will chair a panel
discussion of "Nursing and Health: Per-
sonal Attitudes and Professional Image. ..
Panelists are: the nun.,e and her own
MAY 1974

health - Jean Reid Everard. CNA special
studies officer: self-image and the nurse
- Lorine Besel. director of nursing.
Royal Victoria Hospital. Montreal; dy-
namics of effective representation -
Nicole du Mouchel. executive director
and secretary-registrar. Order of Nurses
of Quebec; student expectations - Karen
Prokopanko. nursing student. Red River
Community College. Winnipeg: and
client reaction - Nancy Anderson. nurse
investigator. University of Manitoba
school of nursing.
On Thursday afternoon. simultaneous
sessions will be presented. Convention
participants may choose from:
. Research in nursing practice: defining
the problem - Pamela Poole. research
consultant. health programs. Health and
Welfare Canada. and Rita Dussault.
director. school of nursing. University of
Laval, Quebec City.
. Accreditation. continuing education.
and specialization in nursing - Huguette
Labelle. principal nursing officer. Health
and Welfare Canada. and president-elect,
CNA.
. Towards a definition of nursing prac-
tice - Sister Bachand. research offi-
cer. CNA.
. Initial assessment in acute illness: when
minutes count - a multidisciplinary
presentation organized by E. Margaret
Nugent. director. nursing of adults,
Health Sciences Centre. Winnipeg.
. Care in renal failure - a multidiscipli-
nary presentation organized by E. Marga-
ret Nugent. Winnipeg.
. How to develop a research problem -
videotapes in French and in English by
Dr. Thomas Boudreau. faculty of medi-
cine. U ni versity of Sherbrooke. Quebec.
. Nursing perspectives in the Canadian
Penitentiary Service - Dr Chuni Roy,
medical director. and Olive W. Simpson.
director of nursing. regional medical
center. Canadian Penitentiary Service.
Abbotsford. B.C.

Refresher Courses For Nurses
Are Being Held Across Country
Ottawa - Inactive nurses in a number of
provinces have recently had the opportun-
ity of taking a refresher course to help
them return to their profession. March
and April were popular months for these
courses.
The Registered Nurses' Association of
Nova Scotia. in cooperation with the
department of manpower and immigra-

tion. held a refresher course from March
4 to April 19 at the Victoria General
Hospital school of nursing in Halifax.
More than 50 persons attended the
course. which included classroom lec-
tures and clinical experience. This course
was designed to make it possible for
nurses who were inactive for 5 to 15 years
to go back to nursing and to help
overcome the nursing shortage in the
Halifax area.
A 6-week reorientation course that
began March 18 in Saint John. New
Brunswick. was organized to provide a
group of inactive nurses with adequate
knowledge and support to become up-to-
date in nursing and confident about return-
ing to active practice. Sponsored by the
New Brunswick Association of Registered
Nurses. with financial assistance pro-
vided by the department of manpower and
immigration. the course included lec-
tures. demonstrations, films. and practi-
cal experience in applying theory to
patient care.
Some 22 inactive nurses from com-
munities within a 90-mile radius of Saint
John were enrolled in this course. Those
who completed the course, which was
offered through the cooperation of Saint
John General Hospital. are eligible for
active membership in NBARN
Last November. the Manitoba Associa-
tion of Registered Nurses conducted a
refresher program survey. in cooperation
with the Manitoba Community News-
paper Association. As a result. a 6-week
refresher program for former practicing
registered nurses ""as held in Brandon
from February 18 to March 29: another
program. which began in Dauphin April
29, ""ill end June 6.
Both the Brandon and Dauphin pro-
grams were sponsored by the Red River
Community College in Winnipeg.
Two-thirds of these programs consisted of
clinical experience and the remainder of
classroom instruction.
In Saskatchewan. some directors of
nursing have asked the Saskatche"" an
Registered Nurses' Association to allo""
them to offer a refresher course at their
hospital to inactive nurses living in the
immediate area. The council of SRNA.
however. has turned down these requests.
One of the requirement.. for a refresher
course is that the clinical portion be taken
at a hospital of not fewer than 79 beds.
This rules out a number of hospitals that
are short of staff.
According to SRNA, "if refresher
THE CANADIAN NURSE 7

news

courses for inactive nurses were per-
mitted at every hospital that has a short-
age, the association would have dif-
ficulty in ensuring that those nurses
who completed the course were com-
petent and safe practitioners."
SRNA is now reviewing its policy on
refresher courses and is exploring the
possibility of offering them at community
colleges. A regulation passed by SRNA a
number of years ago requires any nurse
who has worked less than 30 days in a
5-year period to take a refresher course
before she can be re-registered. This
course, which is a\'ailable by corres-
pondence from the University of Sas-
katchewan in Regina, is offered in
January and September of each year.

R.C. Nurses Reject Hosp. Contract,
Dispute Goes To Arbitration
Vancouver, B.C. - Some 7,700
registered nurses in British Columbia
overwhelmingly rejected a two-year hos-
pital contract offer last February, which
had been worked out by the bargaining
committees of the Registered Nurses'
Association of British Columbia and the
British Columbia Hospitals' Association
(BCHA).
At the- end of the last contract, which
expired December 31, 1973, the wage
base for the nurses was $675 a month.
The tentative agreement worked out by
RNABC and BCHA would have increased
this to $815 a month.
The nurses' objection to this offer
stems from the wage differential between
them and the province's practical nurses,
who recently won an antidiscrimination
adjustment that gave them a 58 percent
increase. In 1975, the base rate for
practical nurses will be $855 a month.
The RNABC and BCHA committees re-
turned to the bargaining table briefly in
February. BCHA broke off talks, however,
when the RNABC committee asked for
$915 a month - the minimum amount
the nurses would accept.
Strike votes were then taken at the
Royal Columbian Hospital in New West-
minster, the Royal Jubilee Hospital in
Victoria, and the Vancouver General
Hospital. At all three hospitals, the nurses
were almost unanimously in favor of
taking strike action.
RNABC was about to serve strike notice
at the Royal Columbian Hospital at the
end of March when a mediator was
appointed for a minimum of 10 days by
William King, labor minister for the
province of British Columbia.
8 THE CANADIAN NURSE

On April 5. RNABC told The Canadian
Nurse: "Since we got the distinct impres-
sion that registered nurses would not be
allowed to withdraw their services and
since mediation services broke down
partially because management would not
move from its position at all, it was clear
that a binding decision would be forced
upon us. We are pleased that the decision
is to be binding on both parties and that a
knowledgeable person familiar with the
situation has been appointed to conduct
the inquiry. ..
Clive McKee was the person appointed
by the labor minister to the Industrial
Inquiry Commission. RNABC expected a
settlement in two weeks.

Stories Of Nurse Shortage
Give Wrong Impression - SRNA
Regina, Sask. - The Saskatchewan Reg-
istered Nurses' Association is concerned
that newspaper reports about a shortage of
nurses in the province may have left the
wrong impression with the public.
"There is not a shortage of nurses in
Saskatchewan, but rather a shortage of
nurses who wish to work," explains SRNA.
It notes there were 6.605 nurses regis-
tered with the association as of December
31, 1973, and there are about 4,000
nursing positions in Saskatchewan (at
least 2,500 of which are in hospitals).
Thus enough nurses are eligible to prac-
tice to fill the required positions.
Yet until the results of a questionnaire
on employment and movement patterns of
nurses are known, SRNA admits it "can
only guess at why nurses do not wish to
work. ..
One reason considered obvious. how-
ever, is the low salaries paid to nurses in
Saskatchewan. "The current starting
wage for a general duty nurse... is $580 a
month. This compares with $660 in
Manitoba and... $665 in Alberta. British
Columbia nurses recently rejected a new
starting wage of $815 a month."
SRNA also points out that for the 4,000
married nurses in the province, the $1
paid for shift differential is not much
incentive, "particularly since they must
take their turns on nights and evenings."
But it is not fair to expect the single
nurses to work all night shifts, says the
association.
Because many nurses are dissatisfied
with their jobs and are resigning, SRNA
fears this situation could cause a poor
quality of patient care. If the nurses who
continue to work are asked to carry a
heavier load of responsibility for a long
time, "it does not take them long to
realize that the care they are required to
give... is being spread too thinly."
A recruitment campaign for nurses,
which some Saskatchewan hospitals have

been conducting in Britain, is seen by
SRNA as on I} a short-tenn solution. "If
nurses in this province are not wilIíng to
work. recruiting nurses from (outside)
the country does not cope with the prob-
lem, which could become a long-term
one."
Another solution suggested for the
employment problem is that the nursing
schools increase their enrollment and
graduate a class in January as well as in
August. Although this might help staff
hospitals and nursing homes during the
summer, SRNA warns that "it could also
result in an oversupply of nurses... as was
the case three years ago when about 600
nurses could not find work. "

RNAO Urges Continued Provision
For Safe Transportation At Night
Toronto, Onto - The Registered Nurses'
Association of Ontario has asked its
15,000 members to resist vigorously the
passage of legislation that would end safe
transportation requirements for women
who do late night work.
RNAO President Wendy Gerhard is-
sued a statement March 27, 1974,
commenting on the announcement by
Margaret Birch, provincial secretary of
social development, that a change in the
law would be a further step toward equal
rights for women.
"We are distressed and baffled by Ms.
Birch's viewpoint. Protection is not dis-
crimination; women are particularly vul-
nerable to crimes of violence and rape."
the RNAOpresident said.
Ms. Gerhard noted that when the
Ontario Council on the Status of Women
first recommended the deletion of the
safe transportation provision of the Em-
ployment Standards Act. the ministry of
labour asked for further study to be done
by the council. Then the council again
advised the ministry of labour to repeal
the provision. Ms. Birch revealed the
government's intention to comply, in a
speech delivered at a recent conference on
Law and Women in Windsor.
"It seems clear to us that the ministry
of labour was doubtful of the wisdom of
repealing the provision, as well it
might," said Ms. Gerhard. "Women's
rights surely include the right to protec-
tion. The RNAO Standards of Employ-
ment for Registered Nurses require em-
ployers to provide safe transportation to
and from home for all nurses coming on
or off duty between midnight and 6:00
A.M. That includes male nurses. We
don't discriminate in matters of personal
safety, though women do face special
risks. ..
Statistics for 1972 showed approxima-
tely 24,000 nurses employed by hospi-
tals, where their services are required
(Continued on page /2)
MAY 1974

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.'t) ì developmental differences

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.'f '. .... '_ throughout childhood, indicates
\ , .'. - 'f 0'_
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d.evia
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, and explains
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.'.('..-&. . their Im.plicatlo.ns for he
lth
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. ItJ .Þ, . gUidelines for continued learning
,
'.. .' " J"
: and gives helpful information on
-" ....:
-
,.";" making referrals.
................
-. ' B P GGY
4 Y E L CHINN, R.N., Ph.D.;
and CYNTHIA JO lEITCH, R.N.,
Ph.D. March, 1974. 122 pages plus FM
I-VIII, 8" x 10",20 illustrations.
Price, $5.20.

j

child health
maintenance: concepts
in family centered
care

Providing a clear delineation of the
nursing process in the children's health
care arena, this text presents concepts
inherent in maintaining or restoring a
child's health in view of his family and
environment. A unique conceptual
framework of competency development
helps students see each child as an
integrated whole - affected as a total
individual by health management and
intervention. Discussions incorporate all
aspects of growth - physical, learning
and thought, social and inner-development.
By PEGGY l. CHINN, R.N., Ph.D. March,
1974.542 pages plus FM I-XII, 8" x 10",
214 illustrations. Price, $13.15.

'

growth is
fi ed with
first
expenen

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MOSBY' I'

THE

TIMES MIRROR
c. v MOSBY COMPANY LTO . , J
86 NORTHLINE ROA
,. '. :.;
TORONTO, ONTARIO "
M4B 3E5 : ',.-'

..... ',-
-.

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Drawing by
Wendy Benron, Age 6

....................rìE3VV rTì()S()
tE3)(tS

New 7th Edition!

Gragg-Rees

scientific principles in nursing

By using a variety of physiological, psychological, and
sociological concepts, this new edition provides a theoreti-
cal model for effective application of scientific principles
in daily patient care. Students are given a solid base for
understanding, motivation for independent study, and an
awareness of their role within the framework of the health
care team. New material includes biopsychosocial aspects
of patient care, death and dying, and communication and
patient teaching.
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.

New 8th Edition!

Larson.Gould

orthopedic nursing

This new edition presents a comprehensive resource on
orthopedics applicable to nursing at all levels. Discussions
cover: body mechanics; care of patients in casts, traction,
braces, and surgical patients; rehabilitation pain; trauma
to bones, joints, and ligaments. Also included is material
on: arthritis; bone tumors; infections of bones; meta!Jolic
disorders; congenital deformities; developmental diseases;
cerebral palsy; neuromuscular affections; operative pro-
cedures and legal liability of nurses.
By CARROLL B. LARSON, M.D., F.A.C.S.; and MARJORIE
GOULD, R.N., B.S., M.S. April, 1974. Approx. 576 pages, 7" x
10",572 illustrations. About $12.10.

A New Book!

Morel-Wise

urologic endoscopic procedures

This comprehensive presentation considers the historic
development of urologic endoscopic procedures as well as
practical considerations such as equipment care, suite
layout, and safety precautions. Each procedure is treated
in depth, detailing the nutse's responsibilities in cyto-
scopic procedures, bladder biopsy, transurethral resection,
etc. Illustrations depict equipment and describe each
procedure.
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.

A New Book!

Conover

cardiac arrhythmias: exercises
in pattern interpretation

This practical volume can reinforce and broaden student
expertise in interpretation of arrhythmias. Common and
rare patterns - more than 200 - are included for per-
sonal diagnosis. The reader is prompted to make the
step-by-step deductions that will lead to an accurate
conclusion and supplied with an analysis by the author
of how a correct diagnosis could be reached.
By MARY H. CONOVER, R.N., B.S.N.Ed. January, 1974. 292
pages plus FM I-X, 8" x 10",234 ECG tracings. Price, $8.95.

A New Book!

Bergersen-Sakalys

review of pharmacology
in nursing: mosby's
comprehensive review series

The concise question-and-answer format of this practical
new text helps students review and reinforce all major
aspects of pharmacology as they relate to nursing.
Pharmacologic principles, administration of drugs,
specific drugs which act on the various body systems and
toxicology are discussed. A pertinent, up-to-the-minute
chapter gives students new insight into recognition,
control and treatment of drug abuse.
By BETTY S. BERGERSEN, R.N., M.S., Ed. D.; and JURATE A.
SAKAL YS, M.S. May, 1974. Approx. 176 pages, 5%" x 8%".
About $4.75.

() .'.
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10 THE CANADIAN NURSE

MA Y 1974

hep them deveop
.

A New Book l

readings in child and
adolescent psychiatric nursing

Bringing together almost all written material presently
available in the field of child psychiatric nursing, this
volume is the only one presently addressing itself specifi-
cally to the nurse's therapeutic role with emotionally
disturbed children and adolescents. This book is develop-
mentally organized, beginning with a total frame of
reference, and includes a wealth of clinical examples.
Edited by CLAIRE M. FAGIN, Ph.D., R.N.; with 32 contributors.
January, 1974. 190 pages plus FM I-XIV, 6" x 9",10 illustrations.
Price, $6.05.

New 2nd Edition l

Aguilera-Messick

crisis intervention:
theory and methodology

This new edition recognizes crisis intervention as a logical
extension of the problem-solving aspects of the nursing
process and self-awareness. The concise explanations
define crisis intervention and the interrelation of various
disciplines in its applications. These topics are augmented
by the discussion of historical development and inter-
vention techniques.
By DONNAC. AGUILERA,R.N.,M.S.:andJANICEM. MESSICK,
R.N., M.S.; with foreword by GEORGE ALBEE. June, 1974.
Approx. 148 pages, 6W' x 9W', 13 illustrations. About $6.30.

A New Book!

Lipkin

psychosocial aspects of
maternal-child nursing

Directed toward the family unit and psychosocial factors
influencing family development, this book considers
pregnancy, labor, delivery, and postpartum situations in
psychosocial perspectives. It details the pregnant couple,
the postpartum couple: the child from birth to six years
and from six to juvenile, the juvenile, adolescent, and the
terminally ill child.
By GLADYS B. LIPKIN, R.N., M.S. May, 1974. Approx. 192
pages, 7" x 10",31 illustrations. About $6.60.

f

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MAY 1974

.

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New 2nd Edition!

Douglass-Bevis

nursing leadership in action:
principles and application
to staff situations

Providing a foundation for the growth of leadership
skills, the authors approach the study of leadership from
a scientific point of view, presenting basic leadership
content in the form of predictive principles and their use
for effective team functioning. Through a theoretical
framework, the book defines and shows how to
formulate principles, and gives examples of their use
in solving nursing problems; helps the student use
acquired knowledge to become an effective leader; and
offers guidelines for better use of the available nursing
staff.
By LAURA MAE DOUGLASS, R.N., B.A., M.S.; and EM
OllVtA BEVIS, R.N., B.S., M.A. April, 1974. Approx. 192
pages, 7" x 10", 17 illustrations in 17 figures. About $6.05.

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

... ....
. ..
\
>

THE

I

MOSBY

TIMES MIRROR
C v MOSBY COMPANY L TO
86 NORTHLINE ROAD
TORONTO, ONTARIO
M4B 3E5

' -.
t', ...

THE CANADIAN NURSE 11

news

(Continuedfrom page 8)
around the clock on a 7-day-a-week basis.
According to RNAO, if the nurses are
prepared to serve the public, the public
should be equally prepared to ensure that
safe transportation is available to and
from their homes when public transporta-
tion is neither readily available nor safe.
"If repeal of the safe transportation
provision is pursued by the government,
the RNAO will seek to marshall the
support of its membership to protest and
resist the change," Ms. Gerhard promi-
sed. "We shall do everything possible
to see that this protection for women is
continued. Furthermore, all persons em-
ployed at night should have this protec-
tion. The proposal to end it is illogical,
unreasonable, and absurd."

Research Proceedings Available
Montreal - Copies of the Proceedings of
the Colloquium on Nursing Research,
held March 28-30, 1973, in Montreal, are
available in French and English on a
first-come, first-served basis. The report
contains papers presented by 30 Canadian
nurses.
To receive a copy of the report, in
French or English, write to: Project
Coordinator, Colloquium on Nursing Re-
search, McGill University School of
Nursing, 3506 University Street,
Montreal, Quebec, H3A 2A7.

ICN Accepts Withdrawal
Of South African Assoc.
Geneva, Switzerland - The 15-member
board of directors of the International
Council of Nurses (ICN), meeting in
Geneva on March 28-30, 1974, accepted
the withdrawal from membership of the
South African Nursing Association
(SANA).
In a statement issued March 29, the tCN
board of directors said it hopes that, in the
foreseeable future, SANA will be in the
position to join once again with the
international community of nurses to
share in the promotion of world health
through the ICN, the international organi-
zation for the profession of nursing.
The SANA board of directors announced
its withdrawal from ICN membership in
July 1973, two months following the tCN
15th quadrennial congress in Mexico
City. At the congress, ICN'S governing
body, the council of national representa-
tives, had requested SANA "to take action
to enable nonwhite nurses to serve on its
12 THE CANADIAN NURSE

board of directors." The association was
given until January I, 1975 to comply
with the [CN request or face expulsion.
Until the South African withdrawal,
tCN had 80 national nurses' associations
in membership. ICN now represents close
to one million nurses in 79 countries,
grouped in a federation which, in the
terms of its constitution, "is organized
and functions unrestricted by considera-
tion of nationality, race, creed, color,
politics. sex, or social status. ..
ICN assists national nurses' associations
to improve the standards of nursing and
the competence and status of nurses,
promotes the development of strong na-
tional nurses' associations, and serves as
the authoritative voice for nurses and
nursing internationally.

Applications Are Being Accepted
For First Judy Hill Scholarship
Edmonto1l, A Ita. - The first Judy Hill
Memorial Scholarship will be available
September I, 1974. Applications are
being received for the scholarship, which
has a maximum value of $3,500 and is
tenable in Canada, the United Kingdom,
Australia, or New Zealand.
This scholarship will fund postgraduate
nursing educ"tion, with emphasis on
midwifery and nurse practitioner prepara-
tion, for a period of up to one year.
Applicants should be fluent in the English
language, possess an RN diploma or
equivalent, and have a desire to work for
the federal government or one of the
provinces at a northern fly-in nursing
station, after completion of the scholar-
ship year.
When applying for this scholarship,
nurses should submit a curriculum vitae,
copies of educational qualifications pre-
sented on entry to nursing school, verifi-
cation of diploma, proposed course of
study, preferences for place of study, and
two character references.
Applications should be sent by June I
to: The Chairman, the board of trustees,
Judy Hill Memorial Fund. 829 Centen-
nial Building, Edmonton, Alberta. A
successful applicant from outside the
country will be helped by the trustees
to meet the requirements for regisrra-
tion by a provincial nurses' associa-
tion and for landed immigrant status.

Regi
tered nllr'CS,
your community needs
the henefit of yoU!
skills and experience.
Volunteer now to
Il....:h 51. John Amhulance home
nur,in!! and child care courses.
Conlad your Provincial Headquarters,
St. John Ambulance.

In February 1974, Health and Welfare
Minister Marc Lalonde presented a che-
que for $25,000, on behalf of the federal
government, to Edmonton lawyer Philip
Ketchum, chairman of the board of
trustees of the Judy Hill Memorial Fund.
The presentation ceremony took place at
Charles Camsell Hospital in Edmonton,
which is the federal government's main
referral center for Indians, Eskimos, and
other residents of the Northwest Ter-
ritories.
In presenting the cheque, Mr. Lalonde
said that Ms. Hill would remain in the
memory of Canadians, who had contri-
buted generously to the fund, as the
Medical Services nurse who died on duty
while she was escorting Eskimo patients
from her remote Arctic nursing station to
hospital in Yellowknife.
The purpose of the Judy Hill Memorial
Fund is to provide grants to enable nurses
to improve their education for service in
the Canadian Arctic and to exchange with
nurses in England, where Ms. Hill was
born. All money received by the estate of
Ms. Hill has been donated to the fund.
Contributions to this fund are income
tax deductible. Persons can send dona-
tions to the Judy Hill Memorial Fund, c/o
Toronto-Dominion Bank, Centennial
Building, 23 Sir Winston Churchill
Square, Edmonton, Alberta. Cheques
should be made payable to the Judy Hill
Memorial Fund.

Commonwealth Nurses' Federation
Elects Canadian To First Board
London, England - One of 6 members
elected to the first board of the Common-
wealth Nurses' Federation is Helen K
Mussallem, executive director of the
Canadian Nurses' Association. The elec-
tion results were announced in mid-
March by the federation's secretary.
Dr. Mussallem, who represents the
federation's Atlantic region, was nomi-
nated by the directors of CNA and elected
by associations in the Atlantic region.
The region includes nurses' associations
in Canada and II Caribbean countries.
Dr. Mussallem has been a member of
thc interim board of the federation since it
was set up in 1971. CNA is a founding
member of the Commonwealth Nurses'
Federation.
Other members elected to the federa-
tion board are: Serara Kupe, Botswana
(Africa East and Central); Rachel Palmer,
The Gambia (Africa West); Enyth Hold-
gate, New Zealand (Australasia, Far East,
and Pacific); Mary Philip, India (South
Asia); and Muriel Skeet, United Kingdom
(Europe).
The Commonwealth Nurses' Federa-
tion held an all-African seminar on
"Educating nurses for community health
services," in January 1974. (News,
March 1974, p. 10).

MAY 1974

in a capsule

Women who adopt get paid leave
An aml:ndm
ntto th
Nationallnsuran-
ce L aw in hrad. \\ hich \\ a
approv
d
by the Knesset (parliament) a year ago.
mal-.ö \\om
n who adopt a child und
r
10 years of age digihk fÒr a ca<;h h
nl:-
lïl. Thi
b
ndït i

ljuivalcnt to th

maternity pay natural mothers receive.
According to the Novcmbl:r 197
i
-
su
of th
IlI1el"/llitiu/llil Lahul/I" Rc-
l'it'II', thi
am
ndmcnt is intl:nd
d to
allow a woman to
ta\' at hom
with h
r
adoptl:d l:hild during th
fir<;t difficult
month
aha adoption. \\ithout s
riOlh-
Iv affLcti ng th
fam il\ IIlcoml:.
- Thi
an

ndml:nl. - \\ hich wa
rl:tro-
activ
to April I. Ilr I. compkl1l
nt

,I pr
vious anwndment to th
\\'ol1l
n'

Employm
nt Law. Und
r this Im\.
wom
n \\ho adopt childlTn arc digibk
for 12 \V
cb' unpaid kav
and furth
r
ah
cnc
s from worl-. \\ ithout pay. on
th

am
hasi
a
natural mothl:r
.

Stress caused by bedpan
The
tress experienced by patients who
are required to use a bedpan or commode
is explored in a study entitled
"Physiological Measures of Anxiety in
Hospital Patients." The author of this
study is Anne Munday. a nur
e in the
United Kingdom who is at present lectur-
ing in the department of nursing studies at
the University of Edinburgh. Scotland,
Ms. Munday believes that identifying
patients' anxieties presents problems for
nurses who may rely on their own
Judgments of what might cause
tress; the
nurse
fail to understand the patients'
fears in a strange environment. where
they are faced with unfamiliar proce-
dures.
This study. in which the author has
tried to identify anxiety by measuring
changes in heart rate and in the activity of
the palmar sweat gland
. is available from
the Publications Department. Royal Col-
lege of Nursing. Henriena Place. London
WIM OAB. England.

Giardiasis folluws USSR trip
A physician from New York City wrote a
letter to the editor of The New England
Journal of Medicine January 31. 1974. to
save other touri
ts the disability he
experienced after his trip to the Soviet
Union. He said his discomfort could have
been avoided if he had been briefed
properl y .
MAY 1974

..r.!!:...

IH

I

4

Dr. Edward Gendel described his ex-
perience as follows:
"About a week after a quick trip to the
Soviet Union. 1 repaired to a clinical
laboratory in New York for a stool
examination. The. . . supervisor asked
me where 1 hdd been. and when he heard 1
had spent four days in Leningrad and four
days in Moscow. he said "Giardia." And
so it proved to be - 1 had a florid crop of
Giardia lamblia in my intestines . . . .
"I was symptom free in the Soviet
Union but. when 1 had been home for 72
hours. mild nausea. a feeling of disten-
tion. anorexia. belching. flatulence. and
then diarrhea developed. . . . I lost 4.5
kg in weight. felt like hell and looked it.
according to my observant colleagues.
The therapy is quinacrine (Atabrine). 100
mg three times a day. A three-day course
was not effective for me. exacerbation
occurring when I stopped the drug. A
further course of seven days seems to
have done the trick

,
ð II

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D

"Communication with four people
who had been with me on the
trip . . . disclosed similar symptomatol-
ogy in all four. 1 telephoned the United
States Public Health Service in New York
City to alert them to the possibility of
scores of cases of giardiasis. 1 also
wanted to know why our group had not
been warned that the water in the Russian
cities might be contaminated. (Water
appears to be the mode of transmission.)
"Subsequently. 1 was questioned by
the Contagious Disease Center in
Atlanta . . . . The man in Georgia in-
fonned me that the center knew of the
problem . . . . In response to my query
why the public had not been alerted to the
danger. he said that in the interests of
diplomacy. no direct representations had
been made to the Soviet Union. and no
general warnings given to travelers to that
country. but instructions were being
fonnulated on the matter for distribution
to physicians."

tJ
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"It's on lune 16 to 21 - Pass the Word!"

THE CANADIAN NURSE 13

/

MRS. R. F. JOHNSON
SUPERVISOR

,

CH ARLENE HAYNES

Q
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'OHN, L.P.N.

-
.
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I lETTERING,______________________ 2nd LlNE,_______________
1 S:.);lI 1 DISCI1PTIOI l::

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11A!

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I 169 new Duotone combmlnH satin 0 Sliver 0 Polished not 0 Ok. Blue 0 2 Pins 3.75 0 2 Pins 4.95
I back ound with polished edges. 0 Satm apply 0 White (ume flamel (same name)
I PLASTIC LAMINATE... slimmer, Does Does I OWh,te 1 lli g

lue l 01 Pin ,95 01 Pin 1.55
559 bro.;.der; engraved t
ru
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to not not 0 Med. Green - 0 2 Pins 1.65 0 2 Pins 2.60
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GENEROUS NEW GROUP DISCOUNTS on all
Items shown, for group purchases, graduation giftS, favors, etc.
6-11 same items. deduct 10"0. 12 or more, 20%.
See different schedule of discounts for Name Pins below.

Tailored

I !II tal
"'.169

IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS!
Choose style you want. shown left. Print name (and 2nd bottom left Attach extra sheet for additional pinS
line if desired) on dotted lines below. Check other InfO In NOTE SAVINGS ON 2 IDENTICAL PINS. . . more cOllv
ment.
boxes on chart. clip this sectIOn and attach to coupon spare in case ot loss.

'IIS 'c
a . ale
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el"
Ired
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ile
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. Please add 25, per arder NAM& PIN QUANTITV DI&COUNTB'C
lor 3 pin. or I.... 10-24 pIns, deduct 10% 25.99 pins. 15% 100 or more pins, 2D%
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Finest forged Steel.
Guaranteed 2 years.

II plrbacÞs .. Ih . ty C ch

\ No COO's or billing to individuals.
I enclose $ I Mass. residents add 3% S. T.
Billing terms available to institutions only. A $1. service charge eåJed to
I all institution ardars billed at less than $10 I
Send 10 .. .
A EXAMINING PENLIGHT
I _\, Wl1ile barrel with caduceus Imprint, aluminum
\
band and Clip. 5" long. U.S. made. batteries Included (re-
I I placement batteries available any store). Your own IIgl1t. gift boxed.
Ha. 007 PenliEbt. _ 4.29 ea. Your Initials enaraved. add 50;, per lie'ht.

NURSES PERSONALIZED { _
ANEROID SPHYG. .
A superb instrument especially designed
for nurses by Reister bacta. precisIon
craftsmen In W Germany. Easy-Io-attach
Velcro" cuff, lightweight, compact. fits /
into soft sim. leather zippered case .
2
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to 320 mm., to-year accuracy
guaranteed to :!: 3 mm. Serviced
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initials engraved on manometer
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A wise investment for a lifetime
of dependable SerVll'e l
No. ID6 Sphyg.... 37.95 .a.
BLOOD PRESSURE SET
Excellent Quality Clayton Aneroid Sphyg. from
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guaranteed 10 years. Black and ct1rome manom-
e eter, cat to 300 mm. Velcrcr grey cuff. black
tubing, soft leatlierette zipper case. Clayton No.
414 Nurses Stethoscope and Scope Sack Included
(see below nghV. FREE gold mltlals on case and
Scope Si!Ck
No. 41.10 B.P. Set. . . 29.95 set complete
Du ree Sphyg. only No. IDS... 22.95 with cas..

CAP ACCESSORIES

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CAP TOTE keeps your caps c"s
and clean
willie stored or carried. flexible clear plastic, white

tnm, zipper, carrying strap, l1ang loop. Stores flat. Also
for wiglets, curlers. etc. 8112" diad 6" 1111"'-
No. 333 Tot. . . . 2.95 .a. Gold init. 5O,ITot.

WHITE CAP CLIPS Holds cop,
firm1y in place! t-iarð to-find wl1ìte bobbie pms,
enamel on fine spring steel. Eight 2" and eiE'ht
'\ 3" clips included in plas.tic snap box.
No. 529 Clips 75.. per box (min. 3 boxesJ
MOLDED CAP TACS
Replace cap band instantly. Tin)' plastic ....

tac, dainty caduceus. C"oose Black or

Crystal Wit" Gold Ceduceus. The neater
way to fasten bands. ...:
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METAL CAP TACS Pa" 01 dainly
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bands securely. Sculptured metal, iold fimsh,

"W ill approx. %" wide. CtJoDse RN, LPN, LVN. RN
I Caduceus or Plain Caduceus. Gift boxed.
R TI'
No. CT.l (Sp.cily Inilials), No. CT.2 (Plain
"'t'. Cad.) or No. CT.3 (RN Cad.) . . . 2.95 pro
SEL-FIX CAP BAND Black velvet4r-----..-....
band matenal. Self.edhesive, pre:!!ses on I \
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several times. Each band 20'1 long. pre-cut to
popular widtl1s: 114'1 H2 per plastic box) 112 1 '

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.. I I

ORDIR NO.

ITEM

COLOR Sill QUANT. PRICI

---

.
I INITIALS as d.sired: _ _ _
TO ORDER NAME PINS, 1111 out all inlormation in box,top
I right. clip out and attach to this coupon.

Use extra sheet 10r addltlona1 items or orders.

Street

City

.Zip

Stat. .

..

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\

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Engraved
t Free!
-...,...", cope Sack
; alt Price

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Free Initials R with v.our own
Littma!!
Nursescope!

Famous Littmann nurses. dia.
phragm stethoscope . . . a fine
precIsion instrument, witl1 l1igl1
sensitivity for blood pressures.
apical pulse rate. Only 2 ozs., fits
m pocket, wltl1 gray vinyl anti- No. 2160 Nursescope incl.
collapse tubing. non.chlillng epoxy Free Initials. .
13.95 ea

diaphragm. 28'1 overall. Non rolat-
Ing angled ear tubes and chest
piece beautifully styled In cl10ice
of 5 Jewel.hke colors: Goldtone,
Sllvertone, Blue, Green, Pink."
"IMPORTANT: New "Medallion" styling mcludes tubmg In colors to matc"
metal Darts If desired. add $1. ea to price above; add '.M'. to Order
No. 2160Ml on coupon.

FREE INITIALS! Your initials en.
graved FREE on cl1est piece; lend
mdillidual distinction and help pre.
't'ent loss.

SCOPE SACK See special hall.p,ice

e:n

d:r
d
it
a

y

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LITTMANN COMBINATION STETHOSCOPE
Maximum sensitivity from tl1ls fine professional instrument. Con.
vement 22" overall length, weiE'hs only 3 1 12 oz Chrome b,naurals
fixed at correct angle. Internal spring, stainless cl1est piece, 1
"
diapl1ragm. 1114'1 bell. Removable non chili sleeve. Gra)' vinyl tubing.
Two imtials engr. on chest piece.
No. 21DO Combo Steth .. . 24.95 ea. Du t Y I ree
LITTMANN PEDIATRIC STETHOSCOPE
Same as above. except smaller chest piece for use witl1 Infants and
small cl1l1dren. Diaphragm 1%" dia, bell I !ß" Black tubing. Includes
2 free Initials engr. on cl1est piece
No. 2111 Ped. Steth... 24.95 ea. Duty Iree
CLAYTON DUAL STETHOSCOPE
Ligl1twelght dual scope imported from Japan; "igtJest
sensiti
lty for apical pulse rate. Cfuomed binaurals and
cl1est piece wilh I Va" bell and I Va" dlapl1ragm,
grey anti.collapse tubing. 4 OZ., 29 '1 long. Extra
ear plugs and diaphragm mcluded Twa initials
engraved free. -
No. 413 Dual Steth .. .17.95 .a.

LIGHTWEIGHT CLAYTON STETHOSCOPE
As above, except smgle diaphragm n y." diaJ. Weighs only 3 oz
htra ear plugs and diapl1ragm included No initials available.
. No. 414 Clay. Steth.. .8.95 .a. Duty Iree
eRA è) SCOPE SAC K neatly carnes and protects
I
Nursescope or any scope. Double-thick frosted
Ç/ ' flexible plastic, white vinyl binding 4V2"x9V2".
...- ___ -;:) Your own Imtlals l1elp prevent loss.
No. 223 Sack. . . 1.00 ea. (Deduct 50.. when Dr.
dered with any scope ilbÐve). Gold initials. add 50...

.

StlSSORS and FORtEPS

LISTER BANDAGE SCISSORS
3 1 12'1 Mini.scissor. TinY, handy, slip Into
uniform pocket or purse. Choose Jewelers
gold or gleaming chrome plate finish
No. 3500 3'12" Mini. . .. . . . . 2.75
Ño. 4500 4%'1 size, Chrome only. ..2.95
No. 5500 5V2'1 size, Chrome only. . . 3.25
No. 7027114" size, Chrome only. ..3.75
5'12" OPERATING SCISSORS _ .-0'eJò
PohstJed Slalnless Steel, straight blades.

:.)
No. 7D5 Sharpl Blunt points. . . 2.95 .
No. 706 Sharpl Sharp point. . . . 2.95 -
No. 710 4 1 12" IRIS SCIS., Stainless, Straight... 3.75
No. 712 5V2" Littauer STITCH Scis., Stainless. 3.75
o ELLY FORCEPS
T --- '!"'! So handy for every nurse! Ideal for clamping
.
NO.o;5
,:
nlt:
fg
:
I
I
:S LS

tl,.
I
:'. 3.75
0
.R No. 725 Curved, Box lock........ 3.75
No. 741 Thumb Dressing forcep. Serrated, StraiE'ht. 5 1 12" ....3.75
No. 744 Sponge, Serrated, StraiE'ht, Box Lock. 9" . . . . . . . . . . . 6.80
No. 734 Backl1aus Towel Clamp, Box Lock. 5V2'1 . ..3.75
3 initials engraved an any abov" add 50.. per Instrument.

MEDI-CARD SET Handiest 'efe'ence
D

eller! 6 smooth plastic cards 13Va" x 5 1 12") cram. _
med wltl1 information, includmg Equivalencies of
-
II
Apothecary to Metric to t-iousel1old Meas, Temp. .
"C to of, Prescrip. Abbr., Urinalysis, Body Chern.,
1
Blood .Chem.. Liver Tests, Bone Marrow, Otsease l '1 7 -
Incub. Periods, A.dult Wits., etc. All In wt1ite "
-.
vinyl 110lder with gold stamped caduceus. <
No. 2B9 Card Set . . . 1.50 .a.
YOur initials gold-stamped on hOlder.
add SO.. per set.
POCKET SAVERS P,event stains and wear! !lJ

Smoott!. philble pure white vinyl. Ideal
low-cost KfOUp gifts or favors. ,..
He. 210-E (riE'htl. two compartments
witl1 flap. gold stamped caduceus. . .
Packel of 6 lor $1.50 t
o ND. 191 tleft) Deluxe Saver. 3 comet
I change pocket & key chain . . .
Pack.. 01 6 lor $2.98
eD.A. Nurses' POCKET PAL KIT
Handiest for busy nurses. Includes wtJIte

D . eluxe Pocket Saver. with 5 1 12" Lister SCissors
(both sl10wn aboveJ, Tn-Color ballDolnt pen,
plus l1andsome httle pen light. . . all silver
o flnisl1ed Change compartment, key cl1ain
No. 291 Pal Kit. . . . . . . . 6.50 .a.
3 Imtials enaraved on sl1ears. add 50e per kit.

<:RfcD f)
J

Nightingale Pledge KEY CLIP
Heavy bronze medallion die struck by master
craftsmen. rose gold antiqued fimsh. Complete
traditional Pledge on one side, reverse blank for
Initials; date, etc. Clip pulls off easily to add
your keys 1 1 12" diameter. Ideal for gradual IOn
gifts. favors. awards Gift boxed.
No. 711 Pledg. Clip. . . . . . . . . 3.95 .a.
add 50.. for Initials or date, 1.00 for both

BIC 4-Color PEN
Fine plastic ball pornt from famous
maker. Ct1ange color Instantly Includes Black,
Blue. Red and Green. all enclosed wlt",n barrel. No. M-li9 4-Color Pen
Refills available at stationery counters. . . . 1.25 ea.
CROSS PEN --.. . '"(";',.:11.,1(""",,,, r.

World.famous ballpoint. with

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lIh coupon ___
!../
Relills awall ewt'rywl1ere Llfellm. Ruaranlee
No. 3502 Chrome 8.95 eo. No. 6602 12k.. G.F. 12.95 e..

-

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-

Bzzz MEMO-TIMER Time hot packs, heal d:
lamps. park meters. Remember to check v,tal sißn!.,
ca. " ...':.. ')1
give medication, etc. LIE'htweighl compect II 112" dla).
sets to buzz 5 to 60 mln Key flng. Swiss made.
No. M.22 TImer. . . . . . . . 5.49

Whittenton fo.A/tio.
Ufli/onn

'"

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.POLO
This front zipper sporty um'or
has a wide elastic band tho""

stops at the front and IS finishec
off with a wide belt look Tlilin
large pockets. Inner surgic
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Polyester Warp t<nit
STYlE No. 4615
3/4.15/16 & 18 & 2D. ..
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Short sleeves 100% Dacron
Double Knit
STYLE No. 4632
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ClassIc coatstyle with full front
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STYLE No. 5681
3/4.15/16. . .2D.95
110% Dacron Polyester, 20% Cot
ton, Sl'1ort Sleeves
STYlE No. 578D
3/4.15/16...17.95

@
R:

A lifetime of service' Finest black 1Iø"
ien cowhide rugged shtct1ed rivet
construction. Water repellant. Roomy
interior. snap In washable liner com.
putments to orgamze contents Snap
strap holds top open dunng use Harne
carð 110lder on end. Rugged carrymg
straps 6'J x 8" x 12" Your mitlals
Rold embossed FREE

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Genuine Leather
NURSES BAG
No. 1544.1 8aR
(with liner) . . . 42.50 ea.
Extra liner
No. 4415... 8.5D

All-Weather NURSES' CAPE

@A

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Stay snug In cool weatl1er, dry m the rain.
Tre(hhonal Navy wltl1 Bngl1t Red limng.
finest tailoring of 65% Dacron polyester,
35% combed cotton. Zepel treated. 100%
Nylon Ouralyn limng. Snap fasteners, arm
openings. Matchmg head scarf SMAll (up to
34 bustl, MEDIUM (35.38,1 or LARGE 139.42)
. specify size on coupon.
No. 658 Cape . . . . . . . 15.95.a.
3 Gold lnatlals Dn clilar. add 1.00 per cape.

. NURSES CHARMS <:w -"
fmest sculptured FlstJer charm
<"'-
)
Sterlmg or Gold filled (specify under COLOR on coupon). j ... ..
For bracelet or pendant cham. Add to your collection! " f '
No. 263 Caduceus; NQ. I
Cap: No. 68 J. 1- .... I
Grad. Hat: No.8. 8and. SCls;iors . .4.49 ea. C:r
\

'
" ,

"
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Damty. I!etëllied 14K Gold caduceus. for on or off duty
wear. Shown actual size. Gin boxed for friends. too.
No. 13/297 Earnngs .. ..... 5.95 per pair.
PI N GUARD Sculptureo caduceus, chalOed

to your professional letters. eacl1 with pmbackl )'

safety catch. Or replace eltl1er with class pm for

safety Gold finish. gdt boxed Choose RN. LPH
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I ENAMELED PINS Beautifully sculplured status
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Dime-sized. pin back Specify RH. LPN, L VN, or HA on coupon.

No. 205 Enam. Pin 1.95 ea..

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Endura NURSE'S WATCH FlOe Swiss mede
waterproof timepiece Rollsed easy.to.reold wl1lte numerals
I and l1ands on black dial, luminous markmgs Red sweep
second hanl! Cl1rome fm 11. stolmless back Includes
11
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Very depenðable Includes 3 Initials enlraved FREEl
li5- No. 1093 NUrse6 Watch. . . . . . . . . . . 19.95 el.

\

new products

{

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

Cephalosporin antibiotic
Smith Kline & French has introduced
Ancef (sterile cefazolin sodium), a new
cephalosporin antibiotic for parenteral
administration. Ancef is indicated in a
variety of infections: upper and lower
respiratory, genito-urinary, skin, soft tis-
sue, joint and bone, septicemias and
endocarditis when caused by Ancef-
sensitive microorganisms.
Ancef, a derivative of
7-amino-cephalosporanic acid, is bac-
tericidal; it inactivates the bacterial en-
zyme trans peptidase , a vital enzyme in
bacterial cell wall synthesis.
Ancef has demonstrable advantages:
blood levels are higher and more pro-
longed, less frequent doses of Ancef are
required, pain on injection is minimal,
and in vitro antibacterial activity is
significantly greater. In studies involving
over 1,000 patients, there have been no
clinically significant renal or hepatic
function changes.
Further infonnation is available from
Smith Kline & French Canada Ltd., 300
Laurentian Blvd., Montreal 379, Quebec.

literature available
o Chemetron Corporation' s medical pro-
ducts division has described its volume-
controlled respirator for long-term re-
spiratory support in a new leaflet. The
respirator is designed to control, assist, or
assist control the entire breathing process
of adult patients requiring long-term
breathing support.
The illustrated leaflet provides detailed
information on how the respirator works
and how it is operated, and lists the
special features of the respirator. Schema-
tic diagrams show the theory of opera-
tion, and a chart of typical flow and
pressure curves of the respirator is in-
cI uded.
More infonnation is available from
Chemetron Corporation, Medical Pro-
ducts Division, 1801 Lilly Avenue, St.
Louis, Mo. 63110, U.S.A

OThe new Safeco Oxygen Ventilator,
which is illustrated in a four-page
brochure, is available from Safety Supply
Company, 214 King Street East, Toronto,
Ontario M5A U8.
This ventilator allows total emergency
resuscitation and inhalation, providing
the most practical emergency equipment
for industry, hospitals, schools, amhul-
ances. and police departments. It is
available in a numher of different models
for various uses. All models, parts, and
accessories are outlined in the brochure.

DA complete line of products for hearing
protection is described in the new Bilsom
brochure, also available from Safety
SUPl?ly Company.
Bllsom Eardown, made from an inert,
nonallergenic material that offers excel-
lent attenuation ratings, comfort, and
cleanliness is described in detail. with
illustrations of packages and dispensers.
Bilson Propp is eardown formed into a
ready-made plug, ready for quick and
easy use.
Bilsom ear muffs and Safe-T-Cap ear
muffs are designed for an effective
hearing protection program. Made from
durable plastic and available with liquid-
or foam-filled ear cushions, the ear muff
models are effective where damaging
noise levels are prevalent. The Safe- T-
Cap ear mufL which has a snap-on,
snap-off attachment for fitting on any
cap, is included in the brochure.
A free copy of the new hearing pro-
tection catalogue (no. 74) is availahle
on request from Safet) Sup pi) Com-
pany, 214 King Street East. Toronto.
Ontario M5A UK The catalogue
describð a complete line of hearing
protection. As well as the complete
line of hearing protection products,
the company can provide information
on an effective hearing conseJ\ at ion
program fÒr industrial plants.
Also available from Safet) Supply
Company is information about the new
Safeco Unit First Aid Kit. Fach item
is hygienicall) sealed and color coded.
The contents arc enclo'ied in a durable
metal case: an instruction guide and
IÏrst-aid manual are included.

Oral treatment for gonorrhea
ICN Canada is first in Canada to provide
the preferred oral treatment for uncom-
plicated gonorrhea with Pro-Ampen
500 & 250 kits.
The Pro-Ampen 500 kit contains 7
ampicillin capsules (Ampen), SOO mg.
and 2 probenecid tahlets <Henur) 1>.
SOO mg. The Pro-Ampen 250 "it con-
tains 14 ampicillin capsules (Ampen).
250 mg. and 2 prohcnecid tablets (8e-
nuryl). 500 mg. According to ICN. "the
components of the regime comprise the
preferred oral single-dose alternative
to intramuscul.tr penicillin-G t()r the
treatment of uncomplicated gonorrhea.
,IS recommanded h) the Canadian and
U.S. puhlic health sen ices."
For more information. \Hite to IC"J
Canada limited. 675 Montée de I ic..sc.
Montreal 377. Quebec. \01
THE CANADIAN NURSE 15

New... ready to use...
"bolus" prefilled syringe.
Xylocainè100 mg
(lidocaine hydrochloride injection, USP)

For 'stat' I.V. treatment of life
threatening arrhythmias.

o Functions like a standard syringe.
,'Ii'
o Calibrated and contains 5 ml Xylocaine.

o

Package designed for safe and easy
storage in critical care area

o

The only lidocaine preparation
with specific labelling
information concerning its
use in the treatment of cardiac
arrhythmias.

\

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-1-
.
"'0
o

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an original from
.
S T I
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Xylocaine" 100 mg
(lidocaine hydrochloride Injection U.S P)
INDICATIONS-Xylocaine admimstered intra-
venously i
specificallv indicated in the acute
management 0((1) ventri.cular anhvthmias occur-
ring during cardiac manipulation. such as cardiac
surgery: and (2) life-threatening arrhythmias. par-
ticularly those which arc vcnlncular in origin. such
as occur during acutc myocardial infarction

CONTRAI""DlCATIONS -Xvlocaine is con'ra-
mdicated (I) In patients with a known hIStory of
hypersensitivity to local anesthetics of the amide
type: and (2) In patients with Adams-Stokes wn-
drome Of with severe degrees of sinoatrial. atno-
ventricular or intraventricular block

WARNINGS Constant monitonng with an elec-
trocardiograph IS essential In the proper admmis-
tration ofXvlocaine intravenously. Signs of exces-
sive depression of cardiac conductivity. such as
prolonga.uon of PR interval and QRS complex
and the appearance or aggravation of arrhythmias.
should be followed by prompt cessation of the
intravenous infusion ofthis agent II is mandatory
to have emergency resuscitative equipment and
drugs immediately a\.allable to manage pos"iible
adverse reactions involving the cardiovascular.
respiratory or central nervous systems.
Evidence for proper usage in children is limited

PRECAL TlO!\S -Caution should be employed
m the repeated use of Xylocaine in patients wnh
severe liver or renal disease because accumulation
may occur and may lead to toxic phenomena. since:
Xylocaine is metabolized mainl" In the liver and
excreted hv the kidney. The drug should also be
used with caution In patients with hvpovolemla
and shock. and all forms of heart block (see CON-
TRAINDlCATlONS AND WARNINGS).
In patients with sinus bradycardia the admmls-
nation ofXvlocaine intravenously for the elimina-
tion of ventricular ectopic beats without prior
acceleration In heart rate (e.g. bv isoproterenol
or by electric pacing) ma) provoke more frequent
and serious vennÎcular arrhythmias.

ADVERSE REACTIONS-Systemic reactions of
the following types have been reported.
(I) Central Nervous SY"item: lighthcadedness.
drowsiness: dizziness: apprehension: euphoria:
tinnitus: blurred or double vision: vomiting: sen-
sations of heat. cold or numbness: tWitching:
tremors: convulsions: unconsciousness: and respi-
ratory depTe
sion and aIles'.
(2) Cardiovascular System: hypotensIOn: car-
diovascular collapse: and bradycardia which may
lead to cardiac arrest.
There have been no reports of cross sensitivity
between X)locaíne and procainamideor between
Xylocaine and quinidine.

DOSAC;[ A'IJ> ADMINISIRATIOI\i-Single
Injection: The usual dose IS 50 mg to 100 mg
administered intravenously under ECG monitor-
ing. Thi"i dO"ie may be administered at the rate
of approximate!) 25 mg to 50 mg per minute.
Sufficlem time should be allowed to enable a slow
urculation to I.:arrv the drug to the site of action.
If the inÎtial mjection of 50 mg to 100 mg does
not produce a desired response. a second dose may
be repeated after 10-20 mmule"i.
"0 MORE THAN 200 MG TO 300 MG OF
XYLOC AINE SHOI'LD BE ADMINISTERED
DURING A ONE HOUR PERIOD
In children experience with the drug IS hmned.
Continuous Infu!llion: Following a single mjectlon
in those patienv. in whom the arrh) thmia tends
to recur and who arc incapable of receiving oral
antiarrhythmic therapy. mtravenous infusions of
Xvlocalne may be administered at the rate of I
mg to 2 mg per minute (20 to 25 ug/kg per minute
in the average 70 kg man). Intravenous mfusions
ofXvlocaine 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 sign
of
toxicity. It should rarelv be necessary to continue
intravenous mfuslOns beyond 24 hours. As soon
as po..sihle. and when indicated. patients should
be changed to an oral antJarrh'fthmic agent for
mamtenance therapy
Solutions for intravenous mfusion should be
prepared by the addnion of one 50 ml single dose
vial of Xylocaine 2% or one 5 ml Xylocame One
Gram Disposable Transfer Svringc to I liter of
appropnate solution. This will provide a 0.1%
solution; that is. each ml will contain I mg of
X\locaine HCI. Thus I ml 10 2 mI per mmute
will provide I rng to 2 mg of Xvlocainc HCI per
minute.

With her role broadening at a rapid pace,
the nurse must begin to develop new

kills and to incorporate these into her
frame of reference. In addition. she must
be able to carry out a systematic a
ses
-
ment that is both economical of her time
and productive in the quantity and quality
of data gathered.
The purpose of this artide is to provide
the beginner, whether student or graduate
nur
e, with a basic tool for efficient data
collection, and to help her recognize
gro:>s deviations from nonnal.
A purely physical as
essment must be
combined with data from a variety of
sources to provide a holistic picture. In
this article we will treat only the physical
assessment skills as they relate to the
individual.
Regardle
:> of the :>ophistication of the
asses
ment technique and skill of the
assessor, a few general principles apply:
. Gain a general. overall impression
first and then focu!> on the specific
area

M
. Majumdar i
ASM\tant Profe
!'()r. School
of Nur
ing.
1cMa
ter University. Hamilton.
Ontario
h. Fry i!> a Lecturer at the same
!>chooI. The author!> ackno
ledge the help
received from Dr' Gilbcrt and Block in
reading the mdnu,cript <md prepdfing the
illu,tration
.
MAY 1974

\ If

! (II f I\L
- \' IEIIII EIiIT

.D

D

The authors present a method of assessment and data collection for nurses.

Jean Fry, M.Sc.N., and 8asanti Majumdar, M.N.Sc.

. Follow a planned order of examina-
tion for each system: inspection
(observation); palpation; percussion;
and auscultation. 1
. The body is symmetrical; therefore,
always compare one side with the
other when carrying out your
as
ssment. 2
. Use all sen
es when making your
observations: Use:
eyes - note color of skin, color of
secrction
, excretions, and so on;
ears - identify sound gradation
,
for example. the breathing pattern;
nose - note an) unusual odors
from breath, excretions, or secre-
tions;
touch - recognize nonnalities or
abnonnalities of pulses and organ
sizes and an} abnonnal responses to
nonnal pressure.
The basic assessment technique that
follow
will include a general abdominal
examination. a hematopoietic examina-
tion, and cardiovdscular, respiratory, and
kidney examinations.

Ceneralsurvey
Initially, vie..... the patient from thc foot
of the bed. This allows patient and nurse
to have direct face-to-face contact and
gives the nurse an opportunit) to make
pertinent observ dtion\.

What is the general appearance of the
patient? Does he seem comfortable? Are
there any gross deviations from symmet-
rical appearance'! Does he appear wor-
ried, anxious, or tense? Does he lack
expression? What does his nutritional
status appear to be? Does he seem to be
his stated age? What is his color (pink.
bluish, jaundiced)?
What is his skin texture? Is it dry or
moi
t? Does his hair look dull and lifeless
or shiny? Do hi
eyes protrude or are they
sunken? Is he breathing easily or with
difficulty? Are there any visible tremors?
Any other pertinent observations'! Any
needle puncture marb? \\'hat about hi..
immediate environment? Is there an
ashtray full of cigarette buns at hi

bedsIde? Any evidence of pills or other
medications?
No attempt has been made to elaborate
on the underlying physiological event. or
to interpret the findings of the physical
a
se
sment. Emphasis has been pldced on
outlining a basic mode of as
essment and
data collection for nurses.

THE CANADIAN NURSE 17

I. GENERAL ABDOMINAL EXAMINATION

Inspection Palpation Percussion Auscultation
Df'
cribe the color and Can any m.Jsses or organs bf' Are there any areas of
general contours of the pal I-Jated ? dullness within hollow
abdomen. organs? (These may indicate
mass or fluid.)
15 then' any apparent Is the abdomen tender, A higher pitched tympanic Are bowel sounds present?
deviation from the normal relaxed, or rigid? note may indicate presence
movement ot the abdominal of gas.
willi?

II. HEMA TOPOIHIC SYSTEM

Deviations of this system can be manifested as too many or too few RBc., WBc, and/or
platelets; the observations made will help determine any deviation.

Inspection Palpation Percussion
L.RB.C. ( See I )hotos 1 an d 2 ì Are the spleen, liver, and/or heart
What are the color characteristics of the Áre the extremities warm or cold? Can enlarged?
skin, palm lines, nail beds, conjunctiva the spleen or liver be palpated? What are
of the lower eyelids, mucous membrane the characteristics of the various pulses
and ear lobes1ls there orthopnea or (dorsalis pedis, posterior tibial, radial,
dyspnea? brachial, carotid, and temporal)?
Compare these bilaterally. Are there
ditferences from one side to the other?
2 WB C
Is there any evidence of infection 1 ( 5('(' p hotos 3 and 4) Is sensitivity elicited over sternum.
Cdn the lymph nudes be palpated? elbows, anterior superior iliac crest or
Check occipital region, both sides of along the vertebral column when struck
neck, the axillae, and the inguinal a light blow with the small finger sidE' of
region. (Enlarged lymph nodes in the a closed fist?
inguinal region are often present in
normal per..ons.) Are the<;e
lymph nodes sensitive
to the touch? Lan the
spleen be palpated?

18 THE: CANADIAN NURSE

MAY 1974

.

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Photo" 3
Palpatio" of lymph nodes (both sides of neck).

MAY 1974

i
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, I
I
, I
,

....

Photo 4
Palpation of axillary lymph nodes.

..

\\
l\'
\

Photo:; 1

Palpation of liver

Photo " 2
Palpation of spleen.
.

"
" ,
, '--
.... -

á

"

......

......

,

,
!t.. ,''"'
,

)

--.

,. \
,

.....

"

-
'-
.. -,
.... "
,

THE CANADIAN NURSE 19

( In<;pection

Percussion

3. Plat('k,t

b thele ,my evidence 01 bleeding or
abnormall!ot1ing?

I Palpation

Are the extremities warm or cool? (One
Loul extremity may indilate a block.)

What color are the extrpmitie-,? (A
hlandwd or hlui"h extremity mav
indicate a block in the Clrculatio
) Any
bruising?

Are peripheral pulses normal? Is there
evidence of peripheral edema when
thumb pressure is applied directly over
the malleolus? Is the calf
ensitive to
pressure?

'-

III. CARDIOVASCULAR SYSTEM

f Inspe<.tion
I

Does the patient appear
comtortahle? Can he he flat?
Art-' hi.. h,md
and teet warm?
What IS the color of the lines
in the palms of his hands, hiG
'lailhedG, his conjunctiva, his
parlobes, his tangup Iplllk.
pale, or ( yano<;pdl? Are hi,
neck \ eins distendpd? (Anv
distention of the external
jugular vein, when the
patient's head i
turned 45
degrees or more, indicatð an
Jbnormal inuease in venous
pressure.) Are there any
abnormal pulsations of thp
rhe
t wall? IA thru
t of the
heart during systole may
normally be iaintly vi
lble it!
the left mid-clavicular line
and 5th intercostal space.!

Palpation

When checkin
thp
circulation oi the legs, look at
the fept for visible arterial
pulsatiJns. Dorsali" pedis and
po,terior tibial pulses are
compared in both teet. Pul'ie,>
..r"l;raopr! 1+ tu 4+flum
barely palpable to
hounding).3 What are the
lhara( teristics of the various
pulses (rate, rhythm,
amplitude)? Is peripheral
edema present? What IS thp
CVP?
(
otf' rhoto '>.\
Are Ihere any lardiac thri::3?

^u
-ultation

Percussion

Note intensity and
characteristics of heart
sound". Normal sound is rub
dup.
1st sound : closure at mitral &
triLU
pid valve.
2nd ,ounrl : l!(.surc ot aortl(
ò< pulmonary valve.
Are there any additional heart
,ound'i?
There are four area
of
auscultation:
1. aortic (2nd intercmtal
space to right of sternum);
1. pulmonil (2nd interco
till
space to left ot sternum);
J. mitral area (at cardiac
apex);
4. tricuspid (to left of low
sternum);
Is the blood pressure normal 1

Is the heart enlarged?

MAY 1974

20 THE CANADIAN NURSE

IV. RESPIRATORY SYSTEM

Inspection Palpation Percussion Auscultation I
Vvhat is the pallent's posture? (See p hoto 6) ISpe p hoto 7) Compare sides. Note the
Can he lie flat in bed? Is he Pldu' the JJatient in a sitting Percu
sion uver lungs should characteristics of the sounds
dvspneic. orthopneic? Is he position with his back facing elicit a hollow sound; o\<er IA light rustling sound is
l vanotic? What are the you. Place your hands one on solid organs, such as kidnevs, normal.! It no sound IS heard.
characteristic rate, rhythm, either side of his posterior
hould sound dull the alveolae are not I
and regularity of his chest. thumbs close together expanding.
respiratory motions? Must he and hands spanning out. Ask
use hIs accessory muscles of him to inhale and exhale. If
respiration to breathe? Are hi
vour thumbs move apart
fingers clubbed? Is his chest equally and a good distance
expansion equal and apart. the lungs are
symmetrical, anteriorly and expandmg well.
posteriori v? Asvmmetrical movement of
one side indicates lack of
equality or total lack ot lung
expansion.

V. KIDNEYS

Inspection

Auscultation

View the patient posteriorly;
make sure he is in a sitting
position. Is there evidence of
edema 7 Is there any
asymmetry apparent in the
sacml umbar area? What is
the color, character, and
amount or urine?

l

Palpation

Percussion

Can the kidnevs be palpated?
Have the patient lie flat on hi5
back. With top oi your hand,
applv deep pressure 1 cm.
below the lower costal
margin; with the lither hand,
lift the I..idney anteriorly. Ask
the patient to take a deep
breath. This ma} allO\\ a
previously nonpalpable renal
swelling to he fel\.4 Use firm,
deep pre
sure. Feel for
tenderness and enlargement.

The location and
approximate size and shape
ot the kidneys can be
determmed in this way.

Check the blood pressure. Is
it within normal limits 7

MAY 1974

THE CANADIAN NURSE 21

-

J

..

Photo 11 6
... Testin. for e.uali

\

I

""... f

...

II..
II ..
II ..
" II
-.,jj ::
,l ,"Iff-.
" II
" II
,,,, ,"
, ,,'

of lung expansion.
,

v

Photo "7
.. Method of percussinQ.
,

a,

,\.

22 THE CANADIAN NURSE

\'"

"

-...

.,

Photo "5
Estimating central venous pressure. Elevate Patient's
head and shoulders to 45 degrees. Measure the vertical
distance in centimeters from the sternal angle to the
upper level of distension of the right external jugular
vein.

References
I Morgan. William L., and Engel. George.
The clinical approach (() the patient. To-
ronto. Saunders, 1969. p.85.
2. Buckingham, William B. et al. A priml'/" of
c1il/ical diagl/o.Iis. New Y 01'''-, Harper and
Ro
. 1971. p.9.
3. Morgan, op. cil.. p.149
4. N,IÏ
h. John M., and Read. Alan. The
dil/iml apprentice, 4ed. Bristol. John
Wright and Son
, I Q71.

Bibliography
Buckingham, William B. et al. A primer of
c1il/ical diagnosis. New Yorl", Harper dnd
RO\\. 1971.
Ddp, Hahlon H., and Manning. Rohert T.
Major's phyÜcal diagnosi.f. 7ed. Toronto,
Saundcr
. 1968.
Kampmeier. Rudolph H., and Bla"-e. Thoma

M. Physical e.tall/il/aT/OfI in health Clnd
disease, 4ed. Phlladdphia. Davb Co..
1964.
Lehmann. Janet. Si
ter. AUS.:ultdtlon of he,1n
!'oounds Amer. J ^lIIIS 12:7: 1242-6, Jul.
1'J7:!.
Littman. David. Stetho\core
.md dU!'oculta-
tion. Allier. J. Nun 72:7:1238-41. Jul.
1972.
Morgan. Wilham L.. and Engel. George.
The clinical approach to the patiefll.
Toronto. Saunders, 1969.
Naish, John M., and Redd. AI,tn. The c1illiml
apprenTIce, 4ed. Bri,wl. John Wright and
Sons, 1971.
Sle
sor. Gail. Au,cultation of the ehesI a
clinical nursing ,"-ill Callad. Nun.
69:4:40- 3. Apr. 1973.
Toronto. Universit:r. Faculty of Medicine.
Outline for hÙtor\' taJ...ing and physical
/'J.aminaliol1. Tomnto. lIniver!oit} of
Toronto, 1964.
Traver. Gayle A. A\Sc'Sment of thllrax and
lungs Amn. J. Nun 73:3:466-71. Mar;;
1973.

MAY 1974

What does renal dialysis mean to a patient
and his family?
Vie\\-ing the patient and family through
a theoretical framework helps to detine
the situation and gives direction to
therapeutic intervention.
In General Systems Theory. man is the
system. His bodily functions. physical
and mental. are the subsystems that work
together to maintain homeostasis. The}
use inputs from the environment or
suprasystem to help the system function
at an optimal level. An overload of input.
as well as waste products. is eliminated as
output from the system. Input can be of a
physical or behavioral nature; output can
likewise be so distinguished. For in-
stance. urine is a physical output; anger is
a behavioral output.
A breakdown in a subsystem often com-
pels the system to turn to its suprasystem
for input to help compensate or correct
the defect. Essentially. this model is
analogous to a person on home dialysis.
Loss of kidney function leaves an indi-
vidual unable to excrete the end products
of body metabolism; \\-astes accumulate
in the body and begin to build up in the
blood stream. Analysis of the blood of
patients with this condition will sho\\-
inappropriatc concentrations of many of
the blood com.tituents.
Until recently. this overload of blood
constituent!'. led to the individual's death.
MAY 1974

Behavioral effects

of dialysis

From a systems point of view, home dialysis (an input from the suprasystem)
threatens the system (the patient and his family); the response manifests itself in
behavioral output. The nurse has an important role as interpreter of the behavior
and teacher of the patient and his family.

Dianne Walser

"\low. to help him cope with this imbal-
ance. the individual is put on dialysis. an
input from the suprasystem to help com-
pensate for the defect in his waste-
disposal subsystem. However. the sys-
tem. the individual. must adapt to this
artificial regulatory mechanism and. as he
does so. we see the effects of this
adaptation on the individual and those
around him.

Implications for the patient
An individual undergoing hemodialysis
is faced with numerous threats to his
biopsychosocial well-being.
The first and foremost crisis for a
person undergoing dial}sis is the change
in body image.' With an external A V
shunt. he can actually see the two tubes
protruding from his skin and observe his
blood circulating through them. A person
with an internal AV fistula must view the
scabbed and scarred needle marks on his
limbs. Weakness from dialysis: frustra-
tion of certain drives. such as eating; a
decrease in sexual function; and other
physical complications cause a feeling of
loss or threatened loss in all patients.
Restrictions on movement in persons with

Dianne Walser IS d founh-year nursing student
at \k!\.lJster Uni"crsit\' schonl of nursmg.
Hamilton.Ontdrio.

an external A v shunt further increases
their sense of loss of body function.
Dialysis nurses must realize that their
patient<; have these feelings. which can be
the basis for any aversion the patient has
to looking at or touching his limb and his
shunt. Persons with artificial or trans-
planted organs often have fantasies re-
lated to science fiction and. recently. it
has been hypothesized that dial)' sis pa-
tients have an umbilical fantasy. 2 They
are repeatedly attached through their
blood stream and tubing to something
outside of themselve<; that maintains their
life.
It is no wonder they sometimes view
themselves as the living dead and begin to
incorporate their machine into their body
image. which results in unconsciously
considering themselves as no longer
entirel} human. If a patient states <;ome
unusual views about himself. the nurse
must not laugh them off. She should be
open and concerned; allowing the patient
to voice these thoughts about himself\\- ill
help him resolve them.
Dialysis means that the individual must
rely upon a machine and other persom. for
his life. This enforced dependency neces-
sitates a change in Iife-st}le and relation-
ships with others. In an adolescent. this
dependency contradicts the developmen-
tal t.lSks of this stage in life; mixed
feel ings toward the parent<; may arise. In
THE CANADIAN NURSE 23

this situation. the nurse working with the
patient and his family must help the
members to define their roles. so family
.interactions will not deteriorate and cause
emotional pathology.
The adult patient equates his
ituation
to a child's dependency on his mother,
and this symbolic regression may cause
ambivalent feelings.
When the patient is married, the
óecrease in sexual desires and
capabilities, along with guilt feelings over
the anxiety he is causing his spouse and
family, can magnify dependency feel-
ings. It then becomes the nurse's respon-
sibility to help the patient be as indepen-
dent as possible and to help him verbalize
his feelings, so they will not fester within
him.
The economic pressure of missed
work, resulting in lowered pay, jux-
taposed with the high cost of dialysis, is a
great worry for patients, especially those
who are the breadwinners for their
families. The nurse may be able to put the
family in touch with financial assistance.
Whether she is able to do this or not, she
must realize that the patient has financial
worries and be receptive to him if he
wants to discuss them.
Closely related to the stress of depen-
dency is the constant threat of death. The
patient is well aware that he would not be
able to survive for long without the
dialysis ma
hine. The machine becomes a
concrete reminder of the fragility of life.
Being on dialysIs is not the death knell;
dialysis helps the person to gain the most
from his life. The nurse must believe in
this philosophy herself to be able to help
the patient adopt it.
When faced with these threats to his
life and self-image, it is natural that the
patient will employ defense mechanisms
to help him cope. De-nour et al J found the
methods of adaptation for patients on
chronic hemodialysis included denial,
displacement, isolation of affect, projec-
tion, and reaction fonnation. It is logical
to think that helping individuals achieve
greater independence through home
dialysis will lessen problems posed by
chronic dependence on hospital staff for
hemodialysis.
Many patients exhibit these behaviors
while they are training for home dialysis.
24 THE CANADIAN NURSE

The nurse must be aware of the coping
mechanisms used by the patient and their
effect on his comprehension, and help
facilitate his growth. She also needs to be
aware that resolution may take an indefi-
nite period of time or, indeed. it may
never really be accomplishe
.
Abram,4 in his theory of adaptation to
chronic dialysis, integrated the physical
and the psychological conditions of a
chronic hemodialysis patient into a pro-
cess of acceptance of dialysis. Phase I,
the uremic syndrome, refers to the central
nervous system signs of uremia, usually
manifested during the first dialysis. Phase
2, the shift to physiological equilibrium,
is called the return from the dead, as the
patient begins to feel a new sense of
well-being. It takes two to six dialyses to
achieve this equilibrium.
The convalescent or third phase oc-
curs from the third week to the third
month of treatment. The patient returns to
living and begins to face realities. The
struggle for nonnalcy is the last stage; it
may be classed as the problem of living
rather than dying. The patient has ad-
justed to the routine but is still continuing
to work through this conflict.
These phases can be aptly applied to a
patient undergoing home dialysis. Most
patients begin home dialysis before they
deteriorate physically. They are able to
avoid Phase I. However, they can ap-
preciate that dialysis has saved them from
death. They quickly shift to a state of
physiological equilibrium and are actively
aware of their environment, the dialysis
equipment and procedure. The nurse,
while teaching the individual about home
dialysis, should be aware of the effects of
his physical condition upon his learning
ability. Content must be reviewed fre-
quently and understanding expressed as to
why he is sometimes physically incapable
of learning.
The convalescent period involves an
independency-dependency struggle for
the individual, who must learn to rely on
family members. It is not unusual for him
to become depressed after a few weeks of
training, due to dependence on family
members. the overwhelming amount of
material to be learned. and the attempt to
integrate dialysis into his life and his
family's life-style. During this time, the

nurse must support the patient and family,
giving them positive reinforcement about
their progress in learning and responding
to the patient's self-degrading remarks
with comments to reassure him of his
worth. This will help him build up his
self-concept and go far in dissipating the
depression.
The last stage, the struggle for nor-
malcy, will take an indeterminable
amount of time, and, in fact, may never
be fully achieved. Since the perception of
nonnal differs, it is impossible to judge
nonnalcy for a patient.
The patient's dialysis experience may
vary from one time to the next. Shea et aI5
document a series of reactions to certain
stages of dialysis. The strength of emo-
tions will relate to the physical process of
going on and off dialysis. Patients appear
apprehensive, restless, and more irritable
than usual just prior to going on Jialysis.
However, anxiety peaks at the beginning,
when the patient is being connected to the
kidney, and at the end of dialysis when he
is coming off.
This is a logical emotional reaction,
because these are the most critical periods
- the cannulas leading into his blood
vessels are being changed from one
circuit to another and, should anything
happen, the patient realizes that he could
lose some of his blood, the medium by
which he is kept alive. Each time this
procedure is perfonned, the patient is put
in a life-threatening situation, and his
home situation. his physical well-being,
and the smoothness of the last procedure
will affect his subsequent reaction. After
he has come off dialysis, he will usually
experience physical weakness and
lethargy, the degree of which will depend
on how well he set the controls during the
dialysis. Thus, because new situations
will arise and necessitate a changing
pattern of adaptation by the patient, the
struggle for nonnalcy will continue as
long as the patient stays on dialysis.

Implications for the family
Whether it is nuclear or extended, the
family operates like a system; its mem-
bers are interdependent and at the same
time independent. In a true system. what
affects one part of the system will affect
the whole system. Therefore, an indi-
MAY 1974

vidual within a family can change and
adjust to his condition in a healthy way
only when his family system allows and
facilitates it. {,
The home dialysis nurse must rely on
her knowledge of the various crises that
will face the family, their reaction pat-
terns. and her sensitivity to people. In
general. the stresses affecting the patient
will prevail. as well as fear that the
condition may be genetically related. In
this stage, support through repeated ex-
planations, an understanding attitude,
and obvious concern for the patient and
the famiiy do much to relieve their stre:.s.
However. after dialysis treatment has
proved effective in relieving the symp-
toms of uremia and the acute situation has
retreated, other threats prevail. Finances
are one problem, but more important is
the reversal of roles occurring among the
family members, especially in the
fdmilies of male patients. If the father is
unable to work and provide for the
family, some other member has to per-
fOnTI this function, necessitating a shift in
roles. For some members, this shift can
be crucial. For example, the absence of
the working mother at mealtime can upset
a child and cause rejection of the father,
through fear of losing the mother.
Fear of having to learn to operate the
dialysis machine also affects the family
members. A natural reaction is
withdrawal, and withdrawal from the
patient, at a time when support has never
been more needed, can be a devastating
experience. The nurse must be aware of
the possibility and help prevent with-
drawal by including the family as she
teaches the patient.
Continued home dialysis can cause a
strain on the relatives if they perceive no
end to the triah involved. A mother may
have to hold a job, look after her home,
and help with her husband's dialysis.
After awhile she may experience feelings
of deprivation and hostility toward her
husband, for which she feels guilty,
initiating a progressive deterioration in
the situation. The patient, in an attempt to
rationalize his inability to fulfill his role
in the family, may overemphasize his
illness. causing further resentment in the
family.
In the opposite situation, the family can
MAY 1974

become overprotective of the patient and
stifle his independence, leading to further
dependence. Here, the patient becomes a
scapegoat for the family and is unable to
function outside the system, if forced to
do so.
lt is important that the dialysis nurse be
aware of the general precepts determining
family behavior. 7 This includes the con-
cept, mentioned earlier, that families are
governed by rules because they are a
system. A system needs homeostasis and,
if the balance is disturbed, problems
arise. Growth in a family can occur only
when all members are free to define their
relationships and can communicate well.
This emphasizes the need for all members
of the family to share, to some extent, in
an understanding of the patient's prob-
lems and his care. The nurse should make
this goal of sharing one of her highest
priorities for the patient and his family.

Implications for the nurse
The nurse has to have the best interests
of the patient and his family at heart; her
involvement has to go beyond the
therapeutic level to an emotional one.
Rodriguez 8 states this view well when she
says, "if we give a life to a person, we
must not leave him to cope with all the
implications alone." She feels that one of
the commitments made to the patient
must be to care how he feels and to listen
to him when he calls for help. The calls
for help may be verbal or nonverbal,
direct or indirect, including signs of stress
in other members of the family. For the
nurse to be able to respond effectively to
these cues, she must know the patient and
his family extremely well.
To expect such involvement by the
nurse, one must also advocate a support
system for her. By becoming involved,
she can lose her perspective and profes-
sional detachment. In such situations, she
must have an outlet for her feelings and a
source of objective feedback. It is plaus-
ible to have group therapy sessions for the
nursing and other staff; led by someone
who does not participate directly in the
dialysis unit but is involved with the staff
nurses. These meetings serve as a "jam
session" where feelings regarding be-
havior of patients, families, and staff are
shared and discussed. Objective feedback

regarding the course of action followed
by the nurse is given, and support for
each other provided. In this manner, the
nurse can give comprehensive care that
benefits the patient, and also maintain her
personal integrity and her capacity to risk
total involvement with another person.
From a systems point of view, home
dialysis (an input from the suprasystem)
threatens the system (the patient and his
family); the reaction manifests itself in
behavioral output. The nurse has an
important role as interpreter of the be-
havior and teacher of the patient and his
family.

References
I. De-nour. A.K. Psychotherapy with pa-
tients on chronic hemodialysis. Br. J.
Psychiat. 116:207. Feb. 1970.
2. Abram, Harry S. The psychiatrist. the
treatment of chronic renal failure. and the
prolongation of life. II. Amer. J. P
ychilll.
126: ]63. Aug. 1969.
3. De-nour, A.K. et at. Emotional reactions
of patients on chronic hemodial)sis.
Psychosom. Med. 30:5:525-6. Sep'/Oct.
1968.
4. Abram, op. cit.. p. 159-62.
5. Shea. E.J. et at. Hemodialysis for chronic
renal fail ure. IV. Psychological <:onsidera-
tions. Ann. Intern. Med. 62:3:558. Mdr.
1965.
6. Kossoris, Penny. Family therapy: an ad-
junct to hemodialysis and transplantdtion.
Amer.1. Nurs. 70:R: 1730-3. Aug. 1970.
7. Ibid.. p. 1732-3.
8. Rodriguez, Dorothy Balton. Moral issues
of hemodialysis and renal transplantation.
Nurs.Forum.IO:2:203,1971. ':""

THE CANADIAN NURSE 25

WANTED: a definition
of nursing practice

This paper is offered for your consideration in anticipation of a workshop to be
held in conjunction with the Winnipeg convention of the Canadian Nurses'
Association, June 16-21,1974. Make your opinions known to your official
delegates!

Madeleine Bachand, r.h.s.j.

Never before has the nurse sought as
earnestly for a definitive statement on
professional practice as she is doing
today. With the exception of the physi-
cian, she has, for decades, been the only
professional entrusted with the complete
care of the sick. Many writers of dis-
cernment and foresight. including Flor-
ence Nightingale. have tried to set the
boundaries of her role. Yet here we are,
in 1974, still trying to achieve such a
definition, spurred on by the health field
concept put forward by the federaJ minis-
ter of health and welfare. Marc Lalonde.
The nurse is trying. legitimately, to
establish her rightful place in the health
care team. In the process of development.
she has had to undergo uncertainties and
frustrations; she has been at the mercy of
the ambitions and demands of other
professions. Her subordination to the
physician has been particularly conspicu-
ous since the turn of the century.
In 1909, Quebec physicians were le-
gally rec()gnized as having exclusive au-
thority for the care of the sick. including
obstetrical confinements. Gradually,
similar powers have been granted to the
other provincial medical associations. Let
us take as an example the Act defining the

26 THE CANADIAN NURSE

practice of medicine in Nova Scotia,
promulgated in 1969. It includes the
following rights:
a) to allege by advertisement, sign or
statement of any kind, ability or
willingness to diagnose or treat any
human disease. defect, deformity or
injury;
b) to advertise or claim ability or
willingness to prescribe or adminis-
ter. or to prescribe or administer
any drug. medicine or treatment, or
to perfonn any operation or ma-
nipulation or to apply any apparatus
or appliance for the cure or treat-
ment of any human disease, defect,
defonnity or injury.

What about nursing?
Are there any statutes stating the
powers of nursing as clearly? As of
February 1974. one association possesses
the right of appeal to a definition written
into law. This is the Order of Nurses of

Sister Bachand is engaged in research work
with the Canadian Nurses' Association. This
paper provides, in broad outline, the content
of a project currently in progress.

MAY 1974

Health Manpower in Canada, 1973

00
95
90
85
80
75
70
65
60
55
50
45
40
35

25
20
15
10
5

-
_ 19%
- -

Nurses

------
16% II 14
_
6% II II _

Nursing Nursing Aides,
Assistants Trained Or-
derlies

Doctors

115,114

48,670 11,447

Others

43,741

34,508

Fig.1 - According to Canada Health Manpower, 14 major professions
encompassed 253,400 workers, of whom 70% were in the category of
nursing, and 14"/0 in medicine.

MAY 1974

Quebec. A legal definition of nursing has
yet to come for the nine other provinces.

Transfer of functions
The transfer of duties from the medical
profession to other categories of health
workers has been taking place at a steadily
increasing pace. This has served to
entrench the authoritative relationship of
the doctor to other professions. especially
nursmg.
What does the nurse want? Simply the
right to practice her profession without
sanction. She \\-ants to work coopera-
tively with the doctor and in harmony
with other health professionals. Placing
total responsibility for the care of the sick
in the hands of the physician established a
hierarchy of health professions. and we
know where it put the nurse. Can this
relationship now be reestablished along
horizontal lines. without confrontations?
Certainly, a definition of the profession of
nursing v. ould ease the shift.

The changing scene
The comprehensive nature of medical
and hospital care, advances in medical
science. the development of scientific and
technical knowledge. and greater sophis-
tication in the general public have created
a need for more highly qualified person-
nel. As a result. more than 50 categories
of health workers have appeared on the
labor market in the past 20 years. Canada
Health Manpower divulged that. in 1973.
14 major professions encompassed
253.400 health personnel.
FiRllre I illustrates in percentages the
relationships among professions of in-
terest to us. You wi II note that 70 percent
of the health workers come under the
category of nursing: 14 percent under
medicine. The present trend is to prepare
THE CANADIAN NURSE 27

Nurse - Physician Cooperation

HEALTH NEEDS OF THE INDIVIDUAL

Primary concern
of nurses

care

-Identification of
health needs

Cure
and

cure

-Distribution and
control of re-
quired care

Activities relative to
diagnosis and treatment
(gray shows area
of cooperative efford

-Treatment

-Diagnosis

Figure 2 --Response to individual health needs involves several
categories of health workers, including doctors and nurses. What-
ever their specific fields of interest, some of their activities
will overlap, in the area of care as well as treatment. The care-
cure concept calls for cooperative effort. Taken in its broadest
sense, care influences cure.

specialized technicians to support profes-
sional staff. This is reaching a point in
proliferation where patient care is becom-
ing progressively more fragmented.
Taken to its extreme, such fragmentation
could seriously undermine - even
destroy - nursing and dehumanize care.
One way to offset this situation appears
to be the establishment of a legal defini-
tion of nursing practice. The nurse would
then be in a position to assume her
rightful role; the public would be in a
better position to know what to expect
from her. The definition should be suffi-
ciently flexible to allow for changes in
response to public or professional need.

The Quebec precedent
The precedent the Quebec legislature
made in passing Bill 250 (Professional
Code), which came into effect February
28 THE CANADIAN NURSE

I, 1974, should be of interest to other
provinces. It has given rise to the creation
of 38 professional bodies, 21 of which are
from the health field. Of this latter group,
II are concerned with exclusive practice
rights. (For example, Ordre des
médecins, Ordre des infirmières et infir-
miers du Québec.) The other 10 regulate
title - auxiliary nursing groups come
under their jurisdiction, among others
(Corporation professionnelle des infir-
mières auxiliaires du Québec).
Medical and nursing practice are so
defined that close cooperative relation-
ships could be set up. Figure 2 illustrates
this. The new statute cites certain actions
relative to diagnosis and treatment.
which, under specific prescribed condi-
tions, could be performed by personnel
other than physicians. This implies that,
once such procedures have been handed

over to nurses. they become nursing
functions and as such are the duty and
responsibility of the nursing profession.
The concepts of care and cure, herein
considered to be the principal concerns of
doctors and nurses, were the subject of a
study by Garceau and Larose. * They
reviewed nursing literature related to
care-cure from 1957 on. After examining
342 periodical articles and 159 books,
they concluded that these concepts should
be essential components of any definition
of nursing practice.

In search of a definition
A precise demarcation between medi-
cal and nursing practice is difficult to
achieve as there will inevitably be some
overlapping. At present, an identical
action or procedure can be classified as
either medical or nursing. depending on
whether it is carried out by a doctor or a
nurse. Should the patient respond poorly,
the nurse is in a very vulnerable position
if the action falls within this gray area.
There could be some question as to
whether or not it is part of the nurse's
sphere of responsibility; whether she
possesses the necessary knowledge and
ability: what legal right she has to
perfonn it. .
Society is increasingly insistent that the
nurse be held responsible for her own
actions. Numerous cases in Canada and
the United States exemplify the tendency
of the courts to follow this course. We
have a professional obligation to study
court decisions in tenns of determining
what society expects of the nurse and
what our professional objectives should
be.
In view of the various factors already
stated, as well as the uncertain legal status
of the profession, the Canadian Nurses'
Association recognizes the value of a
conceptual approach to nursing practice.
which would provide a basis for legal
definition.

* Garceau. Guy-Anne et Larose. Odile.
Analrse des concepts "care" et "cure" en
nuning. Montréal. 1973. (Thèse (M.Nuß.)
- Montrédl).

MAY 1974

The model
The diagram in Figure 3 is a suggested
model. The black circle represents the
area under study. Each proposed concept
is accompanied by an explanatory note to
emphasize its importance in any potential
definition of nursing practice.
The scope of acth"ity
The scope of nursing activity includes:
health promotion. prevention of illness.
restoration of health. and rehabilitation

and support services (relief of suffering.
preparation for a peaceful death).
The education of the nurse prepares her
for service of a different kind than that of
the physician. She accepts full responsi-
bility for such service and she wishes to
be held accountable for it.

The individual
Traditionally. the nurse is concerned
with the whole person. in health or in
illness. from conception to death. The

Fig. 3

NURSING CARE
A conceptual model

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tIJ

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-
-
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ø(' . '" Co 8'0
09 ('10>""
."ent IIt"OI

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Scope of Action

II Health Field Concept

. Nuring practice

MAY 1974

term "conception" implies the part
played by the nurse through prenatal
teaching and materna! health counseling
prior to the baby' s birth.
Health field concept
This concept encourages integration of
health promotion activities. The concept
is comprised of four main elements:
human biology. environment. way of life.
and organization of care.
The nurse's role
This has already been illustrated in
Figure 2. Because the physician is cure-
oriented. he concerns himself with diag-
nosis and treatment. Nurses should chan-
nel their efforts toward health and care.
either by helping the patient to regain his
health or by creating a milieu in which he
can maintain it. Modem nursing educa-
tion programs take this aspect into con-
sideration.
Relevant questions
. Based on the proposed model. how do
you envisage nursing practice in relation
to the following:
- identification of health needs?
- provision and control of care and cure?
- cooperation in diagnosis and treatment
in "cure" situations?
. What contribution can the nurse make
to improvement in biological inheritance.
in the quaJity of the physical and social
environment of the individual?
. How can we help Canadians to get
more out of life?

THE CANADIAN NURSE 29

T HERE ARE MANY REASONS WHY we
decided to base our curriculum on a
nursing model. Of these. the chief are:
o widespread talk about the health team,
with nurses and other health profes-
sionals becoming colleagues of the
physicians; and
o widespread demand for nurses to act in
the extended or expanded role as nurse
clinicians. clinical nurse specialists,
nurse practitioners. or physician's as-
si
tants. Though these tenns are not
defined with any exactitude, they
imply an increasing degree of inde-
pendent action and. therefore. of inde-
pendent thought and decision making.
A team is made up of a group of people
who are roughly equals. as in an or-
chestra. a choir, or a ball team. Each
member has an area of expertise that is
essential to the whole and that is recog-
nized and appreciated by each other team
member. Each performs his own part.
neither expecting another to undertake it
nor expecting to undertake another's.
All teams, though made up of equals,
have a captain or leader or conductor.
Although he might not be able to perfonn
all. or even any, of the individual parts.
he understands the contribution of each to
the whole and is thus able to coordinate
them.
Difficulties arise in creating a health
team, because the members are not
roughly equals. The physicians have
undergone by far the most rigorous
30 THE CANADIAN NURSE

An experimental
nursing curriculum

This article explains why the school of nursing faculty at the university of
British Columbia decided to base the curriculum on a nursing model, rather than
on a medical model; what the model is; how the model engenders nursing prob-
lems as distinct from medical problems; and how the subject matter arises from
the model.

Muriel Uprichard, Ph.D.

training. are the most highly rewarded
financially, the most free to make deci-
sions and policy. and. despite all the
current criticism of them. the most valued
by society. Moreover, this has been true
from time immemorial and will not be
easily shaken from the public conscious-
ness.
In contrast to all this. the other health
professionals are less strong and re-
spected, less powerful and wealthy. and
less inwardly secure and assured. Over
the past century they have all (dentists.
phannacists. nutritionists. therapists. so-
cial workers. nurses. and. of late. tech-
nologists. and technicians) been strug-
gling to discover their identity. establish
their unique function. and claim their
rightful share of the work load and it

emoluments. Their success is dependent
upon their traditions. their predominant
sex, economic status. length of educa-
tion. and the leadership that fate has
vouchsafed them.
Now we are asking these nine or ten (or
more) diverse groups of health profes-
sionals and workers to form a team. The
physician is to give up his position of
preeminence and become a team member.
The others are to become his colleagues
and rise to his level.
This is a large order. Not only are we
expecting a doctor to stop being the
captain of the team, but we are also
asking the other professional groups to
give up seeking their own autonomy and

identity and to merge themselves into one
another. By and large. they are not ready
to do this because they have not suffi-
ciently established themselves as inde-
pendent entities assured of their uniq ue
function and of the absolute necessity of
its importance to society. Their ego
strength is not sufficiently developed for
them to give up anything yer.
In this
ituation the relationship bet-
ween the doctor and the nurse is critical
becau
e these persons are the heart of the
exercise in both ho
pital and community
agency. Their traditional relationship of
master and servant is challenged by the
emerging roles of the nur
e and the cry
for a team and a colleagial relationship.

W HEN WE. THE FACULTY A r the Univer-
sity of British Columbia school of
nursing. arrived at this stage in our think-
ing. we began to a
k ourselves questions
such as: What is the nurse's area of
expertise? What are we doing to help our
students act in a colleag:dl relationship
with the other health professionals and
especially with the physicians? A doctor
cannot be a colleague unless he has
someone to be a colleague with.
We began to answer by looking at the
traditional nursing school curriculum. It

Dr. Uprichard is Profðsor and Director.
School of Nursing. University of British
Columbia, Vancouver. B.C.

MAY 1974

runs something like this: the principal
areas of study are divided on the medical
model into medicine. surgery. obstetrics.
gynecology. psychiatry. pediatrics. and
geriatrics. Within these there are innum-
erable subdivisions.
The subject matter is the disea
e states:
their pathology. etiology, signs and
symptoms. methods of diagnosis. prog-
nosis. treatment. and side effects of
treatment. This is taught and learned for
hundreds of diseases. After that. if there
is any time left. something is taught about
nursmg care.
So the area that should be the nurse's
expertise is often scarcely touched on.
She has learned some watered-down
medicine. the how of many routines.
procedures. and techniques. but not
necessarily the why. And she hds learned
the values of promptness. obedience.
submissiveness. patience. and humility
before her "superiors."
This is not to say that no good nurse
came from that system. Fortunately.
many persons survive the educational
systems devised to stunt their develop-
ment. But few creative. innovative nurses
can be bred in this manner. Theoretical
knowledge and emotional security create
the springboard to creative action. These
cannot flourish in an authoritarian atmo!'.-
phere.
When we turned to our curriculum. we
realized that we had fallen into almost the
same trap. Not so deeply, perhaps. in that
more theory was taught. more general
education given. But the emphasis was
first on all the other subjects deemed
essential (often by nonnurses) and only
finally, in the remaining time. on the
nur
ing process itself.

H ow TO BE MORE RELEV.pH? We de-
cided to teach nursing first. giving it
our primary effort and the major time
blocks. We now fit the biological and
behavioral sciences around nursing.
teaching them concurrently so the stu-
dents can integrate the needed concepts
from the sciences into their nursing
knowledge.
We also decided we would not teach on
a medical model. but would set out on the
long journey of seeking the unique body
of nursing knowledge. The major prob-
lem seemed to be that there is no unifying
principle around which to create this
MAY 1974

needed discrete and organized body of
knowledge. We decided to devise one In
a year of intensive effort. we created a
behavioral systems model.
At this point I must try to dissipate two
common misconceptions about a be-
havioral
ystems model of nursing. First.
it is often conceived to be primarily
ps}chological. Our model is not so.
Every cell of the body "behaves." These
physiological and psychological be-
haviors are the cause and the effect of one
another. The
um of all is the person's
behavior. Second. it is often thought that
we are de
erting or foregoing the dele-
gated medical tasks. Again. this is not so.
What we are tl} ing to do is define the
unique role of nursing and to organize the
subject matter in such a manner as to
pennit nurses to think in nursing tenns
about the nursing needs of people.
We are viewing man as a behavioral
system made up of a number of
ubsys-
tems. Each of the
e
ubsystems may be
considered. in Lewin's tenns.* as a "Iife
space" and each is responsible for the
satisfaction of one human need. Each
subsystem has two parts: the S} stem' s
need and its ability to reach the goal of
that need; and the surrounding environ-
ment of the subsystem. which contains
forces influencing the achievement of the
goal of the need.
For example. the need of the respira-
tory subsystem is for oxygen to meet the
goal of respiration. The life space or
environment is all those phy
ical organs
and attribute
that pennit breathing, but
also external phy
ical factors. such as
atmospheric conditions. and psychologi-
cal factors. such as fear. anxiety. anger.
and so on.
The subsystems achieve their goals by
a behavioral proces
or proces
es. These
consist of the behavioral system's (i.e.,
the per
on's) knowledge and acceptance
of the need of the goal toward which it
strives. and of the abilities available in the
behavioral S) stem to meet the need and to
move toward the goal. The process also
includes the forces within and without the
system that promote or inhibit such
movement. The nurse's role is thus

* Kurt Lewin. ..Le....in.
Field Theory:' in
Theories of learnmR, ed. Erne
t R. Hilgard,
2ed.. p.258-89.

teaching when knowledge is lacking,
helping when ability is lacking, or chang-
ing the environment when the forces are
such that the system cannot cope.
The subsystems are interacting and
interdependent. In health they are in a
balanced relationship with one another
and the whole system is in balance with
the environment. Such balance is known
in systems theory as a "steady state."
The stead} state is maintained by feed-
back mechanisms within the system and
between the S} stem and the environment.
Such a steady state, however. is always
under tension from both internal and
external sources.
The "well" person is adjusting and
adapting constantl} to these tensions.
When the balance or steady state cannot
be maintained. malfunction results and
help is needed from other persons. Which
health professional can best help to
restore the balance depends on the nature
and degree of the malfunction.
For example. if physiological illness
results, a physician is needed to diagnose
and prescribe cure. If. on the other hand.
lo

of employment results. a social
worker might be more useful. One new
role that appears to be developing for
nursing in the proposed new health
services is that of "sorter-outer," so that
the time of physicians is not spent on
nonmedical problems.
This view of man as a behavioral
system made up of subsystems enables us
to define nursing as: "The nurturing of
man during critical periods of his life
cycle so that he may develop and use a
range of coping behaviors that permit him
10 satisfy his basic human needs and
thereby mnve toward nptimal health. ,.

T HE CRITICAL PERIODS OF the life cycle
are due to the demands of the matura-
tional stages through which we all pass
with greater or lesser stress and to the
los
es due to the unexpected accidents
and hazards of life to which we are all
subject. Each of these kinds of life crises
may create problems which. if not re-
solved. create tensions that disturb the
steady state of the behavioral system.
Examples of the demands of the mat-
urational
tages are: the requirement that
a three-year-old adjust to a day-care
center instead of life at home; the
necessity for an old and ailing man to
THE CANADIAN NURSE 31

leave his life-long home for a nursing
home; and the need for a teenager to
begin to cultivate the acquaintance of the
opposite sex. to say nothing of the
physiological stresses of the growing and
the aging proce!>ses.
The unpredictable hazards lead to
lo!>ses such as the following: a body part.
functional abilities. significant relation-
ships. or social roles.
Some individuals are able to cope with
both the demands of the maturationaJ
stages and of the losses. If a person
cannot cope. problems arise. such as
pain. disturbances of self-concept. of
mobility. and so on. The role of the nurse
is to help the person or patient to develop
suitable coping behdviors to maintain a
tolerable. if not optimal. steady state or
behavioral system balance.
Two things are important to note:
o The problems we have identified are
not necessarily the right problems or
the only problems. If the problems "in
the field" prove not to be these
problems. then we mu!>t revi!>e our
categories. The value of the model is
not that it is perfect. but that it is a
sy!>tematic way of thinking about
nursing. Its inner logic will reveal its
defects. (And. indeed. as I write we
are revising.)
o These nursing problems cut across all
fields of medical practice. Pain. for
example. can be found to accompany
di!>ease!> or injuries as well a!> losses
and stresse!> that are not medical in
nature. such as the los!> of a friend or a
valued position. Disturbance!> in mo-
bility can ari!>e from such diverse
problems as Iming a leg or sinking into
an acute depres!>ion. Disturbances in
self-concept can arise from having a
heart attack or lo!>ing a job. Moreover.
such problems can arise at any age
level and in people both ostensibly ill
and obstensibly well.

T HE STUDENTS AND THE staff are having
to look at people sick and well in two
ways: the medical way and the nursing
way. If pathology is present. what is the
diagnosis and treatment? What is the
nursing care involved? Bue also. with or
without pathology, what demands of the
maturational !>tages or losses due to
unexpected hazards dre creating or ag-
gravating the problem? What can nursing
do to as!>i!>t the per!>on to develop the
coping behaviors needed to resolve it?
32 THE CANADIAN NURSE

The curriculum begins with a study of
nonnal growth and development. with
emphasis on the maturational. physical,
and psychological problems of the well
person. Students then study the demands
made upon the person by stresses of the
maturationaJ stages. and the nursing care
required when these demands cannot be
met by the individual himself. Studies are
made of the losses that each individual
experiences in his life cycle. and of the
nursing care and medical or surgicaJ
interventions required by them.
Later. the curriculum considers how
families react to losses due to unpredict-
able hazards. and studies the role of
communities and nursing in resolving the
problems and tensions arising from them.
The students will emerge ready for
nursing in any hospital or community
field of nursing and for the role of the
nurse practitioner.
The model will also provide the raw
data for nursing research. The nursing
problems will become the computerized
basis of the nurses' notes. organizing
them around meaningful nursing ac-
tivities. These can then be used by the
nurse researcher so that pragmatic and
empiric nursing actions can be studied.
analyzed. collated, and ordered toward
the making of a nursing science.
However. no rearrangement of subject
matter will produce a nurse who has the
knowledge. skill. ability. and personality
characteristics of confidence and creativ-
ity. which enable her to act as a colleague
of the other health professionals, particu-
larly physicians. We are trying a variety
of experiments with methods. in the
belief that. to some extent at least.
process is content.
The first innovation is that all teaching
is done by teams. The first-year students
have a team of eight full-time instructors
and a flexible number of additional
part-time instructors teaching them.
These represent eight different nursing
specializations. including psychiatry and
public health. We want the students to
grasp early that all human beings and
their problems are multifaceted and re-
quire a multi faced approach and that
there mu!>t be a team in nursing, as well as
an interprofessional team.
The second innovation is that we are
increasing the students' opportunities for
independent study by every means we can
find or invent. We are struggling to arrive
at a point where nothing is teacher-taught

that can be student-learned. Class time is
used largely for discussion. By these and
many other techniques. we hope to foster
independence of thought. action. and
study and to inculcate the idea of lifelong
learning.
We have embarked on a difficult and
hazardous journey. It has rewarded us
richly, however. in new insights and
understandings of nursing and of its
relationships with the other health profes-
slOns.

Bibliography
Bennis. Warren G. et al. ed
. The planning of
change, 2ed. New York. Holt. Rinehan
and Winston. 1969. p.268-312.
Bertalanffy. Ludwig von. General S\'stem
theory:foundations. development, applica-
tions. New York. George Braziller. 1968.
Bruner. Jerome S. Toward a theory of
instruction. Cambridge. Mass.. The Bel-
knap Press of Harvard University Prðs.
1966.
Campbell. Margaret A. Unpublished writings.
Hilgard, Ernest R. Theories of learning, 2ed.
New York. Appleton-Century-Crofts.
1956. p.258-8'J.
Watson. James D. The double helix. New
York. Atheneum. 1968.

MAY 1974

A self-help clinic
for women

Because women lack information about their bodies and feel intimidated by
health workers, a small group of women in Saskatoon, Saskatchewan, set up a
self-help health clinic. The author, who has been involved in the clinic project
from the beginning, describes its goals and success.

Audrey Hall

During the summer of 1973. 10 women in
Saskatoon worked on the \\.omen'
self-
help clinic. a project that developed out of
the women's liberation movement. It was
funded by an Opportunities for Youth
grant. The objectives of our project. as
conceived in early 1972. were to:
. Increase women's knowledge of their
bodies. emphasizing the reproductive and
sexual organs.
. Develop a sensitivity and a positive
attitude to their bodies and their needs as
women.
. Develop optimal health potential.
enabling women to prevent or adequately
deal \\. ith health problems.
. Develop an under
tanding of quality
health care so that women expect and
demand such care.
. Equip women to participate in decision<;
regarding their health care.
. Conduct a survey into the particular
needs of women and their perceptions of
the care received from health \\.orkers.

\1-. Hall. .I grddu,lte of Hdmmer\mith Hospi-
tal in London. Engldnd. earned her He,llth
Visitor\ Certificate .It the Bdtter\ea College of
Advanced Technology in London. She j, no",
in the final year of the B.S.N. progr,lIn ,II the
Universit) of Sa,J.",ltche\\ an. Sd,J."dtoon.

MAY 1974

Several factors pointed to the need for
the clinic project. For over three years.
the women's movement in Saskatoon has
run the birth control and abortion infor-
mation center. The center. staffed by
volunteers. gives \\.omen infonnation on
birth control and abortion. and provides
referral to helpful doctors and other
workers. Feedback to this center. along
\\.ith our own experiences. led us to
conclude that many doctors are insensi-
tive to the needs of women and that
\\.omen lack infonnation about their
hodies.
As \\.omen feel intimidated b) health
workers. they are reluctant to ask ques-
tion
that might be regarded as stupid.
This is a real fear in the light of the
negative attitude of many doctors and
nurse!> toward patients who ask questions.
We were particularl) concerned about
the number of women who use inadequate
methods of birth control; those.... ho wait
until the second trimester of pregnancy
before seeking an abortion; and those
\\. ith recurrent vaginal infections and
cy
titis. who know nothing about ho\\. to
prevent the..e condition
and \\.ho ask in
vain for assi
tance from health workers.
The technique of vaginal self-
eX.lmination was of speci.ll interest to us.
By the time our clinic project began,
we had read about the feminist self-help
THE CANADIAN NURSE 33

chnic in Los Angeles, which has done
considerable work on women's health.
We had received information from Van-
couver about a survey into health care,
conducted by feminists. * Also, Our
Bodies, Ourselves had been published;
we decided to use this book as the basic
material for our classes. **

Project gets underway
The clinic project was set up in two
parts - education and research. The
educational section had two teaching
teams, each consisting of two women.
Each team prepared material and class
plans and organized its own classes.
The research section compiled a
20-page questionnaire that covered gen-
eral gynecological matters, menstrual
problems, vaginal infections, contracep-
tion. abortion, pregnancy. and
menopause. It also set up a filing system
for the women's center in Saskatoon and
puhlished a leaflet on the project for
promotional purposes.
Project members worked together as a
collective and tried to reach a consensus
when making decisions. Having persons
work on two separate tasks was a
problem. though. and certainly impaired
the group function. A sociologist. who
volunteered her service, gave us some
valuable help in team-building techniques.
During a one-day workshop with her, we
took into account the importance of
individual needs and the need to work at
maintaining the group.
For some weeks. project members met
weekly as a mutual support group. Al-
though these meetings were rewarding for
a while, they later became unsatisfactory
and ceased. It was a failure we never

* Vancouver Health Collective. A Vallcouver
Womell's Health Booklet, Press Gang Pub-
lishers. Vancouver, 1972.

** The Boston Women's Health Book Collec-
tive. Our Bodies, Ourseh'es, Simon and
Schuster. New York. 1973.
34 THE CANADIAN NURSE

ø

. '-, ..t

'.l

,

/

t
\

....

,,,.
, ,\.

,

----.. - "

-

'-

-'

L..-
/"
.

f"

adequately analyzed or dealt with.
Life experiences of project members
were varied. although most were from
middle-class backgrounds. Their ages
ranged from 17 to 40 years, and their
education from grade 12 to university
degrees and professional qualifications in
teaching and nursing. Only two members
had any formal health education -
myself, a registered nurse. and another
woman who had resumed her studies in
medicine. Several members had worked
as vol unteers in a birth control and
abortion infonnation center, a family
planning association. or SERENA (services
de la régulation des naissances).

Questionnaire brings response
Much of the attention we have received
from the news media has focused on the
results of our questionnaire. The survey,
however, was not statistically significant
only 65 of the 300 questionnaires were
returned to us for analysis, and our
sample was not random. Because a
random study would have taken all our
time and energy, we decided to use the

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questionnaire as a pilot project to gam
experience in the technique.
Some sections of the questionnaire (for
example, use of the diaphragm) were
returned by so few women (7) that no
conclusions could realistically be drawn.
There were, however, 65 responses to the
section on general gynecology: the infor-
mation gained indicated serious deficien-
cies in the quality of health care. Only 31
women reported that their doctors asked
them to return at regular intervals for a
Pap smear, and only 13 were taught to
examine their own breasts for lumps.
Thirty-six women responded to the
section on gynecological infections: of
these, 28 were told by their doctors what
type of infection they had, 21 were told
how it might be caused, and only 15 were
told how they might prevent recurrence.
Forty-five women responded to the
section on oral contraceptives: 33 had a
medical history taken before the Pill was
prescribed, 8 definitely did not recollect
having a history taken, and the rest were
uncertain; 29 had a medical examination
immediately prior to taking the Pill, an
MAY 1974

additional 9 had an examination within a
few months (before or after) of starting
the Pill, and 5 had no examination: 33
were asked to return for a regular
checkup, and only 30 were asked to
return for a regular Pap smear.
Our sample was undoubtedly biased.
Those who responded were either taking
the self-help classes or were otherwise in
contact with the women's movement. A.,.,
most of them were from middle-clas.,.,
backgrounds and were well educated.
they were more likely to question people
in positions of authority. We were disap-
pointed in the small number of question-
naires returned. although we learned a lot
about the technique of constructing them.
The response would probably have been
better with personal interviews.

Classes are meaningful
Our philosophy and approach to the
educational part of the project have been
greatly influenced by our experience in
the women's movement. We have not
wanted to set ourselves up as experts nor
to propose theoretical nonns to which
women should compare themselves.
Problems of women have received little
study until recently. and we believe it is
impossible to state what is nonnal for
women. as all the nonns have been
defined primarily by men in the context of
a patnarchal society.
We have aimed to establish a situation
in which each woman can consider her
own experience as valid and in which .,.,he
can try to communicate her feelings about
her experience in an atmosphere of tru.,.,t
and empathy. This 'iituation .,.,hould en-
able infonnation and feelings to interact.
Classes are held in discussion-type
groups. with a maximum of 10 to 12
people. A maximum of 8 would be ideal.
as larger group"" have proved unsatisfac-
tory. To promote a comfortable atmos-
phere. meetings take place in the homes
of the group leaders.
Teaching aids are simple: posters and
diagrams of the internal and external
genital and reproductive organs, and. for
the classes on contraception. samples of
MAY 1974

contraceptives are available for members
to look at and handle. Copies of the
Montreal collectives' handbooks on birth
control and venereal disease and the
Canadian Cancer Society's pamphlet on
breast self-examination are given to par-
ticipants. We buy copie\ of Our Bodies,
Ourseb'es. in bulk. and offer them to
participants at cost price.
The more experienced we become. the
more flexible we are in treating material
and in allowing the group to digress and
discuss whatever is meaningful. The
order of the material al.,.,o varies; for
example. one group wanted to cover
vaginal self-examination early. so we did
it in session number two. Some groups
are not interested in covering pregnancy.
and some want more on nutrition. Some-
times it is difficult to finish the planned
content in one session. At first we tended
to cram it all in. but now we defer some to
the next meeting.
By December 1973. six months after
classes had .,.,tarted. more than 130 women
had participated in the course. Approxi-
mately 70 percent were middle-class and
well educated. and 30 percent were
working-class. with less formal educa-
tion. We also ran a short series for girls in
an institution for socially deviant ado-
lescents. Our basic information and ap-
proach could be adapted to meet the needs
of people from different backgrounds.
Verbal feedback from participants has
been positive. Many women say how
much hetter they feel when they realize
that the problems they believed were
peculiarly their own are experienced by
many women. They also say they are
more confident when they consult health
workers and when they cope with com-
mon problem.,.,. such as vaginitis and
cystitis. Many women have also
reevaluated their method of contracep-
tion. Tho.,.,e who were not satisfied with
the Pill or IUD are pleased to discover that
effective alternativö. .,.,uch as the dia-
phragm. are available.
In the cla.,.,s we held for couples. 10
person.,., met weekly for 7 weeb during
the summer. They found the experience

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THE CANADIAN NURSE 35

useful, as both the men and women
learned more about each other's point of
view. One problem was that all the
women had enjoyed close interaction
while working on the clinic project,
whereas their mates had not had this
opportunity. One of the men said he felt
they were breaking new ground, which
was exciting, but also rather frightening.
Men would benefit from the kind of
group interaction that exists in the context
of the women's movement. But the
initiative to form groups to discuss what it
means to be male in this society has to
come from men themselves. We have
discussed the feasibility of mixed groups,
in which members are not couples,
although at present we lack contact with
men who would act as discussion leaders.

Clinic continues to meet needs
Approximately 135 persons have par-
ticipated in classes so far, and verbal
feedback at the end of each series has
indicated that many of their needs have
been met. It would be valuable to set up a
fonnal method of evaluation to a
certain
long-tenn effects on self-perception and
interaction with health workers.
As funding for our clinic project ceased
last August and an application for a Local
Initiatives Project grant was denied, we
are now functioning on a voluntary basis.
We have managed to keep at least one
class going most of the time. At present.
we know of many women who wish to
participate, but we lack discussion lead-
ers.
Recently, another registered nurse has
become involved and is prepared to lead
a group. She hopes to work with a group
of lesbian feminists who are interested in
participating in a series that focuses on
their particular needs.
I have found the experience of working
with women, whose education and expe-
rience has been in other areas, exciting.
Too often the process of becoming profes-
sionally qualified in nursing or medicine
produces a person with considerable
technical knowledge, but with tunnel
vision in other respects and an acceptance
36 THE CANADIAN NURSE

of the status quo. Nurses are often
reluctant to share information with
laymen; they hide behind a professional
facade, which may conceal much ignor-
ance.
An important part of self-help is
learning to tune in to what your own body
is communicating to you. In this respect,
several women on the project had a lot to
teach me. I continue to profit from the
shared experience of the classes I lead.
Working on this project has also
deepened my awareness of the politics of
health care.

Nurses are not facing challenge
Medical self-help is developing, in
various fonns, all over Canada. As a
result of the publicity given to our
project, we have received letters from all
over the country, from women aged 17 to
70, telling of their frustrations with the
established health care system and their
need for basic information about their
bodies. Medical self-help challenges
nurses, who can contribute a lot to
projects such as ours. I believe they can
gain even more, personally and profes-
sionally.
But I do not see many nurses meeting
that challenge. For two years, I was the
only nurse actively involved in women's
liberation in Saskatoon; a handful of
others are recognized as sympathizers.
Nurses are a conservative group, reluctant
to take risks. The reaction of most to
anything that smacks of "women's lib"
is negative.
The women's movement is one of the
most significant social movements of our
time, and the fail ure of nurses to recog-
nize that significance could greatly retard
the profession of nursing.

MAY 1974

dates

May 29-June 1,1974
Association for the Care of Children in
Hospitals, 9th annual conference,
Sheraton-Chicago Hotel, Chicago. Con-
ference theme: "Who Puts the Pieces
Together?" For further information, write
to: Myrtha Sice, ACCH Publicity Chairman,
Children's Memorial Hospital. 2300
Children's Plaza, Chicago, III. 60614,
U.S.A.

June 2-8, 1974
One-week, in-residence, labor relations
summer school. Glendon Campus, York
University, Toronto. Participants must be
members of a nurses' association formed
for collective bargaining. For further infor-
mation, write to: Yvonne Trower, Educa-
tional Officer, Employment Relations
Dept., Registered Nurses' Association of
Ontario, 33 Price Street, Toronto, Ontario,
M4W 1Z2.

June 3-5,1974
Seminar on "Home Care Information Sys-
tems II: Patient Selection," University of
Ottawa, Fauteux Hall. Fee: $90. More in-
formation is available from Barbara Schul-
man, Continuing Education Program,
School of Hospital Administration, Univer-
sity of Ottawa, 545 King Edward Avenue,
Ottawa, Ont. K1 N 6N5.

June 5-7, 1974
Canadian Hospital Association, 7th annual
convention, Hotel Vancouver, Vancouver,
B.C. For further information, write to:
Canadian Hospital Association, 25 Imper-
ial Street, Toronto, Ontario, M5P 1C1.

lune11,1974
National Nurses' Institute on Respiratory
Disease, Chateau Laurier Hotel, Ottawa.
Theme: "Home Care of the Respiratory
Patient." The institute will be held in
conjunction with the annual meetings of
the Canadian Thoracic Society and the
Canadian TB & RD Association.

June 15-16, 1974
Northeast Region, American Association
of Nephrology Nurses and Technicians,
second annual symposium, Host Farms
Resort, Lancaster, Pa. Theme: "Problems
MAY 1974

Related to Renal Disease - An Interdisci-
plinary Approach." For further information,
write to: Susan M. Yuhas, 19 Harrison St.,
Pittsburgh, Pa. 15205, U.S.A.

June 16-21, 1974
Canadian Nurses' As-
sociation annual
meeting and conven-
tion, to be held in the
Manitoba Centennial
Centre Concert Hall,
Winnipeg, Manitoba.

ð

June 16-21, 1974
Sixth Pan-American Congress on
Rheumatic Diseases, The Four Seasons
Sheraton Hotel, Toronto, Ontario.

June 18-21,1974
Second in-residence, task-oriented work-
shop on "Evaluation of Student Nurse
Clinical Performance" for teachers in
schools of nursing. Professor Vivian Wood
will be the instructor. Tuition fee of $130
includes fees, accommodation, and meals.
For further information, write to: Summer
School and Extension Dept., U. of Western
Ontario, London, Ontario, N6A 3K7.

June 23-28,1974
Canadian Medical Association, annual
meeting, Royal York Hotel, Toronto, Ont.

C
CARE

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Hospitals-general staff duty, special units
and private duty.
Interesting assignments suited to your
individual needs and preference.

TORONTO - 929-3364
OTTAWA-237-8460
MONTREAL - 932-1481

June 28-30, 1974
Reunion of all Mack graduates, in conjunc-
tion with The Mack Schools of Nursing
centennial celebrations. Events will include
a reunion dinner, Sheraton-Brock Hotel,
Niagara Falls, June 28; a garden party,
June 29; and a church service at St. Geor-
ge's Anglican Church, June 30. For further
information, write to: Ms. Eleanor Snider,
President, Mack Alumnae, 43 Stella St.,
Fonthill, Ontario.

July 7-12,1974
XII International Congress on Diseases of
the Chest, London, England, featuring an
international seminar on "Care of the
Pulmonary Patient" for nurses and allied
health professionals. Seminar will be held
July 8 in Queen Elizabeth Hall. Registra-
tion fee for the seminar: $35 for allied
health professionals; this fee includes
attendance at the congress. For further
information, contact: Bradford W. Claxton,
M.Ed., Director of Continuing Education,
American College of Chest Physicians,
112 E. Chestnut St., Chicago, III., 60611.

July8-11,1974
Third International Symposium on Cir-
cumpolar Health, Yellowknife, Northwest
Territories. For further information, write
to: Secretary-General, Dr. O. Schaefer,
Director, Northern Medical Research Unit,
Charles Camsell Hospital. Edmonton, Al-
berta.

August 2-4, 1974
Final graduation and grand reunion of all
graduates of the Royal Inland Hospital,
Kamloops, B.C. For further information,
write to: Ms. J. Cassell, Secretary, Alum-
nae Association, 1243 Dominion St., Kam-
loops, B.C., V2C 2Y8.

August 30- September 1,1974
Three-day seminar on orthopedics and
rehabilitation for nurses, sponsored by
the University of Miami School of Medi-
cine, department of orthopedics and
rehabilitation, Americana Hotel. Miami
Beach, Florida. For information, please
contact: Dept. of Orthopedics and
Rehabilitation. P.O. Box 875. Biscayne
Annex, Miami. Florida 33152, U.S.A. \-:
THE CANADIAN NURSE 37

names

Alice Mills, executive
secretary of the Sas-
katchewan Regis-
tered Nurses' As-
sociation since
1967, will leave her
post at the end of
June. Ms. Mills

(Reg.N., Wellesley
_ Hospital school of
nursing, Toronto; B.N. (public health),
McGill U., Montreal) early in her cart.er
worked in the Yukon. Saskatchewan, and
in the United States. Before joining the
staff of SRNA. Ms. Mills had for several
years been nursing supervisor of the
Prince Albert health region in Saskat-
chewan.

....

,I ..,

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1 r
".
-- -'

,

Eleanor Macdonald has been appointed
coordinator for the nurses' section of the
Ontario Tuberculosis and Respiratory
Disease Association. One of her first
task!. will be to help organize the program
for the National Nurses' Institute in
Ottawa in June.
Ms. Macdonald (R.N., Royal Victoria
Hospital school of nursing. Montreal;
M.P.H.. U. of Minnesota) has been a
regional health education consultant with
the Ontario Ministry of Health. and has
for some years been a program consultant
with the OTRDA.

A. Doreen Jordan has received a 1973
Davis and Geck Award for editorial excel-
lence. Her paper, "Evaluation of a Fami-
ly-Centered Maternity Care Hospital Pro-
gram. ., won first prize as an article in the
Journal of Obstetric, Gynecologic and
Neonatal Nursing (Vol. 2, No.3, May-
June 1973).
Ms. Jordan's article was selected on the
basis. of originality. relevance, clarity,
documentation and comprehensiveness,
and for its value in stimulating profes-
sional development.

Mary A. Greenwood
has been promoted
to the rank of
commander ;n the
Canadian Naval Re-
serve. becoming the
first woman to
achieve this rank in
the reserve forces.
Before her curr'ò:nt
affiliation with Chedoke Hospitals in
Hamilton as supervisor. Ms. Greenwood
was with the Roval Canadian Navy.
38 THE CANADIAN NURSE

.

--....

Barbara Cardenas, of Sa
katoon. has
been appointell coordinator of the nurse
practitioner training program in the'
University of Saskatche\\ an .... College of
Nursing. Ms. Cardenas has been a di-
rector
)f nursing in :--I iteroi. Bra/il.
where she also taught English tÙr more
than three \'Cars. and has
been an assis-
tant instruétor of pediatric
in Rio de
Janiero. She also helll a variety of
publ ic heal! h po
i tions in rur al and
urban areas of Brazil.
In the United States. she continued
her nur...ing ellucation in the College
SI. Scholastica. Duluth. Minnesota. She
has been a senior pediatrics instructor
in the SI. Barnab.ls School of '\Iursing
in Minneapolis and a public health
nurse \\ith the Brooklyn Visiting Nurse
Service.

Olivette Gareau,
who joined Health
and Welfare Canada
in 1972, has been
appointed commu-
nity health consul-
tant (nursing),
community health
I services develop-
I
ment division,
community health directorate. Health and
Welfare Canada. She was elected a
vice-president of the Amencan Public
Health Association at its annual meeting
in November 1973.
Ms. Gareau achieved prominence in
public health nursing in the Province of
Quebec and became director of the public
health nursing division.
In 1970. Ms. Gareau went to Thailand
with a World Health Organization team to
evaluate rural health services.

....

-
.....

"

","

Rita M. Morin was elected fourth vice-
president and Louise Tod an Ottawa
director at the 54th annual meeting of the
Professional Institute of the Public
Service held in Ottawa in late November
1973.
Ms. Morin has been a member of the
Institute's nursing group since 1965.
She has held the offices of secretary-
treasurer. Edmonton branch chairman,
and director - prairie region.
Ms. Tod. a nursing consultant with
Health and Welfare Canada. has been a
member of the nursing group of the
professional institute since coming to
Ottawa in 1971.

Dolly Goldenberg is chainnan of nurs-
ing education and Luella Surgent is
director/coordinator of the diploma
nursing program at the Windsor
Ontario. campus of St. Clair College of
Applied Arts and Technology. Sandra
Tomney is chairman of health sciences
and Jo An Dale is director/coordinator
of the diploma nursing program at the
Chatham campus of St. ClaircAAT.
Ms. Goldenberg (Reg.N.. Hotel Dieu
school of nursing, Windsor; B.Sc.N..
Wayne State U., Detroit; M.A., U. of
Windsor) has devoted much of her career
to education. including teaching posi-
tions at Hotel Dieu school of nursing,
and the Metropolitan school of nursing
in Windsor. Most recently she was
assistant director of the Hotel Dieu
school of nursing in Windsor.
Ms. Surgent (Reg.N., St. Joseph's
school of nursing, Hamilton; Dipl.
Nursing Educ., U. of Western Ontario,
London; B.Sc.N., U. of Windsor) has
been staff nurse at the St. Catharines
General Hospital. and for several years
has taught at the Hotel Dieu school of
nursing in Windsor.
Ms. Tomney (Reg.N.. Atkinson school
of nursing. Toronto Western Hospital;
Dipt. Nurs. Serv.. B.Sc.N.. U. of
Western Ontario, London) has devoted
most of her career to education.
Following three years with the London
Board of Education. teaching in the
registered nursing assistants' program.
Ms. Tomney joined the teaching staff of
the school of nursing at the Public
General Hospital in Chatham. At the time
of her current appointment. she was
director of that school.
Ms. Dale (Reg.N.. Chatham Public
General Hospital school of nursing;
Dipl. Nurs. Educ., B.Sc.N., U. of Wind-
sor) has. for most of her career, been on
the teaching staff of the school of nurs-
ing, Chatham Public General Hospital.

Mitzie Montgomery is a special consultant
to the minister of health of British
Columbia. Directly responsible to Mr.
Cocke. she has responsibilities that cover
the different fields in health and welfare.
Dr. Montgomery (Reg.N., Toronto
General Hospital school of nursing;
B.Sc.N., U. of British Columbia;
M.S.W., U. of Michigan. Ann Arbor;
Ph.D., U. of Edinburgh) has recently
completed a report on health services in
Scandinavia.

MAY 1974

boo ks

Don't Have Your Baby In The Dory! by H.
Gordon Green. 146 pages. \1ontreaI.
Harvest House. 1974.

The blurb on the book's back cover
describes the author as a "story-teller.
journalist, and author of numerous rol-
licking books about Canadian life." It is
as a teller of rollicking tales that he has
written about the life and work of Myra
Grimsley Bennett, nurse to the people of
the Daniel's Harbour part of the New-
foundland coast since 1921.
The title is taken from a prayer
breathed, so the author says. as a woman
in labor is being transferred from the
coastal steamer through the surf of
Daniel's Harbour for Myra Bennett's
auendance at the birth. Even the name of
the community is a wry joke. for there is
no safe harbor. just a stonn-swept coast.
Often the suppl) ship cannot anchor and
has to go on past, leaving Nurse Bennett
and the other inhabitants without flour.
salt. or mail. It is in these circumstances
that Nurse Bennett has cared for her
patients, playing an "extended" nursing
role for over 50 years.
Myra Bennett's story is good reading;
the author describes events as though he
had witnessed them. He includes quotes
from still-living persons in his narrative.
often in the speech patterns of the
Newfoundlanders.
The life and work of Myra Bennett
have been honored in many ways. includ-
ing coronation medals from King George
V and Queen Elizabeth II. and honora/)'
membership in the Association of Regis-
tered Nurses of Newfoundland.
This book has a place in personal and
institutional nursing libraries. It shows
the cap
bilities of an individual nurse and
the contribution of nursing to the health of
a community, in a way that will lift the
"what's the use?" gloom from any nurse.

Care of the Older Adult b\ Joan l3irch-
enall anu \1an F ikl:n "Streight. 22X
pages. Toronh;. l ippincotL TlJ7.
.
Rel'iel\'ed hy \1l1rgllrel HooIOl/, h-
.\Ociate I'n!rn.\Or (Jr SlInil/g, School
(!rNlInil/g, .\kGill CI/il'en;,y, MOI1l-
real. Quehec

Thi, is ,mother of the mall\ books on
the e1derh that ha\,e been '\Hillen re-
centl). Déspite the tÜct that it is a ne\\
book. cssentiall) the material is not.
The authors indicate that their auuience
MAY 1974

is the pr,lctieal nursc. hut this is not
entireh clear as thev also suggest it is
appropriate fÓr stúdents a
ld other
all ied health personnel.
The content includes a section on
the ageu and their relation to the total
pl)pulation. tìnancial status of the cluer-
I).. and some of the changes in their
social anu f,lmil) situations. The other
major section examines the cluer!\ in
tenns of physiologic'll change, "and
their sequelae. incluuing some specitic
uiseases that commonl). occur in this
age group.
In the prdÜce. the authors st,lIe
that the). intenu to emphasi7e the mmli-
tic at ion of nursing techniques required
to care tÓr the cluerh rather than the
funuamentals. \\hich "the\ assume the
readcr alread) posscsscs. \\ hat e\olves
fails to support this intention; much of
the content is appl icahle to any pcr,on
anu not just thc cldcr!). Similarl). much
of the nursing contcnt is quitc hasic.
Despitc thc rather ps).chosocial.
societal approach to the elder!) that
is put forth in the tÏrst section of the
tx)ok. there is little attempt made to
incorporate the rcle\ ant factors into
thc physiological approach de\'clopeu
in the latter section. One \\onders
\\hether this rather ob\ ious dichotom)
in presentation supports hO\\ the cider!).
sce thcmselves and \\ hether this ap-
proach h) nursing care \\ould mect their
nceds.
The book uoes include somc usdul
suggestions in the care of the older
adult anu \\ould hc useful in look ing
at one uimension of nursing. that i

ph)sical care. Ho\\cvcr. it
needs to
he uscd \\Ïth aduitional 'ource, of
matcrial.

Introduction to Clinical Nursing, 2ed..
hy :'vl).ra Estrin l e\'inc. 515 pagcs.
Philadelphia. F.A. Davis. 1973.
Canadian Agent. I\kGra\\ -H ill R) er-
son. Scarborough. Ontario.
Rniel\'ed h\' Dicllle P('('hillli
, As-
Si.\I(//11 I'rofl;.\.\or, School (
,. Sunil/g,
Li I/il'asily (
,. Calgary. Calgary.
11 haw.

T he format of this scconu Ldition of
\1s. l e\, inc's book is similar to the
first. fhe author's objecti\es .Ire to
prescnt d holistic orientåtion to nursing.
incorporating "the ne\\ roles and res-
ponsibilities that ha\ e become estab-

Iished" since the first euition \\ as pub-
lished.
The theorctical frame\\ork IS based
on the four consen ation principle, of
nursing. and uses these in presenting
the nursing intcn entions required in
meeting the needs of patients \\ ho de-
monstrate failure to ,ustain basic nced,.
Following each chapter there is an out-
line of a basic nursing care mouel rela-
ti\ c to the chaptcr. Each out I ine de...-
cribes objecti\ es. essential science con-
cepts. anllnursing process .1ppllcation...
that are valuable to stlluent. instructor.
anu practitioncr.
Although the author statö that ..thi

book is again addressed to the begin-
ning stlluent of nursing:' it \\ould be .1
\ aluable supplemental text for ,III (C\, d s
of nursing students and a good re\ Ie\\,
text fÖr practitioners. I n itself. it j, not
complete enough for a basic text in
nursing fundamentals. or medical/sur-
gical nursing. but pro\ iues cxcellent
summaries of principles used III spe-
cified nursing intenentions.
The strength of this book I ies in the
emphasis o( a scientific base for nurs-
ing intenention. The \\eakness lies in
only a limited presentation of physio-
logical and pathological profiles when
disturbances. imbalances. failures. or
needs of the human org,lIlism are dis-
c usseu.

As the title suggests. this hook i
an
introduction to drnical nursing. and is
recommended as a supplcme
ltar) 1)1'
complimentary text. rather than a pri-
mar) one.

The Biologic Ages of Man from Con-
ception Through Old Age, edited b)
Da\ id \\. Smith anu Eu\\ in I . Bier-
man. 211 pages. TIH'Onto. Saunuers.
19 7 3.
Rel'iell'eel hy Jlllia"a LlI;:lIrllf... 111-
.\lrllclor, .\lInillg DefJarrmelll. Gram
.HlICFwt/1I Comllll/llily College, Ed-
mOllloll, A Iherlll.

I he purpose of this hook I' de,lrh IHI\-
lineu in the prcf,lCe. It is "to p.:O\ iue
an integrateu portra
,11 of human life
from conceptionthwugh old age:' This
sequenti.tl anal) sis fÒIlO\\s man from the
origins of life. al,mg the continuum of
events that make up life. and concludes
with man's final event. dcath. The
authors consiuer the ph)sical. phpio-
logical. social. dnd behavioral com-
THE CANADIAN NURSE 39

Next Month
in

The
Canadian
Nurse

. Communicating with
the Aphasic Patient

. Helping Hands

. Wild land:
A Mental Health Resource

ð

Photo Credits
for May 1974

McMaster University. Hamilton.
Ontario. pp. 19. 23

Studio Impact. Ottawa. p. 34

40 THE CANADIAN NURSE

books

pnnelll'" that .Ire ...pecilïc tn each nt
JIIan'
blnlngic age
. I hi... hnli
tic ap-
proach i
rcl
'e
hi
lg.
I he initial chaptcr
discu...... the
broad conceph of gnm th and dC\ dop-
JIIelll ,lIld the biolog) of aging. rile)
prm ide a bac"ground for the remainder
of the bonk. \\hieh di
cu

es man'

biologic ages: prenatal. perinatal.
infanC\. childhotld. adolescence. adult-
hood. . and old age. Each chapter re-
\ ie\\
the ph)
ical.
lIcial. and emotion-
al de\dopmental ta
b specific to each
biologic age. as \\ell as outlining the
prohl
m
lh,lt interfere \\ ith the
ear-
n ing nut of the
e ta
b. r he consistent
eÍnpllasi... thrt)uglll'lll the le'\t i... on the
mainknance of \\ellne...s.
I he boo" is representat i\ e of many
aleas. a... i... e\ idenccd h\ the list of
conti ihut ing autlwrs. rhe' infÒrmation
appear... to
be accurate and unbia...ed.
I he author... ha\e attempted to con
i-
del' different
ehools of thought. This
i... illustrated in their ...ection
)Jl child-
hond \\ herc the\ include
e\'Cralmndd

1'01 cmotional' dc\ dopment.
uch as
J-rcull. Fric"...on. Adler. and S"inner.
Their lac" of timc devoted h) ;he
\lHIIl!! adult i... the one na\\ in their
éonti
uum 01 life approach.
I n
uJllJllan. thi... i... a u
eful reference
h 11 beginning" nur
lIlg ...lUdenh: il pro\'-
ide... ,I broad. generalnveJ'\'ie\\ of inlÙr-
mation. It \\l
uld ...erve a
a useful ad-
JUlKt tn te'\tboob that pro\ idc more
det,lilcd information on the
pecilïc
tOpIC'" co\'ered.

Patient Care in Renal Failure (Saunders
Monographs in Clinical Nursing - 5) by
Joan Delung Harringtun and Etta Rae
Brener. 277 pages. Toronto. Saunders.
1973.
Rniewed by Caml J. Cutler, Renal
Unit, St. Pau{'!; HlJ.\pital, Vancouver,
R.C.

The authors stated that their goals in
writing this text were tu provide a dear.
comprehensive guide tu be used by nurses
caring for the renal patient and to produce
a readable guide to clinical practice
involving patients with renal failure.
These goals have been met.
The bouk proceeds in a logical sequ-
ence and brings together the anatomy.
physiology. treatment. and nursing care.
The authors manage to integrate the
scientific principlö of dialysis with the
nurse's role in peritoneal dialysis.
hemodialysis. and renal transplantatiun.
The psychological implications for pa-
tients in renal failure are stressed. The

aspects of the nurse's role in dialysis as a
teacher, clinician, and administrator are
well documented.
The entire text is easily read. pertinent.
and in logical order. The reader must
keep in mind. however, that it was
written in the eastern United States, and
that costs of treatment. methods uf patient
assessment for available programs, pro-
ducts, and dialysis procedures differ frum
those in Canadian renal programs. More
infonnation regarding the disposable
dialyzers currently in use. sueh as the
Gambro and Cordis Dow, would be
helpful.
The text will be useful as a reference
book for student nurses and would make
an excellent text for nephrology nurses. It
will serve as a reference book about
patients with renal failure, in any nursing
unit.

The Cardiac Arrhythmias, 2ed.. by
Brenuan Phibbs. 205 pages. St.
Louis. Mosby, 1973.
Rl'I'iellwl /J\' lie/ell If'lIltulI, ,""tllff
'Vllrse, Lio/l

GlItl' Hospital, .'Voriil
VaIlCO//l'l'r, B.C.

The author has proviued useful inli.Jr-
mation about the treatment of a patient
in a coronary care unit.
The main feature of the hoo" is re-
cognition anu treatment of cardiac
arrhythmias. The laller pan of the boo"
CO\ ers various methods of treatment.
using drugs and other techniques, sueh
a
transvenous pacing. cardio\ersion,
anu uefibrillation.
It is imponant to unuerstanu the
eonuuction system of the heart hefore
even staning to recognize caruiac ar-
rhythmias. anu chapter one, page three.
describes this quite simply so that it is
easil V unuerstoou.
rhe author ha'\ divided the boo" into
two main parts. fhe first half involves
simple arrhythmias that are not consi-
uereu uangerous to the patient. The
seconu part describes complex arrhyth-
mias. which can be fatal. for example.
tho
e inuueeu by urugs. such as digi-
tal is in toxic uoses.

An impairment in the eonuucting
tissue of the heart mav cause a conui-
tion "nown as heart bl()ck. Hedl't bloc"s
arc uescribed with goou ill uSlrations.
M ultifÒcal. premature ventricular
contractions arc uangerous beats. if not
trcateu promptly. The importance of
early recognition is cmphasizeu. If
these beats continue. a fatal arrhythmia
may folIo\\' - ventricular fibrillation.
rhere arc three chapters calleu
"Problems. practice. anu reinforce-
mcnts." which are helpful to the slU-
uellt in learning how to recl1gni7e an
arrhythmia. First. the meuical history
of a patient is outl ined; an elcctroear-
uiogram is ta"en anu a recoruing is
MAY 1974

made of the heart rh\ thm. It i" the task
of the reader to di,ígnoo.;c the .-11\ thm.
pointing out the \ignificance - and
therapy.
Thi
i
a difficult ,ubject for nurses
to understand. The autlior has simpli-
tied "omc chapters b) comparing e\ enb
to simple things in C\er)day life.
Although the book i
intended fÒr
ph)siei
lI1s. it is a valuable source of
information to the nurse \\ho has some
previous kno\\lcdge of electroc.trdio-
graph}. 'f"

A V aids

AV TEACHING PROGRAM
o A medical teaching program that uses
audiovisual techniques to teach students
to recognize lung disease is being intro-
duced by the Humetrics Corporation. Los
Angeles.
The new system. "The Chest: Its Signs
and Sounds." consists of a 1I2-page.
illustrated handbook and 12 cassette
tapes. which duplicate the pulmonary
sounds of the chest. Together. they
provide a complete exposition of the chest
in all its essential phases.
The program was developed to provide
medical and paramedical personnel with
comprehensive infonnation on respiratory
diseases. It is directed to the student
nurse. physical and inhalation therapist.
physician. and others.
With this program. a student can see
and learn to recognize the physical signs
of the chest, as they are presented in the
handbook, and educate his ear to recog-
nize the various respiratory sounds by
listening to the tapes.
Subject matter covers a broad range of
nonnal and abnonnal findings, including
breath. percussion. adventitious and
voice sounds, auscultation techniques,
inspection of the thorax. palpation and
tactile fremitus, and physical diagnosis of
diseases. It progresses from simple ques-
tions to a discussion of complex disease
states.
Additional infonnation on this program
is available from the Humetrics Corpora-
tion. 6374 Arizona Circle. Los Angeles,
Calif. 90045 U.S.A.

ON THE LIGHT SIDE
DJust Between Us Preemies is the title of
a new booklet designed to bring a
lighthearted moment to a hospital's nur-
sery staff. Available free of charge from
Isolette. manufacturer of Isolette Infant
incubators. the booklet contains 13 car-
toons that depict prematurely-born infants
in hUmorou
situations.
These del ightful cartoons are printed
MAY 1974

on colorful, hea\y paper and are suitable
for the nursery's bulletin board or for
framing. Copies of the booklet are availa-
ble by writing to: Isolette. a Narco
Medical Company. 330 Jacksonville
Road. \Varminster, Pa. 18974, U.S.A.

VIDEOTAPE LECTURES
o A complete series of videotape lectures
has been produced by Blue Hill Educa-
tional Systems, Inc., in cooperation with
the baccalaureate nursing faculty at Her-
bert H. Lehman ColIege, City University
of New York.
This experiential program, which can
be integrated into existing curricula,
directs the attention of nursing students
and faculty to the critical areas of physical
assessment and diagnosis. and to the
development of basic knowledge and
skills.
The series consists of 13 lectures that
are 60 minutes in length, and 9 lectures
that are 30 minutes in length. Included in
the series are extensive student guides for
each lecture, a detailed instructor's man-
ual, and a general overview of each
lecture.
Complete bibliographies of suggested
readings for each lecture, a comprehen-
sive physical assessment history-taking

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OTTAWA. Canada K2P 1 E2

guide. and a physical examination fonn
are also included in the series.
For further infom1ation, write to Blue
HilI Educational Systems. Inc.. 120 E.
56th Street. New York. N.Y. 10022.
U.S.A.

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 institu-
tions. Reference CR) items Carchive 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 Fonn for Accession List"
and should be addressed to: The Library.
Canadian Nurses' Association. 50 The
Driveway. Ottawa, Ont. K2P IE2.
More than three titles should be re-
quested at anyone time.

BOOKS AND DOCUMENTS
I. The applicabilin' of organi::Glional wciology, b}
Chris Argyris. London. Cambridge Univer
ity
Press. 1972. 138p.
2. The birth of industrial nursing: its histon and
developmenr in Great Britain. by Irene H. Chdrle}.
London. Baillière, Tindall and Cox. 1954. 224p. R
3. The cardiac rh\'thms; a s\'Stematic approach to
interpretation. by Raymond E. Phillips and Man K.
Feeney. Toronto. Saunders. 1973. 354p.
4. Caring for children in the hospital; instructor's
guide. Chicago. Hospital Research and Educational
Trust. Centre for Educationdl Innovation. 1973.
Published for HRET b} Robert J. Brad\ Co.. B,mie.
Md.129p.
5. Caring for children In the hospital; student
manual. Chicdgo. Ho"pital Re
earch and Educd-
tional Trust. Centre for Educational Innovation,
1973. Published for HRET by Robert J. Brdd} Co..
Bowie, Md. 181p.
6. Communication and relationship styles among
nurse leaders. by Alice E. Ingmire et al. San
Francisco. Calif.. San Francisco State College.
1973. I02p.
7. Development of educatIOnal pro[irammes for the
health professrons Geneva. Wurld Health Orgam-
zation. t973. I02p. (It.. Puhlic health pdper.., no.
52)
8. A different drummer (The histor} ,)f the Sd'-
katchewan P..ychiatric Nune..' A,",ociation)
1948-1973, by F.H. Kahan. Regina. Saskatche\\an
Psychiatric Nurses' Association. t973. 112p. R
9. Education perlTl(1nente t't formation en cours
d'emploi Rollande Gagné. édileur. Montreal. In-
termonde. 1973. I vol.
10. Families. a Canadian perspectl\'e. b\ Benjdmm
Schlesinger. Toronto. McGraw-HIli R}ef'oon. 1972.
t52p.

THE CANADIAN NURSE 41

accession list

I I. The health strategy game; a challenge for
reorRani
ation allli managemellt. by Jame, O.
Hepner and Donna M. Hepner. St. Louis. Mosby,
1973.307p.
12. Instructional technologl in medi< al education:
proceedinRs of Rochester Conference on Self-
Instruction in Medical Education, 5th, 1971. Edited
by Jerome P. Ly,aught. Rochester. N. Y.. Roche,ter
Clearinghouse on Self-InstructIOnal Materials for
Health Care Facilities. 1973. 369p.
13. Larousse de la medecine. sante. hygiène, sous
la direction du Professeur A. Domart et du Dr. J.
Boumeuf. Montrouge. France. Larousse. 1971-72.
3 vols. R
14. Librarl' resources for nurses (a basic collec-
tion for supportinR the nursing curriculum) by Dale
E. Shdffer. Salem, Ohio. 1973. 45p.
15. Li,'ingstone's dictionary for nurses. by Nancy
Roper. 14ed. Edinburgh, Churchill Livingstone.
1973. 592p.
16. A longitudinal studl' of unmarried mothers who
kept their first-born children. 'How mothers and
children, as family units, fare in the communiry'.' by
Judith Pozsonyi. London. Ont.. Family and
Children's Services of London and Middlessex.
1973.64p.
17. Materniry' nursing, by Constance Lerch. St.
Loui,. Mosby. 1970. 360p.
18. Memento pour laformation des aides soiRnants,
par Centre Hospitalier RéglOnal de Montpelher.
Nimes. France. Éditions Notre-Dame. 1973. 331p.
19. Méthodes d'haluation des soins de santé.
DOlumelltations et exerC/ces con{us pour Ie
Séminaire sur r haluation des soins de santé de la
Sub,'ention Nationale à rhygiène. 2éd. Publié sous
la direction de David L. Sackett et Marjorie S.
Baskin. Hamilton, Ont.. rUniv
rsité McMaster.
1973. I vol.
20. Midwife"., by Jean L. Hallum. London. English
Universities PreS!>. 1972. 152p.
21. Pain relieflll labour; a handbookfor midwives,
by Donald D. Moir. 2ed. Edinburgh. Churchill
Livingstone, 1973. 150p.
22 Patient care in renal failure, by Joan DeLong
Harrington and Etta Rae Brener. Toronto. Saunders.
t973.277p.
23. Patholo[iie infectieuse et parasltlllre, par P.
Ambroise-Thomas et al. Paris. Simep, 1973. 93p.
24. Phl'siological measures of anxieTy in hospital
patients, by Anne Munday. London. Royal College
of Nursing. 1973. 66p.
25. A population polh)' for Carlllda? the proceed-
in[is of t"o seminars on the need for a Canadian
population polin- and on the impact of people on the
em'ironment. Toronto. Nov. 20-21, 1972 and May
10-1/, 1973. Toronto. Con,ervation Council of
Ontario. 1973. 59p.
26. Précis de surveillance visuelle scowire, par les
professeurs de I'Institut de Visiologie. Montreal.
Beauchemin. 1967. 21Op.
27. A primer of clinical sl'mptoms, by Robert B
Taylor. Hagerstone. Md.. Harper & Row. 1973.
220p.
28. Principles of human genetics, by Curt Stern.
42 THE CANADIAN NURSE

3ed. San Francisco. Calif.. W.H. Freeman. 1973.
891p.
29. Readl' for report nurse? A studl' of nursing
communication in hospital wards, by Sylvia R.
Lelean. London. Royal College of Nursing. 1973.
163p.
30. Rellllbilitation nursin[i; perspectil'es and appli-
cation.I, compiled by Victor A. Chri,tophen.on et al.
Toronto, McGraw-HilI, 1974. 586p.
31. Report 1972-73. London. General Nursing
Council for England and Wales. 1973. 76p.
32. Report of refresher programs in nursin[i: pilot
pruject for Metropolitan Toronto. Toronto. Regi,-
tered Nurses' Association of Ontario, 1968. 101p. R
33. Report on a meeting on the role of operati01l/l1
.Iludies in health sen'ices and education for these
sen-ices held in BanRko/.., Thailand from 12-21
Dec.. 1972. by Muriel Skeet. New Delhi. World
Health Organization. Regional Office for South-
East Asia, 1973. 74p.
34. The role of the nurse; viells of the patient. nurse
and doctor in some general hospitals in England, by
Evelyn R. Ander,on. London. Royal College of
NUr!>ing. 1973. 135p.
35. Short courses and seminars. Willowdale.Ont..
Development Publications. 1974. 80p. R
36. Standards of nursin[i in the operaring room.
Vancouver. B c.. British Columbia Operdting
Room Nurse,' Group. Task Committee, 1973. 81p.
37. Technique ménagères et hôtelières à /'hôpital:
[iuide pratique. Nimes. Edition, Notre-Dame. 1970.
125p.
38. Therapeutic abortion: an annotated bibliog-
raphl', by David W. Adam,. Hamilton. Ont..
McMaster University Medical Centre. 1973. 69p.
39. Thinkin[i metric, by Thomas F. Gilbert and
Marilyn B. Gilbert. Toronto. Wiley. 1973. 142p.
40. Vieillir; pro jet pour vivre, essai pncho-
sociologique, par Hélène Reboul. Lyon. Chalet.
1973. 223p.
41. Workbook and studl' guide for medlclll-sur[iiclli
nursing; a patient-centered approach, by Alma Joel
Labunski et al. 3ed. St. Louis. Mosby. 1973. 331p.
42. X-ray physics for radiologic technologists, by
Richard H. Schmidt. 5t. Louis, Mo.. Warren H.
Green, 1973. 143p.

-

lilt,,,
,
0"
.-\ 'A(f

..,.

,

LOYE "fI"sf.'
NO\-' HAPPY!
had ugly ..upertluous hair . was
unloved . discouraged. Tried many.
things. . . even razors. Nothing was
"dlisfactory fhen I developed a sim-
ple. painless. inexpensive. nonelectric
method. It hds helped thousand" win
heauty. love. happines.,. My I.REE
hook. "What I Did Ahout Super-
tluous Hair" explains method. !\Idiled
in plain envelope. Also Trial Offer.
Write I\lme Annelle I <tnzclle. P.O.
Bo\. Ii 10. Dcpl. C-402 Adelaide SI.
1'.0.. I oronto :! 10. On\.

PAMPHLETS
43. ANA certifiClltion program. Kansa, City. Mo..
American Nurses' A"oclation. 1973 Contents:
Geriatric nursing. -Pediatric nurse practitioner in
ambulatory health care. -Psychidtric-mental health
nursing.
44. A.N.P.Q. priorities. Montreal. Associdtion of
Nur,e, of the Province of Quebec, 1973. 36p.
45. Ad"ances in methods of fertili1l regulation;
report of a WHO Scientific Group. Geneva. World
Health Organization. 1973. 42p. (Its Technicdl
report ,eries no. 527)
46. Arran[ieme1lts between an institutIOn of higher
education and agencies ,,'hich prOl'ide leaming
laboratories for nursing education. 2ed. rev. New
York. Nationdl League for Nur,ing. Council of
Baccalaureate and Higher Degree Programs. 1973.
8p.
47. Associate degree educatiol! for nursing
/973-74. Ne\\ York. National League for Nursing,
Dept. of A!>!>ociate Degree Program" 1973. 37p. R
48. Characteristics of associate deRree education in
nursing. New York, National Ledgue for NUr!>ing,
Council of AS!>ociate Degree Program,. 1973. pam.
49. Documents fondamentaux; statuts et règlement
(amendés en 1973) Genève. Con,eil International
des Infirmières. 1973. 21p. R
50. Echelle de salaires du personnel. Montreal.
Association des Infirmières et Infirmiers de la
Province de Québec. 1973. pam.
51. Expertise balistique identification et preu,'es
matérielfes, par Yvon Thériault et Jedn Lepage.
Montréal. Institut de Médecine Légale et de Police
Scientifique. Section de Bali,tique. 1970. 40p.
52. Memorandum to the Advisory COlllmittee on
Food Safet)' Assessment; Obserl'lltiol!s, considera-
tiol!
and c01lclusion
with respect to
afery' of the
Canadian food suppll'. Onawa. Canadian NUr!>e,'
A!>!>ociation. 1973. 8p.
53. Nutrition: examen du programllle de rOMS
1965-1971. Genève. Organisation Mondiale de la
Santé, 1972. 38p.
54. Patiellt care in tuberculosis. 2ed. Rev. b} Mary
Louise Atkin,on et at New York. National League
for Nur,ing. ALA Nur,ing Department. 1973. 31p.
55. Practical nursing career; information about
slllte-apprm'ed schools of practical nursi 1Ig,
1973-74. New York. Nationdl League for Nursing.
Dept. of Practical Nursing Programs. 1974. 37p.
56. Report 1972-73. Ona\\d. Canadian Tuber-
culo,i, and Respiratory Di,ease A!>Sociation. 1973.
lip.
57. Report 1973. BailIe Creek. Mich.. W. K.
Kellogg Foundation. 1973. 40p.

GOVERNMENT DOCUMENTS
Alberta
58. Dept. of Health, Medical Services Division.
Health Cllreers, 1973. Edmonton, 1973. I vol.
Call1lda
59. Les centres de soins communautaires au
Canada. Volume 3: orgllnÜmes de soins de
/'aI'enir? Rapport présenté au Groupe d' Etude sur
les Centres de Soins comlllunauwires. Ondwa.
Information Canada. J 972.
60. Dept. of NatIOnal Defence. Down but nut out.
Created by RCAF Survival Training School staff.
Ottawa. Information Canada, 1970: reprinted 1973.
205p.
61. Economic Council of Canada. Report /972-73.
Ottawa,lnformauon Canada. 1973. 38p.
MAY 1974

62. -. Shaping the erpamion: performance indI-
cators. Onawa. 1973. I vol.
63 Health and Welfare Canada. Dental
manpower/popl/lation ratio estimates for Canada
llllder fOl/r siwations. A report prepared for the
Dept. of National Health and Welfare, by D. W.
Lewi
and B.1. Bnmn. Otta...a. 1973. 102p.
(He.1lth manpù...erreportno. 1-73)
64. -. The em/l/ation of the effect;.'eness of
programs desIgned to distribllle health manpower
into l/ndenen-iced area r. A report prepared for the
Dept. of National Health and Welfare, Canada, by
College of Family Physicians of Canada. Otta...a.
1973. 36p. (Health manpo...er report 2- 73)
65. -. Health sernce ereCl/t;.e manpo"er needs
for the se\'enties in Canada. A prelimÙlIln report
prepared for the Dept. of National Health and
Welfare, Canada, by John A.B. McLeish and
Donald V. Nightingale. Onawa. 1973. 27p. (Health
manpower report no. 3-73)
66. -. Repvrt 1972-73. Otta...a. Information
Canada. 1973. 53p.
67. Public Service Canada. A career in the foreign
service. Ona...a. Information Canada. 1973. 20p.
68. St.1ti
tic
Canada. Hvspital morbidit\, 1970.
Otta...a.lnformation Canada. 1973. 153p.
69. -. Salaries of teachers in degree-granting
institlllivns. Pt./. General characteri:.tics. 1971-72.
Ottawa. Infonnation Canada. 1972. 36p.
70. -. Sl/rglcal procedl/res and treatment, IY70.
Onaw.1. Infonn.1tion Can.1da. 1973. 145p.
71. -. Sl/rve\ ofedl/cationjìnance. 1968. Ottawa.
Inform.1tionCan.1d.1. 1973 91p.
72. Staws of wvmen in Canada 1973. OIl.1...a.

Infonn.1tion Canada. for Mini
ter of Labour. Minis-
ter re
pon
ible for the Status of \\-omen. 1973. .Up.
Cl/ba
73. Programa de edl/caciòn en senicio Habana.
Centre Nacional de InfonnaciÒn de Ciencids
Médicas, 1973. 35p.
United States
74. Dep!. of He.1lth. EduC.1!lOn dnd Welfare. Cemer
for Dise.1se Control. Tl/berodvsi:. statistics. states
and cities, 1972. Atlant.1. Ga.. 1973. 15p. (DH
'"
Publication no. fCDCl74-8249)
75. National Library of Medicine. Medical sl/bject
headings - alphabetical lISt, 197-1. Springfield.
Va.. National Technicallnfonnation Service. 1973.
704p. R
76. Patient handling malllllli for emergt'll('\' medical
technicians - ambl/lance. Prepared by Dunlap &
As
ociates for U.S Dep!. of Tran
port.1tion. Na-
tional Highway Traffic S.1fety Administration.
Washington. D.C.. U.S. Govt. Pnnt. Off.. 1972.
123p.

STUDIES DEPOSITED IN CNA REPOSITORY COLLECTION
77. An administrati\'e rerpol/.libilin: the release vf
creat;,'il\' in nl/rsing teachers, by Carol Whitmg.
London. Om.. 1973. 5Sp. R
78. An analnis of home \'isits b\ pl/blic he,llth
Ill/ne... Project 2: An erploralory st/lt!.. in one cvm-
ml/nitv of home visits by pl/blic health nl/rses to
pmients follow",g hospitali:ation fvr attempted
sl/icide, by Rosella Cunningh.1m. Toronlo. 1973.
I06p.R
79. The effect of an experimelllal ql/t'.\l/lming
strateg\' in clinical (Oliferencer and el'all/ation

inten lel\5 on the achiel'ement of Ill/nUlII rtl/delIIS
by Jl\dnne Dolores S"holdra. Se.1llle. 1972. lI)4p.
(The,i, - \\ .1
hington) R
80. Ewde de la (onception dl/ nl/rsing des injìr-
mières rmlinlUltes, par Françoise FOg.1rty Mnntré.1l.
1971. 84p. (The
e IM.Nurs ) - '\lontreal) R
81. Philo.\opJl/e de r eill/cativn de r injìrmière
aspe<l nl/ning pdr Sneur l\1.1rie-Répartrice.

lontreal. 1971. 49p. R
82. SllIdies in nl/rsing J973. AbstracII vf reports
sl/bmitted in partial fl/fjì/fmelll of the reql/irements
for the degree of Master of Science in .\'l/rsing. Ne...
Haven. Conn.. Yale Univer
it}. S"hool of Nursing.
1973. I vol. R

AUDIO VISUAL AIDS
83. Association dö Medecines de Langue française
du Canada. Montréal. 1973.
Sonomed, serie I, no. JO. -Cole A. I. Di.1bete chez
renf.1n!. 2. Glau"ome. -Cote B. I. \1ononuden
e
infe"lueu,..,. 2. Endinile.
84. -. Svnomed, serie J. no II. -Cole A. I.
Hemorragiö du premier uimestre. 2. Otile, .1igües
el chronique
. 3. Réa"tion
allergiques à la
péni"illine -Cote B. I. Infécondite chez 1.1 femme
2. Enuresie.
85. -. Sonomed. serie I. no J2. -Cole A. I.
Insutfis.1n"e "ertebrn-bd
ilaire. 2. Questinnnaire:
médicaments "ompn\é,. -Cote B. I. Cancer du col
uterin. 2. Trouble
de la fon"tion
exuelle. 3.
Commcntaires.
86. Nl/rsing media Ùl//n - J6mm ftlms. 2ed.
Ediled .1nd <:nmpiled by l\1.1nlynne Seguin. Toromo.
1974. 220p.

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MAY 1974

THE CANADIAN NURSE 43

classified advertisements

I

ALBERTA

REGISTERED NURSES reqUired Immediately lor 25-bed Ge-
neral Hospllal 110 miles East of Lacombe, Highway No. 12
Salary and policIes as per AARN. ResIdence available Travel
expenses advanced Will be refunded after one year"s service.
Apply: D"ector 01 Nursing, Coronation Municipal HospItal, Co-
ronatlon, Alberta. TOC 1 CO

REGISTERED NURSES requ"ed for70- bed accredited active
trealment Hospital. Full tl'11e and summer reliel. All AARN per.
sonnel policies Apply in wnting to the Director of Nursing. Drum-
heller General Hospital. Drumheller. Alberta.

REGISTERED NURSES. We need you lor our summer relief
program. Come and loin us for a three or four month penod You
can gain a great deal of clinical experience duri n9 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.

OCCUPATIDNAL HEALTH NURSE. The Red Deer Health
Unit Red Deer. Alberta, requ"es occupational health nUrse
for new Industnal health service to be based in health unit.
OccupatIonal Health Nursing Certilicate (0 H.N.C.) and/or
expenence In industrial nursing preferred Salary range as Red
Deer Health Unt schedule. based on qualifications and prevIous
expenence. plus usual fringe benefits. Application forms and
further details may be obtaIned lrom' Red Deer Health Unit.
4758 - 32nd St, Red Deer, Alberta T4N OM8 Telephone:
(403) 347-1166.

ADVERTISING
RA TES

FOR ALL

ClASSIFIED ADVERTISING

$15.00 for 6 lines Or less
$2.50 for each addilional line

Rates for display
advertisements on request

Closing dole far copy and cancellotion is
6 weeks prior to 1 sl day of publication
month.
The Canad,an Nurses' Associatian does
not review the personnel policies of
the hospitals and agencies odverlising
in Ihe Journal. For authentic information,
prospective applicants shauld apply to
the Regislered Nurses' Associalion of the
Province in which they are interested
in working

Address correspondence to:

The
Canadian
Nurse

{;]

50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P lE2

44 THE CANADIAN NURSE

I I

ALBERTA

REGISTERED NURSES lookoog lor Interes\lng worl< with
congenial staff In a new 50-bed accredited active hospital with
AARN.AHA contract 10 elfect and excellent accommodatIon,
apply to: D"ector ot NursIng. Central Peace General Hospital.
Sp",t RIver. Alberta. TOH 3GO.

GENERAL DUTY NURSES reqUired ImmedIately lor modern
38-bed hosPltal.n the Peace River area Excellent recreational
and social facilities available in the community. Living accom-
modations in comfortable nurses residence. Salary ard benefits
according to AARN agreement. Apply to: D"ector 01 Nursing.
Box 250. Manning MunIcIpal Hospital. Manning. Alberta TOH
2MO.

BRITISH COLUMBIA

OPERATING ROOM NURSE wanted for active surgIcal sUite in
acute accredited hospital. Expenence and/or training in O.A.
technique as well as experience In Obstetrics ard Emergency
desirable. Must be eligible for RNABC regIstratIon. Salary as per
RNABC contract. Apply to. Director of NursIng. St Mary's
HospItal. Box 7777. Sechelt, Bntish ColumbIa

OPERATING ROOM NURSE wanted tor active mo-
dern acute hospital Four Certified Surgeons on
attending staff. E)(perience of training desirable.
Must b.. eligible lor B C. RegIstration Nurses
resIdence avaIlable. Salary according to RNABC
Contract. Apply to D"ector 01 Nursing. MIlls Mem-
orial Hospital. 2711 Tetrault SI.. Terrace, B"tish
Cdumbla.

REGISTERED NURSES & GRADUATE NURSES requ"ed fOI
a new 41.bed Acute Care Hospital localed 200 mIles north 01
Vancouver and 60 miles from Kamloops. B C. limited furnished
accommodation available. Apply to: Director of Nursing.
Ashcroft and Dlst"ct General HospItal. Ashcroft. B"tlsh Colum.
bla VOK 1 AO.

REGISTERED NURSES WANTED FOR FULLY ACCREoDITED
HOSPITAL CONSISTING OF 190-BEDS. GENERAL DUTY
POSITIONS IN MEDICAL-SURGICAL. PSYCHIATRIC AND
ICU.CCU AREAS. MUST BE ELIGIBLE FOR B.C REGISTRA-
TION. BASIC SALARY 1973 - $67200 (NEW CONTRACT
BEING NEGOTIATED.) APPLY DIRECTOR OF NURSING
ST. JOSEPH'S GENERAL HOSPITAL. COMOX. BRITISH
COLUMBIA V9N 4B 1 .

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 5672
$842. B C Reglstratoon required Apply Director
of Nursing, Royal Columbian Hospital. New West-
minster. 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 01.
RECTOR OF NURSING CARIBOO MEMORIAL HOS-
PITAL 517 NORTH SIXTH AVENUE WILLIAMS
LAKE 'BRITISH COLUMBIA

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES requored for small
upcoast hospital Salary and personnel policies as
per RNABC contract Salanes start at 567200 for
Registered Nurses, 5577 75 for Licensed Practical
Nurses Residence accommodation $2500 per month
Transportation paid from Vancouver Apply to
Director 01 Nursing. SI George s HospItal Alert Bay.
British Columbia

GENERAL DUTY NURSES lor modern 30.bed accredited hospi.
tal. Salary and personnel policies In accordance with RNASC
Apply' D"ector 01 Nursing. Chetwynd General Hosptal, P.o.
Box 507. Chetwynd. British ColumbIa.

II

BRITISH COLUMBIA

GENERAL DUTY NURSES lor modem 41-bed hospital located
on the Alaska Highway. Salary and personnel policies in
accordance with RNABC. Accommodation available In resi.
dence. Apply: D"ector of NursIng. Fort Nelson General Hosptal,
Fort Nelson. Bntish Columbia.

GENERAL DUTY B.C. REGISTERED NURSES, fully aCCre.
dlted 39-bed hospItal. Comlortable nurses' resIdence. RNABC
Agreement in elfect. Apply Mrs. E. Neville. RN.. D"ector 01
Nurses, Golden and Distnct General HospItal. P.o. Box 1260.
Golden. B"tish ColumbIa.

GENERAL DUTY NURSES lor 360-bed acute general hospital
Personnel polices in accordance with RNABC Contract Direct
Inquines to: Director of Nursing. NanalO"IO Regional General
HospItal. Nanalmo, British Cdumbla.

TWO GENERAL DUTY NURSES wltn experience in obstetrics
and o.R requ"ed tor a 21-bed hospital in the Southern Intenor
01 B.C. LlVing.in accommodation available Salary as per
RNABC rates Moderate climate. good working conditions and
recreationallaclhtles available. Apply, gIvIng tull parhculars and
references In first letter to the Adminstrator. Siocan Community
Hospital. Box 129, New Denver. British Columbia.

EXPERIENCED GENERAL DUTY NURSES reQlIlred lor
151-bed Hosp'lal, BasIc Salary 5672 - 5842 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. B"tlsh Columbra

GENERAL DUTY NURSES reqUIred lor an 87-berl
acute care hospital In Northern B.C Resrdenct'
accommodations available. RNABC policies In effect
Apply to: Director 01 Nursing. MIlls Memorial Hos.
pltal. Terrace, British Co!umbla V8G 2W7

MANITOBA

Happiness IS working In a Communty Health Centre.
Our Registared Nurses are asked to undertake Important and
responsible tasks. to expenment with new nursing roles. and to
be pert of an interdisciplinary group of professionals. The
Facilities of the Centre Include a 50-bed personal care home a
25.bed hospital. a walk In soclal.medlcat.dental cllmc and 4
outreach clinicS used predominantly by a Nurse Practitioner We
are lookll"IQ for nurses who want to gJVe direction and not Just
take It POSitIons open. (1) REGISTËRED NURSE to assume
public health nurse duties PrevIous e)(penence aOO/or public
health education IS an asset Car supplied (4) REGISTERED
NURSES lor the personal care home. scheduled to open July
1st (2) REGISTERED NURSES lor the hospItal. Salanes are
negotiable with added benefits according to the Manitoba
Association of Registered Nurses schedule For further Informa-
tion please contact the Executive ['I:rector at Box 535.
GLADSTONE, Manitoba ROJ OTO.

REGISTERED NURSE required 8S INSERVICE CO-
ORDINATOR lor 14Q-bed General Hosptal wIth IntenSive Care.
Acute Care and Rehabilitative Care Units Degree In Nursll"IQ
aOO/or teaching expenence required. Apply In writing to:
D"ector ot Nursing. Portage District General Hospital. 524.5th
Street SE. Portage la PraIrie, ManItoba RIN3A8.

REGISTERED NURSES reQu"ed lor the tollowlng
positIOns In a 68 bed acute care general hospital
Night Supervisor Operating Room Supervisor Ex
perlence essential General duty nurseS In Pediatric
Department Remuneration for past expeCience Shift
differential Salary In accordance with M H S C ap
proved rate Apply to Administrator Ste Rose Gen
pral HospItal Ste-Rose rlu Lac Manotoba ROL 1S0

MAY 1974

NOVA SCOTIA

SENIOR FACULTY posItIon open basIc requirement
Bachelor of Nursing Responsible for pediatric as-
pect of an mtergrated program The pediatric pro
gram IS Interfaced with maternity and also with med-
Ical and surgical nursmg Apply to Director of Edu
callon Yarmouth RegIOnal Hospital Yarmouth
Nova Scot 18

Mount Saint Vincent University. Halifax. Nova Scotia Nursing
Oepanment Faculty positions available effective July 1 1974
In Medical Surglcar nurSing. PsychIatric nursing. Community
Health nurSing. Maternal-Child nurSing: Master 5 degree re
quored. Apply to Sister Margaret Molloy. AcademIc Oean. Mount
Saint Vincent University. Halifax. Nova Scotia.

REGISTERED NURSES AND PSYCHIATRIC NURSES -
GENERAL STAFF positIons avaIlable In a 225.bed psychialnc
hospital Onentatlon and mservlce provided. Excellent person-
nel policies and salary commenSurate with qualifications and
experience as laid down by the Staff ASSociation Agreement
APPLY TO: D"ector of NursIng, Cape Breton Hospital, POBox
515, Sydney. Nova ScaM

ONTARIO

SUPERVISOR IN PUBLIC HEALTH NURSING for the
Middlesex-London Dlstnct Health Unit ChallengIng posItIon In
pmgresslve agency Excellent fnnge benellts. For Fall 1974 A
wrriculum vllae should be submitted to: Mrs. Dorothy M.
Mumby. Dorector 01 PubliC Heatth Nursing, 346 South Street
London. Ontano N6B 1 B9

OPERATING-ROOM STAFF NURSE required for fully accre-
dIted 75.bed Hospttal. You WIll be on the Vacalionland of the
North. midway between Thunder Bay. Ontano and Wlnnopeg,
Manitoba BasIc wage IS $689 00 with conSideration for
expenence. Wnte or phone the Dorector of NurSing, Dryden
District General Hospttal Dryden,Ontano

REGISTERED NURSES for 34.bed General HospItal.
Salary $70600 per month 10 $81600 plus expenence al-
lowance Excellent personnel policies Apply to
Director of Nursing. Englehart & Dlstnct Hospital
Inc. Englehart Onlano. POJ 1 HO

REGISTERED NURSES reqUIred lor 107.bed accredIted Gen.
eral HospItal. BasIc salary $695 00 wrth remureratlon tor past
expenence Yearty mcrements. A progressive hospital amidst
the lakes and streams of Northwestem Ontano. Apply to.
Dorector of NurSing, La Verendrye Hosprtal. Fort Frances.
Onlano.

REGtSTERED NURSES required for a new 79-bed
General Hospital In bilingual community of North-
ern Ontano_ French language an asset. but not
compul sory. Salary IS $645 to $758. monthly wIth
allowance for past expenence. 4 weeks vacation
after 1 year and 18 sIck leave days per year ,Unused
sick leave days paid al 100 0 '0 every year Master
rotation In effect Roommg accommodations available
In town Excellent personnel policies. Apply to. Per-
sonnel Director, Notre-Dame Hospital. PO. Box 850,
Hearst, Ont

REGISTERED NURSES: Expe"enced general .July
nUrses required tor 28 bed General Hospital .n North
West Ontano Monthly salary schedule under review
experience recognized Nurses Residence provlC
ps
Individual self contained furnished apartments at
minimal rental rate Apply to the Director of Nursing
General Hospital Manltouwadge Ontario Telephone
82&-3251 (area code 807)

IfEGISTEREO NURSES AND REGISTERED NURSING
ASSISTANTS for 45.bed HospItal Salary ranges
Includ
generous experience allowances. A N s
salary ,680 to <;700 and R N A s salary

90 to ,565
Nurses residence - pravate rooms Wllh bath - 540
per month. Aoolv to The Director of NursIng. Gerald.
ton Dlstnct Hospital Geraldton Ontano POT IMO

RN and RNA full or part.tlme for Balmoral Lodge NurSIng
Home Good wages: private beach for staff residence: family
accommodatIon In country Setting Apply. Balmoral Lodge Nur.
sing Home, Box 331. Gravenhurst, Ontano

MAY 1974

I I

ONTARIO

REGISTERED NURSES and REGISTERED NURSING
ASSISTANTS for 83-bed Home for Mentally Retarded
and PhysIcally Handicapped ChIldren 40 Hour Week
Accommodatoon avaIlable RN s salary $600- $720
and RNA s $520 - $620 plus allowance for expen-
ence Apply to Lakewood NursIng Home. Box- 1830,
HuntsvIlle. Ontano. POA 1 KO

REGISTERED NURSES AND REGISTERED NURSING AS-
SISTANTS for a 41.bed Active Treatment HospItal Excellent
personrel polices plus expenence allowance. Apply to AssIs-
tant Director of Nursmg. T emlskamng Hospitals. New Llskeard
UnIt New Llskeard. Ontano. POJ 1 PO

REGISTERED NURSES FOR GENERAL DUTY, I.C.U.,
C.C.U. UNIT and OPERATING ROOM requored for
fully accredIted hospItal. Starting salary $697.00 wl:h
regular Increments and with allowance for expen-
ence. Excellent personnel policies and temporary
residence accommodation available. Apply to. The
Drrector of NurSing. Krrkland & D.strrct Hospital.
Korldand lake, Ontano P2N IR2.

Port Colborne General HospItal Pon Colborne Ontano - This
modem 143-bed teaching hospital reqUIres REGISTERED
NURSES lor all servIces IncludIng Emergency Operating Room
and Cardiac Care Uno!. Completely furnIshed apartment,slyle

c
n
e't
nc

al
a

an&r
o,;m
g

n
,CI
e

i
HospItal, Pon CoIborne, Ontano.

REGISTERED NURSES for GENERAL DUTY and for
INTENSIVE CARE NURSING. Salary and benehts
comparative with other areas Incl udes 20 days va
cation shift rotation reQUired Residential accommo
dation avail abh Apply to Director of Nursing Hunts
ville District Memorial Hospital Huntsville Muskoka
Ontano

PUBLIC HEALTH NURSES required for generalized prog.
ramme. Salary $8,899.$11 379 Generous fnnge benefits
Expenence recognIZed. Apply to: The D"ector of Public Health
NursIng, Northwestem Health Un!. 15 Ocean Avenue Wes!.
KENORA. Ontano. P9N 3W7

Chlldrens Summer Camps In Scenic Areas of Northern Ontario
require CAMP NURSES lor July and August Each has res.denl
M D. Contact. Harold B. Nashman, Camp Services Co.op ,821
Egllnton Avenue W Toronto M5N 1 E6 Ontano.

TWO NURSES for gl
s summer camp, Eagle lake 40 miles
north of KIngston. Ont - June 25to Aug. 23 - Contact Mrs. C.
labbett, 3 P,ne Forest Road. Toronto 317 Ontano

QUEBEC

TWO REGISTERED NURSES lor Chlldrens CO'Ed Camp. End
of June to August 20th Prefer season $700 plus travel.
Laurentian Region Doctor on staff. excellent facIlities. Write:
Joseph A Fnedman. Dorector YM- YWHA & NHS of Montreal,
5500 Westbury Avenue. Montreal H3W 2W8, 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
he West end of Montreal Appllcatlon
will be
welcomed at Queen Elizabeth Hospital of Montreal,
Nursing Personnel, 2100 Marlowe A...enue Montreal
260 Quebec

TRAVEL THE U.S.A. - ...... our ad page 55 thIs Issue.

MEDOX LIMITED

SASKATCHEWAN

DIRECTOR OF NURSING reqUIred for fully modern 20 Ded
hospital In North Central Saskatchewan. Salary scale and fnnge
benefIts as negotiated by SRNA. Near Provlncal Pari< Progres.
SlVe, modem communlly Admlnlstrabve expenence an asset
but not requored. PosItion available Seplember 1. 1974 Apply
to Administrator, PorOJplne Carragana Union Hospital. Box 70
Porwptne PlaIn, Saskatchewan

I I

UNITED STATES

R.N:s - SOUTHERN CALIFORNIA - Immediate need
eXists for medical-surgical Units Onentatlon and ,"-
service program Excellent salary. full paid benefits
We will assist you with your H-1 visa for Immlgrallon.
An Intenm permit may be obtained from the Callfor-
ma Board of Nursing Education and RegistratIOn to
practice nursmg In Cahforma prIOr to licenSing Con-
tact Personnel Director The HospItal of the Good
Samaritan, 1212 Shatto Street Los Angeles Calofor-
noa 90017 (213) 482.8111 ex 287

RN's and LPN's - Unoverslty HospItal North a
teachong HospItal of the Unoverslty of Oregon MedIcal
School. has opemngs In a vanety of Hospital ser-
Vices. We offer competlhve salanes and excellent
frange benefits InQuires should be duected to Gale
RankIn. Director of Nursong. 3171 S W Sam Jackson
Park Road. Portland Oregon 97201

TEXAS wants yOU! If you are an AN, experienced or
a recent graduate come to Corpus Chns.. Sparkling
CIty by the Sea a cIty bUilding tor a beller
future. where your opportUnities for recreation and
studies are limitless Memonal Medical Center 500-
bed. general teachmg hospital encourages career
advancement and prOVides In-service onentatlOn
Salary from 568200 to 594000 per month com.
mensurate with educahon and expenence Differential
for evening shifts available Benefits Include holi-
days sick leave Vacations. paid hosPitalizatIOn
health. 'ife Insurance pension program Become a
vital part of a modern up-to-date hospital write or
call collect John W Gover Jr. Dlreclor 01 Per.
sonnel Memorial MedIcal Center POBox 5280
Corpus Chris". Texas 78405

NURSES - Come lOIn the southern sunny weather. VacanC1es
available In ICU. OR. surgical. general duty etc 150 dlff U S
and Canadian hospitals in Paohc coast from Bnbsh Columbia to
sunny State of Callfomla Starting salary $9 648.00 - $14.500
per annum. Work permits & other paper work for moving are
provided free. Apply now: Phllcan Personnel Consultants LId..
(MedIcal Placement Specialists). 5022 Vlctona Dnve. Van.
couver. B.C.. Canada V5P 3T8 Telex 0455333

BE A REGULAR
BLOOD DONOR

REGISTE.RED NURSES
AND
REGISTERED NURSING ASSISTANTS

reqUIred for a 104.bed acllve treatment plus
72.bed chronic care umt located at Halleybury.
The Tn.Town area consisting of New Llskeard
Hatleybury, 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 faCiI.
It,es including curling skating, skIIng, SWim.
mlng, boating. hunting, foshlng
Salary fully appropriate to the responsIbIlity of
the posillon: personnel policies In line wIth
Industry and hospItal practice. OnentatlOn
and In.Servlce EducatIOnal programmes are
prov Ided

Apply In writing to,
PERSONNEL OIRECTOR,
Temlskaming Hospitals,
Halleybury, Ontano.

THE CANADIAN NURSE 45

THE CAPTAIN
WILLIAM JACKMAN
MEMORIAL HOSPITAL
LABRADOR CITY
A vacancy exists for the position of

DIRECTOR OF
NURSING SERVICES

at this active 65-bed General Hospital.

Handwritten applications marked
confidential should be addressed to
the:

Administrator
The Captain William Jackman
Memorial Hospital
410 Booth Avenue
Labrador City, Newfoundland

REGISTERED NURSES

required for the following positions:

SUPERVISOR to rotate on days,
evenings and nights.

HEAD NURSE for Obstetric Ward.

B.C. registration will be required. This is a
98-bed hospital with plans to add 35 beds
for extended care. R.NAB.C. policies in
effect. Applications and enquiries to:
Director of Nursing
Kitimat General Hospital
Kitimat, British Columbia
V8C 1 E7

NURSING
SUPERVISOR

required for

PEARSON HOSPITAL,
VANCOUVER

Depl. of Health, Vancouver Under d,recllon to pertorm
supervIsory and admlnlstrallvedulles Involved In the operatIon
01 a number 01 large wards lor TB Post. Polio and/or Extended
Care patIents
ThIS posItIon WIll offer the mature. well motIvated semor nurse
an opportumty to partIcIpate In Improving patIent care through
development of nursing staff
Salary range IS $837.81.011 per monlh (1973 rates) wIth
credIt lor experoence plus addItIonal allowance lor related
umverslty or cllmcal courses must be eligIble lor nursIng
regIstration In B C prelerably have a B S N or equIvalent
administrative courses and several years nursmg experience of
whIch one has been In a supervIsory capacIty at the Head Nurse
level
ObtaIn applICatIOnS Irom the PUBLIC SERVICE COMMISSION
411 Dunsmuir Street VANCOUVER. and return IMME.
DlATEL Y COMPETITION NO. 740 777.

46 THE CANADIAN NURSE

REGISTERED NURSES

required for a modern thirty bed active
treatment hospital, located ninety miles
north of Edmonton, Alberta. Salary sche-
dule effective April 1. 1974 $700, $730,
$760, $795, & $830

Previous experienc.e recognized.

Excellent personnel policies and fringe
benefits.

Room and board available for forty-five
dollars per month in modern hospital
residenæ.

Apply in writing to:
Director of Nursing Service
Boyle General Hospital
Boyle, Alberta

UNIVERSITY HOSPITAL
SASKATOON, SASKATCHEWAN
A 550-bed hospital located on the
University Campus
requires

NURSES

for:
(1) New Born Intensive Care Unit
(2) Medical Intensive Care Unit.
(3) Other specialized and general areas.
Excellent opportunity for development and
advanæment in all environment of patient
care teaching and research.
For further information ptease contact:
Employment Officer, Nursing,
University Hospital,
SASKATOON, Sask.

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS

Applications are invited for all nursing
areas Must be eligible for registration In
Ontario.
For a 391-bed, acute General Hospital
caring for both male and female patients In
downtown Toronto associated with the
University of Toronto.
Residence accommodation available.

Apply to:
Assistant Director of Nursing Service
WOMEN'S COLLEGE HOSPITAL
76 Grenville Street
Toronto, Ontario
M55 1 B2

CONESTOGA COLLEGE OF
APPLIED ARTS AND
TECHNOLOGY
The College invites applications for Fa-
culty positions in our various Nursing
Divisions which are located in Cambridge,
Guelph, Kitchener-Waterloo and Stratford.
Duties to commence in the Academic Year
1974/75.
Candidates must have a B.Sc.N. Degree
or equivalent. and at least two years
nursing experience. Salary will be
commensurate with background and expe-
rience.
Applications, in writing, should be
forwarded to:
The Personnel Department,
Conestoga College of Applied Arts
and Technology.
299 Doon Valley Drive,
Kitchener, Ontario.

IN-SERVICE CO-ORDINATOR

and

INFECTION CONTROL OFFICER

reqUired for 98-bed hospital in NW. region of
B.C. with plans to add 35 beds for extended care.

Applicant will be responsible for planning, orga-
nizing and implementing an in-service education
program as well as checking and controlling
hospital infections.

Experience In teaching/supervision reqUired and
B.C. registration.

Interested applicants please apply to:
Director of Nursing
Kitimat General Hospital
Kitimat, British Columbia
V8C 1 E7

Required for
FLiN FLON
GENERAL HOSPITAL
SUPERVISORS

Responsible for co'ordination and supervi-
sion of Patient Care throughout the hospi-
tal.
Qualifications:
- Current Provincial Registration
- Previous Supervisory Training and/or
Experience
Salary :
- Commensurate with qualifications
and past experienæ
For f'Jrfher details contact:
Mrs. E.- Avison
Director of Nursing
Flin Flon General Hospital
P.O. Box 340
Flin Flon, Manitoba
R8Z 1 N2

MAY 1974

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 CENERAL HOSPITAL
101, College St.,
Toronto, Ontario,
MSG 1L7.

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

MAY 1974

é

...or 'ORT" l

VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA
fhe \Iaritime,' Ið.rgc't teaching ho<;pital. has immedið.te
opening' for Regi,tered Nurse!.. Certified
urs!ng A"i,tant,
and Orderlies. Positions are available in Special Units and
fÒr gencral nur!.i ng dutie,. It i!. the principð.1 adult teachi ng
ho'pital of Oalhomie Univer,ity and al,o operð.te' a large
school of nursing.
SALARY:

Commen,urate \\ith 4ualification<; and e'\pericnce.
SPECIAL CM I '\iCRSES $HI70-$Y5X2
REGISrfRED NURSES $7H16-S9229
CER r. r--LRSI!'.G ASSISTAN rs S5626-$7IHO
;...L'RSI:"JG ORDERliES $4991-S6333
BEr--EFITS:
Full Civil Service Bendit<;. including three \\eeb vaca-
tion. four week, after 5 \eð.r, of service and ,hift diffe-
rentið.1. -
\--or further information and/or application form,_ plea,e
contact:
Per,onneIOffice.
Victoria General Ho<;pital.
Halifa'\. Nova Scotta.

SAINT JOHN GENERAL HOSPITAL
SAINT JOHN, N.B.
Requires

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS

for

GENERAL DUTY

Active Inservice Education programme.
Positions are also available for nurses with special clinical
preparation including cardiac and other intensive care areas.

For further information apply to:
Personnel Director
SAINT JOHN GENERAL HOSPITAL
P.O. Box 2000
Saint John, N.B.
E2L 4L2

THE CANADIAN NURSE 47

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 ex

Responsibilities:
- Classroom teaching and diOical supervision.
Salary:
- Commensurate with preparation and experience
within the CSAO range.
Starting Date:
-August 1, 1974

Direct applications with
complete resume to:
DEAN OF ACADEMIC AFFAIRS,
DURHAM COLLEGE OF APPLIED
ARTS AND TECHNOLOGY,
BOX 385,
OSHAWA, ONTARIO,
L1H 7L7.

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.
'nterested qua'ified applicants
shou'd app'Y to the:
DIRECTOR OF fIIURSING
Montreal Children's Hospital
2300 Tupper Street
Montreal 108, Quebec

48 THE CANADIAN NURSE

PEDIATRIC NURSES

Come to Canada's Ocean Play-
ground!

The Izaak Walton Killam Hospital
for Children is a modern, progressive,
324 bed complex located in downtown
Halifax. Affiliated with the medical
school at Dalhousie University, the
I.W.K. is the Pediatric referral center
for Canada's Maritime Provinces.

Opportunities are now available for
all areas including Neonatalogy and
Intensive Care. Previous experience
in pediatrics not necessary. A full
orientation program is provided.

RN's interested in accepting our
challenge are requested to contact:

ROBERT COOK
Director of Personnel
Izaak Walton Killam Hospital
For Children
5850 University Avenue
Halifax, Nova Scotia

O.R. NURSES
S.C.U. NURSES
GENERAL DUTY
REGISTERED NURSES

Required for a 135-bed active treat-
ment hospital located in a modern city
of some 6,000 people, just forty miles
south of Edmonton, Alberta's capital
and with easy access to lake and
mountain resort areas such as Banff
and Jasper.
Starting salary $665 - $830 commen-
surate with experience and qualifica-
tions. Excellent personnel policies
and fringe benefits available.

Kindly apply to:
Director of Nursing
Wetaskiwin General Hospital
Wetaskiwin, Alberta
T9A 1Y6

CHIEF EXECUTIVE
OFFICER
Ontario Nurses' Association

Qualifications:
. a registered nurse with extensive labour
relations experience
. preferably a degree in nursing or busi-
ness administration
. proven executive ability

Responsibilities:
. to manage the business affairs of the
new union for nurses in Ontario

Salary:
. negotiable

Apply in writing to:

Mrs. Jean Lowery, President
Ontario Nurses' Association
2485A Dufferin Street
Toronto, Ontario
M6B 3P9

OPPORTUNITY -

for an experienced nurse with innovative and creative
Ideas, who can become enthusiastic about meeting
new challenges in a changing and progressing
organization, to serve in the capacity of Director of
Nursing Services.

Applicants must have previous supervisory expe-
rience - post graduate training is desirable. Usual
B.C. hospital employee benefits are offered - salary
negotiable.
The existing hospital has a rated capacity of 63 beds
(approximately 74 set up), An Expansion and Renova-
tion project is underway with completion anticipated
by the end of 1974, which will bring the rated capacity
to 79 beds (including 7 Extended Care beds). A
substantial amount of Emergency and Outpatient work
is also done.

The hospital IS situated in the midllie of the beautiful
Bulkley Valley, and the community offers ample
social, recreational, and sports activities.

Interested persons may obtain more information and
may apply in confidence to the: Administrator, Bulkley
Valley District Hospital, Box 370, Smithers, B.C.,
VOJ 2ND.

MAY 1974

ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO.

REGISTERED NURSES

630.bed fully accredited Hospital provides
experience in Emergency, Operating Room,
Post Anaesthesia Room, I ntensive Care Unit,
Orthopaedics, Psychiatry, Paediatrics, Obste.
trics and Gynaecology, General Surgery and
Medici ne.
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 I nsurance 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 hohdays - 3 weeks annual vaca-
tion after completion of one years service.
APPL Y:

ASSOCIATE DIRECTOR
OF NURSING SERVICE

ST. JOSEPH'S HOSPITAL
30 The Queensway
TORONTO 3, ONTARIO.

THE UNIVERSITY OF CALGARY

FACULTY
POSITIONS

Challenging positions available for
nursing facultY in a four year integra-
ted baccalaureate program. Opportu-
nities exist at the Assistant and Asso-
ciate Professor levels in the areas of
Mental Health/Psychiatric Nursing,
Nursing of Children, and Community
Health/Nurse Practitioner specialties.
Preference will be given to applicants
with Master's or Doctoral degrees.
Appointments to be made July 1 st,
1974.
Salary Scales:
Associate Professor
$17,300. - $22,900.
Assistant Professor
$13,200. - $17,250.
Contact:
Director
School of Nursing
University of Calgary
Calgary, Alberta !I3
T2N 1 N4
Canada
. .

MAY 1974

1+

Public Service
Canada

Fonction publique
Canada

THIS COMPETITION IS OPEN TO BOTH MEN AND WOMEN

REGISTERED NURSES
(Salary to $8988 (Plus Northern Allowance)
Department of Health and Welfare Canada
Medical Services, Northern Region
Various Locations in the Yukon and N.W.T.

An opportunity to see parts of Canada few Canadians ever see. Nurses are required to provide
health care to the inhabitants located in some settlements well north of the Arctic Circle. Radio
telephone communication is available. Join the Northern Health Service of the Department of
Health and Welfare Canada and discover what northern nursing is all about.
Candidates must be registered or eligible for registration as a nurse in a province of Canada,
mature, self-reliant person, preferably with midwifery, obstetrics, pediatrics or Public Health
training and experience. Proficiency in the English language is essential. Salary commensu-
rate with experience.
Transportation to and from employment area will be provided; meals and accommodation at a
nominal rate. Quote No. 74-E-4.
Forward" Application for Employment" (Form PSC 367-401 ) available at Post Offices, Canada
Manpower Centres, and Offices of the Public Service Commission of Canada, to the: Depart-
ment of Health and Welfare Canada, Medical Services, Northern Region, 1401 Baker Centre,
10025 - 106 Street, Edmonton, Alberta, T5J 1H2.
Appointments as a result of this competition are subject to the provisions of the Public Service
Employment Act.

REGISTERED PSYCHIATRIC NURSES
REGISTERED NURSES
Department of Social Services
Required for an 11-bed hospital unit situated within the
Provincial Correctional Centre, Regina

POSITION: On a shift rotating basis, provides psychiatric and medical nursing care to male inmate
patients within the Hospital Unit; and provides emergency nursing care to inmates in the 300 bed
Correctional Centre in the absence of senior nursing personnel.
QUALIFICATIONS: Considerable experience in the field of psychiatric or general duty nursing and
eligibility for registration In the Province of Saskatchewan.
SALARY: Present salary scale. $8,992 - $10,812 per annum
Effective October 1/74: $9,696 - $11,784 per annum
BENEFITS: - extensive orientation program
- 6 week course, during the first year of employment, leading to a recognized
certificate in corrections
- opportunity for post-graduate university study at the Baccalaureate level.
- provision of uniforms
- toll free parking and car heater outlets
- Provincial Government benefits
Registered Retirement Pension Plan
Group Insurance Benefits
3 weeks annual leave
$1.60 shift differential for evemng and mght shifts

For additionat Information and application forms direct inquires to:
Mr. W.C. BELL
Supervisor of Nursing Services, Provincial Correctional Centre,
P.O. Box 617, Regina, Saskatchewan, S4P 3A6.
Please Quote competItion number c/c 6935
Applications to be forwarded to. Public Service CommissIon. 1820 Albert Street. RegIna, Saskatchewan.
S4P 258
ClosIng date for receIpt of applications As soon as possIble.

THE CANADIAN NURSE 49

WE CARE

\tÎJÍ)

HOSPIT AL:
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,
NEW MARKET, Ontario.
L3Y 2R1

BRANDON GENERAL HOSPITAL
SCHOOL OF NURSING
NURSE TEACHERS

FOR
TWO YEAR DIPLOMA PROGRAM
POSITIONS AVAILABLE JULY, 1974
IN
NURSING CONTENT AREAS
OF
"FUNDAMENTALS" - "MATERNAL - CHilD"
"MEDICAL-SURGICAL" - "PSYCHIATRIC NURSING"

QUALIFICATIONS:
Baccalaureate Degree in Nursing is required.
Preference given to applicants with experience in Nursing and
Teaching.

Apply in writing stating qualifications, experience, references
to:

Personnel Manager,
Brandon General Hospital,
150 McTavish Avenue East,
Brandon, Manitoba,

([ID Humber College

The following positions are open in our Health Sciences Division:

CLINICAL EXPERIENCE COORDINATOR

To plan, negotiate and contract clinical and field work experience
in hospitals, health and community agencies. To develop and main-
tain effective relationships with clinical and community agencies.
The successful applicant will have advanced preparation in nursing
education, nursing service or a related health field.

DIRECTOR - POST-DIPLOMA NURSING PROGRAMS

To coordinate the development, and expansion of post-diploma pro-
grams for registered nurses and registered nursing assistants. The
successful applicant will be a registered nurse with advanced pre-
paration in clinical nursing, nursing education, adult education or
related field.

HEALTH CORE COORDINATOR

To review and evaluate the existing health core courses related to an
inter-disciplinary health career mobility concept. To develop and
expand health core components of all health sciences programs. The
successful applicant should be a community health.oriented edu-
cator with recognized expertise and experience in health sciences
research and program development.

SENIOR PROGRAM COORDINATOR

To act as coordinator and liaison for Health Sciences continuing
education activities on and off campus offered through the Centre
f,Jr Continuous Learning. Preference will be given to an applicant
with a background in development and promotion in community
health work and adult education.

TEACHER - EMERGENCY & CASUALTY ATTENDANT PROGRAM

To teach emergency patient care with emphasis on ambulance pro-
cedures. Preference will be given to an applicant who is a Registered
Nurse with teaching and ambulance experience.

TEACHER, NURSING DIPLOMA PROGRAM - OSLER CAMPUS
To teach Psychiatric Nursing theoretically and clinically and to assist
in clinical supervision in medical-surgical nursing. A Registered
Nurse with a B.Sc.N. and two years of experience in nursing practice.
All inquiries or applications should be directed to:
Personnel Relations Center
Humber College
P.O. Box 1900
Rexdale, Ontario
M9W 5L7

50 THE CANADIAN NURSE

MAY 1974

1975
Announcement - Competition
W.H.O. Travel Fellowships
For Canadian Health Workers
Each year, the World Health Organization allocates a number of
Travel Fellowships to Canada for the study abroad of health care, in
order to foster the improvement and expansion of health services in
this country. The Fellowship is granted for short-term programs of
observation or training of approximately one to three months dura-
tion.
Eligible to enter the competition are Canadian citizens engaged in
operational or educational aspects of public health and health care
in a professional capacity. Ineligible are workers in pure research,
persons who wish to attend international meetings, students in the
midst of undergraduate or graduate courses, and applicants more
than 55 years of age. As some classes of Health workers, for
example, employees of the federal government, have easier access
to other sources of training assistance, they may apply but their
applications will be given a low priority.
Candidates will be rated and chosen by a selection committee on
the basis of their education and experience, the field of activity they
propose to study, and the intended use of the knowledge gained
during the fellowship upon return to this country.
Employers of successful candidates are expected to endorse
applications and continue salary during the Fellowship because the
WHO award will cover only per diem maintenance and transporta-
tion. Because of the tourist and holiday season, WHO will not
entertain applications which feature visits to Europe and/or Scan-
dinavia between June 15 and September 15.
Applications should be submitted before September 30, 1974.
Information and forms may be obtained from:
International Health Services
National Health and Welfare
Brooke Claxton Building
Ottawa, Ontario
K1A OK9

Public Health
N u rs e: $9,200 - $10,300

With the MINISTRY OF HEALTH, you will join a public
health nursing team in northern Ontario and provide a
generalized public health nursing service to communities
in unorganized territory not served by health units. Re-
sponsibilities will include maintaining a school health ser-
vice, carrying out a home visiting program, organizing and
operating community immunization programs and assist-
ing in communicable disease control. Location: Thunder
Bay, with considerable travel. Car provided.
Qualifications: registration as a nurse in Ontario and a
recognized certificate in public health nursing: two years
acceptable expenence in public health nursing or related
field desirable; personal suitability.
Qualified individuals are invited to submit applications to:
Senior Personnel Officer, 7 Overlea Boulevard, Unit
"B", 3rd Floor, Toronto, Ontario, M4H 1A8.

This position is open equally to men and women.

&?
Ontario

Ontario
Public Service

Please Write:
Director of Personnel
Halifax Infirmary
1335 Queen Street
Halifax, Nova Scotia
Canada

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MAY 1974

THE CANADIAN NURSE 51

REGISTERED NURSES
AND
REGISTERED
NURSING
ASSISTANTS

Why not come to Montreal, where
openings exist in all services of a
beautiful 450-bed General Hospital.

Write to:
Director of Personnel
ST. MAR V'S HOSPITAL
3830 Lacombe Avenue
Montreal, Que. Tel.: 514-344-3390.

Switzerland
Kantonsspital Winterthur (769 bed) hospital
(near Zürich) needs:

OPERATING ROOM
NURSES

for the Surgery Clinic. Varied work, good
salary, 5-day week, accommodations
available in hospital, cafeteria, swimming
pool, central location for summer and winter
sports.

Apply to:

Kantonsspital Winterthur
Personalbüro/Verwaltung
Brauerstrasse 15
8400 Winterthur ISwitzerland

NURSING OFFICE
SUPERVISOR

required for 270- bed acute care fUlly accre-
dited Hospital expanding to 370 beds. Per-
sonnel Policies in accordanæ with RNABC.
Must be eligible for B.C. Registration.
Preference will be given to applicant with
University preparation in Administration
and Clinical Supervision.

Apply Stating Qualifications to:

Director of Nursing
Prince George Regional
Hospital
Prince George, B.C.

52 THE CANADIAN NURSE

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
I 26-bed, fully accredited hospi-
tal is young, and already expand-
ing. Nursing is a profession we
re
pect and we were the tirst to
plan and develop a unique nurs-
ing audit system. There arc
opportunities for gaining wide
experience, for getting to know
patients as well as staft

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 holida) and week-e
1d
pleasures of Ontario are
aslly
accessible to the North. It you
arc really interested in nursing,
you are needed and will be made
weleome.

Apply in person or by mail to the
Director of Nursing.

YORK
CENTRAL
HOSPIT AL

RICHMOND Hill.
ON1ARIO

DIRECTOR OF NURSING

Qualified Director of Nursing required Immediately to assume
the responsibility of nursing seMces m two hospitals.
Presently T emlskaming Hospitals consists of a 93 bed active
treatment plus 72 bed extended care unit located at Halleybury
and a 41 bed actIve treatment unrt10cated at New liskeard. The
Tri. Town area consisting of New llskeard. Halleybury, Cobalt. all
wIthin 5 mIles of each other wIth an Immediate area population of
approxImately 17.000 and a service population of 25.000. is
located 90 miles from North Bay with dally plane. tram and bus
service to and from Toronto. etc. Good educallOnal facilities and
also locatIon of Halleybury School of Mines. Provmclal School of
Agricultural Technology, and R.N.A. TraIning Centre. BeautIful
recreational facilitIes including curling. skating, skiing. sWIm-
ming, boating, hunting, fIshing.
Salary fully appropriate to the responsIbIlity of the position and
the Industry; personnel policies in line with Industry and hospital
practice

Apply In writing to:
Administrator,
Temiskaming Hospitals,
Haileybury, Ontario, POJ 1 KO.

NURSING OPPORTUNITY
REGISTERED NURSES

required for a 138-bed active treatment hospital
plus

EXPERIENCED NURSES

for a 5-bed I.C.U.-C.C.U. presently being set up
clinical areas include - medicine - surgery, obstet-
rics, paedIatrics and coronary care.

Residence accommodation available.
Address applications and enquires to:

DIRECTOR OF NURSING
BLANCHARD-FRASER
MEMORIAL HOSPITAL
KENTVILLE, NOVA SCOTIA

REGISTERED NURSES

are invited to apply to this active
Regional Referral Hospital in the
B.C. Interior. The Hospital has 344
beds and an expansion programme
underway. All clinical specialties
are represented and provide op-
portunities for varied nursing ex-
perience RN.A.B.C. Contract is in
effect. B.C. Registration is re-
quired.

Please address all
correspondence to:
Director of Personnel Services
Royal Inland Hospital
Kamloops, B.C.
V2C 2T1

MAY 1974

.';" ". ;
...'):::
.....:{0:-
1
í,
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....:..
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...ÔepORIUNIIIES

VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA

The i\1 aritimcs' Idrge't ho'pital. ha, Immediate opening' for
Clinical
ur..ing Supen i'ior... It i.. the principal adult teach-
ing
o"pitð.1 of Oalhou,ie Uni\er..it\ and aho oper<ltc' a
large ,chool of
ur,i n\!.
S/Ù,-\RY: - SII.560-SI3.537
CLll"ICAL :-"l RSING SL'PER \ ISORS
A \Id,te(... Degree i'i preferable but candidate<> \\, ith a
Bachelor.... Degree \\,ould be given con..ideration. 3 \ear...
experience. I 'of \\, hich \\,.1..- at the ,upen i..or} Ic
d i..
required. C our..es in CI inical Special it}
ur..ing. cspecialh
in \Jedicdl or Surgical Nur,ing \\, l)uld be considered
BEND. liS:
Full Civil Service Benefit.... including three \\'ed,,, vaca-
tion and four \\'ed., after li\e }ear.. of..ervicc.
Competition i.. open to both men and women.
For further information and/or application fÒrm,. plca..e
contact:
Per..onnel Olfice.
\'ictoria General Ho..pital.
Halifax. Nm-a Scotia.

t

FOOTHILLS HOSPITAL
Calgary, Alberta

Advanced Neurological-
. Neurosurgical Nursing

for
Graduate Nurses
a six months clinical and
academic program
offered by
The Department of Nursing Service
and
The Division of Neurosurgery
(Department of Surgery)
Beginning: September, 1974
March, 1975
Limited to 8 participants
for further information, please write to:
Co-ordinator of In-service Education
foothills Hospital
1403 29 St. N.W.
Calgary, Alberta
T2N 2T9

FOOTHILLS HOSPITAL

invites applications from graduate nurses eligible for registration who
enjoy nursmg and
seek opportunities for personal
and professional growth

\.

@

Foothills IS a new 766 bed general hospital affiliated with the university of Calgary s
uated in
northwest Calgary. fifty miles east of the rockies.

FEATURES

..

I

OPPORTUNITY

- patient and family - centred approach to health care by all team members

patient care departments In obstetrics, paediatrics. medicine. surgery,
neurosurgery, reactivation. psychiatry. intensive care

.

Centre lor southern Alberta In neonatal intensive care, renal dialySis. and
treatment of glaucoma. detached retina.

for Individualized orientation program
- for broad range of learning experiences and attendance at In.servlce educational programs
- to partICipate in planmng your own program of growth
- excelleñt personnel pOlicies
For application form write to:
Ms. Paige Hegland, personnel officer,
Foothills Hospital, Calgary, Alberta, T2N 2T9

MAY 1974

THE CANADIAN NURSE 53

MONTREAL
NEUROLOGICAL
HOSPITAL

A Teaching Hospital
of McGill University

requires

Registered Nurses
for
General Duty
Previous experience in neurological nursing not
required. Active inservlce educatoon programme.

Apply to:
The Director of Nursing,
Montreal Neurological Hospital
3801 University Street,
Montreal 112, P.O.

OPERATING ROOM
NURSES

- required for 270 bed acute care
hospital
- expanding to 370 beds
- must be eligible for S. C. registration
_ personnel policies in accordance
with RNASC 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.

NORTH NEWFOUNDLAND & LABRADOR

reqUires
REGISTERED NURSES
PUBLIC HEALTH NURSES

InternatIOnal Grenfell AssoCiation provides
medical services for Northern Newfoundland
and Labrador. We staff four hospital s eleven
nursing statIOns, eleven Public Health units
Our main 180.bed accredited hospital IS
situated at St. Anthony, Newfoundland. Active
treatment IS carned on In Surgery. Medicine,
Paediatrics, Obstetrics. Psychiatry. Also,
Intensive Care Unit. Orientation and In.Service
programs 40-hour week, rotating shifts. LIving
accomodatlOns suppl ied at low cosl. 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,
SI. Anthony, Newfoundland.
54 THE CANADIAN NURSE

THE HOSPITAL
FOR
SICK CHilDREN

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Situated inthe stimulating
atmosphere of downtown
Toronto,within walking distance
of the UniverSity of Toronto
The largest ch i Idren's hospital on
the continent offers the
Registered Nurse opportunities
for development in our Nursing
Department. We have many areas
that will interest the Registered
Nurse who is looking for a
challenging career in paediatric
Nursing
Opportunities for employment in
Intensive Care, Renal Dialysis,
Neonatal Unit, Child and FamilY
Unit, Clinical Investigation
Unit, Operating Room, Cardiac
Surgery, Neurosurgery Isolation
and Orthopaedic surgery. We
have a planned orientation and
staff development programme

The majority of in-patient units
a re work i ng the 7 day fortni ght
(12 hour shifts) Salaries are
commensurate with experience
and education. Excellent fringe
benefit programme. Current
registration in Ont. is required

Applications for General
Duty Positions are invited
PLEASE WRITE TO Mrs.C. MACINNES
The Personnel Co-ordinator
555 Universi ty Avenue
Toronto, Ontario, Canada
M5G 1X8
TELEPHONE366
242Ed
528

REGISTERED NURSES

The Red Deer General Hospital is
looking for nurses in several general
duty areas. However, we are espe-
cially interested in grads who have
experience in Intensive Patient Care.
We have a very active 230-bed hospi-
tal in Central Alberta. If you are
interested in finding out more about
our progressive hospital contact:

Personnel Director
Red Deer General Hospital
Red Deer, Alberta

THE LADY MI NTO 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 1 CO

NURSING SUPERVISOR

required immediately
for
Operating Room
and
Recovery Room
Staff responsibilities will include assessing
quality of Nursing Service
and
assisting in the Planning of in-service
programs.
Baccalaureate Degree with broad nursing
experience.
Remuneration will be consistent with ex-
perience and qualifications.
Apply in writing sending complete re-
sume to:
Miss Phoebe Stanley,
Director of Nursing,
Stratford General Hospital,
Stratford, Ontario.

MAY 1974

R.N.'S - TRAVEL
THE U.S.A.

Registered Nurses required immediately in
modern hospitals in the U.S.A. Many hospitals
as well as cities to choose from, such as
Miami, Washington D.C. Philadelphia, San
Francisco, Atlanta and New York.
Arrangements for work permits and other
paperwork provided by us. Air fares advanced if
required and accommodation can be arranged
in the various cities. We can get you permanent
jobs or contracts to work your way around the
U.S.A. - 4 months, 6 months and 1-year
contracts. Medox has offices in Canada and the
U.S.A. to look after you. Why not travel the
U.S.A. with Medox Professional Nursing Ser-
vice?
Write Sheila Britten, MEDOX LIMITED, Suite
302,3 Place Ville Marie, Montreal. Province
of Quebec. H3B 2E3, or call (514) 861-1728
and let us know your interests.

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.

Nursing Sisters' Association
of Canada
Biennial Meeting
Wednesday, June 19th, 1974
Winnipeg, Manitoba
Mess Dinner

See you there!

MAY 1':.174

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Quebec's Health Services are progressive!

So

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IS nursing

at

The Montreal General Hospital

a teaching hospital of McGill University

Come and nurse in exciting Montreal

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The Montreal General Hospital
1650 Cedar Avenue, Montreal, Quebec H3G IA4

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 Canadian applicants.

L_______________________________J
THE CANADIAN NURSE 55

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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.

APPLICATIONS ARE INVITED
FOR THE POSITION OF
CONSULTANT IN NURSING EDUCATION
FOR
THE ORDER OF NURSES OF QUEBEC
o

RESPONSIBILITIES
Work in collaboration wIth the Department of Education In the establishIng of policies and
programmes. in order to meet the pedagogical and professIonal requirements for the educ
tlon 01
nurses in Quebec.
Assume responsibility for assessing basic nursing education in educational establishments and,
pursuant to these VIsits. report on the quality of the educational programmes to the School of
Nursing Committee and to governmental authorities.
Act as advIsor to nursIng educators on questions of pedagogy
Partlclpale in Ihe revision of nursing education programmes.
Interpret to governmental authoritIes. educational establishments and other Interested partIes, the
professional and legal requirements concerning nursing education
Be responsIble for the School of NursIng CommIttee. its subcommittees and ad hoc committees
Work in close collaboration wIth other consultants In nursing education
Visit the various CEGEPs In the ProvInce of Quebec and the universities offering a basIc educatIonal
nursing programme.
Collaborate with updating the roster of resource persons in nursing education
QUALIACATIONS
The applicant must be bilingual and possess'
. a master's degree In nursIng with major In educatIon or the eqUivalent
. a thorough knowledge of trends in educatIon and pedagogy as well as the trends ot nursIng
education throughout the world.
. a good knowledge ot the legislation deahng with the practice of nursing. with health. and with
the distribution of health serVIces and social servIces
Application should be sent with complete resumé by July 1. 1974 to:

Executive Director and Secretary of the Order,
4200 Dorchester Blvd. West, Montreal, Que. H3Z 1V4.

JUDY HILL
MEMORIAL SCHOLARSHIP

APPLICATIONS ARE BEING RECEIVED FOR THIS SCHOLARSHIP, DETAILS OF WHICH ARE AS FOLLOWS:
VALUE - up to $3,500.00.
PURPOSE - To fund post-graduate nursing training (with special emphasis on midwifery and nurse practitioner
training) for a period of up to one year commencing September 1st. 1974.
In Canada, the United Kingdom, Australia, and New Zealand.
should possess the following qualifications:
English speaking;
. R.N. Diploma, or equivalent;
A desire to work for the Government of Canada or one of its Provinces at a fly-in nursing station in a
remote area of Northern Canada for a minimum period of one year following
completion of the scholarship year. (Details of this work will be forwarded on
request.)

TENABLE -
APPLICANTS

AND SHOULD SUBMIT:

. A curriculum vitae;
. Copies of the educational qualifications submitted on entry to nursing school;
. Verification of their R.N. Diploma, or equivalent;
. Their proposed course of study;
. Acceptance and/or preferences for place of study;
. Two character references.
TO: The Chairman, The Board of Trustees, Judy Hill Memorial Fund, 829 Centennial Building, Edmonton, Alberta,
Canada.
BY: June 1st. 1974.
. The Scholarship is contingent on the successful applicant's being registrable by a nursing association in one of the Canadian provinces
and meeting current Canadian immigration requirements for landed immigrant status. A successful applicant from outside Canada will
be assisted by the Trustees in meeting these requirements.

56 THE CANADIAN NURSE

MAY 1974

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. lenge!

of providing health
care for the
Indian pC2opl

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of Canada {.:"
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and Welfare Blen-être socIa'. \ \\.
Canada Canada !j. \ '\
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I Medical Services Branch I
I Department of National Health and Welfare I
I Ottawa, Ontario K 1 A OK9
I I
I Please send me more information on career I
I opportunities in Indian Health Services. I
I Name: I
I Address: I
City: Prov:_

------_________J

MAY 1974

1+

Public Service
Canada

Fonction publique
Canada

THESE COMPETITIONS ARE OPEN TO BOTH MEN AND
WOMEN

Are you interested in working in the NORTH?

HOSPITAL NURSES
PUBLIC HEALTH NURSES
NURSE MIDWIVES

SALARY: $8,988 - $11,716

MEDICAL SERVICES BRANCH - INDIAN
HEALTH PROGRAM
HEALTH AND WELFARE CANADA

Nurses are needed at hospitals located at HODGSON and NOR-
WAY HOUSE, Manitoba and NURSING STATIONS and HEALTH
CENTRES at various locations in Northern Manitoba, Northwestern
Ontario and Saskatchewan.
The requirements include eligibility for registration as a nurse in a
province of Canada, and preferably nursing experience in obstetrics
or midwifery for some positions or a Public Health Diploma, B.N. or
B.Sc.N. degree. Knowledge of the English language is essential.
Additional allowances are paid in isolated locations and extra salary
for nursing specialties used in the performance of the duties.

GENERAL DUTY NURSES

SALARY: $7,826 - $9,440
TREATMENT SERVICES BRANCH
DEPARTMENT OF VETERANS AFFAIRS

The Deer Lodge Hospital at WINNIPEG, Manitoba requires
General Duty nurses to identify the nursing needs of geriatric and
chronically ill patients; to plan and provide nursing care according
to recognized standards and hospital policy; to assume responsibi-
lity for a ward or specialty unit during evening and night hours: to
direct and supervise the work of nursing auxiliaries and to perform
other related duties. Knowledge of the English language is
essential.
The requirements include eligibility for registration as a nurse in a
province of Canada and preferably with experience since gradua-
tion.

Resumés and enquiries about the above opportunities are in-
vited by the:

PUBLIC SERVICE COMMISSION OF CANADA
504 - 266 GRAHAM AVENUE - WINNIPEG,
MAN ITOBA.
R3C OK6.

Pt8llse quote reterence number 74-W802 for the above positions and
specify your areas of Interest and tocatlon preference.
Appointments as a resutt of these competitions are subject to the provi-
sions of the PUbtlc Service Emptoyment Act.

THE CANADIAN NURSE 57

ST. MICHAEL'S HOSPITAL
Toronto, Ontario
invites applications from

REGISTERED NURSES

for

INTENSIVE CARE and "STEP-DOWN" UNITS

Planned orientation and in-service programme will enable
you to collaborate in the most advanced of treatment
regimens for the post-operative cardia-vascular and other
acutely ill patients One year of nursing experience a
requirement.

For detaits apply to:

The Director of Nursing,
St. Michael's Hospital,
Toronto,
Ontario,
M5B 1 W8.

Q

ORTHOPAEDIC &:: ARTHRITIC
HOSPITAL
'V I'V'

43 WELLESLEY STR EET, EAST
TORONTO, ONTARIO
M4Y 1 H1

Enlarging Specialty Hospital offers a unique
opportunity to nurses and nursing assistants
interested in the care of patients with bone and
joint disorders.
Currently required -
Registered Nurses and Nursing Assistants for all
units
Clinical specialists for Operating Room, Intensive
Care, Patient Care and Education.

HEALTH
SCIENCES
CENTRE

WINNIPEG,
MANITOBA

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THIS 1345 BED COMPLEX 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 <It full salary
ON-GOING EDUCATION - Provided through
active in-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 holidays 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, rehabilitation, and paediatrics.

ENQUIRIES WELCOME
FOR FURTHER INFORMATION PLEASE WRITE TO:
PERSONNEL DEPARTMENT. NURSING SECTION
HEALTH SCIENCES CENTRE,
700 WilLIAM AVENUE, WINNIPEG, MANITOBA R3E OZ3

58 THE CANADIAN NURSE

MAY 1974

Assistant
Nursing Director:
$213.00 - $249.50 per week

With the MjNISTRY OF HEALTH s Kingston Psychiatric Hospital, you
will assist the Director of Nursing in the provision of psychiatric
nursing services at this 730-bed accredited hospital.
Qualifications: registered nurse, with psychiatric nursing training;
B.Sc.N. degree or equivalent: preferably a master's degree in
nursing administration; several years psychiatric nursing and
supervisory experience required.

Qualified applicants are invited to forward a resume of training,
experience and references to: Personnel Officer, Kingston Psychia-
tric Hospital, Box 603, Kingston, Ontario, K7L 4X3.

This position is open equally to men and women.

Ontario

Ontario
Public Service

PROVINCE OF MANITOBA
DEPARTMENT OF HEALTH
AND
SOCIAL DEVELOPMENT

Offers:

POST-GRADUATE
PSYCHIATRIC
NURSING COURSE

. Applicant must be a Registered Nurse
. Classes commence in September
. Nine-Month Course in Theory and Practice
. Uniforms and Laundry supplied
. Financial assistance may be arranged
. Residence accommodation may be available
. Limited Enrollment

For further information write to:
DIRECTOR OF NURSING EDUCATION
MENTAL HEALTH CENTER
BOX 420
BRANDON. MANITOBA R7 A 5Z5

MAY 1974

Join our team at
Sunnybrook
Medical Centre-
and grow!

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· University Teachmg 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

t
t

THE CANADIAN NURSE 59
.

THE RELIGIOUS
HOSPIT ALLERS
OF SAINT JOSEPH

TRAIL REGIONAL HOSPITAL

a 238-bed Regional Referral Hospital, located in the West Kootenay
area of British Columbia, invites applications for the position of

NURSE CLINICIAN

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

(Clinical Specialist)
for the area of medical surgical nursing

QUALIFICATIONS:
. Registrability in British Columbia
. Preparation at University Level
. Demonstrable Clinical Expertise
. Teaching skills
. Ability to develop interpersonal relationships

R.S.V.P. FORMATION CENTER
438% College St.
Burlington, Vermont
05401

Salary: Minimum $1070.00
All salaffes presently under review for 1974

FORMATION CENTER
4 Toronto Street,
Ottawa, Ontario.
K1 S ON2

Apply to:
DIRECTOR OF NURSING
TRAIL REGIONAL HOSPITAL
TRAIL, B.C.

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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

60 THE CANADIAN NURSE

MAY 1974

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[andsSt.Thomds'.ltisoneof[hefines[ ALL
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hind Q Q
oq
IOday's St. Thomas' IS a nur
mg [rddillon [hd[ goes bad.
eight centuries.
y"U could join u, at SI. Thoma,' - a, .1 member ,'1'.1
highl).' qualitied tedm \H>rl,.mg \\ ith. some '.'1' the Idte
t and
RlO,t
ophi
tieated fdcilitic, and eqUipmen
m u,e an)\\here.
And v.e would gl\C }OU the ehancc to
peelah,e m .In} "I' [he
follo\\ingdrcas:
Inten
i\e therap} - general surger} eardio Ihora.:ie
,urgcry - rcnal didl)", - orthoPdcdie
paediall ie,
ophthalmolog} dermd[olog) p"c.hla[r} - [hea[re
.:ardidc in\e
lIga[ion g} naccology aeclden[ & em.e,!;en
y
geridtrics and ps\cho-geria[ric, - mid\\lfel} mk":llou,
di..eases - general medicine.
A word of warning - our standard, arc high, a, }OU
v.ould expect [hem to be in a hospi[dl v.hose nUßing
ehool
v.a, foundcd by Florence Nightingale. To be .1 nurse at

MAY 1974

St. Th,'ma,' },'U need a good gencral educdllon dn
full.
nUhing quahtication, in order [0 gain reciproc,JI regl
trallon
\\ilh [he Gcncrdl Nur
ingCouncil.
But if v.e .1,1,. a 101, \\C dlsl' gi\c a lo[ - sccurity - the
v.ee"- holida} a )edr accommodalion thd"
just a step
f",'m the heart of London.
I I' \ ou are intere
ted in a nursing Cdrcer at St. Thomd"
please \\ r'ïte gi\ ing details of qualifica[ions and experiencc to:
'I.1is
Ndtalie P. Tiddy, Nursing St Th '
Officer, Depar[men[ofNursing, . omas

;r

' Hospital, London, Hospital

THE CANADIAN NURSE 61

NURSING EDUCATION
CO-ORDINATOR

For community orientated General Hospi-
tal with expanding programmes. Approxi-
mately 300 nursing personnel.

Duties will include: planning. directing,
implementing and evaluating educational
programmes for all levels of nursing per-
sonnel focusing on the patient as a person,
a member of the family and the commu-
nity.

Salary and Fringe Benefits commensu-
rate.

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

REGISTERED
NURSES

positions available immediately in a 500
bed active Hospital far the following
departments:

Medical/Surgical
Obstetri cs/Gy necology
Psychiatry

Excellent fringe benefits

Apply to:

Director of Nursing Services,
The Metropolitan General
Hospital,
1995 Lens Avenue,
WINDSOR,
Ontario N8W 1L9

62 THE CANADIAN NURSE

THE NORTHWESTERN
GENERAL HOSPITAL

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Fully accredited
Progressive 250-bed hospital
Expansion in progress
20 minutes to downtown Toronto
YOUR PROFESSIONAL GROWTH -
Planned orientation programme
Continuing Inservice Education
BENEFITS INCLUDE -
3 weeks vacation
9 statutory holidays
Cumulative sick leave
Group Life Insurance
Hospitalization
DIFFERENTIAL PAID FOR -
Post Graduates studies
Shift
Past Experience
IMMEDIATE OPENINGS FOR REGISTERED NURSES IN ALL AREAS AND
FOR EXPERIENCED REGISTERED NURSES IN THE INTENSIVE CARE
UNITS AND OTHER SPECIALTY AREAS.

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For information contact: -

Director of Nursing
NORTHWESTERN GENERAL HOSPITAL
2175 Keele St., Toronto, Ontario M6M 3Z4

+

RESCUE BREATHING (MOUTH-TO-MOUTH)

+

THE CANADIAN RED CROSS SOCIETY

StlJrt immediately: The sooner you stlJrt. the greater the chlJnce of success

Open airway by lifting
neck with one hand
.nd tilting the h..d
back with the other
hand.

Pinch nostril. to
prevent air I.akag..
Maintain open airway
by keeping the neck
ele"ated.

Seal your mouth
tightly around the
"ictim'. mouth and
blow in. The victim',
chelt should rise.

Remove mouth.
Release no.tril..
LISten for air escaping
from lung.. Watch
for chelt to fall.

REPEAT LAST THREE STEPS TWELVE TO FIFTEEN TIMES PER MINUTE.
IF AIR PASSAGES ARE NOT OPEN. Check neck and head pOSItIons CLEAR mouth and
throat of foreign substances.
For mfants and children. cover entire mouth and nose with your mouth Use small puffs
of air about 20 times per mmute.
USE RESCUE BREATHING when persons have stopped breathmg as a result of: DROWNING,
CHOKING ELECTRIC SHOCK. HEART ATTACK. SUFFOCATION and GAS POISONING
Don -t give up. Send someone for B doctor. Continue until medicsl help
arrivfls or brflsthinq is restored.

MAY 1974

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REGISTERED
NURSES

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the Beach
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California

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Centinela Valley Community Hospital is a progressive acute care hospital located in a coastal
suburb of Los Angeles, within minutes of Southern California's best beaches and marine areas. We
are located at the center of Southern California's many diverse recreational, cultural, and educational
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Centinela Valley Community Hospital is an expanding hospital which has pioneered the single
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We offer all Nurses an individualized 3-week orientation program which is followed by an on-going
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sities in our area.

General starting salary guidelines are as follows:
R.N.'s- one year experience
R.N.'s- B.S. degree
R.N.'s- B.S. degree & one year's experience
A three dollar shift differential is paid for evening or night shift work.

$845/mo. USA
$S45/mo. USA
$S88/mo. USA

Write today for information regarding California Licensure and work visa requirements.

MICHAEL SERVAIS
DIRECTOR OF PERSONNEL
CENTINELA VALLEY COMMUNITY HOSPITAL
555 E. HARDY AVE.
INGLEWOOD, CA. 90301

An equal opportunity employer

MAY 197..

THE CANADIAN NURSE 63

DO YOU
WANT TO HELP
YOUR PROFESSION?

Then fill out and send in the form below

----------

REMITTANCE FORM
CANADIAN NURSES FOUNDA liON

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A contribution of $ payable to
the Canadian Nurses' Foundation is enclosed
and is to be applied as indicated below:

MEMBERSHIP (payable annually)

Nurse Member - Regular
Sustaining
Patron

$ 5.00
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BURSARIES $ .....
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.. in memory of

Name and address of person to be notified of
this gift .

REMITTER

(Print name in full)

Add ress

Position
Employer

N.B.: CONTRIBUTIONS TO CNF
ARE DEDUCTIBLE FOR INCOME TAX PURPOSES

64 THE CANADIAN NURSE

I nd ex
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May 1974

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wild land: a mental health resource

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Announcing...
The most useful nursing book you will ever own
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A unique, ready reference for safe, effective patient care

The extraordinary new Lippincott Manual puts vi rtually
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You will want this Manual with you always for Immediate answers to your Questions
on nursing assessment and treatment modalities .and for fast reference to
gUidelines - procedures - for patient care.
You will QUickly find the esse'ntlal climcal facts you reqUire to properly assess
patients and to develop and Implement logical nursing care plans for virtually any
situation. including objectives and priorities.
Throughout the Manual capsule guidelines to common nursing and medical
techmQues and procedures.. . preparatory, performance and follow.up.. enable
you to practice anticipatory nursing, by understanding what IS to be done.
why It IS done and expected patient reactIOns.

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Nursing alerts, set off In red-bordered boxes and interspersed throughout. focus
your attention instantly on critical procedural points
Nursing action with rationale IS presented in step-by.step, tabular form Thus
the Manual provides an effective tool for the evaluation of patient care.
Sections on pharmacology and therapeutic nutrition are Integrated throughout
Hundreds of line drawings and photographs explain, demonstrate and clarify
various facets of patient care
Whether you are a practitioner, a returning nurse in need of refresher informa-
tion, an Instructor. or a student this extraordinarily useful manual is for you!
And you can order your copy of the Lippincott Manual. for a limited time only.
at a special introductory price 01 $18.50.

1473 pages. Profusely illustrated Introductory Price: S18.50
Ready June 1974. (After Sept. 30. 1974' $21 50)

By LILLIAN S. BRUNNER, R.N.. M.S. DORIS S. SUDDARTH, R.N, M.S.N.
Bette B. Faries, R.N. MS, Kathleen A. Galligan, R N . M.S.N.
Donnajeanne B.Lavoie, R.N, MS.: AnneC. Schwalenstocker, R N.. M.S.N
With 3 contributors.

SERVING THE HEALTH PROFESSIONS IN CANADA SINCE 1897

----------------------------------------------

ippincott
Please rush my copy of The Lippincott Manual of Nursing Practice at the special introductory price of $18.50.
(After September 30, 1974: $21.50)

J. B. Lippincott Co. of Canada Ltd.
75 Horner Ave. Toronto, Ontario M8Z 4X7

o Please send me a copy and bill me for book and postage later. as I would like to
look over the Manual before deciding to buy 1 understand that I may return

without cost within 30 days if I am not satisfied
LJ Please send the book prepaid and save me the cost of postage I enclose my
check for $18 50 (I may still return It for a full refund within 30 days If I am not
fully satisfied)

Name
Position
Address
City
Province

Postal Code

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THE
ULINIU

TAADOIAAKS RfG us PAT On: a CANADA WADE IN USA

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SHOE
p k
Íl\,VJ\Wi,@

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-6. 7912 Bonhomme Ave. . St. Louis. Mo. 63105

2 THE CANADIAN NURSE

JUNE 1974

The
Canadian
Nurse

ð

A monthly journal lor the nurses of Canada published
in English and French editions bv the Canadian Nurses' Association

Volume 70, Number 6

June 1974

17 Nursing Where The People Are ........................ S. Grassett

20 Wild Land: A Mental Health Resource .................. D.L. Smith

23 Communicating With The Aphasic Patient ........... M.L. Stoicheff

28 Helping Hands ........ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . G. Zilm

31 Idea Exchange

I h.: \1':'" .:'pr,:".:d in th.: ùlllorial and \ariou, anlCk, arc thl"': of Ih.: atllhor, and
do nol n.:c.:"arih r.:pr.:,.:nl Ih.: pol ici.:, or \ ic", of th.: ( anadian '" ur,.:,' \"ocialion.

4 Letters 34 New products
7 News 37 Research Abstracts
15 In a Capsule 39 Books
32 Dates 45 A V Aids
33 Names 46 Accession List

Exe.:utive DireclOr: Helen K. \1ussallem _
Editor: Virginia A. Lindabur} _ Assistant
Editors: Li\-Ellen Lockeberg. Doroth} S.
Starr _ Editorial Assistant: Carol A. D"or-
kin _ Production Assistant: Elizabeth A.
Stanton _ Circulation :\1anaEer: Benl Dar-
ling _ Advertising Mdnager: Georgina. Clarke
_ Sub!oCription Rates: Cdnadd: one yedf,

6.00; two years, $11.00. Foreign: one yedr,
$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 dddress dS ",ell dS the new are necessdfY,
togethcr with regislration number in a pro-
vincial nurses' association, where applicdble.
Not responsible for journals lost in mail due
to errors in dddress.

:\lanuscript Information: "The Canadian
Nurse" welcomes unsolicited articles. All
manuscripts should be typed, double-sp
ced.
on one side of unruled paper h;a'[ing wide
margins. Mdnuscripts are accepted for review
for exclusive publication. The editor reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
diagrams (drawn in india ink on white paper)
are welcomed with such articles. The editor
is not committed to publish all articles sent,
nor to indicate defimte dales of publication.
Postage paid in cash at third class rate
MONTREAL P.Q. Permit No. 10,001.
50 The Drivc"'dY, Ottawa, Ontario, K:!P IE!

CCdnadian Nurses' Associalion 1974.

Editorial I

If an award were to be presented to
those nurses who have shown the
most enthusiasm and perseverence
over the past few years, it would
surely
o to the RNS in the Northwest
Territories. Overcoming obstacles of
distance and weather, these nurses
managed to form the Northwest Ter-
ritories Registered Nurses' Associa-
tion and to hold their founding meeting
this past April. (News, page 8.)
The idea of forming a nursing as-
sociation in the NWT goes back to
1956, when four nurses met in Yel-
lowknife to consider some of the
problems of organization. In 1970, the
Yellowknife Registered Nurses' As-
sociation was incorporated and its
members, along with other nurses in
the north, indicated their desire to form
an NWT nurses' association.
The interest shown by these nurses
in nursing affairs is exemplary. In
1972, twelve RNS from the NWT
traveled a total of 41,000 air miles to
attend the Canadian Nurses' Associa-
tion general mèeting in Edmonton.
While there, they told CNA members
their reasons for wanting an associa-
tion: to improve nursing care through
continuing education programs, to
protect the public, to help nurses keep
in touch with each other, and to give a
united voice to nurses in the north.
These nurses recognized the prob-
lems involved; they described them to
The Canadian Nurse: mail service in
some NWT communities may be as
infrequent as twice yearly, telephone
calls cost about twice as much as in
southern Canada and are similar to
party lines. and inclement weather
can change the best laid plans.
At NWTRNA'S founding meeting,
CNA's executive director, Dr. Helen K.
Mussallem, represented the national
nurses' association. Discussing the
meeting later she said, "The frontier
spirit of nursing is flourishing in the
Northwest Territories. These nurses
are providing primary care in the best
sense and are the prototy,pe of the
nurse in the expanded role. '
Dr. Mussallem described the nurses
she met as "serious, committed, and
goal-oriented" in their efforts to prom-
ote nursing service in the north. She
said she found it refreshing to meet
nurses who are so anxious to have
their own association and to become
part of the national organization. "I
hope we will soon be able to welcome
the NWTRNA as the newest member of
the Canadian Nurses' Association."
We're already polishing our cham-
pagne glasses in anticipation of that
occasion. - VAL.
THE CANADIAN NURSE 3

JUNE 1974

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.

Physical care not enough
I had the recent experience of having a
relative in an ICU - not in Calgary. In
the past, I have worked in four different
ICUs; in each one, care and consideration
of the family were stressed.
Although my grandmother was 83, she
had been active, self-sufficient, and in
fairly good health. Therefore, when she
suddenly suffered a massive coronary, it
was a great shock to our family. She Ii ved
for 18 hours and most of us saw her alive,
but it was difficult to be allowed to visit.
Some of the nurses were extremely
annoyed, and I felt that I should apologize
for having such a large family. One
family member was scolded for "crying
so loud and disturbing other patients."
I am sure my grandmother received the
best possible physical care. I do feel.
however. that since there was little hope,
she should have been in a room alone and
the family with her. Perhaps the hospital
setup did not allow for this at the time,
but an explanation would have been
accepted. - Pamela 1. Kantor, RN,
Calgary, Alberta.

Women expand self-help program
Since I wrote the article, "A self-help
clinic for women" (May 1974>. a series
of classes has been started at the Pine
Grove Correctional Institute for women in
Prince Albert. Saskatchewan.
These classes were organized mainly
by Eleanor Fraser, who knew some of the
staff at the Institute and is the coordinator
of the Women's Centre in Saskatoon.
Before the classes were organized, we
had both discussed the program with the
staff at Pine Grove. We believed there
was a need for a program, as most of the
inmates are young Métis women, who are
socially underprivileged, have low self-
esteem, and have little access to informa-
tion.
Most of the women are serving short
sentences (30 days on the average), which
means there is a lack of continuity for the
classes. Two classes are held every week,
on Tuesday afternoon and Wednesday
morning. The nunber of women in the
class each week has ranged from 4 to 15.
Two members of the Prince Alhert native
women's organization have also been
participating in these classes.
The classes are taught by Ms. Fraser,
who was involved in the self-help clinic
project last summer. and hy Sally Ann
4 THE CANADIAN NURSE

Williams. who is executive officer for the
Saskatchewan Family Planning Associa-
tion. Every Tuesday, they travel to Prince
Albert to teach the inmates at Pine Grove
in the morning and the staff in the
afternoon. On Wednesday afternoons,
they teach 8 to 10 women from the native
women's organization. We hope to start a
course soon for native women in Saska-
toon.
Subject material for the classes in-
cludes body structure and function; con-
traception; vaginal infections and cystitis,
with emphasis on preventive care; preg-
nancy; and sexuality. The approach is
flexible, and opportunity is given for
discussion. - Audrey C. Hall. Saska-
toon, Saskatchewan.

Nurse registers protest
I am writing to register a strong protest to
the segment of Moyra Allen's article
(February 1974) that states: "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 discriminating and will be
called up by the Human Rights Commis-
sion. "
I am aware that this article is comprised
of 22 replies from nurses across Canada
and that problems reported were seen by
them as ethical ones. I do not believe that
research carried out in this manner can be
valid, as the project deal!. with the
personal opinions of a select few. I also
believe that the question of ethics should
be thoroughly researched before the re-
sults of such a project are published.
The nurse who was responsible for the
above quote should be informed that the
Human Rights Commission is for all
human beings, whether they are black,
white, or any other color. If the nurse
feels she has a moral obligation to report a
medication error made by another nurse,
she should report it regardless of the
consequences. Both she and the author,
who took responsibility for the content of
this article, should read the Human Rights
Code. Copies of it are available free of
charge.
In conclusion, the ethical issue of
whether or not to report the incompetency
of a nurse in giving safe care to patients
does not arise. The nurse must be reported
to the proper authorities to safeguard
patients.

Making unfound statements and print-
ing them in your magazine as fact detracts
from the heretofore fine quality of The
Canadian Nurse. - Lynsia Hylton,
Reg.N., Mississauga, Ontario.

Readers are referred to the editorial
"Note" that appeared on page 4 of the
May /974 issue of The Canadian Nurse
-Ed.

Article is "right on!"
I would like to say that the article' 'Poor
baby: the nurse and feminism" (March
1974) is right on! As you will probably
get a torrent of criticism, I feel compelled
to write that I appreciated this article.
The author hit the nail on the head,
howe\er gently. We must become more
aware. It is a slow process, but it is
necessary. r would like to see something
written in the future on sexism in both
nursing and medical textbooks. - Alice
Chen Wing. Terrace, British Columbia.

Women's lib is for everyone
Dorothy Starr's article "Poor baby: the
nurse and feminism" (March 1974) is
most welcome. Although some people
may dismiss it as "just women's lib
stuff," r believe that women's liberation
is also men's liberation. The so-called
feminine and masculine traits are part of
our human potential. Elimination of roles
assigned according to sex can result in
human liberation: women and men can be
free to function fully as persons.
Many times one still hears young
women say, 'Tm going to work for a few
years and then get married." That is their
life plan. These expectations limit
achievement of a woman's full potential,
and can place a heavy burden on her
husband and children by making them the
prime sources of her fulfillment. By not
developing a strong sense of self. absorb-
ing interests and inner resources, she may
find herself dissatisfied in middle and
later life.
I find it unsettling to note that in one
psychiatric day-care facility during a
three-month period, the ratio of women
patients to men is I 0: I (41 females to 4
males). The ratio of women patients has
consistently been higher than men. Many
of these women have huilt their lives
around and through children, husbands,
and homemaking; when their children are
JUNE 1974

grown. they have too few interests to
sustain them.
Human liberation might mean that
more men teach kindergarten. that the
doctor-nurse game is terminated. and that
health team members (of whom 80
percent are female) share equally in the
decision-making process. We might also
see both parents really sharing in child-
rearing. as well a
developing individual
interest<; and careers. \\ith perhaps each
taking turns being "housespouse" or
each \\orking part-time. The lives and
experiences of children and parents thus
could be enriched. If this seems impossi-
ble according to the present work-world
requirements. should we not ask our-
selves if people exist to perpetuate the
present structure of society. or should
society be restructured to provide for the
greatest benefit of its
members? - Gwen May, Winnipeg,
Manitoba.

During my first week. there were seven
deaths. My mind was not used to coping
with one death. let alone seven. I felt
guilty, as though the deaths were a direct
result of my care, but I learned that such a
large number was not uncommon. A
severely dehydrated child. who has
gastro-infection or kwashiorkor. has the
same chance of dying as living. Usually
these children are brought to us in a
moribund condition.
The predominant illnesses are diarrhea
and vomiting; general malnutrition: pel-

lagra and kwashiorkor; pulmonary infec-
tions; tuberculosis; fungus infections; and
osteomylitis. A common ailment is
wonns. which result in severe anemia.
Non-Peruvian members of the staff have a
lower hemoglobin than they nonnally
would have in their own countries,
because they so often give blood to their
anemic patients.
Snake bites are rare in the dry season.
but many are seen in the wet season.
When they are treated within the first 24
hours. snake bites result in almost no

Nurses have duty to unborn
I read with interest the article entitled
"Ethics of nursing practice" (February
1974). and noted with sympathy the
problems faced by nurses in dealing with
abortion procedures and the destruction of
the fetus.
I have been keenly interested in the
advancements made in fetology and
perinatology. With the dawn of prenatal
research. I am acutely aware that the
unborn child has become a patient.
I consider abortion an absolutely last
resource in treating a woman whose
health is seriously endangered. but I find
it is fast becoming a simple surgical
procedure to solve an unplanned preg-
nancy. There is total disregard for the
most defenseless patient.
Nurses are increasingly expected to be
mindless technicians who disregard the
advancement of medical research to cater
to the demands of unethical physicians. I
simply cannot adapt to this new ethic. -
Lorraine Wells. Reg. N., O

'en Sound,
Ontario.

Nursing in the jungle
In the summer of 1973, I accepted the
assignment of setting up a pediatric
department at Hospital Amazonico in
Pucallpa. Peru. This is a nonprotit.
nonreligious. and nonpolitical institution
with 100 beds, 30 of which are for
pediatric patients.
After one month of Spanish school in
Mexico. I arrived at the hospital with
eagerness and high ideals. Present-day
pediatric nursing in Pucallpa is a dream
come true for those who long for "good
old- fashioned" care. As I graduated in
1964 (from the Kitchener-Waterloo Hos-
pital. Ontario).it came as a shock to find
the children at the hospital in two small
rooms with wall-to-wall beds.
JUNE 1974

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THE CANADIAN NURSE 5
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(Continued from page 5)

disability. If untreated, however, they
often result in the amputation of an ann or
leg.
My staff consists of 10 Peruvian
auxiliaries, who were trained on the job. I
make rounds with the doctors, copy their
orders, make out the phannacy and store
orders, take all specimens to the labora-
tory, do any complicated procedures, and
do all the teaching. The auxiliaries are
excellent in starting IVs.
New problems arise every day: there is
no penicillin, no IV solution, no clean
laundry, or no electricity because the
horse ran off with the electric cable. Yet
there are some rewards. More children
get better and go home than if we were
not here.
Where else could I be in charge, do the
teaching, and also have a full hand in
direct nursing care? The 9 to 12 hours that
we work just are not enough to accom-
plish everything. - Irma Giese, Reg.
N., Hospital Amazonico, Pucallpa, Peru.

Thanks from a CNA director
On her way to the Ottawa airport
following the February IY74 meeting of
the directors of the Canadian Nurses'
Association, Jean Pipher was injured in
an automobile accident. Ms. Pipher,
president of the Saskatchewan Registered
Nurses' Association and a director of
CNA. sent The Canadian Nurse thefollow-
ing letter.
I wish to thank the president, directors
of the board, the executive director. staff
of CNA. and many nursing friends for the
encouraging messages, visits. and flow-
ers I received while in Riverside Hospital
following my accident in February.
Nurses, I know, are aware of the
components of recovery, but I was
overwhelmed with this particular de-
monstration of empathetic concern.
Special thanks are given to Jane Hen-
derson, who daily monitored my prog-
ress, applied the nursing process. im-
plemented the art of administration. and
was an understanding and supportive
friend. - Jean Pipher, SasJ...atoon, Sas-
katchewan.

Onto nurses move backwards?
I am writing with regard to the news item
"Ontario CAAT regents set nursing pro-
gram standards" (March 1974, page 12).
As it is my understanding that self-
government is one of the criteria for a
profession. I am upset about our situation
() THE CANADIAN NURSE

in Ontario. We are moving backwards.
The College of Nurses of Ontario was
responsible for setting the standards for
nursing education. Now the Council of
Regents of the colleges of applied arts and
technology will set the standards because
diploma nursing has been transferred to
the community colleges. If one believes
this reason. why didn't the Ontario
Hospital Association set the standards for
nursing education when there were only
hospital schools of nursing?
A provincial advisory committee on
nursing will be established. Big deal! The
council of regents can choose to ignore its
advice, as the council will have written
assurance that the graduates of the
community colleges will be eligible for
recognition by the College of Nurses of
Ontario.
In Ontario, the government giveth and
the government taketh away. Nursing
cannot afford to lose any element of
self-government. Should there not have
been a great stonn of protest over this?
Laura Barr, executive director of the
Registered Nurses' Association of Onta-
rio, has said that "RNAO will be the
watchdog for its members." One won-
ders. - Mary Pat Audcent. Nurse-
Teacher, Ottawa.

RNAO responds
The Ontario Nurses' Act and the pro-
posed Health Disciplines Act (introduced
in the Ontario legislature 2 April 1974)
give the College of Nurses of Ontario the
authority to set regulations for admission
to the register, which is the same kind of
self-government other health disciplines
in Ontario have. The role of the colleges
is to set standards for practice for the
members ofthe professions. -Laura Barr,
Executive Director, Registered Nurses'
Association of Ontario, Toronto.

Another "second-class nurse"
I agree with the letter "Second-class
nurse," written by Patricia M. Briggs of
London, Ontario (February 1974, page
4).
I am another second-class nurse. Ap-
parently working conditions and salaries
for nurses employed in nursing homes are
similar in Ontario and Saskatchewan. We
are expected to nurse, administrate. teach
staff on-the-job, and do all of this on a
ridiculously low budget.
It is next to impossible to persuade
nurses to work in nursing homes. Of
course. one reason is the low salary. I
think another reason is that schools of
nursing have neglected to teach geriatrics.
The young nurse thinks there is no
challenge in nursing the aged.
It is our duty to keep our aged patient
as active in mind and body as long as is
humanly possible. When it becomes

evident that his days on this earth are
nearing an end, it is our duty to make
those days as comfortable as possible,
and let him die in peace and dignity.
As nurses in homes for the aged, we
must develop a certain philosophy that is
geared to accepting the fact that our
patient is going to die. He, himself, has
accepted that fact and often needs a
sympathetic person to discuss his feelings
about death. His nurse should be that
person if his clergyman is unavailable.
There are so many ways we can help
our aged patients, but we are underpaid
and overworked. Governments at all
levels can produce money to support
sports projects, youth projects, and so on.
When it comes to financing adequate care
for the elderly, however, there is never
enough money. We are expected to give
necessary care on a slim budget and live
on less money than do other nurses. -
Ms. E. Sanders. Maidstone, Saskatch-
ewan.

N.W.T. nurses meet
The Inuvik Zone chapter of the Northwest
Territories Registered Nurses' Associa-
tion held its first meeting September 26,
1973. Since then, it has held regular
meetings once a month. The following
officers have been elected: president, Pat
Downey; vice-presidents, Ann Rodney
and Joy Coy; and secretary-treasurer,
Mary-Lane Peters. The committee chair-
men for nursing education are Pat Dow-
ney and Pat Nordstrom: the chairman for
nursing administration is Charlotte
Bowen. The steering committee is com-
posed of Ann Rodney, Barb Martin, and
Sister E. Coady.'
This chapter was formed so that we can
participate in the formation and estab-
lishment of an N . W . T. Registered
Nurses' Association. To do this. we have
corresponded with the Fort Smith chap-
ter. as well as with the Yellowknife
chapter. We intend to maintain contact
with nurses working in the Inuvik Zone
settlements. We sent two nurses from the
Inuvik Zone to the general meeting in
Yellowknife last April 26, 27. and 28;
one nurse was sent from the IOwn of
Inuvik and one nurse from a settlement.
Upon discussion of the registering of
nurses in the N.W.T., we unanimously
agreed with the steering committee of the
N. W. T. Registered Nurses' Association
that we should have our own registrar,
rather than be registered by the federal
govemment. We feel strongly that nurses
should have control over their own
profession and the members in the Ter-
ritories.
Through this newsletter, we hope to let
nurses in the south know about the state
of nursing in the Territories. - Louise
LaBerge, R.N., fIltH'i/... Zone ChapTer,
Northwest Territories Registered Nurses'
Association. Inuvik, N. W.T. '*'
JUNE 1974

news

A Few Who See The Exorcist
Need Mental Health Care

Ottawa - When The Exorcist - a film reputed to frighten and nauseate some of its
viewers - comes to town, what effects do community mental health facilities feel?
A partial survey of Ottawa hospitals, school and university health services, and
telephone crisis centers indicates that few individuals are upset to the point of
seekinJ:!: help after seeing the movie.

The film had been showing in an
Ottawa theater for 13 days when The
Canadian Nurse made the survey. Thea-
ter manager Kim Marlow estimated that
about 30,000 persons had bought tickets
to see The Exorcist, at $2.50 or $3.
during that period. It is a restricted film,
he explained; those who appear to be
under 18 years are requested to show
proof of age. "There is lots of time for
the ushers to go up and down the line and
check ID cards during the two hours that
patrons wait to be admitted to the next
showing," he said.
"After the first week, we had no more
'fainters' or people being sick," Mr.
Marlow said. "Word-of-mouth tells peo-
ple what to expect and those who
shouldn't see it, don't come."
Tim Hogan, psychologist at the Royal
Ottawa Hospital. a mental health facility,
said individuals go to The Exorcist or any
other scary film for two reasons: because
everyone else is going, or because of the
thrill factor. "They like to test the limits
of reality, " Dr. Hogan said.
For a few individuals, such reality-
testing may exceed the limits of their
tolerance. Pat Delbridge, executive direc-
tor of the Ottawa Distress Center, said the
telephone crisis service received some
calls concerning the film. "A couple of
our regular callers went to see The
Ewrcist and now it's worrying them,
adding to their usual burdens." Ms.
Delbridge said the Distress Center has
also received a few crisis calls from
movie-goers. In one of these, the caller
said the film reminded him of a previous
drug trip. Although the trip had been a
good one, the film made him relive it in a
bad way, which gave him difficulty in
handling daily life.
"The second crisis call was even more
frightening; an individual had been co-
ping well but the film provided a
flashback to a situation that had happened
a number of years ago. The caller began
to feel strongly that she couldn't manage
her present life situation.
JUNE 1974

"Both of these crisis calls came in the
middle of the night. One wonders how
many more of these situations there are in
the community, individuals who haven't
come to our attention yet. ,.
Ms. Delbridge sees two effects arising
from The Exorcist. "It may encourage
some people to seek help. It's fairly easy
to say: I've been to see a film and it
frightened me. Without such a 'coat
hanger' the individual may not start the
process of seeking help. So that effect
may be a good one.
"But the film has a bad effect if
individuals feel threatened and unable to
cope, when previously they were living
relatively stable lives," Ms. Delbridge
said.

(Continued on page /2)

Federal Health Proposals Unveiled
At RNAO Annual Meeting
Toronto, Onto - Does further massive
investment in acute health care achieve
the goal of increasing disability-free life?
Not according to The Honourable Marc
Lalonde, minister of National Health and
Welfare, when he spoke to the 49th
annual convention of the Registered Nur-
ses' Association of Ontario on May 3.
Basing his address on the just-tabled
working document, A new perspective on
the health of Canadians, Mr. Lalonde
said that the three main problem areas that
now offer the greatest promise for impro-
ving health are human biology. the
environment. and individual life-style.
By calculating years of potential life
lost, the five gravest causes of death were
found to be: automobile accidents, coro-
nary artery disease, other accidents. res-
piratory disease (including lung cancer),
and suicide.
Mr. Lalonde reported that the principal
or underlying risk factors in these causes
of death were self-imposed. and warned
that unless these risks were reduced. little

progress could be made in reducing the
years of potential life lost.
The document indicates that male
mortality is a serious problem, he contin-
ued, in that men lose almost three times
as many years of potential life as women;
and in all five causes of death mentioned,
the difference between male and female
life-style is a dominant factor.
The health field concept, which views
health problems according to contribu-
tions made by human biology, environ-
ment, life-style, and health care organiza-
tion, points up the importance of develop-
ing programs to reduce the health hazard
for high-risk populations and thus raise
the level of the health of Canadians, as
opposed to focusing mainly on the parti-
cular illness episode of a particular
individual.
Mr. Lalonde told the gathering "your
profession is a moving force in so many
aspects of health that your support can
help us over the whole broad front on
which we hope to advance. ..
Of the 74 proposals contained in the
working paper, Mr. Lalonde touched on
seven of special significance to nursing.
For instance, Proposition 55 considers
"the support of home visit and other
programs for helping chronically ill and
aged people to stay in their communi-
ties," an area where leadership is already
provided by public health nurses.
Proposition 56 asks that consideration
be given to "the development and support
of professional training in gerontology
and geriatrics, including physicians, nur-
ses, and health support personnel." It is
predicted by demographers that the pro-
portion of aged in our population will
continue to increase from its present 8
percent.
According (0 Mr. Lalonde, the key
proposition for nursing may be number
59, which endorses and recommends the
continued extension of the role of the
nurse and nurse practitioner "in the care
of the mentally ill, in the care of the
chronically ill, in the provision of home
care, in family counseling on preventive
health measures both mental and physi-
cal, and the abatement of environmental
hazards and self-imposed risks."
When coupled with the steps now
underway for broadening the role of the
nurse in acute care, the opportunities for
an extended role constitute a real chal-
lenge to nurses. he added.
Mr. Lalonde stressed that the working
paper is intended for all in the health field
THE CANADIAN NURSE 7

news

and not only for the federal government.
It is a presentation of policies to be
developed over the next 10-15 years, and
health professionals are invited to make
their views known during the year ahead.
(The document, A new perspective on the
health of Canadians, is available free
from Infonnation Canada bookstores, or
by writing to Infonnation Canada, Ot-
tawa, KIAOS9.)

ONQ Identifies Serious Gaps
In CEGEP Nursing Education
Mo1ltreal, Quebec - In a brief submitted
to the Quebec minister of education's
advisory council, the Order of Nurses of
Quebec (ONQ) identified a number of
serious gaps in the nur!>ing education
programs of Quebec's community col-
leges (CEGEPS).
Although a scientific evaluation of the
nurses graduating from CEGEPs has not
yet been done, the ONQ stated that a lack
of clinical experience at the college level
could, in the long run, endanger the
quality of care. An inquiry made in
February and March 1974 into some 340
CEGEP graduates working in hospitals
revealed that 67 percent of them felt
inadequately prepared to function as
general staff nurses.
More than 80 percent of CEGEP gradu-
ates felt unprepared to work in intensive
care, the operating room, as a float nurse,
or as an assistant head nurse. However,
60 percent of the assistant head nurses in
the study sample were 1973 graduates.
The ONQ has asked the ministry of
education to revise immediately the plan-
ning for clinical experience and to im-
prove its quality, intensity, and conti-
nuity.
A second gap identified by the ONQ is a
lack of prepared teachers in nursing. Four
years after the integration of the tradi-
tional diploma nursing schools into the
college system, teachers have not reached
the master's degree level considered
necessary by ONQ. In 1973,57.6 percent
of them did not have a baccalaureate
de gree.
The ONQ recommended that the minis-
try of education, together with faculties of
nursing and education, organize prugrams
for teachers who do not have adequate
preparation.
The ONQ, in its brief, also recommend-
ed that:
. The ministry of education, together
with representatives of CEGEPs, the uni-
versities, and the Order itself, study and
propose routes to permit nursing students
to move from the community college to
8 THE CANADIAN NURSE

the university to continue their studies
with a minimum of recycling
. Infonnation sessions be organized for
guidance counselors to make them aware
of the two different routes for nursing
education. Seventy-eight percent of the
CEGEP nursing students questioned did
not know there were nursing courses at
both college and university level.
In reply to an ONQ questionnaire to the
heads of CEGEP nursing departments, 29
percent estimate they did not have suffi-
cient equipment to teach nursing care, 34
percent were dissatisfied with the number
of nursing books and periodicals in their
libraries, 60 percent said they lacked
classroom space, and 71 percent
complained of lacking audiovisual mate-
rial.
Integration into the community college
system has favored the general education
of the nursing student, the ONQ brief says,
but the intensity of the basic program
does not leave time for students to follow
optional courses according to their own
needs.
Of 548 nursing students questioned
about their participation in the student
association of the college, 40 percent said
they did not even know about the
existence of the organization. Of those
who knew about it, 85 percent had never
attended a meeting. Lack of time was the
most frequent reason given.

SRNA Establishes Service
To Help Immigrants Register
Regina, Sask. - The council of the
Saskatchewan Registered Nurses' Asso-
ciation (SRNA) has established a service to
assist non-Canadian nurses to prepare to
write the Canadian Nurses' Association
Testing Service (CNATS) examinations,
which are required for registration.
SRNA council set up an ad hoc commit-
tee to review registration procedures for

Nominations Of CNF Directors
According to the by-laws of the
Canadian Nurses' Foundation (CNF),
any CNF member in good standing may
make a nomination to the CNF board of
directors at the annual general meet-
ing. if the consent in writing of the
nominee has been obtained in ad-
vance.
The 1974 annual general meeting of
the CNF will be held on June 19 in
Winnipeg, during the 1974 annual
meeting of the Canadian Nurses' As-
sociation. (News, April 1974, p. II.)
Nominations should be submitted to
Margaret Nugent, chairman of the CNF
nominating committee, at the CNA
booth in the main foyer of the Man-
itoba Centennial Centre before 5 P.M.
on Monday, June 17, 1974.

immigrant nurses, because Saskatchewan
hospitals are conducting recruitment
camp
igns outside Canada in an attempt
to relIeve the current nursing shortage.
(News, May 1974, page 8.)
The ad hoc committee recommenc'ed
that a nurse from an educational program
outside Canada continue to be required to
write the CNATS examinations for registra-
tion, unless she had passed the National
League for Nursing exams in the United
States.
The service to help non-Canadian
nurses prepare to write the Canadian
registration exams will include providing
information on reference material and
resource persons and, on request, making
available reference materials relative to
the examinations.

Nurses In Northwest Territories
Form Professional Association
Yellowknife, NWT - The founding meet-
ing of the Northwest Territories Regis-
tered Nurses' Association (NWTRNA) was
held in Yellowknife on 26-28 April
1974. Sixty nurses attended the meeting;
weather conditions prevented nurses in
the eastern Arctic from reaching Yel-
lowknife.
The new association has 171 members
out of the 250 RNs in the NWT. The
NWTRNA has members in a territory that
extends from British Columbia to Labra-
dor. and from Fort Smith on the 60th
parallel to Grise Fiord on the 80th
parallel. Although about half of the
NWT'S population is made up of native
peoples, there are no Indian or Inuit
nurses in the NWTRNA.
Meeting on the top (14th) floor of
Yellowknife's only high rise, members of
the new association approved a resulution
that NWTRNA request membership in the
Canadian Nurses' Association when
amendment to the present nursing ordi-
nance regarding licensure and disciplin-
ing has been approved by the Northwest
Territories Council. At present, all RNs
practicing in the NWT must be registered
in other provinces. When the NWT starts
to issue nurses' licenses, the NWTRNA
will apply to join CNA.
In another resolution, the NWTRNA
requested advice and assistance from CNA
in obtaining funds to employ a full-time
executive director. The group also direc-
ted the NWTRNA to continue to make
representations to the Commissioner of
the NWT, requesting that the association
be delegated the responsibility for admi-
nistering the ordinance pertaining to
nurses, when it comes Into effect.
Members of the NWTRNA also expres-
sed concern, by resolution, to the CNA on
the lack of portable pension funds from
the provinces to the NWT.
The constitution and bylaws of the new
association, which were approved on
ICunrmued on page 10)
JUNE 1974

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thumb joint And, TRAVENOl Surgeon's Gloves are made
of a strong, but thin latex which provides
dependable durability and strength without sacrificing
all important sensitivity
CAUTION: After donning, remove powder by wiping
gloves thoroughly with a sterile wet sponge, sterile
wet towel. or other effective method

"The Problem Solver"

BAXTER LABORATORIES OF CANADA

DIVISION OF TRAVENOL LABORATORIES. INC
6405 Northam Drive Malton. Ontario L4V1J3

news

(Co1ltillued from page 8)

April 28, provide for a general meeting
every 2 years. Because of difficulties in
travel and communication. the constitu-
tion provides that a vice-president. secre-
tary. and treasurer or secretary-treasurer
will be appointed by the president from
members of her own chapter. The nurses
appointed will serve as members of the
executive committee and board of
'I\\'TR'IA but will have no voting privi-
leges.
Members at the meeting elected Leone
Trotter as president. Wilma Mackie.
vice-president. and John Hill, chainnan
of the standing committee un nursing
practice; these 3 nurses are from Yel-
10wknife.
Nurses elected to the nominating
committee are: Elaine Richinger and
Nancy Menagh. Yellowknife. and Top
Van Vliet. Coppennine.
The 14-member board of directors of
the NWTRNA will include. besides the
elected and appointed officers and the
standing committee chairman, a layman
appointed by the commissioner for the
NWT; representatives of chapters in Fort
Smith, Inuvik. and Yellowknife; and one
member elected to represent nursing
stations in the zones of Inuvik. Baffin.
Kecwatin. and MacKenzie.
Dr. Helen K. Mussallem, executive
director of CNA, represented the Canadian
Nurses' Association at the meeting and
spoke at the Saturday night banquet. The
banquet speech and a panel discussion on
counseling the alcoholic and his/her fa-
mily were videotaped to be sent to nurses
unable to attend the founding meeting.

N.B. Nurses Sign Contract
Giving 25lk Over 2 Years
Fredericton, N.B. - The New Bruns-
wick provincial collective bargaining
council has signed a contract. covering
about 2.500 public hospital nur
es. \\hich
provides salary increases of 25 percent
over 2 years. The contract runs from I
April 1974 to 31 March 1976.
The ,>tarting salary for a nurse was
$567 per month in 1973; it was raised 10
percent to $624 per month at the begin-
ning of the new contract. Salaries will go
up a further 8 percent on I January 1975
to $674. and by 7 percent on I October
1975 to $721 per month.
The nurses also gained 4 weeb'
vacation after 5 years' employment.
changed from 7 years; $3.50 standby pay;
and $1 shift differential. previously $.50,
for all nurses working the evening
and night shifts.
10 THE CANADIAN NURSE

Officers Of Newest Nurses' Association

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Officers of the Northwest Territories Registered Nurses' Association were elected at
the founding meeting held 26-28 April 1974. Seated left to rif!.ht: John Hill.
chairman of committee on nursing practice; Leone Trotter. president; and Wilma
Mackie. president-elect. Standing left to right are members of the nominating
committee: Top Van Vliet. Nancy Menagh. and Elaine Richinger.

Binding Award In B.C. Gives RNs
Base Rate Of $850 This Year
Vancouver, B.C. - Under a binding ar-
bitration award handed down in April
1974 by a government-appointed Indus-
trial Inquiry Commission, the 1974 base
rate for general duty registered nurses in
British Columbia is $850 a month.
This rate is retroactive to last January
I. The new contract provides for 6 steps;
a nurse at the 6th level will receive
$1.020. As of I January 1975. the base
rate will be $942.
The Registered Nurses' Association of
British Columbia. representing some
7.700 hospital-employed RN s. had asked
for a base rate of $915 this year becau
e
of a 58 percent increase for licensed
practical nurses. which gives them a base
rate of $855 a month in 1975 (News, May
1974. page 8). At the end of their last
contract, the wage base for RNs was
$675.
"We have looked at the [arbitration J
decision and it does go a long way toward
reestablishing the differential between
licensed practical nurse and registered
nurse pay
cales. but it needed to go
further," said Nora Paton. director of
personnel services for RNASe. "We are
disappointed the settlement did not fully
establish the percentage differential. ..
The RNs also received the following

benefits in their new 2-year contract:
. Payment by the employer for 7 working
days of educational leave. and in addi-
tion. professional meetings at the em-
ployer's discretion;
. One weekend off in every 4-week
period. averaged over a 12-week period;
. On 3 statutory holidays (Christmas.
New Year's Day. and Good Friday).
payment of time and a half instead of
straight time;
. A shift differential (for the evening or
night shift) increase from $ 1.20 to $1.50;
and
. A Northern differential increase from
$15 to $20 per month; two places were
added to the category considered for this
differential.

Ontario Community Colleges
Reaffirm Open-Door Policy
Torollto, Ollt. - The Ontario council of
regents for colleges of applied arts and
technology (CAAT,) has reminded college
admini!'.trators of the open-door policy for
admission to courses in the colleges. All
diploma nursing programs in Ontario
moved into community colleges in Sep-
tember 1973. (New,>. March 1973. page
14.)
Admission requirements for nursing
(Co1llillued 011 page 12)
JUNE 1974

NEW
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dermolan@

now containing IRGASAN@ an effective antimicrobial agent from ClBA-GEIGY.. The
inhibitory effects of the new DERMOLAN were compared with the original prod-
uct containing 0.24 0 /0 hexachlorophene.

Min. Inhibitory Concentration (ppm)
I DERMOlAN + Hexachlorophene DERMOlAN with IRGASAN
Staph aureus I 1 1
Salmonella typhimurium I 10 1
E. coli 10 1

New DERMOLAN was more eftective than the hexachlorophene formulation for
Salmonella typhimurium and E. coli, less effective for Pseudomonas and equally
eftective for Staph aureus.
DERMOLAN also contains cooling menthol, and allantoin which has been de-
scribed as a stimulant to growth of healthy tissue-all in a hypoallergenic lanolin base.
You will like its soothmg deodorant antiseptic qualities, and the comfort it gives
) our patients.

I 79. II

dermolan

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1 Gal.

.Descripll\ t:' informatIOn .wadable on request.

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news

(Continued from page 10)

I

programs in the colleges are now set by
the council of regents. (News. March
1974. page 12.) In its memorandum. the
CAAn regents state: '"It is no longer
pennissible to reject applications on the
basis of a minimum average in Grade 12
or lack of an academic standing beyond
the Ontario secondary school graduation
diploma [Grade 121."
Some Ontario diploma schools of nurs-
ing have. in the past. required Grade 13
standing; specified science subjects; or a
specified academic average in Grade 12.
. 'Our experience does not justify de-
manding Grade 13 as an admission
requirement. but we do need to examine
applicants' achievement in Grade 12'"
Donna Wells. director of the Seneca
College nursing program. Toronto. told
The Canadian Nurse.
One Toronto school of nursing tried an
open-door admission policy for 6 years.
For 5 years. it accepted the first Grade 12
graduates who applied. and for one year.
it used a lottery system to select applic-
ants.
This school recorded a 25 percent
attrition rate among students admitted
under the open-door policy: 20 percent of
the students who entered left before they
completed the program. because of
academic failure. Half of the remaining
students failed the registration examina-
tions on first writing; 4 out of 5 failing
students were successful on the second or
third writing. but 10 percent of the class
were unable to become registered.

Occupational Health Certificate
Program Opens In Alberta
Edmonton. A/ta. - Grant MacEwan
Community College will offer a postbasic
certificate program in occupational health
nursing, beginning September 1974.
The certificate program in occupational
health nursing has been designed to
provide registered nurses with the
knowledge and nursing skills necessary to
practice in industrial and work environ-
ments. At the completion of the program,
candidates will be eligible for a certificate
from the community college.
The program is 2 trimesters in length,
with a total of 31 credits. It combines
theory in nursing and liberal education
with clinical instruction and selected
clinical experience. Fully employed can-
didates can obtain the certificate by
part-time attendance at evening or late
afternoon classes; there is also provision
for full-time day attendance.
Candidates for the program must be
12 THE CANADIAN NURSE

registered nurses or eligible for registra-
tion in Alberta. Students are now being
enrolled for the September 1974 class.
Further information is available from
Jenniece Larsen. Chairman. Allied
Health Department, Grant MacEwan
Community College, Old Scona Campus,
10523 - 84 Avenue, Edmonton, Al-
berta.

Open Forum Smooths Way
For RNAO Resolutions
Toronto, Onto - An evening devoted to
open discussion of resolutions for consi-
deration at the May annual meeting of the
Registered Nurses' Association of Ontar-
io (RNAO), served to air differences and
to expedite the meeting itself. Nearly 400
of the 1372 registrants attended this
session.
The resolutions that were considered
and accepted by voting delegates showed
concern over income tax relief for the
chronically ill who need expensive pres-
cribed devices; standards of employment
for the nurse working in an expanded
role; the effect of the 12-hour working
day on patient and nurse. Several resolu-
tions dealt with the special concern of
RNAO members for the care of the aged
and for the education of nurses.
In commenting on the resolution deal-
ing with comprehensive registration
examinations for nurses, Jean Dalziel.
nursing practice standards consultant of
the College of Nurses of Ontario. told that
wheels are in motion to set comprehen-
sive examinations that would tend to test
greater knowledge, and judgment as well.

Hentsch Scholarship For Nurses
Available For Study, Research
Geneva, Switz.er/and - The Yvonne
Hentsch scholarship is offered to a nurse
taking an approved postbasic course or
working on a research project in nursing,
preferably in a country other than the
candidate's own. The scholarship is
worth approximately $5.500 in Canadian
funds (Swiss francs 18,(00). It will he
available for September 1975.
The Yvonne Hentsch Scholarship Fund
was set up by the League of Red Cross
Societies in 1973 to mark the contribution
made to nursing by Ms. Hentsch during
her 33 years' service at the League. A
special international selection committee.
under the nursing unit of the League. will
make the award.
Applicant,> are required to:
. hold a recognized nursing certificate
entitling them to practice nursing in their
own country;
. have the necessary general and profes-
sional educational qualifications required
by the educational authorities sponsoring
the selected study;
. show interest in the development of
Red Cross nursing services;

. submit evidence of having assumed
progressive responsibility in their nursing
experience:
. be sponsored by their national Red
Cross society; and
. submit official evidence of a good
knowledge - speaking. reading. and
writing - of the language in which the
study is to be undertaken.
Applications for the 1975-76 academic
year must be completed and returned to
the League not later than I January 1975.
Application forms and further details
can be obtained from: Nursing Unit.
League of Red Cross Societies. P.O. Box
276, 12] ] Geneva] 9. Switzerland.

ICN Receives Flag
On 75th Birthday
Geneva, Switz.er/and - Former presi-
dent of the International Council of
Nurses. Margrethe Kruse of Denmark,
presented a flag to the organization during
an official celebration of the ICN's 75th
anniversary .
The ICN flag is made of white silk. In
the center is a map of the world in blue
with a little red dot marking the fCN
headquarters in Geneva. Surrounding the
globe is a chain' of gold links that
symbolize the fCN member associations.
The chain is open at the top to indicate
there is room for more members. The
letters fCN are at the top and the date of
ICN's founding, 1899. at the bottom of the
central design.
The observances at (CN headquarters
marked the growth of Il N from its
beginnings in 1899 with 3 member
associations to the present 79 members.
In accepting the flag. (CN president
Dorothy Cornelius. United States. said
the growth of fCN over the past 75 years
has pointed up the natural desire on the
part of nurses world-wide for the transla-
tion of international beliefs into interna-
tional practice.
The 3M Company. which sponsors the
annual nursing fellowship (see Names,
page 33). presented (CN with a huge
birthday cake covered in white and blue
icing, with 75 candles.

ICont;,rued from page 7)

Dr. Hogan said he is "more concerned
with the social effects of a film like The
Exorcist than with the clini.:al effects.
The social impact can be divisive - lib-
eral vs. conservative. church-goer vs.
nonchurch-goer - and lead to social un-
rest.
"Social fabric can be stretched and
torn by those who denounce such a film
and those who react to the denunciations
with defiance."
Dr. Hogan said he would be more
concerned about the film if he were the
JUNE 1974

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The Human Touch In Critical Care Nursing

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I Ahout 200 nurses, representing 42 employing agencies in all
parts of Ontario. attended a 2-day \\>orkshop on critical care
nursing. presented by Toronto General Hospital's nursing
department in April 1974. The workshop concluded with a
panel featuring former patients and a relative, who sharcd \\> ith
the nurses their experiences in an intensive care setting.

Pictured It:fi tn right are the panelists: Helen Smith. staff
nurse in a general surgical unit: M)rna Geldart, who visited
frcquently her critically ill :-.ister: chair\\>oman Joy Van Loon,
psychiatric nursing care coordinator: Jud) Taylor. a patient:
Linda Darlow, a patient; and Gillian Bradbury, assistant head
nurse in the respiratory care unit at Toronto General.

pastor in a small community. than if he
\\>ere the only mental health professional
in town. "I might see years of religious
instruction swept aside by a return \0 the
old superstitions and beliefs. This film
says things that people want to helieve
about the devil and demons."
Three patients came to the emergency
department of the Royal Ottawa Hospital
to seek help after viewing the film. during
the period covered by the survey. A
woman with chronic mental illness was
helped by ventilating her mild emotional
upset to the emergency department staff.
Another woman who developed a strong
fear of being alone. was admitted to the
hospital. The third. a young girl who was
always timid, suffered increased fears
follo\\>ing the film.
One of the psychiatrists at the hospital
rcported an additional three patients as a
result of the tilm. All were depressed
women who suffered from nightmarð
and a fear of being alone.
Two othcr hospitals in the central part
of the city rcportcd thaI neither the
emergcncy dcpartment nor the psychiatric
outpatient facility had yet had patients as
a rcsult of thc film. A spokesman for a
multipurposc clinic \\>ith 24-hour tele-
phone service said no visits or calls had
resultcd from the tilm. Personnel in
health and counseling :-.ervices at the two
local univcrsities reported they had not
seen any studcnts with complaints linked
to The Exorcist.
The tilm opencd during the one-\\>cck
'pring vacation in primary and secondary
schook Reports varied from nurses in
,cveral high schools. One nursc, Shirley
IUNE 1974

Marks. said she had seen 10 students with
Ewrcist- related problems in the first 3
days after the high schools reopened. The
students, both boys and girls. ranged in
age from 14 to 18 and all complained of
an upset stomach on the day following
attendance at the movie. All but one. Ms.
Marks reported. were usually stable
young persons. "They were seen for only
one visit; some needed to lie do\\> n for
awhile, but none of them was sick enough
to be sent home," she said.
Nurses in three other high schools sdid
they had not seen any students whose
complaints were linked to :-.eeing the film.
Brian Topping. nursing supervisor in
the Ottawa Civic Hospital ps)'chiatry
unit. suggested that individuals might
ask, "what benetits can accrue to me
from seeing The Ewrcist?" or "",hat
does it offer me'?" in deciding ",hether or
not to see the film.

Roles Of RNAO, CNO, and ONA
Described By Their Presidents
Torollto, 01/t. - "1 feel like a 49-)'ear-
old mother with a child 10 years old and
one of 7 months" said Wendy Gerhardt.
president of the Registered Nurses' Asso-
ciation of Ontario (R,\;AÜ). at its annual
meeting on May 4. The "children"
referred to were the College of Nurses of
Ontario (('NO) and the Ontario Nurses'
Association (O'lAI.
Margaret Chartcrs. president of the
council of CNO, summarized the \\>ork of
the collegc as registration activities. in-
vcstigation of complaints. and discipline

of members. "Discipline," she said.
"must relate to the quality of nursing, and
the authority of the college is over only
those who are currently registered." She
stressed that discipline need not be wholly
negative. "We have strengthened our
position with registered nursing assistant..
and with lay representation:' she said.
"The ONA is the vehicle for bargaining
by and for nurses." stated Jean Lowery,
its president. This collective bargaining
body. bom October 13. 1973 (see News.
Jan. 1974, p. II). was given legal status
January 15. 1974. The constitution requi-
res that at least 35 percent of an associa-
tion belong to the R:'IJAO before it earns
membership in the ONA and already.
14,000 nurses representing 10 groups of
the more than 100 cxisting groups are
involved in the ONA. according to Ms.
Lowery. She assured the gathering that
R'\IAO wiII remain the spokesman for
nursmg.
Wendy Gerhardt thought of RNAO as
playing the role of "humanizer."
compri:-.ed as it is of people whose clients
reap the benefits. The association ean act
as a pressure group. she said. As an
innovator and predictor of educational
needs, the RNAü gives nurses opportuni-
ties for retreading, refitting, and refur-
bishing. "Because of our autonomy we
can be creative, and our influence is both
direct and indirect." Ms. Gerhardt
concl uded.
This final session of thc RNAO annual
meeting was presidcd over b) the
president-elect, Norma Marm.si. The vi-
deotaped proceedings will he made avail-
able for stud) groups.

THE CANADIAN NURSE 13

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MRS. R. F. JOHNSON
SUPERVISOR

CHARLENE HAYNES

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I STYU OESCJ1,TIOI l llUAL I IIETAL "CC'ò'L

UID I UTTERIIC I HICES"
. 110. COLO. fiNISH (Paasbc) COLOR ÞI'"'' 1 Litl' 1(...'...... 2 Lilies
I ALL METAL. . . Smooth, rounded 0 Does I BI k
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not B O:'a.
1 Pin 225 r] 1 Pin 3.00
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1- MEtAL FRAMED. . . Clð

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I 10' deSIRn; snow-white plaSIIC with 0 Silver frame oñly 0 Ok. Blue 02 Pins 3 75 02 Pins 4.95
1_ <òo sf" . . _ _led framp only (samenilmt>1 (ul'Jlllnamt>1
I MOLDED PLASTIC.. ._Ir ..1Ie,smart. r Ooes Ooes White 0 Black 01 Pin .95 1 Ù 1 Pin 1.55
510 pconomlcal. Will never discolOr. not not only 0 Ok Blue 02 Pins 1.65 02 Pms 2.60
I noath r Jnd :I ( rners and ec es apply ap 1)' lume nilmel (wme namel
* Please add 25. per order NAM. PIN QUANTITV DISCOUNTS.
I for 3 pins or less. 1(}'24 pinS, deduct 10% 25-99 pins, 15% 100 or more pins. 20 0 ""
--------------------------------______1

GENEROUS NEW GROUP DISCOUNTS on all
items shown. for group purchases. graduation gifts. favors. etc.
6.11 same items. deduct 10%i 12 Dr more. 20%.
See different schedule of discounts for Name Pins below.

Ta!'.red
AI etal
1'.,1.9

IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS!

hoo
e st
le you want, sh.own lelt. Print name (and 2nd bottom left. Attach extra sheet for additional pms.
line ,f desired) on dotted lines below. Check other info in NOTE SAVINGS ON 2 IDENTICAl PINS.. . . mare cODvtnient,
boxes on chart, clip this section and attach to coupon spire in case of loss.

PllftJC
lanl e
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Metal
Fral"'ed
No. 100

AIiWh te
p'as ç
I'D. 510

II pIn backs Wllh ..flly c.lch

NURSES PERSONALIZED
ANEROID SPHYG.
A superb instrument especially designed
for nurses by Reister Exacta. precision
craftsmen In W. Germany. Easy-Io.attach
Velcro. cuff, lightweight, compact, fits
into soft slm. leather zippered case
2%" x 4" I ]'I. Dial calibrated
to 320 mm.. 100year accuracy
guaranteed to ::!:3 mm. Serviced
by Reeves If ever required. Your
initials engraved on manometer
and gold stamped (In case FREE.
A wise Investment for a lifetime
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No. 106 Sphyg. . . . 37.95 ...
BLOOD PRESSURE SET
Excellent Quality Clayton Aneroid Sphyg. from
d Japan. Meets all U.S. Gov. specs. :!:3mm accuracy,
guaranteed 10 years. Ellolck and chrome manom.
e eter, cat to 300 mm. Velcrot' grey cuff, black
tubing, soft leath'erette zipper case. Clayton No.
414 Nurses Stethoscope and Scope Sack included
(see below rightJ. FREE gold Initials on case and
Scope Sack.
No. 41.10 B.P. Set. . . 29.955.1 complel.
Duree Sphyg. only No. 108. . . 22.95 wilh c....

CI\P AC ÞESSOP I S

._--
CAP TOTE keeps your caps cris
and clean
while stOred or carried. Flexible clear plastic. white

trim. zipper. carrying strap, hang loop. Stores ffal Also ,..---
for wiglets. curlers, etc. 8 1 /2" dia.. 6" high. ,
No. 333 Tole. . . 2.95 .a. Gold inil. 5O./Tote

WHITE CAP CLIPS lIold. caps
firmly In place! Hard-la-find white bobbie pms.
... ...-: enamel on fine sprinl steel. Eight 2" and eight
3" clips included in plas.tic snap box.
No. 529 Clips 75, per box: (min. 3 bOXIS)
MOLDED CAP TACS
Replace cap band instantly. Tiny plastic
tac, dainty caduceus. Choose Black or
Crystal w,th Gold Caduceus. The neater ,'. --.
way to fasten bands '.. - .
-, _
No. 200 - Sel of 6 Toc. . . . 1.25 per .et ,>--- "

RN1
METAL CAP TACS Pair of daInty I

I jewelrY-Quality Tacs with ørippers. holds cap
n f.õ'NJ . bands securely. Sculptured metal, gold finish,

I"W 1$ approx. W' wide. Choose RN. LPN, LVN, RN
Caduceus or Plain Caduceus. Gift boxed.

...
No. CT.l (Sp.cify Inilial.), No. CT-2IPI.in
Cad.) or No. CT.3 (RN Cad.) . . . 2.95 pro
SEL-FIX CAP BAND BlaCkvelvel
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band matenal. Self-adhesive. pre
ses on,
-.l . -
pulls off; no sewmg or pinning. Rt:usable
several times. Each band 20" long. pre-cut to
popular widths: If." (12 per plastic box) Y.z"
(8 per box)
" (6 per box) 1" (6 per bbx>.
Specify width under ITEM column on coupon. No. 63f.}.:8

.b

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OROER NO.

COLOR SIZE QUANT

ITEM

PRICE

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Use extra sheet for additional Items or orders.

INITIALS.. d.,ired, _ _ _
TO OROER NAME PINS, f,lI oul all informalion in box, top
right. clip out and attacn to this coupon.
) No COO's or billing to individuals
, Mass. residents add 3% S. T.

I I enclose $
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Send to .

Street

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Engraved

Free!
cope Sack
all Price

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Free Initials, tAlith v.our otAln
Littma!!
Nursescopef

Famous Littmann nurses' dia-
phragm stethoscope . . . a fine
precision instrument, with high
sensitivity for blood pressures.
apical pulse rate. Only 2 OlS.. fits
in pocket. Wit" gray vinyl anti. No. 2160 Nursescope incl.
collapse tubing, non.chilling epoxy Free Initials. . . 13.95 ea.
diaphragm. 28" overall. Non-rotat-
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piece beautifully styled 1M choice
of 5 jewel-like colors: Galdtone,
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-IMPORTANT: New "Medellion" styling includes tubing 1M colors to match
metal Darts. If desired. add $1. ea. to price above; add "M" to Order
No. 2160Mi In coupon. Duty free
LITTMANN COMBINATION STETHOSCDPE
Maximum sensitivity from this fme professional instrument. Con-
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fixed at correct angle. Internal spring. stainfess chest piece, I
"
diaphragm. IIf.t" bell. Removable non-chlll sleeve. Gray vinyl tubing.
Two initials engr. on chest piece.
No. 2100 Combo Stelh . . . 24.95 .a.

FREE INITIALS! Your initials en-
graved FREE on chest piece; lend
mdividual distinction and help pre.
vent loss.

SCOPE SACK See .pecial half.pricI
offer in Scope Sack box below.
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sity in Philadelphia teach the stutterer [0
speak in a literally new voice. After a
patient thoroughly understands the cause
of his stuttering, as described by this
theory, he practices deep abdominal
breathing. Instead of pursing his lips
together tightly, anticipating trouble be-
fore he says a word, the patient learns to
[Ouch his lips together softly and to !>peak
in a soft, easy tone. The softer voice
changes the basic position of the larynx,
and so short-circuits the stuttering
mechanism.
An important phase of the therdpy is
deconditioning or desensitizing. For ex-
ample, as many stuttereß are terrified of
the telephone, the patients are first en-
couraged to simply think about the
telephone while talking in their new
voice. Then they might practice their new
voice while looking at the phone. The
next step is touching the phone and,
finally, talking into it.

Schwartz says, "it is possible to establish
high levels of fluency in the average adult
..tutterer within two to three months, and
sometimes in less time with children."
According to Dr. Schwartz, a child
begins to stutter around the age of three or
four, when speech becomes more compli-
cated and the child attempts to use more
sophisticated sentence structures. The
stress of this attempt. or any other stress,
can trigger the child's predisposition to
stutter.
The stress causes the child unwittingly
to tighten his larnyx, and the stuttering
cycle begins. From then on the stutterer
anticipates trouble. unconsciously setting
up his larnyx in a tight posture. This
unnatural posture causes air pressure in
the voice box to build to an explosive
pitch, which in turn sets up a sequence of
events leading to the painful efforts to
talk.
The techniques used at Temple Univer-

Drug can cause lupus
Accordi ng to a rcport h) doctor
in the
department of radiolog) at the Uni\er-

it) of l'tah Medical Centcr in Salt
I ;the Cit). thc drug prncainamidc ha

IlK ,ilk erfed 01 Gll....ing lupu
er) th-
emalo'u
.
I n the Deo:m bel' I I. 19 - 3 i

ue of
11Ie Medical PO,\t. a ne\\s item about
the dOdor,' finding
nOled thaI l'nUl
patient... on procain;mide. \\11l1 appear-
L'd 10 ,ulïer from eonge'li\ e heart
failure. pneumonia. or pl7lmon;lr) em-
hl1li. \\ erL' po"ili\e \\ hen te
ted for lupu

en themalo
U
. \\ hen the drug \\ a'
\\fthdra\\n. ho\\e\er.lhe patienh-,ho\\-
ed rapid imprn\ ement and the ') mp-
tom' di
appeared.
IÎw doctor
' rL'port 01 the fÒur GI'e
hi
tories of procainamide-induced
lupu
appeared in I a
t ;\Jo\'emher\
i...,ue of UaclioloRY.
\\ hen the patiL'nt i
hno\\ n 10 be
tahing prncain;lmide. "Ihe comhin,ltion
of pain in the joint' and heart di,ea'e

or di
ea
e
affect ing the function of
organ
,hould alert Lthe radiolt1gi,t to
th
po
,ihilit) of drug-inducedLlupu

el) Ihemato
us." I he report ,tbo men-
tlon
Ihat "joint pain i
pre
ent in :-;5
percent of the reported ca
e
of thi,

) ndrome."
A
the actual ineidencc of thi

e-
riou
,idc erfect cau
cd h\ the drug
might c\ en he much higllCI
than indi':.
cated h) Ihe rclati\cI) f..:\\ ca
e.. report-
L'LI in thc medical literature. Ihc LJni-
\ el
it) of l'tah ph) ,ician,
a) that
a\\ arenL'

of thi
,\ ndromc h, radiolo-
gl
h could prev
nt unnee

ary or
h,vardou
treatment.

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Help for stutterers
A new treatment for stuttering holds the
promi!>e of a 90 percent success rate.
reported the February 1974 issue of
Today's Health. published by the Ameri-
can Medical Association.
"Our theory details for the fiN time
why people stutter," !>ays Dr. Martin F.
Schwartz, director of the Temple Univer-
sity Speech Research Laboratory. "We
now realize that !>tuttering is a c1as!>ic
psychosomatic illness, in which the stut-
terer has an organic or physical predispos-
ition to stutter. But now it seems more
like!) that the real heart of the problem i..
the larynx, the voice box. "
Using the new techniques, Dr.
JUNE 1974

"-
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L\

/

THE CANADIAN NURSE 15

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1874-1974

Nursing where the people are

It is time for nurses to leave the official buildings and go to patients where they
live and work, says the author, who is employed by the Victorian Order of
Nurses in Vancouver. Since 1972, she has been involved in a research project
that gives a great degree of independence to a visiting nurse attached to a group
family practice.

Stephany Grasset, R.N., B. Sc.

Irritation is the spur to creative problem-
solving. As a surgical nursing instructor
in a city hospital school of nursing, I was
frequently irritated by seeing the imper-
sonal way in which patients were cared
for. The patients and their families were
insufficiently prepared for hospital ad-
mission, treatment, and discharge.
Often I saw the patient come to a
specialty service, to be seen by a rapid
succession of strangers and subjected to
frightening laboratory and diagnostic pro-
cedures. The doctor who knew him best
- his general practitioner - was reduced
to a daily visitor. often as ignorant of the
proceedings as the patient himself.
Too frequently, the patient in the
hospital was seen as a diagnosis. Despite
efforts to take nursing histories, the
information the nurses communicated to
each other about the patient was in
medical terminology; nothing was known
about him as a person, or about hi!>
family. his home, or his community.
Rarely were the family members asked if

Ms. Gras
et. who was born in Sofia. Bulgaria.
has been a Mudent at the Sorbonne in Paris, at
Bellevue Ho
pital School of Nursing in New
York City. and at the Univer,ity of British
Columbia. She has worked and traveled exten-
sively in the United States. has worked .It the
American Hospital in Paris. and has been an
instructor in !>urgical nursing at SI. Paul's Hos-
pit.!l in Vancouver. She joined the Victorian
Order of Nurses in Vancouver in 1971.

JUNE 1974

they were prepared for his discharge, or if
they would rather have him home early.
with community nursing assistance.
Many times I saw the desperation of a
patient longing for discharge, which was
impossible because the necessary referral
to community resources was not made.
was incomplete. or was not approved by
the consultant. This was primarily be-
cause of a lack of communication be-
tween participating professionals.
I wondered how these services might
be integrated to promote the welfare of
the patient and his family. It occurred to
me that a visiting nurse working with the
patient's family practitioner could be the
logical solution.

Nurse joins family practice
I was fortunate to find a group family
practice in Vancouver. where I was
employed by the Victorian Order of
Nurses, interested in this idea. Funds
were obtained to implement it as a
research project. * I became the visiting
nurse attached to this busy. general
practice. which is located in a densely
populated, largely industrial area. Most
of the patients are working class. but
there are various socioeconomic groups.

*In 1972. a tederal health grant was given to
the Richmond-Vancouver branch of the Vic-
torian Order of Nurses for a study of nurse
attachment to a f.!mily practice group. Thi, is
.! thrce-year research projecl.
THE CANADIAN NURSE 17

All ages are represented, as well as
several races and cultures.
My emphasis is on the family unit,
rather than on the individual. A patient
may be acutely or chronically ill, waiting
for admission to hospital, or simply
elderly and in need of care.
I must do some work in the office. For
instance. some patients who have been
under psychiatric care in mental health
clinics are discharged to me; they book
appointments and see me regularly in the
office for continued counseling. One of
the general practitioners and I might
spend time with a family or an individual
who needs psychotherapy and counsel-
ing. Also. adolescent girls often request
that I do the pelvic examination. For this,
an appointment is made that allows plenty
of time for counseling.
Visiting is the key word, however. By
seeing the patient in his family surround-
ings, I can provide nursing services to
other members of the family, if neces-
sary. asse:-.:-. their needs for community
resources. and help maintain the health of
the whole family.
I visit patients from our practice who
are 65 years old or more, unwed mothers,
single parents, and welfare families -
whether or not they are ill. The elderly
patients are encouraged to come to the
office after my first visit if they can. as
they enjoy the outing. If their condition is
fairly stable, I see them on a monthly
basis.
If possible. I see people at home prior
to hospital admission, visit them in
hospital, and see them at home following
discharge. Surgical patients make office
appointments with me for dressing
changes and postoperative examination.

All resources are used
I provide whatever nursing services are
required for our patients and coordinate
community resources for both patient and
family. Community resources are not just
the recognized organizations and ser-
18 THE CANADIAN NURSE

vices, but may also be the patient's
neighbors. the corner store, the local
café, and nearest supermarket.
When Mr. MacNamara was discharged
from hospital after having cobalt treat-
ment for a lymphosarcoma, his condition
deteriorated almost immediately; soon he
was unable to walk without help and had
continuous pain. He had retired, but his
wife still worked in a nearby supermar-
ket.
This couple needed help to carry on. so
I contacted the caretaker of their apart-
ment. He intJOduced me to another
tenant, a widow, who was glad to lend a
hand. She quickly learned how to give
Mr. MacNamara nursing care. His wife
was delighted with this arrangement,
which forestalled financial difficulties
and gave her a new friend.
As the disease progressed, a decision
had to be made as to whether Mr.
MacNamara should be cared for in
hospital or at home. With the nursing
burden becoming heavier, his wife would
have to take time off work. I saw the
manager of the supennarket; he not only
reassured Ms. MacNamara that her job
would be kept for her, but he also offered
to help by lending equipment and supplies
from the store.
Thus, Mr. MacNamara was nursed by
his wife until his death. Neighbors and
co-workers from the supennarket also
helped. I was always available as a
teacher, counselor, and friend.

Time to make house calls
As I am able to spend more time in the
home than the busy doctors, problems
and worries that a patient may regard as
too trivial to report to them are confided
in me. Families phone the office with a
variety of problems. If a house call seems
desirable, I am able 10 visit within an hour
or so and can usually provide appropriate
advice or treatment, thus relieving anxi-
ety.
Children with upper respiratory infec-

tion are often examined in the home.
After giving a physical examination,
which includes examining the ears, nose,
throat, and chest, I may prescribe a
decongestant or an antibiotic, and counsel
the mother and family on the child's care.
Another house call is sometimes required,
or perhaps the patient is referred to his
practi tio!ler.
House calls are frequently required for
patients with a newly diagnosed illness.
Because I am available to monitor the
patient in his home and am in continual
communication with his family physi-
cian, a patient with congestive heart
failure can be treated at home. After I
examine the patient, I may increase or
decrease the medication and may decide
to make two or three house calls to
detennine the course of treatment. If a
patient I see on a house call requires an
emergency admission to hospital I send
him there directly.
Bronchitis, pneumonia, and pulmonary
edema are some conditions I frequently
diagnose. As I carry an assortment of
medications in my bag, treatment can
begin in the home. The family is always
counseled and taught about the patient's
condition. Needed care, follow-up medi-
cation, and treatment are discussed at
length. The patient and his family can call
me at any time if they have misunder-
stood or forgotten anything. Later the
same day, I discuss my diagnosis and
treatment regime with the patient's physi-
cIan.
Health teaching is always an integral
part of nursing. For instance, I have
shopped and prepared a meal for a
low-income family that had nutritional
habits beyond its income. My help paid
off, for the young mother frequently calls
me for further economi<:al and nutritional
recipes. She, in turn, shares her know-
ledge with her friends and neighbors.
A nursing house call can be more
comprehensive than one made by a
general practitioner. I have time 10 become
JUNE 1974

acquamted with the family, its life-style,
and if necessary, the neighbors and
businesses on the street. At times, this
can be important.

Howa home visit can help
Ray was a 60-year-old man living in
the back room of his rented junk shop.
His only family was Prince. a huge police
dog. Ray was not making a living and
was starving because his money was
spent on food for Prince. Too proud to
say anything to his doctor. he finally
collapsed. I sent Ray to the hospital in an
ambulance. and remained behind in his
cold, dingy room with the dog in a small
pen.
In a laundromat two doors down, I met
Jan, who looked after the machines. She
and her husband Mike helped me find a
place for Prince, locked Ray's shop, and
promised to keep an eye on things. Mike

and Jan became sufficiently involved to
visit Ray in hospital and visit him when
he was discharged.
After I saw Ray in hospital and learned
that he had no money for his rent and
nowhere else to go, I visited Bob, the
owner of a small café near the junk shop.
When Ray came home. the café owner
provided fuuù, collected money to get
Prince out of the pound. and fed the dog
with restaurant leftovers.
I then went to city hall to explain Ray's
financial situation. He was exempted
from paying his commercial licence,
although there was still the problem of
rent. Ray was informed that he had to
walk out of his junk shop before he could
qualify for social assistance - something
he would not do. But his neighbors
somehow collected enough money for
Ray's rent that month.
Now Ray is on Mincome** of $200 a

JUNE 1974

month and receives meals-on-wheels,
provided by the VON, five times a week.
In addition, Bob feeds Prince on scraps
from the café. Thus Ray has kept his
pride and his home, and the people on his
street have become his friends.

Conclusion
Nursing in the community is helping
people on their own home ground. After
all, people spend much more time at
home and at work than in the doctor's
office, hospital. or health center. It is
only sensible to practice preventive nurs-
ing, health teaching, and counseling
where the patients live. This means
assuming responsibility for integrating
available services to help restore patients
to the highest degree of physical and
emotional well-being possible for them.
Not only does the nurse "on the street"
know the community resources, but she
makes it her business to use the resources
of friends and neighbors. For example,
many of the patients who come to our
office are middle-aged. have little to do,
and are bored. By interesting them in
helping me do something that is useful in
the community, I have helped these
persons. As a result, many of their health
problems have disappeared.
Such community involvement not only
helps the patient and his family, but also
provides community members with the
opportunity to share in the care of those
needing help. This, in turn, leads to
satisfaction and growth in the participants
and promotes a strong feeling of com-
munity responsibility. What finer role is
there for the community nurse than this
work "on the street'?"

** Briti
h Columbi.l provincial gmcrnmcni
minimum income for per,on, 60 to fi4
}car.. of age.

THE CANADIAN NURSE 19

In The Politics of Experience. British
psychiatrist R.D. Laing says "if expe-
rience is denied, behavior becomes de-
structive. "* He also states that alienation
from our own experience is the usual or
"nonnal" condition of most individuals
in contemporary society. He and other
writers have suggested that the stresses
confronted and roles played by people in
their day-to-day lives account for much
physical and mental illness.
In some societies, both past and present,
means were available by which people
could legitimately drop out periodically to
come in contact with their own inner
experience, to assess and evaluate their
lives and values, or to slow the pace of
their lives in a way that enhanced their
physical and emotional health. In medie-
val societies. monasteries provided such a
refuge, as they do in some eastern
civilizations now. In the urban. industri-
alized society, sickness and hospitalization
are among the few means available to
provide a time-out. although human
beings may be subjected to greater stress
than at any other time in history. Laing
has experimented with the use of "blow
out centers," which provide individuals
with opportunities for rest and recreation.
The encounter group movement. the drug
culture (including adult dependence on

* R.D. Laing. The politics of e>.:perience,
Harmondswonh, Penguin. 1967. p. 24
20 THE CANADIAN NURSE

Wild land:

a mental health resource

The author suggest.. how wise management of the remaining wild lands may help
to promote mental health and enrich human existence, as the world becomes
more urban and technological.

Donna Lynn Smith, R.N., B.Se.

alcohol), sexual experimentation, and the
popularity of evangelical or charismatic
religious groups can be viewed as means
by which people attempt to widen or
deepen their human experience.
Historically. large numbers of people,
including many revered religious and
political leaders, have depended on pe-
riods of contact with nature or sojourns in
the wilderness as a means of "restoring
their souls. ., At a time when the physical
resources of the natural environment have
been catalogued and are in great demand
throughout the world. it is unfortunate
that the value of these areas as human and
health resources has not been empirically
established and is, therefore, difficult to
defend.

Indications of value
There are many indications that wild
land is a \-aluable health resource. Psy-
chiatric nurses working with acutely ill,
regressed patients have described periods

The author gmduated from the University of
Albena Hospital in 1967: she received a
B.Se. from the University of Albena in 1970
and a profe

ional diploma from the Faculty
of Education. U. of Albena. in 1973. She has
been a staff nurse and a nursing instructor, and
is presently Director of Nursing at Lethbridge
AuxIliary HospItal.
he has presented bnet

at two public hearings on land use in Albena.

of improvement and remission of symp-
toms when the patients were able to assist
in planting a garden. Introducing growing
plants to hospital units, where patients of
this sort are housed, has aroused interest,
bringing severely ill patients into contact
with reality. Chronic patients have been
remotivated through systems of reward
and punishment. These and other "natu-
ral" or lifelike situations can call forth a
response based on the perception of
outward reality, rather than on the inner
world that gives rise to the patient's
symptoms. The substitution of experien-
ces in a private, inner world for expe-
rience in the real world is not essentially
different from the substitution of vica-
rious or artificial experience for real
experience in the lives of "nonnal"
individuals.
Aberrant behavior can be observed in
animals subjected to unnaturally over-
crowded conditions or situations in which
their instinctual activities - food-
gathering. mating. and so on - are un-
necessary or impossible. Thi" has its
counterpart in parallels between the size
of our cities and their rates of crime.
delinquency, and alienation. If we look at
a typical urban environment, it is not
difficult to identify certain aspects of
human experience that are scarce. if not
totally absent. This phenomenon has
become a concern of educators, artists.
social scientists. and philosophers.
In a world where real experience is
JUNE 1974

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increasingly difficult to fInd and to
di!.tinguish from the artificial, the wilder-
ness offers a particular kind of real
experience that can help to meet some of
man'!. deepest needs. At the most elemen-
tary level. it can serve as a means for
measuring what is real or natural. Adapta-
tion to a new or changed physical
environment takes thousands of years
through the process of genetic mutation.
In the meantime. the physiological mech-
anisms of the human being still require
old-fashioned inputs, such as clean air.
water. and food that contains actual
nutritional value. The extent of pollution
in our citieo; can only be measured by
JUNE 1974

'it.

- ,

;;,""
r' ; .,.'.'....-:.4..
>"""
..... .. él..",ot'..""4;
:

..\-
.i':;'i
.
-.,..

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. :
. "'{ry-t.. .........
:i

.... ..

,.

."

,
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1
.,

compari!.on with uncontaminated mate-
rials; the psychological effects of constant
contact with man-made. nonliving mate-
rials observed through a !.moggy dtmos-
phere can only be discernable if it is
possible to observe human beings in
environments that are hiologically intact.
Just as the biological process of adapta-
tion may be crucial to man's physical
survival in the altered environment he
continues to create for him
elf. so diver-
sity in his environment nldY help to
strengthen mental adaptability. which has
always been a critical factor in human
survival. In naturally occurring ecosys-
tems. diversity i!> recognized as the basis

of stability; that is. the more diversity of
plant and animal life there is within a
particular system. the greater is the
adaptability of the system and, hence. its
ultimate stability. Human beings appear
to be engaged in an attempt to remove as
much diversity as possible from their
environment and experience. A glance at
the weekly television schedule will illus-
trate this point. but a more pertinent
example may be drawn from the practices
of urban development. which have led to
the minimization of certain important
J...inds of diver!>ity in cities.
A child who grows up in suburbia may
be denied the experience of any contact
with the inner city. members of racial or
ethnic minority groups. or with those
economically or educationally different
from himself. Tl]e existence of the el-
derly. the handicapped, and the mentally
ill are a part of his vicarious experience.
as are the facts of poverty and death.
Crisis centers and health agencies are
familiar with the problems of adaptation
that some of these realities present to
many member!> of society. Isolation from
such social and human realities can result
in the destructive behaviors of fear and
prejudIce. which often have their root!> in
the unknown.
The existence of wild land. even if it is
far from a city. can exert an influence on
the quality of life within a city in a
manner similar to an art gallery or skating
rink within the city limit!.. As a resource
available for use. as one of many choices
in the recreational supermarket. it can
increase the potential for diversity in
people's lives while providing them with
a good object lesson on the importance of
diversity. The exqUIsite complexity and
the strength and endurance that can be
observed in nature can provide man with
a measure that may help him to view his
social and technological accomplishments
in perspective.
The wilderne!.s can provide man with a
much needed source of hope. Rachel
Carson expressed this in her book The
Sense of Wonder:
.. fho!>e who dwell. as scientists or
laymen. among the beauties and mys-
teries of the earth are never alone or
weary of life. Whatever the vexation
or concerns of their personal lives.
THE CANADIAN NURSE 21

-41

"

their thoughts can find paths that lead
to inner contentment and renewed
excitement in living. Those who
contemplate the beauty of the earth
find reserves of strength that will
endure as long as life lasts.
"There is symbolic as well as
natural beauty in the migration of
birds, the ebb and flow of the tides, the
folded bud ready for the spring. There
is something infinitely healing in the
repeated refrains of nature - the as-
surance that dawn comes after night
and spring afterthe winter. "* *
All human beings require a source of
hope and periodic restoration. Those who
have more than the usual reasons for
despair and alienation - the elderly,
handicapped, mentally ill and retarded,
the delinquent, and the underprivileged
- are of particular concern to those
in health professions. Various types of
outdoor experience, ranging from that
available at lake cottage or church camp
facilities to work camp and survival
experiences, are offered to limited num-
bers of such people in our communities
and institutions. Evaluative studies are
needed to ensure the mainrenance of
existing programs and to provide justifi-
cation for funding and further experimen-
tation with therapeutic and preventive
programs.

Priorities for use
The potenrial of wild land as a mental
health resource can be destroyed by
development that damages the land. Until
recenrly, there has been an emphasis in
most parts of North America on the
exploration and extraction of nonrenew-
able resources, which has led in many
cases to devastation of the basic and
irreplacable resource, the land itself.
Surely, we are at a point when priorities
can be reassessed to define progress and
development in terms of human and
social evolution, rather than in the mate-
rial tenns appropriate to countries in the
process of achieving basic literacy and
industrialization. The quality of life pos-
sible, rather than the excess numbers of

* * Rachel Carson, The sense of wonder, New
York. Harper and Row. 1956, p. H8.
22 THE CANADIAN NURSt

goods available, should measure the vi-
sion and management ability of those in
government.
When developmenr of wild lands is
considered, material short-tenn gains
should be weighed not only against the
consequences of pennanently devastating
the land, but against losses resulting from
the devastation of human dignity as the
gap widens between the rich and the poor.
In some cases, social and economic
deprivation in an area can be traced to the
shortsighted development of a nonre-
newable resource. Predictions based
on the increasing volume of visits to
national parks indicate that, within a
few years, it may be necessary to
restrict visitors by requiring them to
make reservations in advance. Who
is the average visitor to an outdoor
recreation area or a national park? Can the
25 percent of our population whose
incomes fall belo\'i the poverty line afford
to exercise their rights to such areas at the
present time?
Individuals who have attended public
hearings on land use planning can corro-
borate that discussions take place largely
between skiers and birdwatchers, entre-
preneurs and conservationists. They may
also have noted that the elderly, the
mentally ill, the welfare recipient. the
native person, the handicapped, or their
advocates from the health professions are
conspicuously absent from such hearings.

Actions needed
Members of health professions could
make significant individual and collective
contributions to discussions on the use of
wild lands. Research projects, which
demonstrate and evaluate the effects of
contact with an intact natural environment
on the treatment and prevention of emo-
tional disorders in various institutional or
community settings, should be initiated
and supported. Multisensory programs of
outdoor education, based on respect for
the land, are needed. These must be more
comprehensive than many now in exis-
tence, which teach camping, survival.
and other skills that tend to emphasize
physical activity, sometimes at the ex-
pense of the environment. Such programs
should teach both children and adults
ways of living hannoniously with other

living things.
There should be an attempt to measure
whether contact with and greater under-
standing of living things can result in
increased respect for all forms of life and
improved human relationships. All too
often, health workers must deal with the
physical, emotional, and social conse-
quences of events that were undertaken
without due consideration of human
needs and health requirements.
Well-informed health professionals,
standing apart from the traditional vested
interests, can make a valuable contribu-
tion to discussions of land use at the
community and national level.

Bibliography
Car"on. Rachel. The sense of wonder. New
York. Harper and Row. 1956.
Ddsman. Raymond F. A d(fJ'erelll kind of
coumry. New York. Macmillan. 1968.
Dubos. René. A God within. Nev. York.
Scribner. 1972.
Halward, Ray E. Honicultural therapy.
COlllcback I :3:37-8. Winter 1973-74.
Jourdrd, Sydney M. Trampe/rem self. 2ed.
New York. Van Nostrand Reinhold. 1971.
Laing. R.D. The politics of nperiellce, alld,
Thc Bird of paradise. Harmond
wonh.
England. Penguin. 1967.
McHarg. Ian L DesiXII l1'ith lIature. Garden
City. N. Y.. Doubleday, 1971.
Murdoch. William W.. ed. Em'Íro1/1nem:
resources, pollutioll, ami society. Stam-
ford, Conn.. Sinduer Ass.. 1971.
Schweitzer. Alben, Out of 111\' life and
thought: all autohiography. Trdnslated by
C. T. Campion. New York, H. Holt & Co.,
1933
Toffler. Alvin. Future shock. New York.
Random. 1970. g

JUNE 1974

Communicating
with the
aphasic patient

Reduced ability to communicate cuts an individual off from many enjoyable
experiences and social contacts. Therefore, the communicative situations in
which a language-impaired individual participates should be as satisfying as
possible. This paper presents some ways in which two people, one of whom is
aphasic, can communicate more effectively with each other.

Margaret L. Stoicheff, Ph.D.

Aphasia means that, due to brain damage,
a person's ability to express himself in
speech or writing and to comprehend the
speech or written words of others is
impaired. The aphasic's impaired verbal
comprehension and/or verbal output will
sometimes be viewed incorrectly by
others as a symptom of mental illness or
lack of intelligence. The patient himself
often needs reassurance that he is not
demented or feebleminded. This reassur-
ance. or lack of it, will be communicated
by the words and attitudes of those around
him.
Although dysarthria or apraxia may
coexist with aphasia, they are not to be
confused with aphasia. Dysarthria is a
disorder of oral communication resulting
from slowness. weakness, or incoordina-
tion of the speech musculature due to
damage of the central or peripheral
nervous system. Apraxia of speech is an
articulation disorder resulting from im-
painnent of the ability to program muscu-
lar movements involved in speaking. in
the absence of slowness. weakness. or
incoordination of the speech musculature.
The symbolic system in the patient with
apraxia or dysarthria is intact.

Dr. Stoicheff. a speech pathologist. is
associate professor. division of speech
pathology. department of rehabilitation
medicine. University of Toronto.

JUNE 1974

Infonnation on factors that influence
the aphasic's communicative ability has
come from a number of sources: research
studies in the area of aphasia. clinical
observations of aphasic behavior. and
published accounts of recovered aphasics
(Ritchie 1960. Hodgins 1964. Buck
1968). Using this available knowledge,
articles (Flowers 1973) and pamphlets
(Taylor 1958. Boone 1965) have been
written on the language problems of
aphasics. These include specific sugges-
tions on how to aid the aphasic to
communicate more effectively.

Our questionnaire
Few attempts have been made to
investigate the aphasic's reactions to his
language disorder (Rolnick and Hoops
1969). To date. there have been no
published data on aphasics' reactions to
specific questions on factors that might
affect communication. Accordingly. we
devised a short questionnaire consisting
of 20 items requiring a "yes" or "no"
response. Ten questions were directed
toward factors that might influence speak-
ing behavior. The other ten focused on
factors generally held to affect com-
prehension.
Aphasic patients receiving therapy in
seven Toronto hospitab during the
months of August and September 1973
provided the data for this investigation.
The questionnaire wæ. presented in each
THE CANADIAN NURSE 23

instance by the speech pathologist work-
ing with the aphasic patient. General
statements on conditions favoring better
speech and comprehension were elicited
whenever possible prior to posing the
specific questions.
The 61 patients who responded to this
brief questionnaire ranged in age from 20
to 88, with a mean age of 58 years. There
were 28 females and 33 males in this
sample. Time since onset of aphasia
ranged from 3 weeks to 10 years.
The speech pathologists were asked to
evaluate each aphasic's comprehension of
this task. The evaluations of patients'
responses are given in TabLe 1. Although
some responses were of dubious validity,
no completed questionnaires were dis-
carded from the analysis on these
grounds.
On the basis of aphasia test results, the
speech pathologists rated the severity of
the auditory comprehension and speech
difficulty of each patient. These data are
presented in TabLe 2 for 60 of the 61
aphasics. It is obviou
from this table that
speaking ability was more impaired than
auditory comprehension. Or, the aphasics
In this study understood more than their
speech output would indicate. This find-
ing appears to be common among aphasic
populations studied. In extensive studies,
Schuell (1962) and Smith (1971) found
that auditory comprehension is the least
impaired language modality in the
aphasic.
TabLe 3 and TabLe 4 present the
responses of the 61 aphasics to each of the
20 questions. The column headed
"Other" covers lack of response, and
responses of "don't know" and "some-
times." The responses made by this
heterogeneous group of aphasics provide
guidelines for talking with the aphasic
individual.

Auditory Comprehension - Table 3
(a) EnvironmentaL or situationaL factors
The aphasics in this study indicated by
their responses to question I that they had
more difficulty in understanding someone
speaking if others were talking at the
same time. This means that auditory
comprehension would be maximized in
quiet surroundings, in surroundings free
of noise and competing verbal stimuli.
Some answers to the general question,
. 'When is it easiest to understand what
24 THE CANADIAN NURSE

TABLE 1
Clinician's Assessments of Aphasics' Responses to Questionnaires
Number
Understood what was requested and made adequate responses 26
Understood most of what was requested and managed to get 28
much of the material across
Unsure of patient's comprehension and responses 6
Definitely did not understand what was requested; attention ]
wandered, etc. -
Total aphasic subject
61
TABLE 2
Rating of Auditory Comprehension and Speech Impairment of Aphasics
Severity of Impairment Auditory Comprehension Speech
Minimal 23 IO
Mild 22 15
Moderate 12 27
Severe 3 8
TABLE 3
Auditory Comprehension of 61 Aphasics
Questions on Comprehension Responses
Yes No Other
.
I. Is it as easy to understand someone if there are
other people talking at the same time? 9 50 2
2. Do people speak clearly enough for you? 47 13 I
3. Do people speak too quickly for you? 26 31 4
4. Do people speak too slowly for you? 8 52 I
5. Do most people say too much at a time? 34 27 -
6. Does it help to understand if people repeat what
they've said? 43 13 5
7. Do you understand as well when you're tired? 14 44 3
8. Do you understand as well when you're upset? 17 40 4
9. Does it help if people face you when they're talking? 47 12 2
10. Does it help if people speak more loudly? 23 36 2
j
Ceneral questions:
( I) When is it ea!>iest to understand what other people say?
(2) Are some people easier to understand than others?

JUNE 1974

other people say?" were along these lines
also:
"When it's quiet""
"When just two people - quiet"
"With just one person, or small
group"
(b) Speaker's output
Responses of aphasics give some in-
sight into the kind of speech that is more
easily understood. The literature contains
numerous admonitions against speaking
excessively loudly to the aphasic indi-
vidual. Most of the aphasics (36) indi-
cated that it did not help if people spoke
more loudly (question 10). Responses
were also examined in terms of severity
of the auditory comprehension problem.
It was found that 73 percent of the
aphasics rated moderate-to-severely im-
paired were negative about people speak-
ing more loudly as compared with 56
percent of those less severely impaired.
One might infer that the greater number
of negative responses from the more
severely impaired aphasics is based on
their having had more frequent exposure
to excessively loud voices than aphasics
who are minimally or mildly impaired.
On the other hand, general comments,
such as "It's harder to understand quiet
voices" or "Some speak too quietly,"
indicate that a voice of normal loudnes"
should be used.
In her book, Schuell (1964) states:
.. Sometimes it is effective to increase the
loudness of an auditory signal until an
optimal level is found. In our experience
this level varies from patient to patient.
Most aphasic patients prefer speech at
ordinary conversational level, adjusted to
the size of the room and extraneous noise.
They do not want people to shout at
them."
The responses of the aphasics to
question 4 indicated that people do not
speak too slowly for the aphasic indi-
vidual. There is not as clear-cut a division
of responses to question 3 on whether
people speak too quickly - 26 affirma-
tives and 31 negatives. When these
responses were examined more closely,
bearing in mind the severity of the
auditory comprehension problem, it was
found that 80 percent of those with
moderate to severe impairment and 31
percent of those with minimal to mild
impairment felt that people spoke too
quickly for them.
JUNE 1974

Thus, one has to know something
about the severity of the auditory com-
prehensIon dithculty to respond most
appropriately in terms of rate of speech.
However, in slowing down one's speech,
it is important to preserve the normal
intonation and stress patterns that provide
nonverbal cues to meaning.
Most of the aphasics in this study (47)
felt that people around them spoke suffi-
ciently clearly. However, general com-
ments made by some aphasics to the
question: "Are some people easier to
understand?" point up that normal clarity
is important:
"Some people don't speak clearly
enough anyway"
"People who open their mouths prop-
erly"
.. Some people have a clearer voice
than others"
"People with an accent are harder"
In terms of quantity of speech, most
aphasics (34) indicated that people said
too much at a time. When responses were
examined by level of impairment, 80
percent of those with moderate to severe
and 49 percent of those with minimal to
mild impairment of auditory comprehen-
sion felt that most people said too much at
a time. Some general comments made
were:
"Long sentences are confusing"
"(Easier) when they're making short
sentences' .
"Some people are phony; they talk,
talk, talk; don't like them"
It would seem important, then, in
speaking with the aphasic not to "over-
talk" and to pause often enough to allow
the aphasic to process what is being said
and indicate whether or not he has
understood. With more severely impaired
patients, it would also be advisable to
keep sentences short.
Forty-seven of the .aphasics indicated
that it helped if people faced them when
talking. Those who have worked exten-
sively with such patients make use of this
observation and make certain that the
aphasic is watching them before giving
instructions. Usually, this is done by
calling the individual by name to attract
his attention.
The majority of the aphasic subjects
(43) felt that comprehension was aided by
repetition of the verbal stimulus. Schuell
(1964) reported that aphasics sometimes
require a second or third repetition to

comprehend. However, repeating a ques-
tion too soon may confuse and distract the
aphasic. It is important to wait longer
than one normally would to allow for the
slower processing (Sarno and Sarno
1969).
Other factors that maximize com-
prehension are related to the subject
matter. No specific questions to explore
this were included in this questionnaire.
However, for the general question
"When is it easiest to understand what
other people say?" aphasics did refer to
the content as being important. Following
are some comments:
"When I know what they're talking
about"
"About something I know"
"People that you're used to; they're on
the same wavelength"
"When it's just plain talk; get down to
my lever'
From these comments, it can be infer-
red that comprehension is aided by topics
that are familiar and of interest to the
aphasic. The use of more familiar words
is also important (Schuell 1964).
A factor one aphasic mentioned as
aiding comprehension was that of ges-
tures accompanying speech. When people
are uncomfortable in speaking situations,
they do not tend to use gestures as freely.
Facial movements and limb movements,
which are nonverbal, do add to the verbal
message and should not be reduced or
eliminated when speaking with aphasIcs.
(c) Aphasic's physical and psychological
stare

Other factors that affect auditory com-
prehension are related to fatigue and
emotional upset in the aphasic. Responses
to questions 7 and 8 clearly indicate that
the presence of either hinders auditory
comprehension. One aphasic described
the effects of fatigue by stating that it was
easiest to understand others "early in the
morning. . . after 9 o'clock my head
gets fuzzy,"
In a recent study, Marshall and King
(1973) demonstrated that fatigue pro-
duced by isokinetic exercise had an
adverse effect on the overall PICA
(aphasia test) scores of 16 aphasic adults.
From experimental findings. clinicians'
reports, and the aphasics' responses. it
may be concluded that auditory com-
prehension will be affected adversely by
fatigue or emotional upset.
THE CANADIAN NURSE 25

TABLE 4
Speaking Performance of 61 Aphasics
Questions on Speech Responses
Yes No Other
I. Do you feel that people listen to you? 39 16 6
2. Does it upset you when people pretend that 36
they understand you? 21 4
3. Do you like people to finish what you say? 37 22 2
4. Is it harder to speak in a group than to one person? 39 17 5
5. Do you speak as well when the other person is in
a hurry? 6 50 5
6. Do you speak as well when you're tired? 2 57 2
7. Do you speak as well when you're upset? 9 49 3
8. Is it harder to talk to someone when the radio
or 1V is on? 37 22 2
9. It is easier to speak on the telephone (T) or
face-to-face (F)? 12(T) 34(F) 15
10. Is it more difficult to talk to the doctor than to
other people? 15 43 3
General questions:
(I) When do you find it easiest to speak?
(2) Are some people easier to speak to than others? (Why?)

Speaking performance- Table 4
(a) Environmental or situational/actors
The context within which the speaking
is done influences performance according
to the aphasics in this questionnaire
study. To question 4, the majority of the
aphasics indicate that it is harder to speak
in a group than to one person. This
indicates that we should guard against
requiring the aphasic to communicate
with (large) groups of people.
Responses of 37 aphasics to question 8
indicate that it is more difficult to talk
when the radio or television is on. As in
the situation of speaking in a group, the
presence of noise interferes with the
concentration necessary to formulate ver-
bal responses. It is probably a good idea
to turn down the volume of nearby radios
or televisions before entering into a
conversation with an aphasic.
This might also be extended to a
practice of closing the door to shut out
noises of people passing in corridors, or
intercom and machine noises, if the
patient's responses indicate that this is
helpful. When counseling families of
aphasics. it is important to emphasize the
need for initial social contacts to be
within the home, where the size of the
26 THE CANADIAN NURSE

group and the noise level can be control-
led.
Another situation that seems to elicit a
majority response is that of speaking
more easily in the presence of the
individual (34) rather than on the tele-
phone (12). It is interesting that for a few
aphasics, the reverse is true. For them,
speaking on the telephone is easier,
possibly because distracting visual stimuli
are eliminated.
(b) Listener behavior
Most aphasics (50) indicated inability
to speak as well when the other person is
in a hurry. Subtle signs of impatience
conveyed in the tone of voice are picked
up as readily as the more obvious physical
movements or words. Aphasics' verbal
comments were:
"Puts me off (when person is in a
hurry)"
"Nervous people are harder"
"People have different personalities
and some won't take time to listen"
Research studies and clinical observa-
tion tell us that the aphasic typically takes
more time than the non-brain-damaged
adult to receive verbal material, integrate
it, and respond verbally. This means that
we must give him more time to respond.

The responses to question I indicated
that the majority of aphasics (39) felt that
people listened to them. When these
responses are considered in terms of
severity of the speaking problem. the
proportion who feel that others listen to
them decreases directly with the severity
of their problem: minimal to mild diffi-
culty. 80 percent; and moderate to severe
difficulty. 50 percent.
One patient with a mild problem, and
whose response falls into the "Other"
category, indicated that "good friends
listen, but acquaintances tire easily and
walk away." A moderately severe
aphasic felt that people did not listen to
her but that they would "when I recover
more. "
Under general comments, some
aphasics indicated that it was easier to
talk to some people:
"They listen to you"
"More understanding people who lis-
ten more easily to me are better for
me'"
"People who listen more than they
speak get you interested in talking"
Most of the aphasics (36) indicated
they did not like people to pretend they
understood them. One mildly impaired
aphasic, who stated that it did not bother
her when people pretended, qualified this
by adding that she refrained from speak-
ing under these circumstances. There
seems to be little value in pretending to
understand what the aphasic is saying, as
most of them realize it.
Surprisingly, many aphasics (37) indi-
cated they liked people to finish what they
said. One aphasic stated: "I can never
finish and, you know, it helps." Clinical
observation supports the view that
aphasics appreciate this assistance at
times, but it is doubtful that most patients
would tolerate it all the time.
Over one-third of the aphasics in this
sample stated they did not like to be
corrected in this way. Then, it would be
advisable to thus help the aphasic spar-
ingly and to be guided by his reaction to
this.
(c) Aphasic's physical and psychological
state

The aphasics (57) indicated over-
whelmingly that fatigue adversely af-
fected their speech. Approximately one-
third indicated that the morning was best
for speaking, linking this to feeling most
JUNE 1974

rested then. However, seven aphasics
stated that dfternoons and evenings.
.. after getting wanned up," were best.
Whefl the aphasic appears to be tired or
states that he is, it may not be the
appropriate time to engage him in lengthy
or demanding conversation.
Similarly, when the aphasic is upset he
does not speak as well, as shown by the
responses to question 7. One patient
stated that he spoke better "when I'm not
mad; unless I get the fonn in my mind, I
can't speak," Occasionally, however,
aphasics do report increased ability to
speak under conditions of emotion.
In question 10, the aphasics indicated
that doctors were not difficult to speak to.
Responses to the second general question
on which people are easier to speak to
indicated that family, friends, speech
pathologist, nurses, and doctors were
easiest. That is, knowing others well, or
feeling that they understand the problem,
makes the aphasic more comfortable in
communicative situations and enhances
perfonnance. General comments were:
"Easier to speak to people who know
my problem"
"You've known them for a long time,
feel more comfortable"
"People coming to the door, I clam
up"

Summary
. For the aphasics in this study, com-
prehension was less impaired than speak-
ing. Therefore, one might safely assume
that the aphasic's comprehension is better
than his speech would indicate. This
means that care must be exercised against
making comments in his presence that he
is not expected to hear.
. Aphasics indicated they understood and

poke more easily in quiet surroundings,
and to one person or small groups at a
time. Aphasics are less able to block out
other happenings in the environment and,
generally, experience more success when
talking face-to-face with an individual,
rather than on the telephone.
. Fatigue and emotional upset adver
ely
affected the aphasic's comprehension and
speaking, according to those in our study.
Thus, it is important to decrease com-
municative demands at times when the
patient appear
tired or up
et.
. Respon
es of the aphasics indicating
thdt the speech of others affected com-
prehension, point up the need for tho
e
JUNE 1974

around the aphasic to develop more
awareness of their own speech and, if
necessary, to modify its clarity, loudness
level, rate, and quantity. Repetition by
the speaker will often facilitate com-
prehension.
. Listener behaviors that adversely affect
the aphasic's speech behavior include
hurrying the aphasic and pretending to
understand him. The aphasic wants his
listener to be patient with his slower
responses and to make an attempt to
understand him.
. Comprehension and speech may be
facilitated by familiarity with the subject
matter and by feeling comfortable with
the person with whom the aphasic is
communicati ng.
. Although generalizations have been
made about communicating with aphasic
adults, it is important to consider indi-
vidual differences in level of impainnent,
personality, and so on. Although some
aphasics may appreciate having missing
words filled in for them, others may
object strongly to this assistance.
. The responses to this questionnaire
point up the need for those coming into
contact with the aphasic to be sensitive to
his language problems, to encourage him
in his struggle to communicate by listen-
ing to him, and by being honest with him
- in short, by treating him as an
individual and an adult.

Bibliography
Boone, Daniel R. Adult has aphasia. Dan-
vilIe, IlL. Inten.tate. 1965.
Buck, McKensie. Dysphasia: professional
guidance for family and patient. En-
glewood Cliffs. N.J.. Prentice-Hall. 1968.
Flowers, C.R, How to talk effectively to adult
aphasic patients. J. Minn. Speech Hearing
Ass. 12:1:26-32,1973.
Hodgins. Eric. Episode: report on the acci-
dent inside my skull. New York,
Atheneum. 1964.
Marshall. R.C. and King, P.S. Effects of
fatigue produced by isokinetic exercise on
the communicative ability of aphasic
adults. J. Speech Hearing Res.
16:2:222-230. Jun. 1973.
Ritchie, Douglas E. Stroke: a diary of
rec()very. London. Faber and Faber, 1960.
Rolnick, M. and Huops. H.R. Aphasia as seen
by the aphasic. J. Speech Hearing Vis.
34:48-53. Feb. 1969.
Sdrnu. John and Sarno, Mdrthd. Srroke: the
condition of the patient. New York.

McGraw-Hill. 1969.
SchueH. Hildred et al. Aphasia in adults.
New York. Harper & Row. 1964.
Smith, A. Objective indices of severity of
chronic aphasia in stroke patients. J.
Speech Hearing DÙ. 36: 167-207, May
197I.
Taylor. Martha L Understanding aphasia: a
guide for family and friends. New York,
Institute of Rehabilitation Medicine. lJni-
versity Medical Center, 1958. r{;l

THE CANADIAN NURSE 27
.

Helping hands

If you have red chapped hands, split cuticles, and broken nails, a four-week plan
is presented here to help you develop the kind of hands you will want to show
off. Both on duty and off, healthy hands are an essential part of good grooming
and good nursing habits.

(
".

Glennis Zilm

The most beautiful hands I have ever
seen, except those of models in fashion
magazine pictures, belonged to an oper-
ating room nurse. Her nails were not
particularly long, as . 'that would be
murder on gloves," but her hands were so
beautifully groomed and so expressively
graceful that they were usually noticed
and commented on.
On the other hand, if you will pardon
the pun, the most dreadful are often
nurses' hands. This is a sad comment
because nurses should be examples to
others of hand health and care.
Good hand care should be an essential
part of good nursing habits. Rough, red,
chapped hands, with split cuticles and
broken nails, are potential disease car-
riers, as well as being unsightly. Those
who neglect their hands are also less
likely to be careful about washing them.
After all. hand washing is an integral part
of nursing routine.
Achieving lovely hands is no off-hand
(excuse me again) matter. A nurse is as
exposed to causes of rough, damaged
hands as any proverbial washerwoman.
Lovely hands are largely a matter of
habit, however. Naturally, general good

\1
. Lilm has her B.Se-N. from the Uni-
versity of British Columbia and onCe taught
nursing fundamentals. More recently, she
was a newspaper reporter in Ottawa and is
now a freelance writer in the Vancouver area.

28 THE CANADIAN NURSE

health and a sound diet help. If you
practice the following few habits consis-
tently for four weeks. you can achieve
beautiful hands fairly easily. Once you
develop the habits, you can keep your
hands beautiful without undue effort.

Getting them into shape
If your hands are in bad condition and
you want a lovelier, more graceful image,
do something about it now. To begin, you
may have to do a little shopping, although
you may find all the essentials in a drawer
or medicine cabinet at home.
These are the basics for hospital nurses:
. Three small, unbreakable bottles of
inexpensive, unscented hand lotion.
A void the big economy size unless you
have first checked and are certain you
have small plastic containers for the
lotion. You can always buy the large size
and refill the small bottles later; now you
need the convenience.
. Three orangewood sticks.
. Three emery boards.
. One nail brush with fairly soft bristles.
Once you have these basics, keep one
orange stick, one board, and one small
bottle of lotion in your purse. The second
set of lotion, board, and stick should go in
the pocket of your nursing uniform or, if
you prefer, in your locker. Make sure
these items are in a handy, prominent
place, and not on the back of the shelf you
cannot see. The third set goes in your
bathroom or on your dressing table, in
JUNE 1974

"

.,

view if pu

ible. You can add a pair of
nail scissors to this set.
Two other useful items are a pair of
lined rubber gloves for dish washing and
cleaning routines at home, and a bottle of
one of the new collagen nail hardeners
that have come onto the market in the last
two years. I tried one of these hardeners
and it helped my soft. splitting nails. Now
I have nails all the same length.
If you have allergies, choose the nail
strengthener carefully because some of
them are strong.

Giving them emergency care
Begin your hand care routine by
thinking of your hand
as an emergency
case: they cannot be completely cured in
one treatment. but you can take a major

tep in beginning the cure.
Fir
t. simply wash your hands and nails
thoroughly in wann, soapy water for at
least five minutes. Dry your nails tho-
roughly, using a soft towel. and as you
dry. gently push back the cuticle at the
base and sides of the nail. The cuticle
should be fairly soft and slide back easily.
unless you have been neglecting your
hand care.
This time it may be necessary to push
the cuticle back gentlv with the blunt end
of the orange stick. Wrap a little absor-
bent cotton on the end of the stick.
Many manicurists recommend cutting
the cuticle, but your hands will stay
JUNE 1974

""

healthier and Jess prone to infection if you
can push it back without surgery. If you
have difficulty, just do the best you can.
Then repeat the whole step the next
evemng.
Every time you dry your hands, take an
extra 10 to 15 seconds and push back the
cuticle. By doing so. you are also more
likely to dry your hands well - and that
will benefit the skin.
Cuticle that extends onto the nail
usually sticks to the nail surface, tears,
and causes hangnails. The nail stays
healthier with the dried flaky cuticle
rubbed off its surface. Remember to do
thi
gently, however. for harsh digging at
the base of the nail damages the new,
softer growth.
Use the pointed end of the orange stick
to clean your nails. A wooden stick does
less damage than a metal file, which may
scratch the undersurface of the nail and
increase the tendency toward split or
layered nails.
Use the emery board to file nails into a
gently rounded shape. But do not file too
deeply into the nail corners; if you allow
these to grow out. the nails will be
stronger and will look longer. Fashion
pictures now show even the long-tipped
lovelies with blunted or squared-off nails.
Nails with these blunt shapes are less
likely to break than the oval or sharply-
pointed nails that used to be in fashion.
The fine side of the emery board will

allow you to complete the filing Job so
well that you can run your nail over a
nylon without snagging it. It is a good
idea to finish your nails that carefully, so
you will have fewer broken tips.
If you are going to try a nail hardener,
this is the time. Once it dries, finish your
hand-care evening by lathering on hand
lotion and acting like Lady MacBeth.
Work the lotion into the cuticle areas, as
well as into the skin, and continue
rubbing the lotion onto your wrists and
anns. You can always work off the excess
lotion by smoothing your elbows.

Keeping them in shape
That first evening's treatment need be
the longest you spend on your hands if
you then develop a few good habits. You
will need to allow at-out four weeks to get
new, lovely hands, for it will take that
long to grow healthier nails. You will also
have to use that time to make your new
habits second nature.
Put lotion on every time you think of it
this first week, but make a conscious
effort to be sure you do it at least six times

.
1

/

THE CANADIAN NURSE 29

\\

a day. For example. do it when you first
get up. on the way to work. during the
first part of your shift, at the lunch break,
during the second half of your shift, when
you take off your uniform and put the nail
care equipment into your next day's
uniform, on the way home, immediately
after doing dishes or hand laundry, and
just before you go to bed.
Whenever you wash your hands, push
the cuticle back. At least once a day use
the nail brush and work away any dead
skin or cuticle on the nail.
At the first sign of a snag (or as soon
as possible after), get out your emery
board and file down the snag. This takes
just seconds, but by doing it at once. you
can almost always prevent the nail from
tearing right across or breaking off.
If you take time to use the fine side of
the emery board every morning, or
evening, you can find rough spots on the
nail and file them away before they
become a snag. You should also use the
nail hardener as often as the directions
advise. usually before going to bed.
This first week is important in esta-
blishing the new habits, but it will also
make you conscious of your hands. After
this, the hardest part of the treatment is
30 THE CANADIAN NURSE

\
Ii"

\,
,

,..,

over. It is then fairly easy to find the
seconds to do your hand care at least four
times a day: morning and night, and twice
in between.
It takes several weeks for nails to
renew themselves completely and for
damaged nails to benefit from your new
routines. You should soon find, however,
that you have longer, stronger nails and
softer. healthier skin.

Professional hands
Model hands are one thing. profession-
al hands are another. Once you have the
habits that will help you grow longer,
harder nails, you will have to think about
a safe length for them.
Patients have a right to be in safe
hands. Long nails and most rings can
do damage, for example, while one is
slipping a drawsheet under an uncon-
cious patient. One hospital I know almost
had a lawsuit over such a scratch
from an engagement ring.
Rings harbor bacteria even when hands
are washed frequently. Now that long,
fine, gold necklaces are so popular, many
nurses wear their engagement or wedding
rings on these, tucked inside the uniform
while they are on duty.

Good reasons exisL too. for hospital
regulations asking staff not to wear
colored nail polish on duty. Patients often
do not approve and sometimes, such as
when they are coming out of anesthetic.
red nail polish makes them think of hands
dripping blood.
Colorle

nail polish. if you like it,
usually is acceptable. Nurses who take
the trouble to keep clear nail polish in
perfect condition usually have good
hand-care habits.

-.

Off-duty hands
The habits that protect your hands at
work pay dividends during off-duty
hours. Curing chapped hands may take a
few weeks. but once it is done, your
hands can show off even at impromptu
parties.
Once your nails are longer, you may
want to try wild colors; for one evening, a
one-coat application ma} suffice.
When it comes time to take it off. a
mild. oily remover should be used lib-
erally.
When you have lovely hands. use them
expressively. Practice some not-too-
obvious gestures in front of a mirror and
be sure to leave your hands out in the
open.
You may further want to play up your
off-duty hands by trying false fingernails
for special occasions. They are fun and.
once you are used to them, fairly easy to
handle. Buy false nails only after your
hands are in lovely shape; nothing looks
more phony than exotic nails on fishwife
hands.
Try inexpensive false nails once or
twice before you decide to wear them on a
special occasion. because they take some
getting used to. If you like them. how-
ever, it is worthwhile to invest in a good
set. which can be trimmed carefully to
your special shape. This set can be used
quickly whenever you want to have an
elegant look that seems as though the only
thing you ever do with your hands is
smooth an occasional fevered brow.

.,..

JUNE 1974

leading a child to drink

Nancie MacMillan

A special challenge in working with
children with gastroenteritis, who have
such an obvious need for fluids, is to
persuade them to drink. The following
idea usually works when "pushing
fluids. "
If the child is old enough, but refuses to
drink from a cup, use an ordinary plastic
medicine cup calibrated to 30 ccs. Show
the cup to the child and get the idea across
to him that this cup is his size, is just for
him and no one else; in other words, it's
his very own cup. The child will often be
happy with the idea of having his own cup
and so drink more willingly.
An added advantage is the obvious
one. As the cup is calibrated, the child's
intake can be accurately measured.
I have also found that the "forced
emesis" of a child who gets üp
et when
forced to drink occurs much less fre-
quently, and that saves my nursing time
and uniforms. g

Nancie MacMillan is on the "per diem" \taff
of The Ho
pital for Sick Children. Tomnto.

No shift supervisors

Frances Schrader

Two and one-half years ago, we decen-
tralized nursing responsibilities at
Trail Regional Hospital and deleted the
job category of nursing supervisor on
evening and night shift
. Trail Hospital is
a regional referral facility with 23R beds;
it i
in the West Kootenay area of British
Columhia. surrounded by mountains.
A budgetary cut forced us to consider
JUNE 1974

alternative proposals for reducing our
nursing budget, such as deleting staff
from the bedside or from a higher salaried
category. At the same time, the resigna-
tion of one of our supervisors gave us an
opportunity to consider decentralizing
nursing hierarchical responsibilities.
As a beginning. we appointed "float"
general duty nurses with experience and
expertise; at the present time. they do not
have formal university preparation. Be-
cause they are not supervisors, they are
expected to get right into the action in
whatever area of the hospital they are
needed.
Instead of relaying changes in patients'
conditions and requests for orders to the
physician via supervisors, the team lead-
ers themselves contact the medical staff.
Contrary to our expectations, doctors
seem to prefer direct communication with
the nurse caring for the patient and have
not indicated that they are being tele-
phoned unneces
arily.
Decentralization of authority from the
nursing office, allowing more autonomy
and, at the same time, expecting more
accountability from head nurses, has been
essential to the success of our plan. This
delegation of authority and responsibility
has been extended to evening and night
team leaders, eliminating the need for
administrative staff to be involved in
many .decisions. formerly regarded as
supervIsory.
To illustrate this: a nurse telephones the
team leader on her ward, saying she
cannot work because of illness. The team
leader, in conference with the other staff
on her team. decides whether it is
necessary to replace the nurse who is ill.
The team leader telephones her decision
to the person delegated to call in replace-
ment staff.
We believe the unit staff are beller able
to assess their needs than someone in a
supervisory position. We have found thdt
general duty nurses make fair assessments

idea
exchange

of the nursing care needs of their patients
and do not ask for a replacement if they
feel one is not needed. It has become
apparent that the nurses prefer making
these decisions themselves, rather than
having them imposed by someone in
authority whom they feel. rightly or
wrongly, doesn't ùnderstand their needs.
Nursing administration staff are avail-
able by telephone. should circumstances
arise requiring a decision beyond the level
of responsibility of the general duty
nurse. Such occasions have been few.
We have not yet convinced the hospital
administration that nurses should not be
responsible for performing duties in de-
partments that do not maintain staff on
shift and weekends. As a result, our
"float" nurses frequently dispense from
pharmacy or perform electrocardiograms.
We are convinced that the persons in
administration must take a serious look at
round-the-clock coverage for all para-
medical services, rather than continue
the "dumping syndrome" of expecting
nurses to provide continuity of service
on evenings. nights, and weekends.
We have not solved all our problems,
but we have maintained adequate num-
bers of nurse practitioners at the bedside
and have balanced our nursing budget
during the past two years. If we have
made gains. it has been done as a
group - indeed, a growing group cohe-
siveness is the largest gain of all.

France
Bo\\,lcn Schrader i
.J gradudte of
Hol} Cros
Hospit.J1 School of Nursing.
Calg.Jry. Albert.J. Alter t\\, 0 yeaß of gencral
duty nur
ing and a pcriod at the Univer\ity of
Alberta. Ms Schrader \\,.J\ the tiN clinical
in
tructor employed ny Mi
ericordid Ho\pital.
Edmonton. She h.J
held a v.Jridv of adminis-
tr.ttive po
ition\ and. lor thc p.J\t
I' YC.Jr\. ha

ncen Director of Nur
ing at Tr.til Regional
Ho\pildl. Trail. Bntish ('o\umbid.
THE CANADIAN NURSE 31

dates

June 16-21,1974
Canadian Nurses' As-
sociation annual
meeting and conven-
tion, to be held in the
Manitoba Centennial
Centre Concert Hall,
Winnipeg, Manitoba.

ð

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 1 XB.

June 18-21, 1974
Second in-residence, task-oriented work-
shop on "Evaluation of Student Nurse
Clinical Performance" for teachers in
schools of nursing. Professor Vivian Wood
will be the instructor. Tuition fee of $130
includes fees, accommodation, and meals.
For further information, write to: Summer
School and Extension Dept., U. of Western
Ontario, London, Ontario, N6A 3K7.

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-
tano.

lune 19-21,1974
Canadian Association of Neurological and
Neurosurgical Nurses, annual meeting,
Sheraton Cavalier Motor Hotel, Saska-
toon, Saskatchewan. For further informa-
tion, write to: Ms. D. Ortynsky, 1914 Cairns
Ave., Saskatoon. For membership infor-
mation, write to: Ms. J. Rapp, 112 Baseline
Rd., Apt 1010, London, Ontario.

June 28-30,1974
Reunion of Class of '69, McKellar General
Hospital, Thunder Bay, Ontario. For further
information, write to: Ms. Heather Short-
ridge, 905 McMillan, Winnipeg, Manitoba,
R3M OT2.
32 THE CANADIAN NURSE

June 28-30, 1974
Reunion of all Mack graduates, in conjunc-
tion with The Mack Schools of Nursing
centenrual celebrations. Events will include
a reunion dinner, Sheraton-Brock Hotel,
Niagara Falls, June 28; a garåen party,
June 29; and a church service at St. Geor-
ge's Anglican Church, June 30. For further
information, write to: Ms. Heather Short-
ridge, 905 McMillan, Winnipeg, Manitoba,
R3M OT2.

July 15 - August 9, 1974
Workshop on "Psychological Concepts of
Human Sexuality," Loyola of Montreal
Evening Division, Montreal. Fee: $100.
Write to: Ms. G. Lennox, Coordinator for
Health Education, Loyola of Montreal
Evening Division, 7270 Sherbrooke St.,
West, Montreal, Quebec, H4B 1 R6.

August 2-4,1974
Final graduation and grand reunion of all
graduates of the Royal Inland Hospital,
Kamloops, B.C. For further information,
write to: Ms. J. Cassell, Secretary, Alum-
nae Association, 1243 Dominion St., Kam-
loops, B.C., V2C 2YB.

August 24-30, 1974
One-week workshop on biostatistics, Uni-
versity of Ottawa, Ottawa. Attendance
limited to 24 applicants who fulfil the
following criteria: actively working on a
biomedical research project; have encoun-
tered conceptual and/or methodological
problems; possess basic knowledge of
statistics; satisfy a selection panel. Applic-
ants must complete an application form,
available from: J.M. Last, M.D., Professor
& Chairman, Dept. of Epidemiology, Royal
Ottawa Hospital, 1145 Carling Ave., Ot-
tawa, K1Z 7K4.

September-December 1974
Part-time, 16-week, postdiploma program
in maternal-infant nursing for registered
nurses, Humber College, Rexdale, Ontario.
For further information, contact: Office of
the Registrar, Humber College of Applied
Arts and Technology. P.O. Box 1900, Rex-
dale, Ontario, M9W 5L7.

September 18-21, 1974
Atlantic Provinces Psychiatric Association,
annual meeting, Holiday Inn, Halifax, N.S.
For further information, write to: Dr.
George Fraser, Secretary, APPA, Victoria
General Hospital, Halifax, Nova Scotia.

October 1-5, 1974
Canadian Psychiatric Association, annual
meeting, Ottawa, Ontario. For further in-
formation, write to: The Secretary, CPA,
225 Lisgar Street, Ste. 103, Ottawa, K2P
OC6.

October 7-9,1974
District I conference of the Nurses' As-
sociation of the American College of Ob-
stetricians and Gynecologists, Chateau
Halifax, Halifax, N.S. Theme: "Portrait of a
Female." Write to: Betty Mciver, Publicity
Chairman, Halifax Infirmary, 1335 Queen
Street, Halifax, Nova Scotia.

October 16-19, 1974
Joint annual and scientific sessions.
Canadian Council of Cardiovascular
Nurses, Canadian Heart Foundation, and
Canadian Cardiovascular Society, Win-
nipeg, Manitoba. For further information,
write to: Canadian Heart Foundation, Suite
1200, 1 Nicholas St., Ottawa, K1 N 7B7.

October 1974 & April 1975
Four-week, full-time, postdiploma prog-
ram in coronary care nursing for registered
nurses, Humber College, Rexdale, On-
tario. Part-time, evening program from
November to March also offered. For
further information, contact: Office of the
Registrar, Humber College of Applied Arts
and Technology, P.O. Box 1900, Rexdale,
Ontario, M9W 5L7.

November 7-9,1974
Nurses' Association of the American
College of Obstetricians and Gynecol-
ogists, District no. 5 conference, Royal
York Hotel, Toronto, Ontario. For furth-
er information, write to: Ruth K. Schin-
bein, Ontario Section Chairman.
NAACOG, District 5, 43 Main St., East,
Apt. 2, Grimsby, Ont., L3M 1M7. 'id
JUNE 1974

names

The International Council of Nurses has
announced tbat Irma Sandoval of Costa
Rica has bee/l..awarded the 3M Nursing
Fellowship for 1974.
Ms. Sandoval plans to use the $6,000
fellowship for doctoral studies in nursing
education at the University of Puerto
Rico. She is director of the school of
nursing, University of Costa Rica, San
José, and is president of the nurses'
association of Costa Rica.
The 3M nursing fellowship is for
post-basic studies. Funded by the Minne-
sota Mining and Manufacturing (3M)
Company, it is administered by the ICN.
A Canadian, Alice Baumgart, was awarded
the 1973 fellowship.

Sister M. Felicitas Wekel, one of 13
honored at Queen's University spring
convocation, had conferred on her an
honorary doctor of laws degree.
Sr. Felecitas (RN,
Providence Hospi-
tal. MooseJaw;RSc,
U. of Ottawa; MSc,
Catholic U. of Amer-
ica. Washington) is
currently president
of the board of di-
\.
rectors of Providence

JI Manor in Kingston,
and vice-president of the board of direc-
tors, S1. Mary's of the Lake Hospital,
Kingston. She was, for many years, at
SI. Mary's Hospital, Montreal, a" direc-
tor of nursing and then director of the
school of nursing.
Active in nursing associations at all
levels, Sr. Felicitas was vice-president
([ 964-67) and president (1967-70) of the
Canadian Nurses' Association.

(..

'-

J....);

Rose Imai has been
appointed informa.-
tion support officer
to the principal nurs-
ing officer of Health
and Welfare Canada.
and will assume her
new duties on com-
pletion of an inten-
; '----:- sive course in French.
Ms. Imai joined the federal service early
in 1973 to become nursing consultant
with the health manpower planning
division. She was formerly a research
officer with the Canadian Nurses' Asso-
ciation.
IUNE 1974

-
... -

r-

Rachel Bureau, pres-
ident of the Order
of Nurses of Que-
bec, has been awar-
ded a bronze medal
by the Academie Na-
tionale de Medecine
de Paris. This hon-
or is in recognition
of her dedication.
determination. and rich experience in
health education.

-
.... .

The school of nursing. Dalhousie Univer-
sity, Halifax, has announced the ap-
pointment of Dr. Floris E. King as profes-
sor of nursing research, the first such
appointment in nursing in Nova Scotia.
Muriel Small ha<; been named acting
director of the school.
Dr. King (Reg N, Toronto East Gen-
eral school of nursing; BScN., U. of
Toronto; MPH, U. of Michigan; PhD.,
U. of North Carolina) director of the
school of nursing at Dalhousie since July.
1972, was the coordinator and originator
of the graduate nursing program at the
University of British Columbia.
Ms. Small (RN, Montreal General
Hospital school of nursing: BScN,
McGill U.: MScN, U. of Washington,
Seattle) has been on the faculty of
Dalhousie since 1970. Her career. de-
voted largely to public health, has inclued
working with displaced persons in Austria
and doing field work for the department
of health in Vancouver. s.c.

Juanita C. Torres (A.B. in business ad-
ministration, Virginia State College, Pe-
tersburg. Va.) has been appointed
business manager of the International
Council of Nurse
. She was formerly
accountant and office manager of the
World Boy Scout Office in Geneva.
As tCN business manager. Ms. Torres
is responsible for the planning and coor-
dination of financial and administra-
tive aspects of headquarters activities.

Dorothy M. Pringle, clinical coordinator,
psychiatry, at Holy Cross Hospital, Cal-
gary, has been appointed director of the
school of nursing, Laurentian University,
Sudbury, effective July I, 1974.
Ms. Pringle (B.Sc.N., McMaster U.,
Hamilton; M.S., U. of Colorado; Den-

ver), a Canadian Nurses' Foundation
scholar. who has had wide experience as
teacher, supervisor, clinical coordinator,
and consultant. has been on the nursing
faculty at McMaster University and ha<;
taught part-time at the medical school,
University of Calgary.

Jean Adams of Fredericton is the third
nonnurse elected to the 25-member coun-
cil of the New Brunswick Association of
Registered Nurses.
Ms. Adams is a research scientist with
the Canadian Department of Agriculture.
Active in many professional societies, she
is also an active participant in such
community concerns as library, environ-
ment, health, urban renewal, and city
council.

Sandra Malabar is director of nursing of
the Waterloo Regional Health Unit. Kitch-
ener, Ontario.

-- Ms. Malabar (RegN,
Toronto General
Hospital school of
n u r sin g: Dip I.
P.H.N.. B.Sc.N.. U.
of Toronto) has
devoted much of her
career to public
health nursing in On-
tario and New Bruns-
wick. She has also taught psychiatric
nursing at the Moncton Hospital school
of nursing and has been staff nurse at
Clinique La Source, Lausanne, Switzer-
land.

,<;-;(

"",

,..,.

Marcia Ames (R.N., SI. Paul's Ho
pital
school of nursing. Vancouver) is serv-
ing a two-year tour of duty with MEDICO.
a service of CARE

She is stationed at a
hospital complex in
Surakarta (Solo) in
Central Java. The
program includes
inservice education
for nurses and la-
boratory physical
therapy training
programs. Ms.
Ames will be caring for patients, in addi-
tion to teaching Indonesian nurses.
Until joining MEDICO. she was on staff
at the Vernon Jubilee Hospital in Vernon,
British Columbia.
THE CANADIAN NURSE 33

-

-

....
y";

\.....

new products

{

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

......

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.

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,

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Pediatric Bed

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...-- . j JLJ
. .
. ..
. .
.
. . 41! .. ..
. .

Monitoring Equipment

34 THE CANADIAN NURSE

1

Cageless pediatric bed
A new cageless pediatric bed is available
from Isolette, a Narco Medical Company.
This electrically-operated bed, which can
lift up to 150 pounds, may be used as a
crib, playpen, or youth bed.
A toggle-switch control panel at the
foot of the bed enables an attendant to
adjust the bed height and mattress to the
desired position. The sturdy steel frame
has no metal bars, thus affording
minimum product maintenance and max-
imum patient comfort.
The bed also features nylon mesh side
nets and Plexiglas end panels that may be
removed easily for cleaning; easy-roll
casters; and a knee-operated side release
that is conveniently located for nursing
efficiency, but is inaccessible to the
patient. Accessories include a restraint
cover, IV pole,. and the Air-Shields
Croupette cool mist and oxygen tent.
More infonnation, including a four-
page color hrochure, can be obtained
from Narco Medical Services, 22 LePage
Court, Downsview, Ontario.

Monitoring equipment
A new series of monitoring equipment for
cardiac, respiratory, medical/surgical,
and neonatal intensive care has been
introduced by Isolette, a Narco Medical
Company.
The Isolette series 7000 equipment is
fully modular so that a bedside monitor-
ing system can grow from a heart and
respiration rate monitor combination to a
complete multiparameter system. The
new series includes units to monitor
oxygen concentration, respiration rate,
heart rate, and blood pressure.
All series 7000 equipment is designed
to minimize human error. Alarm signal-
ing is understandable, control clutter has
been eliminated, and meters are easy to
read. Color-coded stripes on each unit
make it simple to identify monitored
functions.
For further infonnation, write to Narco
Medical Services, 22 LePage Court,
Downsview, Ontario.

Products from ICN Canada
tCN Canada has announced the availabil-
ity of Phenazine - Perphenazine B.P.,
an antipsychotic-antiemetic-antianx iety
drug. It comes in four strengths: 2. 4. R,
and 16 mg. Each sugar-coated tablet is
imprinted with the strength.
(Continued on page 36)
JUNE 1974

Kee(Js
hilll 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.

Sa\'es
V()ll tinle
...
Pampers construction
helps prevent moisture
from soaking through
and soiling linens. As a
result of this superior
containment, shirts,
sheets, hlankets and
hed 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 bahies have
more time to spend on
other tasls.

I,:,.í, ,1
1+ Pel's
f
"'" ..

\
'-

"

PROCTER" GANÐL.

NEW POSEY DEVELOPMENTS

The new Posey products shown
here are but a few included in the
complete Posey line. Since the
introduction of the original Posey
Safety Belt in 1937, the Posey
Company has specialized in
hospital and nursing products
which provide maximum patient
protection and ease of care. To
insure the original quality product,
always specify the Posey brand
name when ordering.

The Posey Safety Bar Kit with soft
padded bar provides a quick, simple,
and effectIve method of preventing a
pallent from "scootIng" forward in
any standard wheelchair, #8151,
$29.85.

... ..
. \

The Posey Comfort Sling. Posey in-
troduces a padded sling that is so
comfortable your patient won't know
it's there. Comfort sling features pad-
ding on shoulders as well as arm.
#7415, $6.00.

The Posey Padded Limb Holder
is lined for comfort; fits wrist or ankle;
completely washable, long lasting. Bed
strap attached to cuff. #25251, $4.20
pair.

new products

J:..- ..

(Continued from page 34)
Levazine (an antidepressant) and C.E.S.
(conjugated estrogen tablets) are also
available from tCN Canada. Levazine
comes in pink tablets (2 mg Perphenazine
B.P. and 25 mg Amitriptyline HCL. B.P.)
and red tablets (4 mg Perphenazine B.P
and 25 mg Amitriptyline HCL. BPI
C.E.S. is available in sugar-coated tablets
of 0.625 mg (maroon colored), 1.25 mg
(yellow), and 2.5 mg (purple).
For further information, contact tCN
Canada Limited. 675 Montée de Liesse,
Montreal 377, Quebec.

-r."I'
," ,
",

J

.\.
.. 1\'
I 'f

\

It,:t

Anne Baby nursing doll
Anne Baby. a training doll for realistic
education in baby care. is available from
Safety Supply Company, 214 King Street
East, Toronto. Ontario M5A U8.
The doll is designed to provide the
trainee with life-like situations in baby
care. The imponant training features are:
life-like appearance, natural weight, cor-
rect length. natural body movements,

The Posey Foot-Guard with new
"T" bar stabilizer simultaneously keeps
weight of bedding off foot, helps pre-
vent foot drop and foot rotation.
#6412, $21.00.

. . ,
, r>

'v,..:,; .

c:,.

.'l

,. -
\ ,,..

. Jj.

þ

, .
I"
'/
,

r:1n. '

(j'",\J

The Posey "Swiss Cheese" Heel
Protector has new hook and eye
fasteners for easy application and sure
fit. Available in convoluted porous
foam or synthetic fur lining. #6121
(fur lining), #6122 (foam), $4.80 pair.

rustproof and watenight design. and
simulated bowel movements. Every as-
pect of baby care is featured.
Anne Baby permits teaching in groups
of up to six students, where mdlvldual
nursing can be effectively practiced. The
doll's construction assures years of use.
Diapers, a jacket, a shin, a wrap. plastic
pants, and a feeding bottle are included
with each doll. Anne Baby comes com-
plete with baby bath and lid. which can
also be used for storage of the doll and
accessones.

5end for the free new POSEY catalog - supersedes all previous editions.
Please insist on Posey Quality- specify the Posey Brand name.

Turn and pull sheet
Posey Company's turn and pull sheet
is dcsigncd to help a nurse turn a heavy
patient. Hand grips on both sides assist
in moving the patient. Thc sheet is made
of washable cotton tlannel. Inquiries
about this sheet can be directed to Enns
& Gilmore Limited, I 033 Rangevie

:
Road, Port Credit. Ontario. VI
JUNE 1974

POSEY PRODUCTS Stocked in Canada

ENNS & GILMORE LIMITED

1033 Rangeview Road. Port Credit, Ontario, Canada

36 THE CANADIAN NUK
1:

research abstracts

The following are abstracts of studies
selected from the Canadian Nurses'
Association Repositor) Collection of
Nursing Studies. Abstract manuscripts
are prepared by the authors.

Boyd, Margaret Louise. Prosthetic ser-
vices in Alberta: needs, resources,
disparities. Edmonton, Alta., 1973.
Study (M.H.S.A.) U. of Alberta.

The investigator undertook to describe
selected aspects surrounding the provi-
sion of prosthetic services in Albena The
investigation was limited to external
prostheses and/or aids, which were re-
viewed in relation to selected dimensions
of the topic including: maxillofacial ex-
traoral prostheses; eye prostheses and eye-
glasses; anificial external ears; hearing
aids; laryngeal prostheses; dentures; spe-
cial intraoral prostheses; wigs; artificial
limbs; corsets. splints, and/or braces;
breast prostheses; and enterostomal ap-
pliances.
The writer began with a review of the
etiology of disease entities, incidence,
and prevalence data as they relate to
patients requiring prostheses. The opin-
ions of three physicians, one prosthodon-
tist, one pedodontist, and those of the
writer provided the major bases for the
study data.
The basic needs of all patients who
require prostheses were outlined. fol-
lowed by a review of the resources
relative to prostheses available in Albena,
including health agencies, health man-
power, and financial resources. Physical
facilities were explored in a cursory
manner only. Disparities in the provision
of health care to patients requiring pros-
theses were explicated.
It was assumed that rehabilitation is
more desirable than indefinite "depen-
dency." On this assumption, the specific
needs of the 12 panicular groups of
patients requiring prostheses were ex-
panded in detail to enable program
planners and/or policymakers to use a
modular or incremental approach in the
implementation of future programs.
On the basis of the investigations, the
writer concluded that: I. there are some
patent disparities in the provision of
prosthetic services to Albenans; 2. cur-
rent major resources for prosthetic ser-
vices in Alberta are not used optimally; 3.
IUNE 1974

certain basic resources do not exist for
specified groups of patients; and 4.
mechanisms for assessing the needs of
prosthetic patients in Albena and allocat-
ing resources in an equitable manner are
inadequate.
Thiny-six recommendations pertaining
to the four central conclusions are pre-
sented in the final chapter of the study.

Kirstine, Myrtle L. Report of a preschool
nursing assessment project: planning,
implementation, evaluation. Toronto,
Ont., 1974. Study. Etobicoke De-
panment of Community Health.

The purposes of this project were to
gather information that may be used in
planning: I. more meaningful health
services for the preschool child, and 2.
educational programs to enable commun-
ity health nurses to assume an expanded
role in child care.
The content of the educational work-
shop for 12 selected community health
nurses is described and evaluated; re-
source personnel. necessary forms and
letters, facilities, and clinical supplies are
outlined.
The pilot nursing assessment of 283
junior kinderganen children (age 3-4
years) included: I. taking a health and
developmental history, 2. vision screen-
ing, 3. hearing screening, 4. the Denver
Developmental Screening Test, and 5.
nursing physical examination.
The profile of the children referred for
follow-up and evaluation of the assess-
ment program are included.
Implications are drawn relating to the
need for identification of children "at
risk" in the early years. and panicularly
relating to the responsibility (service
and/or education) for preparing the com-
munity health nurse to assume this ex-
tended role.

Mann, lames Lyon. SOllli' COIll'l'IJt.\ (
f
drllg-relured patil'lll care as \' iel\'-
ed hy tile f11l{jor IIl'allll Cl/re prelfés-
siclll,\ ill Olltario. fmonto. Ontario.
1l)T2. I hcsi... (M .s-:. Phm.) ('. of
foronto.

This research ha... comprised an Ontar-
io-wide survey of opinions held by the
medical. dental. nur...ing, and pharmac)
profession... \\'ith respect to particulal

drug-rcl ated functions that arc part ot
patient care; these functions relate to
the monitoring of drug use. drug infor-
mation services. and patient counseling.
The questions \\,ere designed to
establish the essentiality of the specific
functions and subsequently to determ ine
the preference between the pharmacist
and the physician. the nurse. or other
paramedical persons as to which profes-
sional should be responsible for per-
forming the function.
The
questionnaire results give e\i-
dence that each of the functions consi-
dered is decmed to be an essential com-
ponent of optimum patient care.
Re...ults of the stud\ indicate that the
physician is consideréd the most desir-
able professional to be charged with
the responsibility for drug use monitor-
ing functions; ...upportive roles arc
ascribed to the pharmacist and the
nurse. Whereas the physician is the
preferred professional. thi... choice does
not appear to be a realistic one. the
present complexity and extent of the
physician's re"'PGn...ibility to patient
care, together with considerations of
economic feasibility. would appear to
dictate that some of these responsibili-
ties should be ddcgatetl. Nevertheles....
medical and dental response is uni t{)rm
in its preference for the physician.
A greater degree of intraprofessional
variation is evident in pharmacy and
nursing response. The nonunitÒrmity
in pharmacy respon...e consistentl)
reflects a ditTerence in re...ponse bct\\een
pharmacy academ ics and community
pharmacists. \\'ho constitute the vast
majorit) of pharmacy practitioners;
hospital pharmacy opinion is generall)
intermediate bet\\,een that of the other
t\\,o subgroups. Academic pharmaq
tends to consider the pharmacist a...
the mo...t desirable professional for many
of these functions; in contra..... commu-
nit) pharmacy has tended to c!l()ose the
ph) sician to a greater extent.
With respect to drug int{mnation
services to members of the health care
team. it can be concluded th.lt funda-
mem,t1 intÖrmation tend... to he readily
available. and that pharmacy is one of
four primar) ...ources of ...uch informa-
tion: the other... are the drug nl<1llllfac-
lUreI'. I ibran facil itie..., and the com-
pendium of - pharmaceutica!... and ...pe-
cialtic.... Detailed drug information
THE CANADIAN NURSE 37

research abstracts

ould appear to be much less accessi-
ble. and in this instance pharmacy was
considered to be the profession to bear
a primary responsibility.
The results of the survey indicate
that the primary responsibil ity for pa-
ticnt counsel i ng in drug-related matters
is assigned to the prescribing physician
(or dentist) except
ith respect to the
provision of information related to
over-the-counter medication. where the
pharmacist shares with the physician
the primary responsibility. The relative
supportive roles of the nurse and the
pharmacist appear to depend on their
primary site of practice. i.e., the nurse
is preferred in the hospital setting,
while the pharmacist is more important
in the community setting.
In the qes of the major health-care
professions in Ontario. pharmacists
are considered to be well qualified \\ith
respect to drug information fundions;
but are ranked below the physician and.
in several cases. the nurse for some
integral aspects of drug-related patient
care, such as drug monitoring and
patient counseling. Thus. the m.
jor
health care professionals in Ontario
consider the provision of drug informa-
tion to the health care team a primary
responsibility of the pharmacy pro-
fession.

Collinge, Judith Mary. fhe concerns
(
r mothet'S dl/ring Ihe first wee/..
{ill/owing discharge (
r thl'ir lIew
hah\' {i'om {Ill illlellsive care II/trSl'rV.
Mo;Ùeal. Que. IlJ73. rhesis (M .Sc.
(Appl.)) ;v1cGill U.

This study. u"ing a qualitative method
of researc h. was desigllLxl to obtain
infÒrmation about the concerns moth-
crs cxperienee the first week after their
baby goes home from an intensive care
nursery; the factors \\ithin the mother.
baby. or environment that affect these
concerns; and the resource personnel
the mothers use to help them deal with
their concerns.
In th is study. concern refers to any
area of special interest. worry. or desire
for knowledge. as indicated verball\'
by the mothe
. "
One visit wa<; made to each of IlJ
mothers between five and nll1e days
after their babies had been discharged
from an intensive care nursery. By
means of an unstructured interview
technique. the mother \\as encouraged
to talk freely about the concerns and
38 THE CANADIAN NURSE

problems she had experienced since
the baby arrived home. The investigator
questioned the mothcr only to clarify
certai n poi nts. All data werc subjected
to content analysis, and statistic.il tests
were used when appropriate.
It was found that mothers experience
a number of different concerns after
the baby comes home. Most frequently
expressed were those related to the
health of the baby. including concerns
about actual or potential illness. devel-
opment. and follow-up care (35 percent
of total concerns). Concerns about
feeding the baby were the next most
frequently expressed (33 percent). tì.)I-
lowcd by those associated with hygiene
(20 percent) and behavior (12 percent).
Thc tindings suggest that certain
concerns are prevalent. and it secms
reasonable to suggest that these might
be made the focus of nursing plans
aimed at preparing the mothcr to take
her baby home.
Specific factors intluencing the
number of concerns a mother has are
also indicated by the findings. Know-
ledge of these factors could hel p nur'ies
identify mothers
ho may have a large
number of concerns at home. and lead
to early nursing intervention aimed at
preventing the development of some
concerns. or lessening their intensity.
However. further investigation into
these factors and their individual or
cumulative ellects
tHlld be benetïeial.
The widespread use of resources
outside the home to deal with the con-
cerns. and the difficulties encountered
by many mothers in obtaining what
they considered satisfactory tì.)lIow-up
care for the baby suggest that outside
resources. although sought by many
mothers. are not readily available to
all. Further investigation into these
rcsources - what resources are avail-
able. how the mothers use them. and
how effective they are in meeting the
mothers' needs - seems to be neces-
sary.

Scholdra, Joanne Dolores. The effect of an
experimental questioning strategy in
clinical conferences, and emluation
interviews on the achievement ofnurs-
ing students. Seattle. Wash.. 1972.
Thesis (Ph.D.) U. of Washington.

This study was to investigate the effects
of using high-level questions in small
group and individual conferences on
performanee in nursing. The dependent
variables were: proportion of effeeti ve
critical incidents; scores on two paper-
and-pencil tests; and scores on two
situation tests.
High-level questions were defined as
comprehension and above of Bloom's
Tuxonomv (1956) Low-level questions
were defined as knowledge questions.

Critical incidents were defined as samples
of nursing behavior that could be rated as
effective or ineffective in terms of patient
welfare.
The four cognitive achievement tests to
study differen
es in treatment effect were
comprised of primarily high-level ques-
tions of a problem-solving type. The
questions on the two paper-and-pencil
te'sts ranged over wide areas of nursing
eontent. The two situation tests were
comprised of problems related to the
synthesis and evaluation of a nursing care
plan for one patient.
The major hypotheses were:
I. Students who are asked high-level
questions in clinical conferences and
evaluation interviews will demonstrate
higher levels of nursing performance as
measured by the proponion of effective
critical incidents. scores on a paper-and-
pencil test, and scores on a situation test,
than students who are asked low-level
questions.
2. Students with High Grade-Point
average [GPA] will demonstrate higher
levels of nursing performance than stu-
dents with low GPA.
3. Levels of questions are independent
of levels of GPA.
A posttest-onl
design, with two ex-
perimental groups, was used. Subjects
were 29 nursing students randomly
selected from students enrolled in a
community college nursing program and
randomly assigned to experimental
groups. Over a 22-week period, 19
students were asked primarily high-level
questions by two experimental instructors
in all clinical conferences and evaluation
interviews. Ten students were asked
primarily low-level questions by a third
instructor in conferences and interviews.
Experimental groups were further divided
into students with GPA of 2:00 and over
and those with GPA below 2:00.
The findings of this study indicate:
I. The use of predominantly high-level
questions significantly influence the per-
fonnance of nursing students on two
paper-and-pencil tests comprised of
primarily high-level questions.
2. The use of predominantly high-level
questions does not significantly affect the
performance of nursing students on two
situation tests comprised of primarily
high-level questions.
3. The use of predominantly high-level
questions does not significantly affect the
proportion of effective critical incidents
demonstrated by nursing students.
4. Students with high GPA demonstrate
significantly higher levels of nursing
perfonnance than students with low GPA
on the cognitive achievement tests, but
not on the proportion of effective critieal
incidents.
As a result of the significant findings,
additional study related to questioning
levels during teacher-student discourse
is warranted. 9
JUNE 1974

books

Administering Nursing Service by Marie
DiVincenti. 340 pages. Boston, Little,
Brown, 1972. Canadian Agent: Lip-
pincott, Toronto.
Reviewed by E. Margaret Nugent,
Director - Nursing of Adults, Health
Sciences Centre, Winnipeg, Man.
This book is designed to assist nurse direc-
tors who have had no preparation for the
role of administrator, those with educa-
tional preparation but no experience, and
those with no administrative background.
The text is divided into 5 parts. Part I
presents an overview of trends in the pro-
vision of health care; the author discusses
patient needs in a hospital and the impor-
tance of sound nursing leadership in an in-
creasingly complex situation. Part II con-
siders the organization and administration
of a hospital and how the nursing depart-
ment relates to the whole. The functions
and responsibilities of the nurse director
are discussed. The concept of manage-
ment and its functions of planning, organi-
zation, leading, and controlling are re-
viewed.
Part III discusses managerial tools that
contribute to improving the administration
of nursing service. Parts IV and V deal
with how nursing administration can es-
tablish and maintain the environment of
which it is a part. Part IV considers the
physical environment, and Part V the
human environment.
The author uses a dictionary approach in
this quick reference book. Simple lan-
guage is used, and a basic knowledge is
not assumed. Areas included are exhaus-
tive in scope but limited in depth. Every-
day situations provide ample, practical il-
lustrations for subjects under review.
Many refreshing and forward-looking
approaches are used. For example, the au-
thor discusses two approaches to firing:
simply to let an employee go or "to fire her
mind and spirit" with the determination to
make good. Her emphasis is, repeatedly,
on building with people. The need for
management and interdisciplinary support
and coordination in establishing effective
relationships is emphasized.

Although some detail may be tiring,
those for whom the book was intended will
find it practical and easy to use The con-
sistently irregular right-hand margins de-
tract from the finished appearance of the
pages.
The author accompl ishes her stated pur-
pose in writing this book.
JUNE 1974

Contemporary Issues in Canadian Law fO!
Nurses by Shirley R. Good and Janet
C. Kerr. 193 pages. Toronto, Holt,
Rinehart & Winston, 1973.
Reviewed by Myrtle E. Crm..ford,
Associate Professor of Nursing,
University of Saskatchewan Col-
lege of Nursing, Saskatoon, Sask.

There has long been a serious gap in
Canadian nursing literature in the area of
the law and le!!al issues. Canadian nurses
have been waitin!! for a book on this
subject. Twenty-four authors, each hav-
ing a special area of expertise, have
contributed to the book.
The foreword has been written by the
distinguished nurse educator, E.A. Electa
McLennan. She describes the book as
"an endeavour to help the nurse com-
prehend the realities of the LAW and its
administration.' ,
The authors dealing with aspects of
Canadian law have, in the main, been
explicit and to the point. The chapters on
"Criminal Law and the Nurse," "The
Drug Question," and' 'The Good Samari-
tan Rule" were especially enlightening
and answer questions that nurses fre-
quentlyask.
I was disappointed in both chapters that
dealt with negligence (part of Chapter 6
and Chapter II). If the nurse were to be
involved in a legal case, it would most
likely be negligence, yet the issues
pertinent to such a case do not come out
clearly.
Interesting and novel issues are raised.
especially in the. chapters on . 'Child
Battering," and "The Law and Nurses'
Notes." The concepts of transfer of
functions from medicine to nursing, and
expanding the role of the nurse (in
Chapter 9) are important ones for nurses
to face.
Two areas that many nurses may not
feel are relevant to them deal with
education and research. and one chapter
that most nurses will feel is highly
relevant discusses collective bargaining.
On the whole. the book is a worthwhile
addition to any nurse's library. Howcver,
the binding of the book is poor. Even
before I had complcted reviewing a ne\\i
copy of the book, the binding had
separated in several places. Other copie!>
have also done this after minimal han-
dling.
The paper cover is allractive and
eye-catching, but the publishers should

consider producing a limited number of
hardcover copies. The present binding
will never hold up in library use, and this
book should be in hospital. agency. and
school of nursing libraries, as well as in
personal collections.

placebo Therapy: A Practical Guide to
Social Influence in Psychotherapy by
Jefferson M. Fish. San Francisco,
Jossey-Bass. 1973.
Reviewed bv Jennie Wilting, Ins-
tructor, Nursing Department, Grant
MacEwan Community College, Ed-
monton, Alherta
This book provides a delightful reading
experience. The author expresses himself
clearly and concisely, with humor sprink-
led effectively thrOl!gh the book.
Placebo therapy is not another school
of therapy: it is a method of conducting
psychotherapy. Placebo therapy uses the
patient's faith to solve his problems. The
author explains how faith can be aroused
to ease or cure psychological distress. He
emphasizes the importance of the
patient's belief in the treatment plan
suggested by the therapist, in his ability to
change, and in his ability to handle his
own life.
One of the main responsibilities of the
therapist. according to the author, is to
help the patient carry the responsibility of
his own life with as Iillle help as possible
from the therapist in therapy sessions.
The author stresses the importance of
keeping the patient out of the sick role,
which would condemn him to years of
therapy.
This is done. first of all. by identifying
the problem areas and limiting the
patient's dcfinition of his mental illness to
a workable size. The patient's beliefs and
therapy goals are u!>ed to define clearly
the mental health toward which the
patient is aiming. Then a ritual to solve
this problem is devised by the therapist.
This ritual is in keeping with the patient's
own beliefs.
Finally, the difficultIes the patient
might encounter in the future are defincd
as life's ups and downs, rather than
mental illness. The patient is reassured
that he will probabl} be ablc to handle
these difficulties in the same manner as he
has handled the problems about which he
consulted the therapist.
The patient is reassurcd that it probably
will be unnece!>sary to return to the ther-
THE CANADIAN NURSE 39

books

apist when the
e difficulties arise, but he
is free to do so. The author gives exam-
ples of ho
placebo therapy could be used
with hypnotherapy, behavior moditica-
tion. group therapy. and even with mass
audiences via lectures, radio, and televi-
sion.
This book should be of interest to
anyone working in the mental health
field. It left me with a feeling of hope for
the individuals who are frequently
doomed to long years of therap) or
hospitalization.

Care and Management of Exceptional
Children by Juanita W. Fleming.
212 pages. New York. Appleton-
Century-Crofts. 1973.
Reviewed by Noreen P. O'Brien,
Instructor, School of NuninR, Uni\'er-
sity of British Columbia, Vancou\'er.

This book represents an mnovative ap-
proach to the care of exceptional children.
It \\as designed to serve as a guide to
profe

ional nurses, and it pre
ent
a
behavioral approach to the management
problems of the exceptional child. The
author's purpose is to guide nurses into a
new perception of what an exceptional
child is and how nurses can best help
these children to "be accepted in society
and function at their maximum poten-
tials. "
The text is a combined product of
several authors and. with the possible
exception of chapter five, is a highly
integrated blend of relevant infonnation.
The first two chapters provide the reader
with an understanding of the forces
influencing exceptional children, their
family situation. and their basic needs.
For the nurse familiar with behavior
modification. chapter three offers a con-
cise appraisal of the potential benetits of
thi
technique for use in changing be-
havioral patterns of exceptional children.
The remaining chapters offer content
surrounding specific types of disabilities
of children. such as mental retardation

yndromes. visual and auditory impair-
ments, and socioemotional disturbances
in behavior. The information is or-
ganized, logically sequenced, extremely
well supported with references; examples
are contributory. Key concepts dnd as-
sessment techniques are emphasized to
assist the nurse in evaluating and inter-
preting behaviors exhibited by excep-
tional children.
The brief discussion covering the gifted
child in chapter five and the scattered
mention he receives elsewhere in the text
40 THE CANADIAN NURSE

appears ill-suited to the pathological
(disability) emphasis of the book as a
whole. Although the gifted child does
satisfy the defined criteria of an excep-
tional child as used by the author. it is
primarily not his behavior but the be-
havior directed toward him by others that
requires the nurse's attention.
In summar), this book is a unique
approach to the problem
and needs of
exceptional children. It is an excellent
illustration of how the author visualizes
the future role of the professional nurse in
the comprehensive care of exceptional
children in all settings. This book would
be a valuable addition to the library of any
nurse having contact with well or excep-
tional children.

Review of Team Nursing by Laura Mae
Douglass. 131 pages. St. Louis,
Mosbv.1973.
Rniéwed b \' Brenela Kel/eha, 11/-
seJTice l:.ì.luc:ution Imtrtlctor, Grace
General Hospital. St. 10l/ll's, Neu'-
fiJl/nelland.

fhe author's stated purposc is "to

timulate all who arc concerned with
nursing leaden,hip to cvaluate their
kno
ledge and al,l, areness of thc
leadership role carefull) and critically."
She stresses the importance l)f
giving the chosen leadcr responsibilit)
and the pO\\er necessary to b.ld, up her
directives. Not only must the leader be
aware of areas of re
ponsibility and his
lines of authority. but each level of staff
must be aware of and in agreemcnt
with these t
lctors.
Guidelines and examples cxplain
how to sct priorities. cstablish goals.
set objectives (operational and support-
ive), how to delegate. and hO\\ to
evaluate personnel. How to write
obieetive
in behavioral terms is one
seètion that is invaluable: few nurse
leaders have been taught this method.
which allows the nurse to apply the
nursing process more effectively.
The author firmly believes in the
philosophy of team nursing. She givcs
a description of various methods of
delivering nur
ing care, minimizing
the value of some. For example. after
describing the functional method. the
argument given for not continuing its
use is ''those
ho arc being servcd arc
dehumanized and thc nursing care is
inferior." The reason is that staff
assignment
are task-oriented and can
be compared with mass production in
indu
try.
It would be difficult to criticize any
of the values of team nursing as outlin-
ed by the author. Yet one must realize
the effectiveness of such a method
depends. also. upon contributing fac-
tors, such as communications. using
effective nursing care conferences.

and properly using nursing care plans.
fhese have to be evaluated effectively
before the leader is able to make a
decision of whether or not to adopt such
a method.
The history of nursing given in
Chapter 2 i
purely American; if the
reader is interested in this area. other
Canadian texts would ha\e to be con-
sulted.
This is a comprehensive text that
should be read not only by team lead-
ers. but also by adm inistrative person-
nel to whom the team leaders are
responsible.

Curriculum Building in Nursing: A Process
by Em Olivia Bevis. 172 pages. St.
Louis, Mosby, 1973.
Revie\"v'ed by 1anice Given, F acult\, of
Nursing, Uni\'ersity of Western On-
tario, London, Ontario.

The author of this book states that its
purpose is "to provide a source for those
engaged in the process of nursing cur-
riculum fonnation, revision. or study"
with a distinct emphasis on "the
problems arising from the lack of pro-
cedural knowledge about curriculum-
building process in nursing. and the
problems inherent in changing." In other
words, this book deals with the actual
mechanics of curriculum construction and
revision and. as such, is a timely con-
tribution for nurse educators.
The author explores all aspects of
curriculum development. Succinct and
well-supplemented by models and illust-
rations, the book contains both a theory-
building and an empirical foundation for
curriculum study. This approach may
present problems for those not totally
familiar with such tenninology and. in
fact, the second chapter is quite complex.
The material on curriculum evaluation
and change appears incomplete: it does
not consider the issue of accountability or
the problems of implementing change and
the assistance necessary to effect change.
once such a deci
ion has been made.
However. the process devices and tools
presented at the end of each chapter are
valuable aids for educators interested in
assessing curricular goals and diagnosing
needs for changes.
This book has much to recommend it.
Framed upon a holistic approach to the
study of nursing. the author presents
another in the recent, growing serie
of
integrative curricular models. Her model,
which appears soundly grounded on
extrapolation and synthesis from the
biological, physical. and social sciences,
and based on nursing as an applied
practice disdpline, is commendable. The
book will appeal not only to those
interested in building nursing curricula.
but also to those interested in the process
of change.

JUNE 1974

Family-Centered Community Nursing: A
Sociocultural Framework, edited by
Adina M. Reinhardt and Mildred D.
Quinn. 304 pages. St. Louis, Mosby.
1973. Canadian Agent: Mosby. To-
ronto.
Re
'iewed b\' Ann Murphy. Nursing
Instructor, St. Joseph's Campus,
Mohawk College of Applied ArtJ and
Technology, Hamilton, Ontario.

This book brings together a wide range of
readings dealing with family-centered
community nursing. Contributing authors
include members of the medical and
nursing professions and the social sci-
ences. Such a diverse group provides an
interdisciplinary approach to community
health care. Its purpose is twofold: first.
to illustrate some of the cultural and
psychosocial factors that determine
whether families will use available
health-care services and, sel:ondly, to
portray newer role.. that the nurse will
increasingly be expected to assume in the
community.
The content ha.. been organized into
eight parts. Each part consists of an
introduction. several readings. a sum-
mary, and a list of referenl:es. Part I
focuses on the changing climate of health
care today. particularly the relationship
between the nurse and the physician. Part
II deals with specific cultural and ethnic
groups. and their use of available health
care services. Familial relationships and
interactions are discussed in Parts III and
IV. along with several conceptual models
for their analysis.
Parts V and VI deal with the commun-
ity and the expanded role of the commun-
ity nurse. as illustrated through several
pertinent case studies. Part VII stresses
collaboration and coordination of all
health-care services. The concluding arti-
cle, in which a perceptive nurse educator
anticipates the direction that professional
nursing will take in the future, is perhaps
the most thought-provoking.
A drawbaà for the Canadian prac-
titioner is that most of the researl:h data
and case studies are drawn from non-
Canadian sources. With this limitation in
mind. this book of readings would be
extremely useful as a resource supple-
ment for anyone currently involved in
nursing edul:ation, in community health
servil:es. or in research.

Reading!'> in Gerontology edited by V ir-
ginia M. Brantl and Sister Mdrie
Raymond Brown. 117 pages. St.
Louis. Mosby, 1973.
Reviewed b,. Dianne B. Clement.
,
Lecturer, 5(:hool of Nursing, McGill
Unh'ersity, Montreal, Quebec.
This book was edited by two nurse
educators. They selel:ted recent and re-
levant readings that would "tie together
JUNE 1974

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underlying concepts and principles di-
rected toward a multidisciplinary ap-
proach to the study of the aged. .,
- The difficulty of this undertaking lies
in the multidisciplinary approach and
becomes evident after surveying the
book. The articles included vary greatly
in terms of their usefulness and applica-
bility and in tenns of the audience to
whom they will appeal. For example, the
first article in the book. "Themes and
issues in sociological theories of human
aging:' is written at a fairly high level of
abstraction. whereas the second. "Age
with a future," is written in more
concrete, lay tenns.
Consistency among the articles appears
to be lacking, and the book does not seem
to fornl a congruent whole. The underly-
ing concepts and principles are not made
clear. For those who pick up the book to
read a specific article, however. this point
will not be important.
One element common to many of the
articles is a basis in research and theory.
The great impact that the theory of
disengagement had on gerontology is
evident as it is discussed several times.
Although some of these articles present
pertinent points and discussions. a
number are about five years old and do
not use the most recent data available.
Robert Kastenbaum' s excellent article.
"The foreshortened life perspective,"
appears in this book. He comments that
much of the research done today is based
on our own perspective and is interpreted
in the light of our own perceptions.
Therefore, we do not have any idea of
how the elderly really view their lives.
A number of the research articles
presented in this book can be criticized in
tenns of Kastenbaum's comment. Arti-
cles. such as "The functional assessment
of elderly people:' and "The effects of
aging on activities and attitudes," present
us with interpretations of statistics and
numbers. These might be of value in
circumscribed situations. but they give us

little infonnation concerning what older
people are like, and little guidance in
understanding and carring for the elderly.
Although this book represents a collec-
tion of relevant reference articles on the
study of gerontology, there is no article
related specifically to nursing care and no
contribution by a nurse. However, people
from many disciplines and at many levels
of development would be able to find one
or two articles that are particularly perti-
nent to them and their work with the
elderly.

Care of the Ostomy Patient by VirgInia
Vukovich and Reba D. Grubb. 138
pages. St. Louis, Mosby. 1973.
Revieu:ed b\' Thurln M. Duck,
Chairman o/Nursing Etecutive Com-
mittee, VanCOLH'er General Hospital,
Vancouver, B.C.

The authors of this book are to be
commended for drawing attention to a
complex problem: the development of
understanding by nursing staff of
hat it
means to be an ' 'ostomate." They have
undertaken thc task of al:tjuainting hospi-
tal staff with the needs of the ostomy
patient so that this specific patient may be
supported in his adjustment to his rear-
ranged body and enabled to return quickly
to his nonnal activities. or be relieved of
his pain and allowed to die with dignity.
One must seriously question the degree
to which the primary purpose of the book
has been met; it focuses mUl:h more on
procedural and technical detail than it
does on the devclopment of understand-
ing. Indeed, many readers may object
strenuously (as I did) to being told to
"explain the prol:edure to the patient"
and to "wash hands thoroughly'-'
However, a secondary objel:tive, that
of communicating to the hospital st.llT
that ostomy surgery carries no more
stigma than do other major surgeries. is
(ContiflUl'd 0" page 44 J
THE CANAD AN NURSE 41

.
...

...

J

New 2nd Edition

Lerch

MATERNITY NURSING

Growth and development hold special meaning for the
maternity nurse. Now the 2nd edition of a popular text
examines the growth and development of this exciting field,
as it charts, in sequence, the course of growth and
development in the maternity cycle. Among the new topics
included are advances in neonatology, and fetal and
maternal monitoring. The author examines the family as a
unit, and places new emphasis on the husband's role in
sharing the birth experience and cooperating in infant care.
A revised glossary includes new terms in fetology, electronic
monitoring devices, and the recovery nursery.

.
By CONSTANCE LERCH, R.N., B.S. IEd.l. May, 1974. 2nd
edition, approx. 352 pages, 7" x 10", 189 illustrations. About
$11.50.

New 3rd Edition!

Lerch

WORKBOOK FOR MATERNITY NURSING

Real istically balanced between fundamentals and
applications, this new edition of a popular workbook
provides case examples, situation-type questions, self-
examinations and current references to help students
correlate technical duties with personalized, family
centered care. It deals with all subjects of maternity nursing
including nutrition, high-risk pregnancy, the prenatal
clinic and care of the neonate. Biological, physiological and
psychological aspects of pregnancy and parenthood are
effectively interwoven.

By CONSTANCE LERCH, R.N., B.S. lEd.). October, 1973. 3rd
edition, 194 pages plus FM I-VIII, 7 1/4" x 10 1/2", 37
illustrations. Price. $5.55.

42 THE CANADIAN NUR
E

A New Book!

O'Brien

COMMUNICATIONS AND
REATIONSHIPS IN NURSING

This new book provides a comprehensive guide to common
factors in communication: use of appropriate language;
poor listening habits; essential characteristics for effective
communication; self-awareness; and reality perception.
Specific communication problems are thoroughly discussed;
saying "no"; ronmunicating with the patient and his family,
team members and administrators; and written
communications. Ten "communications interactions" are
included which apply the communication principles
discussed to specific problem situations.

By MAUREEN J. O'BRIEN, R.N., M.S. May, 1974. Approx. 216
pages, 5W' x 8W', 11 illustrations. About $520.

New 7th Edition!

Griffin-Griffin

HISTORY AND TRENDS
OF PROFESSIONAL NURSING

This updated version of a classic enables students to view
nursing's latest trends in historical perspective. Emphasizing
the evolutionary role of women in today's society, the
authors report on such current topics as: female liberation;
abortion laws; legal aspects of nursing; continuing educa-
tion in nursing; and the "nurse practitioner". Ten new
biographical sketches provide insight into nursing history.

By GERALD JOSEPH GRIFFtN, 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. 7th
edition, 312 pages plus FM I-XII, 7" x 10", 62 illustrations.. Price,
$10.00.

JUNE 1974

Mosby texts spotlight
the path to professional progress.

New 2nd Edition!

Anderson

WORKBOOK FOR PEDIATRIC NURSES

A valuable resource for your students, this effective study
guide is designed to reinforce their clinical experience in
pediatric nursing, and to provide background in growth and
development. The author first examines growth and devel-
opment in general, then presents exercises on nursing care
of the hospitalized child at every age level, from infancy
through adolescence. Among the many stimulating topics
are those on the infant with orthopedic disorders; the child
with celiac disease; cystic fibrosis; the brain-damaged child;
cerebral palsy; and burns.

By NORMA J. ANDERSON, R.N. June, 1974. 2nd edition, approx.
172 pages, 7%x 10Yz", 21 illustrations. About $6.05.

A New Book!

Marram -Schlegel-Bevi s

PRIMARY NURSING:
A Model for Individualized Care

This versatile new text explores the potentials of primary
nursing. It is directed toward orgainzation 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 devel-
opmental 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. MAR RAM. R.N., Ph.D.; MARGARET W.
SCHLEGEL, R.N.; and EM O. BEVIS, R.N., M.A. May, 1974.
Approx. 184 pages, 6" x 9",23 illustrations. About $6.25.

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 for the "ladder
concept" program in nursing education. It presents guide-
lines for adapting programs and modifying curricula in
instituations having both Associate Degree and LPN/L VN
programs. Course structure, content, and unit hours are
outlined, and existing texts particularly suited to the
program are recommended.

By DONNA KETCHUM STORY, R.N., B.S., M.A. February, 1974.
206 paqes plus FM I-XII, 6'%" x 9'%", 9 illustrations. Price, $7.10.

JUNE 1974

A New Book!

Williams

ESSENTIALS OF
NUTRITION AND DIET THERAPY

In three parts, this easy-to-read text develops the basic
concepts of nutritional science, applies these to community
and family needs, an.d provides a basic manual of clinical
nutrition. Both physiologic and sociologic factors relevant
to growth and development are considered in discussions
dealing with nutritional needs of ethnic groups, food costs,
and much more.
By SUE RODWEll WilliAMS, M.R.Ed., M.P.H. May, 1974.
Approx. 352 pages, 7" x 10",33 illustrations. About $6.85.

A New Book!
SELF STUDY GUIDE FOR
NUTRITION AND DIET THERAPY

Williams

Correlated with the above text, this new book applies and
illustrates concepts involved with the study of basic
nutrition. The inquiry-discovery premise on which the book
is based encourages independent thinking.

By SUE RODWELL WilLIAMS, M.R.Ed., M.P.H. May, 1974.
Approx. 248 pages, 7" x 10",37 illustrations. About $520.

A New Book!

Bregman

ASSISTING THE HEALTH TEAM:
AN INTRODUCTION FOR
THE NURSE ASSISTANT

This new text clarifies the role of the nursing assistant. It
includes basic instruction in anatomy, physiology, vital signs
and patient needs. The normal, healthy person is first
examined. Then, the superbly illustrated text con
iders the
effects of illness on the patient, how illness Cdn be
observed, and how to provide care.

By MARCIA S. BREGMAN, B.S., R.N. June. 1974. Approx. 144
pages, 7" x 10", 190 illustrations. About $520.

MOSBY

TIMES MIRROR

THE C V MOSBY COMPANY, l TO
86 NORTHLINE ROAO
TORONTO, ONTARIO
M4B 3E

n.n: C'ANAniAN NIIR
F 41

books

(C"nrillllt',1 from pagl' -I I I
perhap
met by noting that much of what
has been written can be applied to the
nursing care of any patient undergoing
major
urgery.
Beginning with a conci
e review of the
general evol ution of abdominal surgery.
the book proceeds to discus
the functions
of the ostomy speciali
t. disea
es predi
-
posing to ostomy surgery and types of
such surgery. coun
eling programs. pre-
and postoperative care, and such specific
topic
as management of skin excoriation.
appliances. diet, and the ostomy clinic.
The infonnation given In the section on
treatment of the specific topics would
benefit nurses who care for ostomy
patient
.
The empha
i
throughout each of the
chapters is on how-to solutions to general
sets of patients' problems. Such an
approach can be useful. once understand-
ing of the derivation of the problems is
attained. Unfortunately. the authors' use
of this method focuses the reader's
attention on specific technical nursing
action
, rather than on nursing care of the
ostomy patient. For example. only super-
ficial attention i
paid to the emotional
aspects of nur
ing care and to the
management of the patient's behavior in
relation to his condition.
Finally, I find it impossible to deter-
mine for whom this Ix)ok has been
written. It
eems that a competent profes-
sional practitioner would already possess
much of the infonnation that the authors
have tried to impart.

The Surgical Patient: Behavioral Con-
cepts ior the Operating Room Nurse
h) Barhara J. (ìruendemann. Shirlq
B. Ca
terton. Sandra C Höterly.
Barhara B. Mind,Ie). and Mary G.
Shetler. 1:'2 page
. St. I oui
. Mo...hy
IlJ73.
Rn'Ù'It'{'d hr Barham -lllt"Ot1\., 111-
structor, O;J(,/,(/tillg Room, jell'i.\"
(;clI('/'(/1 II (I.\[li tal, lHorltrc{/l, (}uchcc

I he author, havc succecded in creating
a hrieL yet conci,e set 01 criteria tì.l
r
an) operati ng room nu,.,e to appn:ciatc.
rhc general thcme is p.ltiel1l-centcreù
throughout. rather than the technical
appn
ach to \\ hich \\ care accu...tomed
in nH1...t opcrati ng room text....
I \Hl a
",umption... form the hasis of
this hook. First. each ...urgical patient
i... unique: and second. certai n general-
iLation... appl) to ,tli patient.... for exam-
ple. a,ep...i,. For thi
rea
tm. the authors
have not intenùed the text ,IS a hm\ -(0-
44 n.n: rANAnlAN NIIR
F

do-it proccdurc manual but as .I hook
of sclected hasic concepb. They have
included a number of hows to explain
till: \\ hys.
A numher of excellent summarie

an: prcsented. These inelude steriliLa-
tion. asep...i.... po...itioning. and anes-
thesia. In this respect. the book would
he a u
eful guide for the instructor.
and \\l)LIld make interesting readi ng for
aJl level, of operating room statl. The
st) Ie is ,imp1c hut direct.
Chapter 5. which deals with surgical
con
cience. is particularly well wrillen
and re,llistic: it deals with routine pa-
tient-care and many frequently dis-
cu
sed prohlems and emergencics
peculiar to any operating room. Some
.....ecrct'. prohlems are also dealt with
ohjectively: thcsc include shortagc of
personnel. incxpericnced staff. cm-
plo)ce fatigue. and administrative
...uppon. rhe...e topics are all too fre-
quently left to the cotTee room.
Chapter (-, i
intended to enhance
the nurse-paticnt relationship. A por
tion of thi<; chapter is writtcn as a direct
quote. creating a more authentic hack-
ground tÓr the preoperative visit under
discussion. A sect ion of chapter l) in-
clude<; the foil 11\\ -up postoperative vi
it

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th

da)s later. An under...t<lI1ding ,lIld
effIcient nurse, and " cooperative pa-
ticnt in thi
example make this scction
inspiri ng reading. though ideal i...tic.
At the end of cach llf the 10 chap-
ters therc is a comprehelbive list oj
rcfercnces and supplcmentar) readings
that should prove u,eful to operating
room personncl. Thi
hOllk would he
a vall1
lhlc addition to an) operating
room IIhrary.

Respiratory Nursing Care: Physiology and
Technique by Jacqueline F. Wade. 171
pages. St. Louis, Mosby, 1973.
Reviewed by Irene Izatt, Senior Coor-
dinator, Nursing Program, Cnnfeder-
ation CnlLege of Applied Arrs and
Technolog\', Thunder Bay, 01l111rio.

The author of this book believes that
respiratory care is required by must
patients, regardless of age or diagnosis.
Her stated purpose is to provide the nurse
with a knowledge of factors th.lt predis-
pose patients to the development of
respiratory problems, methods of protect-
ing patients from respiratory complica-
tions, and. la
tly., with an understanding
of methods of management employed
when these problems occur.
The first chapter provides a brief
review of the anatomy and physiology of
the respiratory system. This is followed.
in the next four chapters, by a thorough
discussion of gas law
, pulmonary func-
tion testing, ventilation. and blood gases.
The remainder of the book is devoted
to a discussion of commonly encountered
respiratory diseases and the related medi-
cal and nursing management. Respiratory
failure is dealt with in considerable depth,
with particular attention given tu the
medical management of this problem.
Emergency resuscitation. mechanical
ventilation. and intensive respiratory care
in specific conditions are presented in the
final chapter.
The author has succeeded in accomp-
lishing her stated objectiy,es. Pertinent
infonnation required by the nur
e caring
for patients with respiratory problems is
available in thi
sm.lll but comprehensive
book. In addition, and most importantly,
the physiological basis for nUßing actions
and medical therapy is given. thus ensur-
ing that the nurse can perfonn with a
sound understanding of thc why
behind
the care that she is required to give.
This book provides valu.lble infonna-
tion for all nurses, but it is particularly
recommended for nurses working in
intensive respirator} care units, Ho\\ever.
the reader must expect to refer to other
texts for a more complete discussiun of
respiratory diseases per se. the more basic
related nursing care, and rehabilitation
concepts. The
e are not dealt with in this
particular book. ç
IUNE 1974

-..- -

A V aids

PU BLiCA TlONS
o Three different booklets written by
ostomates who discuss the relationship of
ostomy surgery (ileostomy. colostomy. or
urostomy) and its sexual aspects are
available from United Ostomy Associa-
tion. Inc.. IIII Wilshire Boulevard. Los
Angeles. Calif. 90017. U.S.A.
Sex, Courtship and the Single Osto-
mate (24 pages) by Donald P. Binder is
directed to the attitudes of ostomates and
how to overcome the anxieties that a
single ostomate might have regarding
personal relationships involving sex. pre-
paration for marriage, or companionship.
Sex, Pregnancy and the Female Osto-
mate (24 pages) by Carol Norris and Ed
Gambrell Jr. deals with the concerns a
female ostomate might have about sex
and especially about bearing children.
The booklet includes comments and help-
ful hints from ostomates who have had
children after their surgery .
Sex and the Male Ostomate (32 pages)
by Ed Grambell. Jr. is directed to
psychological and physiological sex prob-
lems that can happen to a male ostomate.
It includes possible solutions and alter-
nate methods regarding impotency.

BOOKLET ON HEART DISEASE
DHeart attack! These frightening words
spell an incurable disease that is our
number one killer.
Yet many heart attacks caused by
coronary heart disease (CHD) can be
prevented. The Kemper Insurance Group
in Long Grove, Illinois, has made availa-
ble a booklet called Heart Attack, which
tells how to avoid becoming a coronary
lost cause. This booklet, prepared by
Northwestern Memorial Hospital in
Chicago and available to the public free
of charge. is filled with potentially
lifesaving information from
Northwestern's renowned CHD staff.
The picture that most people have of
CHD is the violent series of events
initiated by a heart attack: they often think
it is precipitated by traumatic physical or
emotional stress. although the heart attack
is only the deadly end product of CHD.
Heart disease cuts across all cultures
and all age groups. As the booklet
explains. cigarette smoking. elevated
blood fats such as cholesterol. and high
blood pressure - all spin-offs of our
society - are the three major risk factors
contributing to the prevalence of heart
disease. A disturbing trend indicates that
JUNE 1974

heart disease is on the nse In young
adults.
According to the booklet. cardiovascu-
lar diseases are resyonsible for more than
half the deaths in the United States each
year. and CHD is the most common fonn.
Also, 50 percent of all those stricken with
a heart attack never make it to the
hospital.
To obtain a copy of this report, send
your name and address to: Heart Attack,
Kemper Insurance, 0-1. Long Grove.
Illinois 60049, U.S.A.

AUDIO CASSETTES
o Au-Vid, Inc. has created a new
teaching aid that lets the patient do the
teaching.
Entitled "Very Important Patients
Speak (VIPS)," this audio package of 12
cassettes contains the narratives of 19
patients who have a variety of educational
and socioeconomic backgrounds. Each
person describes how he faced a major
health crisis - from a heart attack,
stroke, or renal failure to tenninal cancer.
Each of these patients also describes his
feelings and needs from the onset of
symptoms through hospitalization. diag-
nostic procedures, surgery. and dis-
charge.
The tapes reinforce concepts that have
been taught, such as assessment and
intervention, problem-solving, patient
teaching, and communication techniques.
Listening to the tapes enables the student
to assess each patient's needs, while he
develops listening skills. The student's
empathy is fostered by listening to each
person explain his feelings and needs as
he faced surgery. possible death, and
body disfigurement. and the effects of
his illness on family members.
Other possibilities for use of this
package are given in the discussion guide.
included with the tapes. VIPS is available
from Au-Vid. Inc.. Post Office Box 964.
Garden Grove, California 92642. U.S.A.

LITERATURE AVAILABLE
o The York-Toronto Tuberculosis & Re-
spiratory Disease Association has pub-
lished a sequel to the booklet Willy and
the Wheeze (March 1973, page 55). The
new illustrated booklet. entitled So You
Have Asthma: Welcome To The Club, is
intended to help those in the 10 to 16 age
bracket achieve a better understanding of
their asthma. As asthma that persists to
this age is often the most severe variety.

author Helen Barron has touched on the
question of self-control and mastery of
adversity by giving four examples of
persons suffering from asthma, who
nevertheless have achieved distinction in
a given field.
This free booklet is available from
local TB and RD associations. More
information is available from the York-
Toronto TB & RD Association. 157
Willowdale Ave., Willowdale, Ontario.
M2N 4Y7.

FILMS
o The Canadian Film Institute is making
available 18 films that cover all facets of
venereal disease. General or specialized
groups can rent these films. which in-
clude How To Keep From Catching VD
(20 min., color, USA 1971):
VD -Attack Plan (16 min.. color, USA
1973); VD - Verv Communimble Dis-
eases (19 min., èolor. USA 197-); and
VD - Kids Get It Too (14 min.. color,
Canada).
For more information. write to the
Canadian Film Institute. 1762 Carling
Ave.. Ottawa. Ontario, K2A 2H7.

Olt Couldn't Happen To Me (28 min..
color) is a film that focuses on premarital
sex. birth control. and pregnancy. Three
physicians comment on the many aspects
of adolescent sexuality and pregnancy.
and a group of pregnant teenagers discuss
why they failed to use birth control. The
film. which was intended primarily for
high school 'itudents, is considered to be
o.f best use as a basis for group discus-
sion.
Edward S. Herold. assistant professor
of family studies at the University of
Guelph in Guelph. Ontario. produced this
film as a way of showing that pregnancy
can be prevented. He received a family
planning grant from the family planning
division of the federal health department
for the film. It is distributed by Associa-
tion Films. 333 Adelaide St. W.. To-
ronto. Ontario. M5V I R6.

o Two films have recently been released
by Wallcur, Inc. They are available in
16mm and Super 8mm cartridges. Con-
dom Applimtion for Urinary Inconti-
nence (5 min.. color. sound) demon-
strates remmal and reapplication of the
condom appliance. Genito-Recwl Cleans-
ing (13 min.. color, sound) demonstrates
routine cleansing of females. circumcised
THE CANADIAN NURSE 45

males. uncircumcised males. and males
with fecal incontinence. Instructor guide-
lines are available free of charge. Learn-
ing guides are also available.
Anna M. Curren. RN. MA. v,as the
film director. She is an associate profes-
sor of nursing at Long Beach City College
in California and is a director of Wallcur.
Inc, - a nurse-educator owned corpora-
tion.
Free preview copies of these films are
available in 16mm from Wall cur
(Canada). 54 Quinpool Cres.. Ollawa.
Ontario. K2H 6J I. "':':'

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 institu-
tions. Reference (R) items (archive books
and directories. almanacs and similar
basil' books) do nol go t,)ut 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 Library.
Canadian Nurses' Association. 50 The
Driveway. Ollawa. Ont. K2P I E2.
No more than three titles should be
requested at anyone time.

BOOKS AND DOCUMENTS
I. Altered slates of UWarellðs: Readillgs ft om
Sciemific Americall with i11lroductiollS b\' Timoth,' 1.
Tn-IeI'. San Francis"". Freeman. d972 140p.
2. AIZIlual matill!!. Vallcou,'er, JUlie 14-16, 1973.
Reports to the Celleral COllllci/. Ottawa. Canadian
Medical Association. 1973. 99p.
3. Babies by choice, Ilot b,' chalice. A demolBtra-
tioll project /II olltreach famih plallll/ll!! .,en'Ù','s.
prep.!red by the Social Policy and Rcse.!rch Staff.
Vancouver. B.C.. United Community Services of
the Greater VanOJuver Area. 1973. 2v.
4. Call1ldiall edllmtioll illdn, ".9, llo.J, July-Sept.
1973. Ottav..!. Canadian Council for Re\earch in
Education. 1973. 88p. R
5. Call1ldiall hmpitals, 1920 to 1970; a dramatic
half cellllln'. by G. Hane} Agnev.. Toronto.
University of Toronto Press, 1974. 276p.
6. Catalo!!ue de /'audio-"ideothèqlle de la Bib-
liothèqlle d'Ullil't'r.IÍle Lam/. Quehcc (ville), Les
presses de rUni'ersile Laval. 1974. Iv.
7. C ompelldillm oj pharmacelllical alld specialties
(Calllllla) 9th ed. Toronto. C.!nadian Pharmaceutical
Association. 1974. IO:!6p.

8. COllférellce imerpnJ\Ùlciale sur les mallueÜ ell
lall!!ue frallçaise au Callada. Ottawa, 27-28 février
1970. LeI malluel., "colaires ell hlllgue fnmçaÜe au
Callada; rapport de collfereme. Ottawa. Fédération
canadienne des enseignants. I 970'! 8Sp.
9. Currem illdex ro joumals ill educatioll; .Iemi-
allllual cumulatitJll, Jall.-Julle 1973. New York.
Macmillan. 1973. 1032p. R
10. The dem'lIld for health: a theoretical alld
empiril'Q1 illl'estigatioll, by Michael Grossman. Nev.
York. Columbia University Pr.. 1972. liSp. (Na-
tional Bureau of Economic Research. Occasional
paper 119).
II. D,m't ha"e ,'our bub,' ill the dory; a biography
of Myra Bellllett, by H. Gordon Green. Montreal.
Harvcst House. 1974. 146p
12. The E.C.C. made ean, by John R. Hampton.
Edinburgh. Churchill Livingstone. 1973. 68p
13. Frellch hoof... catalogu,'. Ott.!wa. Eastcrn On-
tario Librar} System, 1972. 443p.
14 Lé!!islatioll hospitalière et .I\'.\tème.' I/Os-
pitaliel'.l. par R.F. Bridgman et M.1. Roemer.
Genève. Organisation mondiale de la S.!nté. 1973.
250p. (Organisation mondiale de la Santé. C.rniers
de santé publiljue no. 50).
15. Li.1t of accredited alld prm'i.IÙmaU\, accredited
CWllIlliall hospitals. Toronto. Can.!dian Council on
Hospital Accreditation. 1974. Iv.
16. Li.'illg c<mifortah/\' lI'ith I'l"''' ileostom,', by
Darlene Lars,>n. Minneapolis. Minn.. Sister Kenny
Institute. 1973. 37p. (Sìster Kenny Institute. Re-
habilit.!tion public.!tion no. 718).
17. Mal1l/el de politique.1 et de procedllres: .,en'Ù'e

Request Form for uAccession List"
CANADIAN NURSES' ASSOCIATION LIBRARY

Send this coupon or facsimile to:
LIBRARIAN. Canadian Nurses' Association. SO The Driveway. Ottawa. Ontario. K2P H2.
Please lend me the following publications, listed in the .............................................................. issue of The
Canadian Nurse, or add my name to the waiting list to receive them when available:

Item
No.

Author

Short title (for identification)

Requests for loans will be filled in order of receipt.
Reference and restricted material must be used in the CNA library.
Borrowe r ............................................................................,.............................. Regi strati 0 n No. ................................
Pos iti on .................................................................................... ......................................................................................,...
Add ress .... ........................ ........................................."....... ................................................................................................
Date of req uest ..................................................................... ............................................,...............................................

46 THE CANADIAN NURSE

JUNE 1974

- --

de santé du personnel. par Normand Rainville,
Béatrice Lapune et Ghislaine Cyr. Hull, Centre
Huspitalicrdu Sacre-Coeur, 1973. iv.
18. New directIOns in patient-centered nursmg;
guidelines for systems of sen'ice, education and
research, by Faye G. Abdellah et al. New York.
Macmillan, cl973. 597p.
19. Nineteenth report of World Health OrKaniza-
'ion. Expert Comminee on Drug Dependence.
Geneva, 1973. 38p. (WHO Technical repon series
no. 526).
20. Nursing papers, "01.5, no.3, Dee. 1973.
Montreal, McGill University. School for Graduate
Nurses, 1973. 56p. (Health services today and
tomorrow).
21. Obstetric nursing, by Arlyne Friesner and
Beverly Raff. Flushing, N.Y., Medical Examina-
tion Pub. Co., 1974.204 p. (Nursing outline series).
22. Preparing your income ta
returns Canada and
provinces, by R.A. Lachance and G.O. Eriks. 1974
edition for 1973 tax returns. Toronto. CCH Cana-
dian Ltd.. cl974. 268p.
23. Proceedings. National Conference on School
Health. Ottawa. Oct. 29-31, 1972. Onawa. Met-
ropolitan Life Insurance Co.. 1973. 99p.
24. Redécouvrir Ie langage du corps hwnain; c'est
reconquérir {'amour, par Paul A. Bnileau. Ott.!wa,
Lenreac. 1973. 132p.
25. A role of the federal government in mental
health, (/ report preparedfor the Dept. ofNati01lal
Health and Welfare, by Pierre G. Martel. Sher-
brooke. P.Q.. Sherbrooke University. 1973. 49p.
26. The saintl\' life of Jeanne Mance; first la.\' nune

in North America, by William Henry Atherton. SI.
Louis. Mu.. Catholic Hospital Association of the
United States and Canada, 1945. 95p.
27. Selected SOUrces of information in inremarional
health area.!. Chicago, III., National Council for
International Health. Committee on Information.
1973. Iv.
28. Supervisor\' mc.nagement for health care institu-
tions, by Theo Haim.!nn, SI. Louis. Mo.. Catholic
Hospital Association, cl973. 416p.
29. Surveillance infirmière des malades atteints
de . . . médecine - chirurgie spéciali1és, par Pierre
Delforges et Alain Harlay. Paris, Lamarre Poinat.
1973.207p.
30. Traitement comportemenral en institution
psychiatrique, par Teodoro Ayllon et Nathan Azrin.
Bruxelles. Charles Dessart. 1973. 376p.
31. Understanding medications. by René Poitevin.
Montreal. Habitex. 1973. 127p.
32. La \,érité et Ie can< er. par Roger Spithaki,.
Paris. Editions Resma, 1973. 163p.
33. Vocabulaire des techniques de groupe: forr/liI-
tion, psychotherapie dynamique des groupes et
psychodrame. par Anne Ancelin Schu4zenberger.
Paris. Epi. 1971. 193p.
34. Workbook for maternity nursing, by ConMance
Lerch. 3ed. SI. Louis'. Mosby. 1973. 194p.
35. Workprogram 1973; list of publications. Ut-
recht. Netherlands. NatlOnaal Ziekenhuisinstituut,
1973. 99p.

PAMPHLETS
36. After 65: re.!ources for ,elf-reliance, by Theo-

dore Irwin. New York. Public Affairs Committee,
1973. 28p. (Public affairs pamphlet no. 501).
37. Basic nursing education programmes in British
Columbia. Vancouver. Registered Nurses' Associa-
tion of British Columbia. 1974. 15p.
38. Bibliographies in education. no. 37 - secon-
daryeducation. Ottawa. Canadian Teachers' Feder-
ation. 1973. 21p.
39. Bibliographies in education, no. 38 - indepen-
dent stud\.. Ottawa. Canadian Teachers' Federation,
1973.20p.
40. The big foundarions, by Maxwell S. Stewart.
New York, Public Affairs Committee, 1973. 28p.
(Public affairs pamphlet no. 500).
41. Breathing exercises for asthmatic children.
Evanston. III.. American Academy of Pediatrics.
Section on Allergy. 1969. 16p.
42. Code for nurses; ethical concepts applied to
nur.ling, produced h\' the Profe.l.!ional Sen'ices
Committee and adopted b\' The ICN CounCIl of
National Representatil'es in Mnicu City, 1973.
Geneva. International Council of Nurses. 1973.
pam.
43. Population and the Americanfuture, by Elizabeth
Ogg. New York, Public Affairs Committee. 1974.
28p. (Public affairs pamphlet no. 503).
:W. Psyehosocial asp/xts of abortion. Geneva.
WHO Medlars Centre. 1973. 51 p. (Search no.
W04660/048 and W04661/048.
45. Psycho.wcial faetors amI coronan care or
imensil'e care units. Genev.!. Vv HO Medlars Centre,
1973. 15p. (Search nn. W04680/048).
46. Submi
sion to the New Brunswick higher educa-

This
Publication
is Available in
MICROFORM

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,1'.

CALL ME
A GOOD
THIEF

by
DONALD POLLOCK

Who is Donald Pollock? Born in Montreal, Quebec, he spent 18 years of his
!rfe In and out of prisons. He passed his childhood years in two reform
schools.
He was addicted to drugs for 8' h years. Classified as being cnminally Insane
twice. Was sent to penitentiary four times.
Donald has been arrested for car thefts to hold-ups. He escaped from the
pemtentlary and took a guard's wife hostage. He was classed as a criminal
psychopath.
Today that is all behind him. Donald Pollock is not only a writer but also a
speaker, who In the last 4'/2 years since his release from pnson has spoken
to over 200,000 people. His is an experience you will want to learn about.
The reaction to the book is unbelievable. Today Donald Pollock IS a happy
man.
Please use the order form below.

Xerox University Microfilms
300 North Zeeb Road
Ann Arbor, Michigan 48106
Xerox University Microfilms
35 Mobile Drive
Toronto, Ontario,
Canada M4A 1 H6
University Microfilms limited
St. John's Road,
Tyler's Green, Penn,
Buckinghamshire, England
PLEASE WRITE FOR COMPLETE INFORMATION

11\
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Transformnian Information Centre, Inc.,
3070 Montée St. tfube.rt.
St-Hubert, Québec, Canada, J3V 4H9. Tel. 678-3458
Please send me_copy (copies) of this 427-page autobiography,
CALL ME A GOOD THIEF, at $6.95 each, postage Included.
Name:___________________________________
Address: __________________________________
Ci
:------------------------------------

JUNE 1974

THE CANADIAN NURSE 47

Next Month
in

The
Canadian
Nurse

. RNs at the Bargaining Table

. Tetanus

. Sudden Infant Death Syndrome

. Urban Health Care
in a Rural Setting

ð

Photo Credits
for June 1974

Yellowknife Photo Centre, Ltd..
Yellowknife, NWT. p. 10
Toronto General Hospital,
Medical Photography.
Toronto, p. I3
Information Canada, Ottawa,
p. n
National Health & Welfare.
Information Services,
Ottawa, p. 28
Manotick Photo Services,
Manotock.Ont.,
p. 29 (top)
Rapid Grip & Batten,
Ottawa, p. 29 (bottom)
National Film Board,
Ottawa, p. 30

48 THE CANADIAN NURSE

accession list

tion commiHion on fil/llre de,'efopmem and {lnanc
ingfor post semndary edllcation Frederi.:tion. New
Brun
wi.:k Asso.:iation of Regi
tered Nur
e'. 1973.
16p.
47. Tllbermlin testing: a critical evaillation. Pro-
ceedings of a panel disclI.uion at the American
School Health Association Com'ention, Oct. 1972,
San Diego, Calif. New York. Lederle Laboratories.
1973. 14p.
48. What we know abollt headaches, by Anhur S.
Free
e. New York. Publi.: Afairs Committee. 1973.
20p. (Public affairs pamphlet no. 502).

GOVERNMENT DOCUMENTS
Alberta
49. Legislative Assembly. Special Committee on
Professions and Occupation
. Report. Edmonton.
Queen's Printer, 1973. 72p. (It, Repon 2).
Canada
50. Conseil des sciences du Canada. Considérationf
Sllr les soms de santé all Canada. par H. Rocke
Robertson. Ottawa. Information Canada. 1973.
180p. (It
Etude sp
.:iale no. 29).
51. Depl. of Veteran
Aftalr
. Report 1<}72-73
Ottawa,lnformatior Canada. 1973. IOlp.
52. Health and Welfare. Advi
ory Committee on
Ho
pital Insurance and Diagno,tic Servi.:e,. The
report of the working part'.' on patient care
classification, NOI'emher /973. Ottd"d. Health and
Welfare Canada, 1973. 108p.
53. Law Reform Commi

ion. Report /972/73.
Ottawa. Information Canada. 1973. I v.
54. Mini
tère de la Santé nationale et du Bien-être
social Division des Servi.:es de Bien-être
d'Urgence. Alimentation de secOllrs en periode
d'lIrgence. Onawa, Imprimeur de la Reine, 1970.
208p.
55. Prices and Inmmes Commis
ion. Price forma-
tion in the market for physicwn serl'ices in Canada
1957-1969. by Robert G. Evans. Ottawa. Informa-
tionCanada. 1972. I3lp.
56. Public Service Commission. Selection stan-
dards (interim) scientific and professional categorv,
nursing grollI'. Onawa, 1971. 17p.
57. Statistics Canada. List of Canadian hospitals
and related in
titutions and facilities. 1974. Ottdwa,
Information Canada. 1974 92p.
58. -. A short guide to Canadian unil'ersities and
colleges. by . in cooperation with the A

o.:ia-
tion of Universitie
dnd College
of Canada.
Ottawa, Information Canada. 1973. I \I.
59. -. Trllsteed pemion plans; .financial statistics,
1972. Onawa, Information Canada, 1974. 60p.
60. -. University and college libraries in Canada,
1970-71. Ottawa, Information Canada. 1973. 56p
(S.c. cat. no. 81-206).
61. -. Vital statistics; preliminarv annual report,
1972. Onawa. Information Canada. 1974. 63p.
62. -. Vocational and technical training 1971-72.
Ottawa,lnformationCdndda. 1974. 88p.
63. Treasury Board. Classification standard. Nurs-
ing group, scientific and professwnal categorv.
Publi
hed by Compen
ation and da"ification divi-
sion, Personnel poli.:y bran.:h. Üttdwa. 1971. 36p.

Quebec
64. MiniMère des Affaires so.:iales. Agremellt de.'
établinemellt.' Jenice de r éI'aluation de.' normes et
de r émission de.' permis liste ,Ie.' "entreJ no>,
pitalier.,. Québe.: (ville). 1973. 5\1p.
65. Mini
tère de
Affaire, culturellö RADAR.
Repertoire wliIhtique d'articles de rel'lles du
Quebec. ,'j. no.2. Montreal. 1973. I v. R
U.S.A.
66. Dept. of Labor. Bureau of Labor Statistics.
Tomorrow's manpower need.,: re"earch report on
manpower projection methods. Washington. D.C.,
U.S. Govt. Print. Off.. 1973. 36p. (It
Bulletin
1769),
(,7. National Clearinghou,e for Smoking and
Health. Bibliograp/1\' on ,I11lOking and health,
1970-1972. Wa
hington. D.C., Puhli.: Health Ser-
vi.:e. 1973. 3v.
68. National Library of Medidne. Program., and
services. 1973. Bethesda. National In
titutes of
Health. 1973. 40p.
69. National Medi.:al Audiovisual Center. Motor
picture <lnd videotape catalog /973: selected au-
dio,'i.,uals for the health .,cientist. Atlanta. Ga..
1973. 180p. (U.S. DHEW Publication no. (NIH)
74-506).

STUDIES DEPOSITED IN CNA REPOSITORY COLLECTION
70. The Bloon'iew satellite project: an e"aluatio1l of
the pilot period, 1971-/973. by Margaret C. Cahoon
and Lettie Turner. Town'o, 1973. 85p. R
7 \. A lJescriptÍl'e survey of the etpalll/ed role of the
nune in the Health Sciences Centre Hospital, by the
Ad Hoc Committee "n the E.\paIllJed Role. Van-
<:ouver. B.C., University of Briti
h Columbia
Depl. of P'y.:hiatry. Health Scien.:es Centre Ho
pl-
tal. Nur,ing Divi
i"n, 1973. 74p. R
72. The de,'elopment. implemPntation and emlua-
tion of a workload indnfor Hof\- Family Hospital.
Prince Albert, Sa.,k. Sd
"atoon, Sask.. Univer\ity
of Saskat.:hewan. Ho
pitdl Sy
tems Study Group,
1973. 151p. R
73. Drug distribution. If. Nuning inl'Olvement in
drug distribution, by B.A. Holmlund and CD.
Webster. Sa,katoon. Sa
k.. University of Sa
kat.:h-
ewan. Hospital Sy
tems Study Group, 1\169. 28p. R
74. Etude de.,cripti,'e des actÎ\'Îte.< de l'infirmière ell
pS\'chiatrie communautaire. par Micheline Bouvier
Jetté. Montréal. 1973. 199p. R
75. A feasibilit'.' Jtlldv of the automatic interpreta-
tion of electrocardiograms, by B.A. Holmlund.
Sa
"atoon, Sa
k.. University of Sa
kat.:hewdn
Hospital Sy
tems Study Group. 1967. I('p. R
76. A nursing stud,' tv institute and evaluate an
organi
atiml<ll pattern for nuning a group of
patients in a general hospital using the unit
manager. the nurse coordinator and team nuni1lg,
by Fran.:es M. Howard and R.G. Sagar Kingston.
Ont.. KingMon General Hospital. 1974. 232p. R
77. Predominant penml/.llir." difference.' in .,tlUlent
nurse.f, by Mary Marrs. Waterloo. Out.. 1973. /9p.
R
78. Prosthetic services in Alberta: needs. re-
sources, disparities. by Margaret Louise Boyd.
Edmonton. 1973 176p. R
79. Specialrv preference and use of leÜure time by
student nunes. by Mary Knipe. Ne.... York. I96Q
46p. R
1i0. Staffing b,' patient care work/oad, by M.R.
Biànell. Sa
katoon. Sd
k.. Univer
ity of Sa
kat.:h-
ewan. Ho
pital Sy
tem
Study Group. 1970. 21p. R
JUNE 1974

classified advertisements

I

ALBERTA

DFIECTOR OF NURSING required for thIrty-five bed general
accredited hospital located 80 mIles east of Edmonton. Appli-
cants should have supervISOry or administrative e)(penence and
wIll be involved in the planning of a new health care facIlIty.
Piease address enqulfæ5 or applications to: The Administrator:
Viking MunicIpal HOSpital, Wong, Alberta, TOB 4NO.

REGISTERED NURSES required Immediately for 25.bed Ge-
neral Hospital, 110 miles East of Lacombe. Highway No. t2
Salary and policies as per AARN. ResIdence available. Trave
expenses advanced Will be refunded atter one Y ear's service
Apply: Director of Nursing. Coronation Municlpa Hosp'tal, Co-
ronatIon, Alberta. TOC 1 CO.

REGISTERED NURSES required lor70 - bed accredited actIve
treatment Hospital. Full time and summer relief. All AARN per.
sonnel policIes. Apply in writing to the: Director of Nursing,
Drumheller General Hospital, Drumheller. Alberta

REGISTERED NURSES looking for interestIng work with

n

Ãta:o:,
r:c

a

=

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:
t:
:
apply to: Director of Nursing. Central Peace General HospItal,
Spont RIver, Alberta. TOH 3GO.

GIONERAL DUTY NURSES required ImmedIately for modern
38-bed hospital in the Peace River area. Excellent recreational
and social factlltles avaIlable In the community. lIvmg accom-
mcx:lations In comfortable nurses resIdence. Salary and benefit!
accordIng to AARN agreement Apply to: Director of Nursing,
Box 250, Manning MunIcIpal Hospital. Manning. Alberta TOH
2MO.

ADVERTISING
RA TES

FOR ALL

CLASSIFIED ADVERTISING

$15.00 for 6 lines Or less
$2.50 for each odditional line

Rates for display
advertisements on request

Closing date for copy and cancellation is
6 weeks prior to 1st day af publication
month.
The Canad,an Nurses' Association does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they ore interested
in working

Address correspondence to:

The
Canadian
Nurse

ð

50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P 1E2

JUNE 1974

I I

BRITISH COLUMBIA

OPERATING ROOM NURSE wanted tor active surgIcal suite In
acute accredited hospital. Experience and/or training in O.R.
techmque as well as experience In Obstelrics and Emergency
desirable. Must be eligIble for RNABC registration. Salary as per
RNABC contract. Apply to: Director 01 Nursing. St. _Mary's
HospItal, Box 7777. Sachelt BrI
sh COlumbIa

OPERATING ROOM NURSE wanted lor active mo.
dern acute hospital. Four Certified Surgeons on
attending staff_ Expenence of training desirable
Must be elIgIble for B.C RegIstration Nurses
resIdence avaIlable. Salary according to RNABC
Contract. Apply to Director of Nursing, Mills Mem-
orial HospItal, 2711 Tetrault St.. Terrace, British
Columbia.

REGISTERED NURSES & GRADUATE NURSES required for
a new 41.bed Acute Care HospItal located 200 moles north 01
Vancouver and 60 miles trom Kamloops. B C. t.imlted fUrnished
accommodation available. Apply to Director of Nursing.
Ashcroft and Dlstnct General Hosp,tal, Ashcroft. British Colum-
bia VOK IAfI

REGISTERED NURSES WANTED FOR FUt.L Y ACCREDITED
HOSPITAL CONSISTING OF 190.BEDS. GENERAL DUTY
POSITIONS IN MEDICAL.SURGICAL. PSYCHIATRIC AND
ICU.CCU AREAS. MUST BE ELIGIBLE FOR B.C. REGISTRA.
TION. BASIC SALARY 1973 - $67200 (NEW CONTRACT
BEING NEGOTIATED.) APPLY: DIRECTOR OF NURSING.
ST. JOSEPH S GENERAL HOSPITAL. COMOX, BRITISH
COLUMBIA V9N 4B1

REGISTERED NURSE required for Nicola Valley General Hospi-
tal, located in the Southwestern part of B.C. StartIng salary from
$850.00 to $t,02000. ResIdence avælable. Apply to: Director
of NursIng. N.V G.H.. Box 129, Merritt. Bntlsh Columbia.

EXPERIENCED NURSES (eligIble for B.C. registration) required
for 409-bed acula care, laachlng hosprtallocated in Fraser Val-
ley. 20 minutes by freeway from Vancouver and within easy
access of vaned recreational faCilities. Excellent Onentation and
ContInUIng EducatIon programmes. Salary according to RNABC
contract. Cllmcal areas include: Medicine. general and speciali-
zed. Surgery, ObstetrICs, PediatrICs, Coronary Care, Haemodla-
lysis, Rehabilitation, Operating room. Intensive Care. Emer-
gency. PRACTICAL NURSES (eligIble for B.C. LIcense) also
required. Apply to: Director of NursIng, Royal ColumbIan HosPI-
tal, New Westminster, Bntlsh ColumbIa, V3L 3W7

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 01.
RECTOR OF NURSING, CARl BOO MEMORIAL HOS-
PITAL 517 NORTH SIXTH AVENUE, WILLIAMS
LAKE.'BRITISH COLUMBIA

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES required for small
upcoast hospital Salary and personnel policies as
per RNABC contract Salanes start at $67200 lor
Reg, stered Nurses $577 75 lor licensed PractIcal
Nurses Residence accommodation $2500 per month.
Transportation paid from Vancouver Apply to
Dorector of NursIng St George s HospItal Alert Bay
BritIsh Columbia

GENERAL DUTY NURSES for modem 41.bed hospital located
on t
e Alaska HIghway Salary and personnel policies ,n
ac(.ordance with RNABC Accommcx:latlon available In resI-
dence. Apply: Director of Nursing. Fort Nelson General Hospotal,
Fort Nelson. British ColumbIa.

GENERAL DUTY NURSES, for modern 35.bed hospItal located
In southern B C s Boundary Area with excellent recreation facl-
Itties Salary and personnel policies In accordance with RNABC
Comfortable Nurses s home Apply Director of NursIng. Bound.
ary Hospital, Grand Forks, Bn
sh Columbia

II

BRITISH COLUMBIA

GENERAL DUTY NURSES for 360:bed acute general hospItal.
Personnel poliCies In accordance with RNABC Contract. Direct
inqulnes to: Director of NursIng, Nanæmo RegIonal General
Hospital, Nanaimo, Bri
sh Columbia.

TWO GENERAL DUTY NURSES wIth expenence in obstetncs
and 0 R. reqUIred for a 21-bed hospital in the Southern Intenor
of B.C. Living-in accommodation avaIlable. Salary as per
RNABC rates. Moderate climate, good working conditions and
recreational facIlities available. Apply, gIving full particulars and
references In first letter to the: Administrator. Siocan Community
Hospital. Box 129, New Denver, BritIsh COlumbIa

EXPERIENCED GENERAL DUTY NURSES reQljorl'_d.for
:51-bed HospItal. Basic Salary $672 - $842 per
month. Policies In accordance Witt' RNASC Contract
Residence accommodation available. Apply to
Director of Nursing, Powell River General Hospital
5871 Arbutus Avenue. Powelt RIver, Brltosh Columbia.

EXPERIENCED GENERAL DUTY NURSES tor modern
10.bed hospital with doctors offIces In hospItal
Situated beautiful west coast of Vancouver Island
Accommodation' $5000. a month. Apply Administra-
tor. Tahsls Hospital. Box 399. Tahsls British
Columbia.

GENERAL DUTY NURSES requored for an 87-bed
acute care hospital in Northern B.C Resldencfl
accommodations available. RNABC policies In effect
Apply to: Director of Nursing, MIlls, Memorial Hos-
pital. Terrace, Bntish ColumbIa, V8G 2W7.

GENERAL DUTY NURSES for modem 45.bed hosPItal, located
In north central Bntlsh Columbia. Salary and personnel policies
In accordance with RNABC Accommodations available In resi-
dence. Apply to: Director 01 Nursing, SI. John HospItal. R.R. No.
2, Vanderhoof, British ColumbIa, VOJ 31'.0.

MANITOBA

REGISTERED NURSES required for the following
positIOns In a 68-bed acute carfl' general hospital
Night SupervIsor Operating Room Supervisor Ex.
perlence essenllal General duty nurses In Pediatric
Department Remuneration for past experience Shift
differential Salary In accordance with M H S C ap
proved rate Apply to Administrator Stfl' Rose Gen
eral Hospital. Ste-Rose-du-Lac, ManItoba, ROL 1 SO

NOVA SCOTIA

REGISTERED NURSES AND PSYCHIATRIC NURSES -
GENERAL STAFF posItIons available In a 225-bed psychlatnc
hospital OnentatlOn and Inservlce provided. Excellent person-
nel policies and salary commensurate with Quahflcatlons and
expenence as laId down by the Staff AsS",latlon Agreement
APPLY TO: Director of Nursing, Cape Breton Hosp,tal, P.D. Box
515, Sydney, Nova ScotIa

ONTARIO

OPERATING ROOM STAFF NURSE required for fully accrMI'
led 75.bed Hospllal BasIc wage $689 00 with conSideratIon for
expenence: also an OPERATING ROOM TECHNICIAN, baSIC
"'age $526.00. Call tIme rates avaIlable on request Wnte or
phone the: Director of NursIng, Dryden Dlstnct General Hospital.
Dryden. Ontario.

THE CANADIAN NURSE 49

ONTARIO

REGISTERED NURSES for 34.bed General Hospital.
Salary $706.00 per month to $816.00 plus expenance al-
lowance. Excellent personnel policies. Apply to'
Director of Nursing, Englehart & District Hospital
Inc.. Englehart. Ontano, POJ IHO.

REGISTERED NURSES required for 107-bed accredited Gen-
eral Hospital. Basic salary $695.00 with remuneration for past
expenence. Yearly increments. A progressive hospital amidst
the lakes and streams of Northwestern Ontano. Apply to:
Director of Nursing, La Verendrye Hospital. Fort Frances.
Dnlano.

REGISTERED NURSES required for our ultramodern 79-bed
General Hospital in bilingual communrty of Northern Ontario.
French language an asset. but not cornpulsory. Salary is $705.
to $825. rnonthly with allowance for past experience and 4
weeks vacation alter 1 year. Hospital pays 100% of O.H./.P.,
Life Insurance (10.000). Salary Irn;urance (75 0 " of wages to the
age of 65 with U.I.C. carve-out). a 351 drug plan and a dental
care plan. Master rotation in effect Rooming accommcx:latlons
available In town. Excellent personnel policles_ Apply to:
Personnel Director. Notre-Darne Hospital, P.O Box 850,
Hearst, Ontario.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS for 45-bed Hospital. Salary ranges
Include generous experience allowances. R.N.'s
salary $680 to $780. and R.N.A:s salary $490 to $565.
Nurses residence - private rooms with bath - $40.
per month. Apply to: The Director of NurSing. Gerald-
ton District HOSpital, Geraldton, Ontano. POT 1 MO.

Port Colborne General Hospital. Port Colborne. Ontario - This
modem 143.bed teaching hospital requires REGISTERED
NURSES for all services including Emergency Operating Room
and Cardiac Care Unit. Completely furnished apartment-style
residence. including balcony and sWimming pool facin
lake,
adjacent to hospilal. Apply: Director of Nursing, General
Hospital. Port Colborne, Ontario.

REGISTERED NURSES and REGISTERED NURSING
ASSISTANTS for 83-bed Home for Mentally Retarted
and Physically Handicapped Children. 40 Hour Week.
Accommodation available. RN's salary $600 - $720
and RNA's $520 - $620 plus allowance for experi-
ence. Apply to: Lakewood Nursing Home. Box 1830.
Huntsville. Ontario. POA 1 KO

REGISTERED NURSES FOR GENERAL DUTY, I.C.U.,
C.C.U. UNIT and OPERATING ROOM required for
fully accredited hospital. Starting salary $697.00 with
regular mcrements 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. On'"no, P2N 1 R2.

REGISTERED NURSES AND REGISTERED NURSING AS-
SISTANTS for a 41-bed Active Treatment Hospital. Excellent
personnel policies plus expenence allowance. Apply to: Assis-
tant Director of Nursing. Temiskaming Hospitals. New liskeard
Unit. New lIskeard, Ontano, POJ 1 PO.

RN's end RNA's. Etoblcoke Genera' Hospital Invites applica'
tlons from RN's - RNA's. Etoblcoke General, a 500-bed
community hosprtal 01 Friesen design, is presently expending
hospital beds and servICes to capacity. Applicants must be cur.
rently reglstared In Ontario. Apply to: Personnel Department,
Etobicoke General HOSpital, 101 Humber College Blvd.. Rex-
dale. Ontario, M9V 1 RB.

GENERAL DUTY NURSE. Salary ..8.404.00 per year to
$9.454.00. Toronto. The MlmlCO Correctional Centre, Etoblcoke,
(to be relocated at Milton, Ontario) has a vacancy for a general
duty nurse, to assist the medical officers. dispense medicine and
carry out general nursing treatments in a small infirmary. Please
direct queries to the: Superintendent (416) 255-0131, regarding
the Ontario Government position.

PUBLIC HEALTH NURSES (QUALIFIED) FOR GENERALIZED
PROGRAMME, ALLOWANCE FOR EXPERIENCE AND/OR
DEGREE. USUAL FRINGE BENEFITS. DIRECT ENQUIRIES
TO' MRS. RETA McBEAN. PUBLIC HEALTH NURSING. REN.
FREW COUNTY AND DISTRICT HEALTH UNIT. P.D. BOX 128.
PEMBROKE. ONTARIO, K8A 6XI.
50 THE CANADIAN NURSE

I I

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 Appl,catIOn$ will be
welcomed at Queen ElIZabeth Hospital of Montreal.
Nursing Personnel. 2100 Marlowe Avenue. Montreal
260. Quebec

TRAVEL THE U.S.A. - see our ad page 61 this issue.

MEDOX LIMITED

SASKATCHEWAN

DIRECTOR OF NURSING required lor lully modern 2O-bed
hospital In North Central Saskatchewan. Salary scale and fringe
benefits as negotiated by SRNA. Near Provincial Park. Progres-
sive. modem community. Administrative expenence an asset
but not required. Posi
on available Saptember 1,1974. Apply
to: Administrator, Porcupine Carragana Union Hospital, Box 70,
PoraJPine Plain. Saskatchewan.

RESIGTERED NURSES required for general duty In a 47-bed
hospital In Northern Saskatchewan. A great opportunity 10
broaden your experience. Ideal location for outdoor activities.

'b

s

s:C'ó SI. Joseph's Hospital. lie è

UNITED STATES

RN's and LPN's - University Hospital North. a
teaching Hospital of the University of Oregon MedIcal
School. has openings In 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 S.W Sam Jackson
Park Road. Portland, Oregon. 97201.

R.N:s - SOUTHERN CALIFORNIA - Immediate need exists
for medical-surgical units. Onentatlon and in-service program.
Excellent salary. full paid benefits. We will assist you with your
H-1 visa for immigration. A license In California to practise
nursing IS necessary before employment. Wrrte for an applica-
tion to the' California State Board of Nursing Education and
Reglstra
on, 1020 N Street, Sacramento. California. 95814

TEXAS wants yOU! 11 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 Memonal Medical Center. 500-
bed general. teaching hospital encourages career
advancement and provides in-service orientatIOn.
Salary from $682.00 to $94000 per month com
mensurate with educatIOn and expenence Differential
for evenmg shifts. available Benefits Include holi-
days Sl ck leave vacations. paid hospltallzallon
health. hfe insurance. pension program Become a
vital part of a modern up-to-date hospital wnte or
call collect John W Gover. Jr Director of Per-
sonnel Memorial Medical Center POBox 5280
Corpus Christi, Texas. 78405.

GRADUATE AND REGISTERED NURSES. Vacancies avalla.
ble In ICU, OR surgical, gen. duty. etc. 150 dill. U.S. &
Canadian hospitals In PaCIfic coast from Bntlsh Columbia to
sunny State of California. Starting salary $9.648.00- $14.500.00
per annum. Work permits & other paper works provided free.
Apply to authonzed hosPital representative: Phllcan Personnel
Consultants lid.. (Medical Placement Specialists). 5022 Victo-
ria Dr.. Vancouver. B.C.. V5P 3T8. Canada. Telex 0455333
Tel.: 327-9631.

Walter Safety says,
"Think, don't sink!
Be water wise! Learn
and practise water
safety every day,'"

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 1CO

NURSING OFFICE
SUPERVISOR

required for 270- bed acute care fully accre-
dited Hospital expanding to 370 beds. Per-
sonnel Policies in accordance with RNABC.
Must be eligible for B.C. Registration.
Preference will be given to applicant with
University preparation in Administration
and Clinical Supervision.

Apply Stating QualifIcations to:

Director of Nursing
Prince George Regional
Hospital
Prince George, B.C.

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.

JUNE 1974

Please Write:
Director of Personnel
Halifax Infirmary
1335 Queen Street
Halifax, Nova Scotia
Canada

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PROGRAM DEVELOPER
REGISTERED NURSING

(Instructor, Diploma Nursing Education)

THE DEPARTMENT OF COLLEGES AND UNIVERSITIES AF-
FAIRS, Keewatin Community College, The Pas, Manitoba, re-
quires a Program Developer - Registered Nursing (Instructor,
Diploma Nursing Education). Duties will include: formulate a
program to achieve the College's objective of developing a career
ladder in nursing; plan curriculum content and sequences; prepare
schedule and co-ordinate clinical and academic instruction and
rotation of students through various nursing services, and lead a
health education team through development and implementation of
an innovative nursing education program.
Applicants should have an R.N. status, a degree In nursing
education and a minimum of three years practical nursing
experience. Preference will be given to those with teaching
experience in an R.N. program. Applicants must also have a
demonstrated performance in: dealing with people, understanding
of group processes and familiarity with team leadership techni-
ques.
This IS an attractive opportunity for those interested in being at the
forefront of innovative and new approaches in nursinÇJ education.
SALARY: Up to $16,672. per annum plus Northern Allowances.

Apply in writing, referring to No. VT077 immediately to:
PERSONNEL DEPARTMENT
COMMUNITY COLLEGES DIVISION
C-410 2055 NOTRE-DAME AVENUE
WINNIPEG, MANITOBA
R3H OJ9

JUNE 1974

NURSE
(nurse classitication level 4)
required by

Department of Public Health
fDr the

SOURIS VALLEY EXTENDED CARE HOSPITAL
WEYBURN,SASKATCHEWAN

The Souris Valley Extended Care Hospital located in Weyburn,
Saskatchewan is a 360-bed Level 4 care facility designed to
provide health care to the chronically ill patients in Southeastern
Saskatchewan.
The successful applicants will be responsible to co-ordinate and
supervise patient care on nurSing units and deal with administrative
functions related to such co-ordination and supervision.
QUALIFICATIONS: Eligible for Registration in the S.R.N.A. or
S.P.NA
SALARY: R.N. - R.P.N. - $6,472. - $10,612. (presently under
review) B.Sc.N. - $6,692. - $11,340. (presently under
review)
Applications and further information available by writing:
PERSONNEL OFFICE
Souris Valley Extended Care Hospital
Box 2001. Weyburn. Saskatchewan

For "ppllcal/on torms, pi""'" conl"cl: Public Service Commission, 1820 Albert
Slreel, Regln", S"skalchew"n. S4P 2S8
Ple".e quole compellllon number: cc 7672
Closing dale tor receipl at "ppllc"tions: AS SOON AS POSSIBLE.

THE CANADI,AN NURSE 51

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS

THE RELIGIOUS
HOSPITALLERS
OF SAINT JOSEPH

SAINT JOHN GENERAL HOSPITAL
SAINT JOHN, N.S.
F 'in

for

INVITE YOU to share their 300 year heritage of service to the
Church in health. education and welfare services in
the Umted States, Canada and France
to share their availability to reach out to those m
need In Africa. Peru and the Dominican Republic
proclaimmg 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

GENERAL DUTY

Active Inservice Education programme.
Positions are also available for nurses with special clinical
preparation including cardiac and other intensive care areas.

For further information apply to:
Personnel Director
SAINT JOHN GENERAL HOSPITAL
P.O. Sox 2000
Saint John, N.S.
E2L 4L2

R.S.V.P. FORMATION CENTER
438Y2 College Sl.
Burlington, Vermont
05401

FORMATION CENTER
4 Toronto Street,
Ottawa, Ontario.
K1 S ON2

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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.
E:xcellent 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 51. Catherine Road Montreal 249, Quebec

'>1 THF (" ANAniAN NI JR
E

IUNE 1974

NORTH YORK GENERAL HOSPITAL
INVITES APPLICATIONS FROM:

REGISTERED NURSES AND
REGISTERED NURSING ASSISTANTS
FULL AND PART-TIME POSITIONS

N.Y.G.H. is a 585-bej, fully accredited, active treatment hospital
located in North Me.ropolitan Toronto offering opportunities in all
services.
The Hospital embraces the full concept of Progressive Patient
Care featuring a Self Care Unit and a Psychiatric Day Care
Program.
Our Nursing Philosophy focuses on the patient as an individual and
recognizes the importance of continuing education for the
improvement of patient care.
An active Staff Development program focusing on individual
learning needs is maintained.

Apply to:

Personnel Department
North York General Hospital
4001 Leslie Street
Willowdale, Ontario
M2K 1E1

(Canada)

IN NEWFOUNDLAND

SHORT- or LONG-TERM EMPLOYMENT

for

REGISTERED NURSES
IN OUR CHILDREN'S HOSPITAL

for
Minimum three month tour of duty or longer beginning Mayor June

We pay salaries at annual rate of
$7,452., effective April 1, 1974
$7,652., effective Sept. 1, 1974
ASSISTANCE IN FINANCING TRAVEL OR FINDING
ACCOMMODATION UPON REQUEST

Generous Personnel Policies and Fringe Benefits
Visit & wor\( with us in a city & province noted for friendly
hospitality, great scenery & the pleasant life
SEE MORE OF YOUR CANADA

Send lelters of eppllcallon with copies 01 credenllels & gIvIng two referees to:

Director of Personnel
THE DR. CHARLES A. JANEWAY
CHILD HEALTH CENTRE
ST. JOHN'S, NFLD.

HEALTH
SCIENCES
CENTRE

WINNIPEG.
MANITOBA

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THIS 1345 BED COMPLEX 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:.lt full salary
ON-GOING EDUCATION - Provided through
active in-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
sa!ary based on experience and preparation
paid vacation based on years of service
shift differential for rotating services
10 statutory holidays per year
insurance, retirement and pension plans
SPECIALIZED SERVICE AREAS include orthopedics, psychiatry. post
anaesthetic, casualty, intensive care, coronary care, resoiratory care. dialysis.
medicine and surgery. obstetrics, gynaecology, rehabilitation, and paediatrics

ENQUIRIES WELCOME
FOR FURTHER INFORMATION PLEASE WRITE TO:
PERSONNEL DEPARTMENT, NURSING SECTION
HEALTH SCIENCES CENTRE,
700 WilLIAM AVENUE, WINNIPEG. MANITOBA R3E OZ3

JUNE 1974

THE CANADIAN NURSE 53
.

QÆ
ORTHOPAEDIC &: ARTHRITIC
HOSPITAL
'V I 'V'

ST. MICHAEL'S HOSPITAL
Toronto, Ontario
invites applications from

REGISTERED NURSES

for

INTENSIVE CARE and "STEP-DOWN" UNITS

43 WELLESLEY STREET, EAST
TORONTO, ONTARIO
M4Y1H1

Planned orientation and in-service programme will enable
you to collaborate in the most advanced of treatment
regimens for the post-operative cardia-vascular and other
acutely ill patients. One year of nursing experience a
requirement

Enlarging Specialty Hospital offers a unique
opportunity to nurses and nursing assistants
interested in the care of patients with bone and
joint disorders.
Currently required -
Registered Nurses and Nursing Assistants for all
units
Clinical specialists for Operating Room, Intensive
Care, Patient Care and Education.

For detaits apply to:

The Director of Nursing,
St. Michael's Hospital,
Toronto,
Ontario,
MSB 1 W8.

ROYAL VICTORIA HOSPITAL

Montreal is a fascinating,
bicultural ciry, but don'
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.

w"te to:
Anne Bruce R.N.
Nursing Recruitment Officer
Royal Victoria Hospital
687, Pine Avenue West
Montreal, Quebec, Canada
H3A 1A1

54 THE CANADIAN NURSE

JUNE 1974

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VICTORIA GENERAL HOSPITAL
HALIFAX. NOVA SCOTIA

The :\Iaritime..' largest ho..pital. ha.. immediate openings for
Clinical Nursing Supervi..ors. It i.. the principctl adult teach-
ing ho..pital of D..tlhousie Univer..it} ..tnd also operates a
large school of Nursing.
SAt ARY: $11.5(,0 - $13.537
CLINICAL NI'RSING SLPERVISORS
A J\laster's Degree is preferable but candidates with a
Bachelors' Degree would be given consideration. 3 years
experience. I of which was at the supervisory level i..

equired. Courses in Clinical Special it} Nursing. especially
In Medical or Surgical Nur..ing would be considered.
BENEFITS:
rull Civil Service Benetït... including three weeh vaca-
tion and four weeks after five years of'>Crvice.
Competition is open to both men and women.
I--or further information and/or ..tpplication torm... plea,e
contact:
Personnel Office.
Victoria General Hmpital.
Halifax. Nova Scotia.

BRANDON GENERAL HOSPITAL
SCHOOL OF NURSING
NURSE TEACHERS

FOR
TWO YEAR DIPLOMA PROGRAM
POSITIONS AVAILABLE JULY, 1974
IN
NURSING CONTENT AREAS
OF
"FUNDAMENTALS" - "MATERNAL - CHILD"
"MEDICAL-SURGICAL" - "PSYCHIATRIC NURSING"

aUALIFICA TIONS:
Baccalaureate Degree in Nursing is required.
Preference given to applicants with experience in Nursing and
Teaching.

Apply in writing stating qualifications, experience, references
to:

Personnel Manager,
Brandon General Hospital,
150 McTavish Avenue East,
Brandon, Manitoba.

JUNE 1974

Serve Canada's
native people

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In
a well
equiDped
hospital.

.+ HeaMh and Welfare
Canada

Santé eI a.en-
Ire socIal
Canada

,---------------

I Medical Services Branch I
I Department of National Health and Welfare I
I Ottawa, Ontario K 1 A OK9 I
I I
I Please send. me information on hospital I
I nursing with this service. I
I Name: I
I Address: I
City: Prov: _

_______________J
THE CANADIAN NURSE 55

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

HEALTH
EDUCATION
AND
NURSING CONSULTANT

Required by national voluntary health
organization to develop and
implement, under the direction of the
Executive Medical Director, general
programme of the organization, in
close liaison with provincial
associations, and with emphasis on
health education for professional and
lay groups and nursing education.
Applicant must be bilingual with a
degree in nursing, health education or
public health. Master's degree and
experience In respiratory disease
nursing desirable. Salary range
$15,000 - $18,000.

Applicants should send their
curriculum vitae to:

Dr. J.-J. Laurier,
Canadian Tuberculosis and
Respiratory Disease Association,
345 O'Connor Street,
OTTAWA, Ontario,
K2P 1V9.

56 THE CANADIAN NURSE

THE HOSPITAL
FOR
SICK CHI LOREN

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Situated inthe stimulating
atmosphere of downtown
Toronto, within walking distance
of the University of Toronto
The largest childrens hospital on
the continent offers the
Registered Nurse opportunities
for development in our Nursing
Department. We have many areas
that will interest the Registered
Nurse who is looking for a
challenging career in paediatric
Nursing

Opportunities for employment in
Intensive Care, René:1 Dialysis,
Neonatal Unit, Child and FamilY
Unit, Clinical Investigation
Unit, Operating Room, Cardiac
Surgery, Neurosurgery Isolation
and Orthopaedic surgery. We
have a planned orientation and
staff development programme

The majority of in-patient units
a re working the 7 day fortnight
(12 hour shifts) Salaries are
commensurate with experience
and education. Excellent fringe
benefit programme. Current
registration in Onto is required

Applications for General
Duty Positions are invited
PLEASE WRITE TO Mrs.C. MACINNES
The Personnel Co-ordinato'
555 University Avenue
Toronto, On
ario, Canada
M5G 1XB
TELEPHONE 366'7242 Ext.152B

METRO-CALGARY AND RURAL GENERAL
HOSPITAL DISTRICT NO. 93
Holy Cross Hospital
Rockyview Hospital
Holy Cross School of Nursing
NURSING
AREA CO-ORDINATOR
Holy Cross Hospital, Calgary
Responsible for overall management
of maternal-child nursing care
services. Applicants should have
advanced preparation in maternal
child nursing and/or administration
with baccalaureate degree (major in
administration). Experience should
include 5 years recent including 2
years in maternal child and
administration, Experience and/or
interest in family centred care an
asset. Will work 5 day week including
every 3rd weekend.
Written application including ex-
perience, education, availability
and references to:

DEPARTMENT OF PERSONNEL
HOSPITAL DISTRICT NO. 93
6712 FISHER STREET S.E.
CALGARY, ALBERTA
T2H 2A 7

ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO.

REGISTERED NURSES

630-bed fully accredited Hospital provides
experience in Emergency, Operatmg Room,
Post Anaesthesia Room, Intensive Care Unit,
Orthopaedics, Psychiatry, Paediatrics, Obste-
trics and Gynaecology, General Surgery and
Medici ne.
Basic 2 week Orientation Program and con.
tinuing Active Inservlce Program for all levels
of Staff.
Salary IS commensurate with preparation and
experience
3enefits include Canada Pension Plan, Hospital

enslOn 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.
APPL Y:

ASSOCIATE DIRECTOR
OF NURSING SERVICE

ST. JOSEPH'S HOSPITAL
30 The Queensway
TORONTO 3, ONTARIO

JUNE 1974

NURSING SUPERVISOR

Required for 254-bed

Active Care

General Hospital

Apply to:

Director of Nursing
Moose Jaw Union Hospital
Moose Jaw, Saskatchewan
S6H 1H3
(306) 692-1841 Local 302

NURSING OPPORTUNITY
REGISTERED NURSES

required for a 138-bed active treatment hospital
plus

EXPERIENCED NURSES

for a 5-bed I.C.U.-C.C.U. presently being set up
clinical areas indude - medicine - surgery, obstet-
rics, paediatrics and coronary care.

Residence accommodation allallabte.
Address applications and enquires to:

DIRECTOR OF NURSING
BLANCHARD-FRASER
MEMORIAL HOSPITAL
KENTVILLE, NOVA SCOTIA

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 IBO.bed accredited _ hospital is
situated at SI. Anthony, Newfoundlana. Active
treatment IS camed on m Surgery, Medicine,
Paediatrics, Obstetrics. Psychiatry. Also,
Intensive Care Umt OrientatIOn and In.Servlce
programs. 40.hour week, rotatmg shifts. Llvmg
accomodahons suppl ied at low cost. PUBLIC
HEALTH has challenge of large remote areas.
Excellent personnel benefits mclude liberal
vacation and sick leave. Salary based on
Government scales.
Apply to:
INTERNATIONAL GRENFELL ASSOCIATION
Assistant Administrator of
Nursing Services,
SI. Anthony, Newfoundland.
JUNE 1974

QU,amplain .rgional Q!oUrgr .
Of GAflAL AND VOCATIONAL fOUCA TlON

PEDIATRIC NURSES

ST. LAMBERT-LONGUEUIL
CAMPUS
FACULTY POSITIONS
available in

Come to Canada's Ocean Play-
ground!

The Izaak Walton Killam Hospital
for Children is a modern, progressive,
324 bed complex located in downtown
Halifax. Affiliated with the medical
school at Dalhousie University, the
I.W.K. is the Pediatric referral center
for Canada's Maritime Provinces.

DIPLOMA NURSING
PROGRAM
"NURSING OF PEOPLE ADAPTING
ANO
MALADAPTING TO CHANGE"

Opportunities are now available for
all areas including Neonatalogy and
Intensive Care. Previous experience
in pediatrics not necessary. A full
orientation program is provided.

with patients rather than about patients.

INTERESTING - NEW - INNOVATIVE

Willingness 10 gain wor""ng knowledge 01 French desll
able

RN's interested m acceptmg our
challenge are requested to contact:

Curnculum vitae Including addresses of former er
ployers and references should be submitted to.
Myrtle L Macdonald
Nurslnll.Co-ordinator
900 Riverside Orive
SI. Lambert, Quebec
(Easily accessible
to Montreal)
J4P 3P2

ROBERT COOK
Director of Personnel
Izaak Walton Killam Hospital
For Children
5850 University Avenue
Halifax, Nova Scotia

THE NORTHWESTERN
GENERAL HOSPITAL

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THE HOSPITAL-
Fully accredited
Progressive 250-bed hospital
Expansion in progress
20 minutes to downtown Toronto
YOUR PROFESSIONAL GROWTH -
Planned orientation programme
Continuing Inservice Education
BENEFITS INCLUDE -
3 weeks vacation
9 statutory holidays
Cumulative sick leave
Group Life Insurance
Hospitalization
DIFFERENTIAL PAID FOR-
Post Graduates studies
Shift
Past Experience
IMMEDIATE OPENINGS FOR REGISTERED NURSES IN ALL AREAS AND
FOR EXPERIENCED REGISTERED NURSES IN THE INTENSIVE CARE
UNITS AND OTHER SPECIALTY AREAS.

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For information contact: -

Director of Nursing
NORTHWESTERN GENERAL HOSPITAL
2175 Keele St., Toronto, Ontario M6M 3Z4

THE CANADIAN NURSE 57

REGISTERED NURSES

The Red Deer General Hospital is
looking for nurses in several general
duty areas. However, we are espe-
cially interested in grads who have
experience in Intensive Patient Care.
We have a very active 230-bed hospi-
tal in Central Alberta. If you are
interested in finding out more about
our progressive hospital contact:

Personnel Director
Red Deer General Hospital
Red Deer, Alberta

GENERAL DUTY NURSES

Required Immediately

. lor 270.bed acute care general hospital
expandmg to 370 beds
. clmical areas include: Medlcme Surgery
Obstetrics Paediatrics Psychiatry Rehabilita-
tion Extended Care and Intensive and
Coronary Care
. Must be eligible lor B.C. registration
. Personnel policies m 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

are invited to apply to this active
Regional Referral Hospital in the
B.C. Interior. The Hospital has 344
beds and an expansion programme
underway. All clinical specialties
are represented and provide op-
portunities for varied nursing ex-
perience R.N.A.B.C. Contract is in
effect. B.C. Registration is re-
quired.

Please address all
correspondence to:
Director of Personnel Services
Royal Inland Hospital
Kamloops. B.C.
V2C 2T1

58 THE CANADIAN NURSE

nurses

who want to

nurse

\t \ or\.. Central you can join
an active. interested group of
nurses \\ ho want the chance to
nurse in its broadest sense. Our
I 26-bed. full) accredited hospi-
tal is young. and already expand-
ing. :" ursing is a profession we
respect and we \', ere the first to
plan and develop a unique nurs-
ing audit s\'stem. There arc
opportunities - for gaining wide
experience. for getting to know
patients as well as staff.

Situated in Richmond Hill. all
the cultural and entertainment t
l-
cilities of Metropolitan Toronto
arc available a fe\V miles to the
South, and the winter and
summer holida} and week-end
pleasures of Ontario arc easily
accessible to the :'\orth. I f you
arc really interested in nursing.
}Ou arc needed and \\ ill be made
we !com e.

Apply in person or b} mail to the
Director of Nur<;ing.

YORK
CENTRAL
HOSPITAL

RI( HMO:\D HI! L.
O:\IARIO

DIRECTOR OF NURSING

Individuals with B.Sc.N. and consider-
able experience in Nursing Administration
are invited to submit applications for a
challenging opportunity that is being made
available as a result of the planned
retirement by the present Director of
Nursing.
The hospital is a 495-bed community
general hospital with plans for expansion
to 750 beds and is located in the new City
of Mississauga just west of Metropolitan
Toronto.
Reply In confidence to:
THE ADMINISTRATOR
The Mississauga Hospital
100 Queensway West
Mississauga, Ontario
L5B 1B8

REGISTERED NURSES

required for a modern thirty bed active
treatment hospital, located ninety miles
north of Edmonton, Alberta. Salary sche-
dule effective April 1, 1974 $700, $730,
$760, $795, & $830

Previous experience recognized.

Excellent personnel policies and fringe
benefits.

Room and board available for forty-five
dollars per month in modern hospital
residence.

Apply in writing to:
Director of Nursing Service
Boyle General Hospital
Boyle, Alberta

DIRECTOR OF NURSING

Qualified Director 01 Nursing reQUired Immediately 10 assume
the responsibilIty of nursing servIces In two hospitals
Presently T emlskamlng Hospitals consIsts of a 93 bed active
treatment plus 72 bed extended care umt located at Ha,leybury
and a 41 bed active treatment umt located at New Llskeard. The
TrI- Town area consIsting 01 New Llskeard, Haoleybury. Cobalt. all
within 5 ,..-ules of each other with an Immediate area populatIon of
approxImately 17,000 and a service populatoon of 25 000. is
located 90 miles from North Bay wIth dally plane, tram and bus
servIce to and from Toronto etc. Good educatIonal facIlitIes and
also locatIon of Halleybury School of Mines, ProvIncIal School of
Agricultural Technology, and R N.A Tralmng Centre BeautIful
recreatIonal facIlitIes Including curling, skating. skIIng, swim-
mmg. boatIng. hunting. fishIng.
Salary fully appropriate to the responsibility of [he posltoon and
the Industry, personnel policies 10 line wIth Industry and hospItal
practIce.

Apply in writing fo:
Administrator,
Temiskaming Hospitals,
Haileybury, Ontario, POJ 1 KO.

JUNE 1974

Senior lecturer in charge
DEPARTMENT OF NURSING

STURT COLLEGE OF
AVANCED EDUCATION
SOUTH AUSTRALIA

Slurt College of Advanced Education. situated in
AdelaIde, will begin in 1975 the first tertIary-level DIploma
in Nursing course In South Australia in co-operation with
Flinders Medical Centre, a new major teachIng hospItal
and medIcal schoollocaled on an adjoIning campus and
wIth other health agencIes In the area Sturt College is an
autonomous college under the governance of Its own
Councl' and IS currently engaged In preparation of
pnmary and secondary teachers. The College is very
likely to diversify into other areas 01 traIning lor health
professions and Into soc.a( welfare.
The Senior Lecturer In Charge 01 the Department 01
Nursing will be responsIble for the contInued develop-
ment 01 the program already planned In outkne. The
appoIntee WIll be responsIble 10 the Director 01 the
College and wIll be the chIef liaison person with the
Flinders Medical Centre staff. He or she wIll also be
expected to partiCIpate ,n teachtng of the program.
The essential qualifications for the positIon are a
tertiary degree and a Diploma In Nursing Education.
AdministratIVe experience in a nursing education pro-
gram is hIghly desirable, as IS good organizatIOnal
ablkty and a capacity to work effeckvely wIth people.
The salary range is (Aus) $12,268 to (Aus.) $14,308.
The usual CAE condItIons of appoIntment and staff
benefits will apply.
ApplicatIons should include personal detaIls. qualifIca-
tions, expenence and the names and addresses of three
referees from whom confidential information may be
sought. These applIcatIOns should be addressed to: The
Registrar, Sturt College of Advanced Education,
Sturt Road, Bedlo rd Park, South Australia 5042, and
marked "Confidential". reaching the College no laler
than July 1sl. 1974. Late applicatIons will be accepted
from overseas candidates

HUMBER MEMORIAL
HOSPITAL

Telephone 249-8111 (T oronlo)
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 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.

'
i'
OPPORTUNIJIÊS.......:

,

VICTORIA GENERAL HOSPITAL
HALIFAX. NOVA SCOTIA
The i\laritimð' large
t teaching ho
pit,tI. ha.. immediate
ope nings for Regi..tered N l1r
e
. Certified N ur..i ng A
si
tants
and Orderlie... Po..ition
arc available in Special Unit.. and
101' generalllllr
ing dutie
. It i
Ihe principal adult teaching
ho
pital of Dalhou..ie Univer
ity and al..o opaate
a large

chool of OlIßing.
SA I ARY:
Commen
urale with qualification.. and e'\perience.
SPH"lAI l'f'..11 Nl'RSrS SXI70-$1}5H2
REGISIl:'RI-'D 'JURSE<.; S7Hlft-$9221}
(I RI.NLRSIf'..GASSISIANI
$5ft26-$7IHO
f'..L'RSIN<.j ORDIlHII--S $41}1}1-$ft333
HI-'NH.IIS:
I-'ull Civil Service Hendît... including three wed,s vaca-
tion. four weeks ,ther 5 \ear.. ('If
ervice and ,hift diffe-
rential.
('01' further in fo rn1d I ion and/or application form
. please
contdct:
Per..onnd OlÏlce
"ictori,t Gener,tI Ho"pit,tl.
H..lifd,\. Nov,1 SCOlld

JUNE 1974

DIRECTOR OF NURSING

A challenging position in a modern (1971) 192 bed psychiatnc
hospital with Day Centre and Out Patient Clmic. The hos.
pital IS about to become part of a new Community Mental Health
Centre for the City of Halifax and surroundmg area (pop. 150.000)
and the expansion is planned to include affiliation with Dalhousie
University.
Qualifications
Ellglbl e for Nursing Registration In Nova Scotia:
A degree in nursmg, preferably at Masters level with consider.
able psychiatric expenence;
Administrative expenence In a psychiatric setting:
Recent experience in Community Mental Health Programmes
would be desirable.
Salary: According to qualifications and expenence.

Please apply in writing with a resume stating full
details of education and experience to:

The Administrator
Abbie J.lane Memorial Hospital
5909 Jubilee Road
Halifax, Nova Scotia
B3H 2E2

THE CANADIAN NURSE 51}

REGISTERED NURSES

are required for general duty positions
in all clinical areas.

This is an active treatment hospital of
600 beds located 35 miles east of
Toronto, ONTARIO.

Please address inquiries to:
Director of Nursing
Oshawa General Hospital
24 Alma Street
Oshawa, Ontario
L 1 G 2B9

EXPERIENCED
OPERATING
ROOM NURSES

for 139 Acute, 30 Extended Care Bed
modern accredited hospital on Vancouver
Island. Excellent recreational facilities and
within easy reach of Victoria and
Vancouver. Personnel policies as per
RNABC Contract.

Apply:
Director of Nursing
West Coast General Hospital
814-8th Avenue North
Port Albernl, British Columbia
V9Y 4S1

PUBLIC HEALTH NURSE

Two Public Health Nurses required for
expanding Health Unit generalized
programme. 1974 salary scale $9,050. to
$10,800. Allowance for degree and
experience. Generous fringe benefits and
car allowance.

Apply:

Director of Nursing,
Algoma Health Unit,
235 Wellington St. W.,
Sault Ste. Marie, Oñt,
P6A 1H6.

60 THE CANADIAN NURSE

CLINICAL CO-ORDINATOR

Maternal - Child Service

A modern 433-bed hospital complex requires an Individual
tilth proven leadership ability to become a member 01 a
progressive nursIOg team as Co-Ordinator 01 a 40-bed
Obstetnc/Gynecology Unit and a 35.bed Pediatnc Unit.
The candidate will be responsible lor all activities, 01 the
above areas, related to patient care and staff development and
will have the opportUnity to Implement new creative approaches
to nursing care In line with current patient care Issues.
Qualllications Include a Baccalaureate Degree 10 Nursing with
contIOuIOg education or expenence In the Maternal Child
specialty and Nursing Administration

Send complete resume to:

Personnel Office.
Brandon General Hospital.
150 McTavish Avenue E.,
Brandon, Manitoba,
R7A2B3.

R. N.'S

Required for new 36-bed hospital.
Salary in accordance with Nurses'
Association Agreement.

Apply to:

Director of Nursing
Souris District Hospital
Souris, Manitoba

"WHY NOT GET IT
TOGETHER"

at the

University Hospital
Saskatoon, Saskatchewan

A progressive prairie city of beauty,
clean air and participation

IJurSlng Opportunities Galore!

For further information please contact:

Employment Officer, Nursing
University Hospital
SASKATOON, Saskatchewan
S7N OW8

HEAD NURSE

Bilingual with supervisory experience.

If you are interested in a challenging
position at a 110-bed hospital which
specializes in chest diseases and is
situated in the beautiful Laurentian
mountains just 55 miles from Montreal
apply to: '

Director of Nursing
Mount Sinai Hospital
P.O. Box 1000
Ste. Agathe Des Monts, Quebec

GENERAL DUTY NURSES

wanted as staff nurses for small acute care
hospitals in the out-lying areas of Canada.
Salaries and working conditions are those
that hold generally for the province
concerned. Information and application
forms may be obtained from:

Mrs. Jean Parker
Division of Ministry Personnel
The United Church of Canada
85 St. Clair Avenue East
Toronto, Ontario
M4T 1M8

REGISTERED NURSES
AND
REGISTERED NURSING ASSISTANTS
reqUired for a 104-bed active treatment plus
72.bed chromc care unit located at Halleybury.
The Tro.Town area consisting of New loskeard
Halleybury, Cobalt all within 5 miles of each
other IS located 90 miles from Norfh Bay
with dally plane, train and bus service to and
from Toronto etc. Beautiful recreatlor.al facil.
Itles Including curling, skating, skIIng, SWim.
mlng, boating, hunting, fishing.
Salary fully appropriate to the responsibility of
the position; personnel policies In I Ine with
Industry and hospital practice. Onentatlon
and In-Service Educational programmes are
provided

ApplY in writmj( to:
PERSONNEL OIRECTOR,
Tømlskammu Hospitals,
Halløyhury, Ontario.

JUNE 1974

Switzerland
Kantonsspital Winterthur (769 bed) hospital
(near Zürich) needs:

OPERATING ROOM
NURSES

for the Surgery Clinic. Varied work, good
salary, 5-day week, accommodations
available in hospital, cafeteria, swimming
pool, central location for summer and winter
sports.

Apply to:

Kantonsspital Winterthur
PersonalbüroNerwaltung
Brauerstrasse 15
8400 Winterthur /Switzerland

R.N.'S - TRAVEL
THE U.S.A.

Registered Nurses required immediately in
modern hospitals in the U.S.A. Many hospitals
as well as cities to choose from, such as
Miami, Washington D.C., Philadelphia. San
Francisco, Atlanta and New York.
Arrangements for work permits and other
paperwork provided by us. Air fares advanced if
required and accommodation can be arranged
in the various cities. We can get you permanent
jobs or contracts to work your way around the
U.S.A. - 4 months, 6 months and 1-year
contracts. Medox has offices in Canada and the
U.S.A, to look after you. Why not travel the
U.S.A. with Medox Professional Nursing Ser-
vice?
Write Sheila Britten, MEDOX LIMITED, Suite
302,3 Place Ville Marie. Montreal, Province
of Quebec, H3B 2E3, or call (514) 861-1728
and let us know your interests.

REGISl'ERED NURSES

Southern California
This rapidly e.pandlng 573.bed Medical Center has
opportunIt.es tor RN s mterested m prolesslOnal growth
Huntington Memonalls recognized lor ns excellence of patient
care, research lacilities and teaching programs and offers a lull
range 01 patient care services Including Intensive Care.
Coronary Care. Emergency Room Neurosurgery, Open Heart
Surgery and Rehabilitation Our lull on-going In.servlce
onentabon and training program mcludes classes In Critical
Care, Neonatal and an Arrhythmia Recogmtlon Class Other
programs are gIVen lor Medlcal.Surglcal. Rehabilitallon and
Pediatrics Cardiology
Located m the Rose Bowl capitol. Pasadena, Calilornia,
Huntington Memonal enloys the year around mild dlmale.
excellent lor Ocean, Mountain. and Desert sports and activities.
all wlth'n a one hour drive Our hospital IS located In a
residential area whIch offers excellent IIvmg conditions.
We inv.te your mQu,ry concerning our salanes, benellts,
education. wor1ung conditions and lacilitles We will also assist
Qualllled RN's to aCQulte v,sas lor those Interested In a position
wIth this progressive Medical Center
Write Miss Ann Kaiser, Dir. of Nursing
HUNTINGTON MEMORIAL HOSPITAL
747 S. Faormont SI.
"1.ldenl, CIIII.. 91105
An equal opportunily employer

I
J
" JUNE 1974

16

Public Service
Canada

Fonction publique
Canada

THIS COMPETITION IS OPEN TO BOTH MEN AND WOMEN

REGISTERED NURSES
(Salary to $8988 (Plus Northern Allowance)
Department of Health and Welfare Canada
Medical Services, Northern Region
Various Locations in the Yukon and N.W.T.

An opportunity to see parts of Canada few Canadians ever see. Nurses are required to provide
health care to the inhabitants located in some settlements well north of the Arctic Circle. Radio
telephone communication is available. Join the Northern Health Service of the Department of
Health and Welfare Canada and discover what northern nursing is all about.
Candidates must be registered or eligible for registration as a nurse in a province of Canada
mature, self-reliant person, preferably with midwifery. obstetrics, pediatrics or Public Health
training and experience. Proficiency in the English language is essential. Salary commensu-
rate with experience.
Transportation to and from employment area will be provided; meals and accommodation at a
nominal rate. Quote No. 74-E-4.
Forward "Application for Employment" (Form PSC 367 -401) available at Post Offices, Canada
Manpower Centres, and Offices of the Public Service Commission of Canada, to the: Depart-
ment of Health and Welfare Canada, Medical Services, Northern Region. 1401 Baker Centre,
10025 - 106 Street, Edmonton, Alberta, T5J 1H2.
Appointments as a result ot this competition are subject to the provisions of the P,ublic Service
Employment Act.

DIRECTOR OF NURSING EDUCATION

Required for the Galt School of Nursing - LETHBRIDGE, Alberta
Responsibilities:
Administration of department, supervision of ten member teaching faculty,
program and curriculum development.
Testing and selection of students.
Organization and planning of course materials in conjunction with faculty.
The School:
Well established Nursing School affiliated with two hundred and seven bed
active-treatment Hospital.
Excellent teaching facilities and clinical areas. Three year program with total
enrollment of approximately ninety students.
The Individual:
Extensive teaching experience required, with Master's Degree preferred.
Administrative/Supervisory expenence an asset but not essential.
Provides unique opportunity for individual to develop innovative and
creative curriculum to meet changing demands of nursing profession.
Salary:
Excellent salary range, depending upon training and experience.
Starting date:
July 1, 1974.

For Information and application forms please contact:

PERSONNEL DIRECTOR
Lethbridge General and Auxiliary Hospital and
Nursing Home District No. 65
c/o Lethbridge Municipal Hospital
LETHBRIDGE, Alberta
Phone: 327-4531

THE CANADIAN NURSE 61

MOUNT ROYAL
COLLEGE

A community college is seeking applications
for the position of:
CHAIRMAN NURSING DIVISION
The successful candidate will be responsible for the
administration and control of a nursing program in
basic nursing as well as several post-basic nursing
courses.
Using clinical facilities in various hospitals throughout
the City of Calgary, the 2 year program leads to an
Associate Diploma in Nursing.
Qualifications:
Masters or hIgher degree in Nursing Education, Ad-
ministration and Curriculum Development. Eligible
for nurse registration in Alberta. Preference for in-
dividual who has had nursing, teaching and admin-
istrative experience.

Salary: negotiable
This vacancy is the result of a
resignation, therefore, we wish to fill
the position as soon as possible. Send
curriculum vitae to:
F. R. Fowlow
AlVice President Instruction
Mount Royal College
4825 Richard Road SW.
Calgary, Alta.
T3E 6K6

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WE CARE

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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
62 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

TEAM NURSING AT ITS BEST

YORK-FINCH GENERAL HOSPITAL situated in North-
West Toronto offers:

- 300 bed suburban community hospital with complete services
in Paediatrics, Gynaecology, Obstetrics, Medical/Surgical,
Psychiatry, Coronary Care, Intensive Care, Operating Rooms
and Emergency Departments.
- A Friesen Design enables nurses to spend more time with their
patients as compared to the traditional hospital design.
- Non-nursing activities are delegated to professional support
staff ego Supply Attendants and Administrative Control Person-
nel.
- Paid orientation with opportunity fer Professional Development
through active In-Service programs.
- Attractive Salaries and Fringe Benefit Programs.
- Cultural Exposure - situated at Hwy. 400 and 401 you are
close to Toronto's finest in Theatres, Cinemas, Social Clubs,
Restaurants and York University.
- Living Accommodation - within walking distance of many
modern apartment, condominium and shopping mall complexes.
- 45-60 minutes to Lake Simcoe - Georgian Bay recreational
facilities (Skiing, Boating, Swimming, etc.).

Registered
R.N. 's & R.N.A. 's should contact:
Recruitment Interviewer
York-Finch General Hospital
2111 Finch Avenue West
Downsview, Ontario

JUNE 1974

FOOTHILLS HOSPITAL
Calgary, Alberta

Advanced Neurological-
Neurosurgical Nursing

for
Graduate Nurses
a six months clinical and
academic program
offered by
The Department of Nursing Service
and
The Division of Neurosurgery
(Department of Surgery)
Beginning: September, 1974
March, 1975
Limited to 8 participants
For further information, please write to:
Co-ordinator of In-service Education
Foothills Hospital
1403 29 St. N.W.
Calgary, Alberta
T2N 2T9

TORONTO
GENERAL HOSPITAL

Invites applications from

REGISTERED NURSES
REGISTERED NURSING
ASSIST ANTS
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 Otfice
TORONTO CENERAL HOSPITAL
101 College St.,
Toronto, Ontario,
MSG 1l7.

..J

IUNE 1974

Director
Of Nursing Service:
$15,080.00 - $18,497.00 per year

The MINISTRY OF HEALTH's Kingston Psychiatric Hospital,
requires a Nursing Director (male or female) to plan, organize
and implement its psychiatric nursing programme in this
730-bed accredited hospital.

Qualifications: Registered nurse with PSychiatric nursing
training and several years of psychiatric nursing and supervi-
sory experience. The completion of a recognized post gra-
duate course in Nursing or Hospital Administration. Preferably
a Masters Degree in Nursing Administration. Personal suitabi-
lity.

Qualified applicants are invited to forward a resume of training
and experience to : Personnel Officer, Kingston Psychiatric
Hospital, Box 603, Kingston, Ontario, K7l4X3.

Ontario

Ontario
Public Service

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THE SCARBOROUGH
GENERAL HOSPITAL

invites aøølications 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
n ursi ng.
Our specialties include a Burns and Plastic Umt, Coronary Care, Intensive
Care and Neurosurgery Units and an active Emergency Dep;utment.
. Ubstetric
! Department - participation in "Family centered" teach-
ing program.
. Paediatric Department - participation in Play Therapy Program.
. Orientation and on-goi'1: staff education.
. Progressive personnel policies.
The hospital is located In Eastern Metropolitan Toronto
For further mformation. write to:
The Director 01 Nursing,
SCARBOROUGH GENERAL HOSPITAL,
3050 Lawrence Avenue, East, Scarborough, Ontario.

THE CANADII\,"J NURSE 63

DO YOU
WANT TO HELP
YOUR PROFESSION?

Then fill out and send in the form below

REMITTANCE FORM
CANADIAN NURSES' FOUNDA nON

50 The Driveway, Ottawa K2P 1 E2, Ontario

A contribution of $

payable to

the Canadian Nurses' Foundation is enclosed
and is to be applied as indicated below:

MEMBERSHIP (payable annually)

Nurse Member - Regular
Sustaining
Patron

$ 5.00
$ 50.00
$500.00

Public Member - Sustaining
Patron

$ 50.00
$500.00

BURSARIES $ ..
MEMORIAL $

RESEARCH $

in memory of

Name and address of person to be notified of
this gift

REMITTER

(Print name in full)

Address
Position
Employer ..

N.B.: CONTRIBUTIONS TO CNF
ARE DEDUCTIBLE FOR INCOME TAX PURPOSES

64 THE CANADIAN NURSE

I nd ex
to
Advertisers

June 1974

Baxter Laboratories of Canada . . . . . , . . . . . , . . . . . . .9
Clinic Shoemakers. . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Davol Canada Ltd. ....,............,........ ,16
Hollister Ltd. ........ ...............,.......5
ICN Canada Ltd. ................. .... .Cover III
J.B. Lippincott Co. of Canada Ltd. .... .1, Cover II
C.V. Mosby Company, Ltd. .............., .42,43
MTC Pharmaceuticals Limited . . II
Nordic Biochemicals ............,...... .Cover IV

J.T. Posey Company .............. ..36
Procter & Gamble ... , . . . . . . . . . . . . , . . . . . . . . . . .35
Reeves Company. . . . , . . . . . . . . . . . . , . . . . . . . . . . .14
Transformation Information Centre, Inc. . . . . . . . .47

.--Ilh'l'rti.\ing Manager
Georgina Clar"c
The Canadian Nurse
50 The Driveway
Otl
l\\a K2P I E2 (Ontario)

A cln'rtisillR Representatn'l's
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003
I dephone. (2 15) ;\:1 ill\\ <I) lJ-14lJ7

Gordon Tiffin
2 Tremont Crescent
Don Mills. Ontario
Tekphonc. (416) 444-4731

Member of Canadian
Circulations Audit Board Inc.

BE.:]

JUNE 1974

New from ICN!

What the well-bandaged
patient should wear:

Bandafix is a seamless round-
woven elastic "net" bandage,
composed of spun latex
threads and twined cotton.

Bandafix stays securely in
place; there are eight sizes,
which if used correctly will
provide an excellent
fixation bandage for
every part of the
body.

Bandafix does not change in
the presence of blood, pus,
serum, urine, water or any
liquid met in nursing.

Bandafi,r has a maximum of
elasticity (up to lO-fold) and
therefore makes a perfect
fixation bandage that never
obstructs or causes local
pressure on the blood vessels. .

-

Bandafi:r saves time when
/ applying, changing and
removing bandages; the same
bandage may be used several
times; it is washable and
'. may be sterilized in an
autoclave.
/ Bandafix is an up-to-date
/ easy-to-use bandage in line
, with modern efficiency.
: / ' Bandafi,l; replaces hydrophilic
: gauze and adhesive plaster,
is very quick to use and
has many possibilities of
application. It is very suit-
able for places that otherwise
are difficult to bandage.

.

Banrlafi.r is not air-tight.
because it has large meshes; it
causes no skin irritation even
when used for the fixation of
greasy dressings. The mate-
rial is completely non-reactive.

7;

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Bandafix is economical in use,
not only because of its rela-
tively low price but because
the same bandage may be
used repea tedly.

.

,

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Bandafi.r does not fray,
because everv connection
between the iatex and cotton
threads is knotted; openings
of any size may be made with
scissors or the fingers.

""- -

Bandafix*

Distributed by

IONi ætffim\[ffi

675 MOl/tel' (Ie Licss(', MOlltn'al 377, QI/('b('c

ell('l}iøt('Tcd tradcmClrk of Contincntal PhaTTflfl

'J

Your patients
will amaze
you . . .

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RETELAST is so comfortable and gives ',
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such fast relief. Moreover, RETELAST ,.f.l;
costs up to 40% less than any other :. ......
dressing or traditional bandage. !

'.

,AI OCTO LABOR A TORY L TD .

Laval, Québec
--=--
æ CANADA PHARMACAL CO LTD.,
Toronto, Ontario.

DEMONSTRATION
AND FOLDERS
UPON REQUEST

The

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July 1'974 Q

Y I S S MRA lÇt'ER
158 GUIGUES ST
OTTA
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Sudden Infant Death Syndrome

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Davolchanged 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, Fr
ers and sigmoidoscopic
instruments.

BUILDING ON A CENTURY OF QUALITY
HEALTH CARE PRODUCTS

Price?
Davol suction instruments are
priced to make disposability practical
. avol 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

1874-1974

ç:)

CD

CD

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19

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NEW'74
For fall term needs

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Br\SIC . nDlV
PtfYSIO....- .
MID
MlATO
_
---

New (3rd) Edition-
BASIC PHYSIOLOGY AND ANATOMY
Redesigned with a handsome new format, this major revIsion of a well
established text retains the successful organization of earlier editions.
Coverage of human physiology is expanded; a new chapter is devoted to
body fluids and electroly1es; some 200 drawings are new.
530 pages/illustrated/July 1974
about $13.50.
Ellen E. Chaffee, R.N., M.N., M. Litt.; Esther M. Greisheimer, Ph.D., M.D.
LABORATORY MANUAL IN PHYSIOLOGY AND ANATOMY
264 pageslillustrated/3rd Edition Revised, Spring 1974
perforated-drilled/paperbound, about $3.75.
Ellen E. Chaffee, R.N., M.N., M. Litt.

I'....

.
.>

New-
CLINICAL PHARMACOLOGY
IN NURSING
This entirely new text by the authors of
Pharmacology and Drug Therapy In
Nursing offers quick, easy access to
information needed for expert patient
care. Essential scientilic material is
clearly, concisely presented. Drug
Digests at the end of each chapter
include data on dosage, administration,
adverse effects, indicallons and con-
traindications lor specilic drugs. Factual
data and fundamental principles are
presented in tables and summaries.
700 pages/July 1974/ about $10.75.
Morton J. Rodman, B.S., Ph.D.; Dorothy
W. Smith. R.N., M.A.. Ed.D.
by the same aufhors . . .
PHARMACOLOGY AND DRUG THERAPY
IN NURSING
738 pages/illustrated/1968/$10.75.

CD New (5th) Edition-
FUNDAMENTALS OF NURSING
The Humanities and the Sciences in Nursing
A major revIsion 01 an outstanding text, with
much new material rellecting current nursing
concepts and practice. A holistic approach
to nursing practice and preventive care is
emphasized. The application of systems
theory to nursing care is a feature of this
edition. New chapters focus on community
environment and the nurse's role in promot-
ing optImum sensory stimulation.
450 pages/illustrated/July t974
about $10.50.
Elinor V. Fuerst, R.N., M.A.; LuVerne Wolff.
R.N., MA..; Marlena H. Weitzel, R.N, M.S.N.

......,,-

I

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 Puolishing Company, Inc.

CD

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o New (2nd) Edition-
NURSES' HANDBOOK OF FLUID
BALANCE
The nurse's expanded role In diagnosIs, treat-
ment and evaluation of lab findings is re-
lIected in this edition. The latest findings in
types of imbalances, treatments, and medi-
cation are included; each element, defIcIt
and excess IS dIscussed In greater depth. A
chapter on Fluid Balance In Pregnancy is
entirely new; other new chapters deal wIth
routes of transport, organs of homeostasis,
disturbances of water and electrolytes.
325 pages/illustrated/May 1974
paperbound, $8.75
Norma M. Metheney. R.N., M.S.; William D.
Snively. Jr.. M.D., F.A.C.P.

New-
A GUIDE TO PHYSICAL
EXAMINATION
Expertly illustrated, thIs "how-to" text
bridges the gap bewteen anatomy and
physIology and the" application to the
physical examination. Within each body
region or system, three topics are dealt
with: 1) anatomy and physiology basic
to the examination, 2) examination
techniques, 3) examples of selected
abnormalities.
500 pages/profusely illustrated/August
1974/ about $15.00.
Barbara Bates. M.D.
Also available.
PHYSICAL EXAMINATION FILMS
A new series of 12 sound motion pic-
tures, correlated with the content of
Dr. Bates book. Further information, in-
cluding prices, is available upon re-
quest.

o New (3rd) Edition-
BASIC PSYCHIATRIC CONCEPTS
IN NURSING
This revised editIon focuses on the dynamics
of the nurse's role and lunct,on, and facIli-
tates student progress from the theoretical
to the operational level. Many case studIes
reinforce basic psychiatric concepts and
exp
ain the rationale for nursing Intervention.
Heavily revised content Includes drug abuse,
sexual deviation, palrent management, sel/-
understanding, and recognillon of patient
problems.
600 pages/June 1974/$9.75.
Joan J. KY1Is, R.N., M.S.N.; Charles K.
Holling, M.D.

Please rush me the book(s) whose number(s) I have circled

I

Name
Address
City

1
4

o Payment enclosed (send postpaid)
Books may be returned within 15 days

Province

2
5

3
6

Position
Postal Code
o Use my Chargex number
o Charge and bill me

CN-7-74

.

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will amaze
you . . .

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RETELAST is so comfortable and gives 'I
,

such fast relief. Moreover, RETELAST '

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costs up to 40% less than any other t ì "
dressing or traditional bandage. .

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OCTO LABORATORY LTD.,

Laval, Quebec
æ CANADA PHARMACAL CO. LTD.,
Toronto, Ontario

DEMONSTRATION
AND FOLDERS
UPON REQUEST

The
Canadian
Nurse

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A monthly journal for the nurses of Canada published
in English and French editions bv the Canadian Nurses' Association

Volume 70, Number 7

July 1974

15 RNs Belong at the Bargaining Table ......,......... .B.H. McColl

17 Tetanus: A Case Study. .. . . . . . . . . .. . . . . . . . . . . . . . . . . .0. Westlund

22 Sudden Infant Death Syndrome. . . . . . . . . .

.M.G. Norman

24 Baseball Fever: An Occupational Hazard ..............c. Dworkin

27 Urban Health Care in a Rural Setting. .. . . . .T. Butson, L. McConkey

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5 News 35 Research Abstracts
30 In a Capsule 36 Books
31 Names 39 A V Aids
32 Dates 39 Accession list
33 New Products 56 Index to Advertisers

Executive Director: Helen K. Mussallem _
Editor: Virginia A. Lindabury _ As,istanl
Editors: Liv-Ellen Lockeberg. Doroth) S.
Starr _ Editorial Assistant: Carol A. Dwor-
kin _ Production Assistant: Elizabeth A.
Stanton _ Circulation Manager: Beryl Dar-
ling _ Advertising Manager: Georgina Clarke
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MONTREAL P.Q. Permit No. 10,001.
50 The Driveway. Ottawa. OntdriO. K2P I E2

CCanadian Nurses' Association t974.

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JULY 1974

THE CANADIAN NURSE 3

*

MRS. R. F. JOHNSON
SUPERVISOR

CH ARLENE HAYNES

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GENEROUS NEW GROUP DISCOUNTS on all
Items show!'), for group purchases, graduation gifts. favors, etc.
6-11 Same Items, Deduct 10%; 12-24 Same Items, Deduct 15%
25 or More Same Items, Deduct 20%

r-------------------------------------.
IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS! .
Choose style you want, shown left. Prmt name (and 2nd bottom left Attach extra sheet for additional pms I
Ime If desiredl on dotted lines below. Check other info in NOTE SAVINGS ON 2 IDENTICAL PINS.. . _ more cOD
nllnt.
boxes on chart, clip this section" and attach to coupon spare in case of loss.
.
. LETTERING,______________________ 2nd LlNE:________________
, ' . STY NO LE I I METAl I METAL BACKGROUNO LEmRING I PRICES
OESCRIPTION COLOR FlNISN (

i
) COLOR E"Irmd 1 Lilt E"Irmd 2 Litts
: 169

ALL METAL... Smooth, rounded o Duotone Does D Black o IP,n 2.35 o 1 Pin 3.10
corners. Choose Polished. Satin, or o Gold o POlished not o Ok. Blue o 2 Pins 3.85 o 2 Pins ..95
new Duotone combining satin OS,lyer
backøround with polished edHes. o Satin apply o While lsame namel IsamenalTM!J
PlASTIC LAMINATE... slimmer, Does Does O
.Jg
raCk o I Pin 1.25 o 1 Pin 185
broader, engraved thru surface to not nol o Green .p Dk. Blue o 2Pms 1.95 o 2 Pins 2.90
Jntrashng core color. Beveled apply apply o Slue White Iwmef1ame) lsame name!
border matches lettering. o Cocoa letters only
METAL FRAMED... Classic o Gold Polished White o Black DIPm 2.35 o I Pin 3.10
'Slgn: snow-white plashc with o Sliver frame only o Dk Blue o 2 Pins 3.85 o 2 Pins 4.95
smooth, poliShed beveled frame. only (same name) h.ame nameJ
MOLDED PLASTIC. _' Simple. smart, Does Does White o Black OIP;n 1.25 o 1 Pin \.85
onom.cal. Will never discolor. nol nOI only o Dk. Blue o 2 Pins 1.95 o 2 Pins 2.90
:,mooth rounded corners and edges. apply apply (YrTIe n.me) (Slmenamel

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551

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1510
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NURSES PERSONALIZED
ANEROID SPHYG.
A superb Instrument especially designed
for nurses by Reister bacta, precision
craftsmen in W Germany. Easy.to attach
Velcro
cuff, ligl1twelght, compact, fits
Into soft Slm. leather zippered case
21h" x 4'1 x ]". Dial cahbrated
to 320 mm., 10 year accuracy
guaranteed to
3 mm. Serviced
by Reeves if ever required. Your
imtials engraved on manometer
and gold stamped on case fREE
A wise investment for a lifetime
of dependable service l
No. 106 SDhyg.... 37.95 ea.

Duty
BLOOD PRESSURE SET free
Excellent Quality Clayton Aneroid Spl1yg. from
Japan. Meels all US. Gov specs, :t:3mm accuracy,
guaranteed 10 years. Black and cl1rome manom-
eter, cat 10 300 mm. Velcro tlt grey cuff, black
tubing, soft leall1'erelte zipper case Clayton No.
414 Nurses Sletl1oscope and Scope Sack Included
(see below rigM) fREE gold initials on case and
Scope Sack
No. 41.10 B.P. Set. . . 29.95 sel complele
Sphyg. only No. 108. . . 22.95 with case.

D:d

CAP ACCESSORIES

.--.
CAP TOTE keeps your caps cris
and clean
while slored Dr earned. flexible clear plaslic, wl1lte

Irim. zipper, carrying strap, hang loop. Stores flat Also
for wiglets, curlers, etc. 81,7" dia.. 6" high.
No. 333 Tote. . . 2.95 ea. Gold iml. 5O,/Tole

WHITE CAP CLIPS Holds caps
I -'
firmly In place I Hard 10 find while bobble pinS,
enamel on fine spring sleel Se\'en 2" and four
:-.. 3'1 clips Included In plastic snap box
No. 529 Clips 75, per box (min. 3 boxes)
" MOlOED CAP TAC

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or Cryslal wlIl1 Gold Caduceus The nealer 11
way 10 fasten bands , U-
No. 200 - Sel 016 Tacs . 125 per sel '" ;;::-
Rr:t1
METAL CAP TACS Pair 01 dainly

,ewelrY-Quality Taes with gnppers, holds cap
n RffI . bands securely. Sculptured metal, gold finiSh . ' I
1.:1.;'''' tII approx \í" wide. Choose RN, LPN, LVN, RN
Caduceus or Plam Caduceus. Gift boxed.

'l" No. CT.l (Specily Inilials), No. CT.2 (Plain
. Cad.) or No. CT.3 (RN Cad.) . . . 2.95 pro
SEL-FiX CAP BAND .... '"t
band mate"al. Self.adheSlve, pre"es on.

pulls off; no sewmg or pinmng Reusabl
several times. Each band 20" long, pre-cut to
popular widths: V4" (12 per plastic box) 1,7"
(8 per box) \".." (6 per box) 1" (6 per bbxJ. --..MI
Specify w,dlh under ITEM column on coupon. No. 6343 Band.

1.75 per box,
I I

OROER NO.

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ITEM

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.
. INITIALS as desired: _ _ _
TD ORDER NAME PINS, 1111 out all Informalion in box,top
I right. clip out and attacn to this coupon.
\ Please add 50e: handling/postage
I er e $ , on orders totalling under $5.00
No COD's or b,lhng to individuals Mass. re
ldents add 3% S. T

Use extra sneet for additional items or orders.

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Your
Initials
Engrav.d
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. ope Sick
__
II' Price

-

Free Initials ",with v.our own
Littmanñ Nursescope!
BRAND
Famous Littmann nurses' dia-
phragm slelhoscope . . . a fine
precision inslrument, wilh higl1
sensitivity for blood pressures,
apical pulse rate. Only 2 ozs., fils
in pockel, with gray vinyl anti. No. 2160 Nursescope incl.
collapse tubing, non-cl1l1hng epoxy Free Initials. _ . 14.90 ea.
diapl1ragm. 28" overall. Non rolat-
109 angled ear tubes and chesl
p,ece beautifully styled in choice
of 5 Jewel.like colors: Goldtane,
Sllvertone, Blue, Green, Pmk..
-IMPORTANT: New "Medallion" styling includes tubing in colors to malcl1
melal carls If desired. add $1. ea. to price above; add "M" tc Order
No. 2160M) on coupon. Duty free
LITTMANN COMBINATION STETHOSCOPE
Maximum sensitivity from this fine profess,cnal mstrument Con-
vement 22" overall length. welgl1s only 31,7 oz. Cl1rome bmaurals
fixed at correct angle. Inlernal spring, stainless chest piece, )\".."
diaphragm, 11,1.." bell Remo\'able non chili sleeve Gray vinyllubing

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e26.95 ea. Duty free

FREE INITIALS! Vour imlials en.
graved FREE on chest piece; lend
individual distinction and help pre.
vent Joss

SCOPE SACK See specIal hall-price

rn

d:;ed
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IOW,

LITTMANN PEDIATRIC STETHOSCOPE
Same as abo\le, except smaller chesl piece for use wilh Infants and
small children. DIaphragm] \í" dia , bell 11,1". Black lubing. Includes
2 free Imtlals engr on chest pIece Duty f
No. 2111 Ped. Slelh . . . 26.95 ea. ree
CLAYTON DUAL STETHOSCOPE
Lightweight dual scope imporled from Japan; highest
sensllivlly for apical pulse rate. Chromed binaurals and
chesl piece wilh I If," bell and 1 V, ' diaphragm,
grey anti collapse tubing. 4 oz , 29" Ions. Exlra
ear plugs and diaphragm included. !!!!' Initials
engra\'ed free.
No. 413 Dual Slelh . . . 17.95 ea.

LIGHTWEIGHT CLAYTON STETHOSCOPE
Single diaphragm nv,F' dla) Choose Blue. Green. Red. Sliver Dr Gold
I tubing and chestplece; silwer blnaurals. only 3 oz . extra earplugs and
diaphragm ,ncluded Three free In,tliJlS engraved. Duty free
I No. 4140 Clay. Sleth ... 11.95 ea.

SCOPE SACK neatly carnes and prote<:1s
. " Nursescope or any scope. Double.thlck frosled
flexible plastic, while vinyl bmding 41,7" x9W'.
(V -:::J Your own millals help prevent loss.
No. 223 Sack. . 1 00 el. (Oeduct 50, when or.
dered with any scope abovel. Gald initials. add SOc.

@B:>
EXAMINING PENLIGHT
_l, While barrel wllh caduceus Impnnt, aluminum
Ii.;'
band and clip. 5" long, u.S. made, batteries included Ire-
u: ptacement baUenes available any storeJ. Your own hghl, gift boxed.
NI. ooT po.lipl . . . 4.29 ea. YD.r loltlal. eOVmld, Idd 50, per IIpl.

SCISSOR

and FORC PS Finest Forged Steel.
Guaranteed 2 years.

LISTER BANDAGE SCISSORS
3Y.z" Mini.scissor. Tmy, handy, slip Into
uniform pocket or purse. Cl100se jewelers
gold Dr gleaming chrome plate finish.
No. 3500 3'12" Mini. . .. .. . . 2.75
Ño. 4500 4112" size, Chrome only. ..2.95
No. 5500 5%" size, Chrome only. . . 3.25
No. 702 7V4" size, Chrome only. ..3.75
5W' DPERATING SCISSORS _ .

Polished Stainless Sleel, straight blades.

No. 705 Sharp/Blunt pomls. . . 2.95 . -
No. 706 Sharp/ Sharp poinls . . . 2.95
No. 71041'.0" IRIS Scis., Siainiess, Slraighl. . . 3.75
No. 712 5'/2" Littauer STITCH Scis_, stamless . 3.75
íì
ELLY FORCEPS
, ;---:
So handy for every nurse! Ideal for clamping
1,
No.o;5
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:2:'. 3.75
ñ
.R No. 725 Curved, Box Lock. . . .. . . . 3.75
No:741 Thumb Dressing Forcep, Serrated. Stralrtlt, 5Y.z" ....3.75
No. 744 Sponge, Serrated, Slrailhl. 00. Lock. 9" . .' .. .... 6.80
No. 734 Backhaus Towel Clamp, Box Lock, 5'12" .. .3.75
3 initials engraved on any above, add 50, per instrument.

MEDI-CARD SET Handiest reference
ever l 6 smooth plastic cards 131,.1" x 51,7") cram-
med wilh Information, Including EqUivalencies of
Apolhecary 10 Melric to Household Meas., Temp.
"'C to of, Prescnp. Abbr , UrinalysIs, Body Chem..
Blood "Cl1em , Liver Tesls, Bone Marrow. Disease
'ncub. Periods, Adult Wgls., etc. AIJ in wlJite
vinyl holder wllh gold stamped caduceus.
No. 289 Card Set . . . 1.50 ea.
Your initials gold-stamped on holder,
add 50, per sel.

NURSES BAG Alilellmeofservice
for vIsiting nurses! finest black 1,1" Ihick
len
ine cowhide, beautifully crafted will1
rugged stitched and rivet construction.
Water repellant. Roomy inlenor, with snap-
in washable liner and compartments 10
organize contenls. Snap strap holds top
open dunng use. Name card holder on end.
Two rugged carrYing slraps. 6" x 8" x 12".
Your initials gold embossed FREE on top. An
I outstanding value of superb quality.
No. 1544-1 Bag (wilh liner). . 42.50 e..
Extrl liner No. 4415. . . . . . . . . . 8.50
14K G.F. PIERCED

11\;' EARRINGS Oamly, detailed 1/20 12K Gold Filled
'J :.,

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:Z:I
':

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S
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duly wear Shown
ND. J3/035. ..5.95 per pair
PIN GUARD Sculptured caduceus, charned

to your professional letters. each with pmbackl ., ..
'.'
safety calch Or replace either wllh class pm for

safely Gold finish gift boxed. Choose RN LPN
-. 'I N No. 3420 Pin Guard. . . . 2.95 1.1.
((lRj) ENAMELED PINS Beaulrlully sculplured status
mSlgnia. 2-color keyed hard. fired enamel on gold plale.

Dime sized. pm.back Specify RN.lPN.lVN. or NA on coupon.

No. 205 Enam. Pin 1.95 ea.,
BIC 4-Color PEN
Fine plastic ball poinl from famous
maker. Change color instantly. Includes Black.
Blue. Red and Green, all enclosed wilhin barrel. No. M.119 4-Color Pen
Refills available at stationery counlers . . . 1.25 ea.

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CROSS PEN
' 'ahli,,j(J,,JI(n,,,,,,,, . ,
WOrld famous ballpoint. wdh

scul tured caduceus emblem Full name . , .
fREf enBraved on barrel "nclude name w.th coupon. ___ Çf,'-.!/
Reldls awill eve.ywhere lIlehme guarantee C-...a.
No. 3502 Chrome B.95 ea. No. 6602 12kt G.F. 12.95 ea.

Bzzz MEMO-TIMER Time hot packs, heal
lamps, park meters Remember to check vital silns.
give medlCê'lllon, elc. Lighlwelght com
ct n Y.z'1 dla),
sels 10 buu 5 10 60 mm. Key nng. SwiSS made.
No. M-22 Timer. . . . . . . . 5.49

......

news

R.C. Nurses Raise Fees
To $100 A Year
Vancouver, B.C. - Faced with a deficit
budget for 1974 and the possibility of
cutback in services from their association,
B.C. nurses decided to dig deeper into
their pockets and raise their annual
registration fee to $1 ()() from $50 a year.
The move was approved in a bylaw
change at the annual meeting of the
Registered Nurses' Association of British
Columbia (RNABC) in Vancouver May 8
to 10. The vote for approval of the
amendment raising the fee was 254 in
favor to 12 against, with 4 abstentions
and one spoiled ballot.
The same amendment raised fees for
nonpracticing RNABC members to $20 a
year from $12. It also approved reduced
portions of fees for registration for less
than a full year.
The move to raise fees came on the
third day, after much discussion of the
role the members wanted the association
to fulfill. The discussion revealed mem-
bers wanted increased services, especially
increased staff visits to outlying areas of
the province, and increased staff for
personnel services, which works as bar-
gaining agent for most nurses in the
province.
In the discussions, the 259 voting
delegates (some carried more than one
vote from their chapters) and 394 nonvot-
ing members, students, and guests ex-
pressed strong approval for actions in
recent negotiations.
The RNABC staff and bargaining com-
mittee had negotiated for staff in hospitals
this spring and obtained salary raises to
$852 a month for the basic level for 1974,
rising to $950 in 1975. (News, June
1974, page 10.)
Although this salary level was less than
members had wanted before negotiations
went to compulsory arbitration, delegates
expressed a vote of confidence in the staff
and gave Nora Paton, RNABC director of
personnel services, a standing ovation.
The fee increase was the first in 4
years, said Nan Kennedy. executive
director. It still needs approval by order-
in-council of the B.C. cabinet before it
comes into effect.

Nurse Researchers' Conference
Focuses On Decision Making
Toronto, Onto - The third national con-
ference on research in nursing had the
theme of decision making. About 60
JULY 1974

nurses attended the invitational confer-
ence, held in Toronto 21-23 May 1974.
Nurses were invited to report on 12
research projects, emphasizing decision
making in developing a proposal, apprais-
ing a proposal. designing a study, collect-
ing data, or analyzing data.
Joan Gilchrist, Montreal, who summed
up the conference on the third day, said it
showed the . 'phenomenal growth in
sophistication, relevance, and uniqueness
in research carried out by nurses." She
commented on the emphasis placed on
research into effectiveness of nursing
care, research with increased relevance to
nursing practice.
Dr. Moyra Allen, Montreal, reported
on decisions made in designing a 5-year
study to develop and test a model of
nursing in primary health care settings.
She said the model in the study, designed
by herself and Mona Kravitz, is built to
reflect needs of individuals for health
maintenance. This need is not now being
met, and other professionals are only
marginally interested in health as a family
problem, Dr. Allen said.
Dr. Shirley Stinson, Edmonton, said
the most valuable contribution of this
research project is to provide a nonmirror
image of health/illness. Dr. Allen said
they assume, in the research, that health
and illness is not a continuum. The
project does not develop a model for
taking over the doctor's role. The nurse in
the demonstration project takes on a
family over a period of time and involves
the doctor when his skills are needed.
Discussing access to patients and other
human subjects for research, Horace
Krever, professor of law at the University
of Western Ontario, London, said: "Most
concern about human subjects relates to
intrusive procedures, which could legally
constitute assault and battery. In the
common-law provinces of Canada. pri-
vacy is not well protected. This contrasts
with the United States, where privacy is
protected by law; on this topic you cannot
applt what you read in American jour-
nals.
Privacy is an ethical, not a legal,

Convention Report In August
Reports of the 1974 Canadian Nurses'
Association convention and annual gene-
ral meeting. held in Winnipeg 16-21 June.
will appear in the August issue.

problem. But researchers should apply
ethics to questions of privacy in the same
way as to questions of intrusion. Prof.
Krever said. If the research results are
useless, the researcher has, at the least,
inconvenienced persons.
Speaking of confidentiality for research
subjects, Mr. Krever said "more is
promised than can be delivered. For
instance, if an accident occurs during the
research, tapes or notes can be sub-
poenaed."
Dr. John Godden, former editor of The
Canadian Journal of Surgery, said "A
nurse, like any other human being, learns
to write well only by writing often and by
adopting a critical attitude toward her
own writing." He advised those at the
conference: "If you want to write well,
attempt to write well on every occasion. "

National OR Nurses Conference
Attracts 1,350 To Montreal
Montreal, Quebec - The third national
conference of operating room nurses,
held in Montreal 6-9 May 1974,
attracted 1,350 persons from all parts of
Canada and some from the United States.
Clinical presentations at the conference
included one on total laryngectomy and
techniques of speech adaptation; the other
concerned a new approach to the treat-
ment of pain. presented by a multidiscip-
linary team from Hôpital de
I'Enfant-Jésus in Quebec City.
Speaking about the legal responsibility
of the nurse, Lome Rozovsky, lawyer for
the Nova Scotia hospital insurance com-
mission, told conference attenders that if
they did not want to take risks, they
should leave the health field. The fact that
a nurse interacts with the rights of persons
exposes her to risks.
Mr. Rozovsky said consent for treat-
ment is ba..ed on the inalienable right of
persons to their physical integrity. The
patient must consent in writing to submit
to a surgical procedure. For the consent to
be valid, the patient has to be an adult in
full possession of his civil rights. men-
tally alert (not affected by drugs), and
informed of what is going to be done to
him. The doctor or the anesthetist should
give him this information, not the nurse,
Mr. Rozovsky said.
New techniquö and equipment for
sterilizing the air in the operating room
were described by Dr. Laufman of Albert
Einstein College of Medicine. New York.
THE CANADIAN NURSE 5
,

news

Two questions, coming from a work-
shop on the problems of small hospitals,
were discussed: how to set a limit for
receiving OR requests, so an operating
schedule can be made, and the alterna-
tives of sterilizing surgical instruments in
the OR or in a central supply service.
Participants were asked to complete an
evaluation form at the end of the confer-
ence to help in planning the next national
conference, which will be held in Van-
couver in 1976. The next meeting for
Quebec OR nurses is scheduled for 4-6
November 1974 at the Quebec Hilton,
Quebec City.

Canada Has A Population Problem
Says Family Planning President
Ottawa - Instead of supporting unlim-
ited population growth. the federal gov-
ernment urgently needs a demographic
policy, Montreal gynecologist Lise Fortier
told the annual meeting of Planned Parent-
hood Ottawa on 27 May.
Dr. Fortier, president of the Family
Planning Federation of Canada. spoke
strongly about the population crisis that Ca-
nada, together with the rest of the world,
faces. Dr. Fortier mentioned that if the
present rate of urbanization continues,
Canada will have to build 6 more cities
the size of Toronto in the next 5 years; the
population will reach 30.2 million by the
year 2000; and it will take 70 years to
reach zero population growth.
"No attention has been paid to non-
growth, yet we spend millions of dollars
on public services that may never be used.
Not growing is not synonymous with re-
gression," she said.
According to Dr. Fortier, family plan-
ning programs themselves are unlikely to
reduce population growth. Instead,
"many feel now that what is important is
to motivate persons to have the number of
children that is best for society," she said.
She pointed out some of the principaJ ways
the government can do this:
. :it can educate persons to modify their
behavior;
. it can provide services to bring about the
desired behavior;
. it can manipulate the balance of incen-
tives and disincentives (for example, fam-
ily allowances) to induce couples to reduce
family size;
. and it could use the power of the state to
coerce desired behavior.
"Birth control must be made compul-
sory," Dr. Fortier argued. Just as one in-
dividual is given only one vote, one person
cannot be allowed to burden society with
6 THE CANADIAN NURSE

an unfair share of children, she added.
When the state has the power to decide
who can come into the country and allows
each person to have only one spouse at one
time, "is it different to limit the number of
children [ a couple can have I?"
The speaker voiced her concern that
some persons consider childbearing a
right, not a privilege, and that there has
been coercion to bear children. She would
like to see the one-child family encour-
aged, rather than being thought of as a
disease; the quality of rural life improved;
money spent by the federal government at
the international level only to limit popula-
tion growth; and immigration limited to
refugee groups.
"We are already overpopulated in the
200-mile wide habitable stretch of the
country," Dr. Fortier pointed out. It is a
myth that there are wide open parts of the
country that can still be populated, she
added.
Dr. Fortier is one ofthe Canadian dele-
gates who has been selected to attend the
World Population Conference in
Bucharest, Romania, which is being held
from 19-30 August 1974. This interna-
tional conference will be a highlight of
W orId Population Year and a prelude to
International Women's Year in 1975.

SUN Negotiates First Contract,
Sask. Salaries Now Competitive
Regina, Sask. - A tentative contract
agreement reached by the new Saskatch-
ewan Union of Nurses (SUN) and the
Saskatchewan Hospital Association (SHA)
was accepted by some 94 nurses' units in
the province last May. The new contract
could help alleviate the serious staffing
shortage in the province's hospitals.
The two-year pact gives general staff
nurses in their fust year of service a 21
percent wage increase in 1974 and a 9
percent wage increase and a cost of living
adjustment in 1975.
As of I January 1974, the basic
monthly rate is $707. The rates in three
additional steps are $732, $759, and
$787. Another step will be added in June
1974. As of I January 1975, the basic rate
will be $775 a month, with steps of $800,
$830, $865, and $900.
According to AI Shalansky, the chief
executive officer of SUN, the contract
agreement is to be considered a model
contract. Each staff nurses' association
will negotiate with its own hospital board.
Mr. Shalansky expects that this contract
will be more unifonnly applied through-
out the province than in the past when a
committee of general staff nurses, assisted
by the Saskatchewan Registered Nurses'
Association, negotiated with a committee
of the SHA for a model contract.
The new contract means that a 23
percent wage differential exists between
registered nurses in their first year and

certified nursing assistants in the pro-
vince. SUN wanted a 25 percent differen-
tial.
Ken Hutchinson, director of labor rela-
tions for the SHA, said 31 May that the
contract was fair and brought the nurses'
salaries up to and above those of RNs in
Alberta and Manitoba (News, May 1974,
page 8). He also said that the province-
wide walkout by some 2,000 hospital
nurses 6 May' 'showed that nurses are an
invaluable asset to a hospital." The
walkout, he noted, hit the large hospitals
hard and meant a total withdrawal of
services in small hospitals.
Mr. Hutchinson added that the major
outstanding issue still to be settled - wage
rates for part-time nurses - will be decid-
ed under binding arbitration by Judge
Allastair Muir. Judge Muir was appointed
mediator in the contract dispute early in
May.

Nurses At N.S. Annual Meeting
Appraise Progress Of Profession
Amherst, N.S. - An appraisal of nursing
as a profession in Nova Scotia was the
theme of the 65th annual meeting of the
Registered Nurses' Association of Nova
Scotia, held 22-24 May 1974.
Margaret Bradley said in her presiden-
tial address that the association had made
encouraging progress within the past two
years in establishing itself as an effective
voice before government and the public.
Sister Madeleine Bachand, research
officer for the Canadian Nurses' Associa-
tion, spoke about "Trends and Issues in
Nursing Across Canada." She offered a
"shopping list" of 10 items, which "if
bought or sold in Canada's 10 health
'shops' might vary greatly, as they have
since the proclamation of the British
North America Act. "
Among Sister Bachand's items were:
. increased interdisciplinary collabora-
tion;
. closer collaboration with government
on the part of professional associations;
. emphasis on broader and deeper clinical
knowledge for the nurse, with a view to
meeting more effectively the nursing
needs of patients and public - that is, a
"back to the patient" movement;
. a significant increase in research m
nursmg;
. an increasingly critical analysis of
nursing education and practice; and
. attention by nurses to social issues
paralleling the public's concern over the
widespread ills of today's society.
The past year's work of the standing
committees on nursing service, nursing
education, and social and economic wel-
fare was graphically shown in exhibits
and in program presentations. Highlight-
ing the nursing service program was a
"fishbowl" panel, which included a
physician, a senior citizen, a director of
JULY 1974

nursing in a nursing home, and the
executive officer of the new Nova Scotia
Senior Citizens Commission. The objec-
tive of this panel was to provide RNANS
members with infonnation about the
needs of the aged and how nurses can
help them.

Nfld. Commission Study Tabled,
Major Changes In Nursing NexH
St. John's, Nj1d. - After two years of
studying nursing education in New-
foundland, a royal commission headed by
Dr. Leonard A. Miller completed its
report in February 1974.
This report, which has been tabled in
the provincial legislature, puts forward 25
recommendations. The first is that the
government place diploma nursing pro-
grams within the general education system.
Among the other recommendations are
that:
. a multidisciplinary planning committee
be set up to recommend and supervise the
transfer;
. nursing diploma courses not be longer
than two years, with the change effective
no later than the beginning of classes in
1975;
. the Association of Registered Nurses of
Newfoundland continue to be responsible
for approval of the new curriculum and
for the eligibility of its graduates for
registration;
. no new hospital schools of nursing be
started (with the exception of a possible
diploma school in Grand Falls when a
junior college is established there);
. no new hospital schools for nursing
assistants be started;
. legislation covering the licensing of
nursing assistants be enacted;
. continued progress be made to equate
nurses' salaries in Newfoundland with the
higher levels in the Maritime provinces;
and
. there be monetary recognition for spe-
cial competence in clinical nursing.
In another aspect of nursing education,
the royal commission asks that considera-
tion be given to an "interlocking system"
in which qualified nursing assistants. for
example, could be given credit toward a
diploma course and the diploma graduate
could receive more credit toward the
baccalaureate course.

Professional And Concerned
Sums Up H.C. Nurses
Vancouver, R.C. - Nurses at the annual
meeting of the Registered Nurses' As-
sociation of British Columbia showed "a
strong sense of professionalism. . . and a
real concern for patients," summed up
Dr. Sheilah D. Thompson, director of
counseling at Douglas College of New
Westminster.
Dr. Thompson had been asked to sit in
JULY 1974

as an observer at all sessions of the
meeting, then report to delegates on her
feelings about nurses.
Dr. Thompson is a member of the
board of directors of the B.C. Medical
Centre, a crown corporation set up by the
provincial government with broad powers
to oversee health care and health educa-
tion in the province. (News, January,
1974, page 10).
Most of her report, given on the final
afternoon of the 3-day meeting, praised
nurses for their responsibility toward
patients and the increasing awareness that
patients are individuals with rights and

responsibilities for their own health.
Nurses, she added, are working to pre-
serve those rights.
However, she also had several criti-
cisms of the meeting. A main one
concerned the fact that smoking was
allowed.
"I am astonished and shocked that
nurses have not taken a position against
smoking in respect to themselves, let
alone others." She said most other
meetings she attends in health, education,
or social work circles have outlawed
smoking at meetings.

(Continued on page 10)

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(Continued from page 7)
"If they have to have a cigarette, they
can leave the meeting and go out into the
hall. ..
She also deplored the use of Mrs. and
Miss, saying such use "doesn't clarify
anything except something that has
nothing to do with your profession. ..
She also expressed slight concern about
the format of the meeting, saying any
time a pause occurred in proceedings, all
delegates immediately began to talk to
one another. "There appears to be a need
for a chance to talk - a need for more
involvement. ..
She said if this is so, then provision
should be made to allow such talking, for
example through buzz sessÍons in which
small groups can have a say and a report
be made back to the meeting.
She praised concern of nurses for
general health issues, such as a resolution
that requested the provincial government
to take action to ensure owners of private
spas, swimming and boating facilities
have at least elementary knowledge of
first aid, and decent first aid and resusci-
tation equipment on hand.
Such resolutions indicate concern with
health care in the community, Dr.
Thompson said.

Canadian Council Proposed
At Nursing Research Conference
Toronto, Onto - A questionnaire an-
swered by nurses attending the third
national conference on research in nurs-
ing showed that 70 percent believe they
are ready to organize a Canadian council
of nurse researchers. The third nursing
research conference was held in Toron-
to 21-23 May 1974.
Seventy percent also think such a
council should be affiliated with The
Learned Societies, rather than with the
Canadian Association of University
Schools of Nursing (CAUSN). Nurses at the
conference said a council would serve
useful purposes at international, na-
tional. and regional levels, and would
help to legitimate nursing in the eyes
of academia.
Marjorie Simpson, former principal
nursing officer in Great Britain, said
British nurses were defeated by money
in setting up a nursing research council.
The purpose of the council is the first
thing to decide, Ms. Simpson said.
Other nurses said that CAUSN is not a
suitable group to affiliate with, because
nursing service is not represented in it,
and that the CNA research committee is a
10 THE CANADIAN NURSE

special committee, which could be termi-
nated by board decision.
Shirley Stinson said the University of
Alberta is prepared to host another
conference, with the help of nurses in
service and education in Alberta, Sas-
katchewan, and Manitoba.
The group accepted the sl!ggestion
that the chainnan of CAUSN. the chairman
of the CNA 'research committee, and the
chairman of the research conference
take the proposals to meetings of CAUSN
and CNA.

RNAO Told Nurses Should Become
Communication Experts
Toronto. Onto - Any therapeutic en-
counter in nursing depends on what is
communicated between the patient and
the nurse. This can be verbal or nonverbal
communication, according to Philip Gow-
er, psychiatric nursing consultant for
Ontario's ministry of health. He was
speaking at a luncheon during the annual
meeting of the Registered Nurst:s' Asso-
ciation of Ontario 4 May, 1974.
Although speaking from his experience
in psychiatric nursing, Mr. Gower urged
all nurses to make themselves, quite
deliberately, into experts on communica-
tion as he believes that communication
should be the foundation of every interac-
tion with patients.
He further believes that psychiatric
nursing is and must be based on the
individual and group encounter of one
with another, and to do so takes time to
develop more than a superficial rela-
tionship.
Mr. Gower said that psychiatric nur-
sing can only be properly developed if
practiced by nurses. In our entire country
there are only 44 nurses with a master's
degree in psychiatric nursing. There is
room for many more. he added,

New Independent Diploma School
Will Open in N.B.ln September
Fredericton, N.R. - A third independent
diploma school of nursing will open in
Moncton, New Brunswick. in September.
Sixty students are expected to be enrolled
when the school opens.
The two-year program at The Miss
A.J. MacMaster School of Nursing will
be similar to that offered at the Saint John
School of Nursing and Ecole de Forma-
tion Infirmière d'Edmundston. Harriet
Hayes is director of the new school.
which is named after the first director of
the Moncton Hospital School of Nursing.
The opening of this school will mark
another step in the transition from three-
year hospital nursing schools to the
independent programs. Hospital schools,
which will be phased out by September
1976, are no longer admitting students.
The New Brunswick Association of Re-

gistered Nurses has advocated this change
for a long time. In 1971, the provincial
government accepted it after recei ving the
report of the Study Committee on Nursing
Education in New Brunswick.

Nursing Must Concern Itself
With Moral Character
V,ancouver, R.C. - Provincial registra-

Ion boards recently have been facing
!ncreased problems over their responsibil-
Ity to ensure "the good moral character of
nurses," Thurley Duck, chairman of the
committee on registration, told the annual
meeting of the Registered Nurses' As-
sociation of British Columbia in May.
"There is a need to carry on the
development of guidelines that will en-
able the committee to deal with applicants
or members who have been convicted of
criminal offences," she said in her report.
The problem now mainly concerns
individuals who have been convicted of
drug charges, she told the meeting. The
RNABC registration forms now carry a box
that asks if the applicant has been
convicted in court of anything other than
minor traffic offences. If so, the commit-
tee investigates. but generally rules that
anyone convicted of a criminal offence,
including drugs, cannot be registered.
"Unless we did so. it would mean that
the Association sets itself up to judge a
second time," Ms. Duck said in an
interview later. "We believe we must
uphold the courts."
She said the committee naturally would
be bound by legal rights, now passed by
parliament, which allow an individual to
have his conviction record wiped clean
after a certain number of years without
further offences. As well. convictions are
not recorded for those under age 18.
The committee also judges each case
on its merits. One male applicant reported
he had been convicted and fined for theft
of a radio more than 7 years previously
and had a clean record since. The
committee allowed his application to
stand.
However. Ms. Duck asked all associa-
tion members to consider all aspects of
this question carefully and submit ideas to
the committee for consideration in the
coming year.
The worst aspect of the problem. she
said, is that students are allowed to enter
schools of nursing, complete their educa-
tion, and only discover they are not
eligible for registration when they apply
to the association, "which is charged
legally with the protection ofthe public.
"I believe we must uphold the courts
and protect the public and the profession.
If we are to deal effectively with the
whole issue of moral character, however,
then it has to start with the earliest point
of contact - the school. ..
During the discussion period. a nurse
JULY 1974

asked about registration boards taking
away privileges from RNS. She said she
had nursed in a small town where it had
been well-known that some staff were
"call girls in the evening after work."
Ms. Duck replied the registrar may
revoke registration and could do so if the
women had been convicted of such
charges.
"But it's a sad commentary on the
nursing profession - and on salaries."
she added.

Refresher Course For Midwives
Held At University Of Alberta
Edmonton, Alta. - A 5-day refresher
course for midwives. held at the Univer-
sity of Alberta school of nursing. at-
tracted 35 participants from the Yukon.
Northwest Territories, Saskatchewan,
B.C., and Alberta.
All participants are nurses who have
taken the U. of Alberta program in
advanced practical obstetrics, or who
have S.C.M. (state certified midwife)
status or its equivalent. Nurses attending
the works hip received midwifery prepara-
tion in Australia. India. New Zealand,
England and Wales, Scotland. or the
United States. or had taken courses at the
U. of Alberta or Dal housie U.
The course dealt with current trends in
care of high-risk mothers and babies,
complications of labor, and use of clinical
assessment tools in postpartum and new-
born care. Clinical practice in assessment
of the newborn, and in mother-infant
interaction was included in the course.
The U. of Alberta school of nursing plans
to repeat the refresher course, later this
year.

Research Is Vital To Nursing
British Nurse Tells Conference
Toronto, Onto - "The way of thinking.
the habit of questioning, the ability to
disagree con
tructively. which research
engenders, are vital to nursing." a British
nurse told the third national conference on
research in nursing.
E. Marjorie Simpson. was a nursing
officer in research before she became
principal nursing officer for the ministry
of health in Great Britain, a position from
which she recently retired.
In the conference keynote address,
entitled "The Quest for Excellence."
Ms. Simpson said research "is not a
substitute for but has a special relation-
ship with the mechanism for policy and
decision making. . . The pool of know-
ledge must be constantly fed by the
products of research, and communi-
cation channels kept open so. .. prac-
titioners can draw trom the pool withoul
difficulty.
"Research cannot take decisions. only
IULY 1974

provide infonnation on which decisions
can be made. The research worker has the
task of beavering away in the background
but of keeping in touch with practice so
that the problems she tackles are prob-
lems of genuine importance and relevance
to the field.
. 'The nursing profession as a whole
needs sufficient acquaintance with re-
search to be able to use the results
intelligently. to know what problems are
researchable, and to respect the ethics that
bind the research worker. Such know-
ledge should be obtained in basic nursing
education," Ms. Simpson said.

Stop, Wait, And Listen
When Caring For The Elderly
Ottawa - When caring for an elderly
person. nurses and doctors must be
prepared to spend more time than they do
when caring for a young person. accor-
ding to Dr. Richard Bann. an Ottawa
physician. Dr. Bann. medical supervisor
of Ste Anne's Clinic, Ottawa. was one of
the speakers at a conference on geriatrics.
sponsored by the University of Ottawa
school of nursing and the faculty of
medicine 9-10 May 1974.
"We must be ready to stop. wait. and
listen when we are looking after our
elderly patients," he said. "Whereas a
physical examination for a young or
middle-aged person may take half an
hour, the same examination for an older
person will take at least an hour. if we are
to do a really good job.
"To find out how our elderly patients
are managing in their homes. we should
visit them when they do not expect us."
Dr. Bann said. Then we may discover
that they are still in their pyjamas, have
little food in the house, and just can"t
cope with the situation. ..
Older persons often suffer from iron
deficiency anemia, and they should be
checked yearly for this, Dr. Bann said.
Also, vitamin deficiencies are frequently
a problem. particularly vitamin C. a lack
of which may be partly responsible for the
bruising found on the older person"s
forearms and body.
Dr. Bann emphasized the importance
of helping the elderly person to remain in
the community. and participate in
community activities. as long as possible.
This is for our sake as much as for theirs.
he said. . 'How are other people. including
the young. going to know how to grow
old if they don't see others growing old
with grace?" he asked.
Another speaker at the conference. Dr.
John Wy
pianski. professor of psycho-
logy at the University of Ottawa. said that
depression is the most severe and frequent
feeling experienced by the elderly. "They
have retired at age 65 - the most idiotic
thing our society ever devised! - and
they often lack a reason to live."

Next Month
in

The
Canadian
Nurse

. CNA Convention Report

. Canada Inside Out
- A Nutritional Survey

. Component Therapy

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Photo Credits
for July 1974

The Canadian Foundation
for the Study of Infant Deaths,
Toronto, cover illustration

University of Alberta Hospital,
Edmonton, Alberta, pp. 18. 19

Miller Photo Service,
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Aussie Whiting. Expos Baseball Club,
Montreal, p. 26

THE CANADIAN NURSE 11

news

Dr. Wyspianski said there is far too
much emphasis on youth today, and
called this "terribly unhealthy." Society
should worry less about the identity crisis
of youth, he said. The real identity crisis
comes after retirement, when the person
feels useless and begins to ask himself
"Why am I here?"
"Our society must change the present
inadequate pension plan and should make
sure that the older person has economic
security, he said. I f persons had economic
security in retirement, the number of
physical and psychological problems as-
sociated with the elderly would decrease
dramatically. .,
Dr. Wyspianski said that free transpor-
tation - first class - should be provided
for retired persons. "It is about time that
we gave older persons those things that
are rightfully theirs," he said.

PEl Hospitals Join To Offer
Inservice Programs For Nurses
Charlottetown, PEl - The inservice
education departments of three Prince
Edward Island hospitals and the public
health nursing division of the department
of health joined to offer a 3-day work:;hop
on "Everyday Psychiatry" to nurses in
PEl'S 9 general hospitals.
Seventy-two nurses from hospitals,
ranging in size from 20 to 200 beds,
participated in the workshops, which
were repeated during March 1974, Topics
for the workshop were selected after
consultation with staff nurses, who indi-
cated they would like to learn more about
nursing the patient under emotional
stress.
Topics studied at the workshop were
depression, suicide, and alcoholism. Re-
source persons included a psychiatrist, a
nursing teacher, and 4 staff members of
the Addiction Foundation of PEl.
Inservice education coordinators from
the Charlottetown Hospital, Hillsborough
Hospital, Prince Edward Island Hospital,
and the public health nursing division,
who presented the March workshop, plan
to offer similar joint projects to PEl nurses
in future.

B.C. Nursing Students
Get Increased Stipends
Vancouver, R.C. - Nursing students in
British Columbia will get increased fi-
nancial assistance from the provincial
government, under manpower grants, to
help them through their education, Health
Minister Dennis Cocke told the annual
meeting of the Registered Nurses' As-
12 THE CANADIAN NURSE

'iociation of British Columbia in May.
Financial assistance to students In
nursing programs in colleges and in
baccalaureate programs in universities
will be $150 a month, the minister said.
. 'Because we recognize the scarcity of
nurses, we raised assistance to nursing
students in hospital schools from $18 a
month to $75 dollars a month not long
ago, " he told the more than 500 nurses in
his audience. "That was part of it, but
many nurses now are trained in colleges
and universities."
The minister said the money was
financial assistance, not salary, and could
be used to help students through the
educational period for room and board.
books, and so on.
As well, he announced that $200 a
month would be paid for those in the
master's program in nursing at the Uni-
versity of British Columbia, to a max-
imum of 50 students.
In the same speech, the minister also
announced more attention to the" ABCs of
health" - health promotion, through
physical activity and better nutrition, in a
nonpn,fit organization called Action B.C.
Mr. Cocke urged active concern of nurses
in the program.
It had been promised earlier at a B.C.
conference on health and physical activ-
ity, but this announcement represented
the fonnal setting up of ABC

Committee To Review Nurse's Role
In Sask. Health & Social Centers
Regina, Sask. - A government ad hoc
committee on nursing service in commun-
ity health and social centers in Saskatch-
ewan has been set up to review and clarify
the role of the nurse in these new centers.
Roberta Mireau. nursing consultant for
the Saskatchewan Registered Nurses' As-
sociation, has been appointed to the
committee. which was established as a
result of concerns expressed by SRNA to
the department of public health (News,
Feb. 1974. p.7). Last fall, Ms. Mireau
visited five of these centers.

Have an idea you'd like to
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Chainnan of the committee is Pat
McGrath, nursing consultant with the
Saskatchewan Hospital Services Plan.
Other committee members are M
. O.J.
Ewart. nurse-in-charge at the Hodgeville
community health and social center; Pat
Havanes. nursing consultant for the Sas-
katchewan Hospital Association. Regina;
and Otillia Bieber of the nursing division,
provincial department of public health in
Regina.
The committee's specific tenns of
reference are:
. To develop a description of the nursing
role in community health and social
centers;
. To develop guidelines to assist in
establishing written policies related to the
nursing role in these centers;
. To develop criteria to detennine what
constitutes a "call";
. To suggest ways and means whereby
the nurse can be oriented to her role in the
community center, as well as to the
concept of community nursing; and
. To suggest a means for providing staff
development opportunities for nurses in
the centers.

Bilingual Medical Lexicon
Aids Computerized Records
Sherbrooke, Quebec - A research group
at the University of Sherbrooke is produc-
ing a French medical lexicon. a dictionary
of medical tenns acceptable to comput-
ers. The University of Sherbrooke was
chosen to make up the French dictionary
because it has to be applicable to North
American medicine.
An English medical lexicon has already
been completed at the National Institutes
of Health in the U.S. A German diction-
ary is ready and a Spanish lexicon is
planned for the near future.
According to the March 1974 issue of
the CAMRL Recorder, official publication
of the Canadian Association of Medical
Record Librarians, the bilingual medica]
lexicon will provide unifonn input of
medical tenns for a computer data coding
system called SNOMED: systematized
nomenclature of medicine. SNOMED com-
puters store infonnation in number fonn;
a number can refer to either a French
dictionary of SNOMED, an English diction-
ary, or one in any other language. The
computer input may be in one language,
coded to a SNOMED number. and decoded
from the number to another language.
The committee that is developing
SNOMED believes it will be an effective
medical management tool. SNOMED re-
lates administrative, diagnostic, and
therapeutic procedures directly to diag-
nostic problems. and to final confinncd
diagnoses.
SNOMED is expected to go on trial in
Canada in the summer of 1974. to
demonstrate the feasibility of using such
nomenclature in medica] records. G'
JULY 1974

The
Canadian
Nurse

50 The Driveway, Ottawa K2P I E2, Canada

ð

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Reterences, footnotes, and bibliography should be limited
JULY 1974

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The Canadian Nurse
OFFICIAL JOURNAL OF mE CANADIAN NURSE'" ASSOCIATION
THE CANADIAN NURSE 13

.

accurately
reflected
in three new
MOSBY books

A New Book!

Lagua-Claudio-Thiele

NUTRITION AND DIET THERAPY
REFERENCE DICTIONARY

More than 3,500 word entries relating to
technical and scientific aspects of nutrition and
diet therapy in disease are contained in this
compact reference. Encyclopedic treatment of
terms and a dictionary format simplify your
search for information. Word cross-referencing
and appendix materials provide further know-
ledge and add fullness to the definitions.
Subjects cover dietary standards; basic food
groups; classification of carbohydrates.
proteins. and lipids; and summaries of minerals
and vitamins.

By ROSALINDA T. LAGUA. M.N.S.; VIRGINIA S.
CLAUDIO. Ph.D.; and VICTORIA F. THIELE. Ph.D.
June. 1974. Approx. 336 pages. 7" x 10". 7 illustra-
tions. About $10.25.

MOSBY

TIMES MIRROR
THE C V MOSBY COMPANY. L TO
86 NDRTHLINE ROAD
TORONTO. ONTARIO
M4B 3E5

--

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,

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A New Book!

Story

CAREER MOBILITY
Implementing The Ladder Concept In
Associate Degree And
Practical Nursing Curricula
The curriculum presented in this new book is already being used
successfully in no fewer than six nursing education programs. An
excellent model of the"ladder concept" program, the book presents
guidelines for adapting existing programs and modifying curricula in
institutions having both Associate Degree and LPN/L VN programs.
Course structure, content and unit hours are completely outlined in
useful tabular form. Existing texts. particularly suited to the
program, are cited.
By DONNA KETCHUM STORY, R.N., B.S.. M.A. February, 1974. 206 pages
plus FM I-XII, 6
" x 9
". 9 illustrations. Price. $7.10.

A New Book!

Tobin et al

THE PROCESS OF STAFF DEVELOPMENT:
COMPONENTS FOR CHANGE

This new book sets guidelines for establishing or altering staff
education programs and relates staff development to the overall
continuing education effort. Areas discussed include: the history of
staff development; adult learning; motivation; organization and
administration; philosophy; and learning needs. Sample organization,
data. teaching plans, and policies are presented in the appendices.
By HELEN M. TOBIN, R.N.. M.S.N.; PAT S. YOOER, R.N.. M.S.N.: PEGGY
K. HULL. R.N.. M.A.; and BARBARA CLARK SCOTT, R.N.. M.A.; April.
1974. 174 pages plus FM I-XII. 7" x 10".21 illustrations. Price. $9.40.

To many registered nurses in Canada, the
term collective bargaining smacks of
trade unionism and is considered some-
thing that doesn't apply to the nursing
profession. How inconsistent is the
philosophy of trade unionism with the
concept of professionalism? And why
should the sophisticated measures
adopted by trade unions at the bargaining
table not work effectively for professional
groups?
Recently, registered nurses have taken
a more militant position in bargaining;
this has illustrated the need for profes-
sional groups to look more closely at
collective bargaining procedures.

What is collective bargaining?
Historically, in English or common law
countries, employment has been consi-
dered to be a contractual relationship
between master and servant. This concept
has undergone significant changes, in
terms of what a master mayor may not do
concerning his servant, but the essential
concept of master and servant exists in
employment contracts today.
In the late nineteenth and early twen-
tieth centuries, trade unionism brought
about a significant change, which resulted
in the servants' ability to band together to
seek a common contract of employment.
Previously, it was unlawful for em-
ployees to unite against their master.
As trade unioni!>m became more
sophisticated and brought more pressure
to bear on legislators, statutes were
enacted that set up the legal framework
for negotiations to establish employment
contracts. Trade unions became certified:
the certification enabled the union, by
law, to approach the employer with the
authority to negotiate the wages and
JULY 1974

RNs belong
at the bargaining table

The author, a partner in the law firm retained by the RNABC, discusses the
effectiveness of present collective bargaining procedures for RNS. He answers
the question: Is collective bargaining inconsistent with professionalism?

Bruce H. McColl, B.A., LL.B.

working conditions of all employees,
covered by the certificate, under one
common contract (often referred to as a
master agreement; standard contract; or
standard agreement).
The advantages to be gained in stan-
dardizing working conditions were not
lost on professional and semiprofessional
organizations. Associations, such as re-
gistered nurses, applied .to represent
groups of employees at hospitals and
clinics throughout the country. By doing
this, they gained one of the keystone
powers of trade unions - the right to
bargain collectively for their members.
Although professional and semiprofes-
sional associations achieved the right to
bargain on behalf of their members, most
such associations took the position that
they were nút trade unions. By doing so,
they disassociated themselves from many
by-products of trade unionism: the right
to strike, closed shops, councils of trade
unions, assistance or support to other
groups facing difficulties at the bargain-
ing table, political affiliations, and so on.
By cutting themselves off from the
mainstream of trade unionism, they lost
some of its considerable benefits -

The author, a Vancouver lawyer. is a partner in
the firm, Farris. Vaughan. Wills & Murphy,
who are solicitors for The Registered Nurses'
Association of British Columbia. Following
graduation from the University of British Col-
umbia, he spent several years in personal injury
claims before developing an interest in labor
law, the field in which he is now widely known.
He i
married to a registered nUße and has three
children. This article does not purport to rep-
resent anything other than his own view
on the
subject of collective bargdining.

sophistry at the bargaining table, educa-
tional programs for members, and the
development of power positions vis-a-vis
the employer - advantages not to be
overlooked. At the bargaining table. there
is one essential common denominator of
trade unions and professional associa-
tions: they are both bargaining for em-
ployees with an employer.
I do not believe a strong and vital
position at the bargaining table is incon-
sistent with professionalism. One of a
professional association' s duties is to
make certain that wages and working
conditions complement the association's
concept of professional standards, and
that working conditions are not so oner-
ous that the performance of individual
employees falls below acceptable profes-
sional standards. Professional associa-
tions must also maintain the puhlic's
respect for the profession itself.
The professional association's attitude
has been colored by: fear of adverse
publicity, concern that trade unionism is
inconsistent with professionalism, and
misconception of what a strike is.

The effect of publicity
Professional associations. on the whole,
are too self-centered. To a certain extent,
they fear public reaction. The result ha!>
been, to use an already overused phrase, a
communication gap. Trade unions have
long seen the need to manipulate and use
public opinion.
Registered nurses have long had the
support of public opinion. In recent years.
in the Maritimes, the Prairies. and British
Columbia, threatened or actual strikes by
RNs have resulted in the conclusion of
collective agreements favorable to nurse
.
Had public opinion failed to support the
THE CANADIAN NURSE 15

.

nurses. this would not have been the case.
The public is fickle and there is a need for
constant exposure to the aims and needs
of a trade union.
Equally. there is a need. from time to
time. to gauge public opinion to deter-
mine the appropriateness of certain argu-
ments or the risk of taking certain stances.
In this respect, trade unions are ahead of
professional associations. which fear pub-
licity as a two-headed monster capable of
devouring its own offspring at whim.
There are. undoubtedly, enormous
risks in using the public forum to advance
a thesis, aim, or object. But they are no
greater than those in failing to keep the
public informed of one's viewpoint. The
fear of adverse publicity has resulted, all
too often, in no publicity at all, when
there was a real need for it.

The right to strike
To strike or not to strike has been a
bone of contention within professional
associations for some time. Because
professional associations have been reluc-
tant to support publicly trade unions'
ultimate weapon, some jurisdictions have
removed, by law, the right to strike - if
it existed in law - without much
opposition from the professional associa-
tions themselves. I think this is because
there has been a lack of clear understand-
ing as to what a strike is.
All too often, strikes have been as-
sociated with industrial trade unions, and
the more dramatic strikes have given the
adverse publicity so often associated with
the word. "Strike," however, can mean a
number of things. Essentially, it is an
economic weapon against an employer
who has refused, in the eyes of the
employees, to agree reasonably to wages
and working conditions of his employees.
The right to strike means that, should
the employer's position become en-
trenched and intolerable, employees say
they will withdraw their services until he
takes reasonable steps to settle the issue.
This may result in all employees with-
drawing all of their services. or part of the
employees withdrawing part of their
services - a broad spectrum of pos-
sibilities.
Employees within the medical profes-
sion have quite rightly taken the position:
"the patient comes first": but they say
16 THE CANADIAN NURSE

the natural corollary is that it is wrong to
withdraw services that could affect life
and limb. That may be so, but it denies
that trade unions may call a strike in a
vital sector of the economy and make
arrangements to provide essential services
for a given period. or for the duration of
the strike. I have not seen any evidence
that trade unions hold human existence in
any lower perspective than do members
of the medical profession. Even if they
did, they could not afford the adverse
publicity, which is a considerable issue in
any strike situation.
Does the public think less of a profes-
sional association that insists on meeting
certain minimum standards? What are the
viable alternatives in dealing with such an
intransigent employer? Compulsory arbi-
tration? This is doubtful.
In my experience, no employee is
happy with conditions of employment
forced upon him by outside third parties,
and, usually, a happy employee is a good
employee. More narrowly, do profes-
sional associations want or need third
parties encroaching on their area of
authority?
The failure to understand the difference
between having the right to strike and
actually exercising that right has created
the feeling in professional associations
that to engage in a strike is unprofes-
sional. A comprehensive examination of
the purport, effect, and complexities of a
strike as applied to professional associa-
tions may result in a reiteration of the
wisdom of this attitude. (Indeed. some
persons in the trade union movement are
concerned that the strike may no longer
be a useful weapon in terms of collective
bargaining.) But. to date, few have been
able to advance a workable alternative.
Surely there is a case to be made for
professional associations retaining the
right to strike; 'that right ought not to be
given up without a thorough examination
of the ultimate effect. Certainly, the
removal of the right to strike weakens the
employees' position at the bargaining
table.

The professional association role
The sophisticated approach to collective
bargaining requires persons bargaining on
behalf of a group of employees to have a
clear hand at the bargaining table. With-

out this. the position of the negotiation
committee is ultimately weakened. Prior
to meeting at the bargaining table, a
thorough investigation of aims and de-
mands within the union or association is
required.
Thus, the work of collective bargaining
is not completed at the signing of the
contract. A framework must be set up to
examine continuing problems, educate
the membership as to aims and purposes
of collective bargaining, receive input
from members about future changes in
working conditions, and so on.
It is essential that support be encour-
aged at a grass roots level. If a profes-
sional association does not mform its
members, it may fail to obtain support at
a critical stage in collective bargaining or,
worse, suffer a complete divergence in
aims and objects between the rank and
file. and the negotiating committee. This
problem is not unique to professional
associations: union executives have been
turned out for failure to properly inform
the rank and file on the important issues at
the bargaining table.
A professional association must recog-
nize that its members are entitled to
expect the association to go to the
bargaining table adequately equipped and
ready to do battle for them. How ade-
quately so-called professional associa-
tions are meeting this challenge seems to
require close examination from within.
In British Columbia recently. nurses in
the major hospitals gave their bargaining
agent (The Registered Nurses' Associa-
tion of British Columbia) an overwhelm-
ing mandate to call a strike. The effect of
this action at the bargaining table cannot
be underestimated! It is a mechanism to
indicate clearly to the employers involved
that registered nurses will not be treated
lightly.
This sort of action is seen by some as
union militancy. Frankly. I see it as a
realistic approach to meaningful collec-
tive bargaining.

JULY 1974

A most challenging and satisfying aspect
of nursing is to participate in the care of a
patient with an uncommon, often fatal,
condition, and to observe his progress.
Such a situation requires not only good
communication and nursing skill, but,
more important, close teamwork. Such
teamwork is not limited to nursing and
medical staff alone; it involves a generous
sharing of ideas, knowledge, and the
suggestions of many hospital personnel.
Our intensive care unit of 10 beds has
one bed enclosed in a small room set off
by glass partitions. Into this "room" we
admitted a 43-year-old man with tetanus,
and from this point our unit coordinated
the teamwork to care for this patient.

The disease
Tetanus is an acute, infectious disease
caused by the bacillus Clostridium tetani.
This slender, anaerobic, rod-shaped,
spore-forming organism is found in soil,
garden mold. and manure. It is a normal
inhabitant of the intestines of ruminants
and most domestic animals.
The disease is transmitted by contact
with contaminated soil, street dust, or by
the introduction of spores into wounds by
splinters, nails, or gunshot. Tetanus is not
communicable from man to man, except
by inoculation through a wound.
The incidence of the disease varies;
cases do occur regularly, and epidemics
are noted occasionally. The incidence is
always higher during war. Some cases of
JULY 1974

Tetanus: a case study

Trust and confidence in the close teamwork and resources in an intensive care
unit, allowed a patient suffering from tetanus to undergo a lengthy and difficult
tteatment program and to recover completely from the dreaded disease.

Drexel Westlund

tetanus have developed following surgical
procedures, vaccinations, injections,
tooth extractions, and self-induced abor-
tions. Perforation or puncture wounds are
more commonly infected than open
wounds..
Males are more often affected than
females by the disease, but it is thought
that minor injuries are more common
among males. Children are affected as
readily as adults, with the greatest inci-
dence between the ages of 10 and 15
years. 2 Even today, with highly advanced
medical knowledge and treatment,
tetanus is found throughout the world.
Although prevention is readily avail-
able by artificial immunity, repeated injec-
tions of vaccine must be given to maintain
a titer sufficiently high to protect against
the disease.
Active immunity can be brought about
by three injections of tetanus toxoid, a
week apart. Introduction of the antigen
stimulates production of the antibodies
that fight infection. Passive immunity can
be given by introduction of the antibodies

The author, who graduated from the Edmon-
ton General Hospital School of Nursing,
earned a postgraduate diploma in operating
room technique and management from the
University of Alberta Hospital She works on
the neurosurgical floor of the U. of Alberta
Hospital in Edmonton, Alberta, and is cur-
rently on an extended tour.

through an injection of prepared anti-
tetanus serum. A serum in common use
today is Hyper- Tet, a preparation of
human immunoglobin.
In the disease, the bacillus remains
localized within the area of the wound.
However, it produces a powerful toxin,
with a great affinity for the central
nervous system, that affects motor nerve
endings and cells. When the anterior horn
cells of the spinal cord are affected,
rigidity and convulsions result. 3 Symp-
toms may appear from two days to several
weeks following the injury. The shorter
the incubation period, the more severe the
attack; when the incubation period is only
a few days, the results may well be fatal.
The most important early symptom of
tetanus is trismus, a painless spasm of the
facial muscles that causes difficulty in
opening the mouth and in chewing. Thus,
the disease is called lockjaw. Rigidity
spreads to involve the muscles of the
face, neck, and trunk in varying degrees.
The back usually becomes arched (opis-
thotonos).
In severe cases of tetanus, sudden
violent spasms may be induced by stimuli
such as loud noises, moving the patient,
or knocking against the bed. These reflex
convulsions are exhausting and painful
and usually increase in frequency and
duration as the disease progresses. Death
may occur from these convulsions by
exhaustion, asphyxia, aspiration
pneumonia, or a combination of them.
THE CANADIAN NURSE 17
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The patient, who is sedated with curare, is shown here with the cardiac monitor
and a volume-controlled respirator.

18 THE CANADIAN NURSE

Therefore, treatment must begin as soon
as the disease is diagnosed.

Our patient arrives
Our patient, Mr. T., who farmed about
30 miles out of the city, had stepped on a
rusty nail while working. The same day,
he visited his family doctor in a nearby
town and was given an injection of
tetanus toxoid and penicillin. He had
never been immunized against tetanus or
any other disease.
Four days later, Mr. T. developed a
choking sensation and a stiffening of his
jaw muscles. He was admitted to the local
hospital and transferred to the intensive I
care unit at our hospital the next evening.
On entering the unit. Mr. T. showed
classical signs of tetanus: opisthotonos,
stiff jaw, limited mouth movement, diffi-
culty in swallowing, and generalized
stiffness throughout his body. Our staff
soon noticed his inability to tolerate
stimuli of any kind, whether a movement
or a sudden sound.
Mr. T. was given two deep intramus-
cular injections of 250 units of Hyper-Tet.
Prior to giving these injections, the nurse
explained what she was about to do. She
was given help while administering the
injections, because each needle induced
generalized spasms and tremors.
The internist explained to Mr. T. that.
to prevent his spasms from developing
further, he would receive frequent medi-
cation, which would "put him to sleep"
for about three or four weeks. The
patient's reaction to the situation seemed
to be one of complete acceptance and
trust.
The management of tetanus was to
begin as soon as possible, the essentials
of treatment being:
I. to prevent further absorption of toxin
from the wound,
2. to control reflex spasms by quiet
surroundings and heavy sedation.
3. to prevent intercurrent infections, such
as pneumonia, and
4. to maintain strength and fluid balance.
Soon after admission into our unit, Mr.
T. was told of the surgery he would
JULY 1974

undergo: a tracheostomy, and the de-
bridement of the infected area of his left
foot.
In the operating room immediately
following his surgery, and while still
under anesthesia. Mr. T. was given deep
intramusclar injections of 5,500 units of
Hyper- Tet and 10,000,000 units of
penicillin. Of the 5,500 units of Hyper-
Tet given, 750 units were injected around
the infected area of the foot.
Treatments were begun as soon as Mr.
T. returned from the operating room. In
all, 6,000 units of Hyper- Tet were used to
prevent further absorption of the toxin.
Spasms were discouraged by keeping
lights subdued and noise to a minimum.
Medication to control convulsions
proved to be the most important part of
the treatment. It was initiated by a
constant intravenous dri p of the anesthetic
drug, succinylcholine chloride (sux-
amethonium chloride), which did not
control the spasms.

Curare every half hour
Administration of Tubarine
(tubocurarine chloride, a derivative of
curare) was then begun, with an initial
dose of 30 mg. Thereafter the dose was
decreased to 6 mg. every 45 minutes.
When this did not prevent convulsions,
6 mg. Tubarine were gIven every 30
minutes. This proved to be the maximum
interval we could allow between medica-
tions if convulsions were to be control-
led. A syringe containing 12 mg. curare
was kept in readiness. in case convulsions
should begin again between the times set
for medication.
The staff found thaI the few minutes
prior to the next scheduled dose were the
most crucial, as the low curare titer would
cause tremors and twitching. It was,
therefore, important to give the curare on
time, as it is effective for 30 to 40 minutes
before being excreted by the kidneys. 4

Nursing care
Mr. T's nursing care centered on the
fact that curare completely paralyzes the
JULY 1974

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The patient receives chest physiotherapy. Note the double-cuff tracheostomy
tube being used. A gastrostomy tube is also in place.

body. Because he was unable to breathe
adequately on his own. ventilation was
maintained for him on an automatic
volume-controlled respirator. This
machine allowed continuous control of
inspiratory and expiratory air volume at a
set percentage level of oxygen. which
was changed from time to time.
Because of Mr. T's complete depen-
dence on the machine, the nurse had to be
constantly aware of the sound of the
respirator, ready at any time to continue
ventilation manually by means of an
Ambu bag. During the 24 days that curare
was administered to our patient. mechan-
ical failure of the respirator occurred
twice, and manual ventilation had to be
performed to maintain adequate oxygena-
tion.
Arterial blood samples were taken
daily to assess proper ventilation, that is,
to make sure that sufficient oxygen and
gaseous exchange was occurring in the
body. Because this test was so frequent. a
small polyethylene catheter was im-

planted in the radial artery. The nurse
then withdrew blood for tests and injected
a small amount of heparin into the
catheter to keep it patent.
The prevention of intercurrent infection
becomes a basic problem for a patient
who is in such a paralyzed condition.
Because of his paralytic state and because
of the anatomical difficulty of suctioning
his left bronchus, chest physiotherapy
was important in the care of Mr. T.
Vigorous work was done, and large
doses of antibiotics were administered to
prevent an mfection, such as hypostatic
pneumonia.
Mr. T. had chest physiotherapy on an
hourly basi
. This meant "pounding" his
chest and back with cupped hands to
loosen any secretions that might develop
deep in the lungs. The nurse worked
closely with the physiotherapist. who
visited two to three times daily to perform
therapy.
Nebulization with Isuprel (isop-
roterenol hydrochloride) and Mucomyst
THE CANADIAN NURSE 19

(acetylcysteine) for 10 minutes every
hour was done to loosen secretions in the
bronchus. Care of the tracheostomy fol-
lowed an hourly routine of instillation of
about 5cc. normal saline and deep
tracheal suctioning. Large amounts of
thick secretions that developed required
hourly suctioning of the mouth and
throat, followed by good mouth care.
Neosporin (polymyxin B sulfate) oint-
ment was applied to Mr. T's eyes to
prevent drying of the cornea and eye
infection.
An ultrasonic nebulizer. which pro-
duces a fine mist, was used for five
minutes every three hours to keep lungs
moist and to thin secretions. Because of
complete absence of the cough reflex, a
"co-flator" was used every hour to
further assist in moving secretions. This
machine has a high-pressure suction that
simulates a deep cough when applied to
the tracheostomy opening.
In addition to the chest routine. bron-
choscopies were carried out from time to
time to insure the removal of secretions.
Special attention was given to the left
lung. During his paralyzed state, SIX
bronchoscopies were done at Mr. T's
bedside.
Because of the massive doses of
curare, Mr. T. was supported as an
unconscious patient. We turned him from
side, to back, to side, with good position-
ing, every two hours. To prevent foot
drop and abduction of the feet, we applied
foam rubber booties. which kept the feet
well flexed and in good alignment.
When the physiotherapist visited to
give chest physiotherapy, she also gave a
thorough full range of motion to all limbs.
In between visits, physiotherapy was
carried out by the nurse so that Mr. T.
had passive exercises approximately
every two hours.
Tensor bandages were applied to both
legs from foot to groin to aid the return of
blood to the heart. and to prevent stasis of
blood. Later, the patient was given
anticoagulants, which necessitated good
skin care to prevent breakdown and
possible bleeding. Intramuscular injec-
20 THE CANADIAN NURSE

tions were rarely given to Mr. T., and
most medications were administered in-
travenously.

Nutrition
To enable the patient to survive an
ordeal that could have been lengthy and
violent, it was of vital importance to
maintain his strength and a good fluid and
electrolyte balance. Mr. T. was given
intravenous therapy through "Medicuts"
and "Venocaths" inserted in his
forearms. Despite good nursing care, the
prolonged use of these sites caused
localized inflammation and swelling, and
therefore had to be abandoned. Administ-
ration of intravenous therapy was re-
started several times. Scalp vein Butterfly
sets were not used, because long-term
therapy was anticipated.
To provide nourishment, a gastrostomy
tube was inserted two days following Mr.
T's admission. and gastric feedings were
begun almost immediately. Initially,
feedings consisted of two ounces of milk
followed by one ounce of water every
two hours. These were given slowly and
with much caution, and were to be
stopped immediately if regurgitation de-
veloped (due to the effect of curare on the
cardiac sphincter). Once tolerated, milk
was increased to four ounces and water to
two ounces every two hours.
Gradually, many of the drugs that had
been given intravenously were adminis-
tered by the gastrostomy tube. Intraven-
ous intake was adjusted according to the
amount of fluid absorbed from the tube
feedings. Despite gastrostomy feedings,
Mr. T. lost about 14 pounds in approxi-
mately a month.

Temperature, vital signs
Characteristic of tetanus, Mr. T. de-
veloped pyrexia and moderate
diaphoresis. A hypothermic blanket was
used to control his temperature. Of
construction similar to a thin air mattress,
this blanket circulates ice-cold water
through its compartments to cool the
patient. His temperature was taken
hourly, and the blanket was turned on or

off as needed to keep the body tempera-
ture below 101 of.
Four days after his admission. Mr. T's
vital signs became unstable. Systolic
blood pressure varied from 210 to 110;
pulse rate increased to 150 per minute.
Blood tests showed the partial pressure of
carbon dioxide to be 52 (the normal being
36-42). Pulmonary embolism was diag-
nosed and the anticoagulant. heparin. was
administered to the patient to prevent
further clot formation. However, the vital
signs continued to vary significantly for
several days. Within minutes, the blood
pressure would change from 210/130 to
80/60. The pulse rate would range from
80 to 160 per minute.
Fearing a myocardial mfarction, we
placed Mr. T. on a cardiac monitor. This
revealed normal sinus rhythm, with
periods of tachycardia. In our search of
the literature on other tetanus cases, we
read: "a syndrome compatible with ovet-
activity of the sympathetic nervous sys-
tem has been noted in patients with severe
tetanus treated by tracheostomy, curare
sedation, and intermittent positive pres-
sure breathing ventilation. "S The monitor
indicated some hypoxia when Mr. T. was
suctioned. He was given Inderal (prop-
ranolol hydrochloride) because of his
erratic blood pressure, which persisted for
several days.

Quasi-unconscious state
The most interesting fact about a
patient having prolonged curare therapy is
his apparently unconscious state. Al-
though the drug paralyzes the body, it
does not affect hearing. Thus, the staff
were encouraged to talk to Mr. T. as if he
were fully conscious. The staff had mixed
feelings about talking to an apparently
unconscious patient as if engaging him in
an everyday conversation. but this was
the only means of communication for our
patient at this time.
During his paralyzed state, all proce-
dures were explained to Mr. T. each time
they were performed. We gave him
encouragement and kept him informed
of his progress.

JULY 1974

We conveyed news of his family and
friends to him. The family, extremely
concerned, were well informed of his
progress through their daily inquiries
made by phone calls to the ward.
Mr. T's slow progress, expected by the
medical and nursing personnel, proved to
be frustrating to the family. This resulted
at times in feelings of anger directed to
the hospital staff. In caring for Mr. T.
during his month in hospital, the staff got
to know the family very well. Supportive
care and explanations by attending nurses
and doctors were given to the wife and
family during their visits. Understand-
ably, the hospital environment, with its
strange equipment, was a different and
new experience for them.
Doses of curare were gradually de-
creased in frequency, and then discon-
tinued completely. This became a
drawn-out procedure, as curare was reins-
tituted the moment twitching appeared.
Mr. T. gradually became more respon-
sive, without tremors or twitching, and,
as mentioned earlier, his last dose of
curare was given 24 days after his
admission to our hospital. From this
point, day-by-day improvement was en-
couraging.

Rehabilitation
Due to his lengthy paralyzed state, Mr.
T's body muscles had become weak. The
first sign of body movement was a
blinking of the eyes, followed by move-
ments of the eyes toward moving objects
in the room. Muscles of his face and
upper extremities were the first to return
to normal use. The staff had to teach Mr.
T. how to move his extremities and trunk,
as moving them was more difficult and
painful.
Weaning Mr. T. from the respirator
took a long time. When he began to
breathe more easily on his own, the
concentration of oxygen from the re-
spirator was gradually decreased. When
he tolerated this well. he was taken off the
respirator and allowed to breathe room
air. moistened by heated mist. A few days
afterward, his tracheostomy tube was
JULY 1974

removed and a water-proof dressing ap-
plied. Then he was entirely on his own.
However, chest physiotherapy had to be
continued as vigorously as ever to prevent
infection. When Mr. T. demonstrated a
good swallowing reflex, he was allowed
to take fluids by mouth. His dietary intake
was slowly increased, and, when he could
tolerate a soft diet, the gastrostomy tube
was removed.
Mr. T's positive attitude to his condi-
tion was shown by his repeated attempts
to exercise and by his eagerness to
continue, even to the point of exhaustion.
Though his determination and cheerful
attitude were great assets, rehabilitation
was a long and tiring period.
Mr. T. was transferred to a medical
ward where he made visible progress each
day. The physiotherapy department took
over rehabilitation. The simple act of
walking was the greatest hurdle for Mr.
T. to overcome. Exercises gradually
progressed from passive to active. Weight
bearing, begun slowly, was increased to
maneuvering between parallel bars, and
then to slowly walking without support.
Muscles gradually regained tone and
strength; we;ght increased.
Approximately three weeks after leav-
ing our unit, Mr. T. was discharged from
hospital. Six weeks following discharge,
he returned to the city for a check-up with
his internist.
The staff enjoyed seeing Mr. T. again
when he visited the unit. In recalling his
experiences, he stated that he could
remember hearing staff talk to him and
that he had had sleeping and waking
periods similar to those of day-to-day
living. Mr. T. appeared to be in good
physical condition and had regained all
his lost weight.

Summary
An occurrence of a disease almost
unknown in our part of the world brought
keen interest from many medical and
nursing personnel in our hospital. Prog-
ress and problems that developed were
watched closely; ideas and suggestions
were evaluated and acted on as necessary;

the interest and concern by different
facilities within the hospital were suppor-
tive.
The staff earned much satisfaction in
caring for this patient during the crucial
period of his illness. A patient such as
Mr. T., so dependent on total patient
care, reinforced to the staff the impor-
tance of good communication, sharing of
knowledge. and skilled nursing.

References
I. Top, Franklin H. Communicable Diseases.
3ed.. St. Louis. Mosby. 1955, p. 1065.
2. Ibid., p. 1066.
3. Davidson. Stanley (Sir) and MacLeod,
John. Principles and Practices of
Medicine, ged.. London, Livingstone,
1968. p. 56.
4. Zuck. David. The prillciple.
of anesthesia
for nurses. London. Pitman. 1969. p. 34.
5. Prys-Roberts. C. et aI. Treatment of
sympathetic overactivity in tetanus. Lancet
1:542-5. Mar. 15. 1969.

THE CANADIAN NURSE 21

.

uddenin

nt death syndrome

'.
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,
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Sudden infant death syndrome. SIDS.
crib death, cot death, or sudden un-
expected death are descriptive terms
assigned to a tragic and mysterious form
of death in infancy, which kills one in
every 300-500 live-born children. After
the first month of life, it is the biggest
killer of infants under a year of age.
The history is stereotyped. A healthy
infant, perhaps recovering from a mild
upper respiratory infection. is fed and put
to bed. Minutes or hours later, whoever is
caring for the child returns to find the
infant dead. The key poi,,\ts are the lack of
alarming history and death occurring
during sleep, in an infant less than a year
of age.
Epidemiological surveys have been
carried out and these show a slight
22 THE CANADIAN NURSE

This tragic and mysterious form of death is the biggest killer of infants between
the ages of one month and one year. The author discusses what is known about
sudden infant death syndrome and outlines ways to help the bereaved parents.

Margaret G. Norman, M.D.
preponderance of males and a peak age of
2 months. with a range of 2 weeks to 12
months. Pre matures are at slightly
greater risk than mature infants. Deaths
occur more frequently in the cool or
winter months of the year. 1 .2
There is no genetic or hereditary factor;
SIDS does not repeat in families; and
SIDS may. even take one twin and
spare the other. There seems to be a

Dr. Nonnan graduated from the University of
Toronto medical school in 1958. From 1970 to
1974. she was senior staff pathologist. depart-
ment of pathology. at The Hospital for Sick
Children. Toronto. In June 1974, she became
chief of the department of pathology. Chil-
dren's Hospital of Eastem Ontario, Ottawa.

preponderance of families in the lower
socioeconomic groups. and the mo-
thers tend to be younger than those in a
control group. It should be emphasized
that it occurs in all socioeconomic
groups and to parents of all ages.
Sudden infant death syndrome is not
contagious or infectious, nor will it affect
other children in the family. It happens to
natural infants, and to foster and adopted
infants. It happens in all parts of the
world. It happens in all kinds of situa-
tions - in homes, parked or moving
cars, even in hospitals.
When an autopsy is perfonned, the
only findings are petechiae on the thy-
mus. visceral pleura. and epicardium. and
a mild degree of pulmonary edema. The
findings indicate that death was caused by
JULY 1974

deprivation of oxygen, but how that
deprivation was caused is not known.
Any aspiration found is now interpreted
as being agonal or postmortem, not the
cause of death. If a congenital heart le-
sion, overwhelming infection, or other
cause of death is found, it is not a crib
death. By definition, a crib death is one
in which no cause of death is found.
Autopsies are important, for the parents
are then relieved that everything possible
has been done to investigate their child's
death.

Emotional effects
The emotional effects of crib death can
be devastating to the parents and family.
The parents often feel guilty and blame
themselves, or each other, for causing the
death. They are often depressed. They
may be angry because they do not
understand how an apparently healthy
baby can die without warning; and, even
after an autopsy, no one in the medical
profession can tell them why.
Parents may overprotect their other
children or be afraid to look after them.
Other children in the family may blame
themselves for the infant's death or be
afraid they will die in the same way. They
may revert to a more infantile form of
behavior. Children need to be reassured
and to have their parents' love demon-
strated to them.
Death is handled poorly in our society.
Parents may find others, though sympa-
thetic, feel awkward and unable to talk to
them about the infant's death. Sometimes
the parents find that neighbors or relatives
actually blame them for causing the
infant's death.
Parents may need to be reassured that
their grief reaction is normal, that it will
gradually diminish, and that their life and
feelings wilI return to normal.
Research is being done into causes of
crib death. Because so much is unknown
about it, it has attracted many theories. In
Victorian England, it was called
"overlying" -the adult was supposed to
have rolled over on the infant and
smothered' him; we now know this is not
so. Other disproved theories are enlarge-
ment of the thymus gland. allergy to
cow's milk (crib death occurs in breast-
fed infants, too), overwhelming infection,
whiplash injury of the spinal cord, lack of
calcium or magnesium, absence of pàra-
thyroid glands, and degeneration of the
conducting system of the heart.
One of the most attrdctive recent
theories is that SIDS i.. caused by a failure
JULY 1974

of maturation of mechanisms that control
breathing; there is some indirect suppor-
tIve evidence for this. 3 Much more re-
search is needed to identify and predict
which infants are at risk, and to find some
way of treating them.

The nurse's role
These infants are frequently brought by
ambulance to an emergency department
and are dead on arrival. The parents
should be told as quickly as possible that
the infant is dead. At this time, it is
u
ually not clear why the baby died; it is
better to be honest and tell the parents the
truth: no one knows why the baby died
Frequently the parents are told that the
baby suffocated or smothered: to them
this means an external agent, such as
pillows or blanket. In crib death, the
infants are not smothered by an external
agent; so it is untrue and hurtful to tell the
parents that their infant suffocated or
smothered. Similarly, they should not be
told the baby aspirated or choked on its
feeding. If an autopsy is to be performed,
a discussion of cause of death can be left
until the autopsy findings are known.
Right from the beginning, the parents
should be reassured that they are not to
blame for the infant's death - that the
death was caused by nothing they have or
have not done. 4 It is important to let
parents voice their doubts and questions
They should be told that the babies die
quietly, quickly, and painlessly in their
sleep. They make no outcry or struggle
and give no warning of impending death.
As there is no warning of death, there is
no way of preventing it.
If the baby has died in the care of a
relative or unrelated baby-sitter. the par-
ents may blame themselves for leaving
the child with someone else, or blame the
baby-sitter. It is important to give expla-
nations not only to the parents, but also to
the baby-sitter. Often giving the parents
and baby-sitter written material about crib
death is most helpful: they can reread it
later as they need to.
Weeb or even months later, a public
health nurse may call on the family,
perhaps without knowledge of the infant's
death. It is important to express sympathy
for the baby's death, to let the mother talk
about the infant, and to reassure her.
It is Important for both parents to talk
about the infant's death and come to
terms with their grief, but frequently the
mother is able to talk about it more easily
than the father. If the nurse knows of
other parents who have suffered from a

crib death, she can put those parents in
touch 'With the newly bereaved parents;
parents frequently find it helpful to talk to
others who have suffered in the same
way. It may be possible to form a parents'
group in the community
Parents often fear crib death may repeat
in a subsequent infant. As there is no
genetic factor in SIDS. parents can be
reassured that they need not fear it
happening again. Only a few rare in-
stances of double occurrence in a fa-
mily are recorded.
It is important that a nurse understand
and accept the parents' normal fear that a
crib death may recur. She should sympa-
thize with and support the parents through
the pregnancy and period of understand-
able anxiety. which exi
ts until the new
infant has passed the critical age for crib
death. Parents. who have another child
after a crib death. feel that. in the end.
the joy of the child is worth the concern.

References
I. Protesto
. CD. et aL Obstetric and perina-
tal hi
tories of children who died unex-
pectedly (cot death!. Arch. Dis. Child.
48: II :835-41. Nov. 1973.
2. Bergman. A.B. Studies of the sudden
infant death s}ndrome In King County,
Washington. 3. Epidemiology. Pediatrics
49:860-70, Jun. 1972.
3. Naeye, Richard. Pulmonary arterial ab-
nonnalities in the sudden-infant-dedth syn-
drome. New En/? J. Med. :!89:2:!:1167-70,
Nov. 29. 1973.
4. Pomeroy. Margaret R. Sudden death syn-
drome. A mer. J. NuTS. 69:1886-90, Sep.
1969.

The Canddian Foundation for the
Study of Infant Deaths \\ as formed in
1973. Its purposes are to rai'ie money
for research into the cau
e of SIDS.
to educate the public about SIDS. to
provide information to parents about
SIDS. and to help form parents' group

in local communities.
Brochure'i. entitled Information for
the pare1lts of a child who has died
unexpectedl\' in infancy. are available
in English and French. free of charge.
from The Canadian Foundation for the
Study of Infant Deaths. 17 A verdon
Crescent. Don Mills. Ont., M3A IP4.

THE CANADIAN NURSE 23
.

Baseball
1

an

occupational

-

hazard

The baseball fan at Jarry Park in Montreal sometimes eats too much, spills hot
coffee during the excitement of the game, falls on the stairs, and may even get
hit by a baseball. At these times, the nurses who are on duty come into play.
When they're not working in the first-aid station, though, they are following the
game intently from their seats just behind home base.

Carol Dworkin

Expos fans are as loyal as they come.
After all, they turn out for home games in
Montreal's larry Park in bitterly cold
weather, sit in the pouring rain through
doubleheaders that last until 3:00 in the
morning, and pass out in 90-degree
summer heat. So it's lucky that two
nurses are at every game to give the fans
first-aid attention.
The nurses arri ve two hours before
game time and leave half an hour after the
fans do. Evening games begin at 8:05;
doubleheaders in the evening are two
hours earlier. Day games, which are not
held often, are usually played on Sun-
days.
Although larry Park IS the smallest ball
park in the National League (the Montreal
team is the only Canadian one in major
league baseball), a crowd that can reach
34,000 means that the nurses can expect
to treat anything from frostbite, bee
stings, bums, and blisters to asthma
attacks or lacerations. They also en-
counter those who should not be at a
game - the woman due to deliver her

Ms. Dworkin is a graduate of the Carleton
University School of Journalism. She is
editorial assistant, The Canadian Nurse.

24 THE CANADIAN NURSE

baby that day or the boys injured in an
automobile accident on the way to the
park - but who cannot stav away.

Nurses are fully involved
When they are not with a patient, the
two nurses at the ball park sit in the stands
where they follow the game closely,
commenting on the plays like all the other
seasoned fans. In addition to having
excellent seats in a choice location, they
have a telephone beside them, which
rings when they are needed in the nearby
first-aid station.
During the afternoon home game in
April that opened the '74 season, Judy
Borgford and Pat Titterton spent most of
the time inside, showing me the first-aid
facilities and talking animatedly about
their nursing experiences with the medi-
cal team at Jarry Park. This is the fifth
baseball season for the nurses. In the
Expos first season, St: John Ambulance
staffed the park.
Although the temperature was only 40
degrees the afternoon I interviewed the
nurses and there was a strong wind, few
fans had to visit the first-aid room.
located near the food concessions behind
the stands. As they do with all patients.
the nurses recorded the names of the two
JULY 1974

men who did require attention. One man
said he had been punched in the mouth by
a young fellow.
Judy and Pat, like most of the six
nurses who take turns working at the
games, are graduates of The Queen
Elizabeth Hospital of Montreal - the
hospital that also supplies doctors for the
games and treats players on the Expos
team. A sports-minded internist at the
hospital, Dr. Robert Brodrick, is the
physician for the players; he recruited
nurses from the emergency department
for the ball games after the Expos first
season.
The mother of a three-year-old, Judy
now works part-time for Dr. Brodrick. It
is her job to schedule the nurses for each
game. She has spent three years in
emergency at The Queen Elizabeth and
two years at the Ottawa Civic Hospital.
As a condition of their employment.
the Expos nurses must have experience in
an emergency department. Pat. too, is
well qualified. She is the head nurse in
the emergency department at The Queen
Elizabeth. where she hali worked for six
years.
According to Judy, the nurses get
emotionally involved in the baseball
games. They each attend some 40 games
JULY 1974

:;

.

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f

:'-- II
--..........
..

a season and get to know the players. J-oor
example, when Rusty Staub, their favo-
rite, was traded to the New York Mets
two seasons ago. they were very disap-
pointed. As it happened. the Mets 'Were
playing against the Expos in the opening
home game. and the nurses got to cheer
for their old favorite when he hil a home
run.
Judy takes thi!> baseball fever home
with her. She turns to the sports page of
the ne'Wspaper first thing in the morning.
Her family, too. has caught her en-
thusiasm and follows the Expos games on
television at home or on the radio at the
cottage.

Anything can happen
More than 600 persons required first.
aid treatment during the first season. but
the number has declined each year since.
In 1973, there were just over 400
patients. Among these. the nurse!> treated
66 for lacerations, 81 for headache!>. 33
for upset stomachs (too many hot dog!>
and too much beer), 21 for falls. 16 for
bums. 9 for epi!>taxis. 9 for blister.. fmlll
new shoes. 9 for toothaches, 8 tor bee
stings, 5 for chest pains. 5 for .. an
overdose of ale," 4 for back pain. ano 4
for earaches.

,

.

\-

/

-

There have been six deaths from heart
attacks at the park. One man in his 80s,
who the nurses thought was having a
coronary, would not leave during the
game.
Fortunately. there have been no serious
eye injuries at Jarry Park. Fans are hit by
balls. however. and anyone who is hit by
a ball is examined by a doctor. There
were 47 such accidents in 1973; 16 of
those hit by a ball were sent to hospital.
One of these fans was a doctor from
another city, whose jaw was broken.
If anyone requires more than first aid,
he is driven by police ambulance to
nearby Jean Talon Hospital. The first-aid
station at Jarr} Park contains IWO beds. a
'Wheelchair. a !>tretcher. bandages. aspi-
rins. sodium chloride for soft contact
lenses. glucose for diabetics. a suture set
that is mainly for the players. and other
basic supplies. Oxygen is also kept in the
dub house.
As well as treating the fans, the nurses
look atter many staff members. It is
usuall} the staff working in the food
concessions who require first aid for
bums.
Lalit !>ummer was an unusually de-
IIIdnding one for the nurses. Unlike one
July that 'Was !>ü cold they neecipci
THE CANADIAN NURSE 25

.

Not a rough sport
"Baseball is a gentle sport:' says
Judy, referring to both the fans and the
players. "The baseball crowd is easygo-
ing, friendly, and well mannered." Judy

also points out that "you rarely see
players fight on the field. ..
Some fans do like to drink, and a gang
occasionally comes looking for trouble.
But with excellent security at the park,
these problems never get out of hand.
It's obvious that these nurses enjoy
being part of the Expos team, even if they
work behind the scenes. From April to
October, they are pitching in to help the
home games run as smoothly as possible.
After living baseball all summer, their
enthusiasm carries through to the next
spring, when it's time to head for home
base again. \.f

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blankets, July 1973 was so hot and humid
that many persons fainted. They also
remember the doubleheader in September
that continued through the rain and cold
until 3:00 A.M. By that time, the Expos
had lost both games to the Mets, many
fans had fallen asleep in the bleachers,
and 2 had fallen, unconscious, after
drinking too much. The latter were sent
to hospital.

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Judy Borgford (left) and Pat
Titterton are always eager to be on
duty at Jarry Park when the Expos
are playing a home game. Baseball
is a big hit with these nurses, who
know the game inside out.

.".

Judy Borgford does not have to
leave her seat in the Jarry Park sta-
dium to answer the nurses' first-aid
phone. It only takes a minute or two
for the nurse to reach the first-aid
station, where Montreal baseball
fans are treated for minor injuries
and health problems.

JULY 1974

Compared with some parts of Canada,
Parham village of 250 people and its
neighboring townships in eastern Ontario
are not isolated. Parham is a pleasant hour
and a half drive from Canada's parliament
buildings and about an hour's drive from
the medical school and two general
hospitals in Kingston. Yet when Parham
residents had to travel 80 miles round trip
to Kingston for medical attention, many
did not get the care they needed.
The idea of having a medical clinic in
Parham originated with a Kingston family
physician, Dr. Richard Milne, in May
1968. Not a stranger to the area, he had
worked at a nearby boy's camp.
In July of the same year. nine family
physicians from Kingston offered their
services to staff the proposed clinic. The
Parham United Church manse was rented
as a clinic building, and the Ontario
ministry of health agreed to provide
financial backing. A government grant
paid for equipment and for the salary of a
nurse and a secretary. Physicians' fees
were to be paid by the Ontario Health
Insurance Plan (OHIP).
In October 1968. the Parham Medical
Clinic opened. House-call service and
24-hour coverage could not be provided,
hut between the nurse - who lived in the
area - and the physicians, medical care
would be available eight hours a day,
Monday through Friday, for some 2,000
patients. Anyone requiring hospitaliza-
tion would go to Kingston. would be
followed by one of the clinic physicians,
and would be referred to a specialist, if
JULY 1974

Urban health care
in a rural setting

It is possible to bring urban health care to rural parts of the country, as two
nurses living in small communities in Ontario have demonstrated.

Tish Butson, B.Sc.N., and
Lorraine McConkey, R.N.

necessary. Obstetrical patients would re-
ceive similar care.
Unfortunately, this clinic was forced to
close in March 1974 because of a lack of
funds. While it operated, 14 physicians
from Kingston, one nurse, and one
secretary staffed the clinic. One physician
was at the clinic each morning. Although
some physicians left and others joined the
staff, the original clinic nurse, Lorraine
McConkey, remained.

Northbrook area gets clinic
In 1971, a group of citizens in the
Cloyne-Northbrook area explored ways
of bringing medical service to their
district. The 1,800 residents, scattered in
several small nonfanning villages in the
Land O'Lakes area roughly 65 miles
northwest of Kingston, were 30 to 40
miles from physicians and the nearest
hospital.

Tish Butson, a graduate of McMaster Univer-
sity School of Nursing in Hamilton, Ontario,
has worked as a public health nurse In two
health units in the province. as a teacher with
the Ontario department of health. and as a
senior instructor in a nursing a
sistant program
in Hamilton. She moved to Northbrook in
1969, when her husband bought a general
store. Lorraine McConkey is a graduate of SI.
Joseph's Ho
pital School of Nursing in Peter-
borough, Ontario. Her previou
work experi-
ence was in a ho
pital. She moved with her
husband and children 10 Sharbot Lake. 10
miles from Parham. 7 years ago.

Moreover. the demand for medical care
in the area increases during the summer,
when cottagers and campers swell the
population. At nearby Bon Echo Provin-
cial Park on Mazinaw Lake, the 400 camp
sites are filled. In addition to the summer
visitors' seasonal problems, automobile
accidents are prevalent on weekends.
Those living in this rural area work for
the provincial government, in tourist-
related businesses. in the small-scale
logging and sawmill operations, or travel
to larger centers to work. Some families
increase their income by trapping in the
winter. Deer hunting in the fall is also
important, and this season brings many
city dwellers back.
The citizen's group visited the Parham
clinic to discuss its program, then asked
the Parham physicians to consider a
similar operation in the Cloyne-
Northbrook area. The Northbrook loca-
tion was chosen because of its proximity
to an airfield. its location on a highway
that helps divide the area's two counties,
and the availability of a former school as
a clinic site.
A grant was obtained from the Physi-
cians Services Incorporated Foundation*
for 1972 to 1974 to employ a full-time
nurse and secretary, renovate the interior

* When the Ontario government began univ-
ersal medical in
urance. funds remaining from
PSI - a private medical insurance
scheme - were u
ed to establish the PSI
Foundation.

THE CANADIAN NURSE 27

of the building, purchase equipment, and
pay the physicians' transportation costs.
The citizens hoped that a doctor might be
attracted to the area during this period.
possibly setting up a full-time practice in
the clinic. But to date this has not
occurred.
Since its beginning in January 1972.
the Northbrook Medical Clinic has had
the services of a registered nurse. Tish
Butson, and a secretary. Both live in
Northbrook and work Monday through
Friday. A physician flies or drives from
Kingston three mornings each week.
Patients are assessed and treated and. if
necessary, referred to consultants or other
agencies and hospitals in Kingston. Bel-
leville, or Napanee. * *
The secretary carries out basic recep-
tionist duties, ensures patients' comfort
when they arrive, organizes the
problem-oriented charts, prepares the
monthly schedule of visits by the 12
physicians, bills OHIP. and maintains
bookkeeping, correspondence. and ap-
pointments. This allows the nurse to
spend her time with the patients and
physician.

Clinic nurse's role
The nurse in both clinics has been a
health worker in a primary care setting.
whose responsibilities depend on the
patient's needs at a given time. The nurse
brings skills from her basic nursing
education program, enriched by her ex-
perience and continuing education. She
uses her knowledge of disease processes
and her background in sciences to help
provide the most complete care possible
for the patient.

* *AII those involved in the Northbrook clinic
hope its outlook is more optimistic than
Parham's. A group of 125 citizens. most of
whom use the clinic, met on 14 February 1974
with Dr. Richard Milne and dinil: ,taff to
evaluate the clinic's operation and discuss
funding for 1975. A seconu meeting was
planned for May to consider new infonnation
about sources of funding.
28 THE CANADIAN NURSE

When the physician is at the clinic, the
nurse's responsibilities are to:
. interview patients to help identify their
main problems and collect data to assist in
the assessment of each patient;
. meet certain needs of the patient during
the physician's visit; for example, com-
fort. safety, reassurance of progress,
self-estf'em. and need for change in
activities;
. promote contmuity of care by helping
to detennine changes in the patient's
condition since his last visit. The nurse
tries to represent consistency, as the
physicians alternate their visits through
the month;
. teach the patient by reinforcing the
physician's instructions, explaining the
use of medications. and providing other
needed health information on topics such
as nutrition. prevention of the spread of
infection. rest, exercise. posture. elimina-
tion. care of the skin, and diversional
activities:
. implement certain procedures as pre-
ventive health care measures and help
assess or treat a patient's problem. This
might include obtaining specimens for
laboratory tests, giving injections, provid-
ing treatments such as dressings, and
preparing medications; and
. plan for continuing care: Has the
physician recommended a return visit to
the nurse for treatment or counseling,
review by another physician, or referral to
another agency? What patient information
should be shared or obtained? Does the
family need help in planning or giving
care?
When the nurse is the sole health
worker at the clinic, her role broadens.
She attempts to define the patient's
problem when he arrives by evaluating
his signs and symptoms. length of time
they have been present, his attitude, past
history, and the laboratory and clinical
data she has obtained.
rf she can, the nurse treats the problem,
for example. suturing a simple laceration.
Or she might need to consult one of the
clinic physicians by telephone about the
appropriate medication for a patient. If

the patient needs intensive investigation
to determine the cause of his problem. the
nurse asks him to return to see the
physician. If immediate assessment and
treatment of an emergency nature appear
necessary, she refers him to another
physician or to a hospital emergency
department, phoning ahead to ensure
attention for the patient.
The nurse can more readily obtain
family and health histories. including
social and employment history. when she
is on her own at the medical center. Also,
certain kinds of teaching can be more
effective when the patient visits the nurse
specifically to discuss a problem, such as
obesity, birth control, or health needs
pertaining to pregnancy. child growth.
and development.
She encourages certain patients to visit
her to discuss their social problems,
express their feelings. and receive sup-
port. This is especially important for the
patient who requires regular counseling
where it is easier to relate' to one person
than to several. The nurse follows pa-
tients who have a problem or need that is
stabilized, and refers to the physician as
necessary. Such patients include those
with hypertension or diabetes, the pre-
natal patient, and the patient receiving
immunization or injections for an allergy.
The clinic nurse has a responsibility to
develop preventative programs where
possible, because she is aware of people's
health needs in the area and the needs
already being met by other agencies. An
example of this is the weekly weight-
watching group. held at the Northbrook
clinic. Some of the members are clinic
patients, others are overweight persons
from the area who have had approval
from their family physicians to attend.
Although we have not attempted for-
mal follow-up on weight loss mainte-
nance after the patient has left the group.
the weight-watching program has been
successful in motivating patients to con-
tinue dieting over a prolonged period.
Most are losing two pounds a week on a
balanced, low calorie diet, are learning
more about nutrition and eating habits,
JULY 1974

are sharing their difficulties and ideas
with each other, and are exercising
together.

Never a dull day
The clinics have served a variety of
needs. An elderly couple living near one
of the clinics drop in to chat with the
nurse and secretary about community
news, but also to discuss their problems
with sciatica and angina. A widowed
pensioner boarding at a local hotel needs
help arranging transportation twice
monthly to a hospital-based treatment
clinic in Kingston. A teenager thinks she
might be pregnant.
One middle-aged woman who lives
alone is suspicious and hostile toward her
married children, relatives, and neigh-
bors. She has had psychiatric care in the
past. After she expresses her frustrations
to the nurse, she leaves, usually a little
calmer.
Mr. E., who is 73 years old, suffered a
cerebral vascular accident three years
ago. His speech therapy, introduced in
Kingston, was continued by the nurse at
the Parham clinic. This practice session
evolved into a weekly cribbage session
that both patient and nurse enjoyed.
Rosemary is a 24-year-old woman,
whose family moved to the Northbrook
area in 1969 when her father began
teaching at the district secondary school.
She came to the Northbrook clinic in
October 1973, depressed, overweight.
unable to work, and needing financial
assistance. She had recently moved to her
parents' home following attempted
suicide and resulting treatment in a
general hospital. Finances were tight
because her father had left teaching to
start sheep farming.
When Rosemary came to the clinic, a
staff physician talked with her, prescribed
a tranquilizer, and asked the nurse to help
her lose weight. The nurse asked Rose-
mary to return to the clinic before her next
appointment with the physician. This
enabled the nurse to begin a relationship
with Rosemary and to learn more about
her health and dietary history.
IULY 1974

Monthly visits to the physician and the
nurse were planned so that Rosemary
visited the clinic every two weekc;; in
November and December. In November,
the physician gave her a complete health
examination, ordered laboratory tests.
and reviewed her progress on the medica-
tion. In January, February, and March
1974. Rosemary saw only the nurse
during her monthly visit. The nurse. in
turn. reviewed the patient's progress with
the physician.
Rosemary may soon apply for a course
in hairdressing. She prefers to work away
from home, as she feels her ideas differ
from those of her parents. She has derived
satisfaction, however, from her recent
"spring lambing experience" on her
father's farm and from contributing to the
family economic unit.

After-hour emergencies
There is an understanding that patients
can telephone the nurse, if necessary.
after clinic hours. If the clinic nurse is
away, the patient usually calls another
nurse in the area. as this was the custom
before the clinics were established. Some
patients drive to a hospital if an
emergency occurs.
The nurses handle an average of four
telephone calls or visits by patients on
weekends. There might be two or three
calls each evening, which can usually be
handled over the phone. Some problems
require a visit by the nurse to the patient.
or vice versa. to detennine accurately the
severity of the problem. She might be
able to give guidance or treatment. or she
might arrange for the patient to be seen by
a district physician or hospital emergency
staff.
The after-hour,> load is seldom incon-
venient; most persons do not contact the
nurses unless they really feel unable to
deal with the problem. Also. the nurses
recognize that people are obliged to
consider each other's needs more in a
rural area. Everyone shares transporta-
tion. equipment, and work on fire fight-
ing, recreation programs. and other pro-
jects.

A first -aid team, organized by citizens
in 1967 and ac;;sisted by the Canadian Red
Cross Society, also exists in the area
served by the Northbr00k clinic. The
Northbrook clinic nurse is a member of
this team, which provides help at the
scene of motor vehicle accidents or other
emergencies. such as drownings. until the
ambulance arrives.

Urban health care enjoyed
By increasing the services available to
patients through a rural medical clinic,
the distance from larger centers is
minimized. For example, daily laboratory
service to and from Kingston. bedside
nursing, homemaker service. and
physiotherapy for selected patients are
provided with the help of the county
health unit.
Counseling by a field worker from the
Ontario ministry of community and social
services is availahle twice monthly at the
Northbrook clinic. Liaison with the
county children's aid societies and with
ambulance services are other benefits.
The public health nurse frequently visits
the clinic.
The nurses enjoy the community envi-
ronment. There is good opportunity for
learning and sharing because of the kind
of physicians who have staffed the
clinics.
In this setting, the nurses can gain more
knowledge and learn new skills from the
physicians; they have an opportunity to
practice and discuss their findings with
them. The nurses share their ideas with
each other. too. They can be creative in
meeting patients' needs.

THE CANADIAN NURSE 29

in a capsule

Easier abortiolJ in Norway
Women in Norway could be given the
right to make the final decision on a
possible abortion up to the 12th week of
pregnancy. According to a report on
family policy made to the Norwegian
parliament, the government plans to
introduce a bill that would give women
this right.
An Issue of News of Norway last April
explained that the government proposal
would provide advisory bodies to help
women who are considering an abortion
to reach a decision. "But there will
not. . . be any compulsory requirement
for a woman to seek such advice once she
has talked with her doctor, " the newsletter
said.
Medical and nursing staff who do not
want to take part in sl}ch operations on

grounds of conscience would not be
required to do so, as long as other
qualified personnel could be found. The
newsletter also noted that QPposition to
this proposal is expected to be wide-
spread, and the government, which is in a
minority position in parliament, might not
be able to pass such a measure.
In 1972, 91.4 percent of all applica-
tions for abortions in the country were
granted, according to figures published
with the report on family policy.

Choking on food causes death
Many sudden deaths each year occur
when adults choke on food; asphyxiation
and unconsciousness can follow within
minutes. At such times, onlookers often
assume that the person is suffering a heart

"Don't listen to her! There's no such thing as a 'Registered' Virus!"

30 THE CANADIAN NURSE

attack - with the result that the wrong
treatment is given.
Writing about this serious problem in
the April 1974 issue of Safety Canada,
Dr. B.M. Cochrane explained that this
accident often happens in restaurants.
"The victim is often middle-aged or
elderly and usually wearing dentures.
Often the dentures are ill-fitting and the
victim has fallen into poor eating habits
by not chewing food properly and trying
to swallow large pieces of unchewed
food. . . . The victim most often has had
one or more alcoholic drinks and may be
intoxicated at the time.
"Most often the victim is in the
company of others and all are engaged in
conversation while eating. . . The stage is
then set for the accident - a moment ot
diverted attention and the victim attempts
to swallow a solid piece of food that is
simply too large.
"He suddenly stops all other actions
and stares straight ahead at his dinner
plate, often unnoticed at first by others.
When they do recognize his distress, he is
totally unable to communicate, being
aphonic. He is unable to cough or
breathe. At this point he loses conscious-
ness and irreversible brain damage and
death are close at hand unless the cause is
quickly recognized and the obstructed
airway cleared. "
There is little use in a slap on the back,
and artificial respiration is a waste of
time, Dr. Cochrane notes. It is also
useless to call an ambulance, as the
patient will likely die within five minutes
ifthe airway is not cleared.
Dr. Cochrane estimated that 90 percent
of all deaths caused by choking on food
can be avoided if the food is removed
immediately. When it has been removed.
artificial respiration and cardiac resuscita-
tion, ifneceessary, can be applied.
As only 50 percent of all obstructing
particles can be removed with the fingers,
he mentioned the availability of forcep-
like instruments shaped to the natural
curve of the human airway, which help to
grasp and remove the food particles.
"The public. medical profession, and
restaurant industry may not be fully aware
of the problem. All parties concerned
must be taught how to recognize this
accident and how to treat it quickly. . . .
Instruments to aid in the quick removal of
obstructing food particles from the throat
should be readily available in every
restaurant and bar in Canada. ., <',
JULY 1974

names

Harriett Hayes has been appointed direc-
tor ofthe Miss A.J. MacMaster School of
Nursing, Moncton. N.B.
Ms. Hayes (R.N.,
Moncton Hospital
school of nursing;
B.N., McGill V.,
Montreal; M. Sc. ,
Boston V.) was op-
erating room super-
visor at the Moose
Jaw General Hospi-
tal early in her ca-
reer. She returned to the Moncton Hos-
pital in 1951 and became associate direc-
tor of its nursing school in 1966. Her
nursing association activities have
incl uded a term as president (1970-71)
of the New Brunswick Association of
Registered Nurses.

,

J

Larry McGuire was appointed to the
newly created position of business ad-
ministrator of the Manitoba Association
of Registered Nurses in April 1974. This
position includes the function of public
relations officer.
Mr. McGuire, a graduate in commerce,
has 20 years' experience in business.
Active in community and church affairs,
he is currently a director of the Kiwanis
Club of East K ildonan.

Therese Bonneau was appointed associate
instructor in nursing at Grant MacEwan
Community College, Edmonton, Alberta,
in January, 1974.

Ms. Bonneau gra-
duated from the Mi-
sericordia Hospital
in Winnipeg and ob-
tained a certificate
'\ in advanced practic-
al obstetrics and a
" baccalaureate degree
in nursing at the
Vniversity of Alber-
ta. Edmonton. She has an extensive
background of teaching and nursing ex-
perience.

The Order of St. John has announced
nursing appointments in three provincial
councils:
Sharon Hanrahan Joe of Truro has been
appointed nursing consultant for Nova
Scotia. A graduate of the Victoria Gen-
eral Hospital, Truro, she is particularly
JULY 1974

interested in the St. John Ambulance
Home Nursing program. At one time, she
was on an extended sea voyage on the
oceanic research vessel Hudson.

Nicole Lanctôt is the newly-appointed
nursing consultant for Quebec. After
completing her nursing studies at Hôtel
Dieu de Montréal, she acquired experi-
ence in obstetrics, and was a pioneer in
teaching natural childbirth techniques.
She then specialized in pediatrics and
home nursing while rearing three chil-
dren.

Lillian Pettigrew,
former associate
executive director of
the Canadian
.. Nurses' Associa-
tion, is provincial
nursing officer with
the St. John Brigade
in Saskatchewan.
She has had long
association with the Order of St. John as
consultant-adviser to the area medical of-
ficer in Winnipeg (1954-60) and member
of the nursing advisory committee to the
chief nursing officer (1960-72). She was
made nursing sister in the Order of S1.
John of Jerusalem at an investiture at
Government House, Ottawa, in 1970.

Jeannette E. Watson has retired as profes-
sor at the U. of Toronto faculty of
nursing, an association that began in 1947.
Ms. Watson (R.N.,
Guelph General Hos-
pital school of nurs-
ing; Dipl. Teaching
and Admin., U. of
Toronto; B.Sc.N.. V.
of Western Onta-
rio; M.Sc.N.. Way-
ne State V., Detroit)
had previously devoted many years to
the General Hospital in Guelph. where
..he became assistant director.
Ms. Watson is now writing a second
edition of her textbook. Medical and
Surgical Nursing with Related Physiol-
ogy.

-

-

Myrtle I. Macdonald has been appointed
chairman of nursing at Champlain Reg-
ional College. Sherbrooke, Quebec.
where she is to set up the new diploma
program.

Ms. Macdonald
(B.Sc.N., D. of Al-
berta; M.Sc. (A),
McGill D.) devoted
several years of her
career to public
health. education,
and rural hospital
administration in
India. She has been
a clinical instructor at the Vniversity of
Alberta Hospital School of Nursing and
associate director of nursing education at
Archer Memorial Hospital School, Lam-
ont. Her most recent appointment has
been with the Douglas Hospital. Verdun.
Quebec.

......

Sister Madeleine Ba-
chand (R.N., Hôtel
Dieu. Montreal;
B.N.Ed..V.ofMont-
real; M.Sc. (AppL).
McGill V. ,Montreal)
has been appointed
curriculum coordi-
nator of the nurs-
ing program at Lo-
yola Vniversity in Montreal. having
been a research officer with the Cana-
dian Nurses' Association for three years.
Before coming to CNA, Sister Bachand
was I;'rovincial superior of the Order of
Hospltalières de St. Joseph. Earlier in
her career. she had been director of the
school of nursing at Hôtel Dieu in Mont-
reaL
Sister Bachand has been an active
member of the Order of Nurses of
Quebec since 1953, and has served on
several of its committees.

Eva Wideman has
joined the CARE-
r.! .DICO team at
the Amman Civic
Hospital in Jordan.
Her duties as clini-
cal instructor and
supervisor involve
teaching the Jorda-
nian nursing staff
and upgrading the quality of nursing
care at the institution.
Ms. Wideman (R.N.. Royal Alexandra
Hospital School of Nursing. Edmonton;
B.A., Goshen College, Indiana) has. for
two years. nursed at St. Paul's Hospital,
Vancouver

,

<

THE CANAI)IAN NURSE 31

dates

July 19, 1974
School of Nursing, Toronto General Hospi-
tal, 93rd and last graduation, Convocation
Hall, University of Toronto. Alumnae
members welcome.

August 2-4, 1974
Final graduation and grand reunion of all
graduates of the Royal Inland Hospital.
Kamloops, B.C. For further information,
write to: Ms. J. Cassell, Secretary, Alum-
nae Association, 1243 Dominion St., Kam-
loops, B.C., V2C 2Y8.

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
Waggoner's Lane, Fredericton, New
Brunswick.

August 24-30, 1974
One-week workshop on biostatistics, Uni-
versity of Ottawa, Ottawa. Attendance
limited to 24 applicants who fulfil the
following criteria: actively working on a
biomedical research project; have encoun-
tered conceptual and/or methodological
problems; possess basic knowledge of
statistics; satisfy a selection panel. Applic-
ants must complete an application form,
available from: J.M. Last, M.D., Professor
& Chairman, Dept. of Epidemiology, Royal
Ottawa Hospital, 1145 Carling Ave., Ot-
tawa, K1Z 7K4.
32 THE CANADIAN NURSE

August 30- September 1,1974
Three-day seminar on orthopedics and
rehabilitation for nurses, sponsored by
the University of Miami School of Medi-
cine, department of orthopedics and
rehabilitation, Americana Hotel, Miami
Beach, Florida. For information, please
contact: Dept. of Orthopedics and
Rehabilitation, P.O. Box 875, Biscayne
Annex, Miami. Florida 33152, U.S.A.

September 18-21, 1974
Atlantic Provinces Psychiatric Association,
annual meeting, Holiday Inn, Halifax, N.S.
For further information, write to: Dr.
George Fraser, Secretary, APPA, Victoria
General Hospital, Halifax, Nova Scotia.

October 1-5, 1974
Canadian Psychiatric Association, annual
meeting, Ottawa, Ontario. For further in-
formation, write to: The Secretary, CPA,
225 Lisgar Street, Ste. 103, Ottawa, K2P
OC6.

October 7-9, 1974
Joint meeting of the Association of Cana-
dian Medical Colleges, the Association of
Canadian Teaching Hospitals, the Cana-
dian Association of Deans of Pharmacy,
the Canadian Association of University
Schools of Nursing, and the Canadian
Association of University Schools of Re-
habilitation, Health Sciences Centre, U. of
Calgary, Calgary, Alberta. Information: Mr.
C.A. Casterton, Secretary, Assoc. of
Canadian Medical Colleges, 151 Slater
St., Ottawa, Ontario, KIP 5H3.

October 7-9, 1974
District I conference of the Nurses' As-
sociation of the American College of Ob-
stetricians and Gynecologists, Chateau
Halifax, Halifax, N.S. Theme: "Portrait of a
Female." Write to: Betty Mciver, Publicity
Chairman, Halifax Infirmary, 1335 Queen
Street, Halifax, Nova Scotia.

October 16-19, 1974
Joint annual and scientific sessions,
Canadian Council of Cardiovascular
Nurses, Canadian Heart Foundation, and

Canadian Cardiovascular Society, Win-
nipeg, Manitoba. For further information,
write to: Canadian Heart Foundation, Suite
1200, 1 Nicholas St., Ottawa, K1 N 7B7.

October 1974 & April 1975
Four-week, full-time, postdiploma prog-
ram in coronary care nursing for registered
nurses, Humber College, Rexdale, On-
tario. Part-time, evening program from
November to March also offered. For
further information, contact: Office of the
Registrar, Humber College of Applied Arts
and Technology, P.O. Box 1900, Rexdale,
Ontario, M9W 5L7.

November 7-9, 1974
Nurses' Association of the American
College of Obstetricians and Gynecol-
Ogists, District no. 5 conference, Royal
York Hotel. Toronto, Ontario. For furth-
er information, write to: Ruth K. Schin-
bein, Ontario Section Chairman,
NAACOG, District 5, 43 Main St., East,
Apt. 2, Grimsby, Ont., L3M 1 M7.

December 2-5,1974
University of Manitoba Health Care Evalu-
ation Seminars to assist professionals to
develop an understanding of methods and
techniques required for demonstration and
evaluation of health care projects. Special
focus will be on the application of social
sciences in health care research. For
further information, write to: Susan Hicks,
Dept. of Social & Preventive Medicine,
Faculty of Medicine, U. of Manitoba, 750
McDermot Ave., Winnipeg, R3E OW3.
Deadline for receipt of applications is
September 15.

June 1975
St. Joseph's School of Nursing Alumnae,
Victoria, B.C., 75th anniversary reunion.
For further information, write to: Ms. Phyllis
Fatt, 4253 Dieppe Rd., Victoria, B.C., V8X
2N2.

lune 22-27,1975
Tenth International Congress of Gerontol-
ogy (and Geriatrics), Jerusalem, Israel.
For further information, write to: Con-
gress, P.O. Box 16271, Tel Aviv, Israel.\J
JULY 1974

new products

{

Descriptions ar
based on information
supplied by the manufacturer. No
endorsement is intended.

( .

. . J' -:r
,,, "'-
\ \'"" "-

,
.

Anatomic Anne training manikin
Anatomic Anne Training Manikin shows.
visually, the circulation of blood and the
inflation of the lungs during the correct
performance of cardiopulmonary resusci-
tation. The manikin is designed to simu-
late a human breathing and thorax sys-
tem, including simulated blood flow.
The advantages of Anatomic Anne are
that the student learns the correct head tilt
method and observes any possible ob-
struction of the airway, learns how to
ventilate a patient's lung in accordance
with recommended ratios, and learns the
correct pressure to put on the lower
sternum.
Anatomic Anne helps in understanding
cardiopulmonary resuscitation. It is re-
commended for use in first-aid courses,
high schools. and nursing schools, and is
available from Safety Supply Company,
214 King Street East, Toronto, Ontario,
M5A U8.

Trachea and laryngectomy tubes
New trachea tubes and laryngectomy
tubes of thin wall stainless tubing are now
being offered by Sparta Instrument Cor-
poration. The component parts of these
tubes are fully interchangeable and re-
placement parts are readily available.
Moreover, their stainless steel construc-
tion combines the advantages of strength,
durability, light weight, and maximum air
flow.
The trachea tubes are Jackson design,
sizes I through 10, and are available in
short and regular lengths, rotating lock
and gate lock. with 15 mm adaptor and
with threaded stud for the Morch adaptor.
JULY 1974

Anatomic Anne

..

...
" ,

Trachea and Laryngectomy Tubes

The laryngectomy tubes are Jackson
design with rotating lock, sizes 6 through
12, and Martin design, with gate lock,
sizes 8 through 12.
These tubes are available from Medi-
Craft Ltd., 2775 Thamesgate Drive,
Malton. Ontario.

Female urine specimen unit
A new way to deliver an uncontaminated
urine sample from female patients di-
rectly into a specimen tube has been
announced by Davol Inc. The Davol
Female Cath Kit consists of a stenle, IS

mt. specimen tube with a number 8 Fr.
catheter passing through its flip-top cap.
The small catheter is rigid enough to be
inserted quickly and easily. It cannot be
overinserted because the operator controls
the length that extends from the tube.
Once a sample has been obtained, the
catheter is slipped out of the specimen
tube's cap, the cap is closed, and the
container labeled. The specimen is then
ready for the laboratory.
More information is available from
Enns & Gilmore, 1033 Rangeview Road.
Port Credit, Ontario, L5E IH2.

Maxeran
Nordic Biochemicals Ltd., a member of
the Omnimédic group, has launched a
new drug on the Canadian market. Maxe-
ran (metoclopramide) is well known in
gastroenterology.
According to the company, Maxeran
has brought about a new avenue in
treating digestive disorders; a complete
transformation of radio-diagnostic tech-
niques in gastroenterology; an improve-
ment in the techniques of gastroduodenal
intubation; and new angles for research in
digestive physiology.

l'
I.

Female Cath Kit
THE CANADIAN NURSE 33

new products J

Maxeran is available in three forms:
tablets (bottles of 50 and 500); liquid
(bottles of 110 ml and 450 ml); and
injectable (2ml ampoules, boxes of 5 and
50). More infonnation is available from
Omnimédic Inc., 2775 Montée St-Aubin,
Laval, Québec, H7S 2A4.

Cardiac monitor
A new, miniature. battery-powered car-
diac monitor with a built-in arrest
alarm is available from Isolette, a Narco
Medical Company. This CardioBeeper is
designed to monitor adults, children, and
even newborn infants. The completely
portable unit may be used in the
emergency room, for transport service, in
the recovery room, and in the x-ray
department. Reusable QuickTrodes.
which are placed in the patient's armpits,
can pick up the heartbeat in seconds
without the use of skin preparations. gels,
or paste.
The CardioBeeper is suitable for use in
the intensive care or general nursery, or in
the delivery room. where a special nonin-
vasive device allows the unit to be used
with an infant at birth. The CardioBeeper
pennits accurate monitoring of the heart
rate visually and audibly through_signals
that are activated with each "R"" wave.
Should cardiac arrest or ventricular
fibrillation occur. the CardioBeeper re-
sponds with a continuous lamp and tone
alarm so that vital signs can be checked
immediately and emergency lifesaving
begun. The unit's small size and portabil-
ity pennit continuous monitoring in all
areas of the hospital. It can also be used
when transporting a newborn from the
delivery room to the nursery.
The unit comes complete with elec-
trodes, battery. remote earphone, and
carrying case. Further information is
available from Narco Medical Services,
22 Le Page Court, Downsview, Ontario.

Recliner chair-table
A versatile six-position recliner chair-
table has been designed for multipurpose
use in health care institutions or patients'
homes by Lumex, Inc. The "extra com-
fort" chair-table with an automatic ad-
justing leg rest can be used in dialysis,
blood collection. cardiovascular, and
Trendelenburg positions, among others.
Equipped with 5-inch swivel casters
and wheels and rear push handle, the
recliner-chair is easily moved. The chair,
which has two side-mounted folding
tables in durable wood-grain plastic lami-
34 THE CANADIAN NURSE

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nate. offers an extra-high back with
special sacro-support; an adjustable wing
pillow for head comfort; and extra-wide,
padded, upholstered full-length armrests.
The Lumex chair-table, which has a
heavy duty tilt mechanism, is upholstered
in flame-resistant, expanded vinyl in a
soft gold color. Other upholstery colors
are available on request. The recliner
chair has an overall height of 47 inches
and width of 30 inches. For price and
more infonnation, write to Bercotec,
Inc., 11422 Albert Hudon Blvd.,
Montreal 462, Quebec.

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Recliner Chair-Table

Silastic tracheostomy tube
A silicone pediatric tracheostomy tube.
developed by Dow Corning, represents a
new material-design concept of soft plia-
bility and flexible anatomical construc-
tion. According to the company, the new
tracheostomy tube is a significant de-
velopment in maintaining tracheal airway
patency in infants and young children. An
added advantage is that no evidence of
obstruction by kinking has been reported.
The tube is supplied sterile, packaged
in four sizes, is radiopaque, and may be
autoclaved repeatedly. Write to Dow
Coming Silicones Inter-America Ltd., I
Tippet Road. Downsview, Ontario. M3H
5T2, for Bulletin 14-414: Silastic
Tracheostomy Tube (Aberdeen design).

,

Antitussive
Fisons (Canada) Limited has introduced
Noscatuss, a lime-flavored antitussive.
Noscatuss is a non-narcotic antitussive
that controls cough caused by allergies,
irritants, and respiratory conditions where
cough is a major factor. Its effectiveness
is derived from the properties of nons-
capine, which is one of the isoquinoline
series of alkaloids. Its potency, the
company says. has been shown in numer-
ous studies to be equivalent to that of
codeine, without its side effects. Nos-
catuss is recommended for the whole
family.
More information can be obtained from
Fisons (Canada) Ltd., Phannaceutical
Division. 26 Prince Andrew Place, Don
Mills, Ont.. M3C 2H5.

JULY 1974

research abstracts

Kirstine, Myrtle L. A descriptive studv of
health and related needs of senior
citizens in one housing complex. To-
ronto, Ont.. 1973. Study. Etobicoke,
Dept. of Community Health.

The primary purpose of this study was to
provide baseline data that may be used in
planning health care services to senior
citizens in this type of housing unit. A
secondary purpose was to examine the
possibility of using the data for planning
an extended nursing role in the care of
elderly ambulatory patients.
Community health nurses interviewed
the residents (273 of a po<;sible population
of 320) of a recently opened Metro
housing unit to ascertain their health
needs, social needs or concerns, and the
use of and need for nursing and medical
care.
Some findings were that 24 of the
senior citizens had no physician, of whom
10 believed they had no medical condi-
tion requiring care; 161 were taking from
one to four prescribed medications; I O

were taking nonprescription medications;
34 required dental care; and 20 were on
special diets.
A wide range of concerns were freely
expressed, such as fear of dying alone,
financial problems, and family relation-
ships. Although the building was new,
123 had one to three complaints regarding
the accommodation. Nurses believed that
96 of the residents would require nursing
care within the next month and that four
required urgent medical care.
Recommendations were made regard-
ing nursing services for the residents of
this and similar housing units. Implica-
tions were drawn regarding the need for
educational preparation to enable the
community health nurse to assume an
extended role in the care of chronic and
elderly patients.

McHarg, Linda. Affect changes pre- and
postabortion. Montreal, Que. 1973.
Study (M.Ed.(Counseling)) McGill U

The Sixteen Personality Factors Ques-
tionnaire and the Adjective Check List
were given to patients entering the
Catherine Booth Hospital, Montreal, be-
fore their twelfth week of pregnancy, for
a suction curettage. These two question-
naires were given approximately 12 hours
JULY 1974

before the abortion and again 12 hours
following the procedure.
Pretest measures of anxiety, depres-
sion, hostility, and neuroticism were then
compared with the post-test measures.
The results of the neuroticism scale were
also compared to neuroticism scale results
obtained from a study done by 1.1.
Kear-Colwell (1965) on patients in early
puerperium.
The Adjective Check List showed a
significant drop in anxiety (p< .001) and
depression (p < .00 I) at postabortion re-
test. A less obvious, but nonetheless
significant, drop in hostility (p <.0 I) was
also shown.
With regard to the measures of neuroti-
cism, three factors: seriousness, tender-
mindedness, and submissiveness showed
no significant change as compared with
Kear-Colwell's study, which noted an
increase in neuroticism in factors of
submissiveness and seriousness.
The anxiety component showed a sig-
nificant drop (p.::: .05), and a sub-scale
analysis demonstrated that the drop was
overt anxiety (conscious, felt. asymp-
tomatic) (p< .01) rather than covert. An
analysis of the five primary factors that
make up the anxiety scale revealed no
significant changes.
An increase in psychopathology was
not demonstrated. Relief of depression,
anxiety, and hostility was clearly demon-
strated. There is some evidence to suggest
that postabortion affect differs from post-
partum affect, abortion being less trauma-
tic.

Cahoon, Mar
aret C. and Turner, Lettie.
The Bloorview Satellite Project: an
evaluation of the pilot period, /97/-
73. Toronto, Ontario, 1973. Study. U.
of Toronto.

The problem was to evaluate the Bloor-
view Satellite Project in progressive care
of selected chronically ill adolescents as a
means of preparation for more indepen-
dent living. The immediate purpose was
to provide infonnation for the Board of
Trustees of Bloorview Childrens Hospital
and, ultimately, the Ontario Health Insur-
ance Commission about the feasibility of
the continuation of this project. It was
intended also to provide documentation
for planning and implementing future
extensions of this type of care,
A case study approach based on sys-

tems theorv was the method selected. 1 be
major sources of data were Bloof\ it "'
Childrens Hospital and the Satellite 1<"
cords, minutes of the Satellite meeting'.
diaries of Satellite staff, interview
with
four administrators. 13 staff members ot
Bloorview Childrens Hospital includitF
those in the Satellite, and 13 patients.
The findings revealed problems in
relation to philosophy and objectives,
staff, patients. interpersonal rela-
tionships, finances, facilities, and re-
sources. Expectations for the patic'nl:o.
were not clearly defined or understood
by the patients and staff. Links with
family and community from the tin..
the child was admitted to the inMitution
were not always maintained. The stalf
were found to have a heavy schedule
insufficient built-in external supports
and insufficient preparation and ex-
perience.
The patients were found to he passi'.e
rather than active participants. Discrep-
ancies existed in the area of
dependence-independence (the balam..e
between emotional support and freedom,
between control and gratifIcation).
The study revealed some social and
emotional needs of these adolescent-..
They require meaningful relationships
with people of all ages whom the"
recognize as not having to be involved.
These limitations were not conduci\e
to innovative change in using the facilities
and resources to promote the develop-
ment of patients to reach a functional
capacity for self-care and to live on at
least an interdependent level in the
community.
Recommendations were made about
strengthening and maintaining famIly h.
lationships; establishing and enlarging the
linkage with society; clearer definition of
the expectation for the patient's achieve-
ment of self-care; direct. clear, spc'cihL.
and genuine communications 111 dll arc'dS;
more focus on staffing. \\, ith built in
supports to augment staff's self\\' orth, a

well as that of the patients
On the basis of the project's
ize and
limited number of patients involved,
these conclusions seem justified: that the
Satellite be continued. with modihl..l-
tions; that other satellites be developed to
enable more patients to have famil}-like
experiences as early as possible; and that
there be further investigation dÌ1ected to
staffing, care patterns, interpersonal
communication. and related problems
THE CANAD
N NURSE 35

books

Essentials of Nursing Research by Lucille
Notter. 147 pages. New York, Sprin-
ger, 1974.
Reviewed by Ruth C. MacKay, Asso-
ciate Professor, McMaster University
School if Nursing, Hamilton, Ontario.

This welcome book is written for the
nurse wanting to develop skills as a
clinical investigator, and for the practition-
er wanting to increase her ability to
evaluate published reports. The book is
not intended as a reference for the
established nurse researcher.
With considerable skill, the author
limits her attention to outlining the fewest
essential principles from which a small
clinical study may draw in developing a
problem for study. a method of studying
the problem, and a plan for evaluating the
outcomes of the study. The author as-
sumes the reader has no prior knowledge
ofresearch methodology, mathematics. or
statistics. The investigator is expected,
however, to be able to use clinical
judgment in the identified decisions that
must be made in following the entire
research process.
Possibly, one of the most appreciated
aspects of this book is that it is concerned
with clinical nursing research. The author
states: "In the strictest sense. nursing
research is concerned with the systematic
investigation of nursing practice itself,
and of the effect of this practice on patient
care or on individual, family, or commu-
nity health. ., The book is addressed to the
need to combine clinical judgment with
methodological skills in carrying out a
clinical investigation, a point that is not
always made explicit in texts on research
for clinical investigators.
The book is well organized, using the
systematic approach to the investigative
process as its organizing criterion, well
outlined in the table of contents. The table
of contents, along with a helpful glossary
of research terms, almost manages to
offset the fact that the book lacks an
index.
One might wish that the author had
directed greater attention to the measure-
ment of variables, a problem of consider-
able complexity to those engaged in
clinical studies. A clearer definition of the
level of measurement involved with va-
rious approaches to data collection might
assist the reader to understand the later
process of analysis of data. Yet the
decision to omit statistics from the book,
36 THE CANADIAN NURSE

identifying the role of the statistician as
needed consultant. is to be commended.
Dr. Notter has brought a wealth of
experience and knowledge as editor of
Nursing Research and International Nur-
sing Index to the development of this
carefully prepared book. Its straight-
forward approach and parsimonious dis-
course are bound to be welcomed by
educators preparing undergraduate nurses
and clinicians alike.

Effective Interaction in Contemporary
Nursing_ by Charlotte Epstein. 174
pages. Englewood Cliffs, N.J.,
Prentice-Hall. 1974.
Reviewed by Gail Gitterman, Instruc-
tor, Nursing Department, Ryerson
Poly technical Institute, Toronto, On-
tario.

This book is designed for nurses at all
stages in their development. It has mean-
ing for the student nurse, educator, staff
nurse. and administrator. I would re-
commend it especially for graduate nurses
who have been in the work force a
number of years. The book's optimism is
combined with realism, which does not
frustrate the reader but lifts the spirits
while pointing out realistic methods for
improvement. The narrowest look at the
book might suggest that its comments
focus on communication. It does this and
much more.
The author has outlined a humanistic
approach to interaction and has developed
this in the broadest sense. The breadth of
content does not affect the quality of
detail as we move from the nurse under-
standing herself to the nurse influencing
social change.
One of the book's greatest strengths
lies in its pragmatic presentation. For
example, in the chapter dealing with
stereotypes, the author outlines exercises
to help the nurse understand her own
reactions to patients. One writing exercise
allows the group to put down traits it
would nonnally attribute to men and
women. The author then points out: "if
all around us, people, the media and
institutions seem to operate on the pre-
mise that the traits of the stereotype are
accurate, the victim begins to think there
must be some truth in the picture." She
goes on to say, "the barrier of feelings
among the groups actually prevents equal
status communication. "

Much of the content focuses on de-
veloping self as a free, trusting individual
in relation to others, regardless of the
diversity in backgrounds. Each chapter is
filled with contemporary problems. Sex-
ism, race riots, and the treatment of old
age are a few of the more poignant topics
that are dealt with in this productive style.

Readings in Family Planning: A Challenge
to the Health Professions by Donald V.
McCalister. Victor Thiessen and Mar-
garet McDermott. 256 pages. St.
Louis, Mosby, 1973.
Reviewed by Marion Jones, School
of Nursing, Vancouver General Hos-
pital, Vancouver, R.C.

This book presents a selection of articles
that allows the reader to gain an under-
standing of the nature of family planning,
and of the challenges it offers to both
individuals and health professionals. The
background of family planning is well
outlined, with reference to the urgency
for population control, the policies in
favor of family planning adopted by
various professional associations in the
health field, and the currently used
methods of contraception.
The authors have included articles that
focus specifically on the problems and
prospects of family planning at the level
of individuals. In answering the question,
"Who needs family planning?". the
values of both clients and health profes-
sionals are considered. Three
values - physical. emotional, and social
well-being - appear to be most critical.
The physical health benefits of family
planning are particularly emphasized. and
a strong case is presented for including
family planning as an integral part of
family health care.
Section III of the book explores the
issues of who actually practices family
planning. The general factors involved in
an individual's decision to practice con-
ception control are outlined. Several
articles present evidence that those most
in need of family planning are not more
likely than others to attend family plan-
ning clinics or to adopt and use medically
prescribed contraceptive methods.
Finally, the challenge to health profes-
sionals is clearly defined. Health prac-
tioners have fallen short in their role of
providing effective family planning ser-
JULY 1974

vices. They rarely have an adequate
background in all aspects of family
planning, yet are expected to provide
service to clients in many different
settings.
Educators in the health professions are
challenged to provide opportunities for
interdisciplinary courses and clinical ex-
periences in all basic programs. Nurses,
in particular, because of their varied roles
both in the hospital and in the commun-
ity, are challenged to contribute to family
planning education through good family
health programs.

Waiting For Your Child by Yvette Pratte
Marchessault. 188 pages. Montreal,
Habitex, 1973. Agent: Ampersand
Publishing, Toronto. Reviewed by
Helen O'Connell, Assistant Director,
Public Health Nursing, Ottawa-
Carleton Regional Area Health Unit,
Ottawa, Ontario.

The author states in the foreword that
every woman can deliver her child with a
minimum of discomfort, either conscious
or under anesthesia, if she is informed,
free of fear, and learns to breathe
properly. She then proceeds, in an infor-
mal and easy-to-read style, to deal under-
standingly with pregnancy, the develop-
ment of the baby, physical and
psychological preparation for pregnancy,
prenatal and postnatal exerCises, and
labor. In her desire to leave no detail
uncovered, some of the material is cov-
ered prematurely, necessitating repeti-
tion.
This book is addressed to the middle
class. The mother is advised to go to the
hairdresser and the husband is counseled
to take his wife to their favorite restaurant
or to the theater if she appears depressed.
Much of the terminology would be lost on
the average expectant couple. Although a
glossary is included, many of the words
do not appear in the text and
others - such as symphysis pubis. copu-
lation, embryo, pectoral - which are
used in the text, are not defined.
Too many exercises are included.
Better use could be made of them if they
were grouped together, rather than being
broken into individual segments, many of
which deal with the same material. In
general, the exercises are well described,
although some of the directions could be
quarreled with. Most authorities are
currently in disagreement with arching
the back in pelvic rocking, as well as
placing the legs against a wall for relief
of varicosities, for example.
The sections on relaxation, obstetrical
anesthesia, and breathing are clear and
concise. The author wisely states that she
no longer believes it is necessary to know
several different types of breathing be-
cause when the time comes, one never
knows which to use. She then proceeds
IULY 1974

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with three or four easily understood,
easily followed directives.
This handbook is one of the best
written to date and the understanding
approach taken by the author identifies
her as a person who really cares about the
preparation of parents for one of life's
deepest experiences.

The Nursing Process: Assessing, Planning,
Implementing, Evaluating, 2 ed.,
by Helen Yura and Mary B. Walsh.
215 pages. New York, Appleton-
Century-Crofts, 1973.
Reviewed by Hildy Neufeld, Assistant
Director, School of Nursing, St. Boni-
face General Hospital, Winnipeg,
Manitoba.

Throughout the book, the authors use the
term client rather than patient. They
believe, since nursing is practiced in
many settings, with a variety of consum-
ers - some with potential problems,
and others with actual problems - that
client is a more comprehensive term.
There are five chapters in the book.
The first chapter, entitled .. Development
of the Nursing Process," deals with an
historical review, beginning with flor-
ence Nightingale. A brief review of the
nursing process is also included.
Chapter two deals with the systems
theory as it relates to the nursing process.
In chapter three, we are provided with a
detailed analysis of the components of the
nursing process. Chapter four consists of
numerous patient situations and the appli-
cation of the nursing process.
The final chapter deals with the future
of the nursing process, emphasizing once
again that it can be used for any client,
whether located in the home, hospital, or
clinic.
The objective of this book has been
partially met. The chapter regarding the
use of the systems theory as applied t(
the nursing process is updated content.

However, the information regarding the
four phases of the nursing process is a
review of well-known content.
The book would seem to be intended
for beginning nursing students. The
phases of the nursing process are clearly
outlined; however, the many patient
situations frequently illustrate inappro-
priate nursing care. This is a significant
limitation of the book.

Textbook of Basic Nursing, 2ed., by Ella
M. Thompson and Caroline Bunker
Rosdahl. 841 pages. Toronto, Lippin-
cott, 1973.
Reviewed by Ingrid Headrick,
Teacher, Health Services Department,
St. Lawrence College, Kingston Cam-
pus, Kingston, Ontario.

In this edition, the authors have de-
veloped an informative, practical text-
book that covers all the important aspects
of the curriculum for the American
practical nurse or our registered nursing
assistant.
The book is organized around the
educational principle of simple to com-
plex and the developmental principle of
birth to death. Thus, orientation to nurs-
ing, anatomy and physiology, and basic
nursing skills are presented first, followed
by nursing of the mother and newborn,
the child, the adult, and the-aging person.
Although some authorities might argue
that it would be appropriate to divide the
content of this book into several books, it
is useful to refer to the structure and
function of the body or to growth and
development, while researching a
patient's illness. Each chapter has suffi-
cient depth for the RNA student.
A bonus in this edition is that be-
havioral objectives have been placed at
the beginning of each chapter. The
authors suggest that these are useful
objectives for any practical nursing pro-
gram and should be attained before gradua-
THE CANADIAN NURSE 37
.

books

tion. The student will not necessarily
meet the objectives by reading the chap-
tcr: she may need guidance from her
instructor. These well-defined objectives
can also be used for student self-
c"aluation.
The authors have included a readable
and comprehensive chapter on the prob-
lems of drug abuse. They also deal with
some newer aspects of nursing such as
community health. the nurse-patient-
lamily relationships. and some proce-
dUff's that we do not teach in Canada. fOf
instance. catheterization technique,
which may be included in the repertoire
of skill of the future RNA practitioner.
The strength of this book is that it gives
the student a good foundation in basic
JIlJr
ing. It might have been livelier and
given the student an opportunity to solve
prohlems if some case studies had been
included. although her problem-solving

kjlls will be used in integrating all the
material in this book.
It is disappointing that the unit on
professional aspects of nursing is com-
pletely American in orientation.
Nevertheless, I would recommend this
book as the basic text for nursing assistant

tudents in Canada or as a helpful
addition to any nursing library.

Winter's Protective Body Mechanics; A
manual for Nurses, edited by Annetta J.
Bilger and Ellen H. Greene. 108
pages. New York, Springer, 1973.
Canadian Agent: Lippincott,
()ronto.
Rrviewed by Marilyn Grea
'es, Nurse
Teacher, Humber College, Quo Vadis
Campus, Etobicoke, Ontario.

The editors of this text have revised and
re\\<riUen a manual by Margaret Winters.
Ihey state there is added material on body
mechanics, correlated with rehabilitative
nUfsmg care.
Using an analytical style, a descriptive
text, and many illustrations, the authors
have produced a comprehensive review of
their subject. The manual supplies good
background information for the nursing
arts instructor. Also, it provides an excel-
lent source of information for the student,
and for nurses practicing in fields where
phy
ical needs of the patients are often of
high priority.
The text is in three parts: body
mechanics and alignment, movement of
joints and range of motion, and the effects
of limitation of movement.
Part , explains the gravitational laws,
relating them to the human body during
activity and res\. Attention is given to the
18 nn CANAOIAN NURSE

body mechanics of the nurse as they are
applied to specific actions of walking,
sitting, lifting. and assisting helpless and
semihelpless patients into position in bed.
Part II explains joint movement, gener-
ally and specifically. Anatomical infor-
mation on specific joints is furnished in a
detailed chart. A meaningful account of
nursing applications follows and includes
an illustrative examination of the nurse's
role in assisting the patient in range of
motion exercises. Finally, Part II intro-
duces, in a general way, the role of the
nurse in the care of various medical and
surgical conditions.
Part III of the manual summarizes
briefly the disadvantages and complica-
tions of limited movement. It serves
mostly to emphasize the need for diges-
tion of the foregoing two parts.
A few preventable misprints occur in
the manual: a reference to a non-existent
page 109, and a switch of descriptions for
figures 213 and 214 are both an incon-
venience. The detailed table of contents
compensates for the lack of an index.
It is a concise. well-illustrated manual,
which readers can use easily, and is
recommended as a ready reference.

Nursing and the Process of Continuing
Education, edited by Elda S. Popiel,
248 pages. Toronto, Mosby, 1973.
Reviewed by Norma J. Fulton, Assist-
ant Professor of Nursing, Continuing
Nursing Education, College of Nurs-
ing, University of Saskatchewan,
Saskatoon, Saskatchewan.

This book, a collection of 31 articles,
represents the contributions of 32 authors,
including names well known in nursing
and adult education. The authors, with
two exceptions, are from the United
States; the examples and settings from
their own experience are, for the most
part. relevant to the Canadian scene.
Part I is a thorough consideration of
"What is Continuing Education?" One
author points out that continuing educa-
tion in nursing has been slow in selling
itself as a method of bringing about
change and improvement in health care.
A case for trying interprofessional con-
tinuing education is made by another
author. Others identify the agencies and
individuals who should accept respon-
sibility for the continuing education of
the nurse.
Part II - "Implementation of Conti-
nuing Education" - begins with a dis-
cussion of assessing and determining
learning needs and the learning climate.
The development of a self-study tool and
of a multimedia instructional program are
described at length, including the hard-
ware and software available today, and
the use that can be made of these in
meeting educational objectives.
Part III, "Who is Involved?", empha-

sizes the importance of advisory and
planning committees and the necessity of
involving clientele in program planning.
The responsibilities and rewards of the
director of continuing education are des-
cribed, including 10 specific roles that
she must consider.
The important question of evaluation is
focused on in Part IV. Examples of
innovative continuing education pro-
grams, such as sharing and pooling
in service resources, and telelecture are
described in Part V.
This book is a valuable resource for
those who have responsibilities for inser-
vice programs, staff development, or
broader continuing nursing education
programs.

School Nursing in Transition by Doris
S. Bryan. 204 pages. S\. Louis,
Mosby, 1973. Canadian Agent:
Mosby, Toronto.
Reviewed by Jean E. Innes, Associate
Professor, Communiry Health Nurs-
ing, University of Saskatchewan,
Saskatoon, Saskatchewan.

The aim of this book is to present an
overview of school nursing philosophy,
current practices; and patterns of ad-
ministration in respect to school prog-
rams.
The book is procedure and task
oriented, with little depth or emphasis on
a philosophy of nursing practice. Vital
aspects of school nursing, such as health
counseling and team function, are discus-
sed superficially, and secondary and
tertiary prevention are stressed in specific
childhood disabilities. The book lacks
emphasis on care at the primary level
except in specific examples of immuniza-
tion and some data on the nurse as the
liaison person between the school and the
community.
The dimensions of school nursing are
discussed as a specialized service and as
such are not readily applicable to all of
the Canadian situation. Although most of
the book' s content describes school nurs-
ing in the United States, with models and
measuring instruments amply illustrated,
health agencies in Canada that are heavily
involved in school nursing might find this
book a useful reference.
The reviewer would not recommend
this book to students in schools of
nursing, except as a specific reference,
since much of the information is basic and
would be repetitive .to the learner. The
chapter on change adds little and does not
deal with change process, but rather
cautions readers to be prepared to change
with the demand for adequate health care
by the consumer.
Readers who like precise and direct
information will find this book specific,
well organized, brief, and an easy refer-
ence guide to school nursing. ?
JULY 1974

A V aids

FILMS
o A variety of Churchill health films are
available from Gordon Watt Films. 865
Sheppard Avenue West. Downsview 476.
Ontario. A catalogue for previewing or
replacing films can also be obtained.
The 16mm films available include
Soon Thue Will Be No More Me (10
mins., color), a true story about a young
mother who finds out she has a fatal type
of cancer; Circulation and the Human
Body (II mins., color). a film directed at
students in elementary, junior and high
school grades; Then One Year (19 mins..
color), directed at the grade six to seven
level. which deals with the physiological
changes at the onset of adolescence and
some of the worries of that time; Look
What's Going Around (16 mins.), a film
on venereal disease, which is particularly
well suited for use in a Super 8mm
continous loop projector; and Vasectomy
(17 mins., color).
Study guides are available for all films
and accompany each preview and purch-
ase.

o More Common Than Measles and
Mumps is an II-minute animated film on
venereal disease. produced by students at
Queen's University for students in grades
7 to 10 or II. As well as being
informative. the film is entertaining.
Copies of this film are available from the
Canadian Film Institute, 1762 Carling
Ave., Ottawa. or from provincial bureaus
of health education. The film can also be
purchased for $100 a print from the
Commercial Division, National Film
Board, P.O. Box 6100. Montreal.
Pamphlets on YD are also available free
of charge from: Health Promotion Divi-
sion, Health Programs Branch, Depart-
ment of National Health and Welfare.
Ottawa, K I A 1B4.

CASSETTES ON NURSING RESEARCH

OThe Canadian Nurses' Association lib-
rary has received a set of ten 90-minute
audiotape cassettes of the entire contents
of the Colloquium on Nursing Research.
held in Montreal from March 28 (0 30.
1973. The colloquium was sponsored by
the faculty of nursing at the University of
Montreal and by the schools of nursing at
McGill University and Laval University
in Quebec City.
A set of eleven one-hour videotape
cassettes (Sony KC-60) recorded in black
JULY 1974

and white (mono). and a set of eleven
one-hour videotape half-inch reels have
also been received by the CNA library.
Both videotape sets contain the complete
proceedings. The general discussion por-
tions. however. were not videotaped. The
cassettes have had the plugs removed so
they cannot be accidentally erased.
The three sets can be borrowed from
the CNA library. Borrowers are asked to
give the title of the session and the kind of
tape they wish to receive.
The session titles are: Introductory
remarks. and Development in ideas about
nursing education in the U.S. and
Canada, 1873-1950: Life and writings of
Ethel Johns; Study of nurse activities in
primary care settings; Role of the profes-
sional nurse as a member of an interdisci-
plinary health team in a rural health
center; Analysis of home visits by public
health nurses; Effects on children' s health
and on parent's health behavior of prim-
ary care in three health agencies; Learn-
ing needs of persons on home
hemodialysis; Doctor/nurse shared care
for ambulatory. chronically ill patients;
Development and quantification of a
psychiatric patient classification; An out-
come study of inpatient hospitalization
on a Brief Therapy Unit; and Standardisa-

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otherwise you will likely miss copIes

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tion de l'adaptation française du Denver
developmental screening test auprès
d'une population canadienne
d'expression française.
To borrow any of these tapes. write to
the CNA librarian. 50 The Driveway,
Ottawa, K2P IE2.

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 institu-
tions. Reference (R) items (archive 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 Library,
Canadian Nurses' Association. 50 The
Driveway. Ottawa, Ont. K2P IE2.
No more than three titles should be
requested at anyone time.

BOOKS AND DOCUMENTS
I. An act respecting health sen-ices and social
sen'ices and regulation. Method of studyfor use and
application, edited by Rollande Gagné. Montreal.
Intennonde. 1973. 167p. (Documentation
eries I).
2. ALA handbook of organi::.ation, 1973 {74.
Chicago. American Library Association. 1974. 92p.
3. Beth/l1le, by Roderick Stewart. Toronto, New
Press. 1973. 210p.
4. A Canadian charter of patient's rights, edited by
Rollande Gagné. Montreal. Intermonde. 1973.
118p. (Documentation series 4).
5. Career mobilirv; implementing the ladder con-
cept in associate degree and practical nursing
curricula, by Donna Kelchum Story. Saint Louis.
Mo., Mosb}. 1974. 206p.
6 Catalogue des res.<ources; Ie planning des
naissances [' edllcation semelle la population.
Monrreal. La Fédération pour la pl,IIlJficalion
familiale du Canada. 1973. 52p.
7. Commllnication in nursing practice, b} Eleanor
C Hein. Boston. Linlc, Brown, 1973. 242p.
8. Les conditio1l.f de travail et d' emploi du person-
nel ;,ifirmier. Rapport prepare pour la reunion
speciale. .iI Genè,'e. du 6 all II oClObre 1958.
Genève. Organi\dtion intemationale du travail.
1958
9. Dillionan- of ps}choloR\' and related sdenas.
Engli.fh-French, by Jacques Ca\tonguay. Sdint-
Hyacinthe. P.Q. Edi
em. 1973. 153p. R
10 The dYllamlcs of health care, by Ruth M
French. 2ed. New York. McGrd.....-HiII. 1974. t47p
1 I. Effecti>'e approaches 10 pariellts' behmior. by
Gladys B. Lipkin and Roberta G. Cohen. Nc\\
York. Springer. 1973. 198p.
12. Emerge", ,. medical sen'ices; beha,ioral allli
THE CANADIAN NURSE 39
.

accession list

planning perspectives, edited by John H. Noble et
aL New York, Behavioral publications, 1973. 595p.
13. Foundations of anatomy and physiology, by
Janet S. Ross and Kathleen J. W. Wilson. 4ed.
Edinburgh. Churchill Livingstone, 1973. 453p.
14. The four horsemen: racism, sexism, ,..;Jitarism
and social Darwinism, by Ethel Tobach "", al. New
York. Behavioral publications, 1974. 123p.
15. The geriatric aide, by Jane Henry Stolten.
Boston, LillIe. Brown, 1973. 345p.
16. A handbook of human service organizations,
compiled by Harold W. Demone and Dwight
Harshbarger. New York. Behavioral publications,
1974.6OOp.
17. Health and society. Emerging international and
Canadian trends. Addresses to the Anniversary
S,'mposium of the School of Hygiene, University of
Toronto, April /3 and 14,1973. Edited by Kenneth
F. Clute. Toronto, School of Hygiene. University of
Toronto, 1973. 109p.
18. Health organizations of the United States,
Canada and internationally. A directory of volun-
tarv associations, professional societies and other
groups concerned with health and related fields.
3ed. Paul Wasserman, Managing editor. Washing-
ton. D.C., McGrath Publishing Co., 1974. 249p.
19. Humnn ecology in the Commonwealth. Report
of a symposium held in London in Nov. 1971 by the
Commonwealth Humnn Ecolog) Council. London,
The Commonwealth Foundation, 1972. 52p.
(Commonwealth Foundation. Occasional paper no.
14).
20. Human reproduction and family planning: a
programmed text, by Elizabeth Murphy Whelan and
Michael C. Quadland. Palo Alto, Calif., Syntex
Laboratories, 1972. 128p.
21. Interviewing; its principles and methods, by
Annette Garrett. 2ed. Revised by Etinor P. Zaki and
Marljaret M. Mangold. New York, Family Service
Association of America, 1972. 209P.
22. Leadership technique in expectant parent edu-
cation. by Ann L Clark. 2ed. New York, Springer,
1973. 118p.
23. Mental patients protection act and juridical
aspects of mental diseases, edited by Rollande
Gagné. Montreal, Intermonde, 1973. 133p.
(Documentation series 2).
24. The nurse's guide to healrh services for
patients, by May DiPietro Futrell and Marie J.
Kelleher. Boston, Little, Brown, 1973. 108p.
25. Our hndies, ourselves. A book by and for
women by The Boston women's health book
collection. Ne\\; York, Simon and Schuster, 1973.
276p.
26. Patient care services policy mnnual f r the
nursing department. compiled by Sister Leone
Douville. SI. Louis, Catholic Hospital Association,
1974 l72p.
27. Proceedings of a Colloquium on Nursing
Research. Montreal. March 28-30, 1973. Montreal,
McGill Univer!oity School of Nursing, 1974. 3v.
28. Prostaglandins infertility control. Reportfrom
meetings of the Prostaglandin Task Force Steering
Committee, edited by S. Bergstrom.
40 THE CANADIAN NURSE

Stockholm, World Health Organization, Research
and Training Centre on Human Reproduction,
Karolinska Institutet, 1973 , IISp.
29. Protecrive bodv mechanics: a manual for
nurses, by Margaret Campbell Winters. Edited and
revised by Annetta J. Bilger and Ellen H. Greene.
New York, Springer, 1973. 108p.
30. Repertoire des services sociaux canadiens,
Ottawa, Conseil canadien de Développement social.
1974. Iv.
31. Resource catalogue; family planning sex
education population. Montreal, The Family Plan-
ning Federation of Canada, 1973. 52p.
32. Smaller families through social and economic
progress, by William Rich. Washington. D.C.,
Overseas Development Council, 1973. 73p. (Over-
seas Development Council. Monograph no. 7).
33. A source book of nursing research, compited by
Florence S. Downs and Margaret A. Newman.
Philadelphia, Davis, 1973. 242p.
34. Symposium on love, edited by Mary Ellen
Curtin. New York, Behavioral publications, 1973.
244p.
35. Undersranding aphasia; a guide for family and
friends, by Martha L Taylor. New York, Institute
of Rehabilitation Medicine, New York, University
Medical Center. 1968. 48p.
36. What to tell your child about sex. Rev. 1974.
Prepared by the staff of Child Study Association of
America, Well-Met Inc. New York, Child Study
Press, 1974. 97p.

PAMPHLETS
37. Accreditation; community nursing services.
Guide for preparing accreditation reports. Rev.
New York, N. Y., National League for Nursing,
1972. 15p.
38. ALA Nursing Department at NLN. New York,
National League for Nursing, 1973. pam. (Pub. no.
45-TBI4).
39. The art of understanding: care and caring for
the patient with cancer, by Virginia Barckley. New
York, American Cancer Society, 1973. IIp.
40. The associate degree practitioner and nursing
service needs, by Grace E. Davidson and Marie
Anita Brock. New York, Council of Hospitat and
Related InstitutIOnal Nursing Services, 1974. 19p.
(NLN publication no. 20:-1504).
41. Community health association clinics: an
evaluarion of the hospital utilization of community
health association clinics, Apr. I, 1972 to Mar. 31,
1973. Prepared by J.L McPhee. Regina, Research
and Planning Branch. Saskatchewan Dept. of Public
Health, 1973. 34p.
42. Continuing nursing education in Washington.
Working draft. Seattle, Washington State Nurses'
Association, 1973. 6p.
43. Crisis in nursing; changing roles. Papers
presented at the joint session, Crisis in nursing.
section B. Biennial Convention, Minneapolis, May
6-10, 1973. New York, National League for
Nursing, Council of Hospital and Related Institu-
tional Services. 1973. 27p.
44. Development of autotutorial laboratory for
students in nursing, by Pauline Ann Steigleter.
Plattsburgh, N.Y., 1973. 6p.
45. Differentiated staffing. Ottawa, Canadian
Teachers' Federation, 1973. 14p. (Bibliographies in
education, no. 36).
46. The diplomn nurse, rhe hospital school and the
National Commission. Rochester, N.Y., National

Commission for the Study of Nursing and Nursing
Education. 1972.
47. A guide for establishing statewide joint practice
commissions. Rochester, N.Y. National Commi
-
sion for the Study of Nursing and Nursing Educa-
tion, n.d.
48. Instructional techniques used, emlua/ion of,
and proposals for the post-graduate course in
intensh'e care nursing at Sydney hospital, Sydney,
Australia, by Susan Laurin. Montreal. 1972. 16p.
(Study-Loyola College).
49. An interim statement on continuing education in
nursing. Kansas City, Mo., American Nurses'
Association. 1972. 12p.
50. The National Joint Practice Commis..ion: new
bottles, new wine. Rochester. N.Y., National
Commission for the Study of Nursing and Nursing
Education, 1972.
51. Paraprofessional school personnel. Ottawa.
Canadian Teachers' Federation, 1973. 24p. (Bib-
liographies in education, no. 35).
52. Primary medical care. Report of subcommittee
to the Council on Medical Sen'
es. Calgary,
Alberta, Canadian Medical Association. Subcom-
mittee on Primary Medical Care, 1973. 4Op.
53. Problems in the development of indicators of
health status: some demographic considerations, by
John F. Newman. Chicago. College of Nursmg and
Allied Health Sciences, 1973. 16p.
54. Ratification! why? why not? Ottawa. United
Nations Association in Canada, 1973. 26p.
55. Report of Psychiatric Nurses' Association of
Canada, Education Committee. Winnipeg. 1973.
44p.
56. Report of Saskatchewan Registered Nurses'
Association, Ad hoc Committee on Performance
Appraisal. Regina. 1973. 9p.
57. The role of national voluntary health organiza-
tions in supporting national health objectives.
Interim report, by Thomas R. Hood et al. Washmg-
ton, D.C., American Public Health Associ.ition and
World Federation of Public Health Associations.
1973. 22p.
58. Where the time goes. by P.A. Thomas and
Valerie A. Ward. London. Aslib. 1973. 43p. (Aslib
occasional pub. no. 12).

GOVERNMENT DOCUMENTS
59. Department of Health. Health security for
British Columhiam. Report to the Minister of
Health. Province of British Columbia, by
ichard
G. Foulkes. Victoria. Queen's Printer, 1973. 2v.
60. Bibliothèque scientifique nationale du Canada.
Catalogue coffectij des publications scientifiques
dans Ie.. bibliothèques canadiennes. 5éd. Oll.iwa,
1973. 2v. (NRC no. 13445). R
61. Conseil économique du Canada, pour Ie Comité
interministériel sur CANDID!:. Le commerce
extérieur dans Ie modèle 1.0, par J.R. Downs avec
la collabor.ition de Bobbie Cain. Ottawa, 1973. SSp.
(CANDIDE. Project paper no. 7).
62. L 'offre de Ir.ivail el les v.iriable

démographiques dans Ie modèle 1.0, par Wolfgang
M. IIIing. Ottawa, 1973. 27p. 'CANDIDE ProJecl
paperno. 9).
63. Conseil des sciences du Canada. Formation et
emploi des scientifiques. Caracteristiques des car-
rières de certains diplõmes canadiens et etrangers,
par A.D. Boyd, Ottawa, 1973. 146p. (Conseil de

sciences du Canada no. 28).
64. Dept. of Exlemal Affairs. Canadian represen-
JULY 1974

tari"es abroad. Ottawa. Information Canada. 1974.
65p. R
65. Economic Council of Canada, for the Inter-
departmental Committee on CA'I/DIDE Candide
modèle I.V: labour demand, by Wolfgang M. lIIing.
Ottawa. 1973. 33p. (CANDIDE. Project paper no.
10).
66. Environment Canada. Air pollution in Canada;
a narion-wlde invenrory of air pollutant emissions
for 1970. Otta\\.a. Information Canada. 1973. 47p.
67. Health and Welfare Canada. Hospital morbidicy
and roral mortality in Canada; dara for prIOrities
and goals. Ottawa. 1973: reprinted 1974. 55p.
68. Probability rabies of deaths in the nen ten
,'ears; males andfemales ages 15-80. Ottawa. 1971.
Iv.
69. Federal-Provincial Advisory Committee on
Hospital Insurance. Working Party on Special Care
Units in Hospitals. Guidelines for mmimum stan-
dards in the planning organization and operation of
special care unies in hospitals. Ottawa. 1973. Iv.
70. Health Protection Branch. M
nual for health
hazard appraisal. Ottawa, 1973. Iv.
71. Indian Affairs and Northem Development. The
Canadian Indian - Yukon and Northwest Ter-
rirories. Ottawa. Information Canada. 1973. 56p.
72. Labour Canada. Planning for safeo'. Ottawa.
Information Canada. 1973. pam. (Canada. Occupa-
tional safety manual, pt. I).
73. Nationat Library of Canada. Research and
Planning Branch, Canadian MARC Office. Canadian
"f.4RC communication formac: monographs. Orrawa,
1973. Iv.
74. National Science Library. Progress report on

working program for the health sciences resource
centre of the National Science Libran, 1970-1972.
75. Statistics Canada. Enrolment in e1emenrar)' and
secondary schools in Canada, 1972/73. Otta\\.a,
Information Canada. 1974. 37p.
76. Healrh manpower; registered nurses. 1972,
Ottawa. Information Canada. 1974. 65p.
77. Hospiral statistics. Preliminan annual report
1972. Otta"a. Information Canada. 1974. 44p.
78. Tubercolosis statistics. Vol. 1: Tuberculosis
morbidiry and mortality. 1972. Otta\\.a. Information
Canada. 1974. 119p.
Mauritius
79. Ministry of Health. Central School of Nursing.
Training of studenr nurses. 3 years. \1auritius,
1973. 12p.
Ontario
80 Task Force on Community and Social Services.
Report on ministry organization structure. Toronto.
1973. 79p.
QI.ebec
81. Ministère des Affaires culturelles. RADAR
Répertoire analvcique d' articles de revues du
Quebec, v. I, no. 6 and v. 2, no. I. Montreal. 1973.
R.
Saskatchewan
82. Provincial Library. Regina. Sa
ka[che\\.an.
Bibliographic Services Division. Health and nutri-
tion. Regina. 1973. 21p.
U.S.A.
83. Dept. of Health. Education. and Welfare.
CUrrenr literature on venereal disease, no. 2, 1973.
Washington, D.C.. U.S. Govt. Print. Off.. 1974.
118p.

84. Pubhc Health Service. Division of Nursing.
Research m nursing. 1969-1972: research grants.
Bethesda. Md.. 1973. For sate by U.S. Govt. Print.
Off., Washington. D.C. 28p. (DHFW. publication no.
('l/IH) 73-4891-
85. National Institute of Health. National Siclde
Cell Disease Program. So, I hme the sickle cell
trait. Washington. D.C. U.S. Govt. Print. Off..
1972. pam.

STUDIES DEPOSITED IN CNA REPOSITORY COLLECTION
86. Nurse-patient "solicitation" interactions in a
psychiatric hospital, by Lorene Marie Bard.
Montreal. 1971. l06p. R
87. Registered nurse manpo...er in British Colum-
bia 1973. Vancouver. Registered Nur
es' Associa-
tion of British Columbia. 1973. 28p. R
88. A ,'
'dy 10 determine if a need exists 10 include
the teaching of rehabilitation principles in an
insenice program, by Sister Peter Claver and Sister
James Marie BoslOn. 197U. 58p. R
89. A time stud, of the surgical nursing care
prm'rded by three nurses in a public surgical ward
in 1%0. by Elizabeth J. Worthy. Montredl, 1960.
39p. R

AUDIOVISUAL AIDS
90. Proceedings of Colloquium on Nursing Re-
search, Monrreal. March 28-30. 1973. Montreal.
Faculty of Nursing. McGill University. 1973. ( a )
Videotape. II (60 min. each) reels. black & white.
sound. '/
inch. ( b ) Videotape cassettes, II ( 60
min. each). black & white. mono. ( c ) Audiotape
cassettes. 10 (Q() min. each). {;::

Request Form for uAccession List"
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JULY 1974'

THE CANADIAN NURSE 41

classified advertisements

I

ALBERTA

REGISTERED NURSES required Immediately lor 25.bed Ge.
neral Hosprtal, 110 miles East of Lacombe. Highway No. 12.
Salary and policies as per AARN Residence available. Travel
expenses advanced. Will be relunded alter one Y ear s service.
Apply: Director of Nursing. Coronation Municipa Hospital, Co-
ronation. Alberta. TOC 1 CO.

GENERAL DUTY NURSES required immediately lor modern
38-bed hospital In the Peace River area. Excellent recreational
and social facilities available in the community. living accom-
modations on comfortable nurses residence. Salary and benellts
accordinq to AARN aqreemenl. ADDlv to: Director 01 Nursing.
Box 250. Manning Municipal Hospital. Manning, Alberta. TOH
2MO

REGISTERED NURSES required for 70 bed accredited active
treatment Hospital. Fullti",e and summer rellel. All AARN per-
sonnel policies. Apply In wnting to the: Director 01 Nursing.
Drumheller General Hospital. Drumheller. Alberta

BRITISH COLUMBIA

REGISTERED NURSES reqUIred lor new 25-bed acute care
hosprtal on Fort SI. James. B. C. Starting salary $850.00 per

c

r:

:s
::,':\ ra'

i
o:

:d

1It
1.

f.
BritISh Columbia. VOJ 1 PO. Phone: 996-620 I.

ADVERTISING
RA TES

FOR ALL

CLASSIFIED ADVERTISINC

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$2.50 for each additional line

Rafes for display
advertisements on request

Closing dole for copy and cancellation is
6 weeks prior to 1 st day of publication
month
The Canadian Nurses' Association does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they are interested
in working.

Address correspondence to:
The
Canadian
Nurse

r L

g

50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P 1 E2

42 THE CANADIAN NURSE

I I

BRITISH COLUMBIA

OPERATING ROOM NURSE wanted lor active mo-
dern acute hospital. Four Certified Surgeons on
attending staff. Experience of training desirable.
Must b.. eligible lor B.C Registration. Nurses
residence a.ailable. Salary according to RNABC
Contracl. ApplV to. Director 01 Nursing. Mills Mem-
orial Hospital, 2711 Tetrault St., Terrace. B"tish
Columbia.

REGISTERED NURSES WANTED FOR FULLY ACCREDITED
HOSPITAL CONSISTING OF 190-BEDS. GENERAL DUTY
POSITIONS IN MEDICAL-SURGICAL. PSYCHIATRIC AND
ICU.CCU AREAS. MUST BE ELIGIBLE FOO B.C. REGISTRA.
TION. BASIC SALARY 1973 - $672.00 (NEW CONTRACT
BEING NEGOTIATED.) APPLY: DIRECTOR OF NURSING.
ST. JOSEPH'S GENERAL HOSPITAL, COMOX. BRITISH
COLUMBIA. V9N 4B1.

REGISTERED NURSE required lor Nicola Valley General Hospl'
tal, located in the Southwestem part 01 B.C. Starting salary !rom
$650.00 to $1.020.00 Residence aVailable. Apply to: Director
01 Nursing. N. V.G.H.. Box 129, Merritt, BntlSh Columbia.

EXPERIENCED NURSES (eligible lor B.C. registration) required
lor 409-bed acute care, teaching hosprtallocated In Fraser Val-
ley, 20 minutes by Ireeway lrom Vancouver and wrthln easy
access 01 varied recreatlonallacllrties. Excellent Orientation and
Continuing Education programmes. Salary according to RNABC
contracl. Clinical areas ,nclude: Medicine, general and specialI-
zed, Surgery, Obstetrics, Pediatrics. Coronary Care, Haemoclia-
lysis, Rehabilitation, Operating room, Intensive Care. Emer-
gency. PRACTICAL NURSES (eligible lor B.C. license) also
required. Apply to: Director ot Nursing, Royal Columbian Hospi-
tal. New Westminster. Bntish Columbia, V3L 3W7

GRADUATE NURSES for 21-bed hospital prelerably
with obstetrical expenence Salary in accordance
with RNABC. Nurses residence. Apply to: Matron.
Tolino General Hospital, Toto no, Vancouver Island,
British Columbia.

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES required for small
upcoast hospital Salary and personnel policies as
per RNABC contracl. Sala nes star. at $672.00 for
Registered Nurses. $577 75 for Licensed Practocal
Nurses Residence accommodatoon $2500 per month.
Transportatoon paid from Vancouver. Apply to
Director 01 Nursing, St George s Hospital Alert Bay.
British Columbia

GENERAL DUTY NURSES lor modem 41-be(j hospital located
on the Alaska Highway. Salary and personnal policies in
accordance with RNABC. Accommodation available In resI-
dence. Apply: Director of Nursing. Fort Nelson General Hospital,
Fort Nelson. British Columbia.

GENERAL DUTY NURSES lor 360-bed acute general hospital.
Personnel policies in accordance with RNABC Contract. Direct
Inqulnes 10: Director of Nursing. Nanalmo Regional General
Hospital. Nanaimo, Bntish Columbia.

TWO GENERAL DUTY NURSES With experience in obstetrics
and O.R. required lor a 21-bed hospital in the Southern Interior
of B.C. LIVing-in accommodation available. Salary as per
RNABC rates. Moderate climate. good working conditions and
recreational facilities available. Apply, giving lull parbculars and
references In first letter to the: Administrator. Siocan Community
Hospital. Box 129. New Denver Brrtlsh Columbia

WANTED. GENERAL DUTY NURSES lor modern 70-
bed hospilal. (46 acute beds - 22 Extended Care)
located on the Sunshine Coast. 2 hrs. from Vancou-
ver. Salaries and Personnel Policies In accordance
with RNABC Agreement. Accommodatoon available
(Iemale nurses) In residence. Apply The Director
01 Nursing. SI. Mary's Hospital. P.O Box 676, Se.
chell. Brltosh Columbia.

I I

BRITISH COLUMBIA

EXPERIENCED GENERAL DUTY NURSES tor modern
10-bed hospital with doctors olflces In hospital.
Situated beautllul west coast of Vancouver Island:
Accommodatoon' $50.00 a month Apply Administra-
tor Tahsls Hospital. Box 399 Tahsls. British
Columbia

GENERAL DUTY NURSES required lor an 67-bect
acute care hospital In Northern B.C. Residence
accommodations available. RNABC policies in elfecl.
Apply to: Director of Nursmg, Mills, Memorial Hos-
prtal, Terrace. British Columbia. V6G 2W7.

GENERAL DUTY NURSES for modern 45-bed hosDltal, located
In north central Bntlsh Columbia. Salary and personnel policies
in accordance with RNABC. Accommodations available" in resi-
dence. Apply to: DIrector of Nursing. SI. John Hospital. R.R. No.
2, Vanderhool, Bntish Columbia, VOJ 3AO

NEW BRUNSWICK

GENERAL DUTY NURSES wanted lor 25-bed hosprtal. Salary
and working conditions of employment as per NBARN. Contact:
DIrector of Nursing. Grand Falls Hospital Inc.. P. O. Box 600,
Grand Falls. New Brunswick.

NORTHWEST TERRITORIES

NURSES required lor general duty and charge poSitions lor a
73-be(j active hospital Fully accrediled. Nurses' residence
available. Must be registered In a province 01 Canada. Apply to
the: Director 01 Nursing. Stanton Yellowknlle Hospital, Box 10,
Yellowknlle. Northwest Territories.

NOVA SCOTIA

REGISTERED NURSES AND PSYCHIATRIC NURSES -
GENERAL STAFF positions available In a 225-bed psychiatric
hospital. Onentellon and inservlce provided Excellent person.
nel policies and salary commensurate with qualifications and
experience as laid down by the Statt Association Agreemenl.
APPLY TO: Director of Nursing, Cape Breton Hospital, P.O. Box
51 S. Sydney, Nova Scotia.

ONTARIO

Applications are Invited lor the position 01 SUPERVISOR,
PUBLIC HEALTH NURSING. Quaillications: A Bachelors De-
gree with preparation in SUpervision and Administration. Kindly
apply: Mrs. B. I. MorlCky. Director, Pub
c Health Nursing Ser.
vIces. Kent-Chatham Health Unrt, P.O. Box 1136, Chatham,
Ontano.

PUBLIC HEALTH NURSES required lor generalized prog.
ramme. Salary range $8550 - $10.250, wrth dltterentlal tor
BScN; generous t"nge benehts. Apply to: Miss E. Flaxman,
Director, Public Health Nursing. Haliburton, Kawartha, Pine
Ridge DistrICt Health Unit, Box 337, Cobourg, Ontano, K9A 4K6.

PUBLIC HEALTH NURSE - GREY-OWEN SOUND HEAlTH
UNIT has an opening lor a qualihed Public Health Nur... II you

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Ontano. N4K 3E3.

PUBLIC HEALTH NURSES (OUALIFIED) FOR GENERALIZED
PROGRAMME, ALLOWANCE FOR EXPERIENCE AND/OR
DEGREE. USUAL FRINGE BENEFITS, DIRECT ENOUIRIES
TO' MRS. RETA McBEAN, PUBLIC HEALTH NURSING, REN.
FREW COUNTY AND DISTRICT HEALTH UNIT, P.O. BOX 126,
PEMBROKE, ONTARIO. K6A 6XI

JULY 1974

ONTARIO

OPERATING ROOM STAFF NURSE required for fully accredi-
ted 75 bed Hospital. BasIc wage $689.00 with consideration for
expenence; also an OPERATING ROOM TECHNICIAN, baSIC
wage $526.00 Call time rates available on request Write or
phone the: Director of Nursing. Dryden D,stnct General Hospital.
Dryden. Ontano.

REGISTERED NURSES for 34-bed General Hospital.
Salary 5706.00 per month to 5816.00 plus expenence al-
lowance. Excellent personnel policies Apply to.
Director of Nursong, Englehart & District Hospital
Inc.. Englehart. Ontano. POJ 1 HO.

Port Colbome General Hosprtal. Port Colbome. Ontano - thIS
modem 143-bed teachin9 hospital requires REGISTERED
NURSES for all services Including Emergency Operating Room
and Cardiac Care Unit Completely furnIShed apartment-style

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Hospital. P:>rt Colborne. Ontano.

REGISTERED NURSES reqUIred lor our ultramodern 79-bed
General Hospital in bilingual community of Northern Ontano.
French language an asset. but not compulsory. Salary IS 5705.
to $825 monthly With allowance to! past experience and 4
weeks vacation after 1 year. Hosprtal pays 100% of 0 H.I.P..
Life Insurance (10.000). Salary Insurance (75% of wages to the
age of 65 With UI.C. carve-outj. a 354 drug plan and a dental
care plan. Master rotation In effect. Rooming accommodations
available on town. Excellent personnel policies. Apply to:
Personnel Director. Notre.Dame Hosprtal, P.O. Box 850.
Hearst. Ontano,

REGISTERED NURSES FOR GENERAL DUTY, I.C.U.,
C.C.U. UNIT and OPERATING ROOM required tor
fully accredited hospital. Starting salary 5697.00 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.

REGISTERED NURSES With expenence for 37-bed fully accre-
dited hosprtal In North Western Ontario Accommodation In
nurses reSIdence available Apply: Head Nurse, NIpigon District
Memonal Hospital. Box 37. Nipigon. Ontano, POT 2JO

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS for 45-bed Hospital Salary ranges
Include generous experience allowances. A.N.'s
salary 5740. to $840 and R.N A:s salary 5550. to $625.
Nurses residence - private rooms with bath - $40
per month Apply to: The Director of Nursing, Gerald.
ton District Hospital. Geraldton, Ontano. POT 1 MO

R.N:s and R.N.A's lor 60 bed. 53 bed, and 40 bed nursIng
homes located respecbvely In Palmerston. Seaforth. and
Hensa/I. Ontario. full and part time positions available Apply to:
Drumcrow Farms Llmrted. 360 Wallace Avenue North. LlStowe!.
OntarIO, N4W 1 L4

RN's and RNA's. Etobocoke General Hosprtallnvrtes apphca-
bons from RN's - RNA's. EtoblCoke General, a 500-bed
community hospital of Friesen design, IS presently eXpanding
hospital beds and servICes to capacity. Applicants must be Cur-
renlly regostered In Ontario. Apply to: Personnel Department,
Etoblcoke General Hospotal, 101 Humber College Blvd.. Rex-
dale. Ontano. M9V 1 R8

GENERAL DUTY NURSE. Salary $8.404.00 per year to
59.454.00. Toronto. The MrnocoConecbonal Centre. Etobocoke.
(to be relocated at Milton, Ontario) has a vacancy for a general
duty nurse, to asslSlthe medical officers. dispense medICine and
carry out general nurSIng treatments In a small Infirmary. Please
direct querl9s to the: SL4>9rontendent (416) 255-{)131, regarding
the Onlano Govt'rnment POSItion

QUEBEC

REGISTERED NURSE, 10 assist MATRON, required by The
Wales Hom!,. a modern Home cering for 222 elderly people and
oncludes a"" bed Infirmary. Located at Richmond. Quebec. a
town of approximately 5,000 SItuated between Montreel and
Sherbrooke. Very good weges. IVlng accommodation supplied,
penSIon plan, etc. Apply, staling experience. to: The Matron.
The Wales Home. Richmond. Quebec

IULY 1974

I I

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 Genera' Hospital
on the West end of Montreal. Appllcallons INIII be
welcomed at Oueen Elizabeth Hospital 01 Montreal.
NurstnQ Personnel 2100 Marlowe Avenue. Montreal
260. Ouebec.

SASKATCHEWAN

DIRECTOR OF NURSING required for fully modem 20-bed
hospital In North Central Saskatchewan. Salary scale and fnnge
benefits as negotiated by SRNA. Near Provincial Park. Progres-
sive. modem community. Admlnistrabve expenence an asset
but not required. Position available September 1. 1974. Apply
to: Admlnostrator, Porwplne Canagana Union Hospital. Box 70.
Porwplne PI",n. Saskatchewan.

DIRECTOR OF NURSING for fully modern 36-bed Nursing
Home In North Central Saskatchewan. Progressive. modern
community. Near Provincial Parle AdministratIVe experience an
assel but riot required. Must be R.N. or R.P.N. State salary
expected. Write to: Administrator. Red Deer Nursing Home Box
70, Porcupine Plain, SasKatchewan. SOE 1HO. or Phone--Bus:
278-2417 or 278-2233 Res 278.2450.

UNITED STATES

RN's and LPN'S - Unoverslty Hospital North. a
teachong Hospital of the Unoverslty of Oregon Medical
School. has opentngs on a variety 01 Hospital ser-
Vices_ We offer competitive salanes and excellent
Irlnge benefits. Inquires should be directed to' Gale
Ranktn. Director of Nursing. 3171 S W Sam Jackson
Park Road. Portland. OreQon. 97201

R.N:s - SOUTHERN CALIFORNIA - Immediate need exists
for medical-surgical units. Orientation and in-service program
Excellent salary, full paod benefit... We WIll assist you with your
H-1 visa for immigration A license In California to practise
nursing IS necessary before employment Wnte for an applica

tlon 10 the. California State Board of NurSIng Education and
Registration. 1020 N Street. Sacramento. California. 95814.

CURRICULUM COORDINATOR - Challenging opportunity In
NLN. accredited program to provide leadership in Implement-
Ing new Master"s program in nursing and reviSion of under-
graduate program. Candidates should have experience in uni-
versity teaching and cUrriculum development doctoral prepara-
tion preferred, M.S. minimum Position now open. An equal
opportUnity, affirmative action employer. Send resume to: S.
Rosalie Sitzmann. R.N.. Ph.D.. Chairman. Search Commlltee,
College of Nursing. South Dakota State University. Brooklngs.
South Dakota 57006.

UNIVERSITY FACULTY - Need for fall of 1974 in NLN.
accredited baccalaureate program. (1) Department Head. Doc-
toral or Master's preparation With administrative experience; (2}
Medical.Surgocal faculty, Master s preparation In Med/Surq
Nursing. (3) Communrty Health Nursing faculty. Master'.
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Brooklngs. South Dakota 57006

TEXAS wants you' 11 you are an RN. expenenced Or
a recent graduate come to Corpus Christi Sparkling
City by the Sea' a city bUlldtng for a belter
tuture. where your opportUnities tor recreation and
studies are limitless Memonal Medical Center. 500-
bed general. teaching hospital encourages career
advancement and provides tn-serVICe onentatlon.
Salary from 5682.00 to $940 00 per month, com-
mensurate With education and experience Differential
for evenmg shifts available Benefits mclude holt.
days Sl ck leave. vacations paid hospitalization,
health hie msurance penSion program Become a
vital part of a modern up-to-date hospital. write 01
call collect John W Gover Jr.. Director of Per
sonnel Memorial Medical Center. POBox 5280
Corpus ChriSti, Texas, 78405.

GRADUATE AND REGISTERED NURSES. Vacancies avalla.
ble In ICU, OR. surgIcal gen. duty. etc. 150 CIH. U.S. &
Canadian hospitals In Paohc coasl from Brlhsh Columbia to
sunny State of Cafifom... Starting salary $9.648.00 - $14.500.00
per annum. Work permits & other paper works provided free
Apply to authonzed hOSl)ltal representative Phllcan Personnel
Consultants Ltd.. (Medical Placement Speclallstsl, 5022 Victo-
ria Dr.. Vancouver, B.C.. V5P 3T8. Canada. Telex 0455333
TeL:
27 .9631.

THE TORONTO WESTERN
HOSPITAL

Invites application from

REGISTERED NURSES

For General Duty. Must be able to do
rotation.
Excellent personnel policies and
fringe benefits.

Apply to:
Personnel Department
399 Bathurst Street
Toronto, Ontario
M5T 2S8

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 unots.
Our main lBO-bed accredited. hospital IS
situated at St. Anthony, NewfoundlaM ActIve
treatment is carried on in Surgery. Medicine,
Paediatrics, Obstetrocs. Psychiatry. Also.
Intensive Care Unit. Orientation and In.Service
programs. 40.hour week. rotating shifts. Living
accomodations suppl ied at low cost. PUBLIC
HEALTH has challenge of large remote areas
Excellent personnel benefits include liberal

acatlon and sick leave. Salary based on
Government scales.
Apply to:
INTERNATIONAL GRENFELL ASSOCIATION
Assistant Administrator of
Nursing Services,
St. Anthony, Newfoundland.

L 'HOPIT AL MONTFORT

OTTAWA

requires the services of

Registered Nurses

full-time and part-time day
evening and night.

Apply to:
Personnel Office,
HOpltal Montfort,
Montreal Road,
Ottawa, K1 K OT2, Ontario

THE CANADIAN NURSE 43

L'HOPITAL MONTFORT
OTTAWA
requires the services of

REGISTERED NURSES

for its new Intensive Care Unit

QUALIFICATIONS:
. Registered Nurse
. At least 6 months experience
in an Intensive Care Unit
· Preferably bilingual.

APPL Y TO:
Personnel Office,
HOpital Montfort,
Montreal Road,
Ottawa, K 1 K OT2, Ontario.

UNIVERSITY HOSPITAL
SASKATOON,SASKATCHEWAN

A 550-bed hospital located on the Univer-
sity Campus

(1) Psychiatry
(2) New Born Intensive Care
(3) Other specialized and general areas.
Excellent opportunity for development and
advancement in all environment of patient
care teaching and research.

For further Information please contact:
Employment Officer, Nursing
University Hospital
SASKATOON, Saskatchewan
S7N owe

GENERAL DUTY NURSES

Required immediately for acute care gen-
eral hospital expanding to 343 beds plus
proposed 75 bed extended care unit.
Clinical areas include: medicine, surgery,
obstetrics, paediatrics, psychiatry, activa-
tion & rehabilitation, operating room,
emergency and intensive and coronary
care unit.
Must be eligible for B.C. Registration
Personnel polides in accordance with
R.NAB.C. contract:
SALARY: $850 - $1 020 per month
(1974 rates)
SHIFT DIFFERENTIAL

APPL Y TO:
Director of Nursing
Prince George Regional Hospital
Prince George, B.C.

44 THE CANADIAN NURSE

EXPERIENCED R.N.'s

Required for Obstetrics. Pediatric and
Medical/Surgical wards. Salary $885.00
per month with extra allowance for experi-
ence.
Vacancies also available for LP.N.'s.
Salary $670.00 per month.

Write to:
Director of Nursing
Churchill Health Centre
Fort Churchill, Manitoba
ROB OKO

THE UNIVERSITY OF
BRITISH COLUMBIA
SCHOOL OF NURSING
Faculty Positions

Rapidly developing undergraduate and
graduate programs require senior and
junior faculty members. Applicants should
have graduate education and experience in
a clinical area and/or in education, cur-
riculum development, evaluation or re-
search. Must be eligible for B.C. registra-
tion.
Excellent salary and fringe benefits.

Apply to:
Muriel Uprichard, Ph.D. Director
School of Nursing
University of British Columbia
2075 Wesbrook Place
Vancouver, B.C., V6T 1W5

CALGARY ALBERTA
ROCKYVIEW HOSPITAL

EVENING
NURSING SUPERVISOR

To coordinate total patient care activities
during evening shift.
Should have supervisory experience and
advanced training. Salary recognizes edu-
cation and experience. Excellent benefits
program.

Apply:

Personnel Officer
Hospital Dfstrict No. 93
6712 Fisher Street S.E.
Calgary, Alberta
T2H 2A7

ASSISTANT DIRECTOR
OF NURSING

required Immediately

lor a 420-bed General Hosprtal scheduled to open in
1975;
preference will be given to individuals with a B.Sc. In
Nursing or a Nurse with varied nursing and adminis-
trative experience; knowledge or French will be an
asset;
salary commensurate with education and experi-
ence;

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for further Information write 10: -
Director 01 Nursing Service
laurentian Hospital
1222 Perls Crescent
Sudbury, Ontario, P3E 3A2

A Breast Cancer Screening Program is
proposed for the Province of British
Columbia. This program requires a

NURSE

registered with the province of B.C. to
do clinical examinations of breasts and
to explain and teach the patients self-
examination of the breast.

Please apply In writing to:
Dr. J.S. Dunbar
Breast Cancer Screening Project
Room 711
828 W. 10th Avenue
Vancouver, British Columbia

REGISTERED NURSES
and

REGISTERED
NURSING ASSISTANTS

Why not come to Montreal, where
opening exist in all services of a beauti-
ful 450-bed General Hospital.

Write to:

Director of Personnel
ST. MARY'S HOSPITAL
3830 Lacombe Avenue
Montreal, Quebec
H3T 1 M5
Tel.: (514) 344-3390

JULY 1974

PUBLIC HEALTH NURSES
REQUIRED

Headquarters:
Various locations in Northern Saskatchewan
Salary:
With diploma - $741 - $901 (plus Northern Allowance)
Without diploma - $672 - $818 (plus Northern Allow-
ance)
With B.Sc.N. - $779 - $945 (Dlus Northern Allowance)
Duties:
The Dept. of Northern Saskatchewan is developing new
health programs to respond to the unique health needs of
Northern people. Nurses are required to make use of their
full range of nursing skills and abilities to initiate and
develop new programs in conjunction with a growing range
of allied health and social service personnel.

Please dIrect enquIrIes to:
Janis M. Pohjavuori
Dept. of Northern Saskatchewan
Personnel & Training Branch
Box 5,000
La Ronge, 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 work in a
spirit of openness to God and the needs of others

R.S.V.P. FORMATION CENTER
438Y2 College St.
Burlington, Vermont
05401

FORMATION CENTER
4 Toronto Street,
Ottawa, Ontario,
K1S ON2.

JULY 1974

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VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA
The :\Iaritimes' largest teaching hospital. has immediate
openings for Registered Nurses. Certified Nursing Assistants
and Orderlies. Pmitions are available in Special Units and
for general nursi ng duties. It is the principal adult teachi ng
hospital of Dalhousie University and abo operates a large
school of nursing.
SALARY:
Commensuratc with qualifications and experience.
SPECIAL l NITNLRSES $8170-$9582
REGISTERED NLRSES $7816-$9229
CERT. NLRSING ASSISTANTS ,$5626-$7180
NLRSING ORDERLIES $4991-$6333
BENEFITS:
Full Civil Service Benefits, including three weeks Vdca-
tion. four weeks after 5 years of service and !.hift diffe-
rential. .
For further information and/or application form!.. pled
e
contact:
Personnel Office.
Victoria General Hospital.
Halifax, Nova Scotia.

OTTAWA CIVIC HOSPITAL
REQUIRES

HEAD NURSE
FOR EMERGENCY

Apply in writing to:

Miss Marjorie Mills, Reg. N. B.Sc. N.
Assistant Director Nursing Service
Ottawa Civic Hospital
1053 Carling Avenue
Ottawa, Ontario
K1Y 4E9

THE CANADIAN NURSE 45

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 withm 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, fishmg.
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 writinJ! to:
PERSONNEL DIRECTOR,
Temiskammg Hospitals.
HaileybuIY, Ontario.

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.

NURSING OPPORTUNITY
REGISTERED NURSES

required for a 138-bed active treatment hospital
plus

EXPERIENCED NURSES

for a 5-bed I.C II -C.C.u. presently being set up
clinical areas include - medicine - surgery, obstet-
rics, paediatrics and coronary care.

Residence accommodation a"allab/e.
Address applications and enquires to:

DIRECTOR OF NURSING
BLANCHARD-FRASER
MEMORIAL HOSPITAL
KENTVILLE, NOVA SCOTIA

46 THE CANADIAN NURSE

TH E HOSPITAL
FOR
SICK CHILDREN

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Situated in the stimulating
atmosphere of downtown
Toronto, within walking distance
of the University of Toronto
The largest children's hospital on
the continent offers the
Registered Nurse opportunities
for development in our Nursing
Department. We have many areas
that will interest the Registered
Nurse who is looking for a
challenging career in paediatric
Nursing

Opportunities for employment in
Intensive Care, Renal Dialysis,
Neonatal Unit, Child and FamilY
Unit, Clinical Investigation
Unit, Operating Room, Cardiac
Surgery, Neurosurgery Isolation
and Orthopaedic surgery. We
have a planned orientation and
staff development programme

The majority of in-patient units
are working the 7 day fortnight
(12 hour shifts) Salaries are
commensurate with experience
and education. Excellent fringe
benefit programme. Current
registration in Onto is required

Applications for General
Duty Positions are invited
PLEASE WRITE TO Mrs.C. MACINNES
The Personnel Co-ordinator
555 Universi ty Avenue
Toronto, Ontario. Canada
M5G 1X8
TELEPHONE 366-7242 Ext.1528

REGISTERED NURSES

The Red Deer General Hospital is
looking for nurses in several general
duty areas. However, we are espe-
cially interested in grads who have
experience in Intensive Patient Care.
We have a very active 230-bed hospi-
tal in Central Alberta. If you are
interested in finding out more about
our progressive hospital contact:

Personnel Director
Red Deer General Hospital
Red Deer, Alberta

EXPERIENCED
OPERATING
ROOM NURSES

for 139 Acute, 30 Extended Care Bed
modern accredited hospital on Vancouver
Island. Excellent recreational facilities and
within easy reach of Victoria and
Vancouver. Personnel polices as per
RNABC Contract.

Apply:
Director of Nursing
West Coast General Hospital
814-8th Avenue North
Port Albernl, British Columbia
V9V 4S1

THE LADY MI NTO 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 1 CO

JULY 1974

CAPITAL REGIONAL DISTRICT
COMMUNITY HEALTH SERVICES
VICTORIA, B.C.
PUBLIC HEALTH NURSE

Salary range $807. - 974 per month (1973 Pay Scale)
Required for duties in a generalized community
health programme with the Capital Regional District,
which is located on the Southern tip of Vancouver
Island and is comprised of seven adjoining municipali-
ties and seven electoral areas. Applicants must possess
a nursing degree or Registered Nurse qualifications.
together with a recognized Canadian Public Health Nurs-
ing Diploma. The successful applicant will be expec-
ted to provide their own transportation initially and
therefore must possess a valid B.C. Driver's Licence. A
liberal fringe benefit programme applies including
superannuation, sick leave, medical coverage and car
allowance.

Application in writing, stating education, experience,
work history and references will be received by the
undersigned as soon as possible.

Assistant Secretary-Treasurer,
Capital Regional District,
524 Vates Street,
Victoria, B.C.

QÆ
ORTHOPAEDIC IlL ARTHRITIC
HOSPITAL
'VI

43 WELLESLEY STREET, EAST
TORONTO, ONTARIO
M4Y 1H1

Enlarging Specialty Hospital offers a unique
opportunity to nurses and nursing assistants
interested in the care of patients with bone and
joint disorders.
Currently required -
Registered Nurses and Nursing Assistants for all
units
Clinical specialists for Operating Room, Intensive
Care, Patient Care and Education.

JULY 1974

,

. .... ..
,; ". .
..

I PPORTUNIIIE

VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA

The Maritimes' largest hospital. has immediate openings for
Clinical Nursing Supervisors. It is the principal adult teach-
ing hospital of Dalhousie University and also operates a
Idrge ..chool of Nursing.
SALARY: $11.560 - $13.537
CLINICAL NllRSING SLPERVISORS
A '-Ia..ter's Degree is preferable but candidates with a
Bachelors' Degree would be given consideration. 3 years
experience. I of which was at the supervisory level is
required. Courses inClinical Special it} :'\Jursing. especiall}
in 1\kdical or Surgical Nursing would be considered.
BENEFITS:
Full Civil Service Benefit... including three weeks vaca-
tion and four weeks after five years of service.
Competition is open to both men and women.
For further information and/or application forms. please
contact:
Personnel Office.
Victona General Hospital.
Halitax. I
ova Scotia.

M aster the
A rt of
Surgical techniques in a teaching
and research
Hospital in which the most modern
surgical procedures are being
performed.

Applications are invited from Operating Room Nurses who
must be able to supervise OR technicians.

Nurses who wish to take in-service program in mastenng
OR techniques will be considered for staff positions.

For Information, apply to:

Anne Bruce, R.N.
Nursing Recruitment Officer
Royal Victoria Hospital
687 Pine Avenue West
Montreal, H3A 1A1, P.O.
Tél.: 842-1251. local 677 or 490

THE CANADIAN NURSE 47
.

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 Surgery and
Medicine.
Basic 2 week Orientation Program and con.
tinuing Active Inservice Program for all Ie els
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. JOSEPH'S HOSPITAL
30 The Queensway
TORONTO 3, ONTARIO.

PEDIATRIC NURSES

Come to Canada's Ocean Play-
ground!

The Izaak Walton Killam Hospital
for Children is a modern, progressive,
324 bed complex located in downtown
Halifax. Affiliated with the medical
school at Dalhousie University, the
I.W.K. is the Pediatric referral center
for Canada's Maritime Provinces.

Opportunities are now available for
all areas including Neonatalogy and
Intens,ve Care. Previous experience
in pediatrics not necessary. A full
orientation program is provided.

RN's interested in accepting our
challenge are requested to contact

ROBERT COOK
Director of Personnel
Izaak Walton Killam Hospital
For Children
5850 University Avenue
Halifax, Nova Scotia

WE CARE

REGISTERED
NURSES
Required Immediately

A 300-bed, active treatment hospital requires:
1. An experienced nurse, interested in, and willing to accept
training in Rehabilitation Nursing. Preference given to nurses
with experience, or training in this specialty.
2. An experienced nurse, with preparation, or experience, in
Intensive or Coronary Care Nursing, or interest in training for
this nursing specialty.
QUALIFICATIONS: Successful completion of an approved basic
course in Nursing. Active registration in New Brunswick, or eligible
for same. Must be able to work rotating shift.
SALARY RANGE: $624. - $724. per month. Salary commensu-
rate with qualifications and experience.
Excellent fringe benefits. Three weeks vacation after one year
service. Insurance and pension programs available.

Apply to:

Personnel Director
WEST SAINT JOHN COMMUNITY HOSPITAL
B 3610, Postal Station B
Saint John, N.B., E2M 4X3
Telephone Collect - 672-8000, Local 301

48 THE CANADIAN NURSE

REGISTERED
NURSES
CAREER OPPORTUNITIES
PSYCHIATRIC NURSING
THE UNIVERSITY OF
BRITISH COLUMBIA

The Department of Psychiatry, a teach-
ing and research centre for the University
of British Columbia, offers a stimulating
environment for both baccalaureate
graduates and those of other nursing
programmes.
Primary Nursing System; Multidiscipli-
nary Team; Problem oriented Records;
Staff Development; administrative support
for new ideas: that's why a nurse is really a
NURSE at the Health Sciences Centre
Hospital!
Applicants must be registered or eligible
for registration with the Registered Nurses'
Association of British Corumbia. Policies
are in accordance with the R.NAB.C.
Agreement.

Apply to:
Mrs. Helen Gemeroy, R.N., M.A.
Director of Nursing
Department of Psychiatry
., Health Sciences Centre Hospital
The University of British Columbia
Vancouver, B.C., V6T 1W5

\fIi)
I

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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:
Compètitive salaries and excel/ent fringe benefits.
Planned staff development programs.
Please address all enquiries to:
Assistant Administrator (Nursing)
York County Hospital,
NEWMARKET, Ontario.
L3Y 2R1

JULY 1974

OSHAWA GENERAL HOSPITAL
Hospital expansion, pursuit of forf'!1
1 educB:tion a.nd transfers have
made the following interesting positions available In the Department
of Nursing.
CO-ORDINATOR OF IN-SERVICE EDUCATION
Requirements: .
Current Ontario Registration as a Registered
urse
Preparation and/or experience in A
ult Tea<:h.mg
Preparation and experience in Nursing AdminiStration

ASSISTANT CO-ORDINATOR IN IN-SERVICE EDUCATION
Requirements: .
Current Ontario Registration as a Reg
stered Nurse
Experience in Operating Room ess
ntlal
Teaching and administrative experience preferred

NURSING CO-ORDINATOR - OBSTETRICS/PAEDIATRICS
Requirements:
Current Ontario Registration as a Registered Nurse
Advanced Clinical preparation
Preparation and/or administrative experience

HEAD NURSES:
1. Surgerv 2. Paediatrics 3. Rehabilitation
Requirements:
Current Ontaf"io Registration as a Registered Nurse
Preparation and/or experience in the clinical area
Preparation and/or administrative experience

GENERAL DUTY NURSES - ALL DEPARTMENTS

Current OntRrin Registration as a Registered Nurse

II1Quires may be directed to:
Mrs. J. Stewart
Director of Nursing
Oshawa General Hospital
24 Alma Street, OShawa, Ontario.

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THE SCARBOROUGH
GENERAL HOSPITAL

invites applications from:
Registered Nurses and RegIstered Nursing Assist-
ants to work in our 6S0-bed progressive, accredit-
ed, community-centered, active treatment hospital.
We offer opportumties in Medical, Surgical, Paediatric, and Obstetrical
nursing.
Our specialties include a Burns and Plastrc Unit, Coronary Care, Intensive
Care and Neurosurgery Units and an active Emergency Departmpnt.
. Obstetrical Department - participation in "family centered" teac".
ing program.
. Paediatric Department - participation in Play Therapy Program.
. Orientation and on.goi
staff education.
. Progressive personnel policies.
The hosp.tal,s located in Eastern Metropolitan Toronto
FOr further information, write to:
The oirector of Nursing,
SCARBOROUGH GENERAL HOSPITAL,
3050 Lawrence Avenue. East. Scarborough, 0 ntario.

JULY 1974

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I
\ - --.1' Department of National I
r" Health and Welfare
I \ Ottawa, Ontario Kl A OK9 I
I I
I Please send me more information on nursing I
I opportunities in Canada's Northern Health Service. I
I Name: I
I Address: I
City: Prov: _

---------______J

\

.+

Hea"h and Welfare
Canada

Sanle eI Bien êlre SOCial
Canada

THE CANADIAN NURSE 49
.

ST. MICHAEL'S HOSPITAL
Toronto, Ontario
invites applications from

REGISTERED NURSES

for
INTENSIVE CARE and "STEP-DOWN" UNITS

Planned orientation and in-service programme will enable
you to collaborate in the most advanced of treatment
regimens for the post-operative cardio-
ascular a
d other
acutely ill patients. One year of nursing expenence a
reauirement.

For detalts apply to:

The Director of Nursing,
St. Michael's Hospital,
Toronto,
Ontario,
M58 1 WB.

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
Eligibl e 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:

Tne Administrator
Abbie J. Lane Memorial Hospital
5909 Jubilee Road
Halifax, Nova Scotia
83H 2E2

I

The health care team

Join us at
Sunny brook
Medical
Centre

. 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

-
t

50 THE CANADIAN NURSE

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.
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JULY 1974

REGISTERED NURSES
Southern California
This rapidly expandIng 573-bed MedIcal Center has
opportunitIes for RN's interested in professIonal growth
Huntington Memorial IS recognized for ns excellence 01 patient
care. research facilitIes and teaching programs. and offers a full
range of patIent care services including' IntensIve Care.
Coronal'j Care. Emergency Room. Neurosurgery. Open Heart
Surgery and Rehabilitation. Our full on-gOIng In-servIce
orientatIon and training program includes classes In Cntlcal
Care. Neonatal and an Arrhythmia Recognition Class. Other
programs are given for Medical.Surglcal. RehabIlitation and
Pedlatrtcs CardIology.
located in the Rose Bowl capitol, Pasadena, Calitornia,
Huntington Memonal enJoys the year around mild climate.
excellent for Ocean. Mountain. and Desert sports and actIVItIes,
all within a one hour drive. Our hospital is located In a
resIdential area, which offers excellent living conditions.
We invIte your InquIry concermng our salanes, benefits,
education. wort<ing conditIons and facIlitIes. We WIll also assIst
qualified RN's to acquire VIsas for those Interested in a positIon
with this progressIVe Medical Center.
Write Miss Ann Kaiser, Dir. of Nursing
HUNTINGTON MEMORIAL HOSPITAL
747 S. Fairmont SI.
Pasadena. Calif.. 91105
An equal opportunity employer

MONTREAL
NEUROLOGICAL
HOSPITAL

A Teaching Hospital
of McGill University

requi res

Registered Nurses
for
General Duty
Previous experience," neurological nursmg not
required. Active inservice education programme.

Apply to:
The Director of Nursing,
Montreal Neurological Hospital,
3801 University Street,
Montreal 112, P.O.

REGISTERED NURSES

required for a modern thirty bed active
treatment hospital, located ninety miles
north of Edmonton, Alberta. Salary sche-
dule effective April 1, 1974 $700. $730,
$760, $795, & $830

Previous experienc.e recognized
Excellent personnel policies and fringe
benefits.

Room and board available for forty-five
dollars per month in modern hospital
residence.

Apply In writing to:
Director of Nursing Service
Boyle General Hospital
Boyle, Alberta
I JULY 1974

SOUTH AUSTRALIAN HOSPITALS

DEPARTMENT

FLINDERS MEDICAL CENTRE

Applications are invited for the following nursing appointment at the Flinders Medical
Centre which is a new teaching hospital located on campus at Flinders University of South
Australia. The Medical Centre is approximately 9 miles from the Adelaide city centre

The first 350 beds and the necessary hospital supporting services are being progressively
commissioned to admit patients late in 1975. A total of 700 beds is planned by 1980.

DIRECTOR OF NURSING SERVICES

DUTIES:
Responsible to the Hospital Administrator for the nursing services. Initially to assist and
advise the commissioning team in the planning of policies and procedures for the
implementation of the nursing services.

SALARY:
$A 10,950 per annum

QUAL/FICA TlONS:
Eligiþle for reg.istration as a General Nurse and Midwife (essential) and Infant Welfare Nurse
(desirable) with the Nurses Board of South Australia; and a Diploma in Nursing
Administration from a recognised College of Nursing or its equivalent. Extensive experience
in the organisation and management of nursing services, preferably in a major teaching
hospital.

Applications for the above position, marked confidential, and stating age,
qualifications and experience, should be addressed to:

The Administrator,
Flinders Medical Centre,
BEDFORD PARK, S.A. 5042

and will be received until and including August 15th, 1974.

I

THE CANADIAN NURSE 51

UNIVERSITY OF
ALBERTA HOSPITAL

EDMONTON, ALBERTA

SAINT JOHN GENERAL HOSPITAL
SAINT JOHN, N.B.
Requires

invites applications from general duty nurses

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS

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.

for

GENERAL DUTY

Planned Orientation Program,
In-service Education Program.

Active Inservice Education programme.
Positions are also available for nurses with special clinical
preparation including cardiac and other intensive care areas.

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

For further information apply to:
Personnel Director
SAINT JOHN GENERAL HOSPITAL
P.O. Box 2000
Saint John, N.B.
E2L 4L2

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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. Bursarres 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

52 THE CANADIAN NURSE

JULY 1974

PETERBOROUGH
CIVIC HOSPITAL

Invites Applications from

REGISTERED NURSES
for
General Duty
in
General Intensive Care Unit
Emergency Department

- Active Inservice Education
Program
- Progressive Personnel Policies
One Year of Experience Required

For Further Information Apply to:

The Director of Nursing
Peterborough Civic Hospital
Weller Street
Peterborough, Ontario

DIRECTOR OF NURSING

Individuals with considerable experi-
ence in Nursing Administration and
preferably a B.Sc.N. are invited to
submit applications for a challenging
opportunity as Director of Nursing at
St. Anthony's General Hospital, The
Pas, Manitoba.

The Hospital is a 142 bed accredited
and General Hospital which has just
recently completed an extensive reno-
vation and construction program,
thereby offering modern equipment
and facilities.

For further Information, please contact:

The Administrator
St. Anthony's General Hospital
P.O. Box 240
The Pas, Manitoba
R9A 1 K4

JULY 1974

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Quebec's Health Services are progressive!

So

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IS nursing

at

The Montreal General Hospital

a teaching hospital of McGill University

Come and nurse in exciting Montreal

r-------------------------------,

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The Montreal General Hospital
1650 Cedar Avenue, Montreal Quebec H3G IA4

Please tell me abaut hospital nursing under Quebec's new concept of Sociol and
Preventive Medicine.

Name

Address

Quebec language requirements do not apply to Canadian applicants.
L_______________________________J
THE CANADIAN NURSE 53
.

JUDY HILL MEMORIAL
SCHOLARSHIP

The Trustees announce that the dead-
line for applications for this Scholar-
ship has been extended from June 1 st
to August 1 st, 1974.

For full details of the Scholarship see
the advertisement in the May issue of
The Canadian Nurse.

All applicatIons should be addressed to
the:

Chairman
The Board of Trustees
Judy Hill Memorial Fund
829 Centennial Building
Edmonton, Alberta

NURSING SUPERVISOR

Required for 254-bed

Active Care

General Hospital

Apply to:

Director of Nursing
Moose Jaw Union Hospital
MooseJaw,Saskmchewan
S6H 1H3
(306) 692-1841 Local 302

PUBLIC HEALTH NURSE

Two Public Health Nurses required for
expanding Health Unit generalized
programme. 1974 salary scale $9,050. to
$10,800. Allowance for degree and
experience. Generous fringe benefits and
car allowance.

Apply:

Director of Nursing,
Algoma Health Unit,
235 Wellington St. W.,
Sault Ste. Marie, Ont,
P6A 1H6.

54 THE CANADIAN NURSE

THE MONTREAL
CHILDREN'S HOSPITAL
REGISTERED NURSES
NURSING ASSISTANTS

DURHAM COLLEGE
OF APPLIED ARTS AND TECHNOLOGY

invites applicants for

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 t-IURSING
Montreal Children's Hospital
2300 Tupper Street
Montreal 108, Quebec

FACUL TV POSITIONS
in the Nursing Department

Qualifications:
- Registration in Ontano
- Umversity 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 1,1974

Direct applications with
complete resume to:
DEAN OF ACADEMIC AFFAIRS,
DURHAM COLLEGE OF APPLIED
ARTS AND TECHNOLOGY,
BOX 385,
OSHAWA, ONTARIO,
L1H 7L7.

TORONTO GENERAL HOSPITAL

CLINICAL
CO-ORDINATOR
SURGICAL SPECIALTIES

This position carries the responsibility for the total administration and
supervision of Nursing activities in the clinical area.

Desired Qualifications:
. Registered Nurse in the Province of Ontario
(or eligible for registration)
. Bachelor of Nursing degree
. Experience in Surgical nursing
· Administrative and Clinical experience essential

Applications should be directed to:
VICE PRESIDENT, Nursing
TORONTO GENERAL HOSPITAL
101 College Street
Toronto, ONTARIO
M5G 1 L7

JULY 1974

TWO HEAD NURSES

(for Pediatrics and Emergency Depts.)
required for modem, well-i!quipped, 250-bed
General Hospital, centrally located In South West
Ontario university town less than one hour from
T oronto/Hamilton.
Applicants should be registered in the Province
of Ontario, have at least 6 years nursing
experience, some of it preferably in a senior
position. Additional preparation such as Nursing
Unit Administration diploma in Baccalaureate
degree would be desirable.

ApplIcations should be submitted to:
Personnel Officer
Guelph General Hospital
115 Deihl Street
Guelph, Ontario, N1 E 4J4

KEEP IN THE
SWIM WITH
+
WATER SAFETY

NURSING OFFICE
SUPERVISOR

required for 270- bed acute care fully accre-
dited Hospital expanding to 370 beds. Per-
sonnel Policies in accordance with RNABC.
Must be eligible for B.C. Registration.
Preference will be given to applicant with
University preparation in Administration
and Clinical Supervision.

Apply Stating Qualifications to:

Director of Nursing
Prince George Regional
Hospital
Prince George, B.C.

JULY 1974

Registered Nurses
and
Nursing Graduates

The emphasis is on the individual Nurse and Patient at the
Johns Hopkins Hospital in Baltimore, Maryland.

If you are an experienced Nurse or a graduate of a 2 or 4 year program, then
Hopkins can help you further your career in Medical, Surgical, Intensive Care,
OB/GYN or Ophthalmological nursing.
Benefits Include:

. An Intensive 5 week orientation program
. Full tuition reimbursement
. Inexpensive dormitory housing on Hospital property
. Visas available In 6 to 8 weeks
. Licensure reciprocity granted
Orientation dates are: August 12, September 16, and October 21, 1974.
For more In'ormatlon call (collect):

Office of Professional Recruitment
Johns Hopkins Hospital
624 N. Broadway
Baltimore, Maryland 21205
Phone: 301-955-5592

--
, "
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Baptist Hospital of Miami, Florida... where " I .
.
"
professional and personal lives combine con- I I ,

'\ '
veniently with sunshine and excitement. Our I , \, . , '
expansion from 305 to 525 beds on 67 landscaped , '
acres has created openings for both staff and \ I
leadership positions. On duty, you'll enjov " I
INDIVIDUALIZED ORIENTATION I

', \, " ' ,
STABILIZED ASSIGNMENTS "
\ t , .

INSERVICE EDUCATION { ·
,
.
TOP PAY
FULL BENEFITS \.... \ , ...
I
PROMOTIONAL OPPORTUNITIES I '
Off duty, you're just minutes away from apartments, I '
shopping centers, beaches, theatres and parks in one of , '
suburban Miami's most picturesque areas. I'
If you are professionally committed to nursing, cut out I '
for Baptist Hospital of Miami. I . ,
- - - - - - - - - - - - -- .... .- - -J "-;. I-
I Mrs. Maureen Enright I
I Professional Placement Officer I
BAPTIST HOSPtTAL OF MtAMI
I 8900 North Kendall Drive I
I Miami, Florida 33156
I I'd like to know more about nursing opportunities at Baptist Hospital. :
I Name
I Address. . . I
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.

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Cut Out
for Miami

THE CANADIAN NURSE 55
.

nurses

who want to

nurse

At York Central you can join
an active, interested group of
nurses who want the chance to
nurse in ib broadest sense. Our
I 26-bed, fully accredited hospi-
tal is young. and already expand-
ing. '\;ursing 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
;,:xperience, for getting to know
patients as well as staff.

Situated in K.ichmond Hill, all
the cultural and entertainment fa-
cilities uf Metropolitan Toronto
are available a few miles to the
South. ., and the winter and
summer holidav and week-end
pleasures of Oiltario arc easily
accessible to the North. If you
are really interested in nursing,
you arc needed and will be made
welcome.

Apply in person or by mail to the
Director of Nursing.

YORK
CENTRAL
HOSPIT AL

RICHMOND HI! L.
OJ\. fl\RIO

56 THE CANADIAN NURSE

Index
to
Advertisers

July 1974

Davol Canada Ltd. .

. . . . .. ............................... Cover II

Encyclopaedia Britannica. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Cover III

Hollister Limited

7

Johnson & Johnson Limited. . . . . . . . . . . . . . . . . . . .

.......... 8.9

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A lh'ertisiflg Represefltal/\'es
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003
fclephone. (215) Mid\\a) l)-1
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2 Tremont Crescent
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fdephone: (416) 444-4731

Member of Canadian
Circulations Audit Board Inc.

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SOFT
ST ARTERS
BY
WHITE
SISTER

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PROMINENT DEALERS
listed alphabetically by
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THE

LINI U

TftADUIAAKS NO uS
"'1 on & c..ur.ADA wADE IN USA

SHOE

kWc,mm
Wh.ai,@

For a complimentary pair of white shoelaces,
folder showing all the smart Clinic styles,
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THE CLINIC SHOEMAKERS
Dept. CN-8, 7912 Bonhomme Ave.
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SOME STYLES ALSO AVAILABLE IN COLORS
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about 23.95 to 29.95

The
Canadian
Nurse

ð

A monthly journal tor the nur
e
of Canada published
in English and French edition
by the Canadian Nurses' Association

Volume 70, Number 8

August 1974

15 Report of CNA Executive Director.........:.... .H.K. Mussallem

20 Convention Report

29 Canada Inside Out: Surveying the
Nation's Nutrition....................,...........,.. .L.T. Kane

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4 Letters 36 Names
7 News 38 Dates
33 Research Abstracts 39 Books
35 In a Capsule 41 Accession List

Execulive Director: Helen K. Mussallem.
Editor: Virginia A. Lindabury . Assistant
Editors: Liv-Ellen Lockeberg. Dorothy S.
Starr . Editorial Assistant: Carol A. Dwor-
kin . Production Assistant Elizabeth A.
Stanton . Circulation Manager: Beryl Dar-
ling. Advenising Manager: Geoq
ina Clarke
. Subscription Rates: Canada: one year,
$6.00; two years. $11.00. Foreign: 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 weeh' notice; the
old address as well as the new are necessary.
together with registration number in a pro-
vincial nurles. association. where applicable.
Not responsible for journals tost in mail due
to errors in address.

Manuscript Information:. "The Canadian
Nurse" welcomes unsolicited articles. All
manuscripts should be typed. double-spaced.
on one side of unruled paper leaving wide
margins. Manuscripts are accepted for review
for exclusive publication. The editor reserves
the nght to make the usual editorial changes.
Photographs (glossy prints) and graphs and
diagrams (drawn in india ink on white paper)
are welcomed with such anicles. The editor
is not committed to publish all articles sent.
nor to indicate definite dates of publication.
Postage paid in cash at third class rate
MONTREAL P.Q. Permit No. 10.001.
50 The Driveway, Ottawa. Ontario, K2P IE2
CCanadian Nurses' Association 1974

Editorial I

A number of readers have recently
asked: "What's happened to The
Canadian Nurse lately? Why are there
so few pages?"
It is true that there are fewer pages.
In 1969, for example, the number of
pages averaged 80 per issue. From
1970 to 1973, we reduced the pages
to an average of 72 monthly. In the
past few months, however, we have
been limited to an average of only 64
pages a month.
One reason for this sharp decrease
in size lies with the exorbitant costs
involved in publishing and mailing a
monthly magazine. Postal costs alone
are almost beyond belief. Before April
1969, when the new postal rates went
into effect, the average monthly bill for
mailing both The Canadian Nurse and
L'infirmière canadienne was $770. In
1973, the average monthly bill was
$9,680. in spite of fewer pages in each
magazine.
What does this mean to you, the
reader? As I see it, it means that you
will have to help us - even mOre than
before - to decide what you want to
see in your professional journal. Be-
cause, with fewer pages, we are going
to have to be very selective indeed.
However, quality does not have to
disappear with a reduction in quantity.
With your assistance, we will continue
to work to improve The Canadian
Nurse.
Our plan is to publish mOre articles
and to reduce the number of pages in
certain departments, such as "new
products" and "books." Before we
make a definite decision, however
we
would like your comments. What do
you find most helpful to your profes-
sional practice? Short of a readership
survey, which we cannot afford at this
time, we have no way of knowing how
you would feel about eliminating Or
reducing these departments, unless
you write to us.
Recently, an ad hoc committee was
set up by the CNA directors to study
the two Journals. This committee will
examine all aspects of the magazines
and will attempt to answer the ques-
tions asked by CNA's executive direc-
tor, Helen K. Mussallem, in her report
to the 1974 annual meeting and
convention. Her questions are: "How
can these publications serve the ob-
jectives of the association? Should
CNA continue to produce its own
professional magazines? If so, should
the project be continued in its present
form and content?"
These are questions that concern
all CNA members. I hope that you will
react to them. - VAL.
THE CANADIAN NURSE 3

AUGUST 1974

letters

{

Letters to the editor are welcome.
Only signed letters, which include the writer's complete address,
will be considered tor publication.
Name will be withheld at the writer's request.

Author replies
The article "Ethics of Nursing Practice"
(February 1974) provided a resumé of the
ethical problems experienced by 22
nurses in Canada. Believing that the
nature of ethical problems encountered by
nurses is changing. the Nursing Research
Committee of the Canadian Nurses' As-
sociation sought to study the situation
and, eventually, to provide Canadian
nurses with more information on these
problems. Although responses were re-
ceived from only 22 nurses, it was hoped
that a summary of the results printed in
The Canadian Nurse would motivate
other nurses to describe ethical problem!>
they have experienced, so that the com-
mittee on nursing research might pursue
its original plans.
Since publication of the article, a few
more nurses have forwarded information
on ethical problems, and some have
expressed utter dismay that such prob-
lems would be discussed in their journal.
In the meantime, The Canadian Nurse
has apologized for not chopping out the
offending parts of the article before
publication.
It would appear that those against
discussing issues that are perceived by
some to be ethical in nature, coupled with
the silent majority - those who are not
overtly concerned with ethical problems
- make up most of the nursing profes-
sion. We might conclude that problems
relating to sex, abortion, living and not
living, malpractice. discrimination, and
so on, are taboo subjects to be swept
under the carpet.
Women all over the world are reaching
out to be part of the great issues of our
times. Why has nursing not become part
of this movement to promote and develop
the rights to think and to be equal
participants in the critical decisions that
are being made about human beings'? This
movement toward equal rights for women
seems to have passed nursing by!
What kind of a profession does not
concern itself in its practice with these vi-
tal issues as they affect human beings?
For example, wh} should the nursing pro-
fession not wish to discuss the problem of
discrimination? Do we think it does not
exist? Or the problem of abortion or of
life-prolonging measures? Why must we
in our publication espou.se a policy of
reader happiness and problem cover-up?
We are still clothed in the trappings of the
4 THE CANADIAN NURSE

Victorian era and we continue to allow
others to make the ethical decisions that
we put into practice. - Moyra Allen,
Montreal.

R Ns belong in doctors' offices
I recently had a disturbing argument with
my husband regarding the training of a
layman to do the job of a registered nurse
in a doctor's office. According to him,
teaching a nonprofessional to do office
work is better - economy-wise - than
hiring an RN, because the trained person
can do a job just as well and sometimes
even better than an RN for less compensa-
tion. My husband added that the RN's
type of work in an office is demeaning to
the nursing profession.
I have three years of nursing education
behind me and five rewarding and satisfy-
ing years of experience. My work has
consisted of every possible nursing task,
from cleaning bedpans to the more
sophisticated and automated way of nurs-
ing today. I do not, therefore, consider an
office job demeaning. After all. patients
are patients wherever they may be, and
giving complete and high-quality nursing
care is what makes a nurse; this includes
cleaning and preparing examining tables,
washing specula, and so on.
I believe that training a layman for
cheap economic considerations is much
more demeaning and does not help to
upgrade the standard of the nursing
profession. If one can pick anybody from
the street and teach him what nursing is
all about, why do we have to strive so
hard to get recognition and earn degrees
to perfect the trend that Florence Nightin-
gale pioneered?
I would be interested to know the views
of my fellow nurses on this subject. This
practice is getting popular and disturbing,
considering that my husband is all for it
and a woman has been hired. She is being
taught to do ECGs, remove stitches,
prepare injections (the doctor usually
administers them), and do other things.
As this person is obviously violating
some extremely legal acts. my growing
concern for her and for my profession
prompted me to write.
If we nurses do not watch out, a
number of unqualified personnel will be
walking all over us in the near future. It is
happening already with the avalanche of
LPNS, CNAS, and aides. Reduction of

nurses' preparation to two years is one of
the most disastrous and degrading steps
that our nursing executives have im-
plemented yet. I do hope they realize the
hannful consequences soon, before the
situation becomes totally hopeless. -
Wilinia B. Garbe, Estevan, Saskatch-
ewan.

Statement is misleading
Each month The Canadian Nurse pu-
blishes abstracts of studies from the
Canadian Nurses' Association repository
of nursing studies. At the heading of the
section it states, "Abstract manuscripts
are prepared by the author... ." This
statement is technically true. however it is
misleading. In my case, the abstract,
which appeared in the March 1974 issue,
was not the one submitted with my study.
What did appear was an extensively
edited version of the original, which quite
frankly does not make much sense.
I fully realize that the constraints of
space may necessitate a reduction in the
size of any copy submitted. Nevertheless.
if these abstracts are to be of value to the
reader, would it not be advantageous to
have the author do the editing? If this is
not feasible, at least have the author
approve any editing prior to publication.
An abstract is already a synopsis of a
particular study and, as such, highlights
the essential points. Further editing by
persons who are not familiar with the
study can seriously affect the reader's
comprehension of the research and its
possible use. -Elizaheth Finch, Ottawa.
If a research ahstract has been shortened
or edited hy the CN] staff. it is sent to the
researcher for appmval prior to puhlica-
tioll. As we have alread\' explained to Ms.
Finch, her abstract llllfortlinatel\' es-
caped this procedure. /t is reprinted on
page 34. - Editor

News item is untimely
I \\-ish to respond to an item in the news
section under the title. "ONQ Identifies
Serious Gap!> in CEGFP Nursing Educa-
tion" (June 1974. p. 8).
The study referred to in thi!> item makes
grave statements without supporting evi-
dence. although it does acknowledge that
a scientific evaluation of the nurses
graduating from the CEGI-P program has
AUGUST 1974

letters

POSEY fOR PATIENT
COMfORT. SAfETY. CONTROL

not been done. Comments of the same
nature as those reported in this news item
were made by nurses in Moyra Allen's
study of the nursing program at Ryerson;
yet at Ryerson the nursing program is
only two academic years in length and at
the CEGEPs it is three.
This item states that 62 percent of
CEGEP graduates felt inadequately pre-
pared to function as staff nurses. Feeling
unprepared does not mean it is true. One
would like to know how well these
graduates were able to nurse, rather than
how comfortable they felt in the hospital
system. I have heard university graduates
after five years' study, responding in the
same manner when they first enter the
hospital to work as a general staff nurse,
despite the fact that they do possess the
knowledge and skills to practice a high
level of nursing care.
No recent graduates of any diploma
nursing program are prepared to work in
the intensive care unit or operating room
or to become an assistant head nurse. One
feels concerned that 20 percent of those
questioned felt they were prepared to do
so. Furthermore, not only would it be
impossible to provide clinical experience
in special units during the three academic
years for the members of the program, it
would also be unwise to rotate a continu-
ous stream of 1>tudents through such units
where an immediate response to critically
ill patients' needs is imperative.
I have worked at the bedside with
student nurses in the CEGEP program and
have been impressed with the level of
performance of these students at the end
of the first year, despite the short time
they 1>pend on the ward each week.
Evidence can be easily gathered to show
that student1> can learn to give basic
nur1>ing care in a few weeks by using
carefully selected learning experience1>
that provide the student with the oppor-
tunity to apply knowledge and develop
skills. This rapid development of nursing
ability cannot be achieved, however,
without a pre- and postconference with an
experienced nurse educator who has
carefully delineated the level and scope of
nursing the student must achieve at the
end of the first year.
The statement in this neW1> item that the
Order of Nurse1> of Quebec has asked the
ministry to revise planning for improving
quality. intensity, and continuity of clini-
cal care is distressing, as no ministry can
do this; such action rests with the nurses,
for only nurses can improve nursing care.
whether it is at the bedside or through
nursing education.
The second gap identitied by the ON()
concerned the lack of prepared teachers.
AUGUST 1974

The new Posey Products shown
here are but a few of the many
products which compose the com-
plete Posey line. Since the intro-
duction of the original Posey Safety
Belt in 1937, the Posey Company
has specialized in hospital and
nursing products which provide
maximum patient protection and
ease of care. To insure the original
quality product, always specify the
Posey brand name when ordering.

The Posey 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
complete Posey line. #1731 (with
ties), $6.50.

t

J(

The Posey Tie-Back Vest ties in back
making it difficult for the patient to
remove and has shoulder loops which
may be used to prevent the patient
from sitting up or sliding in bed. There
are eight safety vests in the complete
Posey line #35Bl,$11.55.

;

'"

,

..

The Posey Hand Control Mitts
protect patients from injury to them-
selves if their hands and fingers are
not restricted. This milt is one of
fifteen hmbholders in the complete
Posey line. #2811 (colton), $9.30pair.

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,#"

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.

The Posey Patient Restrainer with
shoulder loops and extra straps keeps
the patient from falling out of bed
and provides needed security. There
are eight different safety vests in the
complete Posey line. #3131 (with ties),
$9.45.

f,\
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The Posey "Swiss Cheese" Heel
Protector Simplified design, generous
coverage of heel and ankle, hook and
eye fastener to keep It in place. Syn-
thetic fur; washable. #6121, $5.40 pair.

Send for the free new POSEY catafog - supersedes all prevIOus editIOns.

Please insist on Posey Quality - specify the Posey. Brand name.

POSEY PRODUCTS Stocked in Canada

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1033 Rangeview Road, Port Credit, Ontario, Canada

THE CANADIAN NURSE 5

Next Month
in

The
Canadian
Nurse

. A Psychological Contract
of Service

. Knee Arthroplasty

. The Nurse as a
Family Therapist

. Component Therapy

ð

Photo Credits
for August 1974

David Portigal, Winnipeg, Man.,
cover photo,
pp.7.8.9.21.23.25-28

Niagara College, WeIland, Ont.,
p. 13

Crombie McNeill. Ottawa,
p.16

University of Calgary,
Public Relations Office.
Calgary, Aha. p. 36

6 THE CANADIAN NURSE

letters

(Continuedfrom page 5)
and indeed it is a serious problem if 57.6
percent of the teachers of nursing do not
have a baccalaureate degree. It would
seem more appropriate at this time to
stress the need for upgrading these
teachers than to be concerned with having
all teachers with a master's degree. I do
agree with the recommendations that
programs need to be organized for
teachers who do not have adequate
preparation.
The CEGEP program for nursing is a
radical change from the hospital school of
nursing, and like any change brings with
:t new problems. It behooves all nurses in
the Prm,ince of Quebec to support and
assist the graduates of these new prog-
rams to adjust to the work situation rather
than denigrate their ability to nurse with
no real sUl?porting evidence. This news
item is untImely. - Mirth Doyle, Assis-
tant Professor, McGill University School
of Nursing, Montreal, Quebec.

Editor's Note
. 'The Canadian Nurse" reports the news
as it happens. Although Ms. Doyle may
believe that the study or the release of its
contents was untimely, we believe we had
a responsibility to report an important
ONO study.

Criticizes news report
I cannot let go uncorrected the impression
created by the news item regarding the
collegial nursing program in Quebec
(ONQ Identifies Serious Gaps in CEGEP
Nursing Education. June 1974). My
colleagues and I. who are involved in the
teaching of nursing in the colleges, were
dismayed at the tone of this item. There
was a clear impression given that the
system is a failure: by implication, a
failure as opposed to previous systems of
nursing education.
The first point to be made is that the
material for the present news item was
obtained from an opinion survey. It was
not a scientific study, and the questions
asked of the respondents were not
oriented to finding out whether the
college nursing program is achieving
what it set out to do. The questions that
were asked relating to adequacy of
preparation for an assistant head nurse
position, for example, are irrelevant and
misleading in relation to success of the
program. It must be obvious that this
would not be an appropriate objective for
a college-based program, any more than it
was for the previous hospital diploma
programs .

One of the many disturbing impres-
sions left by the news item has to do with
teacher preparation. The item implies that
the teachers are less well prepared than
was the case in the past. The reality is that
we now have more prepared teachers
working in the system than was the case
with the hospital-based schools, although
we would like to see even more im-
provement in this area. But the lack of
preparation of nurses for both teaching
and administrative positions is a national,
and in some instances a regional, di-
lemma, and not one that can be linked
exclusively to the collegial nursing prog-
ram.
No claim is made that the collegial
system is perfect, We would certainly
welcome a well-organized. scientific
study of the graduates of the program so
that we could plan appropriate improve-
ments. But it is an unbalanced system of
reporting that focuses on the problems to
the exclusion of the achievements. And I
hope that our graduates are not made to
feel inadequate because of the tone of the
published news item.
The persons who have been involved
with the teaching of nursing students in
our college have been impressed with
their vitality, their enthusiasm for nurs-
ing, and their ability to adapt to a variety
of nursing situations. We believe that our
graduates have the ability to handle
beginning staff nurse positions and that
they have the basis in knowledge and skill
for acquiring more refined skills in the
so-called "specialty" areas. No basic
diploma program can, or should, be asked
to claim more.
A final word about the purpose of the
brief that was the basis for The Canadian
Nurse article. The brief was intended to
recommend areas for improvement in the
collegial nursing programs. It was not
intended to be an indictment of the
system. but, unfortunately. that is how it
has been interpreted in the item in
question. - Mary Barrett, Coordinator
of Nursing, Vanier College. Montreal,
Quebec.

Reader interested in SLE dub
I was interested to read the letter from
Margaret Duffy (April 1974. page 4)
regarding the formation of a club or group
to communicate the experiences of SLE
sufferers.
As an SLE sufferer for 5 years. I would
be most interested in joining a discussion
group to exchange ideas and experiences.
I am a medical technologist. now deeply
involved in the marketing side of the
pharmaceutical industry. My wife is a
registered nurse.
Bonnie Hartley's article. "I've got a
wolf by the ears" (January 1974) was
excellent, and I would like to congratulate
her. - Jim Sheridan. Dollard des Or-
meaux. Quebec. G'
AUGUST 1974

news

Delegates Elect New Members
Of CNA Executive Committee
Winnipeg, Man. - The results of the
election for the members of the CNA
executive committee for 1974-76 were
announced on the final morning of the
annual meeting and convention of the
Canadian Nurses' Association.
Huguette Labelle is president of CNA
for the 1974-76 biennium. Joan Gilchrist
was chosen president-elect by acclama-
tion, Earlier, Beverly Du Gas, who was
also running for president-elect. withdrew
her name from the nominations, Helen
Taylor was elected first vice-president
and Margaret McLean, second vice-
president.
CNA voting delegates elected the fol-
lowing members-at-large: Fernande Har-
rison, nursing administration; Shirley
Stinson, nursing education; Lorine Besel,
nursing practice; and Glenna Rowsell,
social and economic welfare. (See the
April 1974 issue, page 21, for biog-
raphies of the new officers.)
Elected to the committee on nomina-
tions for 1974-76 were Laura Butler,
Thunder Bay, Ontario; Apolline
Robichaud, Fredericton, New Brunswick;
and Marguerite Schumacher, Calgary,
Alberta. The CNA directors appointed Ms,
Schumacher chairman of this committee.

CNF Board Will Look At Costs,
Membership And Board Structure
Winnipeg, Man. - A resolution, passed
by members of the Canadian Nurses'
Foundation at the CNF annual meeting 19
June, during the week of the CNA annual
meeting and convention, requests the CNF
directors in 1974-76 "to propose to a
special general meeting changes required
to reduce costs, while at the same time
maximizing attainment of Foundation
objectives, and in particular give consid-
eration to effecting the following:
I. review of membership structure;
2. review of board structure and ac-
tivities;
3. review of administrative policies and
procedures, "
This resolution was introduced because
CNF s annual revenue has been inadequate
to maintain its current level of operation
and because CNF has relied on CNA for
financial support to cover costs of fund
management and secretariat services.
CNF's financial problems were spelled
out in Gay Engensperger's presidential
address. ". . .CNF has been unsuccessful
AUGUST 1974

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Ready For A New Biennium

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Members of the new CNA executive committee, photographed outside the Manitoba
Centennial Centre, are. left to riRht, Helen Taylor, first vice-president; Fernande
Harrison, member-at-Iarge, nursing administration; Lorine Besel, member-at-Iarge,
nursing practice; Margaret McLean, second vice-president; Huguette Labelle,
president; Marguerite Schumacher. outgoing president; and Joan Gilchrist,
president-elect. Missing from photograph are Glenna Rowsell. member-at-Iarge.
socioeconomic welfare; and Shirley Stinson, member-at-Iarge. nursing education.

in attracting revenue from the public,
Indeed. revenue from individual nurses
has fallen well below expectation and
annual needs, These two facts. in combi-
nation with the. . decision of the CNA
directors to terminate support to the
Foundation. threaten the continuation of
the CNF annual scholarship program."
Several alternatives to the present
foundation structure were mentioned dur-
ing the CNF meeting: one was to dissolve

CNF and turn the mor..:y over to another
charitable organization, and another was
to transfer CNF funds to a trust fund of
CNA.
Michael Edwards, a representative of
CNFs auditor: said no purpose would be
served financially by establishing CNF as
a trust fund of CN A. "It does not cost any
more to run a foundation than a tru!>t
fund," he explained.
Pamela Poole. Ottawa. asked whether
THE CANADIAN NURSE 7

the CNF board had considered using bursary
funds as noninterest loans. George Hynna,
CNF legal counsel, answered that nonprofit
corporations such as CNF must dispense 90
percent of all money received from in-
dividuaIs, corporations, and membership
fees for charitable purposes. If this were not
done, CNF would lose its charitable status
and be subject to tax.
Referring to the decreasing member-
ship in CNF (800 members in 1973), CNF
Secretary- Treasurer Helen Mussallem
said it is "shocking that so many CNF
scholars are not members of the founda-
tion." If 50 percent of these scholars
were still CNF members today, this would
be a generous estimate. she said.
One member from New Brunswick
said a reason for the small number of mem-
bers is that CNF members are upset that it
costs more than $4 to process a $5 member-
ship. A receipt rather than a card would be
plenty, she said.
The report of the nominating commit-
tee, which allowed the names of the
1973-74 board of directors to stand for
nomination to expedite the board's work
in the new biennium. drew considerable
reaction from members. As 5 members of
the CNF board must be members of the
CNA board, according to CNF by-laws,
members did not feel they could vote for
the CNF board until the results of the CNA
election were known on the final day.
By the time the CNF session was
adjourned, a number of nominations to
the board had been made from the floor.
In addition, those nominated by the
nominating committee and the names of
those proposed by the provinces to the
committee were on the final ticket of
nominations.
When the meeting reconvened 21 June,
the CNF election was held. The 5 mem-
bers of the CNA board elected to the CNF
board are Joan Gilchrist, Quebec; Mar-
garet McLean, Newfoundland; Judy
Prowse, Alberta; Glenna Rowsell, New
Brunswick; and Helen Taylor. Quebec.
The other 4 directors elected to the ne\\.
CNF board - all of whom were on the last
board - are Gay Engensperger. British
Columbia; Fay McNaught, Manitoba;
Marilyn Riley, Nova Scotia; and Apolline
Robichaud, New Brunswick.

Man. Health Minister Urges Nurses
To Speak Directly To The Community
Winnipeg, Man. - Manitoba's minister
of health and social development. in his
keynote address during the official open-
ing of the annual meeting and convention
of the Canadian Nurses' Association 16
June, encouraged nurses to voice their
concerns and the knowledge gained from
their profession directly to the commun-
ity, and to become more involved in other
areas of health.
The Hon. Saul Miller said nurses
should no longer view themselves as only
8 THE CANADIAN NURSE

Citizen Schumacher

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CNA President Marguerite Schumacher
was made an honorary citizen of the
City of Winnipeg during the official
opening of the CNA annual meeting
and convention in June 1974.

a part of the health hierarchy. "Your
membership has ideas on many other
social concerns and you should become
much more vocal in expressing these
concerns." He said he was thinking
especially of the front-line nurse. who is
often forgotten but who has so much to
contri hute .
Throughout his addres
, Mr. Miller
placed emphasis on health. rather than
illness. But he noted that "to shift the
focus on health rather than sickness care
is extremely difficult. What makes it
difficult is that the bulk of the manpower
resources, training programs, services,
and economic resources focus on sick-
ness. Even the measurements of
health . . . are from the perspecti ve of
the pre valance and effects of sickness. ..
The health minister also spoke out
against the domination of the health
system by anyone group. such as
hospitals or doctors. "We want to see all
aspects of health care given their full
share of emphasis in development and
competition for health care dollars. We
want prevention and support services to

be given more emphasis, but as an
integrated part of, not separate from, the
other components of the health care
system. ..
Mr. Miller added, "The question is not
who will dominate, but how can we get it
all together at the community level for the
benefit of the local community and the
individual member of that community. "
A special honor during the gala open-
ing ceremonies went to Marguerite
Schumacher, CNA president for the
1972-74 biennium. Councillor Robert
Steen, representing the City of Winnipeg,
presented her with a handsomely framed
honorary citizenship. Mr. Steen paid
tribute to Ms. Schumacher's contribution
to health services and to the nursing
profession.

Canadian I ndian, Metis Nurses
Meet And Plan 1975 Conference
Winnipeg, Man. - Registered nurses of
Canadian Indian and Metis ancestry met
in Winnipeg on 6 and 7 June. Delegates at
the first meeting of the Native nurses'
group came from the Yukon, Alberta,
Saskatchewan, Manitoba, Ontario, and
Quebec.
The purposes of the initial meeting
were to try to find out how many RNs of
Indian. Metis, and Inuit (Eskimo) ances-
try there are in Canada, and to promote
the profession of nursing among Native
women during International Women's
Year, 1975.
Delegates to the Winnipeg meeting set
up an interim committee to plan a national
conference of Native RNS, to be held in
1975. The purposes of such a conference
are to develop a registry of nurses of
Indian, Metis, and Inuit origin, and to
examine ways of implementing educa-
tional methods, by setting up a consulta-
tive mechanism of nurses, for the better-
ment of health services to Indian, Metis,
and Inuit communities.
Joycelyne Bruyere, Winnipeg, is coor-
dinator of the national conference. Nurses
named as regional representatives to the
interim committee to plan the conference
are: Marilyn Van Bibber, Yukon; Mary
Barkhouse, B.C.; Rhonda Blood and
Madeline Stout, Alberta; Irene Desjarlais,
Saskatchewan; Janet Fontaine, Manitoba;
t:hzabeth Jacobs, Ontario; and Cecelia
Curotte, Quebec.
General discussion at the Winnipeg
meeting concerned such aspects of nurs-
ing education as recruitment, guidance
counseling, school dropout rates, and
general attitudes to nursing as a profes-
sIon.
Community-based problems discussed
included unemployment, job placement,
alcohol and drug abuse, cultural conflicts
on health matters, and the role of women
in dealing with these issues. It was agreed
that professional nurses can be a force in
improving communities; they can encour-
AUGUST 1974

age Indians and Metis to seek profes-
sional training or to upgrade their para-
professional nursing preparation.
At an evening program, a brief seminar
was held on Indian nursing education.
Two student nurses made a presentation
of their experiences, difficulties in obtain-
Ing financial assistance, and thoughts on
nursing education. Representatives from
the Manitoba Metis Federation, Manitoba
Indian Brotherhood, Manitoba Medical
Services, and federal department of In-
dian Affairs were present as guests; they
acted as consultants on questions related
to their programs.

Nurse-Midwives Vote To Create
A National Committee
Winnipeg, Man. - Nurse-midwives
from across Canada got together 18 June
during the annual meeting and convention
of the Canadian Nurses' Association and
voted unanimously to take steps to create
a national committee of representatives
from each regional association. Among
the 51 nurse-midwives present, there was
heavy representation from the Northwest
Territories and the Yukon.
The nurse-midwives in Canada are
divided into 4 regions: Western, Atlantic,
Ontario, and Quebec. So far, only the
Western region has adopted a formal
constitution (News, February 1974, page
10).
Objectives of the national committee
are to provide coordination and liaison
between regional associations, national
professional associations such as CNA. and
other groups; and to consider the forma-
tion of a national association of midwi-
ves.
Pat Hayes, an assistant professor at the
University of Alberta in Edmonton and
president of the Western region nurse-
midwives association, was nominated
spokesman for the national committee.

Exchange of Nurses With Cuba
Will Begin Later This Year
Winnipeg, Man. - As a result of a visit
to Cuba last April by the principal nursing
officer of Health and Welfare Canada,
four Cuban nurses will visit Canada in the
late fall of 1974 and three Canadian
nurses will visit Cuba for approximatel}
two weeks in February or March 1975.
Huguette Labelle, who gave a report to
the board of directors of the Canadian
Nurses' Association I3 June, went to
Cuba to provide the University of Havana
with advisory services in developing a
nursing education program and to discuss
bilateral aid between Cuba and Canada.
In her repon'on this visit, Ms. Labelle
said she "was favorably impressed by the
accessibility of health care services, espe-
cially primary care, to the population; by
the system for citizen participation in
AUGUST 1974

Nurse-Midwives Labor At Winnipeg Meeting

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Six of the 51 nurse-midwives from across Canada who met in Winnipeg in June are,
left to right (back row), May Toth, Hamilton; Mary Cameron, Toronto: Kathleen
Kleefstra, Hamilton; Daphne Chase, Sioux Lookout; (front row) Doreel; Simmons,
Winnipeg; and Pat Hayes, Edmonton.

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planning, implementation, and evaluation
of primary health care services: and by
the rapid and efficient use of statistical
information. ..
The Cuban nurses who visit Canada
will be chosen from among those involv-
ed in planning and implementing the
new nursing program at the University of
Havana, said Ms. Labelle. She invited
CNA to develop criteria for selecting
Canadian candidates for the return visit
and to recommend who should go. Travel
costs will be borne by the nurses' country
and accommodation costs by the host
country.
Criteria for selecting the Canadian
nurses were developed during the CNA
directors' three-day meeting. The nurses
selected should:
. have comprehensive knowledge of the
system of health care in the provinces and
at the national level;
. have knowledge in depth of either
community health, medical (ho\pital)
centers, or education:
. be in a position where information
obtained through the visit can be dissem-
inated as widely as possible, to nurses and
allied health professionals, nationally or
in a large geographic area;
. have the ability to write a comprehen-
sive report on the visit; and
. have demonstrated ability to adjust to
socio-cultural differences.
CNA directors will be asked to submit

names of nurses, and the final selection
will be made by the CNA executive
committee.

Victorian Order Nurses Log
1.5 Million Visits in 1973
Edmonton, Aim. - Victorian Order
nurses across Canada made nearly 1.5
million visits in 1973. This figure was
reported on 6 June 1974 by Ada E.
McEwen, national director of the Vic-
torian Order of Nurses (YON), at the
Order's 76th annual meeting held in the
Hotel Macdonald, Edmonton.
"The patient and the family continue to
be the main focus of service, with an
increasing number of visits," Ms.
McEwen said. There is a continuing shift
from institutional to home care, and more
than 1,300,000 visits v.ere made by YON
staff to patients with medical and surgical
conditions.
Victorian Order nurses are making a
gradually decreasing number of visits to
pre- and postnatal patients and to their
newborn babies: less than 42,000 such
visits were made in 1973. In some VON
branches, prenatal. maternity, and new-
born supervision programs have been
transferred from Vo:-; to an official
agency, such as a regional or community
public health unit, I\1s. McEwen said.
(Continued on page II)
THE CANAD
AN NURSE 9

4N
tf7Z,v...;-

MRS. R. F. JOHNSON
SUPERVISOR

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CHARLENE HAYNES
---- - OLBKUu

MRS. \1.
,,,r. OHN. L.PN.

-... plr,"c

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No. 333 Tote. ..2.95 el. Gold mit. 5O,/Tote

WHITE CAP CLIPS Holds caps I
firmly in place! Hard.to.flnd white bobbie pins,
enamel on fme spnng steel. Seven 2" and four
3" clips included m plastic snap box.
No. 529 Clips 75c per box: (min. 3 box:es)
MOLDED CAP TAC

Replace cap band Instantly TIny plast,c taco ?
damty caduceus Ct!oose Black, Blue, White
or Crystal with Gold Caduceus The neater.
way to fasten bands .
No. 200 - Set 01 6 Tacs . . . 1.25 per set '::. I

Fõft1
METAL CAP TACS Pair 01 dainty
'Pt.U.1 Jewelry-quality Tacs with grippers. holds cap
n
bands securely. Sculptured metal, gold finiSh' 1

"'"" . approx W' wide Chouse RN. LPN. LVN. RN
Caduceus or Plain Caduceus. Gift boxed
nWi:fJ ".. r>: No. CT.l (Sgecify Initials), No. CT.2 (Plam
L:'..Vl.U I. Cad.) or No. CT-3 (RN Cad.) . . . 2.95 pro
SEL-FIX CAP BAND 8Iack.el.et4

band material. Self.adtleslve, pre
ses 01, I -.l
pulls off; no sewing or pinning Rtusable
several times. Each band 20" long, pre-cut to
popular wldttls: V.." U2 per plastic box) V2"
(8 per bold
" (6 per box) I" (6 per bbld.
Specify wldttl under ITEM column on coupon No. 63f.
58

.box
TO: REEVES COMPANY, BOI C ,Allieboro, Mass. 02703
I OR8ER NO. II' mmm PRICE
I I -
I I
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---

Use extra sheet for additional Items or orders.

City .

Stete

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GENEROUS NEW GROUP DISCOUNTS on all
Items show'l for group purchases, graduatl 1
.ifts. favors, etc.
6-11 Same Items, Deduct 10%; 12-24 Same Items, Deduct 15%
25 gr Mgre Same Items, Deduct 20%

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IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS!
Ctloose style you want, shown left Prmt name (and 2nd bottom lelt Attach El'tra sheet for additional pms
hne I' desired) on dotted lines below C"eck other mfo In NOTE SAVINGS ON 2 IDENTICAL PINS.. . . more coo1&tnlent,
boxes on chart, chp ttlis section and attach to Coupon spare In case of 105s.

I METAl METAl BACKGROUNO LETTERING PRICES
OESCRIPTION COLOR FINISH COLOR COLOR E_'ILiII E_'2UII.
(Plallic}
ALL METAL... Smooth. rounded o Duolone Does D Black DIPin235 o 1 Pin 3.10
r:orners. Choose Pohshed, Satin. or o Gold o Pohshed nol o Ok Blue o 2 Pins 3.85 o 2 Pins 4.95
1ew Duotone combining satin o Sliver
background with pohshed edges o Satin apply o White IVmet1ðrpel (same namel
PLASTIC LAMINATE... slimmer, Does OWh,t... o Black o 1 Pin 1.25 o I Pin
Does
Ok. Blue us
broader; engraved thru surface to nol not OG'
o 2 Pins 1.95 o 2 Pins 2.90
contrasting core color. Beveled apply apply o Blue It

:

s only IsamefJamel Iyme".rnel
border matches lettering. o Cocoa
METAL FRAMED .. ClassIc o Gold Polished While o Black o I Pin 2.35 o 1 Pin 3.10
< sign; snow-white plastic with OS.lver frame only o 010: Blue o 2 PinS 3.85 o 2 Pins 4.95

mooth. polished beveled frame only Iwme namel Iwme namel
MOLDED PLASTIC . Simple, smart, Does Does White o Black o I Pin 1.25 DIPin US
economical. Will never discolor. not not only o 010:. Blue o 2Pms 1.95 o 2 Pins 2.90
SmooCh rounded corners and edges. apply apply (samen..lme) lsamenamel

Pirtle
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I INITIALS IS de,ired: - - -
TO OROER NAME PINS, lill out all information in bo., tog
I right, clip out an a attacn to this coupon.
\ Please add 50( handling/postage
I enclose $ , on orders totalling under $5.00
No OD's or blllmg to Individuals Mass residents add 3% S T
I I

EXAMINING PENLIGHT
I Send to I 1" White barrel Witt! caduceus Imprint. aluminum
6..::t}. band and clip. So, long. U S made, battenes Included Ire.
I Street I u:..- placement battenes available any storeJ. Your own light, gift boxed.
ND. 001 Penllpt. . 4.29 ea. YDur Inltlall Inl"lYed, add 50, plr Ilpt.

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all Price

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Free Initials R with y,our own
Littmann Nursescopef
BRAND

Famous Littmann nurses' dla-
ptlraø:m stettloscope . . . a fine
precision mstrument, witt! tligh
sensitivity for blood pressures,
apical pulse rate Only 2 OlS., fits
in pocket, wittl gray vinyl anti. No. 2160 Nursescope inCl.
collapse tubing, non chilling epoxy Free Initials. . . 14.90 ea.
dlaptlragm. 28" overall. Non.rotat.
Ing angled ear tubes and ctlest
piece beautifully styled in choice
of 5 Jewel.llke colors: GDldtlne.
Slivertone, Blue, Green, Pink..
.IMPORTANT: New' Medallion" styling Includes tubing in colors to matctl
metod parts. If desired, add $1. ea. to pnce above, add "M" to Order
No 2160!!I on coupon. Duty free
LITTMANN COMBINATION STETHOSCOPE

FREE INITIALS! Your mitials en-
graved FREE on ctlest piece; lend
IMdivldual distinction and tlelp pre.
vent loss

SCOPE SACK See special half price
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Ma)amum sensItivity from ttllS fme professional Instrument. Can.
vement 22" overall lengttl, weigtls only 3'(2 Ol. Ctlrome blnaurals
fixed at correct angle. Internal spring stainless ctlest piece, 1:t4 11
diaphragm, I
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1 w :.

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LITTMANN PEDIATRIC STETHOSCOPE
Same as above. except smaller ctlest piece for use Wlttl mfants and
small children Diaphragm l::tí . dia , belli '4" Black tubing. Includes

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CLAYTON DUAL STETHOSCOPE
lightweigtlt dual scope imported from Japan; hlgtlest
senSlltvity for apical pulse rate. Ctlromed bmaurals and
ctlest piece wittlll,1:" bell and I fl" diaptlragm.
grey anti.collapse tubing 4 Ol , 29" long. Extra
ear plugs and dlaptlragm Included !!! Imtlals
engraved free.
No. 413 Oual Steth . . . 17.95 ea.

LIGHTWEIGHT CLAYTON STETHOSCOPE
Single diaphragm (1%" dla) Ct!oose Blue, Green. Red. Silver or Gold
I fubl11l' arid chesfp.ece, slh.er bl11aurals. only 3 01 , edra earplugs and
dlaptlragm mcluded Ttlree free milials engraved D t f
. No. 4140 Clay. Steth ... 11.95 ea. U y ree

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No. 223 Sack . . . 1 00 ea. (Deduct 50c wtlen or-
dered wlttlanr sClpe abovel. Gild imtlals, add 50,

. .

--------.
Fmest Forged Steel.
Guaranteed 2 years.

SCIS-OPS ard FORC PS

LISTER BANDAGE SCISSDRS
3Yz" Mini scissor. Tiny. tlandy, shp mto
uniform pocket or purse Choose lewelers
gold or gleaming chrome plate finistl
No. 3500 3112" Mini. .. 2.75
Ño. 4500 4112" size, Chrome only. . . 2.95
No. 5500 5112" size, Chrome only. _ . 3.25
No. 7027114" size, Chrome only. ..3.75
5Y2" DPERATING SCISSDRS

Polistled Stainless Steel, straight blades. -

No. 705 Sharp/Blunt goonts. . . 2.95
No. 706 Sharg/Sharg goints .. . 2.95 -
No. 710 4112" IRIS Scis.. Stainless, Straight. . . 3.75
No. 712 511.z" Littauer STITCH Scis., Stainless. 3.75
+-: J<ELLY FDRCEPS
,

.

tlandy for every nurselldeal for clamping

off tubing, etc Sta.nless steel, 5Yz"
No. 25-72 Straight, Box lock. . . . . 3.75
t?.A No. 725 Curved, Box lock. . ... . . . 3.75
No. 741 Ttlumb Dressing forcep, Serrated, Strailht. 5Yz" ....3.75
No. 744 Søonle, Serrated, Straipt. Box Lock. 9" . ..... .... 6.80
No. 734 Backhaus Towel Clamp. Box Lock, 5112" . . 3.75

3 initills Ingraved on In, Ibo.e, Idd 50, per instrumlnt

MEDI-CARD SET Handiest relerence
ever l 6 smooth plashc cards (31)8'/ X 5Yz") cram.
med wilh Information, Including Equivalencies of
Apothecary to Metric to Household Meas, Temp.

C to of, Prescnp. Abbr , UrinalysIs, Body Ctlem.,
Blood .Ct!fm, Liver Tests, Bone Marrow. Disease
Incub Peuods, Adult WRts, etc. AU in wl1ite
vmyl holder Wlttl gold stamped caduceus.
No. 2B9 Card Set. . . 1.50 el.
Your initials gold-stamped on holder,
add 50. per set.

NURSES BAG Aliletimeof....ice
for vlsitmg nurses! Finest black 1,1:" ttllck
genuine cowtlide, beautifully crafted wlttl
rugged stitched and rivet construction.
Water repellant. Roomy IMterior, with sna

In washable liner and compartments to
organize contents. Snap strap tlolds top
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No. 1544.1 Bag (with liner). . 42.50 ea.
b:trø lintJr No. 4415. . . . . . . . . . 8.50
14K G.F. PIERCED
EARRINGS Darnty detaIled 1/20 12K Gold FIII.d
caduceus Witt! 141( posts, lor on or off duly wear Showl1
actual Slle Gift bored for fnends, too
No. J3/D35. .5.95 ger gair
PI N GUARD Sculptu.." caduceus. charned

to your professional letters. eactl wit'" plnbackl -
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,
safety catch Or replace either wlttl class pin lor
. '.
safety Gold flmsh. gift boxed Ctloo'je RN, LPN
o '}N No. 3420 Pin Guard. . . . 2.95 ea.
.$) ENAMELED PINS 8eautlfully sculptured status
, insignia 2-color keyed hard fned enamel on gold plate
'ÑÃ'. lime Sized pin back Specify RN LPN l VN, or NA on coupon.
\U!1' No. 205 Enam. Pin 1.95 ea.,
BIC 4-Color PEN
Fine plastic ball pOInt from famous
maker Change color Instantly Includes 8Iadl:.
Blue, Red and Green, all enclosed within barrel. No. M-119 4.Color Pen
Refills available at stationery counters . _ . 1.25 ea.

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CROSS PEN -- ;s:.:.: 'alnl;,,-tJ..7(n
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World I amous ballpoint. wlll'l
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5cul lured caduceus emblem full nlme ---. . ,_
fREr engraved on barrel hnclude name wilt! coupon, --......::;. ......
Refills av,11 everywhere lifetime j1uaranlee .

No 3502 Chrome 8.95 ea. No. 6602 12kt. G.r. 12.95 ea.

BZZl MEMO-TIMER TIm. hot pack.. he.t
lamps, park meters Remember to check vital signs,
gIVe medication, etc Lighlwelgtll compact U V2" dla),
se!s to buzz 5 to 60 mln I(ey ring Swiss made.
No. M.22 Timer . .. . .. 5.49

.
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news

{Continuedfrom page 9}
"In all. a total of 107.9[9 patients
received [.445.850 VISitS [in
1973] . . . . Of the visits made to pa-
tients discharged during the year. 65
percent were to persons over 65 years of
age." These individuals suffered mainly
from chronic conditions. !ouch as ar-
teriosclerosis. stroke. congestive heart
disease. cancer. diabetes. and arthritis.
"In spite of advances in medical science.
these patients must be satisfied \\ ith care
rather than cure." Ms. McEwen pointed
out.
Occupational health programs provided
by ::!4 VaN branche<; to some 30 industries
offer an ideal opportunity for counseling
to help individuals understand how they
can reduce self-imposed health risks. For
example. vo"'" provides counseling ser-
vice on a full-time basis to civic emp-
loyees in t\\O communities. and on a
part-time basis to employees of a tele-
phone company. a bank. a dairy. and
textile. paper. and plastic manufacturers.
Ms. McEwen said the increasing use of
\'0'< service by insurance companies in
conducting paramedical examinations of-
fers another contact \\ ith a younger and
generally healthy group.
Another group of VaN patients. neither
as young nor perhaps as healthy but still
living independently. are the residents of
senior citizens' housing complexes. They
are receiving or requesting more assis-
tance from va"'" in organizing health
counseling services.

Seminar On Mental Health Services
Planned For October, Nurses Told
Winllipe
, Mall. - A large group of
nurses interested in mental health services
attended a luncheon meeting [8 June.
during the annual meeting and convention
of the Canadian Nurses' A..<,ocialÍon, to
hear about plans for a national invitdtional
seminar to be held in Scarborough.
Ontario. 6-1} October.
Dorothy Bur\\ell and Lorine Besel are
CNA's representative<; on the ad hoc
national committee on mental health
professions. \\ hich was set up in 1972 to
plan the seminar. Ms. Burwell. who is
director of nursing education at the Clar"-e
In<,titutc of Psychiatry in Toronto. repor-
ted on plans for the \\ or"- ing ..emi nar on
"The Delivery of Mental Health Ser-
vices:' Ms. Besel. director of nursing at
the Royal Victoria Hospital in Montreal.
wa<, co-chairman of the meeting.
C:'\IA. as one of the spon.,oring associa-
tions. will send 10 delegate!. to the
seminar; they will be selected by the
AUGUST 1974

provincial nurses' associations. A total of
150 delegates from all regions of the
country will be invited. including repre-
jentatives from the national psychiatric,
medical, social work. and occupational
therapy associations. Members of consu-
mer. clergy. and Native Canadian groups
will also be invited.
This seminar. which will include prob-
lem solving. is intended to be a simula-
tion model for other work conferences.
"We hope the representatives will return
home and present similar conferences or
seminars in their own provinces," Ms.
Burwell told The Canadian Nurse. She
added that nurses at the seminar will work
in small groups with other professionals
to study examples of Canadian communi-
ties that need community mental health
services.
There will be resource persons. rather
than speakers. at the seminar. The only
position paper will be given by Dr.
Stanley Freeman. who has been working
on a 5-year project in Toronto to develop
community mental health services in a
framework of general health services.

Onto Nurses, Hospitals Settle
6 Days Before Strike Deadline
Toronlo, Ollt. - At press time. a settlement
had been reached in collective bargaining
between 46 Ontario nurses' associations
and 40 employing hospitals. Agreement
came 6 days before the deadline set for an
illegal strike of 10.000 nurses.
Anne Gribben. employment relations di-
rector. Registered Nurses' Association of
Ontario, called the agreement a "tremen-
dous breakthrough." Local nurses' associa-
tions and hospital boards can accept or re-
ject the agreement. but they cannot alter it.
. 'The hospitals have recognized the prin-
ciple of joint bargaining between the On-
tario Nurses' Association [the union of
nurses' collective bargaining un its] and the
hospitals' negotiating committee. and have
adopted the method for negotiation of con-
tract rene\\al in 1975:' Ms. Gribben told
The Canadian Nurse. "The nurses have
agreed to go to arbitration in 1975, if con-
tract negotiations run into difficult)."
Terms of the province-wide agreement
parallel those of an arbitration award
handed down earl) in July. in a dispute
between the nurses' association of Ottawa

Countdown 1973

C oulltdown /973, a boo"- of Canadian
nursing ..tatistics. has recently been
published by the Canadian Nurses'
As!.ociation. Copies are $4.00 and
may be ordered from CNA House. 50
The Drive\\ay, Ottawa. Ont.. K::!P
I E2 Please include payment \\ ith the
order.

Civic Hospital and the hospital. When talks
between the Ontario Nurses' Association
(aNA) and the employing hospitals resumed
in mid-J uly, the aNA made the terms of the
Ottawa Civic Hospital award the basis of
settlement.
The provincial settlement provides for a
starting monthly salary of $800 retroactive
to I January 1974, $850 on I July 1974,
$915 on I January 1975, and $945 on I
April 1975. The contract runs until the end
of July 1975. This is identical to the Ottawa
Civic award.
In determining fringe benefits, the
province-wide settlement applied the arbi-
tration award to local conditions. For exam-
ple. the award gave Ottawa Civic nurses a
shift differential of $1.50, up 40 cents from
$1.10. The province-wide settlement pro-
vided a shift increase of 40 cents to a max-
imum of $1.50; hospitals with a shift dif-
ferential above $1.50 will maintain their
present payment.
In the settlement. hospitals agreed to pay
retroactive salary to nurses no longer em-
ployed in the agency.
Recent negotiations in British Colum-
bia resulted in a monthly starting salary of
$850 in 1974 and $942 in 1975. (News,
June 1974, page I 0.) The S askatche wan
Union of Nurses recently completed
bargaining that gives nurses a basic
monthly rate of $707 in 1974 and $775 on
I January 1975. (News, July 1974, page
6.)

Correction
The League of Red Cross Societies in
Geneva. Switzerland, has informed us that
the closing date for applications for the
Yvonne Hentsch scholarship for the
1975-76 academic year is October /5,
/974, not January 1975 as reported in The
Canadian Nurse (June 1974, p. 12).

Minister's Position Worries AARN
Edmollton, A/fa. - A policy position
recently outlined b) James Foster, minis-
ter of advanced education in Alberta.
gives the department of advanced educa-
tion legal and financial responsibility for
nursing education - a decision that
worries the Alberta Association of Regis-
tered Nurses.
Mr. Foster's policy position states:
"The preparation of health manpower is
to become the responsibility of the de-
partment of advanced education, which
shall liaise with the department of health
and social development, the Alberta
Hospital Services Commission, the de-
partment of manpower and labor, and
appropriate agencies and a!osociations to
ensure that educational training programs
are adequate to meet the needs of the
people of Alherta. ..
AAR:'\I supports the idea that nursing
education he dealt with in educational
THE CANADIA
NURSE 11

news

institutions, but it i!> concerned over
maintaining educational standards for
professional nursing in such institutions.
Because nursing is the only professional
health training program in community
colleges to date, AARN is worried "that
nursing will assume the same status as
general education programs, which do not
need external monitoring."
In Alberta, the universities' coordinat-
ing council has been responsible for
approving nursing programs; this includes
prescribing, maintaining, and controlling
minimum standards of nursing education.
AARN notes that "today, this body is
challenged by individual presidents of
colleges wishing to assume the role of
approving their own programs."
The nurses' association believes that as
nursing has the responsibility to provide
good and compassionate health care to the
public, it . 'must be extremely vigilant of
the standards of education of its mem-
bers. ..
Another concern of AARN's is that
nursing programs in community colleges
must compete for funds with the other
programs. "This competition could lead
to budgetary constraints, which in them-
selves could affect standards of nursing
education," says AARN.
These problems are being reviewed
with the minister of advanced education.
It is AARN's belief that these points must
be resol ved before any further plans are
consolidated.

RNANS Urges Govt. to Expand
Health Services For The Aged
Halifax. N.S. - In a brief to the minister
of public health, the Nova Scotia council
of health, and the Nova Scotia Health
Services and Insurance Commission, the
Registered Nurses' Association of Nova
Scotia (RNANS) emphasized the need to
improve and expand health services for
the aged population of the province.
Ofthe changes recommended, the most
urgent was the inclusion of all health care
under the insured plan. At the present
time, Nova Scotia health insurance in-
cludes only hospital and doctor's care.
The RNANS wants the plan to cover
long-tenn care, including necessary med-
ical and nursing supervision, physio-
therapy, occupational therapy, speech
therapy, social services, consultant nu-
trition service, and provision of prosthe-
ses.
The RNANS brief urged that drugs be
included in health care insurance. Since
the brief was presented, the Nova Scotia
12 THE CANADIAN NURSE

government has announced that drugs for
senior citizens are covered by the plan.
The RNANS brief also urged the gover-
nment to establish mandatory standards
for nursing homes. The brief included
standards for nursing homes in Nova
Scotia, compiled and recommended by
RNANS.
Among specific recommendations, the
RNANS brief on health care for aged
persons recommended that the Nova
Scotia government:
. establish a crash program of health
assessment for the aged, through easily
accessible clinics, organized transporta-
tion, and traveling teams, if necessary;
. initiate an insured home care program
to coordinate existing health facilities and
services in the community, and to include
new services, such as homemaker servi-
ces, where they are not available;
. to use the knowledge and skills of
selected professional nurses by expanding
their role to include primary and conti-
nuing assessment of the health needs of
the aged, with appropriate referrals to and
consultation with other members of the
health team; and
. discourage the practice of unnecessa-
rily relegating aged persons to psychia-
tric care, but rather arrange for careful
assessment and accomodal1on in a plea-
sant environment appropriate to the needs
and wishes of the aged and their families.

Every Nurse Must Become Involved
In Research In Nursin

Ottmva, ant. - Research must be every
nurse's business if nursing is to collabo-
rate with, rather than continue to be
dependent on, other health professions,
according to Professor Margaret Cahoon
of the faculty of nursing, University of
Toronto.
She was addressing the 11 th annual
nurses' institute on respiratory nursing
research and respiratory care in hospital
and at home, held on June II in
conjunction with the annual meeting of
the Canadian Tuberculosis and Respira-
tory Disease Association.
"To have all nurses involved in re-
search in nursing does not suggest that all
nurses become investigators," said Dr.
Cahoon, ,:'but they all have a role in
research.
She identified five aspects of that role:
. being supportive to patients who are
research subjects and to investigators
studying nursing problems;
. identifying and referring problems hav-
ing to do with discrepancies in care of
patients;
. guarding that ethics of nursing and
other research are consistent with the
ethics of nursing practice and patient care;
. interpreting research activities to other
nursing personnel; and
. appraising, as a consumer, research
findings and new knowledge, or new

applications of knowledge already
known.
Dr. Cahoon said that nursing is an
occupation, and nothing but good can
come of examining it; but that in Canada,
it is tragic that almost no nurses can
devote full time to research.
Howe.ve.r, she concluded, encouraJ!;ing
and realIstIc research goals are evolving.
These include: the shift of research focus
to the investigation of nursing problems,
the emergence of clinical studies in such
areas as respiratory care, the appointment
of nurses to research positions in selected
hospitals, and the probable development
of a Canadian council of nurse resear-
chers.

Seminar on Maternal Health
Updates Nurses' Concepts
Toronto, ant. - Nurses of all ages filled
the auditorium at Humber College of
Applied Arts and Technology 6 June for a
one-day seminar on "Today's Nurse,
Today's Parent." At least one baby could
be heard in the audience.
The seminar, sponsored by Humber's
health sciences division, was the second
such seminar held to bring graduate
nurses and students up-to-date in the
latest concepts of maternal care. A
postdiploma program for registered
nurses is offered at the college to those
employed in a maternal-infant health
setting.
Donna Shields, a member of the
nursing faculty at the University of
Toronto, discussed the psychology of
childbearing - the normal emotional
changes that occur during and immedia-
tely after pregnancy. She said that "some
women identify strongly with the fetus
and have fun with it," whereas others
"never respond to and accept preg-
nancy. "
Because pregnancy is largely an intel-
lectual concept during the first trimester,
many women who have an abortiçJn in
this period experience no guilt feelings.
"Problems arise when [the woman]
realizes there really is a baby," ex-
plained Ms. Shields.
It is in the second trimester that the
pregnant woman starts to fantasize about
her baby. After birth, however, the
mother has to see the baby as an
individual separate from her and from her
fantasies of the child, the speaker said.
She said it is a myth that a woman
looks at her baby and immediately loves
it. "Many women do not love their babies
for a few days, weeks, or months,
particularly if they are new mothers."
This is a shock to them and can cause
self-doubt, anxiety, guilt, and depression.
added Ms. Shields. She told her audience
that these women need a lot of support
from the nurse.
Ms. Shields also spoke about mood
AUGUST 1974

swings - a common response to preg-
nancy. She mentioned the pattern of
introversion and passivity, which begins
around the end of the first trimester and
peaks around the seventh month.
During this time, "the woman soaks in
affection like a sponge; this is a period for
her to recharge her batteries." If she does
not do this, it is hard for her to give out
affection when the child is born, she said.
She emphasized that support from the
husband is extremely important at this
time. The nurse can explain this to him
and, if necessary, to the children.
The nurses present were told that they
should not be frightened when pregnant
women tell them many personal stories.
"Nurses tend to put the damper on
patients. We don't like them saying
certain things." Nurses must let the
woman talk to them about her feelings
and must support her, Ms. Shields said.
"Teaching the pregnant woman helps
to strengthen her ego. It is very important
to give her knowledge so she feels she can
cope with the situation. But give her
knowledge like a wise sister:' she
concluded.
Another seminar speaker was Peter
Butler, a sociology professor at Dalhousie
University in Halifax. In his talk on "The
Changing Family and its Impact on
Childbearing," he questioned whether
the reduction in the size of the family will
ultimately result in the social legitimiza-
tion of childlessness and whether deci-
sions relating to procreation will become
subject to public control.
In the relative isolation of urban house-
holds, it has become' 'burdening psycho-
logically to produce happy children," Dr.
Butler said. He noted that studies in the
past five years have shown that the
presence of children, not the number of
children, is related to dissatisfaction in
marriage. "Parenthood makes demands
that most couples are unprepared to
meet," he said.

Human Needs of Chronic Patients
Must Be Met First, Nurses Told
Otlawa, Onto - A patient feels abando-
ned by the physician and rejected by the
whole team unless he is acutely ill, Dr.
Arthur Scott told the 150 registrants at the
nursing institute on respiratory nursing
research and respiratory care on June II.
These feelings are evident among pa-
tients with chronic respiratory problems
who were visited at home during a recent
study, said Dr. Scott. who is associate
professor, department of anesthesia, Uni-
versity of Toronto faculty of medicine.
Dr. Scott asked: "Who should visit the
chronically ill patient? Were the whole
health team to go, there would scarcely be
room for all their cars in a patient's
driveway.
"One person could do ninety percent
of what is needed by a patient and could
AUGUST 1974

1 OOth Anniversary Of Canadian Nursing Education

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A hundred years of nursing education were recognized during the week of June 24,
when graduates from the Mack school of nursing in S\. Catharines, Ontario,
celebrated the centennial anniversary of the school's founding.
Reflecting the change in the uniforms of student nurses at the Mack school over
the years are first-year nursing students at Niagara College's Mack Centre of
nursing education. Left to right, Irene Roorda in the present-day nursing student's
uniform, Louise Visentin in the uniform worn from 1967-69 at the Mack Training
School for Nurses, and Julie Watson and Nancy Spero in uniforms of the late 180ûs.

make a referral for th"e remammg ten
percent," he said. Dr. Scott went on to
describe that person, two examples being
the Victorian Order nurse and the public
health nurse.
The home visitor must be a generalis\.
He or she needs to be a friend; to have
basic nursing skills; to be a physiothera-
pist, a respiratory technologist, a teacher,
a social worker, a physician: and to keep
an open line of communication.
Such an approach means looking after
human needs first, he said, then going on
to the special needs of the individual and
to assuring him that help is at hand.

Regi
tered nur
cs,
your community needs
the benefit of yoU!
skills and experience,
Voluntèer now to
leach 51. John Ambulance home
nur
ing and child care Courses.
Contact your Provincial Headquarters,
St. Joha Ambulance.

Health Professionals Discuss
Prevention Of Diabetic Problems
Toronto. Onto - Nurses, dietitians. so-
cial workers, podiatrists, and doctors
from across Canada attended a workshop
on "Individuals with Diabetes - as peo-
ple and patients," held at Geneva Park
Conference Center in Orillia, Ont. 12-
14 June.
The professional health workers sec-
tion of the Canadian Diabetic Association
wæ, formed in 1973. Their common
purpose is team education of diabetics to
prevent the heart, circulatory, and sight
complications associated with the dis"
ease.
The purpose of the workshop in June
was the "education of the educators."
Physicians, who have referred patients to
the tri-hospital diabetic education center
at Women's College Hospital. Toronto,
estimate that 1.560 hospital-days (costing
taxpayers around $100 per day) have been
saved in the past year by teaching
preventive health care techniques to 411
diabetics who attended their 4-day educa-
tion programs in the same time period. r!;J
THE CANADIAN NUHSE 13

KeelJS
him 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.

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Saves
YOLI tillle
Pampers construction
helps prevent moisture
from soaking through
and soiling linens. As a
result of this superior
containment, shirts,
sheets, blankets and
hed pads don't have to
hc 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.

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rROCTER . C:;AWIIL[ CAR.3ZZ

Report
of
CNA Executive Director
to
the Annual Meeting and Convention
Canadian Nurses' Association

June 1974

Helen K. Mussallem

Ouring the past 10 years, I have been employed fulI-time as
executive director by the Canadian Nurses' Association. In this
period. the staff of CNA House ha'i completed an impressive
volume of work on your behalf. As your executive director, it
has been necessary for me to travel to most parts of Canada
many times and also to many different countries beyond
Canada. This has given me an opportunity to observe the
problems and progress of professional nursing, not only in
Canada, but in several other parts of the world.
At this time, I propose to do two things: I would like to
review the highlights of our work since we last met. And. at
the same time, I would like to make some general observations
- and perhaps raise a fe\'. questions - on a number of
situations that I believe will intluence the future of professional
nursing in Canada and the future of this association.
One of the immutable rules of economics that most of us
ledrn is that time is money, and one can't spend the same dollar
twice and remain solvent. Similarly, it is not possible to use
the same hour twice and remain healthy. Since becoming your
executive director, one of my primary responsibilities has been
to manage the time of the staff and money of the association
with these rules in mind so that maximum results are obtained
from the use of our resources.
One of the tas"-s completed by the staff in 1974 was a
thorough analysis of the programs and budgeh of the CNA. In
compiling this information. we examined "person-days." as
well as costs. required for each of the many activities of the
CI'oA staff. I won't visit this document on you - it is more than
AUGUST 1974

100 pages in length - but I shalI use some of the information
we obtained in this study for ilIustration purposes.
Exclusive of the 8 persons employed full-time In the testing
service. the staff at CNA House now numbers 43. the same as in
IY66. Each of these people has a normal total of about 220
wor"-ing days each year for CNA work. This makes a total of
about 11,220 "person-days" available per year. although.
inevitably, many people wor"- more than this number of days.
The total time of the staff is divided among the main functions
carried out at CNA House. as follows:

. Secretariat - that is. board of directors. member-
ship, and corporate affairs
. Adl'anceme1/1 of professioll - that is. research,
advisory. library. archives 17.Y"
. Sen'ice (0 memhers - I shall mention this in
two parts:
Professional journah . .
Education ...
. Professional and public cnmmllnications - that
is. information, promotion. national health
agencies. government and international agencies.
· Administration - that includes personnel ad-
ministration, finance and control. procurement.
and mar"-eting .. . . . .
. Opalltions - including, plant and equipment.
office services. purchasing and stores. sales.
and shipping .............. ...........

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THE CANADIAN NURSE 15
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These estimates are made in round figures because effective
use of available time results in some people working at
different times on several different jobs. All of these people
are, however, fully employed. Inevitably, new problems and
projects will continue to arise. And since the present staff is
already fully employed, the only way in which we can take on
new projects is either to stop work on some of the existing
projects, or to add more staff. I'm sure you are all familiar with
that particular type of squeeze.
New projects, however, are inevitable in a dynamic
organization where the status quo will not suffice for the
changing needs of tomorrow. Change always brings new
situations, and some of these situations result in problems, or
- as I prefer to call them - challenges. It is important, I
believe, to realize that CNA is not alone in the challenges it
faces today; every organization and association in the western
world faces similar problems.
The CNA is neither unique nor unduly beset by difficulties; in
fact, as a professional association, we have more reason for
16 THE CANADIAN NURSE

optimism than most. This does not mean that we can safely
assume that the future will continue to be much like the past
and that we can make our plans accordingly. Normal
short-term and long-range planning requires us to attempt to
assess the needs of the future and to prepare to meet these
needs. The changes that occur in CNA should not be forced on
us by expediency; they should not "just happen," but should
be planned.
It is against this background that I shall raise a few questions
as I proceed with this review.

,.

MEMBERSHIP
The first of these questions concerns the one crucial element
in any association - its membership. CNA membership now
exceeds 97,000. That is an increase of about 50% over the
64,000 of 1961. At the present rate of growth, the total CNA
membership will pass the 100,000 mark within the next year or
so.
We also have in Canada about 32,000 registered nurses who
are practicing but are not CNA members.
So, my first question is: in 10 years' time, what will be the
ratio of registered, practicing nurses who are CNA members to
those who are not? Will it be greater or less? Will CNA be a
cohesive organization, representing all Canadian registered
nurses, or will it have become a federation of voluntary groups
representing a minority of practicing nurses? It is important
that those of us who are members of CNA ask what we should
or could be doing to have all registered, practicing nurses
represented by a national organization.

Liaison
One continuing responsibility of the CNA is that of
maintaining liaison and two-way communications with various
organizations that share mutual interests or common objectives
with CNA. Because the field of health in which the CNA
functions is so broad, it follows, inevitably, that the
association shares some common interests with many
organizations. Communication with these groups is both
important and time-consuming.
One achievement of the past year was the report of the
working party on liaison with the CNA, which provided
recommendations and guidelines for CNA work of this nature.
It is a subject, however, that merits continuing review in
relation to the time-effectiveness of the staff organization.
The following brief tabulation will provide some indication
of the scope of CNA work in this area, which led to the study
and recommendations by the working party.
The CNA now maintains liaison of some form with a total of
more than 100 different agencies, associations, or
governmental organizations.
I won't attempt to name these agencies or individuals, but
.they include: 20 different areas within Health and Welfare
Canada; 18 other government departments; 9 national nurses'
AUGUST 1974

associations and groups exclusive of provincial associations,
such as neurological and cardiovascular nurses' associations;
10 national associations of other health professions. such as
dental and medical associations; 7 national health associations
and other agencies - for example. the Canadian Hospital
Association; 37 other national associations and agencies; 4
international groups; and 2 committees or programs jointly
sponsored by the CNA.
All these individuals, groups, or associations have
implications for nursing and all exercise some influence on
matters of health. The exchange of information with them is
vastly useful. But, be it casual or intensive, it represents a
heavy demand on staff time. The situation is not new. nor will
it ever be completely resolved.
The results of our work with some of these groups is
measurable and visible. With others, the work may be equally
valuable. but is less visible and measurable. We shall always
be faced with the questions: To what extent should CNA
resources be invested in liaison of this kind? In other words.
how far can we go and where do we stop?

Special I nterest Nurses
Within this broad spectrum of mutual interest groups are a
number of special situations I would like to mention. Among
the professional nurses who are members of CNA, there exists a
substantial number of specialized practitioners who. in fact,
constitute special interest groups. Typical of these groups are
operating room nurses, public health nurses, psychiatric and
other mental health nurses, and nurse midwives. This list is not
all-embracing, but it may be typical.
As health and medicine become more specialized. this
specialization will be reflected in nursing preferences and
activities. As times and conditions change, the question will
continue to arise: to what extent can the aspirations and
professional standards of these groups be advanced within the
CNA?
The working party on liaison made a number of
recommendations with respect to such nurses and the
dimensions of their participation in CNA affairs. The mutuality
of interests and the evolving nature of these interests will
require the enlightened attention of the CNA for many years to
come.

Diplana Nurse- Degree Nurse
Another area of continuing interest is that involving the
diploma nurse, the baccalaureate nurse, and the nurse with a
masters degree. Some years ago. the CNA established as a
desirable objective that one nurse in four should have a
university degree. The reasons for this objective were highly
laudable, but the extent of its realization has not been
spectacular. The ratio of degree to diploma nurse in 1973 was
about I in 12 and, although the number is increasing, the ratio
is somewhat tortoise-like in its forward progress.
AUGUST 1974

It may be desirable from time to time for the CNA to redefine
this objective: what is expected of the nurse with a diploma. a
baccalaureate. or a masters degree? And what should her role
be as a nurse-member of the health team? These are questions
of concern to all nurses. Can the CNA help to answer them by
defining levels of specialization and encouraging continuing
education within the profession?

Nursing Assistants
Nursing assistants represent another group within the health
team that has special implications for the CNA. There are now,
in Canada. some 60.000 nursing assistants, and the number
appears to be growing. They have recently taken steps to form
a national organization. The relationship between the nursing
assistants and some of the provincial professional associations
is already close. Some provincial associations provide
registration services to the assistants. The CNA testing service
provides examinations.
Should the CNA be moving toward closer liaison with
nursing assistants as a group? Professional nurses do, in fact,
work side by side with nursing assistants: but how good are our
communications with them and where are the lines of work
division and responsibility drawn? If these relationships have
become unclear, perhaps it is time to redefine and clarify them.

Students
Nursing students represent another group that I believe
should be high on the priority list for CNA attention.
There are, this year. about 27,000 nursing students in
Canada. Some of these students are now members of nursing
student organizations and these organizations provide a new
and useful conduit for liaison between students and the CNA.
These students are the professional nurses of the future - the
future officers of the provincial associations and the national
association. I do not believe we can overemphasize the
influence they will ultimately exercise on the profession.
How can CNA best develop lines of communication 'that will
stimulate the interest and participation of these student groups?
Recently, the association took a tentative step in this direction.
Queries were sent to all provincial associations requesting the
information that will be needed to communicate with these
students. We can profitably give some thought to where we
go from here and the value of this investment in the future.

Associations of Allied Professions
Now. let us look for a moment at the broader field. It has
been a traditional practice - and in some instances an
increasingly effective practice - of the CNA to maintain close
liaison with professional groups working in the health field.
A case in point is the joint committee of the Canadian
Hospital Association. the Canadian Medical Association, and
the Canadian Nurses' Association. CNA work with this
committee - which has an area of interest embracing the vast
THE CANADIAN NURSE 17
.

majority of practicing nurses - has been and continues to be
exceedingly valuable. But. as mentioned earlier, there are
many other allied professional groups with interests
overlapping those of the professional nurse. A short list would
include doctors, dietitians, dentists, pharmacists, and social
workers.
Perhaps we might also include here such groups as Victorian
Order of Nurses. Red Cross. and St. John Ambulance.
Somewhat further removed. but still within the orbit of nursing
interests. are the many societies. leagues. associations. and
foundations that devote their efforts to specific areas of health
threats such as cancer. heart. and multiple sclerosis.
All of these endeavors are eminently worthwhile. All are
relatp.d to the professional interests of nurses. But liaison with
these groups requires CNA time. and reduces the time and
resources available for other projects. We should continue to
evaluate the expenditure of CNA staff time in relation to
contributions to CNA objectives derived from this work.

Government Relations
With the trend toward the provision of health care costs from
the public purse - or the government - it is abundantly clear
that, regardless of cost, the CNA must maintain increasingly
close liaison with government and government health
agencies. On the policy level. the concern of governments with
health will influence the future nature and scope of
professional organizations such as the CNA. In some areas,
this is already evident. At the level of operations. the effect
will be equally acute.
The range of government interest in health matters - and
the organizations set up to deal with them - is already wide
and is increasing. As mentioned earlier. there are now a total
of 38 different individuals or groups within the federal
government concerned directly or indirectly with health and
nursing. They operate in a field of health where nurses can
contribute. Much of our work, and the result of much of our
work in these areas, is valuable but not readily visible to the
membership. How far can we or should we extend our
resources in this direction?

Consumers
Another element that has assumed importance with the
advent of tax-paid health care is the increasing interest of the
public - the ultimate consumer - in the directIon and
delivery of health services. We know the consumer is critical
of the direction and provision of health services - as indeed
the CNA is on occasion. We also know that health care is within
the legitimate interest range of the consumer, who ultimately
pays the bills. It is not unreasonable to assume that the
philosophy. objectives. and practice of professional nursing.
and more particularly the decisions and reasons for the
decisions, would be something of a mystery to the public.
To what extent can the CNA exercise self-regulation without
assuming at one time the conflicting roles of accused, judge,
18 THE CANADIAN NURSE

and jury? Does this situation justify the participation of one or
more members of the public in our affairs? If so. how could
this be done in a manner that would satisfy the interests of
professional nursing and the public?

International
I have mentioned a number of areas that seem to be pertinent
on the Canadian front. Offshore. there are other developing
situations that will require attention and decision.
Canadian nurses. of course, have a commitment to the
International Council of Nurses. I believe the CNA discharges
its responsibilities in this area quite effectively. The World
Health Organization is also supported by Canada. The
Commonwealth Nurses Federation is another organization in
which the CNA is involved and committed.
More recently, Canada has joined the Pan American Health
Organization. This is a health organization involved with the
countries of North and South America and the Caribbean.
Canada is in a unique position to contribute technology and
experience to improved health services in these countries, and
the Canadian government has indicated it will cooperate to
provide it. These projects will have a nursing content.
Will this content be provided through the CNA - or will the
flag be carried by others? What are CNA responsibilities and
capabilities in this area? Perhaps we need to redefine them in
the light of the extent and limits of our resources.
Having talked at some length on the subject of liaison, I
would now like to turn to a few more tangible matters.

COUNTDOWN
In February of this year the board of directors decided that
the publication Countdown would be given a new look in an
effort to reduce production costs. For the past seven years,
Countdown has brought together. for the first time in history,
statistical information about nurses, where they are, what they
are doing, and what trends are evident in the preparation and
occupation of nurses. The CNA was the first member of the
Canadian health professions to assemble such statistics.
Clearly. Countdown is a worthwhile project. On the other
hand, gathering, collating. interpreting the data. and then
publishing it required a sizeable investment of CNA resources.
Negotiations are now in progress with St:uistics Canada for
the purpose of transferring the collection of Canadian nursing
statistics to this agency.

LIBRARY
The library has grown from a few bookshelves in CNA
headquarters into its present status as the only truly national
nursing library in Canada.
Obviously, the library represents a truly worthwhile project,
with its excellent collection of books, periodicals, nursing
studies, and other information of vital interest to the
AUGUST 1974

profession. There can be no doubt about its value to the
profession in Canada. And, yet, perhaps we should be asking
ourselves a number of questions:
. Are its services being used to maximum advantage by the
largest possible number of nurses?
. What can be done to make these services more easily
accessible?

PROFESSIONAL MAGAZINES
Another of the demanding duties of the CNA staff is the
preparation, editing, and publication of the two monthly
professional magazines, The Canadian Nurse and L' in-
firmière canadienne. The historical roots of these publi-
cations predate the CNA itself - in fact, they go back to
1905, when the first such publication was produced by a
part-time editor for a commercial firm. It was bought by the
predecessor of the CNA in 1916 for $2,000, with $500 down
and the rest in pledges.
Over the years, the control and circulation were modified
several times to satisfy changing circumstances, but it was not
until the late 1950s that it became a truly bilingual publishing
project, with all members of the CNA receiving it in their
language of preference as part of their membership in the CNA.
The combined circulation of the magazines is more than
100,000, an extremely high figure among professional
magazines. I might add also that we have to process about
50,000 changes of address in a year.
I'm a prejudiced witness, of course, but I believe these
publications have served their readers - and the association
- extremely well. The cost of these magazines has remained
relatively static since 1966 but, unfortunately, as with most
other things, the time and cost of producing them are rising. It
is also significant that many of the provincial associations now
have their own publications.
Criticism we have had, and this is normal and desirable with
such divergent reader tastes. So, as the poets said long ago,
"The old order changeth and giveth place to new." It is
appropriate that, in the changing order of things, these
publications should be reevaluated periodically, and the CNA is
now in the process of such a reevaluation.
As a matter of practical use of time and funds, it has become
desirable to ask such questions as: How can these publications
serve the objectives of the association? Should the CNA
continue to produce its own professional magazines? If so,
should the project be continued in its present form and content?
These are questions that a committee, appointed by the board
of directors, is now examining, but they will require
reexamination from time to time in the years ahead.

ACCREDITATION
The question of a national accreditation system for
educational establishments teaching student nurses is one that
will not be solved easily or quickly, and has been the subject of
a CNA study by the exploratory committee on accreditation. As
AUGUST 1974

a consequence, the board has recommended that the CNA
develop optimum standards for nursing education programs in
this country.
It is true that provincial standards are established and
accepted, but these standards cannot establish uniformity of
quality in our graduates: nor do they provide an assured basis
for the portability of professional skills throughout our IO
provinces. We know that at the discussion stage within federal
government circles is the concept of a national body to act as
coordinator of accreditation in the health field. To the extent
that this involves professional nurses - as it surely will - it
will become an area of activity requiring periodic examination
and decision by the CNA..

LICENCE RENEWAL
The concept of continuing education as a prerequisite for
renewal of licence is likely to become urgent in the future.
Consideration of the two is made necessary by rapid advances
of knowledge and technology in health and, as a consequence,
in the profession of nursing. It is just a matter of time until
practicing, professional nurses will be required at intervals to
submit to some form of evaluation of their contemporary
nursing knowledge.
This is another area in which the CNA could provide
leadership. What provisions should we be making to give the
profession guidance on this subject. as well as on certification,
specialization. definition of roles and titles. and such matters?

PREPARATION OF TEACHERS
In its lifetime, CNA has devoted much time, effort. and study
to improve the process of preparing nurses for practice. The
big battle - to secure for the profession education rather than
training - appears to be won. but this development,
progressive though it is. brings new problems in its wake.
What has not yet been resolved is a satisfactory method of
preparing and providing the teachers who will educate 'itudent
nurses. What. if anything. should the OIA do about this
situation?

CONCLUSION
These are a few of the questions that are legitimate concerns
of a national association such as CNA. There is much that can
and should be done. The underlying quest!,," is: Will it be
done? The answers we arrive at today will determine the nature
of your association tomorrow.
Make no mistake about it. CNA does have a future. Ten years
from now, this association. stronger than ever, will be meeting
as we are meeting here today. What we do in the interval will
largely determine what they can do then. The direction is up.
Our role is to keep it that way. <;;

THE CANADIAN NURSE 19

Another annual meeting and convention
of the 97,000- member Canadian Nurses'
Association is now history, but some
issues raised in Winnipeg during the June
1974 meeting will require considerable
study before they can be settled.
The 1.200 nurses attending the meeting
June 16-2) in the Manitoba Centennial
Centre Concert Hall were treated to a full
program of CNA business, panel discus-
sions, and multi sessions devoted to the
theme "Nursing and Health." A ) 5-
minute physical fitness appraisal test was
available throughout the week. and a
student-day program in the middle of the
week was successfully staged by Mani-
toba student nurses.
The Manitoba Association of Regis-
tered Nurses made sure everyone had
an opportunity to enjoy the offerings of
multicultural Winnipeg. which is celebra-
ting its centennial this year. A banquet,
tours of the city, a riverboat excursion.
and a folklorama festival of food. music,
and dancing were some of the well-
planned events held in the evenings for
CNA members. A museum of man and
nature, a planetarium, and beautiful gar-
dens within the Centennial Centre
complex invited exploration. Winnipeg's
consistently blue skies and perfect wea-
ther were an added bonus.
20 THE CANADIAN NURSE

An interdenominational church service
Sunday afternoon and festive opening
ceremonies the same evening lent a )ocal,
national, and international flavoring to
the proceedings. Representatives of the
City of Winnipeg, the Manitoba govern-
ment. the International Council of Nur-
ses, the World Health Organization, and
the American Nurses' Association were
on hand to bring their greetings to
Canadian nurses. A message of greeting
from Prime Minister Trudeau was read to
the nurses. The opening ceremonies
concluded on a light note, with the
performance of a delightful Molière
farce, The Ðoctnr in Spite of Himself. An
amateur group from Actors' Showcase
entertained the audience with a great deal
of spirit.
A reception given by the Manitoba
Provincial Staff Nurses' Council follow-
ed. The first evening of the convention
ended with the sound of spontaneous
singing and the joyful greeting of friends
from all comers of the country.

Down to business
It was down to business Monday
morning. CNA president Marguerite
Schumacher set the tone when she urged
members to make their opinions known.
"Not only is it your right to be here, but it

is your responsibility to become better
informed. to advise, and to play your part
in the decisions that will advance the
nursing profession. .,
In reviewing the objectives defined for
the 1972-74 biennium, Ms. Schumacher
said a major breakthrough was CNA'S
acceptance, in March 1973, as a sponsor
of the Canadian Council on Hospital
Accreditation. . 'This. . was the result
of eight years of representation," she
reminded CNA members.
One objective of the past biennium
was "to inform the general membership
of current issues having an impact on
nursing by using the library as a center
for information exchange, by publishing
information in the official journals.
and by preparing and distributing working
papers on nursing concerns." Ms Schu-
macher said that "because of the con-
stant growth in this area. a depart-
ment of information services has been
defined in the administrative structure
of CNA House. This department groups
together such activities as public relations,
the journals. and the publication of CNA
documents. ..
The president finished her address with
a highly original multimedia production.
Colored slides showing much of Canada's
(Report c01llinued vn page 22)
AUGUST 1974

'.,6 .

Conventioneers found lots to do in
Winnipeg. When they wanted to know
more about local attractions, they just
had to ask a straw-hatted representative
of the Manitoba Association of Registered
N"....:?<.

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nursing. . ." could be what CNA's new
president, Huguette Labelle, is saying to
the reporter who interviewed her on the
final day of the convention.

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AUGUST 1974

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Members on this lively panel discussed
"changing work relationships." From left
to right are Horace Krever, faculty of law,
University of Western Ontario; Alice
Baumgart, panel chairman; Maria Gomori,
director of the social service department
at St. Boniface General Hospital,
Matlitoba; atld Murray Katz, a Montreal
physician.

THE CANADIAN NURSE 21
..

(Report contmued from page 20)
scenic landscape, nurses at work in
various settings, music ranging from
Nova Scotia bagpipes to the popular
French-Canadian Mon Pays, and finally
the leaf and the lamp emblem of CNA
blended together.

Political awareness
The subject of "politics" surfaced at
various times, beginning with Tuesday
morning's panel discussion on "changing
work relationships." Murray Katz, a
young Montreal physician, said nurses
have to be more politically and economi-
cally aware. He told the nurses that they
do not know how to lobby and that to do
so they must understand how government
works.
Dr. Katz, who said he has always been
in a salaried position, spends much of his
time as a journalist, a consultant to
governments, and a representative for
various professional groups. He was
critical of groups who submit naive briefs
to government and who consider it
"unprofessional" to lobby. "If nurses
are not free to go into a community and
create practice setups they want, it is
because they have not convinced those
who are active at the constituency level,"
he said.
To illustrate the importance of political
activity, Dr. Katz compared physiothera-
pists and chiropractors. He said "physio-
therapists are locked up in hospitals,
receive small salaries. and are not allow-
ed to prescribe, order x-rays or tests. or
see anyone except on referral." On the
other hand, "chiropractors can do what
they want, earn between $40,000 and
$60,000 a year, and are recognized as the
'doctor-physiotherapist.' ..
The difference between the two
groups, he explained, is that one has been
"nice," while the other got its degrees in
the provincial legislatures. Dr. Katz indi-
cated, however, that physiotherapists are
becoming politically active. He recently
wrote a book on lobbying for them.
22 THE CANADIAN NURSE

Speaking with reporters after the panel
discussion, Dr. Katz said he had attended
a school for chiropractors under an
assumed name. He found that these
students learned that people have unmet
needs, that doctors do not communicate
and give too many drugs, and that
patients want to be touched. Thus, chiro-
practors know how to make people feel
better, he said. He also remarked that
.. doctors refer patients to chiropractors to
gel them [patients] off their back."
Although Dr. Katz was cntlclzed by a
sucial worker on the panel for' 'playing
his own little power game," and by some
members of the audience, there was loud
applause when he said the following: If
God had been a nurse when Moses,
leading the Jewish people out of Egypt,
asked God to part the waters, God would
have called for a three-year environmen-
tal impact study instead.
A member of Tuesday afternoon's
panel on " changing structures in health
services" warned nurses that as profes-
sionals they must work with other groups
involved in providing health services -
including politicians.
Lloyd Axworthy, a member of the
Manitoba Legislative Assembly and di-
rector of the Institute of Urban Studies at
the University of Winnipeg, said that
professionals should work with politi-
cians at the local level and with members
of the community. He reminded his
audience that a person's civic duty was
not fulfilled just by turning up to vote
every four years.
During a panel on "personal attitudes
and professional image," Nicole Du
Mouchel told nurses, "Don't waste your
time with technocrats. Go to the top - to
the minister." Ms. Du Mouchel, execu-
tive director and secretary registrar of the
35,OOO-member Order of Nurses of Que-
bec. was speaking about the way her
association faced a "life and death"
situation in 1971 when the Quebec
government introduced a bill to reorgan-
ize health services. In Quebec, she

explained, the nurses' association has
worked closely with representatives of the
state to make them clearly understand the
role of nurses in the Quebec health
system.
Ms. Du Mouchel said, "Nurses must
be in constant communication with those
in government who pass bills." She
added that it is not enough to react to a
crisis. "Our contact needs to be broad,"
she explained, as other issues, such as the
environment and language, "all affect
health and nursing in Quebec and on the
national scene. ' ,
Good nurse candidates must also be
found to run for public office, said Ms.
Du Mouchel. "We must persuade them to
run, help them, and support them
afterward. "

Resolutions ruled out of order
Some heated discussion took place
during the general session and coffee
break Friday morning, when two resolu-
tions contained in the report of the
resolutions committee were ruled out of
order. One of these concerned Amnesty
International, a British-based nonpolitical
organization whose primary objectives,
the resolution stated, are to release
"persons imprisoned solely for political
or religious beliefs who have not used or
advocated the use of violence" and to
oppose the use of "torture or cruel,
inhuman or degrading punishment. "
This resolution, submitted by Lynne
McLure and Greer Black, Manitoba,
called on CNA to support the objectives of
Amnesty International and objectives
directed toward achieving them, and to
consider proposing a resolution in favor
of this organization at the next Congress
of the International Council of Nurses.
The British Columbia delegation ques-
tioned whether this resolution came with-
in the objects of CNA, one of which is to
interpret nursing at the national and
international level. CNA legal counsel
George Hynna, who was acting as
(Report continued on page 28)
AUGUST 1974

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Delegates had a chance to meet new
people and to renew friendships at the
reception following Sunday's opening
ceremonies.

The Paddlewheel Queen, carrying a cargo
of happy nurses, is piloted by Eleanor
Mitchell, Ontario.

Rachel Bureau, right, president of the
Order of Nurses of Quebec, talks to two
other members of the CNA board of
directors, Glenna Rowsell and Greer
Black. Mr. Black is president of the
Manitoba Association of Registered
Nurses.

,

AUGUST 1974

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THE CANADIAN NURSE 23
..

Resolutions Passed at

CNA Annual Meeting and Convention

Whereas the fitness program being conducted at the
convention has sensitized nurses to the need for more
knowledge about their own life-style and level of
physical fitness;
Be it resolved that CNA explore ways and means of
developing a plan of action to sensitize or raise the level
of awareness of nurses to life-styles conducive to
optimum health.

Whereas different curricula now prevail across Canada
for nurses being prepared for an expanded role; and
Whereas some registered nurses are performing medical
functions, particularly in physicians' offices, without
benefit of appropriate formal education; and
Whereas there is no protection for the public or the nurse
practicing in this expanded role;
Be it resolved that CNA take leadership in establishing
guidelines for standards for preparation, continuing
competence to practice, responsibilities, legal protection
and remuneration for the nurse in an expanded role; and
Be it further resolved that CNA take whatever action it
deems necessary to protect the public and the nurse. and
discuss these concerns with other appropriate organiza-
tions such as the Canadian Medical Association.

Whereas it is important for the nurse to keep abreast of
health needs of society; and
Whereas there are constant changes in technological and
social sciences;
Be it resolved that the CNA board of directors explore
the possibility of developing guidelines for standards of
ongoing education as a requirement for
registration/I icensure.

Whereas there is a significant increase in the number of
young disabled and aged persons; and
Whereas there is presently a lack of postbasic educa-
tional programs in Canada for nurses interested in or
involved in the care of geriatric or long-term patients;
and
Whereas there is a limited number of resource personnel
available within the provinces for such programs;
Be it resolved that the CNA board of directors be urged
to encourage the development of programs for registered
nurses in geriatric and long-term care in some Canadian
colleges and universities.

Whereas it is an accepted fact that there is a great need to
increase research in health care and health care delivery;
Be it resolved that until such time as there are sufficient
individuals with research skills. the department of

24 THE CANADIAN NURSE

national health and welfare be urged to engage sufficient
qualified staff to provide, upon request, adequate
multidisciplinary consultative services to persons en-
gaged in the development and implementation of
health-related research projects.

Whereas the nursing research committee believes that
the Nursing Studies Index is one of the most effective
stimuli to the development of interest and participation in
nursing research in Canada;
Be it resolved that the CNA directors give priority to
continuing publication of the Nursing Studies Index.

Whereas an annual meeting and convention of the CNA
must be held every two years and there is no stipulation
as to the length of the convention; and
Whereas increasing membership leads to attendance of a
larger number of voting delegates at increasing costs;
Be it resolved that the CNA board of directors be asked
to consider that the annual meeting and convention held
biennially not exceed three days. including business,
educational. and professional sessions.

Whereas today's trends do not support the practice of
categorizing individuals according to sex and/or marital
status;
Be it resolved that the Canadian Nurses' Association
adopt the practice, to the extent possible, of using the
given name and surname only for all identification
purposes.

Be it resolved that the present fee structure be
discontinued as of the annual meeting of the CNA in
1975; and
Be it further resolved that an ad hoc committee be
established to investigate alternative fee structures under
the following conditions:

a. The ad hoc committee submit proposals for alterna-
tive fee structures to the October-November 1974
board of directors meeting.
b. The board of directors consider the proposals at that
meeting and make recommendations re fee structure
and fee rate for circulation to the provincial associa-
tions no later than December I. 1974.
c. The provincial associations be requested to respond to
these recommendations by February I, 1975.
d. The board of directors propose a resolution to change
the fee structure and rate to be voted upon at the 1975
annual meeting of the association in accordance with
Bylaw No.6.

AUGUST 1974

A well-deserved coffee break - without
the coffee.

Florence Martyn,.kJj, never misses a CNA
convention! NolV 80 years old, she came
to the Winnipeg convention from New
York City. A graduate of the Royal
Alexandra Hospital in Edmonton, she
chats on the deck of the Paddlewheel
Queen with Heather Latter, who is a
student nurse at the Royal Alexandra.

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AUGUST 1974

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THE CANADI ,'NURSE

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Aboard the Paddle wheel Queen, sailing
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Everyone enjoyed the "folklorama,"
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delicious cigars - uh, I mean sausages."

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parliamentarian, agreed that this resolu-
tion did not come within the stated objects
of CNA.
Also ruled out of order wa!> a resolution
a!.king CNA to "take all nece!.sary mea-
sures so that Bill C-256 [ to amend the
Criminal Code to protect hospital and
medical staff who refuse to participate in
therapeutic abortions I is sanctioned by
the incoming parliament. "
This resolution, submitted by Made-
leine Morgan and Francine Bruneau,
Quebec, explained that "nurses, who, for
reasons of conscience, refu!.e to take part
in abortions, are facing serious prejudice
(Hamilton-Ajax)" and that legislation in
several other countries allows nurses to
"opt out" of a!.sisting at abortions for
rea!>ons of con!>cience.
It was pointed out by Wendy Gerhard,
Ontario, that CNA has a policy statement
encompassing the intent of this resolu-
tion. At the last CNA biennial convention,
delegates passed a resolution "that CNA
take the necessary steps to encourage the
inclusion in the Code of Ethics of each
province the following statement: Each
nurse has the right to refrain from
participating in any procedure that
conflicts with her moral or religious
convictions, within legal limits, without
prejudice. ..
Ms. Sl.:humacher, who chaired this ses-
siun. ruled the re!>olution out of order
becau!>e uf this previously passed statement.
Anotl]er comment in relation to the
abortion resolution wa!> made by Betty
28 THE CANADIAN NURSE

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Wilton. Newfoundland. She said, "There
are times when abortion is essential for
the life of the patient." Referring to the
danger that women in small centers can
face. she added, "We must make sure the
patient is protected. "
Nine of the 14 resolutions submitted
were approved by voting delegates. (The
approved resolution!> are on page 24.)

Tribute paid to three nurses
A speciall.:eremony was held during the
convention to honor three outstanding
Canadian nurses: E.A. Electa MacLen-
nan, Nova Scotia; Alice Girard, Quebec;
and Lyle M. Creelman, British Colum-
bia. Marguerite Schumacher prai!>ed these
nurses for their contributions to the
advancement of the nur!>ing profession
and to the improvement in health care
services. They were presented with
jeweled pins in the shape of CNA'S
emblem - the leaf and the lamp.
M!>. MacLennan is a former director of
the school of nursing at Dalhousie Uni-
versity in Halifax and a former president
of CNA. She retired from her position at
Dalhousie in 1972, after more than 20
years as director.
Dr. Girard, the first woman to be
appointed a dean at the University of
Montreal. WdS dean of the faculty of
nursing frum 1962 to 1973. She is a past
pre!>idem of CNA and ICN, and was
recently electl:d president of the Victorian
Order of Nurses for Canada. She was the
only woman named to the Royal
Commission on Health Services in 1961.

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Dr. Creelman, who has retired to her
home on Boen Island. B.C., was born
and educated in Nova Scotia. She was the
chief nurse with the United Nations Relief
and Rehabilitation Administration in
Germany from 1945 to 1946. and joined
the World Health Organization in 1949.
She participated in a national study of
public health nursing for the Canadian
Public Health Association, and is a
former director of nursing services with
the Metropolitan Health Committee in
Vancouver.
These nurses were selected from names
submitted by provincial nurses' associa-
tions.

Gaelic greeting
Before CNA members left the 37th
annual meeting and convention in Winni-
peg, they were invited to attend the 1976
biennium in Halifax, Nova Scotia. Sister
Marie Barbara. president of the Register-
ed Nurses' Association of Nova Scotia.
gave the nurses the traditional Nova
Scotian greeting to all who come to this
province by the sea: Ciad MiLe FaiLre.
Translated, this Gaelic message means "a
hundred thousand welcomes. "
The nurses of Prince Edward Island
will also be helping to entertain those who
attend the Halifax convention. After two
conventions in the west, it's time to look
toward the Maritimes - well known,
too, for their hospitality.

AUGUST 1974

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(Report clmtinued from puge 221
parliamentarian, agreed that this resolu-
tion did not come within the stated objects
OfCNA.
Also ruled out of order was a resolution
asking CNA to "take all necessary mea-
sures so that Bill C-256 [ to amend the
Criminal Code to protect hospital and
medical staff who refuse to participate in
therapeutic abortions I is sanctioned by
the incoming parliament. "
This resolution, submitted by Made-
leine Morgan and Francine Bruneau,
Quebec, explained that "nurses, who, for
reasons of conscience, refuse to take part
in abortions, are facing serious prejudice
(Hamilton-Ajax)" and that legislation in
several other countries allows nurses to
"opt out" of assisting at abortions for
reasons of conscience.
It was pointed out by Wendy Gerhard,
Ontario, that CNA has a policy statement
encompassing the intent of this resolu-
tion. At the last CNA biennial convention,
delegates passed a resolution "that CNA
take the necessary steps to encourage the
inclusion in the Code of Ethics of each
province the following statement: Each
nurse has the right to refrain from
participating In any procedure that
conflicts with her moral or religious
convictions, within legal limits, without
prejudice. "
Ms. S
humacher, who chaired this ses-
sion, ruled the resolution out of order
because of this previously passed statement.
Anotl]er comment in relation to the
abortion resolution was made by Betty
28 THE CANADIAN NURSE

Wilton, Newfoundland.

are times when abortion
the life of the patient."
danger that women in Sl
face, she added, "We mu
patient is protected. "
Nine of the 14 resol
were approved by voting
approved resolutions are (

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Tribute paid to three nurs

A special ceremony w.
convention to honor th
Canadian nurses: E.A.
nan, Nova Scotia; Alice
and Lyle M. Creelman,
bia. Marguerite Schumac
nurses for their contri
advancement of the nu I
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servIces. They were
jeweled pInS In the s
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Ms. Maclennan is a h
the school of nursing at
versity in Halifax and a i
of CNA. She retired fron
Dalhousie in 1972, afte
years as director.
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'A.
appointed a dean at th. W,
Montreal, WdS dean of
nursing from 1962 to 19 "
president of CNA and ....
recently elected president (.)
Order of Nurses for Cana
only woman named
Commission on Health Se

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in a capsule

Woman achieves equality
Late last year, a young Alberta woman
was sentenced to prison for six months on
a conviction of drug trafficking. But the
magistrate told the woman he would have
imposed a longer term if she had been a
man.
Equality recently triumphed, however,
when the case was appealed by the
Crown. The Appeal Coun decided to
increase the sentence to a year.
This news was reponed in the March
1974 Bulletin, published by the Canadian
Criminology and Corrections Association.

Smoking and drug consumption
Do cigarette smokers differ from non-
smoker
in their consumption of medici-
nal drugs?
This question was the subject of a
report, entitled "Smoking and Drug
Consumption in White, Black, and Orien-
tal Men and Women," published in the
May 1974 American Journal of Public
Health. In this report, the authors - Carl
C. Seltzer, Gary D. Friedman. and A.B.
Siegelaub - presented the responses of
the 70,289 smokers and nonsmokers to a
self-administered questionnaire on the
ingestion of drugs.
The data given in this report were the
result of examinations performed in San
Francisco and Oakland, California, bet-
ween 1964 and 1968. With few excep-
tions, the survey showed that cigarette
smokers reported using more drugs than
their nonsmoking counterparts.
In their summary, the authors stated
that a larger pecentage of white and black
men and women (and to a lesser extent
oriental) smokers "report taking cough
medicine, aspirin-containing drugs, pain
medicine, prescription analgesics
(codeine, etc.). phenobarbital or barbitu-
rates, sleeping pills, tranquilizers. diure-
tics, hormones, iron or anemia medicine,
Benzedrine or Dexedrine, antibiotic
,
stomach or digestive medicine. and laxa-
tives and cathartics. ,.
On the other hand, a larger percentage
of nonsmokers took antihistamines and
asthma medicine. It is possible, the
authors commented. "that persons with
these conditions avoid smoking." They
also mentioned the possibility that the
increased use of cough medicine, antibio-
tics. and stomach medicine by smokers
could be related to a reported increased
incidence of respiratory infections and
higher prevalence of peptic ulcer disease
in those who smoke.
AUGUST 1974

. 'But most of the other excess use of
drugs by smokers Cdnnot be obviously
related to the effect of smoking," they
added.

Infection flowers in vases
Flowers can cheer up patient
. but the
blooms can abo cause postoperative
infection if they are left in vases.
This danger. which was discovered
during research by David Taplin and
Patricia Mertz in surgical wards and a
burn unit in two Florida hospItals. was
reported in The Lancet and Nursing
Times.
According to Nursing Times, the re-
searchers concluded that flower vases
should not he introduced into hospital
areas where there are su
ceptible or
dehilitated patients.
"Clean tap water. after three days in
the vases. was found to contain large
numbers of potentially pathogenic gram-

"

\ \ \ I
I

"'""
'-

negatIve bactena, whIch have been found
to be the most common cause of postop-
erative infection. Some are of human
origin, but the vast proportion are found
in wet sites in the hospital - sinks.
mops. taps. baths. soap dishes. and so
on. ..
It was the flower va'ie. however. that
was found to be the most important
reservoir of these bacteria. Approxima-
tely half the bacteria were resistant to
gentamicin and to other useful antibiotics,
the research showed.
.. Wilted flowers and putrid water from
the vases may he discarded or changed hy
nurses. nur
ing aide.... vi
iting relatives.
or by the patient himself. usually into the
han ibasin in the room or the adjoining
to\' .. e"pl,lIned the t....o n
searehers.
The\ added that flo.... er... h:1\ e no place io
unit...
uch .IS hum. inten...ivc carl'. imlI1u-
no,uppressive. neuro..urgical, kidney dial-
ysis. or neonatal.

I

,

I

----

/

"Now that you mention it, you're right - I
haven't seen her since the Winnipe
convention, either"

THE CANADIAN NURSE 29

CAnADA InSIDE OUT:

lu,ueying Ihe nalion'l nul,ilion

Imagine a job that offers the opportunity
to combine one's favorite form of recrea-
tion - traveling - with an interesting
and unusual nursing experience! That
opportunity was mine for over two years
as a member of the 1970-72 tield survey
team for Nutrition Canada. This was a
coast-to-coast expedition from Kelligrews
to Kitimat, from Port Alberni to Port au
Port, as we interviewed, examined, ques-
tioned. and quantified. Ultimately. we
gathered 28 million items of information
on over 19,000 Canadians. I
The first volume of this information
has now been published in Nutrition, A
National Priority, A Report by Nutrition
Canada to the Department of National
Health and Welfare. This will be fol-
lowed later by 12 regional reports and by
reports according to subject matter.
Stored in the data bank in Ottawa is a
veritable national feast of facts about the
health and nutrition of the Canadian
public - facts that can be used as the
basis for educational and regulatory pro-
grams to improve the well-being of the
Canadian consumer.

Why a nutrition survey?
In 1964 the Canadian Council on
Nutrition, supported by the Dominion
Council of Health, recommended that a
comprehensive nutrition survey be under-

The author, a graduate of SI. Michael's
Hospital school of nursing in Toronto. and
McGill University. Montreal. is presently on
the staff of St. Lawrence College. Brockvillc.
Ontario.

30 THE CANADIAN NURSE

An RN who traveled across the count
y with Nutrition Canada, the federal
government's project to study the nutritional status of the Canadian population,
tells about her experiences "on the road."

Lenore T. Kane, B.N.

taken. The reasons for this recommenda-
tion were many. Disturbing evidence had
been cropping up, showing that rickets
was still occurring in this country. Ab-
sence of Vitamin A stores in the liver was
being documented recurringly at autopsy,
raising the possibility that Canadians
might be lacking reserves of this essential
nutrient.
Spot checks on schoolchildren's
lunches indicated that segments of our
child population were not as well fed as
had been assumed. Also, there was a
growing need for information about
present-day eating habits. With increas-
ing urbanization and modern technology,
life-styles are changing and so. too. are
food styles.
Precooked foods, instant foods. snack
foods, mixes. and extenders - all con-
taining additives - are found in in-
creasing variety to meet the growing
demand. In addition. foods are being
shipped over greater distances and are
being stored for longer periods. These
foods require the use of additives.
Food additives serve many useful pur-
poses, and because of them our grocers'
shelves and our kitchen cupboards can
display a diversity of products unknown
to our grandparents. Obviously. increas-
ing amounts of these nonnutritive sub-
stances are being consumed by Cana-
dians. Yet no accurate record or analysis
of food intake of our population was in
existence before the nutrition survey.
For these reasons, and because nutri-
tional health is fundamental to the
maintenance of general health. the con-

cept of a national nutntIon survey was
supported by both federal and provincial
health officials.

Planning
Such a nation-wide survey had never
before been done in Canada In fact. no
survey of this scope has been attempted
on a national scale by any country; we
may serve as a pattern for others.
To provide a sound body of precise
infonnation. expert groups were assem-
bled. tapping the human resources of
universities and governments to plan the
study. These groups defined the scope of
the survey; the survey design; the popula-
tion sampling methods; the methods of
collecting dietary, clinical. dental, and
biochemical data; and the standards for
data interpretation.
Central facilities were established in
Ottawa for training. publicity, supply.
laboratory analysis. and data processing.

Survey design
The study was designed to estimate the
nutritional characteristics of the Canadian
population on the basis of: geographical
location (provincial and regional), type of
community (metropolitan. urban. or
rural). season. income level, age. sex,
and pregnancy. This was to be accomp-
lished by assessing clinical evidence,
anthropometric measurements. biochemi-
cal determinations of blood and urine.
and dietary intakes of nutrients. food
additives. nonnutrient substances. and
pesticide residues.
In September 1970. the field survey
AUGUST 1974

----

team. together with advance party per-
sonneL assembled in Ottawa to meet with
planners and instructors and to be ini-
tiated into the methods of the survey.

Field survey team
Lodged in the first of a "random
sampling of Canadian motels." we met
our "fellow travelers" - 20 individuals
from various parts of Canada. * For the
next two years we would share a unique
social, occupational. and nomadic adven-
ture. We were to staff the five compo-
nents of the mobile survey center: ad-
ministrative, dental. dietary. laboratory.
and medical.
Followmg the sampling design, house-
holds would be randomly 'ielected in the
designated enumeration areas. Occupants
would then be listed by Statistics Canada
enumerators and another random selec-
tion made. stratified to give us the desired
mix of participants.
Forty-eight persons were to partici pate
from each enumeration area. and the field
survey unit wa<; set up to accommodate

.. Ot the 20 people in the tield operation. only
four sta
ed with the project for the t....o yedf'.
of its duration. Of these four. three \\ere
nup,es. "Does thb say something tor the
stamina or flexibilit
of nup,es?" the author
asks.

AUGUST 1974

-

--.....

the same number in a day - 12
individuals in each of the four 2-hour
sessions. A total of 403 enumeration
areas was to be selected in the 10
provinces.
A French-speaking team was used in
Quebec and northern New Bruns\\ick.
:\1edical residents from several Quebec
hospitals served on this team in rotation
and carried out the medical assessment.
The two phases of the Quebec survey
were carried out consecutively. and it was
completed in six months.
Separate sampling designs \\ere plan-
ned for the Eskimos and for Indians on
reserves.

Advance party
Bet\\een the selection of the individu-
als and their arrival at the survey site. a
minor miracle had to be accomplished.
This was the work of the advance party -
four nun,es with public health experience.
Theirs was the challenging job of selling
the survey to the selected people and
ensuring their turnout. No participants -
no survey!
Traveling by car. one week ahead of
the main team. our advance-party nurse
would reach her target area for that day
and stop first at the local health unit. Her
blue car \\as distinctively marked in
orange and white "National Survey -

Nutrition Canada - Enquête :'IIationale."
Her conspicuousness was intentional. as
publicity \\as essential to gain public
support and cooperation. Radio, press.
and TV were all supplied with informa-
tion to promote the survey and acquaint
people \\ ith its purpose.
The good offices of the local health
unit were used to full ad\antage. A local
public health nurse. \\ ho \\ as enthusiastic
and well acquainted with the area. was a
great asset. as our advance-party nurse had
to find her way daily on yet another
unfamiliar city street or country road.
Sometimes the local health nurse was able
to accompany her on her "house calls."
When a commitment was accepted at a
home. an appointment was given. trans-
portation arrangements were completed.
and infonnation was obtained on food
buying. storage. and preparation.
We found that resronse rates \\ ere
highest among those living in rural areas
and lowest in metropolitan areas. We
found no consistent difference in response
rates related to income levels. 2

The traveling circus
Meanwhile. the field-survey team. like
a traveling circus. \\ æ. arriving in the area
visited one week previously by the
advance party. Forming a short parade of
four vehicles. we seldom went unnoticed.
THE CANAD N NURSE 31

Once we were followed to our destination
by an eager group of children who
thought we were a cooking school and
were hoping for samples of our wares!
Our caravan consisted of a 3 1 h-ton
truck (filled with the survey equipment>,
a minibus and a passenger car (filled
with team members). and a panel truck
(filled with the team'.. luggage and
expendable supplies).
The survey site was
elected in advance
by the regional director according to
specifications, if these could be met. Not
every rural (or metro) area that turned up
in our random selection had a large,
well-lighted gymnasium. From time to
time we found ourselves hauling our
equipment up to a room over a fire hall,
or to a room behind the furnace in a
church basement, or into the local health
unit to' 'occupy" its offices for the day.
On arrival, we sized up the available
area, allocated !>pace to the varif\u!.
components. unloaded our equipment.
and soon had the room transformed into a
maze of cubicles.
While finishing touches were made
by some, the driver left in the minibu!.
to collect the participants for the 1:00
32 THE CANADIAN NURSE

P.M. !>ession. and the remainder of the
team tried to find a nearby spot for lunch.

Inside the survey center
All would have returned by 1:00 P.M..
including the driver with his bu!>load of
participants. At the early afternoon ses-
sions we usually saw the younger children
and their mothers. Volunteer baby-sitters
were recruited locally to facilitate the
mother<;' attendance. As each person
arrived. he was registered by the recep-
tionist and taken to one of the five areas
he would visit within the next two hours.
Half the time was allotted for the
dietary interview. Here, patience and
persistence paid dividends. Aided by
portion-sized food and serving models,
the nutritionist elicited a detailed descrip-
tion of each and every item of food and
drink consumed on the previous day.
Next. she named specific foods which,
unknown to the participant, contained
additive!. or pesticide residues. She
helped him to recall the frequency of their
use over the past month. Each food was
recorded on a dietary form and then
tran!>cribed into a code number from
which nutrient intakes could be com-

.-

puted, using food composition tables.
Amu!.ing episodes in the life of a team
nutritionist came occasionally. ",hen she
tried to help a child sort out his candy
consumption following Halloween or an
adult hi!> food following a special occa-
sion marked by the enjoyment of snacks,
cocktails, and Chinese food!
Across the hall, enclosed within the
medical compound. other participants
underwent their health assessment. Dres-
sed in a blue disposable gown and paper
slippers, which they donned in our
portable changing rooms, they proceeded
to the anthropometrist. where they were
sized up in 14 different directions.
Again, skill and patience were needed
to obtain precise measurement!. on active
infants and toddlers. These body mea-
surements combined to give us ponderal
indices. growth rates, and body propor-
tions.
Next, the participant was !.een by one
of the two team nurses. Questions were
asked about illness. past or present, that
might in any way affect the selection or
digestion of foods. thus influencing nutri-
tional status or the biochemical paramet-
ers of nutritional statu... Specific informa-
AUGUST 1974

tion was recorded about smoking habits,
current medication, and about women' s
reproductive history.
A medical examination. designed to
detect abnormalities indicative of malnut-
rition. past or present, was next carried
out. Any positive findings were checked
by the team physician. When an urgent
health problem was found, the matter was
referred at once to the local public health
nurse and to the individual's family
doctor.
Our two laboratory technologists were
responsible for the collection of blood and
urine samples from each volunteer.
Hemoglobin and hematocrit levels of the
blood, and glucose and albumin in the
urine were checked on the spot. The
technologists centrifuged the blood and
obtained the serum. Serum and urine
specimens were then frozen in a portable
freezer, packed in dry ice (which we
made en route), and forwarded by air to
our central laboratory in Ottawa. There.
17 separate biochemical determinations
were performed on each individual's
specimens.
A dental examiner assessed and re-
corded details of each tooth, condition of
gums, accuracy of the bite, and the fit,
function. or need of dentures.
With good luck and good management.
the 12 participants would all complete the
entire process within the allotted two
hours. The driver. having collected the
next group. would be ready to take the
first ones home. With a one-hour break
for dinner. we continued until 10:00 P.M..
then repacked our possessions, stowed
them in the truck, and set off for our next
motel.

Impressions
They were long days. but there were
compensations. There were "travel
days," when the distance to be covered
precluded other work that day. but often
allowed time for sight-seeing along the
way. There were weekends when we
could ski in the Rockies or fish for giant
tuna in the Atlantic because we were
there! There were free mornings when we
could explore the local points of interest
- historical, or cultural. or scenic - or
nutritional!
Personally. Nutrition Canada gave me
a real sense of identification with Cana-
dians in all parts of this vast land. To have
AUGUST 1974

such a penetrating and pcrva
ive look at
one's country and one's fellow country-
men wa<; an exceptional and invaluable
experience.
It was a unique opportunity to hear
Canadians express their concerns about
health and health care. Because we were
"from away." as they say on The Island,
the people could use us as a sounding
board for their vexations and anxieties. It
made me acutely aware of deficiencies in
our health care system and gave me a
much wider perspective from which to
view my place in it as a nurse.
The inconsistencies of weather or
human nature. of mail delivery or of
admimstrative "snafus," which affected
us so acutely at the time. were a small
price to pay for the sensations stored in
my memory bank: the taste of bakeapple
jam or freshly smoked salmon; the quiet
and intense whiteness of the Rogers Pass
just before a snow slide; the greens of the
Cypress Hills in early spring; the bleak-
ness of the Hansen Lake road. deserted
except for a timber wolf and the dust; the

Ii; \ - 'I
II

old Métis with the scars of scrofula; or the
veteran of the Somme who shuffled in on
his wooden leg, being a good citizen still.
nearly 60 years later.
Am I tired of traveling? I think I'm
ready to unpack my suitcase - or did
someone mention Nutrition Nepal?

References
I. Nutrition, A National Priority, Report by
Nutrition Canada 10 the Department of
National Health and Welfare. Ottawa,
Information Canada. 1973.
2. Ibid.. p. 14.

Bibliography
Campbell, J. Alexander, and Sabry, Lachary.
Nutrition Canada. Nutrition Today
6:6: 17-22. Nov./Dee. 1971.
Pett. L.B. Signs of malnutrition in Canada.
Conad. Med. Ass. J. 63:1 :1-10. 1950.
Nutrition, a national priority. A report by
Nutrition Canada to the Department of
National Health and Welfare. Ottawa,
Information Canada. 1973. ?

,

THE CANADIAN NURSE 33
.

research abstracts

The following are ab
tracts of studies

e1cctcd from the Canadian Nur
cs'
As-;oeiation Repositor) ('ollection 01
Nursing Studics. Ahstract manu
cripb
arc prepared by the author
.

Purushotham, Devamma. Pilor project to
develop a post-diploma program in
intensive care nursing. London, On-
tario, 1973. Report, Fanshawe College
of Applied Arts and Technology.
(Sponsored by The Physicians' Ser-
vices Incorporated Foundation.)

In response to a community need, Fan-
shawe College undertook a two-year pilot
project concerning the intensive care
nursing program. Supported by the doc-
tors of Ontario through the Physicians
Services Incorporated Foundation. the
program was endorsed by the Ontario
Medical Association. Ontario Hospital
Association, and Registered Nun,es' As-
sociation of Ontario.
The purpose of the project was to
determine a suitable postdiploma program
in intensive care nursing to improve
clinical competency of nurses working in
intensive care units (lCU). Implicit in this
attempt was the assumption that greater
knowledge and skills lead to improved
patient care.
Subsequently. three distinct modules of
four-, six-, and eight-week courses were
developed and offered to registered
nurses. Concurrent and follow-up evalua-
tions were undertaken for each session. In
all. II sessions were offered and 101
nurses participated in the program.
Evaluative findings indicated that par-
ticipation in a course for the intensive
care nursing program resulted in a better
clinical performance of the participants as
perceived by themselves. as well as by
their immediate superiors. The study
showed longer courses tended to produce
bettèr clinical performance. Nurses with
ICU experience unanimously felt the prog-
ram taught them the rationale (whys) for
their actions.
The courses were found to be inade-
quate for beginning practioners and
lacked depth for experienced nurses in
pursuit of advanced knowledge and skills.
Clinically. the program provided the
students with practice in nursing of a les

intensive and complex type, but they have
not had time to get acquainted with more
acute/critical care nursing.
34 THE CANADIAN NURSE

It was evident from the study that a
wide range of knowledge and skills is
required for the care of the acutely ilL
Insights derived from the study led to the
following recommendations:
I. That a basic level po
tdiploma
program in intem,ive care nursing be
offered to registered nurses;
2. That workshops. seminars, and
symposia be provided periodically, both
regionally and provincially, for voluntary
participation to keep abreast of develop-
ments in the management of acutely ill
patients; and
3. That the employing agencies give
monetary recognition to the ICU nurses
taking the course.

Potter, Thelma I. A study of user charac-
teristics {
tf'!cting health care utiliza-
tion. Toronto. Ontario, 1974. Study.
Ontario Institute for Studies in Educa-
tion.

This study was designed to determine
characteristics of the users of health care
that may make a difference in the extent
to which available services and facilitie

are used.
The population under study consisted
of 75 huusehold
with a total user
population of 284 individuals. The
households were systematically selected
from geographic areas designated high,
middle, and low income. Although 25
households from each area were selected,
the households were reclassified accord-
ing to Blishen's Occupational Class
Scale. resulting in unequal numbers in
each group.
The data were collected by direct
interview with the female head-of-
household informant (except where a
male lived alone). The interview
schedule was directed to four broad
area
: family
ocioeconomic status.
health utilization pattern. mother
legitimization of the sick role (MLSR). and
knowledge of health and illness.
Operational measures were the Blishen
Occupational Class Scale. number of
visits to the doctor, number of visits to
"other" facilities and services, and
number of admissions to hospitaL For

1LSR. a modification of Petroni's Sick
Role Index was developed. Knowledge of
health and illness was measured by a
modified version of the CBS National
Health Test used by Litman in 1968.

Statistical methods for analysis of
variance were the t-test and the F-test.
Results showed statistical significance for
the greater use of the doctor by the higher
socioeconomic group. A positive rela-
tionship occurred between scores on
MLSR and use of the doctor. and also
MLSR and the use of "other" facilities
and services.
Further study is recommended in the
area of mother influence over family
health patterns, and in attention to the
need for health information and teaching
to all socioeconomic groups for promo-
tion of positive health practices.

Hilton, B. Ann. Quantity and quality of pa-
tients' sleep and sleep-disturbingfactors
in a respiratory intensive care unit. To-
ronto, Ontario. 1974. Thesis (M.Sc.N.)
U. of Toronto.

This descriptive study was to identify the
quantity and quality of sleep and the fac-
tors that disturbed the sleep of selected
patients in a respiratory intensive care unit
(lCU).
They included documentation of be-
havior that might be related to sleep
deprivation. and identification of factors
the patients perceived as interfering with
rest and sleep. The ultimate purpose of
this investigation was the provision of
care more conducive to patients' rest and
sleep.
Polygraphic recording on an electro-
encephalographic machine docu-
mented brain wave potentials (EEG).
eye movements (EGG). and skeletal mus-
cle tension (EMG) for 48 continuous
hours. During the recording, the obser-
vers noted whatever might be interpreted
as a sleep-disturbing or sleep-preventing
factor. Observations of unusual behavior
that might have been related to sleep
deprivation were also recorded.
Approximately one week following
transfer from the ICU, each patient was
interviewed to ascertain his own normal
sleep patterns. to identify factors he
believed prevented the obtaining of rest
and sleep, and to record the recall and
perceptions of unexplained experiences.
Ten subjects. aged 34 to 81 years.
constituted the study sample.
A comparison of the subjects' normal
sleep patterns and the norms cited in the
literature indicated that patients had less
total sleep time than normally and that
AUGUST 1974

research abstracts

percentages of time in the sleep stages
were not those of the normal cycle. Poor
quality sleep was evident in all patients.
No complete sleep cycles were experi-
enced.
Six subjects experienced some be-
havior related to sleep deprivation. such
as nightmares. restlessness. and halluci-
nations. Two patients were unable to
recall their experience in the ICU.
Factors disturbing patients' sleep were
due mainly to noises of staff and envi-
ronment. Assessment and therapeutic
procedures were the next most influential
sleep disturbers.
Factors that disturbed or prevented
sleep occupied 20 minutes of every hour
and were mainly directly patient-centered
(therapeutic procedures. personal care.
and patient communication). Staff noi
e
followed. There was an inverse relation-
ship between the number of factor

occurring and quantity of sleep experi-
enced by the patient during the night.
Patients identified the various factors that
disturbed their sleep.
No generalizations can be made. How-
ever. it can be concluded that these
patients had difficulty meeting their
"normal" needs for sleep due to frequent
interruptions and possible sleep-
disturbing factors. Behavioral changes
related to sleep deprivation were ob-
served. Mo!.t disturbance was cau
ed by
noise from staff communication. envi-
ronment. equipment. and the other patient
and his care.

Freeman, Lorene Marie Bard. Nurse-
patient' 'solicitation" interactiolls in a
psychiatric hospital. Montreal. Que..
1971. Thesis (M.Sc.(A)) McGill U.

This descriptive study examined the sol-
iciting behaviors and encumbent re-
sponses that occurred during interactions
between nursing staff and psychiatric
patients.
The findings were based on 114 nurse-
initiated and 64 patient-initiated solicita-
tions observed in two "open" wards of a
Montreal psychiatric teaching hospital.
Soliciting behaviors were classified as
those dealing with the patient's personal
needs (inner-directed) or those concerned
with his environment (other-directed).
Responses were categorized according to
the degree to which they complied with or
satisfied the solicitations.
It was found that:
. Nurse-initiated solicitations occurred
with about twice the frequency of
patient-initiated solicitations.
AUGUST 1974

. With the exception of one attendant. all
hospital personnel were represented in the
three response classifications: reciproca-
tion, deferment, and disregard.
. Patient contacts by the professional
worker (registered nurse. medical and
nursing students. etc.) occurred more
than twice as often as those made by the
nonprofessional (nursing assistants and
orderlies) .
. Of nursing solicitations. 70 percent
referred to inner-directed, 25 percent to
other-directed. and 5 percent to non-
specific patient concerns.
. Of patient solicitations. 53 percent
referred to inner-directed. 31 percent to
other-directed. and 16 percent to nons-
pecific patient concerns. The frequency
of staff responses was greatest for recip-
rocation (70 percent); while deferment (9
percent) occurred less than half as fre-
quently as disregard responses (21 per-
cent).
. More nurse-patient interactions involv-
ing the same sex had some dissonance
than did interactions of cross-sex pairs.
Dissonance was the behavior that fol-
lowed a solicitation exhibiting some le"el
of disharmony or disagreement with the
initiated focus of concern.
The study suggested that an analysis of
patient-nurse behaviors could be used to
determine when and to what extent
dissonance occurred in interactions and.
therefore. the degree of hannony that
could be expected in various nurse-patient
relationships.
Finch, Elizabeth. A study of the cOllcerns
of ambulalory patients ill the hospital
emergency room and the professiollal
response to those cOllcerns. Montreal.
Quebec. 1973. Study (M.Sc.(Appl.))
McGill U.

This study. u
ing qualitative röearch
methods. identitìed and classified the
health concerns of ambulatory patients
who use the ho
pital emergency room as a
primary care center. and the response
strategies of professionals interacting
with them.
Data were collected by observing
patient-nurse. patient-doctor interactions.
and by un
tructured intervie\\-s. The
sample consi
ted of 30 patients. 19 male
and II female.
In this study. concern refers to any
behavior exhibited b
the patient while in
the emergency room that would indicate
interest or unea
iness related to his state
of health or the conditions surrounding it.
Professional response is defined as any
statement or action by a nurse or doctor
related to the expre

ion or resolution of a
patient's concerns.
On analysis. concerns of these patient

could be grouped into three general areas.
each including specific categories of
concern:
I. Current he.1lth problem, including

symptomatic discomfort. proposed treat-
ment. and possible outcome.
2. Emergency health service. including
wditing and delay. plus impersonalization
of medical care.
3. Social and economic
ituation. includ-
ing absence from work. retirement. and
mode ofliving.
Professional responses could be di-
vided into three major groups of
strategies: those that I. facilitate expre
-
sion of concern (approaching. inquiring.
exploring). 2. facilitate resolution of
concern (examining. explaining. treat-
ing). and 3. inhibit re
olution of concern
(ignoring).
Patient!. expressed 133 concerns: 70 to
nurses and doctors. the remainder to the
researcher. Concerns of symptomatic dis-
comfort were most frequent (58.64 per-
cent). and professionals concentrated on
eliciting and resolving these concern... (58
of the 70).
Approximately 30 percent of concerns
were related to emergency health service
and
ocial and economic situation. most
elicited by the researcher.
Analysis of profe
sional response

show
a total of 278 responses made to 70
concerns. \\ith a mean of 3.97 response..
per concern.
\1ore responses were made to facilitate
expression of concern (138) than to
facilitate resolution of concern (119).
Only 21 responses were inhibitory. Doc-
tors made more than t\\-ice as many
responses as nurses (193 to 85). and
responding strategies of nurses \\-ere
mainly to facilitate expres
ion of concern.
Inquiring was the strateg) most fre-
quently u...ed by staff.
Finding
of this stud) suggest that
medical and nursing personnel in the
emergency room need to examine their
roles in relation to the ser" ice they
provide to ambulatory patient
. It would
be useful for nurses to develop new
response strategies that would allow them
to supplement and complement ph) si-
cians' work. or assume new roles in
keeping with their own professional
background. In so doing. they would
prov.ide a more effective and economical
servIce.
In conjunction \\ ith developing new
nursing roles. some restructuring of the
department is indicated: to delineate more
clearly ambulatory and intensive care
services. to provide professional screen-
ing of patients. and to encourage de-
velopment of a broader per
pective of
ambulatory patient
by emergency room
staff.
Because of its ready accessibility to the
community. the emergency room
taff
has a unique opportunity to stud
com-
munity health needs and to experiment
with health care practice
designed to
meet tho
e needs. Findings from this
study provide a ba
i
for experimentation
of this nature.

THE CANA
AN NURSE 35

names

Alma Reid Becomes Doctor Of The University Of Calgary

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Alma Elizabeth Reid,/eft, accepts an honorary degree (DUC) from the chancellor of
The University of Calgary, W.A. Friley, at the spring convocation held May 31,
1974. Dr. Reid delivered the convocation address at the morning ceremony.

Brenda Steed has been appointed informa-
tion officer with the Alberta Association
of Registered Nurses. The immediate
goal of the newly-designed information
services program is the dissemination to
the membership of information on the
activities, interests, and objectives of the
association.
Ms. Steed (B.Sc.N.. U. Western Onta-
rio, London) who has been employed in
nursing in Edmonton began her new
duties e
r1y in May 1974.

.

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....

....,

. .
BrendlJ Steed Val Cloarec
Valentine (Val) Beatrice Cloarec has been
appointed executive director of the
Saskatchewan Registered Nurses' Asso-
ciation, based in Regina.
36 THE CANADIAN NURSE

Ms. Cloarec (R.N., Holy Cross Hospi
tal School of nursing, Calgary; Dipl.
Publ. Health, University of British Co-
lumbia; B.Sc. N., B.A., University of
Saskatchewan, Saskatoon; B.LS., U.
British Columbia) worked as a staff nurse
in several hospitals in Saskatchewan and
the Northwest Territories before joining
the Saskatchewan department of public
health in 1953.
In 1968 Ms. Cloarec became assistant
head of public services at the main library
of the University of Saskatchewan in
Regina. Before coming to SRNA, she was
executive director of the Calgary Associa-
tion for the Mentally Retarded.

An honorary doctorate of the University
of Calgary (D.U.C-) was conferred on
Alma Reid when she addressed the convo-
cation in late May.
Ms. Reid has been acting director of
Laurentian University school of nursing,
Sudbury, following her retirement as
director of the McMaster University
school of nursing. She has now retired for
a second time and lives in Hamilton,
Ontario.

Sister Marie Barbara was elected president
of the Registered Nurses' Association of
Nova Scotia at its annual meeting in May.
Sister Marie Barbara (R.N., New Wa-
terford General Hospital school of nurs-
ing: B.Sc.N., Sf. Francis Xavier Univer-
sit), Antigonish; M.S., Boston Univer-
sity) is director of Sf. Martha's Hospital
school of nursing, Antigonish, and is
sister superior of the sisters of Sf.
Martha's Hospital.

Marguerite Schumacher has been named
director of the school of nursing at the
University of Calgary, effective Septem-
ber L Ms. Schumacher (R.N., Victoria
Hospital, Winnipeg; B.Sc.N., Western
Reserve University, Cleveland, Ohio;
M.A.. Ed.M., Columbia Umversity,
New York) has. for the past year, been
coordinator of the divIsion of health
sciences at Red Deer College, Red Deer,
and prior to this served as chairman of the
nursmg program.
Ms. Schumacher was advisor to the
schools of nursing for the province of
Alberta for ten years, prior to which she
was director of education, Winnipeg
General Hospital school of nursing.
Ms. Schumacher has just completed
her tenn as president of the Canadian
Nurses' Association. From 1965 to 1967,
she was president of the Alberta Associa-
tion of Registered Nurses.

Nicole DuMouchel,
executive director
and secretary of the
Order of Nurses of
Quebec, has been
elected vice-president
of the Quebec Inter-
professional Coun-
cil. Representing the
_ 38 professional cor-
porations recognized by the Quebec gov-
ernment, the Interprofessional Council
is to assist these corporations in applying
the professional code of the province.

...r
\

.

I

Mabel Edith Trowbridge, a member of the
Vancouver branch of the Nursing Sisters'
Association of Canada, died May 10,
1974.
One of the first to graduate as a nurse
from the University of Alberta, Ms.
Trowbridge was nursing director of the
maternity unit of the University of Al-
berta hospital, Edmonton, when she
AUGUST 1974

joined the South African Military Nursing
Services. Her work during World War II
took her first to Johannesburg. then
northward to Egypt and later to Italy. On
returning to Canada in 1946 she joined
the nursing staff of Shaughnessy Hospital
in Vancouver, where she remained until
her retirement in 1969.

M. Jean Wilson has retired from the
faculty of nursing of the University of
Toronto.

Professor Wilson
(B.A., U. of Sas-
katchewan, Saska-
toon; Reg.N., To-
ronto General Hos-
pital school of nurs-
mg; B. Paed., U. of
Toronto) came to
the U. of Toronto
school of nursing as
clinical instructor nearly 40 years ago.
She was responsible for the development
of the basic bachelor of nursing cur-
riculum, a key contribution in the de-
velopment of integrated baccalaureate
nursing programs if) Canada.

\

4. ...

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John Scholes has been appointed assistant
administrator (nursing) and director of
nursing services at Trenton Memorial
Hospital, Trenton. Ontario.
Mr. Scholes (R.N.,
St. Charles Hospi-
tal; R.M.N., St.
Bernard's Hospital;
Dipl. Hospital Or-
ganization and Man-
agement, Canadian
Hospital Associa-
..À. tion) was, for many
A years, with the
Royal Canadian Air Force. Since 1965,
he has been associate director of nursing
administration at Kingston General Hos-
pital, Kingston, Ontario.

--

Sister Marion Barron,
director of nursing
at the St. Michael's
Campus of The
George Brown Col-
lege of Applied Arts
and Technology, To-
I ronto, was appointed
I I the first dean of the
I newly formed divi-
sion of nursing at George Brown College,
effective June I, 1974.
Sister Marion Barron (B.Sc., St.Louis
University; M.A., Ed. M., Columbia
University, New York; Ph. D., Catholic
University of America, Washington,
D.C.) was the director of S.. Joseph's
Hospital school of nursing from 1951 to
1964, and became director of St. Mi-
chael's school of nursing in 1969.
AUGUST 1974

\

Sister Yvette Delorme, s.c.o., has been
appointed associate director of nursing at
St. Joseph's Hospital, Sudbury, Ontario.
Sf. Delorme (Reg. N., Ouawa General
Hospital school of nursing; B.Sc.N., U.
of Ottawa) has worked at the Ottawa
General Hospital both as staff nurse and
as instructor in orthopedics and obstet-
rics. She has also been on the nursing
staff of St. Joseph's Hospital in Sudbury.

Margaret Ann Robinson is operating room
supervisor at The Montreal Children's
HospitaL
Ms. Robinson (R.N.. Winnipeg General
Hospital school of nursing) has
specialized in operating room nursing,
having worked as operating room head
nurse at the Winnipeg General Hospital
and as operating room supervisor at the
Santa Cabrini Hospital in Montreal prior
to her present appointment.

Alice (Prim) Furlong has been appointed
assistant executive secretary of the As-
sociation of Registered Nurses of New-
foundland.
Ms. Furlong (R.N., St. Clare's Mercy
Hospital school of nursing, St. John's;
B.N., Dalhousie University) has had
previous experience with the ARNN. She
has been on the faculties of St. Clare's
Mercy Hospital school of nursing, and
the S.A. Grace General Hospital school
of nursing in St. John's. She was
part-time clinical teacher at the Dalhousie
University scþoolof nursing while pur-
sumg her studIes.

Maria Jean, former public relations officer
of the Order of Nurses of Quebec, has
accepted an appointment in Oran, Alge-
ria, to organize a multidisciplinary maga-
zine for North African medical, parame-
dical, and health workers, that is expected
to become the official organ of the
Algerian Ministry of Health.
This is a Canadian International Deve-
lopment Agency project administered by
the faculty of nursing, University of
Montreal

Alice K. Smith has received an achieve-
ment award for outstanding performance
in nursing service from the nursing
education alumnae association of Teach-
ers College, Columbia University, New
York. The presentation was made at
the annual dinner held June 12 in San
Franci'ico, California.
Ms. Smith (R.N., Winnipeg General
Hospital school of nursing; B.S.N.Ed.,
Columbia U., New York; M.P.H., Yale
U. school of medicine, New Haven) is
senior nursing consultant, medical ser-
vic
s branch, Health and Welfare Can-
ada, Ottawa.

Philip E.T. Gower has been appointed
consultant in psychiatric nursing. medical
and nursing branch. Ontario Ministry
of Heaith, Toronto.
Mr. Gower (R.N.. Nova Scotia Hos-
pital school of nursing, Dartmouth;
B.Sc.N.. U. of Western Ontario. Lon-
don; M.S.N., Yale University, New
Haven, Conn.) recently completed his
studies as a clinical specialist in psy-
chiatric nursing. Formerly, he was staff
f\ nurse, clinical co-
. ordinator, and assist-
tant director of nur-
sing service at Queen
Street Mental Health
Centre, Toronto. He
has been a member
of the finance com-
mittee and the board
of directors of the
Registered Nurses' Association of On-
tario and a member of the finance
committee of the Connecticut Nurses'
Association. U.S.A.

Jean Newman
(MHSA, U. of Al-
berta, Edmonton) is
the recipient of the
Robert Wood John-
son award. This
award, in memory
of the founder of
Johnson and John-
son Company. i s
presented by the faculty of the division of
health services administration. U. of
Alberta, to the graduate who demonstra-
tes the most promise of making a note-
worthy contribution in that field.
Ms. Newman is director of nursing at
the Charles Camsell Hospital. Edmonton.

'I \
,

,.r

,

Shirley M. Stinson has been named vice-
chairman of the Health Industry Commit-
tee of the 1974 National Economic
Conference. Under chairman Thomas
Boudreau. the committee will concentrate
on the current situation and relevant
targets for the health care industry in
relation to the economy as a whole,
focussing on four main issues: inflation,
productivity. materials and energy supply
shortages. and manpower use and availa-
bility.
Dr. Stinson is professor. school of
nursing, and division cf Health Services
Administration. Univer!.ity of Alberta,
Edmonton,

Myrtle Kirstine has been appointed direc-
tor of nursing with the York Regional
Health Unit in Newmarket, Ontario. Ms.
Kirstine was formerly d...sociate director
of nursing education with the Etobicoke
Community Health Dept. and associate
professor. faculty of nursing, University
of Toronto. ..;;
THE CANADIAN NURSE 37
.

dates

September-December 1974
Part-time, 16-week, postdiploma program
in maternal-infant nursing for registered
nurses, Humber College, Rexdale, Ontario.
For further information, contact: Office of
the Registrar, Humber College of Applied
Arts and Technology. P.O. Box 1900, Rex-
dale, Ontario, M9W 5L7.

September- December, 1974
The University of Toronto faculty of nurs-
ing is offering three evening courses:
Counselling the Emotionally/Mentally Dis-
turbed Patient, Parts 1 and 11; and Family
Dynamics. Further information is available
from the Director, Continuing Education
Program, Faculty of Nursing, University of
Toronto, 50 St. George Street, Toronto;
telephone 928-8559.

September 18-21, 1974
Atlantic Provinces Psychiatric Association,
annual meeting, Holiday Inn, Halifax, N.S.
For further information, write to: Dr.
George Fraser, Secretary, APPA, Victoria
General Hospital, Halifax, Nova Scotia.

September 22-27, 1974
Registered Nurses Association of Ontario
personal growth and group achievement
conference, Honey Harbour. Apply to:
Professional Development Dept., RNAO,
33 Price Street, Toronto, Ontario, M4W
1Z2.

September 24-27,1974
Psychiatric Nurses Association of Canada
annual business meeting, Chateau Hali-
fax, Sept. 25-27, 1974. This will be the first
meeting for the Association as an incorpo-
rated body.
On September 24, preceding the meet-
ing, the PNAC, in co-operation with E.R.
Squibb & Sons Ltd., will present a seminar
on Community Mental Health/Psychiatric
Nursing. Further information available
from: The Psychiatric Nurses Association
of Canada, 871 Notre Dame Ave., Winni-
peg, Man., R3EOM4.

September 30 - October 4, 1974
Second Annual Childbirth Education
Workshop, McMaster University Medical
Centre, Hamilton, Ont. For more informa-
38 THE CANADIAN NURSE

tion contact: Dr. Murray Enkin, Associate
Professor, Dept. of Obstetrics and Gyne-
cology, St. Joseph's Hospital, 25 Charlton
Ave. E., Hamilton, Ont., or Karyn
Kaufman, Clinical Nursing Specialist, Ma-
ternal and Child Health, McMaster Univer-
sity Medical Centre, 1200 Main St. W.,
Hamilton, Ont., L8S 4J9.

October 1-5, 1974
Canadian Psychiatric Association, annual
meeting, Ottawa, Ontario. For further in-
formation, write to: The Secretary, CPA,
225 Lisgar Street, Ste. 103, Ottawa.

October 4, 1974
The 3rd Interdisciplinary Conference on
problems related to the provision of
emergency medical services in Ontario,

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OTTAWA. Canada K2P 1 E2

sponsored by the Ontario Medical Associ-
ation, Ontario Hospital Association, Regis-
tered Nurses' Association of Ontario,
Emergency Nurses' Association of On-
tario, Ambulance Services Branch of the
Ontario Ministry of Health, and the Associ-
ation of Casualty Care Personnel, will be
held at the Skyline Hotel in Toronto,
Ontario. Information and registration forms
can be obtained from: Dr. Michael E.
Dixon, Director of Medical Services, On-
tario Medical Assoc., 240 St. George St.,
Toronto, Ont., M5R 2P4.

October 5,1974
Workshop on Nursing and the Law, Scar-
borough Regional Campus of Centennial
College of Applied Arts and Technology.
Address queries to: R. Hopper, Scar-
borough Regional Campus (Nursing)
C.C.A.A.T., 651 Warden Avenue, Scar-
borough, Ontario.

December 2-5,1974
University of Manitoba Health Care Evalu-
ation Seminars to assist professionals to
develop an understanding of methods and
techniques required for demonstration and
evaluation of health care projects. Special
focus will be on the application of social
sciences in health care research. For
further information, write to: Susan Hicks,
Dept. of Social & Preventive Medicine,
Faculty of Medicine, U. of Manitoba, 750
McDermot Ave., Winnipeg, R3E OW3.
Deadline for receipt of applications is
September 15.

June 1975
St. Joseph's School of Nursing Alumnae,
Victoria, B.C., 75th anniversary reunion.
For further information, write to: Ms. Phyllis
Fatt, 4253 Dieppe Rd., Victoria, B.C., V8X
2N2.

August 11-16, 1975
World Assembly of War Veterans, to
commemorate the 30th anniversary of the
end of World War II, Sydney, Australia.
Pre- and post-convention tours available.
Registration fee: $A. 30.00. For further
information, write to: Assembly Secretar-
iat, G.P.O. Box 2609, Sydney, N.S.w.,
2001 , Australia. <G'
AUGUST 1974

books

Readings in Child and Adolescent Psychia-
tric Nursing, edited by Claire M.
Fagin. 189 pages. Toronto, Mosby,
1974.
Reviewed by Shirley Waddington,
Nursing Program (Vanier), Algonquin
College of Applied Arts and Techno-
logy, Ottawa, Ontario.

The editor of this book, as stated in the
preface, has collected the major. general
articles written in this clinical area from
1960-1972. She has grouped these in
sections, which makes for easy reading.
One can pursue one's area of interest
without having to skip through articles
that are out of context. For example. if
one is interested in adolescent psychiatric
nursing, one would consult part iii,
Nursing Intervention with Emotionally
Disturbed Adolescents. Further, if the
area of interest were drug abuse, one
would find these articles grouped together
in this section.
The range of subject matter is broad,
covering such areas as the contributions
of different clinical settings to the curricu-
lum, innovative field placements of stu-
dents, the role of the nurse in therapy,
establishing rapport with adolescents,
and, as previously mentioned, drug
abuse.
To the person interested in this subject,
be that person an educator wishing to
develop a curriculum including this
branch of nursing. a practitioner in the
field, a practitioner or student wishing to
enter it, or one who has a particular
interest in it, I highly recommend this
book.

Pharmacodynamics and Patient Care by
Marjorie P. Johns. 337 pages. To-
ronto, Mosby. 1974.
Reviewed by Mary Houston, Lecturer,
School of Nursing, Misericordia Gen-
eral Ho!>pita/, Winnipeg, Manitoba.

The author present
drugs in the context
of their principal use for the control of
functional problems. The chapters have
been assembled in units that pre!-ent
commonalities of patient problems; each
chapter within the unit is planned a!- an
independent module. Using patient prob-
lems as the conceptual framework ha

allowed single presentation in depth of
drugs, and decreased the amount of
repetition required when drugs are
AUGUST 1974

grouped by chemical structure or body
system effect.
The book is divided into six units. each
dealing \\-ith a patient problem. For
example. unit three deals with drugs u
ed
to control excretion of fluid. metabolic
wastes. and toxicants. In this unit. the
author presents chapters dealing \\- ith
pulmonary ventilation. fluid balance. tis-
sue toxicants and debris. enteric elimina-
tion. emesis. and gastric acidity and
intestinal motility.
A brief review of nonnal physiology is
presented as an introduction to each
chapter. followed by pharmacodynamics
in altered physiology. Tables are used to
present the nonproprietary drug name,
proprietary name. and daily adult dose
range.
Readers will be pleased to see a section
in each chapter dealing with patient care,
which will encourage the student to apply
previously acquired kno\\- ledge when
planning nursing care. Each chapter ends
with a comprehensive reference list.
The topic dealing with drug administra-
tion routes discusses nursing respon-
sibilities related to the administration of
various preparations. The actual computa-
tion of dosages. pouring of dosages. and
administration of parenteral medications
would have to be supplemented by other
mean
.

Guidelines for Comprehensive Nurs-
ing Care in Cancer, edited by Helen
Duncan Behnke. 391 pages. New
York. Springer. 1973.
Raiewed by Sheila B. Emhury, Assi.f-
tant Professor. School of Nursing,
Uni
'ersity of Calgar)'. Calgan'. Al-
berta.

This book is a result of the premise that
nurses. besides being doers, should dis-
seminate their knowledge, innovations,
and expertise in oncological nursing.
When the Memorial Sloan-Kettering
Cancer Center. New York, spon
ored 10
seminars, the infornlation was compiled
to present current concepts on cancer
nursing. emphasizing the multidiscipli-
nary approach.
This is well illustrated in the chapter on
pediatric oncology. The di!-cussion par-
ticipants included a head nurse. social
worker. school teacher. phy!-ician. recrea-
tion specialist, clinical nur
ing instructor.

and a child psychiatrist. Ne\\- concepts
di
cussed are the holi
tic approach (0 the
care of children with cancer, day hospital
care. and earl)' detection of cancer by
nurses.
Through the discussion of the medical
aspects. nursing. rehabilitation. radiation.
chemotherapy. and tumors of the
pecific
parts of the body, interest is stimulated in
oncological nursing as a specialty. The
quality of life for cancer patients will
improve through the ever-changing and
increasing therapeutic measures. which
help restore many people to useful lives.
A broad spectrum of care for patients
with rectal and colonic tumors includes
hospital and home care. Questions and
answers follow the fonnal lecture presen-
tation; many specific details are covered
in this manner. Guidelines for health
teaching are included in the appendix.
Graduate nur:;
s and student nurses
caring for patients with cancer \\-ill find
thi!- a worthwhile reference book.

The Dynamicsof Health Care, 2ed.. bv Ruth
M. French. 147 pages. Scarborough,
McGraw-Hili Ryerson, 1974.
Reviewed by Yvonne Millward, Tea-
cher, Toronto General Hospital Cam-
pus, George Brown College, Toronto,
Ontario

The author states In the preface: . 'There is
a real need for knowing more about the
context within which we work - the
people and the institutions - before we
can under
tand. appreciate. and seek
opportunities for the creative cooperation
that is so essential in this age of speciali-
zation. ..
The broad range of topics includes: our
concern - health; the patient agencies
involved in health care; history and de-
velopment of hospitals. induding sociolog-
ical a..pects and organizational structure;
health services per
onnel; professional
philosophy; ethics of professional practice;
law and profe!-sional practice; interpersonal
relationships; and an introduction to re-
search. Because of this variety in content,
data on anyone subject is brief. but many
references are provided at the conclusion of
each chapter.
What caught the reviewer's attention
and interest was the concise and com-
prehensive presentation of each topic. For
example. the chapter on the patient
commences with the origin of the word
THE CANADIAN NURSE 39
.

"patient," then proceeds to "Historical
Perspectives" of the patient from the
most primitive cultural level to the pres-
ent day. The author discusses the "sick
role" with its rights and duties;
psychological aspects of illness, which
incorporates the patient's self-concept
(considered as an important determinant
in response to illness and treatment
regimen), stages of reaction to illness,
and the family's response to illness.
Included are sociological aspects of
illness, such as cultural influences on
types and incidence of diseases;
socioeconomic factors; mortality (which
discusses the second goal of health care;
which is "to provide, as nearly as
possible, an environment for a dignified
death, along with compassionate support
to those who mourn that death"). The
book concludes with mention of and
controversial comments on "A Patient's
Bill of Rights."
When dealing with more abstract topics
such as philosophy, ethics, law, and
research, the author defines terms simply,
clarities ideas, and leads into the specifics
of application to health care. This is a
short, to-the-point text, which covers a
myriad of factors affecting the delivery of
health care.
Although some information is pertinent
only to the American situation, this book
is an excellent guide for teachers as a
jumping-off point for discussions, and for
students as an introduction to the com-
plexities of the dynamics of health care.

learning to Live With Cancer by Kelly M.
Sveinson. 122 pages. Clarke, Irwin
and Company, Toronto, 1974.
Reviewed by Joyce L. Collins, Winni-
peg, Manitoba.

"Keep up the fight with all the strength
you can muster, whether it be for a week,
a month, a year or more!"
Kelly Sveinson, who contracted Hodg-
kin's disease in 1962, followed this
advice, which he gives in the introduction
to his book. He wrote his story in the
hope that it would help other cancer
patients and their families.
Mr. S veinson describes the course of
his illness and gives specific suggestions.
You have cancer; how do you tell your
friends? You take treatl1i
nts; he com-
pares control and cure. There is radiation;
he details the method and reasons. You
are nauseated; he faced that, too. You
can't sleep; he deliberately called up
memories and dreams to find peace. You
are depressed; direct your thoughts to
"affirmatives - and dreams (of friends,
of tranquil scenes)."
The author stresses the value of the
power of positive thinking and the will to
live. After the initial shock of diagnosis,
his illness became an opportunity. It gave
40 THE CANADIAN NURSE

him a reason to examine the why of life.
Hope runs through every chapter.
Although giving some credence to faith
healing, the author is adamant in stating
that doctors' orders must be followed.
The doctors at the Manitoba Cancer
Foundation encouraged him to write this
book; they expressed the need for a
nonmedical text for patients.
Along with his own experience, he
gathered material from other patients,
friends, and relatives. A prolific reader,
the bibliography shows his intense search
for understanding. From this came a book
. that is concise, sympathetic, and useful,
Not only cancer patients may benefit
from his experience. It can be useful in
other illness or for helping anyone to
direct and detine his attitude toward life.
Appendix I is specifically aimed at
nursing personnel. This section is a must
for nurses. Although it includes some
blunt criticism, it also suggests quite
feasible solutions.
Learning to Live With Cancer appeared
in book stores in April 1974. The author
brought the first copies home to Winnipeg
that month. He died the same week. The
hope contained in this small book will
help others fight cancer "with all the
strength you can muster. ..

Maternal-Child Nursing by Violet Broad-
ribb and Charlotte Corliss. 702 pa-
ges. Toronto, Lippincott, 1973.
Reviewed by Gail Pahwa, Clinical
Instructor in Maternity Nursing, St.
Michael's Campus, George Brown
College, Toronto, Ontario.

The authors state that the purpose of this
book is to provide the student with a basic
foundation on which she can build future
learning and practice in maternal and
child health, to the degree she needs and
desires. It is emphasized that the mother
and child are integral parts of a whole -
family and community - and, therefore,
cannot be isolated from these in the
planning and giving of nursing care.
The first five units of the book discuss
maternity nursing to the end of the
neonatal period. Current trends in
community health, maternity care, and
child rearing practices are included in unit
one, along with the anatomy and physio-
logy of reproduction. Units two, three,
and four cover the maternity cycle. The
neonate is dealt with in unit five.
Units six to twelve discuss the child in
specific age groups from infancy to the
social problems of adolescence, ending
with the unmarried teenage mother. Nor-
mal growth and development is covered
throughout the book; the first chapter of
each unit in the latter half of the book is
devoted to this topic.
An attempt at separating the normal
from the abnormal appears to have been
made at the cost of organization. The

student may find it difficult to follow the
text, as information on a single topic is
spread throughout the book. In chapter
18, the use of disposable diapers and
diaper service is mentioned, but informa-
tion on how a mother should care for a
neonate's diapers at home is presented in
chapter 29 under the topic of skin
conditions affecting infants beyond 28
days of age.
Occasionally. although a nursing prob-
lem has been introduced, the nursing
care has been omitted. Thrush in the
newborn is mentioned in complications of
pregnancy, but detection and the nursing
care arising from this problem is not
available in the book.
The authors have fulfilled their objec-
tive in providing a basic text. This book is
suitable for a student nurse concurrently
studying maternal-child nursing at a basic
level. Reference material, such as that
indicated in the bibliography and sugges-
ted readings, would have to be used to
provide an adequate foundation in mater-
nal and child nursing.

Case Studies of Nursing Intervention by
the Dept. of Nursing Education, Uni-
versity of Kansas Medical Center. 245
pages. Scarborough, Ontario,
McGraw-Hill Ryerson, 1974.
Reviewed by Betty Young, former facul-
ty member, Nursing Program, Scar-
borough Regional Campus, Centen-
nial College of Applied Arts and
Technology, Scarborough, now direc-
tor of nursing, Leisure World Nursing
Home, St. George Street, Toronto,
Ontario.

Each case study was written by a different
author, using factual information gained
from "direct personal experience in giv-
ing nursing care to these patients." The
studies are intended for use in a bac-
calaureate program, "to serve as a basis
for discussion" of the nursing process in
complex health problems.
Reading the book as an entity was a
mind-boggling experience, because each
author used her own method of presenta-
tion. Information was often not presented
in a logical order; this resulted in duplica-
tion of data. Many presumably typo-
graphical errors are present. Several
short forms are used that are not
understood universally.
However, if one were using an indi-
vidual case study to learn to evaluate
nursing care for a specific disease condi-
tion, perhaps these details would not
distract from its usefulness.
The table of contents is listed according
to patient's name (a refreshing touch !),
age, diagnosis, and whether acute or
chronic. Many of the studies included
persons with multiple problems - physi-
cal, social, or emotional- and it would
AUGUST 1974

greatly benefit the casual searcher to have
these listed briefly in the table of con-
tents. (For instance, Ms. Simon. with
diabetes and leg amputation, also had
congestive heart failure.)
The study guide at the end of each
chapter provided several question

er-
taining to evaluation of the nursmg
process. To assist in this. several ques-
tions were aimed at helping the student
understand the underlying pathophysiol-
ogy, the principles governing nursing
actions, and the relationship of growth
and development to the current problem.
These were generally excellent. Emph3sis
on alternate nursing actions would have
been a valuable addition.
This book would be useful, as sug-
gested, for a baccalaureate Shldent. Be-
calise of the multiplicity of problems in
most situations, its usefulness for students
in basic degree programs would be
limited to the latter part of the program.
However, the case studies could easily be
adapted by an individual teacher to meet
the specific needs of the student at any
level, and pertinent questions could be
selected from the stud) guide. <G

accession list

Publications on this list have been received
recently in the CNA librar} 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 institu-
tions. Reference (R) items (archive 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 I nrerlibrary loan only.
Request for loans should be made on the
.. Request form for Accession List" or on a
standard Interlibrary Loan form and
should be addressed to: The Librarv.
Canadian Nurses' Association. 50 The
Driveway, Ottawa. Ontario. K2P IE2.
No more than three titles should be
rt'quested at anyone time.

BOOKS AND DOCUMENTS
L Adulthood and aging: an interdis( iplinan. de-
velopmental ,'iew, b} Dougld
C Kimmel. :\Ie"
York. Wiley. 1974. 484p.
2. The bod\"s response to trauma: fractures, b}
Grace K. Clissold. :'lie" York, Springer, 1973 2:!9p.
3. A breath of reassurance subtitled nursing respon-
sibIlities to patients.. ith respirator-. diseases. 20th
annual institute, by Dalhousie University, Halifdx.
School of Nursing. assisted b} the Canadian
Tuberculosi
and Respitatorv DIsease A'
ociation.
Feb. :!4-26. 1974. Hdlilax. 197 L 77p.
AUGUST 1974

4. Critical care nursing, edited by Carol
n \-1
Hudal.. Barbard \-1 Gallo and Thelmd Lohr
Philadelphia. Lippincott. 1973. 351 p.
5. The de.'elopment and control oj "e.. drug
products. Proceedings of B.C. Centennial S}m-
pOSlum on the Development and Control of :'I:ew
Drug Product
. VancoU\er. Oct. I and 2. 1971.
Edited by
I. Pernaro" ski and Marvin Darrach.
Vancouver. Organizing Committee for the... Sym-
posium. 1972. 149p.
6. Developmental p.ncholog\. by Roben \1. Liebert
et al. Englewood Cliff
. N.J.. Prentice-Hall. 1974
676p.
7. D\namicanatom\' & ph\'Siolog\'. by Leroy Lester
Langley et al -led. '\Jew York, M(-Gra.. -Hill.
1974. 820p.
8. Elernellran- reuhook of unarom
arId physiology
applied to nursing, by Janet T.E. Riddle. 4ed.
Edinburgh, Churchill Livingstone. 1974 149p.
9. Elements of medical genetics, h\. Alan E.H
Emer}. 3ed. Edinburgh, Churchill Livingstone.
1974.23lp
10. FlUId and elecrro(He balance. a programmed
leXl. by \Idrgaret L Dickens. 3ed. Philadelphid.
Davis, 1974. 338p.
It. Guidelines for comprehensi,'e nursing care in
cancer. report of a serie.> of cOlllinuing education
seminars in the care of the patient with cancer. held
at Memorial Sloan-Kettering Cancer Center. directed
by Beatrice A. Chd
e and GU} F Robbins. Edited by
Helen Duncan Behnke. ]';e" York, Springer. 1973.
391p.
12. Health and social ..e/fare in communitv de-
\'elopment. The role of the nurse. Bri
tol. Florence
Nightingale International NUN.'S Association. 1973.
63p.
13. Human experience: a psycholog\' of growth. by
Ronal G. Poland. Saint Loui" Mo
by. 1974. :!25p.
14 Immediate care of the a(/ltel\ ill and injured.
edited b} Hugh E. Stephenson. St Loui
.
1o
by.
1974. 266p.
15. The infant and pre- schoolC'r. pediatric proh{nl/S
in family practice, b
J.B.J. McKendrv dnd J.D.
Barley. Don Mil". Ont.. Longman. 11J74 338p
16. /niti(l/ion iJ la I'ie de> deji, lent> d' age
préscolaire Guide pralique pour les parent.>. par
\-Iargaret Anne Johnson. Traduit par Johannd
Couderc. Montreal. A

ocialion du Québec pour les
Déficients mentaux, t973. 185p.
17. Manllel de reanimation medicale iJ r u.wRe de,
infirmreres et de.> etudiants hospllallen. pM C.
Lecacheux. Pari,. Mdloine. 1973. 306p.
18. Memoire au COll.leil "'perieur de rt.,lucation
.Iur r optioll techlll<jIl('1 irrftrrrlll re.> dar" ft, sut<-III('
collegial acruel. Momredl. Ordre dcs Inlïrmicre
et
Intirmiersdu Quehec. 1974. 5Qp.
19. MonilOrinfi n'ntral "'1I0U' preHure: u ProK-
rammed s"qUl'>1Ce. hy Jedn M "-rucgcr 'l:c" Yorl..
Springer. 1973. 95p
:!O. Need \our do, tor be so uwle.I.\' By Andrew
Malle
on L('ndon. -\lIen &. Un"in. 1973. :!5CJp.
21. Ve.. perspectÙ'es in 1II"ltal h(lItdicap. b)
Alistair Forrest et al ldinburgh. Churchill Living-
stone. 1973. 235p.
22. Ob.>tades to opl/mal care. Proceedmg' of
American A
sociation for Child Care in Ho
pitals.
7th Annual Conference.
Iontreal. '1a} :!4-:!7. 1972.
Cleveland. Ohio, 1973. 101p
n. Orthoped;. nurs/llg. h} Ann P Smith. Flu,hmg,
N.Y..
Iedical Examinallon Pub 0'.. 1974. Imp.
(:'Iiur
ing Outline Sene')

:!4. Paediatric nursing. b) \ldrgMet Agne
Dun-
combe and Barbara F. \\i eller. 4ed. London.
Bdillière Tindall. 1974. 466p. (]';urse
' aid"eries)
:!5. Pharmacologl' for Ilune>. b" J .R. Trounce.
Edinhurgh. Churchill Livingstone. 1973. 376p.
26. ProceedinRs of a Vational Conference on
Fami/\' Planning. First, Feb. 28. \/ar. 2. /972.
Ollcnnl. Otta"a. Health and Welfare Cdnada. 197:!.
176p.
27. ReI'ie.. of pediatrtc nursmR. b} Florence Bright
Roberts. St. Louis. Mosb}. 1974. l77p. (Mosb}',
comprehensive review series)
:!8. The surlier\' of childhood for 1Iurses. b

Raymond Farrow and Duncan Forre
t. 4ed. Edin-
burgh. ChuH,hill Livingstone. 1974 3:!lp.
29. S\'Stème de sen-ices d' urgence QI'allt proje/.
Préparé par Giles Gendron et aL Hull. Con
eit de la
Sante et des Services sociaux de 1'0utdouals. 1973
76p.
30. Teachmg
n-/es and leaming. b, Daniel Sol-
omon et aL Chicago. Center for the Sludy of Liberal
Education for Adults, 1963. l64p. ,CSLFA Re-
seMch report)
31. Trawlu r d' une Confére//( e nationale sur Ie
planllingfamilial. première. 28fe.'. - Z mars. 1972.
Ollal\O. Ott3"a. Santé et Bien-être
ocial Canada.
1972. 187p.

PAMPHLETS
32. Action for home and school and parent-teacher
groups to prevent school age> childrell frolll smoking
cigarettes, prepared b} the Smokillg and Health
Commillee Toronto, Canadian Home and School
and Parent-Teacher Federation. 1973. lOp.
33. Distribution of QI'ailable hea/th care personnel
and healrh resources in Canada, b} Stanle)
Greenhill. Olla"a. Canddian Public Health Associd-
tion, 1973.41 p. (CdI1dda. Community Hedlth Centre
Project Commillee. Commi
sioned paper)
34. Elllplo\'en' expectations of the registered nurse
Erpla>1aliO>l of compelenn' rarillg sca/e. Toronto.
Ontario Ho
pital Association. 197" lOp.
35. Leaming alld teachinK through discussioll. b}
Ida Ste"art Hill and \\i illiam Fd"cell Hill. Chicago.
Center for the Stud} of Liberal EducatIon for Adults.
1958. :!3p.
16. NursinK: communin'-related personnel allÌludes
alld projecls. by Dorolh} Kergin. 011.1".1. Canddian
Public Health Association. 1973. :! I p. (Canada.
Communit, Health Centre Project Committee.
Commi
,ioned papen
17. Programme d' actualiwtion professionneffe
/",ur infirlllier(e)\ prepare e>1 collaboration a,,'c Ie
>en'/Ce de r education cOlllinu,>. Revise. \Iontredl.
Ordre de, lntirmières et Intirmier, du Quebec. 1974.
15p
38 R,>nm/lne/l(latwns for medical nursing prac
tie es: apprm'ed b\ loilll COlllmillee on Nun/llK
Medical and Ho.Ipital Ser-.ices. the Sus/... R,>gistered
Nurses' Association. the Sask. College of Ph \'Sic tans
and SurReons and the Sask. Hospital Aswciation.
Regina. 1973. 9p.
39. Un rc>ume d' urle serie d' eairs et de discussIOns
presente
s Ie 25 mai /973: les repercussIOns sur la
diffu.>io>1 des senices de la sante. Rapport d'un
SI-mposium sur I
s Priorites de la Recherche dam Ie
Domainede la Sante au Canada. Montréalle 25 mm
1973. Montreal. Laboratoires
1erd Fro"t. 1974.
43p.
40. R'porton the "ork,hop (1/1 h,'allh programs he/d
THE CANADIAN NURSE 41

at CIDA Dee. 4 and 5, 1973. Ollawa. C.madmn
Interndtional Development Agency, Non-
Governmental Organizations Division. 7p.
41. The role (?f the lIurse in communin' health
centres. by Pamela M. Churchill. Ottdv.a. Canadidn
Public Hcalth As
ociation. 1973. 16p. (Candda.
Communit) Health Center Project Comminee.
Commissioned paper)
42. So vou ha.'e asthma: we/come to the club!
Toronto. York-Toronto Tuberculosis & Rðpirdtor}
Disease Association, J 974. pdIJJ.
43. Students and smoNng. Report of the 197/-72
Cana(lian school survey on cigarerre smoking b\'
Canadian Home and School and Parent-Teacher
Federation "ith the cooperation of the Dept. oj
Statistics, UnÙ'ersin' vf Waterloo and Dept. of
NatÙmal Health and Welfare. Toronto. 1973. 30p.

STUDIES DEPOSITED IN CNA REPOSITORY COLLECTION
44. COllcept du moi et choix pr(ifeHitJ/lnel che

fetudiante infirmière, par Anicelle Guay. Ottawa,
1968. 99p. R.
45. An explorarury stud\ of the nallire (if the
patients' understanding of three seleered neurologi-
lal diagnmtic procedurl'S, by Eunice Bralaschul..
London, 1973. 95p. R
46. Nursing and personal care services. A report /0
the Nm'a Scotia Council of Health, by Peter C.
Gordon. Halifa,. Communications and Information
Centre. Province of Nova Scotia for the Nova ScotIa
CouncilofHealth.1972.8Ip.R
47. Report of a pre-school nursing assessme>11

projecr planninR Implementation e,'aluation, b)
Mynle Lavina KIr
tine. Etobicoke, Onl.. EtoblCoke
Community Health Dept.. 1974. l04p. R
48. Srrucruration du persOl/lld, par Gaétan Garon.
Roland Joncas et Real Moffet. Québec. Untversite
Laval. 1973. 84p. R

GOVERNMENT DOCUMENTS
Canada
49. Communtty Health Centre Project Comminee.
Commissioned papers. Caregorv A, Social issues.
Ottawa. Canadian Pubhc Health Association, 1973.
12v.
SO. -. Commissivned papers. Category 8, Health
professional.. and communin health celllre.'. Ollav. a.
Canadian Public Health Association. 1973. 20v
51. -. Commissioned papers, CateRorv C The
nstem. Ottawa, Canadian Pubhc Health Associa-
tion. 1973. 16v.
52. -. CommIssIOned papers. Catl-gOT\' D, The
health centre. Ottav.a. Canddian Puhlic Health
Association. 1973. 13v.
53. Dept. of Consumer and Corporate Affairs.
Metrication: a guide for comumers. .
ed. Ollav.a.
Information Canada. 1974. pdm. (Consumer re-
search repon no. 2)
54. Dept. of National Health and Welfdre. Famil\-
plw/1/ing sen'ices in Canada, 1972. A report
prepared for National Conference 011 Famil\- Plan-
ning, Feb. 28- Mar. 2.1972. OttdWd. 1972. 47p.
55. -. Health manpowl'r development program,
Canada. ObjecrÙ'e alld goals.fÙcal .-ear 1974 f75 ill

appro.'ed bv the Conference of Dl'put\, Ministers of
Health. 12 Dee. 1973. Ollawa. 1974. 9p.
56. -. A new perspectwe on the health vf Cana-
dians: a "'orJdng documem b\' Marc Lalond,'
Minister of National Health and Welfare. Ottav.d.
Information Canada, 1974. 76p.
57. Dept. of Ndtiondl Health and Welfare. Long
Range Planning Branch. Regionalization of health
services in Canada. a sun'ev of dnelopmems, 1974
Ottawa. 1974. 63p.
58. Information Canada. Organization of the gvv-
ernmentofCanada, 1973. Onawa. 1974. Iv
59. Labour Canada. Labour standards in Canada,
1972. Ottawa. Information Canadd, 1974. 71 P
60. Public Service Canada. Office of Equal Oppor-
tunities for Women. The employment oflwmen in the
public sen'ice of Canada. Mandate for change.
Ottawa. 1973. J6p.
61. Statistics Canada. Director\ of prim Ie elemen-
ran' and .>econdary schools in Canada, 1972f73.
Ottawa. Information Canada. 1974. 48p.
62. -. Research and development e\'penditure.> in
Canada, 1963-1971. Ottawa. Information Canada.
1974. 23p.
63. - Uni,'ersin' education growth 1960/61 to
1971 f72. Ottav.a. Information Canada. 1974. 119p.
U.S.A.
64. Dept. of Health. Education and Weltare. Public
Health Service. Health ser\'ice.' research hibliog-
raph\' 1972-73, by John W. William,on and Jamcs
B. Tenney. Washington, D.C. U.S. Govt. Print.
Off., 1972. 58p. ..;;

Request Form for "Accession List"
CANADIAN NURSES' ASSOCIATION LIBRARY

Send this coupon or facsimile to:
LIBRARIAN, Canadian Nurses' Association, SO The Driveway, Ottawa, Ontario. K2P 1 f2.
Please lend me the following publications, listed in the .............................................................. issue of The
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Item
No.

Author

Short title (for identification)

....................-................................................................................................

Requests for loans will be filled in order of receipt.
Reference and restricted material must be used in the CNA library.
Borrowe r .............. ................ ............................... ............................................... Regi strat ion No. .................... ._..........
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42 THE CANADIAN NURSE

AUGUST 1974

I
I

classified advertisements

ALBERTA

NURSING COORDINATOR required lor a lull tIme day posItIon
at the Fort McMurray General HospItal. Approp"ate education
and experience In the field of contlnumg ed'Ucatlon preferred.
At present this IS a 54-bed hospital In a raplóly growing town
with plans tor expanSIOn to a 3QO-bed communrty hospotal.
Interested persons please apply In wntmg. stating education and
ß
e
:rt'ig:;,
.
xt

oDF'

r
a":.s}:;
e%.:''1-o
c
'gray

REGISTERED NURSES required tor 70 bed accredited active
treatmenl HospItal. Fulltl'T1Ð and summer rellel All AARN per-
sonnel polICies. Apply In wntJng to the: Director of Nursing.
Drumheller General Hospital, Drumheller. Alberta

REGISTERED NURSES reQUlrOO lor 58.bed 3cbve treatment
hospotal, 146 mIles NE of Edmonton In beautIful Vacation
Cou,'try. All AARN benefits -IncludIng new Staff Nurses
DIVISIOn. Apply In wnting to' 0 O.N.. Lac La Blche General
Hospltaf. Lac La l31che, Alberta. TOA 2CO.

GENERAL DUTY NURSES required ImmedIately lor modern
38-bed hospital In the Peace River area. Excellent recreational
and social facIlities available In the communty _ l1vlng accom-
modations In comfortable nurses residence Salary and benehts
according to AARN aQreemenl. ADOlv to: DIrector 01 NursIng.
Box 250. MannIng Munrclpal Hospital Manning, Alberta TOH
2MO.

GENERAL DUTY NURSES required by a small rural
hosp
af. Salanes according to an agreement reached between
Alberta Nurses Assoclahon and Alberta Hospnal ASSOCIa-
tIon Apply. wnh lull partIculars. to: Mr L F Krawchuk, Ad.
mlnrstrator Glendon MunicIpal Hospnal. Glendon Alberta.
TOA 1 PO.

ADVERTISING
RA TES

FOR All

CLASSIFIED AD\ ERTISING

$15 00 for 6 lines or less
$2.50 for each additional line

Roles for display
advertisements on request

Closing dole for copy and cancellation is
6 weeks prior to 1 st day of publication
month.
The Canadian Nurses' Assacialian does
not revIew the personnel' policIes of
the hosPlrals and agencies adverlising
in the Journal For authentic information,
prospective applicants should apply to
'he Registered Nurses' Assacialion of the
Province in which they ore interested
in working -

Address correspondence to:
The
Canadian
Nurse

r
';:::7

50 THE DRIVEWAY
OTT AWA, ONTARIO
K2P 1 E2

AUGUST 1974

I I

BRITISH COLUMBIA

DIRECTOR OF NURSING reqUIred lor 21.bed acute hosJ.>
af
near tamous Long Beach In PACIFIC RIM NATIONAL PARK.
Fnendly atlrlosphere. Must be eligible for Be regls.rabon.
Training and/or expenence In administrative duties preferred.
Apply: Adminostrator To',no General Hosp
af. Box 190. Tofino.
British ColumbIa VOR 2Z0 (604) 725-3212

REGISTERED NURSES WANTED FOR FULLY ACCHtDITED
HOSPITAL CONSISTING OF 190.BEDS. GENERAL DUTY
POSITIONS IN MEDICAL.SURGICAL. PSYCHIATRIC AND
ICU.CCU AREAS MUST BE ELlGfBLE FOR B C REGISTRA.
TION. BASIC SALARY 1973 - $67200 (NEW CONTRACT
BEING NEGOTIATED.) APPLY: DIRECTOR OF NURSING.
ST. JOSEPH S GENERAL HOSPITAL CDMOX BRITISH
COLUMBIA. V9N 4B1

REGISTERED NURSE requirOO tor NIcola Valley General Hospi-
laI, locatOO In the Southwestern part 01 B C. Starling salary from
$850.00 to $1.020.00. Residence available Apply to: Director
of Nursing. N.V.GH. Box 129 Merritt. Bntlsh Columboa.

OPERATING ROOM NURSE wanted lor achve mo-
åern acute hospital. Four Certified Surgeons on
altendtng staff Experience of training desirable
Must bE' ehglble for B C RegIstration. Nurses
residence available Salary according to RNABC
Contract Apþly to: Director 01 Nursing Mills Mem-

nal HospItal. 2711 Tetrautt St.. Terrace. Bntlst
Columbia.

POslbon lor MATRON In 112-bed modern Senior Cihzens
Lodge Mus! be Registered Nurse with lIuent knowledge ot
Polish and English language Supe""sory expenence pre.
ferab
ReSident accommodation available. Salary In accord.
ance with RNABC Apply to: Administrator Kopernok Looge
3150 Rosemont Dnve. Vancouver BritIsh Columbia, V5S 2G9

EXPERIENCED NURSES (eligIble for B C. reglstrabon) required
for 409-bed acute care teaching hospltaJ located In Fraser
Valley. 20 mtnutes by freeway from Vancouver. and within
easy access of vaned recreational facllllles. Excellent Onenta-
hon and Cont..-ulng Educahon programmes Safary $850.00 to
$102000 Chnlcal areas Include MedIcIne. General and Spe'
clalized Surgery. Obstetncs Pedlatncs. Coronary Care. Hemo-
dialysIs. Rehabilitation. Operating Room IntenSive Care. Emer-
gency. PRACTICAL NURSES (ehglble tor B C LIcense) also
required. Apply to. Nursing Recruitment Personnel Department.
Royal Columbian Hospital New Westmmster. Bntlsh ColumbIa
V3L3W7

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES reQult ,j 'ul smaU
upCoast hospital :;, ary and personn I poll's a
per RNABC contract Salanes slart at S67200 lor
Regl slered Nurs s 577 75 for Llc ed PractIcal
Nurses Residence accommodation 52500 per month
Transportation paid from Vancouvpr Apply 10
Director of Nursing 51 Gc Jrge S Hospital AI rl Bay.
BritIsh ColumbIa

EXPERIENCED GENERAL DUTY NURSES for modern
10.bed hospital with doctors offices In hospital
Situateå beautiful west coast of Vancouver Island.
Accommodation S5000 a month ApPly Admlnlstra.
tor. Tahsls Hospital 80x 99 Tahsls British
ColumbIa

SENERAL DUTY NURSES lor modem 41 bed hospltallocatea
:>n the Alaska HIghway Salary and personnel pohcles In
iccordance With RNASC. Accommodation available In reSi.
:lence Apply Director 01 NursIng Fort Nelson General Hospotal
=ort Nelson Bnbsh Columbia

GENERAL DUTY NURSES,lor modern 35 bed hospllallocatad
In southern B C s Boundary Area with excellent recreation facl-
htles Salary and personnel pohcles In accordance wIth RNABC
Comfortable Nurses s home Apply. Director of NurSing Bound.
ary Hospital Grand Forks. Bnhsh Columbia

I I

I
I

BRITISH COLUMBIA

TWO GENERAL DUTY NURSES WIth expenence In obstetncs
and O. R reQUlrOO tor a 2 l.bOO hospital in the Southern 'nlenor
of B.C. L/\/Ing-In accommodatIon available Safary as per
RNABC rates Moderate climate. good working condItions and
recreatlonallac
lbes avaIlable. Apply. ØlVlng full perbculars and
references In first lener to the AdminIstrator 510can Commurllty
Hospotal Box 129. New Denver, Brrtlsh Columbia

GENERAL DUTY NURSES required for an 87.bed
acute care hospital in Northern B.C. ResldencIJ
accommodations available. RNABC j)ollc.les In effect.
Apply to Director of NursIng, MIUs. Memorial Hos-
p
al. Terrace, Bntlsh Columbia, V8G 2W7

GENERAL DUTY NURSES lor modern 45-bed hosoltal. locatec
In north central Bntlsh Columbia. Salary and personnel poliCieS
In accoråance with RNABC Accommodations available In rest-
dence. Apply to Director of Nursing. SI. John Hospital. R R No
2, Vanderhoof. Bntlsh ColumbIa. VOJ 3M

MANITOBA

REGISTERED NURSES required tor 56 bed accredited hospo-
tal P,ne Falls General Hospltaf. Pine Falls. Manotoba LocatOO
85 miles north-east of Winnipeg Residence accommodatron wITh
cookIng faCllilles aVailable. Past expenence recognized Apply to
Director of NursIng Box 2000. PIne Fafls General HospItal.
p,ne Falls. Manotoba ROE IMO.

R.N:s and L.P.N:s requrred lor new 35-bOO hospital. Salary In
accordarce with Nurses ASSOCiation Agreement. Apply to.
Director of Nursing. Souns Dlstnct Hospital Soons Manitoba.
ROK 2CO

NORTHWEST TERRITORIES

NURSES required for general duty and charge pOSlbons lor a
73.bed active hoSpltaf Fully accredited Nurses reSidence
aVilllable. Must be regIstered In a proWlce of Canada. Apply 10
the: Director 01 Nursing. Stanton Yellowknde Hospital. Box 10.
Yellowknife Northwest T erntones

ONTARIO

OPERATING ROOM STAFF NURSE required lor lully accredI-
ted 75-bed Hospital. BasIc wage S689 00 WIth conslderallon for
experIence. afso an OPERATING ROOM TECHNICIAN, baSIC
wage $526.00 Call time rates available on request Wnte or
phone the Director 01 NursIng, Dryden Distnct General Hospital.
Dryden Ontano

REGISTERED NURSE wallted Immediately lor a 17.bed
hosprlal In Northern Ontano Salary $700 - $825 monthly.
Hornepayne IS an exclltng and Interesbng town or 1800
people Apply to the Dlreclor 01 NurSing Hornepayne Com.
munoty HospItal, Hornepayne. Ontanc Telephone: (1107)
868-2442

REGISTERED NURSES for ::!4.bed General Hospital
Salary $70600 per month 10 $81600 plus expenence al.
lowance Excellent personnel policies. Apply to.
Duector of NurSing. Englehart & District HospItal
Inc.. Englehart, Ontano POJ IHO

REGISTERED NURSES required lor our ultramodern 79.bed
General Hospital If1 bilingual community of Northern Ontano
French language an assaI. but not compulsory Safary IS $705
to $825 monthly w
h allowance for past eXj)enence and 4
weeks vacatIon alter 1
ar HospItal pays 100 0 0 of 0 HIP ,
LIfe Insurance (10.0001. Salary Insurance (75 0 001 wages to the
age 0165 wIth U.I C carve-out) a 354 drug plan and a dental
care plan. Master rotallon In effect Rooming accommodallons
aVailable In town. Excellenl personnel pol1C1es Apply to
Personnel Director Notre.Dame Hosp
aI. POBox 850
Hearst Ontario

THE CANADIAN NURSE 43
.

ONTARIO

REGISTERED NURSES required lor a 12-bed IntenSIve
Care-Coronary Care combIned unit. Post basic preperation
and/or suitable experience essential. Apply to: Personnel
Manager. SI. Mary's General Hospotal. 911 Queen's Blvd.,
Mchener. Ontano. N2M 152

REGISTERED NURSES with expenence lor 37.beá lully accre.
dited hospltaJ In North Western Ontano. Accommodation in
nurses reSidence available. Apply: Head Nurse Nipigon Distnct
Memorial Hospital. Box 37. NipIgon, OT1lario. POT 2JO.

REGISTERED NURSES AND REGISTERED NURSING
ASSIST ANTS lor 45-bed HospItal. Salary ranges
Incluóe Qenerous experience allowances. R.N.'s
salary $740. to $840.. and R.N.A:s salary $550. to $625..
Nurses residence - private rooms with bath - $40.
per month. Apply to: The Dorector 01 Nursing, Gerald-
ton Dlstnct HospItal, Geraldton, Ontano, POT 1 MO

REGISTERED NURSES FOR GENERAL DUTY, I.C.U.,
C.C.U. UNIT and OPERATING ROOM reQulreó for
lully accredIted hospItal. Starting salary $697.00 with
regular increments and with allowance for expen-
ence. Excellent personnel policies and temporary
residence accommodation available. Apply to: The
Director of Nursing. Kirkland & District Hospital.
Kirkland Lake. Ontario. P2N 1 R2.

GENERAL DUTY NURSE. Salary $8.404.00 per year to
$9,454.00. Toronto. The MimlCO Correctional Centre. Etoblcoke,
(to be relocated at Milton, Ontario) has a vacancy for a general
duty nurse, to assist the medical offic
rs, dispe':1
medicine and
carry out genera] nursing treatments In a small InfIrmary. Ple
se
direct Queries to the: Superintenóent (416) 255.0131. regardIng
the Ontario Government position.

PUBLIC HEALTH NURSES required lor generalized prog.
ramme. Salary range $8550 - $10,250. w
h differential lor
BScN; generous fnnge benellts. Apply to; Miss E. Flaxman.
Director, Public Health Nursing, Haliburton. Kawartha, Pine
RIdge District Health Unit. Box 337. Cobourg. Ontano. K9A 4K8.

puaLic HEALTH NURSE - GREY.OWEN SOUND HEALTH
UNIT has an opening lor a QualiliOO Public Health Nursa.1f you
are interested in obtainin-.9 more Information about this posit!on.
please contact: Miss E. Davidson, B.Sc.N.. Director of Nursing.
Grey-Owen Sound Health Unit, County BUilding. Owen Sound.
Ontario, N4K 3E3.

PUBLIC HEALTH NURSES (QUALIFIED) FOR GENERALIZED
PROGRAMME. ALLOWANCE FOR EXPERIENCE AND/OR
DEGREE. USUAL FRINGE BENEFITS, DIRECT ENQUIRIES
TO' MRS. RETA McBEAN. PUBLIC HEALTH NURSING, REN-
FREW COUNTY AND DISTRICT HEALTH UNIT, P.O. BOX 128.
PEMBROKE, ONTARIO. K8A 6X1

QUEBEC

NURSE or NURSING ASSISTANT. fmmediate opening In
co-OO Boarding School in country. Applicant must live-In and
share duties with another nurse. Apartment with mæd service
provided. Excellent working conditions lor mature lady. LIberal
holidays. Applications stating exparience. age and references in
writIng to: BURSAR, BIshop's College School, Lennoxville,
Quebec.

SASKATCHEWAN

DIRECTOR OF NURSING lor lully modern 36-bOO Nursing
Home In North Central Saskatchewan Progressive, modern
community. Near Provincial Park. Administrative experience an
asset but not required. Must be R.N. or R.P.N. State salary
expected. Wnte to: AdmInistrator. Roo Deer Nursing Home. Box
70. Porcupine Pie",. Saskalchewan. SOE tHO, or Phooe-Bus:
278.2417 or 278-2233 Res: 278.2450.

UNITED STATES

REGISTERED NURSES - SI. Bernardine Hospital. Southern
Calilornia. ImmOOiate openIngs lor RN's days, PM's, or nights
lor ICU-CCU. Oncology. and Medical/SurgIcal units. Excellent
beginning salary with a minimum ot ::Mj
. to ::M:':$:J. a month to
start, depandlng upon expenence. Shift óifferentlalln additIOn to
startIng salary lor PM's and nights. Temporary room and board
provldOO at no cosl. Additional benefits include a paid lor
retirement program, Jjberal \lacation and hohday benefits. Work
Visa assistance provided. Interested candidates may wnte:
Director of Personnel. SI. Bernardlne Hospital, 2101 North
Waterman Avenue. San BernardIno, CA. 92404 Tel.
714.883-8711 ext. 2276

44 THE CANADIAN NURSE

I I

UNITED STATES

RN'S and LPN's - Ul1Iversity Hospital North. a
teaching HospItal of the Ul1Iverslty 01 Oregon Medical
School. has openings," a variety of HosPital ser-
vices. We offer compehtlve salaries anó excellent
fringe benefits. InqUires should be directed to Gale
Rankm. Director of Nursing. 3171 S W Sam Jackson
Park Road. Portland. Oregon. 97201.

R.N:s - SOUTHERN CALIFORNIA - Immediate need exists
for medical-surgl(;al Units Onentatlon and in-service program.
Excellent salary. full paid benefits. We will assIst you with your
H-1 visa for Immigration. A license In California to practise
nursing is necessary before employment. Wnte for an applica-
tion to the California State Boaró of Nursing Eóucatlon and
RegIstration. 1020 N Street. Sacramento, Caillornla. 95814.

TEXAS wants yOU! If you are an RN. experienced or
a recent graduate come to Corpus ChristI. Sparkling
City by the Sea . a city bUlldll1g for a better
future. where your opportunities for recreation and
stuóles are limitless Memorial Medical Center. 500-
bed. general. teaching hospital encourages career
advancement and provides in-serVice onentatlon
Salary Irom 5682.00 10 5940.00 per month com-
mensurate with education anó experience Differential
for evening shifts. available. Benefits Incluóe holi-
days Sl ck leave vacatIOns paló hospitalizatIOn.
health. life Insurance. pension program Become a
vital part of a modern up-to-date hospital wnte or
call colfect John W Gover Jr. Director of Per.
sonnel Memorial Meólcal Center P D Box 5280
Corpus Christi. Texas. 78405.

GRADUATE AND REGISTERED NURSES. VacancIes availa-
ble in ICU. OR. surgical. gen. duty. etc 150 dlff U.S. &
Canadian hospitals In Pacific coast from British Columbia to
sunny State 01 California StartIng salary $9.648.00- $14.500.00
per annum. Work permits & other paper works provided free.
App'y to authonzed hosPital representative Philcan Personnel
Consultants Lló., (Medica' Placement SpecIalists). 5022 Victo-
na Dr., Vancouver. B.C.. V5P 3T8. Canada. Telex 0455333
TeL 327-9631.

PETERBOROUGH
CIVIC HOSPITAL

Invites Applications from

REGISTERED NURSES
for
General Duty
in
General Intensive Care Unit
Emergency Department

- Active Inservice Education
Program
- Progressive Personnel Policies
One Year of Experience Required

For Further Information Apply to:

The Director of Nursing
Peterborough Civic Hospital
Weller Street
peterborough, Ontario

HUMBER MEMORIAL
HOSPITAL

Telephone 249-8111 (Toronto)
200 Church Street,
Weston, M9N-1 M8, Onto

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.

AUGUST 1974

REGISTERED NURSES
AND
REGISTERED NURSING ASSISTANTS

required for a 104.bed active treatment plus
72-bed chronic care umt located at Halleybury.
The Tri.Town area consisting of New Llskeard
Haileybury. Cobalt all withm 5 miles of each
nther is located 90 miles from North Bay
with dally plane, tram and bus service to ant
from Toronto etc. Beautiful recreational facll
itles including curling, skating, skiing, sWim.
ming. boatmg, hunting, fishmg.
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 DlRECTDR,
Temiskaming Hospitals,
HalleytJury, Ontario.

REGISTERED NURSES

Southern California
This rapidly expandong 573-bed Medical Center has
opportunities for RN's Interested," protessional growth.
Huntington Memorial is recognized lor ds excellence 01 patient
care, research facilities and teaching programs. and oilers a lull
range 01 patrent care services including Intensive Care.
Coronary Care Emergency Room. Neurosurgery. Open Heart
Surgery and Rehabilitation Our full on-going in-service
onentabon and training program includes classes In Cntical
Care. Neonatal and an Arrhythmia RecognillOn Class. Other
programs are given tor Medical-Surgical. RehabilitatIOn and
Pediatrics Cardiology
Located In the Rose Bowl capitol. Pasadena. Call1ornla.
Huntington Memorial enfoys the year around mild climate.
excellent lor Ocean, Mountain. and Desert sports and activities.
all with.n a one hour dnve. Our hospital IS located In a
residential area. which oilers excellent/lving conditions.
We Imde your inquiry concermng oUr salanes, benefits.
education. wor1<ing conditions and facilities We will also assist
Qualilled RN s to aCQuire visas for those .nterested on a pOSIlion
With thiS progressive Medical Center.
Write Miss Ann Kaiser, Dir. of Nursing
HUNTINGTON MEMORIAL HOSPITAL
747 S. Falrmont SI.
Pasadena, Calli.. 91105
An equal epportunlly employer

NORTH NEWFOUNDLAND & LABRADDR

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 main IBO.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. rotatmg shifts. Living
accomodahons 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.
AUGUST 1974

"MEETING TODAY'S CHALLENGE IN NURSING"

QL'EEN ELIZABETH HOSPITAL OF "IONTREAL
CENTRE

A Teaching Hospital
of McGill University

requires

REGISTERED NURSES

AND

REGISTERED NURSING ASSISTANTS

Quebec language requirements do not apply to Canadian applicants.

. 255-bed General Hospital in the West end of Montreal
. Clinical areas include Progressive Coronary Care,
Intensive Care, Medicine and Surgery, Psychiatry.

Interested qualified applicants should apply in writing to:

QUEEN ELIZABETH HOSPITAL OF MONTREAL CENTRE
DIRECTOR OF PERSONNEL
2100 MARLOWE AVE., MONTREAL, QUE., H4A 3L6.

TORONTO GENERAL HOSPITAL

CLINICAL
CO-ORDINATOR
SURGICAL SPECIALTIES

This position carries the responsibility for the total administration and
supervision of Nursing activities in the clinical area.

Desired Qualifications:
. Registered Nurse in the Province of Ontario
(or eligible for registration)
· Bachelor of Nursing degree
· Experience in Surgical nursing
· Administrative and Clinical experience essential

Applications should be directed to:
VICE PRESIDENT, Nursing
TORONTO GENERAL HOSPITAL
101 College Street
Toronto, ONTARIO
M5G 1 L7

THE CANADIAN NURSE 45

REGISTERED NURSES
GENERAL DUTY

Required for modern, fully equipped
28-bed hospital, with two Medical and one
Dental staff. Salary range $707-$830.
Excellent personnel policies. Accommoda-
tion available in residence.

Apply to:
Administrator
KIPLING MEMORIAL UNION HOSPITAL
Box 420
KIPLING, Saskatchewan
SOG 2S0

REGISTERED NURSES

Applications are invited for
general duty positions

in this active treatment hospital which
is currently expanding from 269 beds
to 420 beds. Opportunities available
in most departments commencing
September 1974 onward.

For further Information write:
Personnel Director
South Waterloo Memorial Hospital
Cambridge, Ontario
NIR 3G2

ADMINISTRA TIVE
SUPERVISOR

With post graduate courses and experi-
ence relative to nursing administration. An
opportunity to exercise skills of leadership
and to participate in an ongoing progres-
sive management development program.
Applicant should be able to rotate on night
tour of duty.

Apply:

Assistant Administrator (Nursing),
York County Hospital,
NEWMARKET, L3Y 2R1,
Ontario.

46 THE CANADIAN NURSE

GENERAL HOSPITAL
SCHOOL OF NURSING

Applications are Invited for the poslhons of
Nursing Instructor I
Nursing Instructor II (Paediatric Nursing)
Nursing Instructor II (Medical-Surgical
Nursing)

Salary in accordance with Association of RegIStered
Nurses of Newfoundland province agreement.
Qualifications - Baccalaureate Degree In Nursing and
expanence in Nursing Education preferred but not.
essential.
Duties to commence July or August.

Address applications to:
Director of School of Nursing
General Hospital
St. John's, Newfoundland

ASSISTANT DIRECTOR
OF NURSING

required Immediately

lor a 420-bed General Hospital schedulOO to open in
1975;
preference will be given to individuals with a B.Sc. in
Nursing or a Nurse with vaned nursing and adminis-
trative experience: knowledge of French will be an
asset;
salary commensurate wITh education and experi-
ence;
r&
'õ'cf
:
:fe

e5'1i
i

d

:J; 09
:

ig city of

For further Informal/on write to: -
Director of Nursing Service
Laurentian Hospital
1222 Paris Crescent
Sudbury, Ontario, P3E 3A2

DIRECTOR OF NURSING

required for fifty bed active treatment
medical and surgical hospital, located in
bilingual community 60 miles from
Montreal and Ottawa.
Qualifications should include previous ex-
perience in supervision, and Ontario re-
gistration.

Please apply to:
Administrator
The Smith Clinic
144 Main Street East
Hawkesbury, Ontario
K6A 1 A4

THE BOROUGH OF NORTH YORK

Requires
Supervisor of
Public Health Nursing
Applicant must possess a B.Sc.N., and
several years' experience as a staff nurse,
plus either experience in supervision and
administration or an Advanced Diploma in
Supervision and Administration of Public
Health Nursing.
Salary Range: $10,951. to $12,826. per
annum subject to revision.

Appty in writing to:
The Director of Personnel
& Labour Relations,
5000 Y onge Street,
Willowdale, Ontario,
M2N 5V7

GENERAL DUTY NURSES

Required immediately for acute care gen-
eral hospital expanding to 343 beds plus
proposed 75 bed extended care unit.
Clinical areas include: medidne, surgery,
obstetrics, paediatrics, psychia!ry, activa-
tion & rehabilitation, operating room,
emergency and intensive and coronary
care unit.
Must be eligible for B.C. Registration
Personnel policies in accordance with
R.N.A.B.C. contract:
SALARY: $850 - $1 020 per month
(1974 rates)
SHIFT DIFFERENTIAL

APPL Y TO:
Director of Nursing
Prince George Regional Hospital
Prince George, B.C.

HEAD NURSE - OBSTETRICS

A 495-bed communoty hospital has Immediate opening
for a well qualified Individual
HEAD NURSE
- Current Ontano RegIStratIOn
- 2-3 years expenence In Obstetrical Nursing plus
Nursing Administration.
- Preference grven to applicants with B.Sc.N
SALARY
$10,000 - $11,900 per year, plus allowances lor post
graduate preparation and exper:dnce.
Excellent working conditIOns and full range of fnnge
benellts are also ollerOO.
Our staff IS aware of these vacancies.

Reply In cnnlidence, wnte or phone
Director of Nursing
The Mississauga Hospital
100 QueenswayWest
Misslssauga, Ontario
L5B 1 B8

AUGUST 1974

ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO.

REGISTERED NURSES

630-bed fully accredited Hospital provides
experience in Emergency, Operating Room,
Post Anaesthesia Room, I ntensive Care Unit,
Orthopaedics, 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 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.
APPL Y.

ASSOCIATE DIRECTOR
OF NURSING SERVICE

ST. JOSEPH'S HOSPITAL
30 The Queensway
TORONTO 3, ONTARIO.

-- "

McMASTER
UNIVERSITY
School
of Nursing

Nurse faculty members required as soon as
possible for a School of Nursing, within a
Faculty of Health Sciences. The 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,
with clinical specialist preparation or experi-
ence and/or preparation in teaching preferred
in adult health, medical-surgical or pediatrics.

Application, with a copy of
curriculum vitae and
two references to:

Dr. D. Kergin, Associate Dean (Nursing),
Faculty 01 Health Sciences.

McMaster University,
Health Sciences Centre,
1200 Main Street West,
Hamilton, Ontario, LSS 4J9.

DURHAM COLLEGE
OF APPLIED ARTS AND TECHNOLOGY

invites applicants for

FACUL TV POSITIONS
in the Nursing Department

Qualifications:
- Registration In Ontano
- UniversIty preparation In Nursmg education. bac-
calaureate degree preferred
- Minrmum of two years bedside nurSIng expanence
Responsibilities:
- Classroom teaching and dlnlcal superviSIon.
Salary:
- Commensurata with preparation and experience
within the CSAO range.
Starting Date:
-August 1, 1974

Direct applications with
complete resume to:
DEAN OF ACADEMIC AFFAIRS,
DURHAM COLLEGE OF APPLIED
ARTS AND TECHNOLOGY,
BOX 385,
OSHAWA, ONTARIO;
L1H 7L7.

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-

Jewish G
!!
!!J' Hospital

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 mformation, please write:
Director, Nursing Service JEWISH GENERAL HOSPITAL
3755 Cote St. Catherine Road Montreal 249, Quebec

AUGUST 1974

THE CANADIAN NURSE 47
-

DIRECTOR OF NURSING

required for hospital at Happy Valley.

Midwifery and experience necessary.

Please apply to:
Dr. K. Dyson
International Grenfell Association
Happy Valley, Labrador

ST. MICHAEL'S HOSPITAL
TORONTO, ONTARIO
has two poSItions available in

STAFF DEVELOPMENT
(one in Psychiatry, one in I.C.U.)
Applicants must be capable of developing
and conducting an energetic orientation
and in-service programme on the nursing
unit.
Qualifications:
University degree and/or equivalent clini-
cal experience

DIrect EnquIrIes to:
The Director of Nursing,
St. Michael's Hospital,
30 Bond Street,
Toronto, Ontario,
M5B 1W8.

SENIOR
PSYCHIATRIC NURSE
HOLY CROSS MENTAL HEALTH
CENTRE
CALGARY, ALBERTA
Responsible for participation and de-
velopment of treatment programs involving
patients, nursing staff and students.
Should have qualifications and experience
to meet requirements of senior position.

Apply:
Department of Personnel
Hospital District No. 93
6712 Fisher Street S. E.
Calgary, Alberta
T2H 2A7

48 THE CANADIAN NURSE

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
I 26-bed, full)' accredited hospi-
tal is young. and already expand-
ing. ]\;ursing is a profession we
respect and we were the first to
plan and develop a unique nurs-
ing audit s)'stem. 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
accessihle to the North. I f you
are really interested in nursing,
you are needed and will he made
welcome.

Apply in person or by mail to the
Director of Nursing.

YORK
CENTRAL
HOSPIT AL

RICHMOND HIl L,
ONTARIO

DIRECTOR OF NURSING

required for accredited 93-bed active-
treatment hospital. Position available
immediately.
Administrative education and experi-
ence essential. B.Sc.N. preferred.

Apply, In wrttlng stating qualifications and
references, to:

Administrator
The Salvation Army Grace HospItal
678 West 26th Avenue
Vancouver, British Columbia
V5Z 2E6

THE IZAAK WALTON KILLAM HOSPITAL
FOR CHILDREN
HALIFAX, NOVA SCOTIA

offers a 12-week

POST BASIC
PAEDIATRIC NURSING PROGRAM
for
REGISTERED NURSES

CLASSES ADMmED
JANUARY, MAY, SEPTEMBER

For furthør Information and detail write:

Associate Director of Nursing Education
THE IZAAK WALTON KILLAM HOSPITAL
FOR CHILDREN
HALIFAX, Nova Scotia
B3J 3G6

NIGHT

NURSING
ADMINISTRATIVE
CO-ORDINA TOR

HOLY CROSS HOSPITAL
CALGARY, ALBERTA

Responsible for effective administration of total nursing
sørvlces of the hospital dunng night sMt. Will possess
qualifications and advanced traming with current expen-
ence to meet the requirements of this senior position.

DEPARTMENT OF PERSONNEL
Hospital District No. 93
6712 Fisher Street S. E.
Calgary, Albørta T2H 2A7

AUGUST 1974

THE LAOY MI NTO 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 1CO

EDUCATION OFFICER

required for 340-bed acute care hOspital in
Central Interior of British Columbia. Successful
applicant will be responsible for the co-<>rdination
and development of all educational programs
within the hospital. Applicant should have ex-
penence and/or training in educational methods
and auáo-visual techniques. Preference wdl be
given to applicants possessing related nursing
education or hospital expenence. Salary range
commensurate with experience.

Pluse forward complete resume of quat/tlca-
tlons and experIence to:

Mr. A.G. Boyd
Assistant Administrator
Prince George Regional Hospital
Prince George, British Columbia
V2M 1S2

PUBLIC HEALTH
NURSES

Required for the Sudbury and District
Health Unit
Beginoing September 1974

APPL Y TO:

Director of Nursing
1300 Paris Crescent
Sudbury, Ontario
P3E 3A3

AUGUST 1974

THE HOSPITAL
FOR
SICK CHllDR EN

t
'-

,

,.

"

Situated in the stimulating
atmosphere of downtown
Toronto, within walking distance
of the University of Toronto

The largest ch ildren's hospital on
the continent offers the
Registered Nurse opportunities
for development in our Nursing
Department. We have many areas
that will interest the Registered
Nurse who IS looking for a
challenging career in paediatric
Nursing
Opportunities for employment in
Intensive Care, Renal Dialysis,
Neonatal Unit, Child and Family
Unit, Clinical Investigation
Unit, Operating Room, Cardiac
Surgery, Neurosurgery Isolation
and Orthopaedic surgery. We
have a planned orientation and
staff devetopment programme

The majority of In-patient units
are working the 7day fortnight
(12 hour shifts) Salaries are
commensurate with experience
and educallon. Excellent fringe
benefit programme. Current
registration In OnLis required

Applications for General
Duty Positions are Invited
PLEASE WRITE TO Mrs.C MACINNES
The Personnel Co-ordinator
555 University Avenue
Toronto, Ontario. Canada
M5G1X8
TELEPHONE 366'7242 Ext.1528

REGISTERED NURSES
AND
NURSING ASSISTANTS

Required for 11 O-bed hospital which spe-
cializes In chest diseases. situated In the
beautiful Laurentian mountains and loca-
ted only 55 miles from Montreal. Good
personnel polides and residence accom-
modation available.

Apply:
DIRECTOR OF NURSING
Mount Sinai Hospital
P.O. Box 1000
Ste. Agathe Des Monts, Quebec
JaC 3A4

REGISTERED NURSES

Full and Part Time

Are you ready for a change,
a challenge. an opportunity.

Be part of the
REHABILITATION TEAM

in a newly built centre for
Spinal Cord Injuries

TORONTO

Appty to:
Director of Nursing,
520 Sutherland Drive,
Toronto, Ont., M4G 3V9.

NURSE CLINICIAN

required for 40 bed Psychiatric Unit in
accredited general hospital.

Post graduate course in Psychiatry with a
minimum of fivE' years related experience.

Baccalaureate degree preferred.

Excellent working conditions and benefit
programme

Please apply to:
Employment Supervisor
Belleville General Hospital
Belleville, Ontario

THF CANADlAl'J NURSE 49

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THE SCARBOROUGH
GENERAL HOSPITAL

invites applications from:
Registered Nurses and Registered Nursing Assist-
ants to work in our 6S0-bed progressive, accredit-
ed, community-centered, active treatment hospital.
We offer IJpportunities m 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, 0 ntario.

ST. MICHAEL'S HOSPITAL
Toronto, Ontario
invites applications from

REGISTERED NURSES

for
INTENSIVE CARE and "STEP-DOWN" UNITS

Planned orientation and in-service programme will enable
you to collaborate in the most advanced of treatment
regimens for the post-operative cardio-
ascular a
d other
acutely ill patients. One year of nursmg experience a
requirement.

For detaits apply to:

The Director of Nursing,
St. Michael's Hospital,
Toronto,
Ontario,
MSB 1 W8.

50 THE CANADIAN NURSE

DIRECTOR
SCHOOL OF NURSING
UNIVERSITY OF VICTORIA
VICTORIA, B.C.

Applications are invited for the position of Director of the
School of Nursing. This is a new programme and the first
students will be admitted in September 1975. The initial
programme will lead to a B.S.N. for students holding the
R.N. or equivalent. The programme should be innovative
and provide close interaction and common learning experi-
ences with students in the other helping services (social
work, counselling, child care, etc.).
It is expected that the candidates would qualify for a senior
academic appointment and should have the appropriate
academic and professional qualifications. The candidate
should be available on or before July 1, 1975.

Applications and nominations, with curriculum vitae,
will be received until October 1, 1974 and should be
sent to:

Dr.J.M. DEWEY,
Dean of Academic Affairs,
University of Victoria,
Victoria, B.C., Canada, V8W 2Y2.

SHERBROOKE HOSPITAL

SHERBROOKE,QUEBEC.
invites applications from

REGISTERED NURSES
GENERAL DUTY

138-bed active General Hospital; fully accredited with
Coronary, Medical and Surgical Intensive Care.
Situated in the picturesque eastern Townships,
approximately 80 miles from Montreal via aUIOroute.
Friendly community, close to U.S. border.
ood
recreational facilities. Excellent personnel policies,
salary comparable with Montreal hospitals.

Apply to:

Director of Nursing

SHERBROOKE HOSPITAL
Sherbrooke, Quebec.

AUGUST 1974

ORDER OF NURSES
OF QUEBEC
o

Public Relations Officer

A qualified, well-educated Public Relations Officer,
french speaking with a command of English, is required
by the Order of Nurses of Quebec. Situation, based in
Montreal, emphasizes information program for 43,000
members, but duties also include liaison with provincial
and federal governments, provincial and national nursing
associations and related groups and media relations at
national, provincial and regional levels.

All applications, in writing with all necessary relevant
information, should be forwarded, in confidence, before
August 30, J 974, to:

Miss Nicole Du Mouchel, R.N., M.N.,
Executive Director and Secretary of the Order,
Order of Nurses of Quebec,
4200 Dorchester Blvd. West,
Montreal, Quebec,H3Z IV4.

STATE OF KUWAIT
MINISTRY OF PUBLIC HEALTH
DIVISION OF NURSING

POSTS
a. One Assistant Director, Division of Nursing, Community
Health Nursing Services.
b. One Assistant Director, Division of Nursing,
Inservice Education (Staff Development).
aUALIFICA TIONS
1. Secondary School or its equivalent.
2. A diploma from an internationally accredited School of Nursing,
and preferably a B.Sc., Nursing Degree from an accredited
University or College.
3. A one year post-basic course in Midwifery, mainly for first post.
4. 1-2 years specialisalJon in either field, and preferably M.A. or
M.S.
5. A minimum of 3-5 years experience in senior positions in either
posts, but preferably a joint responsibility of Nursing Education
and Nursing Service Administration in relation to the In service
Post.
6. Has good command of English and awareness and, if recruited,
should enroll in an Arabic Teaching Institute. (Knowledge of
Arabic is an advantage.)
SALARY
Salary will be based on qualifications and years of experience.
Applications should be addressed directly to the:
Under-Secretary
Ministry of Public Health
P.O. Box 5
KUWAIT

AUGUST 1974

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VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA
1 hc :\Iarilimcs' largcst Icaching ho'pilal. ha, immcdi.tlc
opcnings for Rcgislcred "Jur,cs. Ccrtificd :-':llf,ing r\"i...tant...
and Ordcrlies. Position
arc .H.lilablc in Spccial Lnit, .md
tor gcneral nursi ng dutics. It i
thc princip.11 adult Icachi ng
hospital of Dalhousic L!nivcrsit} and al,<) opcratc' a largc
...chool of nursing.
SAl ARY: -
Commcn,uratc with qualification... .Ind c'\pcricncc.
SPECIAl CNII Nl RSFS SSI70-)Y5S2
RfGISTERED NURSfS Snlft-
Y22Y
('ERr. NURSING ASSISTA;-..TS ,S5ft:!ft-$7IHO
NL.:RSING ORDERLlr
$..W91-$ftJ33
BFN Ef'ITS:
Full Civil Scrvicc Bcnctïh. including Ihrcc \\cck, \ac.l-
tion. four wecks .Ihcr 5 \cars of
crvicc .md ,hift din"c-
rcntial. ..
lor further information i..nd/or .tpplic.llion form,. plca,c
Clmtact:
PCf'ionncl Office.
\ïctona Gcncral HO'ipital.
Halifax. 'ova Scot"..

STATE OF KUWAIT
MINISTRY OF PUBLIC HEALTH
DIVISION OF NURSING

POSTS
a. One Specialist in Neuro-Surgery Nursing
b. Three Nurse Specialists in Pre-mature Baby
Nursing

aUALIFICA TIONS

1. Secondary School or its equivalent.
2. A diploma from an Internationally accredited School of
Nursing, or a B.Sc., Degree in Nursing from an
accredited University or College.
3. A minimum of One year speciality in each field
4. A minimum of Two years experience,
5. Has good command of English language, and if
recruited, should enroll in an Arabic Teaching Institute
(Knowledge of Arabic is an advantage.)
SALARY
Salary will be based on qualifications and years of
experience.
Applications should be addressed directty to the:
Under-Secretary
Ministry of Public Health
P.O. Box 5
KUWAIT

THE CANADItN NURSE 51

Q

ORTHOPAEDIC k ARTHRITIC
HOSPITAL
'VI

43 WEllESLEY STREET, EAST
TORONTO, ONTARIO
M4Y 1H1

Enlarging Specialty Hospital offers a unique
opportunity to nurses and nursing assistants
interested in the care of patients with bone and
joint disorders.
Currently required -
Registered Nurses and Nursing Assistants for all
units
Clinical specialists for Operating Room, Intensive
Care, Patient Care and Education.

ASSISTANT DIRECTOR
OF NURSING

required for 98-bed acute hospital with 35-bed
extended care unit presently under construction, to
take over from present Director of Nursing upon
retirement.
Located in pleasant, modern town in Northwestern
B.C.
B.Sc. in Nursing or University preparation and
previous experience in nursing administration re-
quired.

Applications to:
Administrator
Kitimat General Hospital
Kitimat, British Columbia

52 THE CANAlJIAN NUK
E

SAINT JOHN GENERAL HOSPITAL
SAINT JOHN, N.B.
Requires

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS

for

GENERAL DUTY

Active Inservice Education programme.
Positions are also available for nurses with special clinical
preparation including cardiac and other intensive care areas.

For further information apply to:
Personnel Director
SAINT JOHN GENERAL HOSPITAL
P.O. Box 2000
Saint John, N.B.
E2l 4L2

REGISTERED NURSES

Are required ImmedIately for our 40 bed General Hospital in
beautiful Northern Saskatchewan.

We serve 4,500 people from a modern, active community with all
services and excellent recreational facilities.

We have a nursing staff of 21 and a medical staff of three
physicians, including a general surgeon.

Canadian Union of Public Employees IS certified agent.

1974 salary scale - $8,484 to $9,960 annually plus a generous
northern allowance, shift premiums and subsidized room and
board in modern residence. Fringe benefits include. 4 weeks paid
vacation after 1 year's service, Increasing to 5 weeks after 3 year's
service; SHA group insurance plan; excellent pension plan; air
transportation paid on hiring and for vacation.

Applications or inquiries should be directed fo:
Mrs. B. Musschoot,
Director of Nursing,
Municipal Hospital,
Box 360,
Uranium City, Saskatchewan,
SOJ 2WO.

or
Phone collect person fo person af 8411.

AUGUST 1974

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
Uni versity.
Qual ifi cati 0 ns
Eligible for Nursing Registration in Nova Scotia;
A degree in nursing, preferably at Masters level, with consider-
able psychiatric expenence;
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
Abbie J. Lane Memorial Hospital
5909 Jubilee Road
Halifax, Nova Scotia
83H 2E2

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

AUGUSt 1974

HEALTH
SCIENCES CENTRE
INTENSIVE CARE NURSING

.Myocardial infarction
. Arrhythmias . Pacemakers
. Renal Failure . Trauma
. Respiratory Failure .Shock

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24 BED INTENSIVE CARE UNIT

in a

1,400 BED UNIVERSITY-AFFILIATED HOSPITAL
OFFERS

A 12 MONTH CLINICAL COURSE
IN INTENSIVE CARE NURSING FOR All
REGISTERED NURSES ON STAFF IN THE
INTENSIVE CARE UNIT

Opportunities To Learn-
- Nursing care of critically ill
- Resuscitative measures
- Use of monitoring and other advanced equipment
- Multidisciplinary approach
Through -
- Four weeks of planned orientation
- Supervised clinical experience
- Continuing In-service program
- Series of comprehensive lectures
- Concentrated study and hard work

For further information write to:

Course Co-ordinator
Intensive Care Nursing
Health Sciences Centre GH601
700 William Avenue
Winnipeg, Manitoba, R3E OZ3

THE CANADIAN NURSE 53
.

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

Montreal is a fascinating,
bicultural city, but don'
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
H3A 1A1

54 THE CANADIAN NURSE

+

+

RESCUE BREATHING (MOUTH-TO-MOUTH)

THE CANADIAN RED CROSS SOCIETY

Start iMmediately: The sooner you start. the greater the chance of success

Open airway by lifting
neck with one hand
and tilting the head
back with the other
hand.

Seal your mouth
tightly around the
victim's mouth and
blow in. The victim's
chest should rise

Remove mouth.
Release nostrils.
Listen for air escaping
from lungs. Watch
for chest to fall.

Pinch nostrils to
prevent air leakage.
Maintain open airway
by keeping the neck
elevated.

REPEAT LAST THREE STEPS TWELVE TO FIFTEEN TIMES PER MINUTE.
IF AIR PASSAGES ARE NOT OPEN: Check neck and head positions, CLEAR mouth and
throat of foreign substances.
For infants and children, cover entire mouth and nose with your mouth. Use small puffs
of air about 20 times per minute.
USE RESCUE BREATHING when persons have stopped breathing as a result of: DROwNING,
CHOKING, ELECTRIC SHOCK, HEART ATTACK. SUFFOCATION and GAS POISONING.
Don't give up. Send someone for a doctor. Continue until medical help
arrives or breathing is restored.

ROYAL VICTORIA HOSPITAL

AUGUST 1974

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VICTORIA GENERAL HOSPITAL
HALIFAX, NOVA SCOTIA

The
laritime
' large
t ho
pital. ha
immediate openings for
Clinical Nursing Supervisors. It is the principal adult teach-
ing hospit.J.1 of Dalhousie L;niver
it\ .J.nd abo operdte.. .J.
l.J.rge sc hool of N ur
i ng.
SA-l ARY: - 511560 - $\3.537
CLINICAL '\l'RSING SUPER\ ISORS
A :\laster"s Degree is preferable but candidates with a
Bachelors' Degree would be given consideration. 3 years
experience. J of which wa
.J.( the
upervisory level .s
required. Courses in Clinical Spcci.J.lit} Nursing. especially
in :\kdical or Surgical Nursing would be con..idered.
BENEI-1TS:
rull Civil Service Benefits. including three wecl...s vaca-
tion and four weel...s after five ..ear
of service.
Competition is open to both nien and women.
For further information and/or application forms. please
contact:
Per
onncl Office.
Victoria General HÜ'>pit.J.l.
Halitax. Nova
coua.

WE CARE

'Í/ÍJ J

,
,

,

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

AUGUST 1974

worth
looking
into...

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nursing
with Canada IS
federal public
servants.

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Hearth and Wellarp
Canada

Sante el Blen-elre social
'-'doada

,---------------

I Medical Services Branch I
I Department of National Health and Welfare I
I Ottawa, Ontario K 1 A OK9 I
I I
I Please send me Information on career I
I oPportunities in this service. I
I Name: I
I Address: I
City: Prov: _

_______________J
THE CANADIAN NURSE SS

..

Fonction publique
Canada

Public Service
Canada

These competitions are open to both men and women

NURSES

Part-time

Full-Time

Short-term

The Department of Veterans' Affairs urgently requires
nurses for a variety of duties, including active and chronic
care and psychiatric nursing.

We offer you excellent fringe benefits. orientation prog-
rams, and opportunities for further development.

To discuss your needs, and ours, call collect:

Director of Nursing
Camp Hili Hospital, Halifax
(902) 423-1371
Westminster Hospital, London
(519) 432-6711
Deer Lodge Hospital, Winnipeg
(204) 837-1301

Knowledge of the English language is essential for these
positions.

THE RELIGIOUS
HOSPIT ALLERS
OF SAINT JOSEPH

INVITE YOU

to shdre the., 300 year heritage of service to the
Church ,
o,e"ltl1, education and welfare services In
the Umted States. Canada and France
to share their availability to reach out to those In
need In Africa, Peru and the Dominican Republic
proclaiming Christ
love by care and prevention,
teaching and development programs
to share their common life 01 prayer and work In a
Spillt 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,
K1S ON2.

56 THE CANADIAN NURSE

Index
to
Advertisers

August 1974

Canadian Pharmaceutical Association .. . . Center Insert

Clinic Shoemakers ...... , . . . . . . . . . . . . . . . . . . . .. 2

Davol Canada Ltd. . . . . . . . . . . . . . . . . . . . . . . . Cover III

J. T. Posey Company .......................... 5

Procter & Gamble. . . . . . . . . . . . . . . . . . . . . . . . . . . . .14

R
eves Company ............................. 10

White Sister Uniform, Inc. ..... .1, Cover II, Cover IV

,

Idll'IÏ/l/llg .\1mwgl'r
(j
orgllla Clarke
rhe Canadian Nurse
50 The Driveway
Olla\\..! "-2P I
'2 (Ontario)

..J dn'IIt.\/Ilg Represelltaflves
Richard P. Wilson
219 Ea:.t Lancaster Avenue
Ardmore, Penna. 19003
I
'kphollë (21") :vIid\\ <I) lJ-14lJ7

GOiOlln riffin
2 Tremont Crescent
Don Mills, Ontario
I dëphonc: (4Ió) 444-4731

Member of Canadian
Circulations Audit Board Inc.
t

rmÆl

AUGUST 1974

.

,

\

Now you can squeeze
a little more out õf Davol.

You said bulb syringes get slippeIjT. and finger grip for easy thumb-
So we molded rings onto them. Now . squeeze action.
they won't slip even when your hands Most important, we gave our
are wet. syringes superior suction power and
You told us you wanted a piston capacit
And now you can get even
syringe you could operate with one more out of Davol.
hand. So we added a thumb ring and Take a close look at syringes.
finger rim. You'll see that Davol makes the
We made some other changes, too. difference.
We enlarged our calibrations for easy Davol Canada Ltd., 1033 Range
reading. And gave our bulb-type View Rd., Port Credit, Ont.,
syringes an exclusive Plivol@bulb L5E-1H2 (416) 274-5252

BUILDING ON A CENTURY OF QUALITY ,' C -v; .
1874-1974
HEALTH CARE PRODUCTS
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Style No. 43735
Royale Diamond Tricot Knit
White only
Sizes 3-13
Price $30.00

SHOP IN PERSON AT OUR
BA V STREET STORE
OR WRITE TO OUR MAIL
ORDER DIVISION FOR A NEW
CATALOGUE

Style No. 3738
Sizes 6-16
Royale Diamond Tricot Knit
White $23.00
Royale Corded Tricot Knit
Blue $23.00

UNIFORM SPECIALTY

1254 BAY ST.
(Just above Bloor) TORONTO

J

,

Style No. 43480
Royale Corded Tricot Knit
Sizes 3-15
White - $21.00
Yellow - $22.00

MAIL ORDER DIVISION
372 Queen St. W.
Toronto, Onto M5V 2A3
Please send all mail orders to
above address or phone 366-1414
for fast service.

The

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September 1 974 Q

HISS MRA LOYER
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158 GUIGUES ST
OTTAWA KlN 5H9 00056886

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WHITE
SISTER
PRESENTS
THE
FEMININE
LOOK

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43340

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Sizes 12-20
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White only. ...... about 523.00

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Take any 3 books
for only 99( each
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65380, ON DEATH AND DYING. ElIsabeth
Kübler-Ross ThiS beautIfully wrotten. compelhng
account 01 the anxIeties and needs 01 termInal
patIents IS must readIng lor every nurse Focuses
on the patIent as a human beIng - how he can be
comlorted. howtoeasethegroelolthelamlly 56.95
42820. DRUGSAND NURSING IMPLICATIONS,
SECOND EDITION, Laura E GOVOni and Janice
E Hayes Greatly expanded. revIsed hardcover
edilion 01 nurslng's most prozed handbook on drug
therapy - actlonsand uses, fate and excretion. con-
tra,nd,cat.ons and precautIons. adverse reactions,
route and dosage, and the nurse s responSlblhtles
59.95
52230. HANDBOOK OF DRUG INTER-
ACTIONS, Gerald SWldler This encyclopedIc
relerence is a must Sets down the Interactions
01 more than 1300 drugs, tellong whIch other
drugs must be avOIded wIth a speclloc drug, pre-
lerred methods 01 admlnlstenng, danger signs to
watch lor 515.00
80250. MANAGEMENT OF MEDICAL EMER-
GENCIES. John Sharpe M 0, and Fredenck
Marx. M 0 How and when to act In every sort 01
medical. surgical. or pedlatnc CroSIS A superb
QUlck.relerence gUIde-more than 750 paqes 01
hIe-savIng procedures. 521.50
85190. OBSTETRIC NURSING. 6TH EDITION
Ema Z,egel and Carolyn Conant Van Blarcom
The extensively revIsed and expanded 6th edItIon
offers you a sharp lOOk at every technIque (Irom
antepartum Care and preparation, through birth
and post.partum care) you II need for last pro-
fessIonal maternIty care 59.95
35900. BEHAVIOR MODIFICATION. MIchael 0
LeBow Focuses on your patients actual dIsrupt-
ive Or Irregular behavIor patterns Gives special
emphaSIs 10 such problems as apalhy, social ISO'
latlon. lack 01 sell.sufflClency and chronIc pain
55.95
73790, REHABILITATION NURSING. V,clor
Chnslopherson Pearl Parvin and Mary Opal
A vItally Important new handbook especIally lor
nurses-covers the rehablhtatlon 01 patIents with
hIe-threatenIng dIsorders (such as cancer heart
anacks and lung dIsease), and those suI' ,Ing
neurologICal and sensory deprovatlon 58.50
58171, INTERVIEWING AND PATIENT CARE'
Allan J Enelow M 0, and SCOII N SWisher, M 0
The art and the science 01 talking to the pallent
how to get a clear picture of his biologICal psy.
chologlCal, social and cullural situatIon and how
10 useth,s,mportant,nlormatlon In dIagnosIs 58.50
40130. CONCEPTS BASIC TO NURSING. Pam.
ela Holsclaw Mllchell. Ph 0 A penetrating lOOk
at nursIng today, coverong the nurse patient reo
lat,onshlp (how to cope wIth behavIor problems),
dIagnosIs (Irom IntervIewIng the pal lent to draw
ing conclusIons). and on-gOIng care Charts
tables, Illustrations 58.95

39695. COMMUNICATING IN SPANISH FOR
MEDICAL PERSONNEL. JulIa Jordån Tabery,
Manon R Webb and Bealnz VåsQuez Mueller
R N A compact sell. study Course 01 the medIcal
vocabulary you'li need to communIcate wIth your
SpanIsh-speakIng patients about theor heallh, III.
ness. trealment. tests and medications In SImple
phrases and words 513.50
73960. RESPIRATORY tNTENSIVE CARE
NURSING: FROM BETH ISRAEL HOSPITAL.
Sharon S Bushnell, R N What Iv do for resplra.
tory croses and ways to prevent and deal wIth
many respiratory complICations such as pneu.
mon,a and atelectasIs - all outhned by Beth Israel s
team 01 experts Includes an array 01 charts and
tables lor QUIck calculations excellent dIagrams
Sporal bound 59.95
56281. INTRODUCTION TO LIFE SUPPORT,
Edlled by Mark B Ravin, M 0, and Jerome H
Modell. M 0 What to do In non-surgIcal emergen-
Cies - respiratory lallure cardIac arrest, drug over.
dose, polsonong. shock. coma, metabohc CroSIS An
abundance 01 charts and tables and compact sIze
make thIs the perlecttake.along reterence Soft.
bound $6.95
51950. GUIDE TO PATIENT EVALUATION.
Jacques L Sherman Jr M 0 , and SylVia Kle,man
FIelds. R N M A A concise gUIde to physical
evaluation that IS practically an R N s gold mIne
ProvIdes a clear rundown of all the procedures
and techn,ques needed tor hIstory takIng, the
diagnostIc examInatIon and modern medical rec-
ord keeolng 510.00
73980. RESPIRATORY TECHNOLOGY: A PRO-
CEDURE MANUAL, Four experts gIve step-by.
step Instructoons lor uSing Inhalation equipment
and gIvIng the best respiratory care Many dla.
grams, charts, and how-to" InstructIons lor all
the newest respiratory cevlces, lrom aerosols to
ventIlator 512.95

HOW THE CLUB OPERATES
. The Book Club News, descnblng the comIng
MaIn and Allernate Selections, wIll be sent to you
15 lImes a year al three to lour week Intervals
. II you wIsh to purchase the Main Selection. do
nothing and It wIll be shIpped to you automatl.
cally . II yOu preler one 01 the Allernales, or no
book at all, SImply IndICate your decIsIon on the
repfylorm always enclosed w'ththeNews and mal'
It
n we receIve It by the date speclloed . The
News IS maoled In time to allow you at leasl 10
days to decide II you want the coming MaIn Se
lectlon II. because 01 lale ma.1 dehvery 01 the
News. YOu shOuld ever receIve a Main SelectIon
wrthout havIng had the 10.day consIder aI/on pe
nod, that SelectIon may be returned at Club ex.
pense . Alter complellr,g your tnal membership
you w,lI be entItled 10 take advantage 01 our
bonus plan

64941. NURSING THE OPEN-HEART SUR-
GERY PATIENT, Mary Jo Aspmall, R N M N A
conCise solt.bound handbook tells all aboul nurs-
Ing open-heart surgery patoents dIet drugs. and
dlagnosllc tests how to cope with cnses (In
cludlng shock cardiac arrest eleclrolyte prob-
lems) mechanIcal eqUIpment and more 59.95
37251. CASE STUDIES IN EMERGENCY MED-
ICINE/CASE STUDIES OF NURSING INTER-
VENTION. Two vItal books offer Jve, 100 aclual
case h,slorres on every kInd 01 emergency dls,
order or senous complication you are hkely to
come across -Irom sUIcide attempts to ulcera
tlve colitIS, malar body burns lye Ingestoon, Inlect
ed animal biles lymphocytic leukemia and more
The 2 count as one boOk 512.90
70120. A PRIMER OF CLINICAL DIAGNOSIS.
William B Buckmgham Marshall Sparsberg and
Marl'" Brandlor/brener Complete easy to lollow
manual lakes you thr' ugh the actual process 01
the crucIal diagnostIc examinatIon detalhng every
conceIvable abnormality tt,at could anse 512.75
64530. THE NEW SEX THERAPY. Helen Sl11ger
Kaplan. M 0 Ph 0 A comb,natoon relerence
handbook whIch lucidly explains the most common
sexual disorders and shows how they can be cured
rapIdly Thoughtful and mature 517.50

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The Nurse's Book Society 6-27B
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Please accept my application lor member
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THE

LINIU

TIUDI....u.a ..a. u a PAT 01'. . CIIHAOA ...... IN u."

SHOE
p, k
""\Uh.ai,@

For a complimentary pair of while shoelaces,
folder showing all the smarl Clinic styles,
and list of stores selling them, write:

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THE CLINIC SHOEMAKERS
Dept. CN-9, 7912 Bonhomme Ave.
St. Louis. Mo. 63105

SOME STYLES ALSO AVAILABLE IN COLORS
SOME STYLES 3Y2-12 AAAA-E

about 23.95 to 29.95

"The most difficult job in any hospital
is still that of head nurse," a colleague
stated emphatically, as we discussed
the complexities of nursing service. I
didn't argue with her - after all, what
other role could possibly compete with
the head nurse role for the greatest
number of problems, frustrations, and
conflicts? Granted, the work may be
satisfying, but even so. . .
Why is the head nurse role so
difficult? Probably because of the
many problems inherent in middle
management.
A middle manager must be all
things to all people, and must have, as
one writer put it, "a strong constitution
and a juggler's finesse." . She must
be able to act as subordinate, equal,
and superior, and to relate to persons
at three levels:
· Upward, the middle manager re-
lates to her boss as a subordinate; she
takes orders.
. Downward, she relates to her
team; she gives orders.
. Laterally, she often relates to
peers in the organization as an equal;
for example, she may have to secure
cooperation from some other
department. . *
In addition, the head nurse as
middle manager must relate - and
relate well - to the patients in her
charge. Unlike her counterpart in the
Volkswagon factory, she has "pro-
ducts" in her plant that have
feelings - and a great desire to ex-
press them.
Another problem of middle man-
agement involves responsibility and
authority: the middle manager has
unlimited responsibility for her de-
partment, but does not have complete
authority. The head nurse, for exam-
ple, is responsible for seeing that the
patients on her unit receive complete
care 24 hours a day, yet she usually
lacks authority to hire additional staff
that may be essential to provide that
care.
Another problem of middle
management - a lack of policy
guidelines for the responsible treat-
ment of middle managers - is de-
scribed by John H. Runyon in his
article "A Psychological Contract of
Service" (p. 19). According to Runyon,
the middle manager just hasn't had
time to develop a "declaration of
rights" for himself, and is denied the
right of redress, of access to a grie-
vance procedure, or even a corporate
ombudsman. Runyon attempts to re-
medy this by presenting a "constitu-
tion" for middle managers. It's an
article well worth reading. - VAL.

The.
Canadian
Nurse

ð
'J

A monthly journal lor the nur
e
of Canada published
in English and French editions b
the Canadian Nurses' Association

Volume 70, Number q

September 1974

19 A "Psychological" Contract of Service

24 Component Therapy

28 Stand Up and Be Tested!

30 The Nurse as a Family Therapist

33 lotal Knee Arthroplasty

38 Preschoolers' Orientation to Hospital

. .J.H. Runyon

. . . .G. Rock

. . . . .5. Hill

.s. Gwilliam

. . .c. Stainton

4 Letters 7 News
17 In a Capsule 41 Dates
42 Names 43 Books
48 Accession List 64 Index to Advertisers

Ex""utive Director: Helen 1\.. \Iussallem _
Editor: \ir
inia A. Lindabur
_ A"istdn!
Editors: Lh-Ellen Lockeberg. J)oroth
S.
Starr _ Editorial As\istdnt: Carol A. D"or-
kin _ Production As\istan!' Elizabeth -\.
Stanton _ Circulation MdnaEer: Benl Dar-
lin
_ Advertising Mdnager: Georgina'Clarke
- Subscription Rates: Canadd: one }eM,
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vincid! nurses' assocldtion, "here applicable.
Not responsible for journd" lost in mail due
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Manuscript Information: 'The Canadian
Nurse" welcomes unsoliciled articles. All
manuscripts should be t} ped. double-spaced.
on one side of unrulcd paper ledving wide
margins. Manuscripts are dcceptcd for revie"
for exclusive publication. The editor reserves
Ihe right to make the usual edilorial chdnges
Photographs (gloss} prints) dnd grdphs and
diagrdms tdrd"n in india ink on white paper)
Me "elcomed "ith such drtlde,. The editor
is not committed to publish all articles sen!,
nor to indicdte definite datcs of publicdlion.
Poqage pdid in cash dt third cia" rate
MONTREAL P.Q. Permit No. 10,001.
50 The Drivcwa}, Onawa. Ont.lrio. K2P I E2

CCand
idn Nurses' Associdtion 1974.

. Hugo ER. Uyterhoeven, "General man-
agers in the middle," Harvard Business
RevIew, MarCh-April 1972, p. 75.
. . Ibid., p. 76.
THE CANADIAN NURSE 3
.

SEPTEMBER 1974

letters

{

Letters to the editor are welcome.
Only signed letters, which include the ,,/riter's complete add res!>,
will be considered for publication.
Name will be withheld at the writer's request.

Fitness testing was a good start
As an enthusiast of health promotion. I
joined the staff and nursing students from
the University of Manitoba who were
conducting the fitness testing for nurses at
the Canadian Nurses' Association con-
vention in Winnipeg. These tests were the
beginning steps in the need for nurses to
enter health promotion in a dynamic new
way.
This health approach will have to deal
with three questions: What is my state of
nutrition? How much physical activity do
I have daily? How do I deal with the
stresses of living?
We will be challenged to define nurs-
ing differently. In the past. we have said
nursing was doing for the patient what he
could not do for himself, When this is
taken from us. what will our nursing then
be'

What people need is to see clearly that
some changes in their life-style will
improve their health. and they need
encouragement to move toward this goal.
Nurses will really be involved in selling
individuals the idea of promoting their
own health. This will take nurses who are
personally convinced of this value and act
it out themselves.
Our numbers - the greatest of all the
health professions - and our dual know-
ledge in the physical and social sciences
put us in a unique position to move
toward people with this emphasis. I hope
many nurses will rise to the challenge of
this relevant nursing endeavor.
Eleanor Robson. Vancouver, B.C.

Nurses misrepresented
At a recent panel discussion on the effects
of cigarette smoking. we were subjected
to a discussion in which we felt a nurse
panelist's attitude damaged the image of
nurses in general. Her comments strongly
indicated her own personal bias and
apparent lack of cognitive reasoning.
The panel on which this nurse partici-
pated was composed of persons from the
medical. teaching. and nursing profes-
sions. Unfortunately. this woman was
representing the nursing view on smok-
ing.
Although the audience was composed
of persons from many professions. the
nurse panelist made it clear in her opening
statement that she was directing her
remarks only to the nurses present. She
then began to speak about trivial incidents
4 THE CANADIAN NURSE

related to smoking that have occurred to
her. Her remarks were completely off the
topic. excruciatingly boring. and an insult
to the audience - particularly to mem-
bers of the nursing profession.
This nursing representative made a
pointed ând rude comment to a doctor on
the panel about his overweight problem.
She also answered the few questions
directed to her in a condescending and
offensive manner. By her rude and
tactless attitude. she did a great deal of
damage. Her failure to offer any intelli-
gent information to the seminar did noth-
ing but reinforce the poor image many
other professionals have of the nursing
profession.
We feel it is our professional obligation
to take a stand against this kind of
misrepresentation. which has gone on for
too long. and to defend our role as
members of the health team.
Nurses are often not recognized as a
group of professionals with specialized
knowledge and ability to exercise inde-
pendent judgment. This is due largely to
poor representation by individuals. such
as the aforementioned. As well. our past
subservience to the medical profession
and our reluctance to defend our positions
have perpetuated our poor image.
We strongly encourage nurses to rec-
ognize their abilities and defend their
nursing judgment. Let us not sit back
complacently at a time when nurses must
establish themselves as valuable members
of the health team. - Jane Cunningham,
R.N., B.N., and Nancy O'Brien, R.N.,
B.Se.N., Toronto, Ontario.

Unable to contact Alberta group
I have been informed that there is a Lupus
Erythematosus Society of Alberta (LESAJ.
which ] have been unable to contact.
Perhaps a reader who has knowledge of
this society could make it known. It
would be greatly appreciated. as I am
attempting to form a local
group. - Margaret Duffy, RN,
140 - 4th Ave., Dorion, Quebec, J7V
2Z7.

Letters Welcome
I etters to the editor arc welcome. Be-
cau-;c of
pace limi1ation. writers arc
a..ked to rc..trict their letters to a
maximum of 350 words.

Nurse's efforts are stymied
I read with interest the letter from the
three nurses in Winnipeg. regarding what
they consider to be one of the reasons for
the ever-increasing shortage of hospital
nurses (April 1974. page 6). They are to
be commended for their foresight and the
courage to speak out.
University nursing faculties would do
well to pay heed, because in their frantic
haste to elevate the academic status of
nurses. they are creating and perpetuating
a state of affairs in the profession that
could eventually be disastrous for sick
people everywhere.
I am a diploma nurse/midwife with
some 16 years experience. As I found it
impossible to obtain a promotion without
a degree and recognized a need to further
my education, I decided a few years ago
to set the wheels in motion and investi-
gated the possibility of working toward
my B.N. I found I lacked the necessary
education required for university en-
trance. Obviously. the next step was to
try and upgrade my education by attend-
ing evening classes. To have evenings
free and not have to leave the hospital, I
inquired about an advertised vacancy in
the outpatient department. I was .told by
the personnel officer that as I had no
degree, I would be unable to counsel
patients; therefore, I had no reason to
apply.
My nursing experience is wide and
varied. I worked in Africa for some years
in teaching hospitals and in small clinics.
which were often remote. I also nursed in
South Vietnam during the worst part of
the war. This. plus what I consider to be
good basic preparation, does ensure that
by now I have some ability to counsel and
help patients.
I reluctantly left hospital nursing last
year. Many in my position have already
done so, for we are frustrated and stymied
at every turn in our efforts to obtain
advancement through education. We are
the nurses who worked hard and long
hours on the wards six days a week in the
past, and so enabled younger nurses and
those in good academic standing to obtain
what we are now being denied.
My final thoughts and concern go to
the patients who, if this situation does
not change, may be deprived of much
needed nursing care. That is, after all,
what nursing is all about. - R.N., Ed-
monton, Alberta (name withheld on
request). ?
SEPTEMBER 1974

ALBERTA MANITOBA HAMILTON
- Beube's Hamilton
CALGARY PORTAGE LA PRAIRIE Eaton's
The Bay Marr's Fashion Florence Nightingale Shop
Eaton's WINNIPEG Lockharts Ladies Wear
Johnstone Walker Ltd. The Bay G. W. Robinson Co. Ltd.
Simpsons-Sears Ltd. Eaton's Simpsons-Sears Ltd.
Vogue Uniforms Ltd. Rose Lee Fashion Uniforms KINGSTON
EDMONTON 265 Kennedy Ave. Simpsons-Sears Ltd.
The Bay 837 Sherbrooke SI. Uniform Shop
Eaton's Simpsons-Sears Ltd. KITCHENER
Johnstone Walker Ltd. NEW BRUNSWICK Eaton's
Rose Uniform Shop - - Uniforms Professional
Simpsons-Sears Ltd. FREDERICTON Uniform Salon
LETHBRIDGE Levine's Ltd. Simpsons-Sears Ltd.
Eaton's Simpsons-Sears Ltd. LONDON
Simpson's-Sears Ltd. MONCTON Eaton's
MEDICINE HAT Eaton's Robert Simpson Co. Ltd.
Petite Style Shop George Battah Ltd. Uniform Centre
RED DEER Simpsons-Sears Ltd. Uniforms Unlimited
The Bay SAINT JOHN NEWMARKET
Calp's Ltd. Dawson's Ltd.
BRITISH COLUMBIA Lady in White Boutique
Simpsons-Sears Ltd. OAKVILLE
ABBOTSFORD Professional Beauty Supplies
Suzan's House of Uniforms NEWFOUNDLAND
BURNABY CORNER BROOK ORILLIA
Simpsons-Sears Ltd. Sutton's Style Shop The Stork's Nest
CHILLIWACK GRAND FALLS OSHAWA
Shirl-Ann l!niform Shop Riff's Ltd. Eaton's
Chez L'Uniforme
FORT ST. JOHN ST. JOHN'S Si mpsons-Sears Ltd.
Model Dress Shop The London, New York & Paris OTTAWA
Association of Fashions Ltd.
GIBSON The Bay
Goddard Fashions NOVA SCOTIA C. Caplan Ltd.
KAMLOOPS ANTIGONISH Simpsons-Sears Ltd.
Uniform World
The Bay Wilkie Cunningham
Simpsons-Sears Ltd. OWEN SOUND
Town Talk Uniforms DARTMOUTH Sylphene's of Owen Sound
KELOWNA Jacobsons Of Dartmouth
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LOUGHEED Ein's Ltd. Uniform Shop
Simpsons-Sears Ltd.
The Bay H.\LlFAX
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PENTICTON Eaton's Uniform World
The Bay Robert Simpson Co. Ltd. ST. CATHARINES
PRINCE GEORGE Uniform Shoppe Eaton's
The Bay SYDNEY Magder's Uniform Shop
RICHMOND Jacobson's Ladies Wear Simpsons-Sears Ltd.
The Bay Uniform Shop ST. THOMAS
Simpsons-Sears Ltd ONTARIO Gerrard's Shop
SMITHERS
Village Fashions BARRIE SARNIA
SURREY Moore's Uniform Shop Simpsons-Sears Ltd.
The Bay BELLEVILLE SCARBOROUGH
Simpsons-Sears Ltd. Jackson Metivier Uniform Shop Uniform World
Mcintosh Bros.
TRAIL Simpsons-Sears Ltd. SHELBURNE
The Bay BRAMPTON Hazel's Ladies Wear
VANCOUVER Robert Simpson Co. Ltd. STONEY CREEK
The Bay BRANTFORD
Eaton's Eaton's
Image Uniforms Inc Uniform Shoppe
Jermaine's Ltd. BROCKVILLE STRATFORD
Rose Uniforms 1001 Uniforms H. Shapiro & Sons Stores Ltd.
VERNON BURLINGTON SUDBURY
The Bay G. W. Robinson Co. Ltd. Eaton's
VICTORIA CHATHAM Simpsons-Sears Ltd.
The Bay Artistic Ladies Wear Uniform Centre
Eaton's Eaton's THUNDER BAY
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CNF Awards 4 Scholarships
For 1974-75 Academic Year
Ottawa - Four Canadian nurses will
receive a total of $13,500 in scholarship
funds from the Canadian Nurses' Founda-
tion this year. The awards are for
graduate studies in nursing during the
1974 -75 academic year.
Scholarship recipients are:
. Beverlee Ann Cox, Vancouver, who
received the Katherine E. MacLaggan
Fellowship, worth $4,500; she will under-
take doctoral studies in interpersonal
communication in psychiatric settings, at
Simon Fraser UniversIty, B.C. Ms. Cox
(Queen's Hospital School of Nursing,
Honolulu; B.Se.N. and M.Sc.N.
(psychiatric nursing), U. of Hawaii,
Honolulu) is a nursing consultant, de-
partment of psychiatry, and lecturer,
school of nursing, UBC.
. Lorraine Jean Melchior, London, Ont.,
who received $3,000, including the W.B.
Saunders Company Limited Nursing Fel-
lowship and CNF scholarship funds, to
study for a master of science in nursing
degree with a major in administration.
Ms. Melchior (Victoria Hospital School
of Nursing, London; B.Sc.N., U. of
Western Ontario) is a lecturer in maternal
and child nursing, University of Western
Ontario.
. Anita Patricia Mountjoy, Montreal,
who received the White Sister Uniform
Inc. scholarship award worth $3.000; she
will study for a Master of Science
(Applied) degree with a major in ad-
ministration, at McGill U. Ms. Mountjoy
(Toronto General Hospital School of
Nursing; B.N. (Nursing Administration)
McGill U.) is a head nurse at the
Montreal General Hospital.
. Glennelda Marguerite Warner, To-
ronto, who received $3,000, including
the Agnes Campbell Neill Memorial
Award and CNF scholarship funds; she
will study for a Master of Science
(Applied) degree, majoring in pediatrics,
at McGill U. Ms Warner (St. Joseph's
Hospital School of Nursing, Toronto:
diploma in music, Hunter College, New
York; B.N. (maternal-child health and
nursing education) McGill U.) is a nurs-
ing instructor with the affiliate program,
Ryerson School of Nursing, Toronto.
In 1972, the Canadian Nurses' Founda-
tion awarded $40.200 to 14 nurses, and in
1973, it gave scholarships worth $31.500
to 10 Canadian nurses. The amount of
SEPTEMBER 1974

money available for scholarships has
decreased since the establishment of the
capital trust fund. However, when the
trust fund has reached sufficient size, the
income from its investments will assure
:10 annual amount for scholarships.

Increased Charge For RN Exams
Among Motions Approved By Board
Winnipeg, Man. - At their 14 June
board meeting, directors of the Canadian
Nurses' Association approved three re-
commendations contained in the report of
the special committee on testing service
(SCOTS).
One of the recommendations approved
at the recent meeting increases the charge
for the RN examination to $8 per paper,
effective I January 1975. The other
recommendations approved by the CNA
board are:
. that approval be given for the testing
service to continue with the development
of the French examination and also to
continue with the development of a
comprehensive examination for the RN
program; and
. that the testing service committee be
authorized to seek funding to cover the
cost of developing a comprehensive ex-
amination.
Helen Grice, chainnan of SCOTS, pre-
sented the report. A motion to ratify her
appointment as chainnan was passed by
the CNA directors. Ms. Grice is registrar
for the British Columbia Registered
Nurses' Association.
The following background infonnation
was included in the SCOTS report.
"The testing service has initiated two
expanded programs: the development of a
model for a comprehensive examination
for the registered nurse and nursing
assistant examinations, and the develop-
ment of a French-language examination
for French-speaking candidates (RN pro-
gram). Last year, the testing service
appointed a committee to develop a
model for a comprehensive
examination . . . .
"The purpose of this project is to
develop a model that will serve as a basis
for a comprehensive nurse examination
[which]. .. will be better able to meas-
ure a student's knowledge and under-
standing of a total nursing process. rather
than the present system where the five
clinical areas are measured separately."

The work on the first phase of this project
was scheduled for completion in August.
Exploratory talks were held with the
Order of Nurses of Quebec "to discuss
the development of a French-language
registered nurse examination." The
SCOTS report added that in February
1974, ONQ expressed its willingness to
contract to purchase the French examina-
tion offered by the testing service if one is
developed.
With regard to the $2 increase per
paper for the RN examinations, the report
explained that this will enable the testing
service to complete its projects. SCOTS
estimates the cost of developing a
French-language examination at approx-
imately $225,000 over the next two and
one-half years.
Following her report, Ms. Grice ans-
wered a question about the new French
examination by explaining that it will
differ from the one now available by
being designed in parallel to the English
examination, rather than being translated.
In addition to representation from
Quebec, representatives from Ontario and
New Brunswick will be included in
discussions concerning this new French
examination.

CNA Will Invest Up To $15,000
In NWT Nurses' Association
Winnipeg. Man. - The excitement of
being involved in the birth of an associa-
tion was evident 15 June when Wilma
Mackie, president-elect of the Northwest
Territories Registered Nurses' Associa-
tion (NWTRNA), met with the board of
directors of the Canadian Nurses' Associ-
ation. Agreeing to a request for funds, the
CNA board voted to . Invest up to $15,000
in NWTRNA."
With the CNA money, a $10,000 grant
from the NWT department of education for
certification of nursing assistants, and
membership fees, NWTRNA believes it can
have a balanced budget for the coming
year. Transportation and telephone costs
are two of the major expenses, Ms.
Mackie explained. During the
association's first year, President Leone
Trotter hopes to tour all parts of the NWT,
and the nursing practice board is
scheduled to hold its founding meeting.
Until NWTRNA gets registering author-
ity from the Northwe<õt Territories Coun-
cil, however, it is only a voluntary
THE CANADIAN NURSE 7

news

aSSOCIatIOn (News, June 1974, page 8),
Ms. Mackie told the CNA directors that
their $15,000 grant is so important at this
time because N\\ TRNA has to prove its
economic viability to the NWT Council.
NWTRNA is drafting an amendment to
the registered nurses' ordinance in time
for the October sitting of the NWT
Council. The association estimates that it
could take over registration of its mem-
bers shortly after this amendment is
approved.
On 24 June 1974, a position paper on
professions and occupations was pre-
sented to the NWT Council by the director
of public services for the NWT At this
time, Ms. Trotter asked the Council to
grant the nurses self-regulation and per-
mission for a registrar who would work
within the association, instead of being an
employee of the NWT Government.
The week before the position paper was
pre
ented, CNA sent a telegram in support
of NWTRNA to Stuart Hodgson. Commis-
sioner of the NWT.
Ms. Mackie noted that the association
had come a long way from the time nurses
first approached the "IWT Council, when
it was suggested that they would be
registered by the office that registers
vehicles, issues fishing licenses, and so
on.

Nurses' Attitudes Toward Health
Discussed By Convention Panel
Winnipeg, Man. - Why do nurses lack
interest in their own health'? Can we make
health, instead of illness. exciting, re-
warding. and satisfying?
Jean Everard. a special studies officer
for the Canadian Nurses' Association.
posed these questions while talking on the
topic "the nurse and her o\';n health" at
the CNA convention 20 June. Ms. Everard
was one of four members on a panel that
discussed personal attitudes and profes-
sional image.
She explained that not only do certain
health-destroying life-styles affect us, but
many more subtle forces reward illness.
"For example, you get paid to be off
work sick, but you do not get rewarded
for staying well. People notice you when
you have bags under your eyes and you
look tired. If you are fortunate enough to
be
ick. you will receive calls from friends
you haven't heard from in years, flowers,
cards, and offers of 'is there anything I
can do for you'?' You are in a state of
illne
s and noticed - an important
person, not just one of the crowd."
One reason for nurses' lack of interest
in their own health, Ms. Everard
ugges-
8 THE CANADIAN NURSE

International Women's Year

915

.
AIF

."

This symbol was designed for the
Canadian Government secretariat,
which is coordinating the many projects
in Canada for International Women's
Y ear in 1975. It is appropriate that a
"W" encloses the symbol. In the center
is the "I" and "Y". The " A" and
"f', together with the "I", stand for
"Année Internationale de la Femme."

ted, is that "health is dull in relation to
the excitement of other life-styles which
society advertises, fosters, and rewards.
One has only to review the TV commer-
cials . . . to become alerted to the sense of
excitement in the life-styles that are
projected along with the joys of smoking,
drinking, and [driving] fast cars. "
We respond to these life-styles as
humans who want and need to be
accepted by those around us, Ms. Everard
noted. . 'Our mental health needs may
cause us to ignore our physical health
needs. We are slow to admit that our
health problems may be psychological in
origin. . . . The real difficulty. . . is in
the belief that health risks are something
that happen to someone else, not me."
Lorine Besel. director of nursing at the
Royal Victoria Hospital in Montreal,
stimulated the audience with a discussion
of the private and the professional
"selL" Basing her presentation on Er-
ving Goffman's 8 "territories of the self'
in his book Relations In Public. she
offered her views of how nurses' private
selves are affected by constraints and
opportunities in the work environment.
Ms. Besel concluded that "the cons-
trictions in our expression of a profession-
al self and our lack of control over the
many territories of the self... may be

related to the power and rank problem,
and that may in turn be related to
femalenef,s. "
One example she gave of nurses' lack
of control over their professional self was
in relation to conversation. "Outside of
psychiatry and community work, it is not
common for nurses to have control over
even their conversation with patients.
Unless they are of high rank, nurses are
commonly summoned for discussion by
others. Further, most conversation of
nurses at work is not protected from
entrance and overhearing by others."
On the other hand, "As a private self
we can be relatively certain that we need
speak only to whom we want to, when we
want to, and where we want to. "

UN Seminar Here Introduces Issues
For International Women's Year
Ottawa - As an introduction to Interna-
tional Women's Year, which the United
Nations has proclaimed for 1975, Canada
is hosting an international seminar this
month at the UN's request. During the
first part of the seminar, experts from 32
countries are working on a model of
government machinery to improve the
status of women and promote equality of
both sexes at all levels of society.
The second part of the seminar, which
is being held in the Lester B. Pearson
building from 4 to 17 September, is a
one-week workshop for training represen-
tatives of other countries that wish to
establish national commissions or other
machinery to help women. Only those
invited by the UN wiII be allowed to
attend the seminar. Also because of space
limitations, members of the media wiII
only be able to attend the opening and
closing, and plenary sessions.
Helvi Sipila of Finland, assistant
secretary-general of the UN, will open the
seminar. With the exception of Canada,
each country has been allowed one
delegate and one alternate. As the host
country, Canada has been allowed to have
a delegation of 10, and has been asked to
name one of the three resource consultants
for the seminar.
In April 1974. the federal government
set up an International Women's Year
(lWY) secretariat in the Privy Council
Office; it is planning Canada's program,
and coordinating activities of government
departments for 1975.
During International Women's Year,
the secretariat plans to hold a national
educational and media campaign and 4
regional conferences to create awareness
of the changing attitudes toward women;
have legal barriers to equality removed;
see that government departments and
agencies implement special programs
promoting equal opportunity for women;
(Conrinued on page /2)
SEPTEMBER 1974

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DEMONSTRA TION
AND FOLDERS
UPON REQUEST

-

VALUABLE REFERENCES

INTRODUCTION TO HUMAN PHYSIOLOGY
Mary Griffiths

Well-balanced and clearly organized, Introduction to
Human Physiology focuses on the basic physiological
principle of homeostasis as it proceeds from the physio-
logy of the cell to that of the organ systems. Griffiths
begins by introducing the idea lhat the physiological
mechanisms that have evolved are useful; therefore,
the responses of the body are appropriate, predictable,
and susceptible to logical reasoning.
1974 560 pages $14.25

THE HUMAN BODY: Its Structure and Physio-
logy, Third Edition
Sigmund Grollman, M,S., Ph.D., F.A.C.S.M.
The new third edition of this comprehensive, beautifully
illustrated exposition of human anatomy and physiology
includes the latest research findings on the structure
and function of all levels of organization: cellular,
tissue, organ, and system. It systematically. interwea-
ves structure and function to provide an Integrate,d
picture of the human organism, takinQ the
omeo
tasls
of the cell as a focal point for a detailed diScusSion of
subcellular, macromolecular and molecular structures.
1974 612 pages $11.95

A LABORATORY MANUAL OF MAMMALIAN
ANATOMY AND PHYSIOLOGY, Third Edition
Sigmund GroUman, M.S., Ph.D., F.A.C.S.M.

This manual gives definitive and comprehensive cove-
rage of all aspects of human anatomy and physiology,
including cellular, tissue, organ and system levels of
organization. In a clear, concise manner, basic princi-
ples are presented in an integrated treatment of struc-
ture and function that skillfully interweaves molecular,
submicroscopic, cellular, histological, macroscopic,
and physiological material. New to this edition are unu-
sual and exciting experiments on electrocardiography
and sensory imput of spinal nerves; significant new
material on the skull, shoulder joint, ankle joint, foot, and
muscular system; and expanded coverage of computa-
tion of blood cell factors, electronic recording devices,
and calculations on respiratory capacity.
1974 266 pages $6.25

MICROBIOLOGY IN PATIENT CARE, Second
Edition
Marlon E. Wilson, M,A., Ph.D., and Helen Eckel Mizer, R,N., A.B.,
M.S.

This well-written, well-organized textbook for professio-
nal and technical nursing students and others concer-

10 THE CANADIAN NURSE

ned with patient care emphasizes epidemiology and the
practical applications of microbiology. Part I deals with
basic principles of microbiology and Part II with micro-
bial diseases and their epidemiology.
1974 576 pages $11.95

LABORATORY MANUAL AND WORKBOOK IN
MICROBIOLOGY: Applications to Patient Care
Marion E. Wilson, M.A., Ph.D., Martin H. Weisburd, B.S., M.S., and
Helen Eckel Mizer, R.N., A.B., M.S.

This laboratory manual-workbook is designed for intro-
d.uct
ry courses in microbiology. It emphasizes the ba-
SIC prrnciples of diagnostic microbiology as they apply to
the care of patients with infectious diseases. The exer-
cises illustrate the nature of laboratory procedures used
for isolation, identification, and reporting of infectious
agents as well as the principles of asepsis, disinfection
and sterilization. '
1974 224 pages $5.50

NORMAL AND THERAPEUTIC NUTRITION,
Fourteenth Edition
Corinne H. Robinson, M.S., R.D.

Intended especially for students of nursing and diete-
tics, this edition has been revised and expanded
beyond previous editions in two important ways: in
discussions of nutrition as a science and in the
emphasis placed on nutrition education and dietary
counselling. The special two-column format, new with
this edition, makes the text easy to read, and a
glossary of over 500 frequently used terms is included
for the first time.
1972 753 pages $10.50

TECHNICAL NURSING OF THE ADULT: Medi-
cal, Surgical, and Psychiatric Approaches, Se-
cond Edition
Sandra B. Fielo, R.N., M.A., and Sylvia C. Edge, R.N., M.A.

The second edition of this basic textbook has been
extensively revised and updated to reflect theoretical
and practical changes in nursing as well as the changes
in the health needs of our society. Comprehensive yet
concise, this book offers a well-integrated approach to
all areas of medical, surgical, and psychiatric nursing for
the associate degree student.
1974 640 pages $11.95

SEPTEMBER 1974

AND IMPORTANT TEXTS

BASIC MEDICAL-SURGICAL NURSING, Third
Edition
Mildred A. Mason, R.N., M.Ed.
This popular textbook for practical and vocational nur-
sing students has been expanded to include chapters
on 'The Aging Patient' and 'The Role of the Practi-
cal/Vocational Nurse in Accidents and Emergencies'. A
tabular list of drugs used for various conditions, additio-
nal dietary information as well as in-depth discussions
on the role of the practical/vocational nurse are presen-
ted in this edition.
1974 704 pages $10.25

WORKBOOK IN BASIC MEDICAL-SURGICAL
NURSING
Bonnie K. Smola, R.N.. B.S.N., and Mildred A. Mason, R.N., M.Ed.
This workbook has been designed to accompany the
third edition of Basic Medical-Surgical Nursing but can
be used with any standard textbook for students of
practical and vocational nursing.
1974 224 pages $5.50

PROGRAMMED MATHEMATICS FOR NUR-
S ES, Third Edition
George I. Sackhelm, B.S., M.S., M.A., and Lewis Robins, Presi-
dent, Reinforced Learning, Inc.
Representing a programmed approach to the mathema-
tics of nursing, this manual may be used as a self-
teaching device in a classroom or dormitory setting, or
may be used prior to admission to the nursing program.
This programmed (or reinforced learning) course asks
the student to solve a logical series of problems. Each
problem is designed to stimulate the student to think out
the correct answer on the basis of information she has
alreadv learned. Because she reads the correct answer
after responding to each problem, she will learn quickly
and easily even if her response was incorrect.
1974 220 pages $6.75

CHEMISTRY FOR THE HEALTH SCIENCES,
Second Edition
George I. Sackheim, B.S., M.S., M.A., and Ronald M. Schultz
This popular introductory chemistry text for nursing and
other health-related programs emphasizes the practical
aspects of inorganic chemistry, organic chemistry, and
biochemistry. Theoretical topics are discussed only as
an aid to understanding bodily processes in the human.
1973 515 pages $10.50

lABORATORY CHEMISTRY FOR THE HEALTH
SCIENCES, Second Edition
George I. Sackheim, B.S., M.S., M.A., and Ronald M. Schultz
Specifically designed to accompany the second edition
of Chemistry for the Health Sciences, this laboratory
manual can be used with any general chemistry text that
treats inorganic, organic, and physiological chemistry.
1974 240 pages $5.50

also of interest:

please note that the following three titles are
available from your local bookstore.

THE DENIAL OF DEATH
Ernest Becker, Ph.D.
This 1974 Pulitzer Prize winning book is a profound
synthesis of theological and psychological insights into
man's nature. The author points out the limitations of
psychoanalysis and of reason itself, in helping man
transcend two of the mainsprings of human activity -
his conflicting fears of both life and death.
1973 314 pages $8.95

QUESTIONS ON DEATH AND DYING
Elisabeth Kubler-Ross, M.D.
This sequel to the widely-acclaimed On Death and
Dying discusses the questions most frequently asked
by the hundreds of thousands who read Dr. Kubler-
Ross's first book and put its precepts into practice.
1974 128 pages $1.65

HEALTH: A Quality of Life, Second Edition
John S. Sinacore, Ed.D.
Community and personal health problems such as men-
tal health, family living, personal health maintenance,
disease prevention and control, and community health,
are discussed and illustrated by life situations relevant
to the student's interest.
1974 496 pages $10.95

For further information write to:

COlliER-MACMILLAN CANADA, LTD.

11258 LESLIE STREET, DON MILLS, ONTARIO

SEPTEMBER 1974

THE CANADIAN NURSE 11

news

(Cvntinued from page 8)
coordinate funds available to women's
organizations and other groups for pro-
jects such as setting up film libraries and
centers; and, finally, hold a national
conference in Onawa at the end of the
year.
More information about these activi-
ties, including a brochure and newsletter,
is available from the IWY secretariat,
Privy Council Office, Ottawa. KIA OA3.

Ont. Nurses' Association Brief
Summarizes Bargaining Situation
Toronto, Onto - A 44-page brief. presen-
ted 24 June by the Ontario Nurses'
Association to the Hospital Inquiries
Commission on Salaries, Wages. and
Other Benefits of Hospital Employees.
discusses the experience of collective
bargaining by nurses in Ontario and
conclusions reached as a result of this
experience. Province-wide bargaining
and the collective bargaining situation for
nurses in the other provinces are also
covered.
Prepared on behalf of the DNA and 69
independent nurses' associations in Onta-
rio. this information-packed brief was
presented at a hearing of the hospital
commission that was appointed by the
provincial government to look into the
whole collective bargaining situation in
hospitals (News, August 1974, page II).
The problems of the compulsory arbi-
tration system in Ontario are explained in
the brief. Because early arbitration
awards fell so short of the nurses'
demands, many nurses "settled for too
little simply to avoid arbitration." Such a
settlement was then used by employers at
other arbitration hearings and quoted as a
,. freely negotiated" settlement.
Salary awards. however. have been
only one factor causing concern over
compulsory arbitration. The brief conti-
nues: "The delay
inherent in the system
have constantly been of great concern and
in many instances have caused the nurses
to settle rather than be caught in a frozen
salary and working conditions position
for months on end."
Although delays and an uncertain out-
come are seen as "sufficient reason to
turn away from compulsory arbitration."
a greater rea
()n ha
been the lack of a
"guarantee of retroacti vity." Where a
previous collective agreement existed.
retroactivity has applied to salaries only.
according to the DNA.
"In the past. perhaps the most impor-
tant issue of all regarding. . . retroactivity
was the failure to apply the retroactive
12 THE CANADIAN NURSE

salary adjustment to nurses. . . no longer
in the employ of the hospital:' the brief
adds. Considering the long time it takes
for arbitration awards to be handed down.
"the employer has benefitted tremen-
dously. Approximately 50 percent of his
nursing staff will have worked at last
year's wages and he will not need to
reimburse them with the salary adjust-
ment since they are no longer in the
employ of his hospital:'
The brief mentions. however, that
since September 1972, II arbitrations
have extended retroactive provisions to
employees who have left.
The section in the brief on wage
comparisons brings out some interesting
information. For example. only one
group of nurses in Ontario is presently
organized in the private sector - the
Nurses' Association Chrysler Corporation
Canada, in Windsor. These nurses have
the right to strike and in their present
contract receive a starting rate of $902 per
month in 1974, with an additional cost-
of-living and improvement factor built in.
Comparing nurses' with doctors' sala-
ries. the brief notes that between I April
1972 and 31 March 1973. the average
health insurance payment made to doctors
in Ontario was $43.982; the average
salary for nurses. obtained through collec-
tive bargaining, was $8.280 in 1973 or
"approximately 18.8 percent of the aver-
age payment made to doctors."
"Since [nurses] are part of the health
team with doctors. it would be logical that
their salaries should be pro rata of the
salary of a doctor. The question of 'how
much' has never been determined." the
brief adds.
The first section of the brief concludes
with a summary of practices that are
"totally unacceptable" to the nurses.
including:
. determining their salaries on the basis
of the going rate in a neighboring
hospital. rather than looking at the prevail-
ing salaries for other professions. other
public service employees. and other
workers in our society; and
. paying nurses wages belm" those of
many workers who have less education.
qualifications. skills. and responsibilities
because they are women in a predominan-
tly female occupation.
"No free collective bargaining can
exist when the employer has no real
power to bargain. The imposition of
budgetary guidelines by the ministry of
health on the hospitals has made a
mockery of bargaining, .. ONA says.
Province-wide bargaining, which is
discussed in another section of the brief.
is considered by DNA as "not only a
feasible and desirable means of collective
bargaining. but as the most logical and
rational means for hospital employees."
After reviewing the bargaining structu-
res for nurses in the other provinces. the
brief concludes that most nurses are now

- or soon will be - engaged in
province-wide bargaining.
Limited copies of this brief are avail-
able from ONA. 33 Price Street. Toronto.
Ontario. M4W IZ2. A copy can also be
borrowed from the library of the Cana-
dian Nurses' Association, 50 The Drive-
way, Ottawa, K2P IE2.

Unique Nursing Research Project
Described At NBARN Meeting
Bathurst, N.R. - During the opening
session of the New Brunswick Associa-
tion of Registered Nurses' annual meeting
28 May. a unique NBARN nursing research
project was described by Helen Beath -
the nurse investigator for the project.
Ms. Beath said the research was
initiated to test NBARN's belief that
nursing care can best be provided by
nurses prepared in diploma and bac-
calaureate programs. NBARN further be-
lieves that nursing skills. particularly
those of baccalaureate graduates. can be
more effectively used in hospitals by
reorganizing staffing patterns, reducing
the number of supervisory personnel. and
by delegating nonnursing duties. Ms.
Beath added that the roles of ward
secretary. ward aide. and orderly are
supportive to the nurse.
Two identical 32-bed surgical units at
The Moncton Hospital were used for the
study. A "control unit" that represented
the existing staffing pattern consisted of
registered nurses and registered nursing
assistants. and an "experimental unit"
used diploma and baccalaureate nurses.
Ms. Beath said these two patterns were
compared on the basis of the nursing care
provided. use of nursing skills. cost of
personnel. and the cost of supplies and
services.
From 17 hypotheses. variables were
identified to be measured in comparing
the two patterns. Daily patient profiles
were done to ensure that both units had
the same patient census; the profiles were
done in relation to population and levels
of care required by each patient. Staff
mobility. use of referral services. and
medication and treatment incidents were
tabulated monthly.
According to Ms. Beath. the nursing
care provided was measured by 5 sets of
observations: 2 of these compared the
numbers and categories of personnel who
entered the patient's room, and the
frequency and length of patient bell calls;
the third gave a general picture of the
activities of personnel 0>1 the unit during
24 hours; the fourth involved the observer
becoming the "eyes" of a nurse in
observing all activities relating to a
nursing procedure; and the fifth consisted
of the observer becoming the patient
receiving care.
Observations were begun in Februar)
1972 and completed in April 1973 by 6
SEPTEMBER 1974

RNs who were trained as observers. The
data have since been tabulated and are
now being analyzed. Findings and results
of the project will be published this fall.
Congratulating NBARN on initiating this
research. Ms. Beath called it a needed
contribution to nursing in Canada. A
National Health Grant has funded the
project. which got under way in August
1971.

Manitoba Nurses Say Work,
Learn, And Bargain Together
Winnipeg, Man. - Manitoba nurses have
taken a significant step toward combining
legislation pertaining to registered nurses,
registered psychiatric nurses (RPN). and
licensed practical nurses (LPN).
Two joint resolutions from the Mani-
toba Association of Registered Nurses,
Registered Psychiatric Nurses' Associa-
tion of Manitoba. and the Manitoba
Association of Licensed Practical Nurses
indicate that their discussions of the past
few years have progressed to the point
where a plan of action will now be
considered.
The general membership of these three
associations has approved the esta-
blishment of a council of nurses compri-
sed of the president and two members
from each association; the 9-member
council will act in liaison capacity and
also in an advisory capacity in developing
a unified nurses' Act. The second resolu-
tion calls for a joint continuing education
committee to be established to plan and
organize continuing education programs
that meet the needs of the members of
each association.
The registered nurses abo approved,
through bylaw revision. the provision of
representation for the licensed practical
nurses and registered psychiatric nurses
on the Provincial Staff Nurses' Council
- the body concerned with collective
bargaining for nur
es.
In addition to the present 2 elected RNs
from each of 6 regions in the province,
there will now be I member elected by
and from the LP:'-Js of each region. The
revised bylaw also allows for membership
for RPNS. Of the 35 collective bargaining
units represented by the Staff Nurses'
Council, 23 are comprised of both RNs and
LPNS. Five of these units also include
RPNS.

Debate Heated At NBARN Meeting
When Some Resolutions Discussed
Bathurst, N.B. - The question of whe-
ther new graduates arc performing the
same role as registered nurses while they
await the results of their registration
examinations created heated discussion at
the annual meeting of the New Brunswick
Association of Registered Nurses and the
NBARN council meeting in May.
A resolution supporting this argument
SEPTEMBER 1974

requested that successful RN examination
candidates have their certificates backda-
ted to the final day of writing. Although
this resolution was defeated. NBARN
council members voiced concern for the
nonregistered nurse who accept'> the RN'S
responsibilities and for the RN who
assigns these duties to her. The council
expressed an urgent need to clarify the
legal role of the RN and the graduate
nurse.
NBARN president Bernadette LeBlanc
said "steps must be taken to eliminate
this dangerous practice. .' A position
paper on the job description of a staff
nurse will be developed and presented to
the personnel policy division of the
provincial Treasury Board.
A resolution that was carried by a
2-vote margin encourages present and
prospective employers to provide nurses
with the opportunity for learning a second
language. specifically where such a lan-
guage is a job requirement or directly
influences quality of patient care. This
resolution also requests NBARN to consi-
der establishing a special bursary for
language studies to help nurses serve
patients better in their mother tongue.
Discontent with a I-year nursing or-
derly course. recently established by
Canada Manpower. was reflected in a
resolution calling for a letter to be sent to
Canada Manpower and to the N.B.
community college organization recom-
mending that the course be discontinued.
NBARN will ask that all applicants to this
course be guided into 12-month nursing
assistant program.
Members at the annual meeting feared
that because women were enrolling in the
nursing orderly course. another category
of health worker could be created, which
would be detrimental to patient care.
A related resolution requested that the
provincial Treasury Board be approached
about discrimination between the salary
levels of the registered nursing assistant
and the orderly. NBARN members agreed
that a wide variation exists in the educa-
tional levels of nursing orderlies, that
higher standards of nursing care result
from more education. and that higher
education levels should be remunerated
accordingly.
Other resolutions approved that the
association's standing committee chair-
men be elected rather than appointed. and
that the advisory committee on the educa-
tion of nurses implement at least 2 weeks
of clinical experience in the operating
room in basic nursing programs.
Defeated was a resolution to encourage
employers to pay nurses their regular
salary while they attend university to
obtain a nursing degree.
Decisions taken during the business
session involve the Canadian Nurses'
Association. NBARN will ask CNA tn
investigate application of the Unemploy-
ment Insurance Act in relation to retrain-

ing. relocation. and part-time employee
benefits. CNA will also be requested to ask
the federal government to enact legisla-
tion allowing employees to retire volunta-
rily at age 60 and still receive maximum
benefits.
Dr. Josephine Flaherty. dean of the
faculty of nursing at the University of
Western Ontario in London. was the
keynote speaker at the annual meeting.
Speaking on the theme "riding the crest
of change." Dr. Flaherty said. "it is no
accident that nurses in Canada have never
been as well prepared as they are now to
make major decisions which will affect
the profession for years to come. "
The pace of life is such. she continued.
that we can no longer delay the
decision-making until large numbers of
data have been gathered. analyzed, and
reflected upon at length.
.. No longer do we feel obliged to carry
the burden of omniscience that has
marked so many professions. Rather. our
hallmark is conspicuous effort to develop
strategies to deal with almost instant
obsolescence of knowledge and profes-
sional practice." Dr. Flaherty said.

SRNA Members Pass Resolutions
Calling For Government Action
Regina. Sask. - Resolutions passed at
the annual meeting of the Saskatchewan
Registered Nurses' Association 29-31
May include varied recommendations to
the provincial and federal governments.
The resolutions referring to the provin-
cial government call on SRNA to:
. recommend to the government that the
legal age limit for medical treatment
without the consent of parents or guar-
dians be lowered to 16;
. request the government to provide the
funds and the personnel necessary to
facilitate appropriate orientation of new
graduates by employing agencies; and
. form a committee to define nursing
practice and legal responsibilities in pa-
tient care in the province. and present its
findings to the government as has been
done in Quebec.
Two resolutions calling for federal
government action request SRNA to:
. urge the Canadian Nurses' Association
again to request the government to enact
legislation that would allow employees to
retire voluntarily at age 60 and still
receive maximum pension benefits; and
. urge the government to reintroduce the
amendments to the Canada Pension Plan.
which would have allowed the same
benefits to be paid on the death of both a
female and male contributor. at the first
sitting of the new parliament.
Among the other resolutions passed at
the SRNA annual meeting are:
. that SRNA investigate the feasibility of
establishing. as a requirement for renewal
of registration. the acquisition of a given
THE CANADIAN NURSE 13

news

tColI/Ùwelljmm page 13}

amount of education within a stated
period;
. that the council of SRNA go on record as
supporting the concept that a nurse's
educational preparation, as well as ex-
perience, be recognized in the salary
structure; and
. that SRNA establish a research service
immediately.
Delegates attending the meeting ap-
proved a registration fee increase of $10.
The new fee of $50 will not be effective
until 1976. however. as it requires a
bylaw change at the next annual meet-
ing. Also approved was an increase in the
per member contribution to the Canadian
Nurses' Foundation. As of January 1976,
the SRNA contribution will be increa<;ed to
$2 from $1 per member.

5 Canadians Attend Seminar
With British, American Nurses
Ottawa - Five Canadian nurses were in-
vited to the second King's Fund seminar
for nurses, held at the King's Fund Col-
lege, London, England, 21-27 July 1974.
Three Canadian nurses were invited to the
first seminar held in May 1972.
First-time attenders at the 1974 seminar
were Huguette Labelle, principal nursing
officer, Health and Welfare Canada, and
president of CNA; Dorothy Mumby, di-
rector of public health nursing,
Middlesex-London district health unit,
London, Ont.; and Helen Taylor, director
of nursing, Jewish General Hospital,
Montreal.
Attending the seminar for the second
time were Dorothy Kergin, director of the
McMaster University school of nursing,
Hamilton, Ont., and Helen K. Mussallem,
CN A's executi ve director.
There were 12 senior nurses from each
side of the Atlantic at the 1974 summit
seminar; 5 Canadians and 7 nurses from
the United States met with 12 nurses from
the U.K.
Dr. Mussallem spoke at the opening
session of the seminar. She discussed the
development of social indicators, and the
need for a socioeconometric model for
predictions related to health care. She also
explained the health field concept and its
implications for nursing.
Seminar participants studied the chang-
ing role of the nurse and the relationships
between nursing education and nursing
service, including the need to safeguard
educational freedom but ensure relevance
to service needs and commitment to the
ethos of professional service.
There are plans to hold a third seminar,
14 THE CANADIAN NURSE

also sponsored by the King's Fund, in
1976. King Edward's Hospital Fund for
London (called the King's Fund) had its
origin in the massive response to a public
appeal in 1897 by Edward, then Prince of
Wales, to help the hospitals of London.
The policy adopted then, to maintain the
invested capital sum and to use only the
income, continues to the present day.
Present activities of the King's Fund
include King's Fund College, which offers
courses and special seminars (such as the
seminar for senior nurses from Britain,
Canada, and the U.S.), and suçport for
experimental projects.

Proceedings Of ICN Congress
Are Now Available
Geneva, Switzerland - The most recent
publication of the International Council of
Nurses, entitled Nurses and Nursing,
gives a full report of the ICN Congress
held in Mexico City in May 1973.
This document includes the papers
presented at the plenary sessions, summa-
ries of special interest sessions, action
taken by the Council of National Repre-
sentatives, addresses of welcome, the
admission of new member associations,
the "watchword" for 1973-77, and the
new ICN president's address.
Adele Herwitz, executive director of
ICN, noted there were many .. firsts" at
this congress. It was the first time that all
speakers were nurses, that a concerted
effort was made to involve as many
member associations as possible, that
student nurses participated in all activities
on the same basis as graduate nurses, and
the first time such an ICN meeting was
held in a Spanish-speaking country.
The publication can be purchased by
cheque or international postal money
order for $5 (us) from ICN, P.O. Box
42, CH-1211 Geneva 20, Switzerland.

Migraine Foundation To Conduct
Research, Information Projects
Toronto, Onto - With the launching of
Thé Migraine Foundation at Sunnybrook
Hospital in July, help - in the form of
research and information - is on the way
for migraine sufferers.
Although incorporated in Ontario, the
foundation intends to serve all of Canada.
Its plans include liaison with all levels of
government; cooperation with educa-
tional institutions to ensure that up-to-
date information is included in their
courses of study; promotion and estab-
lishment of diagnostic and treatment
centers; counseling services for migraine
sufferers and their families; assistance to
health disciplines in diagnosing and treat-
ing the migraine; and holding of semi-
nars, exhibitions, public meetings, and
conferences on this topic.
The foundation is also considering
projects on acupuncture, hypnosis, medi-

cation, pressurized rooms, and the best
use of color for relief of the migraine.
There is a possibility in the future of
having a computer bank that would store
patient information for use in statistics,
research, and publication. Such a compu-
ter bank could provide for country-wide
hookup and 24-hour information on a
patient. Specialized studies into factors
affecting migraine, such as nutrition and
environment, are other possibilities the
foundation will consider.
Membership in the foundation is on a
donation basis. Members will initially
receive counseling and information.
A first priority, the foundation says, is
the preparation of a questionnaire to be
filled out by each member. The informa-
tion gathered will be used for research
and statistics. The Migraine Foundation is
located at 390 Brunswick Avenue, To-
ronto, Ontario, M5R 2Z4.

Student Participation Possible
At 1977ICN Meeting In Tokyo
Geneva, Switzerland - The International
Council of Nurses (lDJ) is working out
details of how nursing students can join in
the decision-making and deliberations of
the international nursing body.
At the last meeting of the (CN in Mexico
City in 1973, the Council of National Re-
presentatives (CNR) accepted a suggestion
that an international assembly of student
nurses should meet at the same time as the
CNR and that the student assembly should
have the privilege of sending recommen-
dations to the CNR. At the same time, the
CNR referred the suggestion to the profes-
sional services committee of ICN..
At the present time, nursing students
can influence the international nursing
body only by persuading their national
as
ociation to sponsor a resolution. The
new procedure will give students. through
an international student assembly, direct
access to the decision-making body of
ICN, the CNR.
The International Council of Nurses
meets every 4 years and the Council of
Ndtional Representatives meets every 2
years. The proposal. therefore, would
provide for an international meeting of
nursing students every 2 years.
The professional services committee's
proposals on student participation will be
presented to the ICN board, and then to the
CNR when it meets in Singapore in 1975.
Two Canadians are members of the ICN
board: Nicole Du Mouchel, Montreal,
and Verna Huffman Splane, Vancouver.
The student assembly, and its privilege
of sending recommendations to the CNR,
should be operative at the 1977 meeting
of the ICN in Tokyo. A recent news
release from (CN headquarters in Geneva
encourages student nurses around the
world to start collecting funds to send
their representatives to the 1977 congress
in Japan. '. .
SEPTEMBER 1974

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SUPERVISOR

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in a capsule

No place for music in OR
A plea 10 abandon the growing practice of
allowing background music in operating
rooms comes in a letter to the editor in the
10 June i
sue of the Journul oj the
A mer;cu1l ,"'I ed;cul A uoc;atio1l.
Dr. William M. Oal). Wehqer. Ne....
York. write<;: "The alert anesthesiologist
depends a great deal on his ears to aid him
in safe conduct. He cannot give his full
attention to such vital soumh as those
arising from cardiac monitors. blood
pres..ure determinations. pulse meters.
presences or absences of normal or
abnormal respiratory noises. proper cycl-
ing of ventilators. gas leaks. and other<;.
and also sing along with Mitch.
. 'Operating rooms should be as quiet as
possible except for the essential sounds of
communication between personnel di-
rectly concerned with the patient's care.
The patient is deserving of all the staffs
continuous attention, and not just be-
tween musical scores. When a surgeon
hums or whistles during dn operation. it
usually means he is worried. bored.
embarras,ed. or hopeles<;ly lost."
Concludes Dr. Daly, .., et'
reserve
tranquilization hy music for the psychiat-
ric wing."

What type are you?
The following letter. written hy Dr.
Jerome L Siale and puhlished in The New
E1lgla1ld Journal of Medici1le 30 May
1974. gives the results of an original
study of medical ..taff at his hospital.
"The Boston City Hospital department
of medicine recemly installed a photo-
copier in the medical house-staff library.
Since then, I have conducted a study and
determined that the use of medical litera-
ture hy hou<;e ,tan is controlled h) two
genes. Rand X. The phenotypic expres-
..ion.. are RR . Iho<;e ....ho read the ioumal
and retain the information; '\R . those
unanle 10 read the original joumal and
"ho must Iherefore Xerox it and then read
the copy. and ". those \\ ho Xerox and
file "ilhout e\er reading.
. "Inevitably, there are mulants, some
of ....hom I have so far observed: Xð.
those who Xerox and then lose their copy;
and \ \ \ . known as '..upelfile.'
'Perhaps others "ould he interested in
noting their o....n phenotypes and degrees
of penelrance. Furthermore. I might
suggest that all mutants seek out their
librarians for genetic counselin
."
SEPTEMBER 1'}74

Kidney test proves effective
A school screening program to detect
kidney disease has shown that it is cost
effective to test schoolgirls for urinar)
infection. This conclusion resulted from a
screening program carried out ny The
Hospital for Sick Children IHsn in
Toronto.
A write-up about this program in the
June issue of Ihe ho<;pital's publication
What'
Nt'\\' give.. the folio.... ing statÎ<;tics:
13.457 children ....ere lested (6.X2S noys
and 6.632 girls). Of these. 20R had
urinary problems (173 girl, and Vi h(>
s).
Further tests ..howed that for 8 of the<;e
girls and I boy. the prohlems ....ere major
one, needing immediate medical atten-
tion.
"The total cost for te..ting the bo

. .
was $7.657.50. Since ()nl
one ...eril'us

case \\.1S found, it ma.. not he cosl
effective to check schooÍbnys for urine
infection. But Dr. Gerald Arbus. director
of the HSC dial)'..is unit, sa}s the test
definitely proved cost effective for girls.
'It cost $13.343 to test all the girls in
the program. '0 for each ,erious case
detected. the pi ice "as <1;1.667.88. With
proper medical and/or surgical follow-up.
Dr. Arbus anticipates the problems
detected. " can eilhel he cured or
prevented from becoming more severe."
the publication reports.
Once he has all the results. Dr. Arbus
....ill present hIs ca<;e for government-
backed testing of all Ontario schoolgirls.
to the provincial government. What's
Nell' adds that it cost less to test the
13,457 children than to keep one child on
dial}sis for one year.

tpl!l

"She's a tr.msfer from tht' lhildrt'n's ward."

THE CANADIAN NURSE 17
.

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1890 BRAMPTON STREET, HAMILTON, CANAOA

A "psychological" contract
of service

The rumblings of discontent with work
and the total work environment can now
be heard from the assembly lines of
automoti ve production to the assembly
hall
of academia.
The discomfon and malaise of middle
managers and that of professors, teachers,
nurses. and other professionals is begin-
ning to find expression in aniculated
demands to be heard alld involved - in
movements toward association and union-
ism - in the three-martini lunch and in an
escape to the golf course.
This flight from boredom to alienation.

John H. Runyon is employed as a
manpower resource specialist with the
Government of Canada. where he is
currently engaged in the design and
development of a total work and work
environment study. He has successfully
introduced a self-appraisal approach to
performance evaluation.
A former systems analyst. he was co-
founder of the Systems and Procedures
Association. Ottawa Valley chapter. His
concept of an integrated personnel data
system appeared in national and interna-
tional journals and was used as a basis of
a personnel information system for the
postal service of France. Mr. Runyon's
'iubmission on the formation of organiza-
tion and methods units in government was
accepted by the Glassco Commission and
used as a reference by the faculty and
student body of the University ofB.e.
As a management analyst, Mr. Runyon
has written and lectured to student groups
on the subjects of job evaluation systems
and organizational analysis.
The views expressed in this anicle are
entirely those of the writer and do not
necösarily represent those of the povern-
ment of Canada.
SEPTEMBER 1974

John H. Runyon

this stunting of human and psychological
growth is in evidence everywhere, from
the 2821 managers surveyed in 1971 by
the American Management Association to
the utterances of:
_ U.S. Congressman pucinski of the
State of Illinois, who has documented
evidence concerning the growing de-
mand for meaningful work and who
has termed this crisis as reaching the
.. proponions of a third revolutionary
force";1
- John Crispo. former Dean of the
Faculty of Management Studies, Uni-
versity of Toronto, who was reponed
to have said: "Supervisory and man-
agement personnel have real griev-
ances, including job security and their
frequent role as scapegoats for the
mistakes of top management"; 2
- Chairman Gertensberg of General
Motors, who was reponed as having
said: "The problem of managing peo-
ple is giving G. M. and other auto
makers their biggest headaches -
bigger than even the nev. car recalls
and the continuous battle over auto
safety and pollution controls. "3
These murmurs of discontent. the
reverberations of industrial sabotage, this
waste of human talent and resultant
stress are philosophically passed off as
nothing more than a shift in social. moral.
and work values.
And the sound and fury has not yet
reached the Executive Boardroom, as top
management, which got there by devotion
to the work ethic. has not yet developed
even a posture of listening. Despite all of
the adherence and lip service to the cult of
participative management, little evidence
exists that positive steps are being taken
to reduce or arrest the flow of psychologi-
cal dropouts - those employees who have
long since retired, but who are still on the
payroll of a panicular organization.

Ironically, however, the middle man-
ager is both villain and victim of em-
ployee disenchantment. He is inescapably
implicated and involved in helping to
create the very organizational climate in
which human growth and development is
nurtured. But the middle manager is all
too frequently so caught up in the admin-
istration of "Contracts of Service" and
, -Contracts for Service" that he has no
time in which to design and develop a
Psychological Contract of Service for
himself and thousands of other disen-
franchised managers. The right of re-
dress. of access \0 a grievance procedure,
or even a corporate ombudsman has been
denied him. Must he reson, therefore. to
his declaration of the rights, freedoms,
and obligations as he sees them and as he
might propose in Figure J?
There is a void in policy guidelines for
the responsible treatment of lower and
middle management employees. While a
" constitution" to protect the rights of
these people may seem problematical in
terms of what it should cover, and who
would administer it. it may be the least
troublesome of all the possible alterna-
tives now facing us. However else it may
be interpreted, the declaration shown in
Fif!.ure I is not a call to arms. It is not
meant to suggest nor to foment an
organization of middle managers. Quite
the contrary. If any mcvement of or-
ganized protest is to be forestalled or
prevented, far better that it take the form
and intent of a psychological contract of
serVIce.
While the declaration shown may be

Reprinted, with pernlission, from the Spring
1974 issue of The BU.
i/less Quarterly (School
of Business Administration, The University of
We 'item Ontario, London. Ontario).
THE CANADIAN NURSE 19
.

nothing more than a moral-persuader, or a
conscience-binder. it,; effect and impact
might be such as to improve the quality of
the work environment, in which-
.Organi7ational and personal goals
ma) once again be brought into balance
and harmony;
. The flora and fauna of man's crea-
tivity and innovativeness might once
aga i II be regenerated:
. The protection of man's dignity and
worth might well be cakulated in terms of
a renewahle economic re,OUfce;
. Man'
inr,tinct for organi7ational sur-
vival and his pursuit of pmposeful work
may be protected by a conservation au-
thOlitj wh(lse hahitat is the executive
conscience.
One of the hang-ups to the acceptance
and promul!!ation of a "psychological
contract of service" by the executive
cadre of an I)rganilation is the imagined
loss of managerial prerogative, - the
infringement of their right to manage and
the erosion of their authority and power.
If management means getting things
done throup,h people. then the managel of
Wmonow no longer uses the power base
of his position as a motivator since
employees look to and have respect for
"no'Wledge and competence at the top.
While. osten<,ihly. t()day', executi ve may
loudly suo'LTibe to the tenets and
philosophy thai the "pr,)'Ch%gical"' con-
tract e'pouses. al\ too frequently his own
life-'it)'Ie. his llIoral. ethical. and work
"alue
simply get in the way of effective
implementation.
Management prerogatives are. by de-
finition. exchl'iÎve right-. hased on author-
ity. and thifo. term immediately evokes a
retaliatory exprer;sion of' 'labor rights and
prerop,atÎves." Tim,. this Ilihor /1/llI1t1!!,e-
/1/e"" th i.. .\upl'rior-.\uhol dinale
dichotomy l11ust eventually give way to
rarticipative management in a mutua/.
goal 'iening. problem-solving organiza-
tional climate of trust, openness. and
respect.

Infprprpfafion of a p...ychologkal ('onfracf
of spfvin' (figurp 1)
To the thoughtful and progressive
manager, the rightness and effectiveness
of the seven clauses of the psychological
20 THE CANADIAN NURSE

contract need no further clarification and
justification. He knows that it is the
embodiment of Herzberg's and Maslow's
motivational theories. He knows that the
reality and effectiveness is to be found in
the empirical studies of the late Douglas
McGregor. and of Scott Myers, formerly
with Texas Instruments Inc. U.S.A.
What he does nol know, however. is
the need for such a declaration of right...
and freedoms. because he is unaware of
the underlying forces or currents of
alienation or disenchantment and he is
unaware because he has no systematic,
valid nor objective method of sensing
employeefo.' concerns, attitudes, moods,
etc. The usual or traditional indices that
are used to assess organizational health
are:
. the exit interview;
. absenteeism;
. formal grievances;
. number of quits.
These are. however. nothing more than
broad precursors that something is wrong
since. for each. the real excuses, reasons,
or explanations can be so skillfully
camouflaged. It is for this reason that
compari
on to the "norms" of business.
indufo.try, other branches or divisions,
using these indices is less than valid.
There simply is no universal or generally
accepted criteria. methodology or ter-
minology in use among homogeneous
wor" groups, generic types of organi7a-
tions by which management can rest
assured that it has no employee problems.
Besides, 'Who in the several hierarchial
directorships is anxiom, to get at all the
underlying causes of apath) and dis..en-
SlOn, lest the results should reflect upon
his or her managerial competence'!
There is an additional reason why the
above noted indices are of doubtful "alue.
viz:
knowing why rfllployees slick I\'ilh the
organizalion is equall\' or nJ;en /1/ore
important than knowing why em-
ployees leave.
After all, some employees stick with
the organization for reasonfo. that have
nothing to do with their jobs. their
devotion to the boss. or to the mission of
the organization. Conversely, there are
industrious. highly motivated and innova-

tive employees who choose to leave for
reasons totaIly unrelated to the company
or the job they perform.
For the authority-oriented manager,
therefore, a clause by clause interpreta-
tion is necessary because he is torn
between his innermo<;t con victions and
his alignment with the power struggle at
the top.

Artidp onp (1) - loyalty to thp organiza-
tion
What else can management want or
expect. but that its work force relate to or
be identified with the socially re"ponsible
goals and purposes of the organi7ation -
that employees be committed to work for
the personal rewards of "a sense of
achievement," a "meaningful contribu-
tion." and that they be dedicated to a
"constant ..triving for excellence'?"
The relevtlncy and importance of goab
and objectives come to managerial train-
ing forums in many shades and nuances
- as an academic exercise demanding
precision of definition and disciplined
thin"ing. While thi
may be advanced as
a reason for the reluctant acceptance of
Management By Objectives, there is also
an underl) ing assumption that employee..
down the line have little interest in
organi7ational goals. Based on a carry-
over of traditional principles. a manager's
joh i
th'Jught to have been done when he
ha,:
. specified reporting relationships:
. delineated and defined areas of re-
sponsibility dnd accountahility;
. a<;crihed explicit duties and ta...b.
Too many job evaluation fo.ystems hut-
tre<;s and enforce the task-oriented ap-
proach to management and maintain the
rigidity of organizational structUl ing. 5
Very fe'W managers indulge in a ...ystellla-
tic and continuing exercise of relating
tas"s and duties in a meaningful way to
the mission or purpose of the organization
and of organizational units. which has
become known as the hierarchy of objec-
tives.
If anvone should douht the relevance
and pe;..onal commitment to goals and
objecti"es. if one is to believe in the
subservience of personal motive and
reward to the organizational mission, it is
SEPTEMBER 1974

.
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;:':c
:%
,"" "gees>- ,,,,,.. '" "",09"';'" ,,,,.,est. o' \IS ....""""" an
O\ga o ''''.... _ ,"" ",.Ia'" . eooa'
",. a'" all a pan. 6 10 ... -"

\ ",IS 6ee1",a- '5 \0 ". '':;.0 " ",ga"''''\\OO stud'"' g<OU\>'
í
""
co

:eln. I""'oSSO'

.f.
,
";oI09
'
ps cM"" eo' .....59 C ""..'..
510a. fI se\"loo\ 0\ ff\a.na.geff\ .

.
\

:-"-.......

r

\

.\
\

t

l

Figure I
SEPTEMBER 1974

THE CAi"IIA
DlAN NURSE 21

to be found in the richness of team spirit,
the amalgam of diverse skills and know-
ledge of the thousands of engineers and
technicians who dispatched man to the
moon. The maze of reporting relation-
ships, the agonizing decision-making
levels, and territorial prerogatives had to
give way to one simple, single motiva-
tional objective - "to get a man on the
moon."

Article one (1) - Loyalty to one's work
Given the right organizational climate
(Article 4), meaningful work goals and
the correct leadership style (Article 2),
employees will respond with a sense of
personal commitment and dedication to
their jobs. To argue this point is to
question the reality of man's inner drives
and need for achievement. To doubt the
value of this premise is to refute the
findings of Douglas McGregor and his
universally acclaimed theory "Y'"

Article two (2) - Managerial and work
constraints
Authority-oriented style of manage-
ment tends to stifle employee initiative or
to evoke various forms of employee
alienation through a behavior pattern and
an attitude that mirrors a lack of confi-
dence in and a respect for others.
The restrictive supervisory style is
reflected in the following attitudes and
mannerisms:
. Tell the employee what has to be done,
when and how, but never why.
. Establish quality and quantity control
checks, either by system or other
personnel, but never let the employee
learn from his own mistakes.
. Solicit the views of employees in the
work group concerning increased effi-
ciency and output. problems to be
solved, policy, and organizational
changes, but never, never think of
feedback. Then arbitrarily and unilat-
erally impose decisions that bear no
resemblance to the employee's input.
. Announce by decree that questioning
of policy will not be tolerated. that any
form of criticism or dissent will not be
welcome without attempting to dis-
cover underlying causes of consequent
unrest and apathy. But above all,
assume that you have correctly trans-
lated all of the overt acts of turnover,
absenteeism, alcoholism. etc.. in
terms of the employees' socIal,
psychological needs.
. Insist that all verbal and written
contacts with other officials within the
22 THE CANADIAN NURSE

organization, even for routine informa-
tion needed to perform effectively,
must be cleared "through channels'"
and then wonder why the upward flow
of information has ceased, or has
otherwise been distorted.
. Bypass or shelve the industrious and
loyal employee because he did not
measure up to your unspecified per-
formance expectations or because he
faltered in interpreting what was ex-
pected of him, then set about to
restructure and reorganize people and
processes because a type of organiza-
tional dryrot has apparently set in.

Article three (3) - Organizational change
Employees in increasing numbers are
becoming uprooted, dispossessed, or sur-
plus to functional requirements (either
physically. emotionally. or psychologi-
cally) due to a whole host of changes in
the organization, in the job situation,
and the work environment itself.
In the face of constant change and
uncertainty. what is the price exacted in
terms of mental stress and anxiety? What
is the social, ps.ychological. and
physiological impact on the indh'idual
member of the work force and on emp-
loyee groups?
How long can an employee be left in a
state of uncertainty and anxiety. before a
complete physical and emotional break-
down occurs?
What problems devolve upon manage-
me/lt in motivating its work force and in
creating a climate of growth in the face (if
constant change'!
The plethora of publicity given to stress
and organizational change on T. V.,
newspapers, and professional journals
attest to the need to know, by all levels of
management. how to manage change.
One of the better research papers on
organizational stress leading to a high
incidence of coronary heart disease is to
be found in Dr. Alfred Marrow's book.
The Failure (if Success. 6
While it may be one of management's
prerogatives to introduce change, how it
docs so can lead to a debilitating crisis in
the working lives of its employees.
Certainly, it is something this side of
immorality to keep employees in the dark
about changes in job and organization,
which pose as a threat to their emotional
and psychological well-being.

al assumptions about the nature of man
and by the social, moral. and ethical
values by which human resources are
governed and integrated
The climate of an organization is to an
employee what water i., to a fish. It is
something more than the kind of spirit or
mood that permeates the working atmos-
phere, for it possesses certain definable
characteristics.
The life-giving property that predomi-
nates. however, is freedom from fear,
that is:
. Freedom to cross organizational lines
to seek solutions to mutual problems
without going through channels;
. Free exchange of viewpoints, ideas.
and unadulterated information be-
tween subordinate and employee and
between one's counterparts or peers
that contribute to behavioral patterns
of openness and trust;
. Freedom to disagree with policies,
proposals, and procedures in a con-
structive manner without fear of retali-
ation or of being branded as a militant
- a trouble-monger;
. Freedom to enquire, to innovate. and
to create. knowing that new ideas and
approaches will be welcomed and
rewarded.
The absence of fear, however. docs not
of itself generate a positive or counter-
vailing force of inner drive and higher
motivation, for this falls within the do-
main of leadership, which is contained
in Article 2 of the .. Psychological Con-
tract of Service'" (Figure I).

Article five (5) - Management of the
human resources
How shall it profit an organization.
even though:
. Meaningful organizational goals and
purposes will have been established
(article one);
. Jobs are designed, enriched, or en-
larged to cope with the inherent needs
and drives of workers (article two);
. Planned change has shown a genuine
concern for those employees directly
affecled (article three);
. The organizational climate and mana-
gerial style is conducive to human
growth (article four)
unless there is an abiding concern for
the retention of the human resource.
,
through their motivation. retention,
psychological growth, and opportunities
Article four (4) - Organizational climate for advancement?
The climate of an organization is Thu.f, while those conditions erternal
determined in great measure by manageri- to the employee have been made rif!.ht,
SEPTEMBER 1,}74

they do not guarantee highly productive
effortfrom well-motivated employees.
Thousands of dollars are spent on
professional recruitment. on attractive
advertising campaigns. assessment cen-
ters. batteries of psychological. I.Q., and
other tests. in order to attract the right
person for the right job. Once the em-
ployee is on the payroll, however, little
effort is spent on his retention, motivation.
and development. He is virtually left to
sink or swim. viz. -
. What was expected of him as a new
employee and what he had expected of
the organization was left unsaid:
. His knowledge. abilities, and skills -
his occupational reach - were never
put to the test;
. An) assurance as to "How well he
was doing" was a once-a-year exer-
cise;
. He was only vaguely aware of a
sophisticated manpower plan with its
manning tables, succession planning
charts, fast-track promotional
schemes. etc., but it remained just
that, a plan;
. He was never informed of just what
the promotional opportunities were.
being satisfied with such time-hon-
ored c1ichés as:
.. all development is self-devel-
opment";
"the cream will rise to the top";
. 'you create your own opportunities
for advancement in this organization";
. 'not everyone can be promoted."
If, then, a case has been made for the
management of the human resources. the
significance of meaningful goals and
work, and the impact of the cI i mate of the
organization, and if a correct balance of
all of these variables is achieved. then it is
high time that all levels of management
be evaluated on these factors and given
rewards and recognition in terms of an
incentive bonus. And while this strategem
is highly debatable in terms of the
inadequacy of objective criteria or meas-
ures of success. let no one minimize the
impact of a simple statement of policy
issued from the executive suite. (Such a
dictum is implied in the last sentence of
Article 5 of the proposed psychological
contract of service.)

Article six (6) - The role of the inter-
mediary
The psychological distance of the men
at the top, who must agonize over the
appraisal of multivariate social. eco-
nomic. political. and technological forces
SEPTEMBER 1974

at work. may be felt and interpreted
by the men on the shop floor as aloofness
and indifference. The warmth of human
contact and concern is expressed in tenns
of executive announcements. Respect
for the points of vie.....s of others surfaces
once a year at the bargaining table,
and the elements of the feedback system
consist of work stoppages. work to
rule. mass demonstrations. industrial sab-
otage, and the like.
The concerns of top management from
its perspective and territorial prerogatives
are not thought to be matters that are
communicable in the jargon or vernacular
to which the clerk at the desk or the man
on the assembly line has been accus-
tomed:
- How well does the worker understand
that the real motive 10 introducing
electronic equipment is to provide his
organization with a competitive force
against other rival organizations? Who
is to tell him. and how?
- How does management convince the
rank and file of the organization that a
job enrichment program was destined
to take the monotony and dehumamz-
ing aspects out of jobs? Who is to
convince them that it is not really a
disguised attempt to incredse em-
ployee output? Who indeed, and how?
- If a plant moves to a small community
that provides an abundant labor supply
of the right skills mix and raw materi-
als to prevent the company from going
under financially, how is this to be
interpreted by the worker and his
family other than for the profit motive?
Who can be believed?
- A prominent life insurance company
carried a little footnote in its mass
media campaigns which simply states
- . 'our business is life." This seem-
ingly bland and innocuous organiza-
tional mission found expression and
meaning in the creation of a new
functional unit and thus jobs and the
disappearance of others - in the
hiring of a new knowledge specialist
and the shelving of the old! But who
was given the responsibility of inter-
preting and conveying this embryonic
process to overly educated employees.
and how was it accomplished if at all?
Who could be trusted to know and
understand?
And while personages are likely being
held incommunicado in the room at the
top to work out the strategems for public
dnd competitive consumption. who has
opened the door to the purveyor of bad

tidings, of worker grumblings, unrest.
and turmoil? Who will but see that any of
the organizational or marketing moves
can be jeopardized by employee concerns
and fears that were unleashed from
yesterday's strategic planning?
The time has surely arrived when the
manager in the middle has also arrived in
a new role with a new function. He has
arrived at the threshold of the executive
suite not only to learn and to be listened
to. but he will leave with the new
responsibility of interpreting, conveying.
persuading, and assessing. In his new
role. the middle manager is in fact the real
change agent - the true intercessor.

Article seven (7) - Of ethical conduct and
human values
What more can be learned from or said
about "The Watergate Affair" or the
resignation in 1973 of the Vice-President
of the United States. Mr. S. Agnew, in
explaining and justifymg the premise
contained in article seven?
In the managerial revolution of the
sixties and seventies, the corps of middle
managers has reached a fork in the road.
At this juncture a choice is to be made as
to whether to storm the executive board
room or to stop. unfurl, and to read their
psychological contract of service. The
no-man's-land is not the area of disa-
greement but the meadow and slopes of
executive apathy and indifference.

References
I. The Congressional Record. House of Rep-
resentatives. U.S.A.. July 14,1971.
2. Globe and Mail. dated 15 March, 1973, as
reported by Jame
Rusk.
3. "GM Zeroes In on Employee Discontent"
-Business Week. I:! MdY, 1973.
4. "Organizational Psychology" - Edgar H.
Schein, Prentice-Hdll Inc.. Englewood
Cliffs, New Jersey. ( 19651-
5. "The Significance of Objectives in a Job
Evaluation Sy:-.tem", John H. Runyon,
Canadian Personnel & IndlHrnal Rela-
tions Journal. May 1971.
tJ. "The Failure of Success" edited by Dr
Alfred Marnm - published by Amacon
(1972) (a division of American Manage-
ment Association).

THE CANADIAN NURSE 23

Component therapy

The expre!>sion "The sum of the parts is greater than the whole" may well be
applied to the use of blood components, rather than whole blood, in the
treatment of disease.

Gail Roc", M.D., Ph. D

Be
'au
e dIsease presents itself in such a
v:!riet) \)f
tate
, each exhibiting a differ-
ent hematological defect. treatment with
component
of blood becomes possible.
If able to determine the exact deficit in a
patient, one can supply only that rel]uired
component. Thi
will avoid the necessity
of administering more than what is
actually needed by that patient and permit
the u
e of these other constituents for
something else.
This, then. i
the principle of compo-
ncnt therapy: vpecific blood constituents,
rather than whole hlood, are administered
to patients with hematological deficits.

What are the blood components?
Whole blood compri
es approximately
7 pCfl'C/lt of the tot:!1 body weight and is
made up ot fmIlled elements (45 percent)
and pla'IIld (55 percent). As outlined in
Figure /, further
epdfation into a consid-
erahle number of produch is possible. It
is thöe delived C<lInponents that are
beIng uSl:'d \\ Jlh increasing frequency in
an dttempt to attain a ' 'stcddy state" in
the bhmd (horneo
ldsis).

Why nol use "hoh' blood?
Wh..le hlood ddministration ha... been
cmnpan:d to J "shotgun prepardtion.'"
thdt is. a mulriple component Ireatment
Ihat cOlIlain
..ome of the con
tituent thai
is needed. and some olher con
tiluenls
that dre not. fhl' hds led 10 many
problems. First. enough of the ösential
con
litucnt IIld} not be supplied. Second,
somc \If the extm material adminislered
may be loxic to the patient.

Dr. R\.c" .,
kdlcal Director of the hlood
lran,hhlnn ,,'n i.:e of (he C'\(!.IJian Red Cross
Society. ()\I.\\\ a.

24 THE CANADIAN NURSE

The most common reason why clini-
cians u
e whole blood is to treat hemor-
rhagic shock. The rationale generally
given is: the most phy
iological substance
with which to replace Imt blood is whole
blood. However, acid-citrate-dextrose
(AC/)), or banked blood, is not actually
physiological. Normally, in-vivo blood
has a pH of 7 and contains 3.4 mEq of
potassium per liter.
Upon storage, the pH becomes acid
and both the potassium and gJ ucose
increase. Figure 2 illustrates the change
in potassium concentration during
storage. 2 This stored preparation has in
fact been compared to blood taken from a
ketotic diabetic in renal failure. 1 In man,
marked electrocardiograph changes occur
at plasma polassium concentmtion
of H
mhl/I., and death has heen atlribuled to
plasma pota
sium levels of I 0 ml
q.
In tredtmenl of hypovolemic shock. in
which the patient ha
suffered acute
hemorrhage with loss of large volumes of
whole blood. two objective
must be met:
to restore hlood volume, and to provide
the relJ uired ox ygen-carry ing ca pacit y.
Clinical 4 and experimental' data sug-
gesl thdt a uunhin:!lion of packed rcd
cells and mineral solution
th:!t are
physiologically compatible ....ith plasma is
as effective as whole blood in attaining
both of these objeclive
. Further, thi,
combinatiun is adually a more physiolog-
ical
ollition than stored hank hlood. for
the reason.. previously outlincd.
Another argument commonly given for
the use of whole blood is that the plasma
provides suhst.mces, such as platelets and
coagulation factors, that are necessary for
hernosla<;i:-.. However, wilh a bleeding
disorder there i
a disproportionate re-
quiremcnt fm red cell
. platelets. plasma,
SEPTEMBER 1974

FIGURE 1:

pi asma

1

o
proteins 1

water

fihrinogen

whole blood

formed elements

platelets leukocytes
o erythrocytes
inorganic
..alt

01 neutrophilS\
lymphoC'ytes

The Components of Whole Blood

and coagulation factors. To give enough
\\-hole blood to raise the concentration of
the coagulation factors effectively. ..0
much plasma \\ ould have to be adminis-
tered that congestive hean failure and
pulmonar) edema would becom
> a virtual
certaint) .
In a nnrmovolemic patient. rapid tran...-
fusion of blood produces a transient
rise in venous pressure (VP). Although the
VP falls to normal as 'ioon as the
transfusion is stopped. the blood volume
usuall) remaim aoove nomJaI for many
hour'i. Thi'i increased blood volume is
panly accommodated by vascular filling
in the lungs and is reflected by a decrease
in respiratory vital capacity for several
hours aftcr tran<;fusion."
In a patient who...e vital functions are
alread) compromi'ied. the regulation of
blood volume is impaired and tluid
overloading becomes extremely danger-
OU'i. Failure to recognize early sign'i may
result in the insidious onset of pulmonary
edema. The death of the pdtient may not
even appear to be directly due to the
tram..fusion.
Other problems accrue from the use of
\\ hole blood. As '0 mall) sub...tallccs .Ire
SEPlEMBER 1 'l74

pre...ent in whole blood. there is great risk
of tran'ifusion reactions.
Although initial cross-matching detects
the red cell antioodies. one must also
consider the po...sible existencc of Icuko-
qte or pldtelet antibodies. In addition.
plasma protems may cause a transfusion
reaction. and the plasma citrdtc may hdve
some effect on the patient. These prob-
lems are panicularly pronoum.:ed in pa-
tient__ ""ho have recei\ed multiple tran..fu-
sions. The transmission of scrum hepatitis
is another consideration.
An added advantage in using compo-
nents i'i that. after rcmoving the packed
cells from plasmd. further plasma fradion-

fiGURE 2:

day...

o

10

14

Pota<;'>lum
mEq/litpr

'"

4

20

Variation in concentration of the potas-
sium ion upon ..toral?,C' of whole hlood

ation "" ill produce valuable products
such as platelets. albumin. and the vari-
ous coagulation factors.
For all these reasons. it appears that the
use of concentrated red cells. combined
\\ ith other olood components and crystal-
loids. is preferable to 'itored whole blood.

Blood components prepared
Ideally. olood transfusion centers
would like to meet three objectives: I. to
suppl) the hospital blood banks \\- ith
blood component... designed to meet
specific needs: 2. to maintain adequate
stockpiles of these components: and 3. to
ensure a relatively ..table product.
At present. the following components
are being prepared for hospital use in
Canada: red cells. platelets. leukoc) tes.
plasma. antihemophilic human plasma
(AHFI. plasma protein derivatives, im-
munuglobins. and serum.

18

Red cell..
Blood is normally drawn into an an-
ticoagulant <;olution of acid-citrate-dex-
trose IACDI from which packed red cells
are obtained b) centrifugation. Their
maximal shelf life at 2 0 _6 0 Centigrade
is 21 days. If not used in this period. they
are di__carded. It has been shown that 70
percent of cells stored the maximum of
three weeks ...urvive up to five days in the
circulation after transfusion.
Normall). \\ hen ..tored red cells are
transfused. a certain proponion is elimi-
nated in the first 24 hours: then the cell
survi..al follow, a linear slope declining
gradually over I
O days. when virtually
all of the tram.fused cells are gone. As a
general rulc. any patient in whom eryth-
ropoiesis is impaired should receive
blood less than 7 days old so that the
number of surviving red cells is maximal.
Red cells haw also been preserved in
the frozen state. As 'uch. they have a
survival !line in term... of \'ear'i. Thi...
technique is employed b) the Canadian
Red Cross Rare Blood Bank maintained
at the National Defence Medical Centre in
OUa\\-a Although expensive to prepare
and store. these cells provide an unparal-
leled reserve in cases \\-here compatible
blood is not readily a\ailable.
Packed cells are primarily used for
increasing the ox}gen-carr) ing capacit)
of the pat.em .md art' used. either alone I'r
THF ('ANADIAN NURSE 2'i
.

iO

in combination with other components, to
restore normal hematological parameters.
There is, however. some unresolved
question as to the preference of fresh
blood over stored red cells in regard to
oxygen supply.
During the first two weeks of storage in
ACD, the hemoglobin shows a "shift to the
left" of the oxygen di
sociation curve. 7
This means that the hemoglobin molecule
has an increased affinity for oxygen and
therefore releases less oxygen to the
tissues. The clinical implications of this
statement are uncertain. as it has also been
shown that 24 hours after infusion most
patients have a normal dissociation curve. 8
All Canadian Red Cross blood trans-
fusion services have recently adopted
citrate-phosphate-dextrose (CPO) as the
..tandard anticoagulant. This material
allows the red cell to give up more
oxygen to the tissues. provides more stabi-
lity to some of the coagulation factors,
and reduces the concentration of infused
citrate.
As packed cells provide so many
advantages over whole blood, it would
seem reasonable to use the most recently
collected cells in situations that require
massive infusions of packed red cells. and
thus en
ure adequate tissue oxygenation.

Buffy-coat-poor red cells
Nonhemolytic febrile reactions occur
in approximately 2 percent of transfusion
recipients. In many of these cases. leuko-
cyte agglutinins. or platelet or plasma-
protein incompatibilities are the cause.
Use of red cells. from which the buff)
coat (the upper lighter portion of the
centrifuged blood containing leukocytes
and platelets) is removed by differential
centrifugation. usually results in a marked
reduction or complete absence of these
symptoms.
Buffy-coat-poor cells ma) also be used
in persons on renal dialysis to reduce the
risk of isoimmuni7ation. Selecti ve re-
moval of granulocytes by pas<,ing blood
through a filter is a!--o possible.

Washed red cells
Washed red cells are prepared by saline
washing and centrifugation. This proce-
dure removes residual plasma proteins
26 THE CANADIAN NURSE

and provides cells for treatment of parox-
ysmal nocturnal hemoglobinuria. and for
patients who have developed antibodies
against immunoglobulins. such as IgA.
One wash probably reduces the protein
concentration by 95 percent.

Platelets
Platelets are prepared from fresh whole
blood following removal of the red cells
by centrifugation. This platelet-rich-
plasma (PRPI is left undisturbed for
approximately one hour. after which it is
centrifuged again. Most of the superna-
tant is discarded. and a platelet concen-
trate (PC) is obtained.
The normal life span of human platelets
in-vivo is reported to range from 6 to 9
days. However. the time lapse from
donation to infüsions is critical. Blood
less than 6 hours old provides PRP and PC
with the best in-vivo survival. But. use of
6-hour-old blood puts a severe strain on a
volunteer donor population.
The temperature of storage is another
critical factor. Although considerable con-
troversy exists as to the stability of plate-
lets stored at 4 0 versus 22 0 C. the recent
literature tends to suggest that 4 0 ..torage
is associated with superior platelet pre-

ervation. 9
Transfusion of platelets. which was
almost unheard of until recent years, is
becoming comparatiyely frequent. This is
largely due to the increasing use of
chemotherap) in the treatment of cancer.
with the resultant siJe effect of a decrease
in platelet count.
Indications for platelet transfusion in
leukemia have been listed as follows by
the Platelet Subcommittee (1968) of the
Canadian Red Cros,; Blood Transfusion
Service:
I. Treatment of hemorrhage in the
presence of a platelet count of less than
50.000/cmm. including any overt bleed-
ing (such as epistaxis or hematuria) and
suspected or proven internal bleeding
(such as intracranial. intracutaneous. or
intramuscular bleeding).
2. A fall in the platelet count to below
IO.OOOjcmm. because the ri,;k of hemor-
rhage is then
o high.
Platelets are also given to patients with
severe thrombocytopenia (less than

20.000/cmm) associated with failure of
platelet production. However, they are
seldom used in patients with idiopathic
thrombocytopenic purpura. as in that
condition the transfused platelets are
quickly destroyed.

Leukocytes
Mass preparation of leukocytes is pres-
ently not feasible at a transfusion service.
due to problems of production and stabil-
ity of the product. The average life span
of leukocytes of all types is 12.8 days.
with polymorphonuclear neutrophil sur-
vival of only two to three days.'o
Following transfusion. the viability is
greatly decreased. and some experiments
have shown only a 30-minute survival
of polymorphs.
Attempts to treat severe granulo-
cytopenia with transfusions of leukocytes
have been made. using a continuous-flow
centrifuge for leukophoresis. However.
the short half-life of the cells makes this a
somewhat duhious procedure.

Plasma fractions
Plasma is the supernatant obtained after
centrifugation of whole blood and re-
moval of the cells. It contains the plasma
proteins. water, inorganic salts. lipids.
enzymes, hormones. vitamins. and car-
bohydrates. Plasma is primarily used as a
volume expander and is the component of
choice in the treatment of burns where
fluid. but not cells, is lost. Several fornl';
are available:
Liquid plasma has a refrigerated shelf
life of 21 days. It contains the plasma
proteins. but certain coagulation factors
are lost in its preparation.
Fresh frozen plasma (FFP) can he kept
at -37 0 C for approximately six months.
With this preparation. there is almost
complete preservation of the coagulation
proteins.
Dried plasma keeps almost indefinitely
but may contain viruses. such as the
hepatitis virus, which survive in both
frozen or dried plasma.

Antihemophilic human plasma (AHF)
Cryoprecipitate, or AHF. is a protein
that precipitates from the plasma follow-
ing freezing and slow thawing. It is used
SEPTEMBER 1974

in the specific treatment of Factor VIII
deficiencies in the hemophilic patient.

Plasma derivatives
Pools of hepatitis-antigen-negati ve
plasma are chemically treated to produce
various products. These include:
Fibrinogen, a plasma protein used to
combat hemorrhagic disorders due to
acute afibrinogenemia or chronic
hypofibrinogenemia.
Albumin, the main plasma protein. It is
responsible for maintaining nonnal col-
loid osmotic pressure in the plasma.
Consequently. it is of use in cases of
hypoproteinemia where fluid retention is
a problem.
Human normal immunoglobulin, a
concentrated solution of antibody globu-
lins from a normal healthy population. It
is principally used in the modification of
many viral diseases. ,uch as German
measles and infectious hepatitis. and in
the treatment of severe gram-positive
bacterial infections. Immunoglobulins are
also used in the treatment of antibody
deficiency syndrome (hypogamma-
globulinemia ).
Human specific immunoglobulins.
Several antibody compounds. specific for
an antigen, are also available. These
include antitetanus, antivaccina. anti-
varicella and anti-Rh(D). The latter pro-
duct is an invaluable preventative treat-
ment for women who might otherwise
bear children suffering from hemolytic
disease of the newborn due to Rh
incompatibility.
Prothrombin complrc concentrate tS
supplied in a freeze-dried form that is
quite stable in storage. It is used in
coagulation abnormalities involving
specific deficie
cies.
Factor IX concemrUle is relatively
stable on storage. Factor IX deficiency
(hemophilia-B. or Christmas disease)
may now be specifically treated with this
solution obtained from pooled plasma.

Serum
Serum is human plasma from which the
fibrinogen has been removed. Indications
for use are generally the same a<; for
plasma. However. the protein content of
serum is lower. and it is not effective 10
SEPTEMBER lq74

correction of deficiencies of coagulation
Factors V and VIII.

Conclusion
As indicated above. there are a large
number of blood components available
for general use. Although the benefits of
specific component therapy appear obvi-
ous. clinicians still make extensive use of
whole blood. (In 1973 only 15 percent of
the units were issued as packed cells.) It
is to be hoped that a better understanding
of these advantages. coupled with the
constantly increasing knowledge of the
pathophysiology of disease, will eventu-
ally result in the universal practice of
component therapy.

References
I. Greenwal1, T.J. and perry. S. Preservation
and utilization of the components of human
blood. In Progress in hematology. edited
b} Brown. Elmer B. and Moore. Carl V.,
Ne\\ York,Grune&Stratlon. 1969. v.6,p.
148.
2. Loutit. J.F. and Mollison. P.L Advan-
tages of disodium citrate glucose mixture
as hlood pre<;ervative. Br. Med. J. 2:744,
Dec. I I. 1943.
3. Smiley, R.K. Modern use of blood.
Callad. J. SIU. 15:5:3:! I. Sept. 1972.
4. Greenwalt. np. cil.. p. 157.
5. Moss. G.S. et al. A comparison of
asanguineous fluids and whole blood in the
treatment of hemorrhagic shock. Sur/?
Gvnec.Ohstet. 129:1247. Dee. 1969.
6. Loutit. J .F. et al. Venous pressure during
veni..cction and blood transfusion. Br. Med.
J.:!:658. Dee. 5. I 94:!.
7. Beutler, Frnest and Wood, L A shift to the
left (or d shift to the right) in the regulation
of erythropoiesis. Blood 33:496. Mar.
1969.
8. Bunn. H.F. et al. Hemoglobin function in
stored blooò. J. C/in. 1I11'l'st. 48: 311, Feb.
1969.
9. Filip. D.J. et al. The effect of platelet
concentrate ..wrage temperature on in vitro
platelet function. Blood 42:1006. Dec.
1973.
10. Kline. D.miel L .md Cliffton. Eugene E.
The life-span of leukocytes in the human.
Sciellct' 115:9. Jan. 4. 1952. 9

THE CANADIAN NURSE 27
.

Stand up and be tested!

Nurses at the 1974 C"oJ^ convention were
the fir'it nonexperimental group to meas-
ure their physical fitness by uo;ing ne\\i
tests devised hy Recreation Canada, a
division of the federal health and \\iclfare
department. Jean Reid Everard. CNA'S
,pecial project officer \\iorking on physi-
cal fitness and health. said this i!> the first
time in the world that a fitness test, to be
administered by a family in its home, will
be available to the general public. It is
hoped that the test kits fOf home use will
be available in the Fall
Induded among the 46 I persons who
took the physical fitness tests in Winnipeg
were nur!>es allending the convention,
interpreter'i providing translation, and
many of the commercial exhibitors. One
exhibitor asked to be te'ited a second time
to beller his first score.
Some results from the physical fitness
tests were punling. The most striking
inconsistency was that nur!>es were shown
to be above average in cardIOvascular
health. but also above average in percent-
age of bod} fat. Fat. but o;ound in \\iind
and heart?
"These two result
do not mesh:' Ms.
Everard said. "There is a poo;sihility that
the averages used in the tests in Winnipeg
are not nomlO; for the general Canadian
public'" 1 he experimental group in
Canada. from which the averages were
drawn, was made up of university stu-
dents. There were moæ than the expected
numher of 40- to ('O-}ear-olds among
persons tnted In \\ innipeg. I he re!>ulto;
28 THE CANAOIAN NURSE

point out the need for further work to
determine the average values to be used in
these tests, Ms. Everard said.
There are 5 aspects to the fitness
appraisal:
. height and weight;
. the "pinch test" to measure adipose
tissue at 4 sites - suhscapular. triceps,
abdomen, and suprailiac;
. strength as measured by hand grip;
. flexibility of hip and shoulder joints;
and
. the "step test" to measure cardio-
vascular fimess.
First- and third-year nursmg students
from the University of Manitoba adminis-
tered the tests. Students were recruited by
Helen Glass, director of the U. of
Manitoba school of nursing. Barbara
Warren, instructor in the university
school. coordinated student schedules and
obtained extra equipment for the tests,
!>uch a!'. rulers and scales. scn:ens, mats,
and a hackup tape recorder for "step
test" music.
Specialized measuring tools, such as
calipers for body fat measurement and
hand grip scales, were provided by
Recreation Canada. All measurements in
the fitness appraisal are in metric values.
Three staff members from Recreation
Canada allended the CNA convention to
teach the student!'. how to do the testing,
interpret test results, and give suggestions
on exercise to correct deficiencies re-
vealed by the tests. A Canadian musician
was commio;o;ioned to compo!>c special

music for the cardiovascular fitness "step
test," with a different tempo for each age
group.
Fitness appraisal was offered at the
1974 CNA convention to allow individuals
to assess their personal level of physical
fitness, and to demonstrate some of the
!'.implest fitness tests that can be adminis-
tered at low cost and in minimal time, to
adults of all ages.

The fitness appraisal program includes
t:-'e physical fitness t('sts and a health
halard appraisal ljuestionnaire. The ques-
tionnaire elicits responses on an
individual's life-style and points out areas.
of probable health risk.
Two staff members from the non-
medical use of drugs directorate, Health
and Welfare Canada. allended the CNA
convention to administer the question-
naires. They interpreted the computer
printout made availahle to each respond-
ent. indicating change!> in life-style that
would decrease the individual's health
ri!>k.
.. Anything that sensitizes nurses and
helps them identify areas of need for
exercio;e, and that arouses their interest,
will motivate them to work for their own
physical fitne'is," M!>. Everard said.
A resolution that CNA ex-
plore wa}s of developing a plan of action
to sen!>itile nurses to life-styles conducive
to optimum health was accepted by voting
delegatc'i at the convention. (August
1974. page 24.)

SEPTEMBER lq74

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The nurse in this photo is able to lift the ruler unusually high. show.
ng above-average shoulder joint flexibility. Hip joint flexibility
Nas measured by a slt-and-reach test

Guided by a University of Manitoba nurSing student, two nurses
measure their strength on the hand grip scale. Right-and left-hand
scores were averaged to get the individual's strength rating. to be
compared with other women of the same age.

"'"

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A nursing student records the pulse of a
volunteer during the "step test" ThIs slm.
pie measurement of the ability of the heart-
lung-circulatory system to supply muscles
with oxygen necessary for the output of
energy is not as accurate as laboratory tests
but is more accurate than any previolls step
test.

UP. down, up. down. Nurses exercise to
music at a tempo set for their age group:
17.19, 20.29. 30-39.40.49. 50-59.

Although she is slim. this nurse has some
body fat as measured by the calipers in
the "pinch test" on her abdomen.

The nurse as a family therapist

The nurse can gain autonomy in providing psychiatric therapy by becoming a
skilled family therapist. The author illustrates the work of a family therapist by
describing sessions with two families.

Susan Hill, B.N.

In the department of psychiatry at the
Manitoba Health Sciences Centre in Win-
nipeg, nurses and other health profession-
als. such as social workers. occupational
therapists. psychologists. and psychiatric
residents, are encouraged to gain skill in
family therapy techniques.
The initial step in becoming a family
therapist is understanding and believing
in the family as an important social unit.
There are several techniques one can use
to enhance the process of becoming a
family therapist. One such technique is
role playing simulated families within a
multidisciplinary group of health profes-
sionals. This provides the beginning
therapist with confidence in dealing with
family process. as well as focusing her
attention upon the complex nature of
family interaction.
To illustrate, the family therapy group
of which I am a member, at the Health
Sciences Centre, consists of four nurses,
one occupational therapist, one social
worker, two psychologists, and two psy-
chiatric resident supervisors. Recently,
we role played a family comprised of Ed
and Sally Jones and their two sons.
Michael aged six, and George aged two.
Four other members of the group were
rotating therapists; that is, when one
therapist felt off the track, the next
therapist would take over.

30 THE CANADIAN NURSE

The presenting problem was Sally's
unceasing headaches, which had been
investigated medically with no physically
related pathology found. Throughout the
interview. the children were poorly behav-
ed. running about the room, throwing
the toys around. and making noise. The
therapist
, however, ignored the chil-
dren's behavior, as did the parents. and
tried in vain to discuss the problem areas
in the family.
In discussing the role playing, the
group concluded that the issue of the
children's behavior control had to be dealt
with immediately. It was hypothesized
that the issue of behavior control was
likely at the root of the presenting
problem, that is, Ms. Jones' headaches.
Several of the group, including myself,
identified with the issue of behavior
control of the children. as they had
experienced the same issue during live
family
essions. In this way, complex

Susan Hill gradudted from the University of
Manitoba school of nur
ing with a bachelor of
nur
ing degree in 1972. She worked as a
general duty nur
e in the young adult psychia-
tric ..ervice and in the inpatient ddult psychia-
tric
ervice of the Manitobd Health Sciences
Centre in Winnipeg. before becoming the

econd nur
e to function a
a psychiatric nurse
therapi
t in outpatient psychiatry.
SEPTEMBER 1974

family interactions can be analyzed and
dealt with for use in family sessions.
Another technique involves observing
live family interviews through a one-way
mirror. This provides an opportunity for
the supervisor to point out the process of
family interaction and the techniques the
therapi!>t is using.

Supervision
Even though these other two tech-
niques - that is. simulated family role
playing and observing live sessions - are
helpful. skill in family therapy techniques
cannot be developed without conducting
live family sessions. Supervised family
sessions, where the therapist sees the
family while her supervisor observes
from behind the one-way mirror. are
helpful. Immediate feedback is given by
the supervisor; he knocks on the door and
the therapist leaves the session for a short
time.
The supervisor supports the therapist
by guiding her in areas
he should be
dealing with. If the therapist is having
difficulty with the session, the supervisor
may enter the session as a final resort and
help out. This immediate feedback is not
only supportive but is also a valuable
learning experience.
All family therapy sessions should be
videotaped. if possible. When immediate
supervision is unavailable, videotaping
can be u
ed for supervision hefore the
next session with the family. . 'The use of
the videotape feedback is extremely use-
ful because it expose
the complexity of
the field it plays back and allows for
manipulation of information in time in
ways that combat linear simplicity.". In
spite of the obvious advantages of video-
taping, I find it painful to play back my
videotapes; I am my own worst critic.

Initial interview
In the initial interview, it is crucial for
the therapist to develop a positive rela-
tionship with each family member. Ivan
Boszonnenyi-Nagy stated "the main in-
SEPTEMBER 1<<)74

dication for family therapy resides in the
therapist's capacity for 'multidirectional
partiality,' that is. his inner freedom to
take turns in siding with one family
member after another as his empathic
understanding and technical leverage re-
quire."2 In other words. the nurse must
establish rapport through the ability to
empathize with each family member.
After developing rapport with the fa-
mily and assessing their problem areas,
the therapist suggests that the family
auend a specific number of therapy
sessions to work on these problems. A
verbal agreement on the number of
meetings between the therapist and the
family is called a contract. It is important
that each member of the family agree

with the contract. The family is told that.
at the completion of the contract. the
therapist and family .....ill decide if another
contract is desirable or necessary.
I have found the contract a useful tool;
it seem
to stimulate prompt action.
When the number of sessions is indefi-
nite, the family and therapist do not seem
to work as hard at dealing with the
family's problem!>. I abo believe that
families seem to find a contract of a
limited number of sessions less threaten-
ing than an indefinite number of ses-
sions.

The B. family
The following i
an eXdmple of a tiN
interview. within an institutional
euing.
in which a sati
factory relationship was
established and a contract made.
Mr. and Ms. B. were referred to me for
family therapy. Three months previously.
when the Bs had their fir
t child. Ms. B.
.....as diagnosed as having a postpartum
depression. She was referred to our
outpatient psychiatric department. where
she was seen by a psychiatric resident.
She was tredted with supportive therapy
and antidepressant medication. After
three months. her condition .....as unchang-
ed and the re
ident felt family thcrdp)'
was indicated. The family therapy group

concurred, and the B.s agreed to come.
In our clinic. for the most part. the
patients are assessed in the context of
their environment. The family is usually
brought in for the assessment, and then
the treatment is decided upon. Sometimes
family therapy is not appropriate. for
instance. if the patient does not have a
family, if an adolescent is trying to
become independent and move away
from home. or if the family does not want
to come.
All members of the health team take
part in deciding if family therapy is
appropriate. As a primary therapist. I take
an active role in such a diagnosis.
During my initial interview with Mr.
and Ms. B., I began developing a
relationship with each of them. The
couple had been married for four years.
Mr. B. had two month!> remaining in hi!>
course in dentistry and was to enter
practice immediately after graduation.
Ms. B. was a legal secretary and had
supported the couple throughout their
mamage.
Mr. and M
. B. had not wanted to have
a child until after Mr. B. was establi
hed
in his dental practice. However. about a
yearpreviou!>ly. :'vIs. B. had been diagno-
sed as having endometriosis and was
advised by her g)' necologist to get preg-
nant. The couple decided to take the
gynecologist's advice and Ms. B. became
pregnant. She retired from her job three
months before the baby .....a
born.
After the birth of the baby. Ms. B.
found it diftïcult to manage. She had
freljuent crying spells and demanded
more and more from her husband. M!>. B.
had always controlled the finances and
managed the home. \1r. B. lOok over the
bulk of these responsibilities.
During the initial intef\ ie....., it became
apparent that the mdin issue wa
that of
role reveßal. Ms. B. had relinquished her
role as breddwmner and hedd of the
family to Mr. B. She felt u
eless and
inferior to her husband. who .....auld soon
be a denti
t. Mr. B. could not understand
THE CANADIAN NURSE 31

his wife's inability to cope;
he had
previously been what he described as
..the strong one." In trying to help his
wife, Mr B. took on more and more of
her duties, leaving her feeling even more
helpless.
A contract of three sessions was set up
with Mr. and Ms. B to deal with this and
any other problem areas.
At the end of the contract of three
sessions, Mr. B. was continuing to carry
most of the responsibilities. Ms. B.,
however, had begun to take more interest
in the baby and her crying spells were less
frequent. Two additional contracts of
three sessions were fulfilled before the
B.s had worked out a satisfactory arrange-
ment for sharing the responsibilities, and
Ms. B. again felt useful.

The S. family
It is not always necessary, or even
desirable, to work with families in the
instItutional setting. Seeing the family in
the home may be a better experience. The
direct observation of the family in the
natural background of their own home
can bring into quicker focus the signitï-
cant dynamics in the life of the family,
and can be of great service in guiding the
treatment. 3
The importance of the home environ-
ment upon the dynamics of the presenting
problem is illustrated by the S. family.
Mr. S. was referred by the hospital's
outpatient medical department for treat-
ment of his alcoholism and "complaints
about his wife." The S. family were
assigned to me for therapy. after team
discussion. I saw Mr. and Ms. S. for a
contract of three sessions.
Mr. S. had retired two years previously
from a small priming company. where he
had worked as a foreman for 37 years. He
was 72 years old and very hard-of-
hearing. Ms. S. was 65 years of age and
had a part-time job selling cosmetics. Mr.
S. thought hi
wife "went out too much'"
He got lonely and would drink. Ms. S.
believed her husband never wanted to go
anywhere with her, but would rather stay
home and drink.
32 THE CANADIAN NURSE

The solution seemed obvious to me and
to Mr. and Ms. S.: they should find a
common interest. something to do to-
gether. However, after three sessions in
the hospital, all attempts had failed.
It was at this point that I decided to
make a home visit. Mr. and Ms. S.
agreed. and I visited their home. The
home visit pointed out to me a significant
dynamic of their family life that had not
been apparent In the previous ses
ions.
During the family sessions. Mr. and Ms.
S. sat side by side. Ms. S. spoke directly
into her husband's right ear. In the family
room at home, however. Mr. and Ms. S.
had their own special chairs, which were
separated by a side table. Ms. S.' s chair
was on Mr. S.'s left side. Ms. S. quickly
got tired of shouting at Mr. S.; Mr. S.
became frustrated because he could nor
hear his wife. and he left the room. With
this new insight. I could plan ne",
approaches to discuss with the S. family.
However, shortly after I had made the
home visit to them. I received a phone
call from a social worker at another
hospital in Winnipeg where Mr. S.
attended physiotherapy for a lung condi-
tion. The social worker was also seeing
Mr. and Ms. S. regularly for marital
counseling. As this social worker had
been seeing the S. family for a somewhat
longer period than I. it was decided that I
would terminate my therdpy with them. I
sent her information about Mr. and Ms.
S. that I thought would be helpful,
including what I had learned from my
visit to their home.
Although home visiting has definite
advantages. it has limitations. too. Home
interviewing does not permit videotaping.
so supervision is limited. It is also more
time consuming. 3S the therapist must
travel to the family's home.

Satisfactions
Functiomng as a family therapist has
provided me. as a nurse, with much
satisfaction. First, I can function autono-
mously in providing psychiatric therapy.
The traditional doctor-nurse relationship.
in which the nurse carries out "doctor's

orders." is altered. I independently
conduct family sessions. using the psy-
chiatrist for consultation only.
Secondly, it's a rewarding experience
to see readmissions decrease in number.
My day-to-day contact with psychiatric
patients in hospital initiated my interest in
family therapy. The importance of a
patient's family became obvious when the
patient was readmitted shortly after being
discharged. As the environmental in-
fluence of the family is dealt with through
family therapy. the readmission rate
seems to decrease.

Condusion
In conclusIOn. family therapy is an
important therapeutic technique. and a
nurse does many things as a family
therapist. She uses relationship and sup-
portive psychotherapy. Interpretive psy-
chotherapy is sometimes used. Problem-
solving techniques are an important too\.
Family therapy is difficult because the
therapl
t must be aware of the dynamics
of the situation and must know how to use
techniques at the appropriate time. There
is no set manner to do family therapy;
each family session is unique. The impor-
tance of videotaping and supervision, for
the experienced as well as inexperienced
family therapist. cannot be stressed
enough.
The nurse can gain autonomy in provid-
109 psychiatric therapy. through becom-
ing a ...killed family therapist

References
1 Aueß\\ald. E.H. Famihe.... ch
nge. and the
ecologICal pcr...pecti\e. :'ll/l/ih' ProceH
10:3:279.1971.
2. BosLormcnYI-Nagy. Ivan. loyalty implica-
tion... of the trdnsferem:e model in psycho-
therapy. Arch. Gen. P.Hchim. 27:374-liU.
Sep. 1972.
3 Freidman. Alfred S Family themp} as
conducted in the home. Fall/if\' Process
1:1:132-40.1962.

SEPTl:MBER 1974

\.nno..neing a speeial

_oney.saving otTer o!1
the DIOst ..scl..1 n..rs.ng
l)()Ok vo..
11 ever own:
.

The Lil
incott
ltlanualor
Nursing Practice

A nnitl..e
reatly
reference for sare

erfective patient care

The extraordinary new Lippincott Manual puts virtually all of
nursing right at your fingertips! In three major units , . .
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plus overall nursing management in concise, outline form
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You will want the new Lippincott Manual with you always for
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it is done, and expected patient reactions.

The tt
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1473 pages. Profusely illustrated. Introductory Price:
$18.50. July 1974. (After Sept. 30, 1974 $21.50)
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The Uppincott
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A unique, ready reference for safe, effective pati ent care

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This is the one, indispensable reference for every
nurse's professional library. It's the book that presents
the facts of clinical nursing step-by-step, in concise,
outline form. . . instant information you can use im-
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this extraordinary-useful book at a special introductory
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The Lippincott Manual of Nursing Practice puts virtually
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presents in outline form clinical problems, their causes,
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The information you require is available at a glance

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13 NURSING OF FAMILIES IN CRISIS
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Sutterley and Donnelly
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NTENSIVE CAÆ
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30 RESPIRATORY INTENSIVE CARE
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31 NUTRITION IN NURSING
Anderson, et al.
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406 pages Tables and Charts 1972 $8.75

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New (3rd) Edition -
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TALKING WITH PATIENTS
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373 pp. 2nd ed. 1973 $10.75

=

Total knee arthroplasty

Following total knee arthroplasty, patient!> walk with greater ease and can return
to their normal daily activities without bein
restricted by painful movements.

Suzanne Gwilliam

Total knee arthroplasty is a relatively ne\\-
and successful operation for persons
<;uffering from the pain, loss of move-
ment, and deformity of arthritis. Thi!>
procedure deals specitìcally with the knee
joint and has been developed from exper-
ience with hip arthroplast
.
Total knee arthroplasty ha!> been used
in treating posttraumatic arthritis, primary
degenerative joint disease (osteoarthriti!>),
and secondary degenerative joint dbea!>e
(rheumatoid arthriti!>). It i!> not used for
po!>tseptic joint disease becau!>e the !>ep!>i!>
may Mill remain in the bone.

Surgi('altreatment
Three common methods of surgical
treatment for arthritic joints are arthrodc-
..i!>, osteotomy. and arthropla!>ty. The
<;urgeon chno!.e!> the procedure he be-
lieve!> will be!>t suit the patient.
Arthrode!>i!> is the fusion of a Joint. It
eliminate!> a painful joint and !>upplie!> a
stable limb. However, it may plaæ
con!>iderable !>train on other joints of the
body and there is, of course, loss of
movement .
Osteotomy i!> the removal of a \\-edge

"'. G....lllimlJ I!. a <,tudent in the fmal cia" 01
the Guelph Gener.Jl Ho,pitdl<,chool 01 nur..ing.
pre<,entl} under the juri<'l.hctiun ot Cone<,wga
Cullcge ot Applied I\rt!o and T echnolog} .
Guelph. On'arll' She e'prc"e, her .Jpprel.'id-
lion to hcr in,trul.tnr. Vlvi.Jn LUl:.J<,. B Sc.]\;
and to Dr. Mil:h,\I:1 H.JI!. unhopcdil: ,urgeon.
fur their :t"j<,t.Jncl: in prepdrmg thi, ,trllcle

SEPTEMBER lCJ74

of bone. This ..traightens the limb, re-
align!> the forces pa!>sing through the joint.
and may be an effective treatment \\hen
!>peciall) indicated.
Arthropla..ty requires the replacement
or the relining of joint surface.. and ma)
he effected by interposing material
bet\\-een the two surfaces of the joint (for
example. cup arthropla!>ty), or by repldc-
ing one surface only of the joint (for
example. Moore's prosthesis in the hip
and \1aclntosh pro!>thesis in the knee), or
by replacement of both JOInt ..urface!..
thu!> the ''total'' arthropla..ty. Arthro-
plasty is de"igned to matntain movement.
wherea!> arthrode!>is i!> the eliminatiun of
movement.
Earlier total knee arthropla!>t} em-
ployed the u!>e of a hinge. In the natural
knee there are movements of rotation of
the femur around the tibia. a.. well a,
flexion and extension. Thi!> hinge did not
dllow for thi!> rotation and, becau!>e the
metal and bone surfaces could not htnd.
the !>train cdu!>ed the prosthesis to loo!>en
in the bone. There \\a<; also con..iderahle
mechanical wearing of the hinge, !>ome-
times to the extent of total di!>tntegrdtion.
Ba!>ed on the experience v. ith the!>e
hmge prostheses, surgeon!> established
eight characteristics of an "tdeal" pros-
thetk knee. * It !>hould: relieve pain;
provide stability; allow adequate motion;

. Ge",,,,'d,, rO'<l1 Allee proHI/,"'" <I hiRhh
ugPl((1t cln, {It.' ( lupmt'" ,n "'-nf.'t.' \ur.
{ J
Cmadian H......medil:,1 lid.. Guelph. Om,.,,,,
THE CAr-"ADlAN NURSE II
.

r
\

r

Fig. I. The articulated portions of the
totul knee prosthesis.

retain ligaments. if they are intact; be
made of mdterial acceptable to the body;
allow correction of knee deformity; allow
for minimal removal of bone; and reduce
the possibility of infection to a minimum.
In other words. the pro
thesis should
resemble closely the human knee. A
geometric knee for total knee arthroplasty
has been developed to meet these eight
requirements.
The geometric knee unit consists of a
metal femoral condylar unit and a high-
density polyethylene tibial plateau unit
(Figure I). The femoral unit has two
convex surfaces that are bridged to
eliminate the necessity of aligning each
condylar rt:placement separately (Figure
2). Tht: under!>urface ha
protrusions to
allow tixation to the distal femur. using
menthyl methacrylate (Figure 3). This
minimizes interference with the intrame-
dullary canal.
The tihidl unit con
ists of two concave
tibial plateaux that accept the convex
femoral condylar units. The tibial sur-
face
are dlso bridged anteriorly so that

Iight rotdtion of the tibia about the femur
is possihle. Thi
design allows for reten-
tion of the crudate ligaments. The tibial
unit can be fixed to the tibia without
opening the medullary cavity. A wire is
embedded about the plastic tibial unit to
provide for radiologic delineation.
Both units are secured in place with
methyl methdcrylate. This is supplied in
powder form and i
mixed with a catalyst
until it rt:
embles dough. When it i
like
putty. it i
applied to the surface of the
hone.
Methyl methacrylate harden'i in about
eight minute
. It holds the designed
,
THE CANADIAN NURSE

. . ,

Fig. 2: Articular surfaces of the prosthe-
sis (femoral portion below).

irregularities of the units within the
troughs and drill holes of the bone. and
enters into the trabecular spaces of the
cancellous bone. Unlike a glue, this
material interlocks the prosthesis with the
bone. It is not an adhesive.
Since the motion of the prosthesis is
that of a sliding hinge, a larger surface
area becomes involved in weight-bearing;
friction and. therefore. mechanical wear
are reduced. Highly polished metal, mov-
ing over high-density plastic, produces
less friction than that of metal on metal.
This particular design allows a flexion
motion of 90. Patients are advised not to
kneel. Postoperatively, they experience
surprisingly little pain. Compared to other

Fig. 4: Amero-posterior radioRraph oj
rheumatoid knee prior to :;ur!!.erv

1

I 1

Fig. 3: Nonarticular surfaces of the
prosthesis (femoral portwn abOl'e).

knee arthoplasties. less physiotherapy is
required.

Patient history
A 63-year-old teacher. who had been
suffering from rheumatoid arthritis with
increasing pain and loss of movement in
both knees for five year!>, had been
confined to bed or wheelchair for the last
year. She Wa
referred by her family
doctor to an orthopedic surgeon who.
with an internist. examined her and found
her healthy enough to undergo major
surgery .
The patient's knees had fixed flexioJ'b
contractures of 4 -0 and 350 which had to be
straightened out as much as possible

Fig. 5: Lateral radiograph of rheumdtoÙ/
knee prIOr to surgery

SEPTEMBER 1974

;:---

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---
*-. "
,
,
.

> I'
i""'\:- fo.

--...-
- -
-;;...--

..

.

I
I

Fig. 6: Line of initial saw cut made
through disralfemur.

before surgery. Preoperative therapy
consisted of applications of hot packs and
quadriceps-setting exercises designed to
stretch the contracted hamstrings and
joint capsule and strengthen the weakened
quadriceps mechanism.
Arrangements were made for a physio-
therapist to visit this patient's home three
days a week to supervise the exercises
and preoperative therapy. Meanwhile.
she was to do her exercises several times
a day on her own. By the time she was
admitted for surgery. the fixed flexion
deformities had been reduced to 28" and
22': respectively. (Figures 4 and 5).
(This patient had only fixed flexion
defonnities; many other rheumatoid pa-
tients also suffer from valgus defonnities.
where the knee bends outward. and from
varus defonnities. where the knee bends
inward. )
Two days prior to surgery. the patient's
leg was painted with Bridine (povidone-
iodine) from hip to toes. This was
repeated on the morning of her surgery.
following a shave preparation.

Operative procedure
The surgery was performed with a
tourniquet applied to the upper thigh. The
leg was draped in such a way that the
knee could be moved freely. The incision
wæ. made on the medial aspect of the
knee and curved medially at the patella
and extended to the tibial tubercle. The
total length of the incision was about
eight inches.
The skin. muscle. and fascia were
retracted. and the capsule was incised to
expose the distal femur and the head of
the tibia. The knee was then flexed
SEPTEMBER 1974

,

-:-:;y

'
-------
'i7

Fig. 7: Removal of anterior and posterior
portions of femoral condyles.

sharply to expose the femur better and
facilitate its shaping. In essence. the end
of the femur was shaped by sawing off the
anterior. distal. and postenor condylar
surfaces and making dnll holes into the
condyles. A power saw wa
used to avoid
splitting the bone. (Figures 6, 7. und 8.)
The tibia was then prepared b) sawing
off the plateau medial I) and laterally.
leaving the central spine with cruciate
ligaments mtact. Designed slots were
made on the surface of the tibia. using a

ouge. (Figures 9,10, and 1/.)
When shaping was complete. a trial
reduction was done to assure correct
alignment and a secure fit. (If the
prosthesis does not sit correctly. the
bones are further shaped until it does.)
Once proper fit was established. the
femoral unit was secured pernlanently in
place with methyl methacrylate. A plastic
femoral pusher was used to hold the
femoral unit in place during setting of the
methyl methacrylate to avoid
cratching
the highly polished surface.
Another trial reduction was done. and
the knee was put through a range of
motion to make sure that the units
articulated in full extension and that the
prosthesis did not move out of position as
the knee was flexed. When this proved to
be satisfactory. the tibial unit was also
pennanently secured in place with methyl
methacrylate. Pressure was applied to the
lower tibia. with the knee in C1ltension.
until the methyl methacrylate was fully
set
The joint was then irngated and Inspect-
ed to remove excess methacrylate. A
suction drain from the knee wound was
brought out through a stab wound. The

.

-
...::.....-- ---...

;,
':.

-
.

Fig. I(- The filial
huping of distal femur.
Drill holes are "ot \'i\ible from side.

knee wound wa... then closed. using
continuous chromic sutures. and a padded
Robert Jones cnmpre.....lon bandage was
applied. (Figures I:! and /3.)

Postoper ative care
Movemem of the knee \\-as started after
four days. but l'xen:iscs \\-en: done from
the first day to strengthen the quadriceps.
The patient WdS allowed to stand at her
bedside for a few minutes I3 days after
surgery. The following day she walked a
few steps on her new knee. with the aid of
a walker.
Each day she walked a little further
until she had good control of the new
joint. She wa!' delighted to find that she
could walk with no pain in that knee and
looked forward to havmg the other knee
replaced. (Most patIents are weight-
bearing sooner than 13 days; this patient's
delay in standing was due to her involve-
ment of both knees. )
Recently. this patient returned home
after having her other knee arthroplasty.
She uses canes and stands straighter than
she has for years. She reports no painful
sensations in either knee and says. "All
the hard work wa... certainly worthwhile!"

Nursing care
The nursing care of a patÜ:nt receiving
a total knee arthroplasty is slightly differ-
ent from that of other knee surgery. The
leg must be maintained in strict exten-
sIOn.

lIIustnllton, are reprodm:ed. \\ Îlh permis-
sion, from Ihe hrochure "Genmedic Total
Knee Pro,lhe'I
:' puhli'hed by Canddian
Howmedica Ltd., Guelph, Onldrio.
THE CANADIAN NlJRSE 35
.

I I I
jJi

Fig. 9: The tibia see II from the frollt,
indicatillg areas of hone to be removed.

The pillow used under the leg should
give its support under the calf. not under
the knee. If the pillow is allowed to slide
up under the knee. flexion of the joint
results. Most rheumatoid patient
have
fixed flexion contractures before surgery.
and special care is needed to prevent this
contracture from recurring. This is be-
cause the already weak quadriceps have
been relatively lengthened by the shorten-
ing of the bone during surgery. The
combination of weakened quadriceps and
tense hamstrings tends to pull the knee
into flexion.
As with all incisions. good aseptic
technique is used when changing the
dressings. The amount and type of drain-
age are carefully noted and recorded. If
Hemovac drains are used. they are
usually removed in two or three days.

Fig. 12: Antero-pmterior radiograph
after insertioll of prosthesis.
36 THE CANADIAN NURSE

FiX. 10: The tibia seell from the Jrcmt
after shaping by rem(willg merlilll and
lateral plateaux.

depending on the amount of drainage.
Good healing of the incision is e
sentia]
to the successful operation of the prosthe-
sis. Rheumatoid patients generally have
poor and delayed hea]ing.
Most patients walked poorly or not at
all before surgery and therefore need
constant reassurance that they now have a
good. strong knee. They often need to be
reminded that they must trust and use
their new knee.
The first few times up are the most
anxiety producing. and a physiotherapist
or a nurse should remain close at hand to
offer both physical and psychological
support. After a while the patient gains
confidence and control and rapidly be-
comes less dependent on others.
Before being discharged. the patient
should have had experience walking up

Fig. 13: Lateral radiograph after inser-
tion of prosthes is.

[I / /11
f"*-"
I
I
j I
I
, r I
Ç(fI,
fjll,
I r" ,
I J \, If\l
,

Fig. II: Superior surface of tibia illdicQ-
tillx slots cut ill bOlle, olle allteriorly and
one in each plateau.

and down stairs. and
hould have prac-
ticed activities of daily living. He should
be confident of being able to manage in his
own home.
A physiotherapist. who works with the
Victorian Order of Nurses. usually goes
into a patient's home and assesses condi-
tions there. She may have suggestions on
what should be altered to make the
surroundings more suitable for the patient
when he arrives home. The public health
nurse also offers assistance to the patient
after discharge. so he is never without
someone to call on for information.

Summary
Tota] knee arthroplasty has provided
three important things: striking relief of
pain immediately postoperatively; im-
provements in rotary motion. flexion. and
stability; and significant correction of val-
gus. varus. and flexion defonnities.
The patients walk with greater ease
than they did before. They can return to
their nonna] daily activities without being
restricted by painful movements. Al-
though it is too early to determine the
ultimate effectiveness of this operation.
patients who have had total knee arthro-
plasty seem satisfied. Opinions are posi-
tive.

Bibliography
Canadian Howmedica Ltd. Geomedic IOwl
knee prosthesi.\. A hiXhh SiXllifìcalll dl'-
velopmelll ill kllee surxen'. Guelph. On!..
Canadian Howmedica Ltd.. n.d. pam.
Coventry. Mark B. et al. A new geometric knee
for total knee arthr()pla
ty. Clill. Orrho.
ReI. 83:157-62. Mar./Apr. 1972.
Kettlekamp. Donald B. and Leach. Robert B..
eds. Total knee replacement. Clill. Orrhn.
Rei. Res. vol. 94. Jul./Aug. 1973.
SEPTEMBER 1974

The
Canadian
Nurse

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SEPTEMBER 1CJ74

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The Canadian Nurse
OFFICIAL JOURNAL OF TIlE CANADIAN NURSES ASSOCIATION
THE CANADIAN NURSE 37

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Most pediatric admissions in the pre-
school age group are of an emergency
nature. They give parents little or no time
to mentally prepare a child for his stay in
hospital; and many anxious parents may
not have enough information about hospi-
tal life to help their child. The young
child, whose cognitive ahility to interpret
new situations is still limited. often

Ms. Stainton, B.SLN.. M.S.. is assistant
professor at the school of nursing, University
of Calgary. Calgary. Alberta. She notes.
.. Research in preschool hospital orientation
appears to be almost nonexistent. Many
assume sueh a program does some good, bur
no one seems to have set out to find out. Thus,
the response to this 'ieclion of the article would
be helpful ..
A 13-minute blad. and white videotape
Orielltatioll to ho.,pital for preschoolers
can be obtained from the University of
Calgary communications media department.
38 THE CANADIAN NURSE

Preschoolers'
. .
orientation
to hospital

'\ \

,,\
,
r
,1/ ,I

...."
-- ..

-
,

-
..

I
(f

interprets the sudden and complete re-
moval from the family as punishment.
Unfamiliar sights and sounds with which
he has had no previous experience can
generate fantasies and fears.
Studies on reactions to and results of
hospitalization on children. expecially
young children. have been numerous in
the past twenty years. 1.2 It is now well
documented that separation from the
family. and especially mother. during the
early years of life creates psychological
stress and trauma.
It is now known that the child who
appears "settled in" to the hospital
environment has gone through the phases
of separation anxiety described most
recentl) by Robertson J and is likely to
have permanent prohlems in his future
relationships.
Millar states. "Hospitalizing the pre-
school child exposes him to separation
and other stresses that are frequently
beyond his adaptive capaciry. and may

Five Calgary hospitals are participating in
an orientation program for preschool chil-
dren who are well. This standardized
program forms a base for research on a
child's ability to cope with the anxiety of
hospitalization when he has been shown
what to expect. A panda is used as a model.

Colleen Stainton

interfere with his subsequent psychologi-
cal growth. "4
Under the assumption that the un-
known contributes to fear and anxiety. the
author, together with five hospitals in
Calgary that admit children, planned a
program to allow well children in the 3 to
6-year-old group to become familiar with
equipment and procedures that are fairly
general to a child's hospitalization or any
medical examination.

The program - Part 1
The first part of the child's orientation
is a play experience with a toy panda bear
(Panda)* and real equipment used in
hospital. It is established that the childrep

* A giant p.mda was chosen a<; an asexual
objeet but one that had a body form not unlike
the child's, that is. arms and legs. An artificial
rectum was made with help from surgical and
Idundry staff.

SEPTEMBER 1974

are well and are just visiting the hospital.
The panda. however. is sick and has to
sta) In bed all day.
A discu
sion tiJkes place about the
rea
on
for side" on the bed. ""here
mommy and daddy are ""hen one \
akes
up in the hospital in the morning. and
why, most like I). the first person the
children will see each day is a nurse.
They are reassured that parents and
friends ""ill \Î<;it as early in the day as
possible.
The children wah:h while the nurse
begins the in-bed care of Panda. His
temperature i<; taken while pos<;ible sites
are discussed. Rectal temperature taking
is demonstrated"" ith the explanation that.
although this may feel strange. it doe
n't
hurt. The children are encouraged to
express their feelings about this proce-
dure. often considered intrusive b) this
age group.
By this time. rapport has been estab-
lished. and the children are eager to
beeomt.. involved. They then take turns
helping Panda use the urinal and/or
bedpan. after which he is thoroughly
bathed and dried. then given hi
break-
fast.
It is important to note that. consis-
tently. the children'.. response 10 these
acti \ ities taking place in bed is one of
strangeness or wrongness. Showing them
the specieú equipment and giving them
the correct term for each utensil as it is
used or demon
trated seems to help them
accept these facts.
This age group has only recently gone
through a period of rigid training in these
personal activities and is very conscious
of the correct method and place for
carrying them out. It would appear that
the hospitali7ed child requires more exp-
lanation and support ""hen activities of
daily living take place in. bed than has
perhaps been realÎ7ed in the pa<;1.
After morning care. which includes a
discussion on care of the teeth. the idea of
medication<; is introduced. Most children
have taken medicine and know it may be
in the form of a drink or a pill. Panda i..
"given" some medicine while the chil-
dren recall for one another hm
the
medicine may taste.
SEPTEMBER 1974

Although the children take turns with
other aspects of the program. all the
children give Panda an injection. Indi-
vidual attention is accorded each child to
help him work out feelings he may have.
The children agree that a needle hurt.. and
that a hug afterwards is comforting. It is
fascinating to observe the children in this
phase. and much could be learned from
further study. The site for the injection is
left entirely up to the child. Some
aggressively insert the needle into a site
with which they have had personal
experience (as evidenced by scars or
verbal comments). Others may be reluc-
tant to inflict the inevitable hur1 or to
demonstrate acknowledgment of the hurt
by giving Panda a hug.
While ..till dealing ""ith feelings about
needles. intrdvenous infusion is explained
with the description of a "drink in the
arm." It is emphasized that. once the
needle is inserted. it doesn't hurt any
more and one can play in bed. \
alk in the
corridor. or even go to the playroom
while the needle remains in.

Part II
The second part of the program pro-
vides the children with an oppor1unit) to
use equipment commonly used in
doctors' offices. emergency rooms. and
hospital units. Being aware that children
up to six are acutely conscious of their
bodies and developing body image. the
adults encourage them to explore their
bodies with the equipment. again using
correct term.. for the equipment. proce-
dures. and bod) par1s. Questions are
answered accurately at the child's level.
During a rest period. the children have
juice and cookies while enjo) ing a game
of identif) ing parts of the body depicted
In x-ra)s.

Part III
The third part of the program begins in
the x-ray department where everyone sees
the large camera that takes pictures of
""the in..ide of your body." Squeals of
delight float through the department as
the youngsters enjoy a ride on the x-ray
table while it is moved through a variet)
of positions.

In the laboratory. culture plate.. are
used to explain that ..ometimes a sample
of blood. or urine. will help the laborat-
ory technician find out ""hat is making the
child sick and \\ hat medicine will make
him better.
A visit to the kitchen rea
sures the
children that food i<; available even"" hen
momm) isn'1.
In the pediatric unit<;. the program is
reinforced. Here the children see parent<;
visiting. a croup tent in operation. and
perhaps a boy. pla)ing in bed \\hile an
intravenous runs. who \\-aves a cheery
"Hi.'" The nursing and medical ..taff
offer reassuring friendly comments a<; the
tour group passes through. The pia) room
dnd "playlad)" are happily commented
on b) the children.
The program conclude.. b) returning to
Panda. removing the intravenou<; from his
arm. ** and summarizing tho..e things that
hurt and those that don'1.
Parent discussion groups hel p inform
parents about ""hat the children experi-
ence in the orientation program Special
guidelines are developed for preparing a
child scheduled for elective hospitaliza-
tion. Parents arc encouraged to plan to be
with a hospitalized child a!o. much as
pos
ible. participating in and ledrning the
care so the child ma) be di<;charged as
soon as possible.

A climate of research
The 1 1 12 -hour program \
a
de..igned
around social learning and developmental
theories. The author initiated a pilot
project. by conducting the program in one
of the five participating ho<;pitals each
week from Januar} to June 1972. Chil-
dren from local k indergar1en
came to the
hospital in group'" of 15 to .!() at a time.
Coming to the hospital was con
idered

* * The .llIthor di,cm ered. .....th thc help of
one ,en,jti
e four-}ear-old. Ih.ltlhe IV , tl/l he
l'on,idered 01 perm..nent .Ippenddge Inltial!}.
Ihe IV .... 01' !cUm until the children had len the
ho,pildl. to emphd,iLe the import<lI1ce of II
h3ving to 'Ia} in r,,
ilion. Thi, \oung man
v.j,hed 10 kno.... h(>\\ he could ,,\im in Ihe
,ummer "\\ilh Ihal Ihing on me.'
THE CANADIAN NURSE 39

----
- --

.. ......... ...,

preferahle \0 taking the program to the
childr.:n III any other community selling.
as it provided thcm "' ith an opportunity to
see thc real ho.,pital selling while remain
ing .,afdy apart from it. During this pilot
pha'\c of the program. I.mm children
participated.
rhe re.,ponse to the pilot pha'\e wa'\
mo.,t re.... arding. "' ith bookings from
kimkrgarten'\ corning too quidly for thc
author 10 cope with thcm herselt. III
\1an:h 1l)72. a group of nur'\l' \olunteers
was trained to carryon the program.
with t....o of the five ho"pital
offering
extra programs before the pilot pha.,e wa'
(1\'er.
("ommunit
re.,pnnse was such thJt I X
to ::!() volunteer nurses have been conduct-
ing this program for the past t",o years
(Septemher to June) in all five hospital,
Thl
mcans that in Calgary. as many a' 19
IIIIClitallon' take pla<:e e,Kh month \\ ith
::!O Itl
<; pre.,chool l'hildren allending
C.Il h onl' l'he re..pon
e, fnml the creative
and l'nthu"'J,tIC vulunteer'. kindergarten
40 THE CANADIAN NURSE

tl'achers, pediatric personnel. and ho'\pi-
tal administration have been supportive
and certainly essential in view of the
,Ipparent popularity of the program.
Correctly. several have raisl'd que'\-
tions: Is this necessary? Does it do any
good? What does this program do to the
children?
A review of the literature indicates that
although many such programs arc in
operation. research as to their effect on
the child is minimal. This program has
been standardiled to allow re'\earch to he
done. One "mall preliminary study. soon
to be published. docs reveal some posi-
tive effects.
The author and some members of the
faculty of education of the University ot
Calgary are engaged in research intended
to demon'\trate that programs of this
nature do redu('e the trauma experienced
hy young childrcn when they are hos-
pitali/cd. We hope to discover how. and
if. this type of experiential learning
provides a child in this age group with

skills to help him cope with the inevitable
anxiety of hospitalization and master the
experience so that the outcome has some
po,itive effect on his learning and self-
confidence.

Rt'ferences
I Prugh. Dane G et ..II. A study 01 the
emotional reaction
of childrcn ami
families to ho..pitaliLation .\Ild illne
,
A/l/cr. .I Ortho-P,Hc-h. 23:70-lOó. Jan.
1453.
2 Vernon. Oa"id ^.. et al. P.Hch%Klclll
rC'.\pOIl.H' of dùlclrC'1I to h".\p/1l1li
lIt;oll
./I/(I iI/II C'.\ .\; II rl'\'i C' w of th e lit e/'ctlllr ('
Springfield. III.. CC Thoma.... 14M.
3. Robertson. Jall1c
. Youllg c/ùlclrell ;11
hospital. New York. BJsic Boob. IlìõH.
4. Millar. T P The h'''pital and the pre,chool
child CJùlclrnl 175:171-õ. Sepl./Olt
11ì70.

SEPTEMBER 1974

dates

Septt'mber .l0, 1<J74
The Saskatchewan Institute of Applied
Arts & Sciences, five-year reunion of 1969
graduating class, Holiday House Restaur-
ant, Saskatoon. Saskatchewan. Informa-
tion and tickets available from Mary Ann
Shaeffler, #11 -- 1705-22nd St., N.w.,
Saskatoon, Saskatchewan, S7M OT4.

September l(). n, 1974
Canadian Society of Extra-corporeal Circu-
lation Technicians, 7th annual meeting,
Holiday Inn, Downtown Toronto, Ontario.
Exams for certification (members only) will
be held September 19. All dialysis and
heart-lung perfusionists are welcome. For
further information write to; CanSECT, Box
7317, Ottawa, Ontario, K1L 8E4.

Septembt'r .l3-24, 1974
Seminar on "Budgeting in Health Care
Administration.' For further information,
write to: Barbara Schulman, Coordinator,
Continuing Education Program, School of
Health Administration, UniverSity of Ot-
tawa. Ottawa. Ontario.

September .l9- October 2, 1 <}74
Conference on "You & Long Term Car-
ing," Geneva Park, Lake Couchichlng,
Ontario. Registration fee. $110.00. For
further information and applicallon forms.
write to; Professional Development Dept..
Registered Nurses Association of Ontario,
33 Price S1., Toronto, Ontario, M4W 1Z2.

O
t()bcr 1-5, 1 <J74
Canadian Psychiatric Association, annual
meeting, Ottawa, Ontario. For further In-
formation, write to: The Secretary, CPA,
225 Lisgar Street. Ste. 103. Ottawa.

O
tob('r 3-4, 1974
Two-day workshop entitled "It Depends,"
focussing on nurses response to a variety
of dependency needs, Foothills Hospital,
Calgary. Alberta. Workshop sponsored by
the schools of nursing of the University of
Alberta and the University of Calgary. and
by the Alberta Alcoholism and Drug Abuse
Commission Fee: $20.00.

EPTEM8ER 1')74

October 7-9,1974
Newfoundland Hospital Association, an-
nual convention, St. John's, Nfld. Write to:
Executive Director, NHA, 95 LeMarchand
Road.. St. John's, Newfoundland, AIC 2H1.

October n, t974
Health team conference on "The Art of
Understanding - Care and Caring," Mc-
Master University Medical Centre, Hamil-
ton, Ontario. For more information,
contact: Ms. M. Ford, LC.S.L.T., Coordi-
nator of Education, Canadian Cancer So-
ciety, 204 Eglinton Ave., E., Toronto, Ont.
Or Dr. D. Kergin. Associate Dean, School
of Nursing, McMaster University, 1200
Main St., W., Hamilton, Ontario.

October 24-26, 1974
Ontario Occupational Health Nurses' As-
sociation, annual convention, Park Plaza
Hotel. Toronto, Ontario. For further infor-
mation, write to: Peggy Sewell, 104 New-
castle St., Toronto, Ontario.

October 26,1974
Seminar on "Working Under Stress" with
Dr. Malcolm Beck. psychiatrist, of Charlot-
tetown, P.E.1. at the University of Moncton,
N.B. Registration fee: $5.00. Open to
nurses and paramedical workers. Spon-
sored by the Atlantic Christian Fellowship.
For further information, write to: Ms. Jean
Kimball, 195 City Line, Saint John, N.B.

November .J-6, 1 <}74
Conference on the clinical nurse specialist
in Ontario, Geneva Park. Lake Couchlch-
ing, Ontario. Open to RNs who have had
preparation as a clinical nurse specialist.
For further information, write to; Profes-
sional Development Dept., Registered
Nurses' Association of Ontario, 33 Price
St.. Toronto, Ontario, M4W 1Z2.

November 13-15, 1974
Seminar on "Nurse to Nurse Dynamics:
Jubilee Auditorium, Club Room, Edmon-
ton, Alberta, in conjunction with the Alberta
Hospital Association convention. Topics
include: communications, motivations,
evaluations & job performance, changing

trends in OR nursing, pre- and postopera-
tive visiting, tour on Friday. For further
information, write to: Muriel Shewchuk,
R.R. No 1, Sherwood Park Alberta.

November 13-15, 1974
Alberta Hospital Association, 56th annual
convention, Jubilee Auditorium Edmon-
ton, Alberta.

November 1:>- 1 b, 1974
University of Alberta School of Nursing,
50th anniversary of the school s commen-
cement. For further information. wnte to'
Ruth E. McClure, Director, School of
Nursing, U. of Alberta, Clinical Sciences
Bldg., Edmonton, Alberta.

November 18- 1 q, 1974
Symposium on infection control within the
hospital, Edmonton Inn, Edmonton. Al-
berta. Sponsored by Ward 11, North
Central District of the Alberta Association
of Registered Nurses. Presented by Ame-
rican Sterilizer Company. Direct enquines
to: Helen Palamarchuk, Redwater. Alta.

November 20- 2.l, 1974
Saskatchewan Hospital Association. an
nual meeting and convention Centre of
the Arts. Regina, Saskatchewan.

November 27-2<}, 1<J74
Manitoba Health Conference, Centenmal
Concert Hall, Winnipeg Manitoba

Aprif 11- 18, 1')75
New South Wales College of Nursing.
Sydney, Australia, invites Canadian RNs
to attend their annual conference Dr.
Mildred L Montag. T eacners College
Columbia University, will be coordinator of
the conference. For application forms,
write to: Executive Director, N.S.W Col-
lege of Nursing, 36 Allen St., Glebe,
N.S.W. 2037, Australia.

June 22-27,1975
Tenth International Congress of Gerontol-
ogy (and Geriatrics), Jerusalem, Israel
For further information, write to Con.
gress, P.O. Box 16271, Tel Aviv. Israel.
THE CAr-.;ADIA
NUR
1 41
.

names

New members ",ere elected to the council
of the Saskatchewan Registered Nurses'
Association at its annual meeting in
Regina:
Sheila Belton, president-elect, is assistant
director of nursing, inservice education,
Wascana Hospital. Regina;
Jean Callaghan, second vice-president, is
night supervisor at City Hospital, Saska-
toon; and
Stella Pankratz, chairman of the commit-
tee on nursing, is administrative assistant,
diploma nursing program, Kelsey Insti-
tute of Applied Arts and Sciences, Saska-
toon.
Jean MacKay of Regina, a nursing consul-
tant with the provincial department of
health, is president of the SRNA.

Dr. loP. Chiasson
has been elected
president of the
__ f:l"'1 Canadian Hospital
Association at its an-
nual meeting and
convention in V an-
couver. Dr. Chias-
son, a specialist
a in genetics, is pro-
fessor and chairman of the department of
biology at St. Francis Xavier University
and a board member of St. Martha's
Hospital. Antigonish, Nova Scotia.

Beth Robinson, supervisor, Prince Ed-
ward Island Hospital. Charlottetown, was
elected president of the Association of
Nurses of Prince Edward Island at the
May meeting of the association
Ella Macleod of the PEl civil service
commission is past president and Betty
MacEachern, associate director inservice
education, PEl Hospital. Charlottetown,
is president-elect.

Marilyn lo Carmack has been appointed
director of placement service of the
Registered Nurses' Association of British
Columbia.
Ms. Carmack (R.N., Calgary General
Hospital school of nursing; B.Sc.N., U.
of Washington, Seattle) has, for several
years, been director of nursing at River-
view Hospital in Vancouver.

An honorary doctor of science degree was
conferred on Myra Maud Bennett at the
June medical convocation of Memorial
University, St. John's, Newfoundland.
42 THE CANADIAN NURS[

Ms. Bennett came
'. ... from England in
1921 to nurse the
.J . . .. people of the north-
west coast to New-
foundland. She was
among the first four
... nurses employed by
the Newfoundland
Outport Nurses' As-
sociation, later known as NONIA.
Some highlights of her 50 years of
pioneering as a nurse are recorded in
Don't Have Your Baby in the Dory by H.
Gordon Green (see May, p. 39).

The new executive of the nurses' section
of the Canadian Tuberculosis and Respi-
ratory Disease Association, elected in
June, are: Chairman, Claire Martin of
Montreal; past chairman, Betty Greene,
St. John's, Newfoundland; members.
Joann MacMorran, of Winnipeg. Mani-
toba, Elaine Dorken of Vancouver, B.C.,
and Eleanor Macdonald of Willowdale.
Ontario.

The Mildred L Walker Bursary Fund was
established by the University of Western
Ontario Faculty of Nursing, London,
Ontario, by the many students and friends
of Ms. Walker. During the 1973-74
academic year, awards were given to the
following students: Margaret Blanch,
Carolyn Gooding, Joyce Johnston, and
Pamela Wright.

Shirley Post was ap-
pointed director of
nursing at the chil-
dren's Hospital of
Eastern Ontario, Ot-
tawa, when it opened
a tew months ago,
having been exec-
" utive assistant to the
. .... hospital board and
acting director of nurses since 1971. Ms.
Post (Reg.N., Toronto Western Hospital;
B.Sc.N.Ed., M.H.A., U. of Ottawa) was
formerly assistant director of the Ottawa
General Hospital school of nursing.

CORRECTION
Myrtle Macdonald is setting up a nursing
program at the St. Lambert, Quebec
campus of Champlain College, not in
Sherbrooke, as noted In July, p.31.

Other recent appointments to the
Children's Hospital of Eastern Ontario
follow:
Monique Boulerice (Reg.N., Hôtel Dieu
Hospital, Cornwall. Ontario;
B.Sc.N.Ed., U. of Ottawa), coordinator
inservice education;
Mary Dorothy Chan (S.R.N., Whipp's
Cross Hospital, London, England;
S.C.M.. Hillingdon Hospital, Middlesex,
England: B.Sc.N.Ed., U. of Ottawa)
clinician, intensive care;
Cathie Closs (R.N., S1. Mary's Hospital,
Montreal; B.Sc.N.Ed.. U. of Ottawa;
M. N . , U. of Pittsburgh) patient care
coordinator:
Anne-Marie Cyr (R.N.. Hospital Sainte-
Justine, Montreal; B.Sc.Inf., U. of
Montreal) patient care coordinator,
emergency;
Beverly Joan Kelly (Reg.N., Wellesley
Hospital, Toronto; Dip!. Child Study,
Institute of Child Study, Toronto; Ed.M.,
Tufts U.. Boston) chief of nursing educa-
tion and child study;
Jocelyn Lawrence (Reg.N., St. Michael's
Hospital. . Toronto) coordinator patient
care. evenings;
Helena Alice MacKenzie (Reg.N.. Ottawa
Civic Hospital; B.Sc.N.Ed.. Ottawa U.)
coordinator, operating and recovery
rooms;
Heather Ogilvie (Reg.N., Hospital for
Sick Children, Toronto: B.Sc.N.
(Admin.), U. of Western Ontario, Lon-
don; M.S., State U. of New York at
Buffalo) coordinator of education and
research;
Ann Theresa Pederson (R.N., S1. Mary's
Hospital. Montreal; B.Sc.N., U. of Ot-
tawa) assistant director of nursing, days;
Mary Sternic (R.N., Grey Nun's Hospital,
Regina; B.N., McGill U.; Cert. Hosp.
Admin., U. of Montreal) coordinator
patient care services; and
Pearl Gladys Whyte (Reg.N., Ottawa
Civic Hospital school of nursing;
B.Sc.N., U. of Windsor; S.L.M., Simp-
son Memorial Maternity Pavilion, Edin-
burgh, Scotland) clinician, child deve-
lopment.

Therese Bonneau is associate instructor in
nursing at Grant MacEwan Community
College, Edmonton.
Ms. Bonneau (R.N., Misericordia
Hospital. Winnipeg; B.N.. U. of Alberta.
Edmonton) brings to her position an
extensive background of teaching and
nursing experience. ."'"
SEPTEMBER 1974

books

Anne Francis; an autobiography. by Flor-
ence Bird. 324 pages. Toronto.
Clarke,lmin & Company. 1974.

Although the book deals.... ith the author's
parents. school. travel. and marriage \0
John Bird. the focus is on the public life
of Anne Francis. communicator. The
author first used the pen-name. Anne
Francis. to prevent her husband from
being held responsible for ideas in her
ne"",spaper article published in The Win-
nipeg Tribune, of which he wa., associate
editor.
The author says '"I was bom with a
.,i!ver spoon in my mouth and it almost
choked me. It is in the hope of helping
other women to find themselves that I
have wrillen these reminiscences of my
slow growth from a pampered, conceited
girl to a woman with some self-
kno....ledge. "",hose eyes and heart have
been tumed outward by experience to-
....ani other people."
The la"t 5 chapters of the book concem
the Royal Commission on the Status of
Women in Canada, of which the author
""'as chairman. Background on the work
of the Commission, comments on the
hearings and on the difficult job of
....riting the report, and an updating on its
implementation are interesting and valu-
able information from the Commi!'.sion's
chaIrman. For this reao;on, the book
belongs in a health science library.

Need Your Do(tor Be So U!>elt'Ss
by An-
drew Malleson. 256 pages. London,
G. Allen & Unwin, 1973.
Re
,iell'ecl by Philip E.T. GOII'er,
Psvchiatric Nun-ing Consu/tall1,
Ontario Ministry of Hl'lllth,
Torontu. 011lario.
Although "",rillen by a doctor, this book is
full of stories frankly demonstrating how
futile. or even dangerous. the past work
of his colleagues has been. For nurses. it
provides an indirect warning of what
could also happen in nursing when its
practitioners complacently follow all the
correct rituals. but are insen!'.itive to the
real health needs of those being nursed.
This brave document is a fascinating.
humorous. yet thorough review of the
whole field of medical care. with illustra-
tions of past fads in actual medical
treatments. and suggestions as \0 what
constitutes current fads in health care.
SEPTEMBER 1974

In his final chapter. "Healthy Doctor-
ing." Dr. Malleson encourages the full
use of the unique capacities of each
member of the health team. especially in
functioning together in a community
health center. Human resources are too
scarce to be wasted in mere jurisdictional
disputes. The book ends with the presen-
tation of a number of experiments in
community health care. the most impres-
sive - and the most recent. - being the
attempt at complete rationalization of
health services throughout the province of
Quebec.
Although threatening \0 many medical
specialists. who stand \0 lose some of
their power in hospitals. the resulting
decentralized control .... .gives the con-
sumer a liberal dose of influence in
deciding what sort of health service he
wants. ..
It is not too late for nurses to join their
patients in effecting changes in the
provision of hedlth care. This book, at
once an irritant and a stimulant. should
encourage those nurses who "",ish to plan
for themselves in developing a unique
role in the growing field of community
health. rather than remaining tied to the
present hospital organizations.

Between Patient and Health Worker by
Thelma Lee Dorroh. 262 pages. Scar-
borough. McGraw-Hili Ryerson.
1974.
Reviewed b\' L\"nne Giesbrecht, Nurs-
ing /1lJ.truct
/r, Hl'alth Sciences Centre
School of Nursin!?, Winnipl'g, Man.
This book on communication and de-
velopment of interpersonal relationships
is directed at the health worker. The
author defines the health worker as
"nonprofessional. subprofessional,
paraprofessional or ancillary personnel. ..
The book is simply wrillen and easy to
read. Interest is added by the use of
examples to illustrate points. The writing
is unique - much of it reads like a
dialogue between the author and the
health worker. The book progresses from
basic concepts to help the health worker
understand his patients and his own needs
and reactions to actual guidelines that will
be useful with his increased understand-
ing of human reactions and relationships.
It is divided into four units. There is a
concise summary at the end of each
chapter, as well as a practical assignment

related to the information presented in the
chapter. The first unit points out that both
patients and health worker respond to
illness and these reactions depend on
many things. The next two units elaborate
on this.
Unit two is concentrated on the reac-
tions of the patients and the family. The
health worker is presented with several
basic communication techniques to help
him with various patient situations. but
the individuality of each situation is
stressed. This unit covers a wide varietv
of patient and family situations and I
"
quite inclusive.
Unit three is geared more \0 helping the
health worker understand his own reac-
tions and relationships. not only with
patients but with all co-workers. The
fourth unit presents basIc concepts and
skills for understanding and working wIth
people.
The author concludes by saying that the
book focuses on the caring part of the
health worker's responsibilities. The
book is only a guideline aimed at making
the health worker aware of interpersonal
relationships.
The material presented is basic but. on
the whole. well presented. It is interesting
to read and could be of real value for
aux iIIary staff.

Clinical Assessment for the Nurse Prac-
titioner by William C. Fowkes, Jr. and
Virginia K. Hunn. 190 pages. To-
ronto. Mosby. 1973.
Re
'iell'ed by M. Colleen Swinton,
Assistant Professor, School of
Nursing, Unh'ersity of Calgar\',
Calgary, Alherta.
This concise book. wrillen by a physician
and nurse practitioner. recognizes the
need of a textbook for nurses who provide
primary care. Both authors have been
involved in training programs for nurse
practitioners through the California reg-
ional medical programs.
The book is divided into five sections.
The first section, entitled" Extended Role
of the Nurse," deals with the develop-
ment of the concept of primary care.
identifying this role as the major one of
the nurse practitioner. Other roles. such
as nurse clinician and physician's assis-
tant. are differentiated. The second sec-
tion. entitled . 'Patient Interview," de-
fines the nurse practitioner's respon-
(C"mìl/ll<'d "" p<ll((' 4f>J

THE CANADIAN NURSE 43

x

'r

11
new
books detail
significant
additions to the
nurse's role

A New Book'

EMERGENCY CARE:
Assessment & Intervention
This complehen
lve presentdtlon of medical emergencies
offers in depth coverdge of related phy
iologic and
pathophysIOlogIC considerdtions, along with intervention
gUidelmes. Chdl 'ers discuss emergency medical care,
legal conslderdti. liS. psychiatric emergencies, etc.

EdIted by CARMEN WARNER SPROUL, R.N.. P.H.N.; and
PATRICK J. MUlLANNEY, M.D.; with 32 contributors. Oct-:J-
ber, 1974. Applox. 496 pages, 7" x 10", 122 illustrations.
About $14.65.

A New Book'

Whdley

UNDERSTANDING
INHERITED DISORDERS

The au thor Illtroduces LJdsic concepts of inher ited
dlsea
es by fllst presenting general principles and then
outlinmg their applications and exceptions. Comprehen-
sive coverage includes: the physical basic of inheritdnce;
gene transmission in families; singh:
gene disorders;
chromosome ahberrations; control of heritaLJle dis-
orders; and much more.

By LUCH 1 E F. WHALEY, RN. M.S. June, 1974. 220 pages
plus FM I.XII, 6y,," x 9y,,", 121 illustrations. Price, $11.50.

A New Book!

Willial

ESSENTIALS OF
NUTRITION AND DIET THERAPY

Pertment 10 health workels at all levels. this new tt
develops basic concepts of nutritional science and d
therapy. Its broad coverage includes physiologic as '^'
as sociological factors relevant to growth and devel(
ment. The first section provides a thorough introductj
to human nutrition. Part two considers the fo
environment while the third section provides a ba
mdnual of clinical nutrition.

By SUE RODWELL WILLIAMS, M.REd., M.P.H. May, 1

342 pages plus FM I-XII, 7" x 10",33 illustrations. Price, $6.

A New Book! Willia
SELF STUDY GUIDE
FOR NUTRITION AND DIET THERAI
Although specifically correlated with ESSENTIALS
NUTRITION AND DIET THERAPY, this new gL
may be utilized with nutrition and diet therapy book
all levels. It makes use of a combination of rev
quizzes, multiple choice and discussion questions,
study projects to reinforce under
tanding and appl
tion.

By SUE RODWELL WILLIAMS, M.R.Ed., M.P.H. May, 1!
208 pages plus FM I-VIII, 7" x 10", 37 illustrations. P
$5.20.

New 3rd Edition! Anthc
BASIC CONCEPTS IN ANATOMY AI
PHYS 10 LOGY: A Programmed Presentati(
This manual teaches the fdcts necessary for developir
clear understanding of the human body. Material
LJeen totally reorganrzed 10 focus on functions of
body. The endocrine chdpter has been enlarged (
siderably and contains informdtion concerning relea
fdctors from the hypothalmus. An entirely new chal
discusses the respiratory sys1em.
By CATHERINE PARKER ANTHONY, R.N., B.A., M.S.,
1974. 182 pages plus FM I-VIII, 7" x 10",54 illustrations. P
$6.60.

44 THE CANADIAN NURSE

SEPTEMBER 1974

IV 9th Edition! Mereness- Taylor
ESSENTIALS OF
PSYCHIATRIC NURSING

! authors cover personality development, communica-
1 skills as a therapeutic tool, and the use of self in
rapy in one-to-one and group relationships. Each
chiatric entity is covered from the standpoint of
se, symptomatology, treatment, and role of the nurse
therapeutic work with patients. The history of
chiatry is also outlined.
DOROTHY A. MERENESS. R.N.. Ed.D.; and CECELIA
NAT TAYLOR, R.N., M.S. July, 1974. 356 pages plus FM
11,7" x 10",26 illustrations. Price, $9.50.

Vew Book!

FAMILY-CENTERED COMMUNITY
NURSING: A Sociocultural Framework
is highly useful book of readings examines the varied
ets of family and community living which must be
Isidered in planning and delivering health care pro,
ms. Articles stress the importance of understanding
tural and social factors, methods of communication,
a-gather ing, etc.

tad by ADtNA M. REINHARDT, Ph.D.; and MtLDRED D.
INN, R.N., M.S.; with 40 contributors. October, 1973. 304
as plus FM I.XVI, 6W' x 9y,,". Price, $7.10.

/Jew Book!

Vitale et al

PROBLEM SOLVING APPROACH TO

URSING CARE PLANS: A Program
ering a programmed format, this new book presents a
blem solving approach to implementation of relevant
sing care plans. Case studies reinforce and demon-
Ite principles presented in each section. Topics
lude: purposes of nursing care plans, data collection
I methorls, data classification, deductions, etc.
BARBARA ANN VITALE, R.N., M.A.; NANCY V.
fULTZ, R.N., M.A.; and PATRICIA MARY NUGENT, R.N.,
. April, 1974. 126 pages plus FM I.XII, 7" x 10", 28
.trations. Price, $6.05.

A New Book! Hilliard
ORIENTATION AND EVALUATION OF
THE PROFESSIONAL NURSE

Intended as an alternative to the orientation rrogram of
profes
ional nurses to the clinical areas of the hospital,
this book facilitates the transition flOm student to
practitioner. It provides easy reference to hospital
procedures and offers statistically valid measurement
tools for evaluating competency in nur
ing.

By MILDRED HILLIARD, R.N., B.S., M.S. August, 1974.
Approx. 228 pages, 7%" )C 10W', 56 illustrations. About $7.90.

New 2nd Edition'

Becker Hassler

VOCATIONAL AND PERSONAL
ADJUSTMENTS IN PRACTICAL NURSING

This new edition prepares stuúents for adjustment to
professional life. The role of the LPN in hoth hospital
and community is defined, and standards for profes-
sional conduct are set forth. Legal, religious, and racial
aspects of practical nursing; and types of nursing care are
discussed in depth.

By BETTV GLORE BECKER, R.N.; and SISTER RUTH ANN
HASSLER, S.S.M., R.N., B.S., M.S. December, 1973.177 pages
plus FM I-XII, 6" x 9", illustrated. Price, $4.50.

An Updated Version! Ray
DRUGS. SOCIETY. AND
HUMAN BEHAVIOR

The new update of this highly successful book includes
key 1973 and 1974 references, up to.rlate information
on drug legislation, and new trends in drug usage. New
research evidence is also presented on cigarette smoking
and alcohol health hazards. With each chapter now
"current" - this new version is a welcome addition to
your classroom or library.

By OAKLEY S. RAY, Ph.D.; with 23 consulting authorities.
July, 1974. 299 pages plus FM I.XIV, 7" x 10",35 Illustrations.
Price, $6.85.

MOSBY

TIMES MIRROR
THE C V MOS8Y COMPANY, L TO
86 NORTHLINE ROAD
TORONTO. ONT ARlO
M48 3E5

SEPTEMBER 1974 THE CANADIAN NURSE 45

OkS

(Continued from po,!?,' 43)

sibilities in communicating and history
taking; detailed guidelines are provided.
The next part, "Examining the Pa-
tient," provides the descriptive informa-
tion that nurse practitioners have re-
quested. Included are sections on ap-
proaching patients, tools used for exami-
nations, and a detailed examination of
each body section. A brief overview of
anatomy and physiology with diagrams
helps to provide the rationale for each
examination. This section takes up the
major portion of the book and includes
special areas, such as neurological and
obstetrical examinations.
The fourth section deals with labora-
tory studies and describes in a detailed,yet
succinct manner, all the studies likely to
be encountered by a nurse in a primary
care setting. The final section, "Clinical
Applications of the Diagnostic Process,"
integrates all sections of the book by
giving examples of patients with an acute
problem and a chronic problem.
Each chapter includes a discussion of
record keeping in relation to the topic and
concludes with a pertinent bibliography.
This concise book describes the as-
sessment phase of the nursing process in a
manner helpful to nurses in any setting.
However, nurses in public health, clinics,
ambulatory care settings, and all those in
extended roles will find this book an
invaluable source of information.
Teachers and students of nursing will find
assistance determining learning objec-
tives.
I highly recommend this book to all
nurses wishing to improve assessment
skills in their practice of nursing.

Physical Management for the Quadriplegic
Patient, by Jack R. Ford and Bridget
Duckworth. 392 pages. Philadelphia,
F.A. Davis, 1974. Canadian Agent:
Toronto, McGraw-HilI Ryerson.

Written by the head remedial gymnast
and the occupational therapist of the G . f.
Strong Rehabilitation Centre in Van-
couver, this book contains hundreds of
photographs to illustrate each step of
every suggestion for helping the person
with quadriplegia become as independent
as possible.
The book is written primarily for those
who work with traumatic quadriplegics,
but it is also intended for the individual
quadriplegic and his family. The authors
indicate that the book is intended to be
used as a working manual. The pictures,
explanatory text, and excellent index are
admirably designed for this purpose.
46 THE CANADIAN NURSE

Although the book is expensive, it is a
reference work that should be included in
the libraries of health agencies that have
luadriplegic clients, and health science
5chools.

Cardiac Arrhythmias: Exercises in Pattern
Interpretation by Mary H. Conover.
291 pages. Toronto, Mosby, 1974.
Reviewed by Adele Simon, Lecturer,
Cofltinlling Education, Health Scien-
ce.f Divi.fÙm, Algonquin College of
Applied Arts and Technology, Ottawa,
Ontario.

This workbook presents 234 KG rhythm
strips for the student of electrocardiogra-
phy. Each tracing is followed by a
fill-in-the-blank section.
As the degree of complexity of the
cardiac arrhythmias increases, additional
electrocardiographic observations are re-
quested in a fixed sequence. The reader is
thus prompted to develop a pattern of
deductive reasoning: the continued use of
this pattern interpretation simplifies the
diagnosis of even the most sophisticated
arrhythmias presented at the end.
A detailed explanation, which follows

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each self-study section. includes possible
etiology and clinical significance. but
there is no mention of treatment. The
tracings are clinically relevant as many
contain frequently encountered artifacts.
This book is intended to provide only
practical exercises: it presupposes a fami-
liarity with the anatomy and physiology
of the heart. cellular physioh'g}. lead
systems, normal electrical activation of
the heart, and mechanisms of arrhy-
thmias. For the student with inadequate
background. an extensive bibliography
with pertinent references to recent litera-
ture is provided. The bibliography itself
may be beyond the understanding of the
neophyte.
The tracings are presented in 10 chap-
ters. They range from arrhythmias origi-
nating in the sinus node to atrial. junction-
al, and ventricular ectopics. Pacemakers
are included. and there are exercises for
determination of electrical axis and loca-
tion of myocardial infarcts.
Each chapter also contains examples of
arrhythmias presented earlier. Because
the author feels that the ccu nurse "needs
challenges" she has included a "fun
section" containing examples of more
complicated mechanisms, such as retro-
grade Wenckebach, supernormality. and
reciprocal beats.
This book would best serve as a

orkbook for students in a coronary care
course or for nurses in a ccu. providing
them with many examples of tracings
they frequently encounter. as well as
many that are rarely recognized. A table
of contents groups the entities and makes
it possible to find quickly examples of
most electrocardiographic diagnoses.
Teachers of electrocardiography may
find this text useful as a source of
teaching material to supply examples of
common as well as hard-to-find tracings.

Survival: BlacklWhite by Florence Hal-
pern. 238 pages. Toronto, Pergamon,
1973.
Reviewed b\' Helen H. Cm'e, A.uol'Íate
Professor, 'Queen'.f University School
of Nursing, Kingston, Ontario.

This, as the author says in the preface, is
a book about black people. Its value lies
in the fact that it is based. not on the
results of studies, but on the author's
intimate involvement in the lives of the
black people of the south. To this
experience she has brought the perception
of the psychologist. and the result is a
unique blend of emotional insight and
scholarly analysis. In this book the
meaning of the black experience in
America comes alive for the reader.
The author does not theorize; she
describes. Out of her experience she
learned how the black person thinks and
feels, and came to realize that being
SEPTEMBER 19ì4

sympathetic and broad-minded does not
bring about constructive change. Her
thesis. as she develops it throughout the
book. is that what is needed is an
appreciation of the life-style of the black
American based on an understanding of
his past. She believes that the white man
has to come to terms with the fact that it is
his way of responding to the black man
throughout his history that accounts for
black personality traits and behavior.
Only when he can accept this fact is there
hope that white and black people can
come together in mutual trust and under-
standing.
The first and longer part of the book
deals with the effect of the conditions
under which the rural black people were
compelled to live from Reconstruction
until the present upon their emotional,
social. and intellectual life, and upon
their adjustive patterns. These patterns
are contrasted with those of the white
middle class, which constitute "the Ame-
rican way of life.'- The second part
explores the impact that current economic
and political changes are having on the
black way of life. both in the south and in
the migration to the cities.
For Canadians, Survival: Black/White
has relevance. not only for understanding
the black/white problems of the United
States, but for understanding our own

relationships with native Canadians,
black, and other minority groups. The
author does not simplify the issues, but
she clarifies them. Florence Halpern
sharpens our sensitivities and makes us
aware of our own unconscious misunder-
standing that obscures the issues to be
faced. This book is both timely and
penetrating.

Pediatric Physical Diagnosis for Nurses by
Mary M. Alexander and Marie Scott
Brown. 275 pages. Scarborough,
Ont., McGraw-Hili Ryerson. 1974.
Reviewed by Holley Imhoff, Instructor
of Pediatric Nursing, College of Nur-
sing, University of Saskatchewan,
Saskatoon, Saskatchewan.

This book deals with an aspect of the
controversial phrase "expanded role of
the nurse." It is, as the title indicates, a
book that presents information about the
nurse and pediatric physical diagnosis.
Physical diagnosis is considered by the
authors to be a part of the nurse's
expanded role; this nurse is a better
prepared and expert nurse-clinician. The
authors state that "changing from physi-
cal assessment to physical diagnosis
merely meant increasing the depth of

nurses' observational skills by glvmg
them a more thorough conceptual frame-
work for observation and by adding
certain technical skills. such as the use of
the stethoscope and otoscope."
The book is based on the idea that once
a person can recognize what is physically
normal. abnormalities become apparent
and can be dealt with. To accomplish
this, a background knowledge of anatomy
and physiology is necessary. Each chap-
ter of the book deals with a particular part
of the body for which the anatomy is
described in adequate detaiL After a
discussion of anatomy, the authors talk
about what to examine for. the instru-
ments to use. and where to examine.
Because of the wide areas of informa-
tion covered, it is impossible to include
all aspects of the anatomy or pathology.
For this type of knowledge, the reader is
referred to other "good" texts on the
topic in question.
This book would be particularly useful
to any nurse who wishes to improve her
skills in physical assessment; it could also
be used as a textbook for those in
educational settings who are learning the
skills of physical diagnosis. Although the
book is called Pediatric Physical Diagno-
sis, it could be used as a general guide, in
terms of principles, for the physical
diagnosis of any age group.

Applications are invited for the position of

In decubitus
ulcers

NATIONAL DIRECTOR,
FAMIL V HEALTH
THE CANADIAN RED CROSS SOCIETY

Nursing Care is -,
what it's all about.

Position Summary
The position encompasses a broad range of responsibilities
including coordination and development of family health
services in the provincial divisions as well as advising in
relation to other interests of the Society, nationally and
internationally.
Qualifications
The applicant is a registered Nurse.
Qualifications are personal and professional achievement
including university preparation (Master's degree in Nursing
preferred) and a high level of energy and imagination.
Skills in inter-personal relationships, especially the ability to
communicate with a variety of individuals and groups are
essential. Bilingualism would be an asset.

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, 120 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

m

---------------

--
- -------

c

D YES, please contact me to schedule a viewing of
Westwood's in-service film on decubitus ulcers.
Westwood Pharmaceuticals Toronto, Ontario M8l 2E3

Name

Title

Institution

Address

SEPTEMBER 1974

City

Applications should be sent with complete resume
Immediately to:
National Director of Administration
Canadian Red Cross Society
95 Wellesley Street, East
Toronto, Ontario, M4Y 1H6

Area code_ Telephone No._

Province

Poslal Code

THE CANADIAN NURSE 47

Next Month
in

Tht'
Canadian
Nurse

. Research is Not Every
;\Jurse's Busine<;s!

. Headaches

. Diahetic Da). Care ('enter

. Energy Sources for
Implanted Pacemakers

ð

Photo Credits
for September 1974

Miller Services Ltd., Toronto.
..:over photo

Da\id Portigal & Co.. Winnipeg,
Man.. p. 29

48 THE CANADIAN NURSE

Child Health Maintenance: A Guide to
Clinical Assessment, by Peggy L.
Chinn and Cynthia J. Leitch. 122
pages. Toronto, Mosby, 1974.
Re
'iewed by Marjorie E. Shaw,
School of Nur.fing, McMaster Univer-
sity, Hamilton, Olltllrio.

This book is directed (0 students and
practitioners. It contains a collection of
assessment guides meant to facilitate
pediatric care. It contains extensive detail
in selected areas that may give the
uninitiated an illusion of completeness.
The first chapter outlines the tech-
niques of intervie\\-ing. counseling. and
assessment when dealing with children. It
assumes the practitioner has prior know-
ledge of these areas, and concentrates on
the adjustments one makes \\-hen working
with the pediatric age group. This is a
meritorious approach. It is a pity the
authors did not continue in the same vein.
The preface states that the book is not
meant to be a "crutch," but it certainly
has that potential. There are pages and
pages of detail on "how to" carry out a
physical examination. Numerous charts.
tables. and graphs. containing excess
infonnation in some cases, are meant as
aids in assessing developmental levels
and deviations from the norm.
The amount of detail in limited areas is
misleading. One gets the impression that
this is the ultimate checklist in pediatric
nursing. However, after careful examina-
tion. many errors of omission become
obvious.
The book's greatest fault is the lack of
emphasis on changes that occur at the
various developmental level!.. and how
one deals with these differences. The
reviewer wonders why the authors
selected the existing format. It would
have been preferable to concentrate on the
uniqueness of pediatric care, guiding the
practitioner to adapt her approach to each
situation.

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 reference
items, may be borrowed by CNA mem-
bers. schools of nursing and other institu-
tions. Reference (R) items (archive 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 lnterlibrarv loan only.
Requests for loans should be made on

the "Request Form for Accession List" or
on a standard Interlibrary loan form and
should be addressed to: The Library,
Canadian Nurses' Association, 50 The
Driveway. Onawa. Ontario. K2P I E2.
No more than three titles sh()uld be
requested at anyone time.

"

BOOKS AND DOCUMENTS
I. Amlmlali,," guide for "''' 't'.<. Iw , oi, S"rl'n\t'n
and Palricia B. Ulrich. Minnl'ap"li'. Minn., Si'll'r
Kenny Instilule. 1974. fifip. (Rt'hahilitalion puhlica-
lion no. 7)
2. Child p..vchialrv for ,'ude'l'." by F H. Stone.
Edinhurgh. Chtm'hill Ilving'lone, 1974. I lOp.
(1 i, ing'lone me.dicallext serie,)
3. La direclÙm du p('rjOllllel, pro Lucien Alherr el
al Monlréal. Agence d' Are, 1973. 277p
4. Di.wulmlllaged .,'udell" ill R.N. program... A
comparali,-e
IUtJ.- of ..ch(.ol ('ompleti,," record" of
two /iroup.. of soci,,-ec(momÎCalh dÜnd"olllaged
sludelll.. ill progmm.. lelldill/i 10 regi,'ered Ilur,.e
licell.ure. Þy M. Eli7ahelh Camegie. Ne", York,
l\Iational League for NII"ing. 1974. II
p. (League
exchange no. 100)
5. FmlualÙm de.. pro/iramme.' d'h,'gièlledu mili('/,:
rapporl d'ull groupe ..ciell/i(ique de rOMS Genève,
Organisalion mondiale de la santl'. 1971. 6!!p. lit'
Serie de rapports tel'hnique' no. 52!!)
6. Higher educuli,," ill nur..illg. R('plJrl Oil a
..ympn..ium Oil /fi/iher EducalÙm ill Nur,<;Il8. The
Hague, 3 Ocl. - .
No,'. IlJ72. C"penhagen,
Reginnal OffiC'e fnr Furope. Wnrld Health Organi-
zalion. 11J71. 47p.
7. L""e olllilife: fer/ilih' allli ('('"ceplitm pre,'emit,".
Ottawa. S
RI'NA. 1974. 47p.
!!. MUllual for Ihe Imll'p(WI nf high-ri../( Ill''' horll
illf"'''': prillciple<. pnIÙ-ie,. elfuipmelll. lechllilfues,
hy S}dne} Segal. SherÞrooke. P.I}, Canadian
Paediatric Socielv. 1<172. IIJRp
9. Malhfor med... a prc>gramm('d letl, Þy Anna ".1-
Curren. Ottawa. Walkur. 1973. 52p.
10. M"dem hedside Ilunilll!. hy Vivian M Culver

ed. Philadelphia. Saunder;. 1974. 7!!9p.
tl. Nunill!? cmuword. alld ",her" nrd game". by
Sheryl! fkmp'ev (ì,mJen Gr<>ve. Calif. Trainex.
1973. )(lOp.
12. Nwriti,,"/'.ardim'(H('ulapl'\ie'... 1970.71. "Iew
York. AmerÌC'an Hearl Association, Suhcommittee
of Dielitian, and l\Iulrilinnl\I'. 11J72. %p.
13. Orthopl'llir Ilunill!? hy Carroll B t dr"," and
Marjorie Gould. 8ed St (<,uis. Mo . Mo,hy. 1974.
4!!7p.
14 Paper.. pr('sell/ed al Ihe COllference Oil Ihe
Colllrol of UliliWlion ill Tl'lll'hin!? Ho.pital. Fri-
dar, Nov. 1(" IlJ7
f),," Mill., O'll. 'pollwred
b, Olllario ("",,,,('iI of Admilli.,m'on of Tear'hill!?
Ho.pita/... f)oll Mill" Om f)'"ario /I"",ilol
Au,...ioli,,"./1)74 (,.
15. Ph".iologic(/I m"(HUre.' of allx,l'I,' ill ho.piTllI
palie",.., h} Annl'Mundav London. Royal College
nf Nu"ing and Nalion.11 Counnl of \lu"e, of Ihe
Uniled Kingdom. 19ï3. 6fip. (The ,tu<h of nur'ing
care projeC'treports Ser. 2, no. 3)
16. Phninlogyfor ""nes: a /iuÙle for Ilurses alhnl
he(/llh prrl""uÙmo/'. ulld ph\'Si.-iall (/"i"all/\ hv
Warren Redwnnd GUIld el al Garden Grove. Calif..
Trainex. 1<l7l. 2
lJp (Trainex manual serie')
17. A popular;nll rnlle, for COllada? The proceed-
ill/is of two .<emillors Oil Ihe lieI'd for a COlladiall
populal;oll p,.lin' and on Ihe impacl of people Oil Ihe
SEPTEMBER 19ï4

e1n-ironment held at The Ontario Institute for
Studies in Education, Toronto, Nov. 20-21, 1972
ùnd The United Church House Toronto. Ma.\' 10-1 I.
1973. Toronto. Conservation Council of Ontario
and Family Planning Federation of Canada. 1973.
59p.
18. The price of healrh. by Jean-Luc Migué and
Gerard Bélanger. Translated from the French.
Toronto, Macmillan, 1974. 229p.
'9. Proceetlings of National Conference on Nurses
for CommuniTy Sen-ice, Orrawa 13-16 Nov. 1973.
Sponsored by Dept. of National Health and Welfare
and Canadian Nur
es' '\\Sociation. Onawa. Cana-
dian Nurses' Association. 1974. 129p.
20. La reutilisarion des effluents: methodes de
traitement des ealLt u.ees et mesures de protection
sanitaire; rapport d' une réunion d' experts de
{,VMS. Genève. Organisation mondiale de la santé,
1973. 68p. (Its Série de rapports techniques no. 517)
2 I. The therapeuti< ctJInmuniry; a sourcebook of
readings. Edited by Jean J. Rossi and William J.
Filstead. New York. Behavioral Publications. 1973.
344p.

PAMPHLETS
22. A communirv librarlan's traming program. A
report bv Joseph F. Shubert Jrom a New Mexico
program and guidelines for de,.eloping training
programs based upon correspondence studv and
adult education techniques. Boulder. Co\., Western
Interstate Commission fur Higher Education. 1973.
34p.
23. Continuing educatIOn guidelines for state
nurses' associations. Kdnsas City. Mo.. American
Nurses' Association. 1974. pam.
24. Helping the handicapped teenager mature, by
Evelyn West Ayrault. New York. Public Affairs
Comminee, 1974, 27p. (Public affairs pamphlet no.
504)
25. In hospital the child and the famil\', by Betty
Ann Countryman. Franklin Park. III.. La Leche
League Internapional. Inc., 1974. pam.
26. Policies, procedures and criteria for approval
of nursing educatIOn programs in Sa.katchewan.
Regina, Saskatchewan Registered :-.Jurses' Associa-
tion. 1973. 12p
27. Questions/answers. Series of fact sheets on
vision. Ottawa. Canadian Association of Optome-
trists. 1973. 5 pam
28. Recommendations for medical nursing praC-
tices; approved b\' Jomt Commirree on Nun-ing,
Med/('al and Hospital Services. The Saskatchewan
Registered Nurses' Association. the Saskatchewan
College of Physician> and Surgeons and the
Saskatchewan Hospital Association. Regina 1973.
9p.
29. Standards for continuinR education in nursing.
Kansas City. Mo.. American Nurse, N.sociation.
1974. pam.
30. A summary ofa series of papers and discussions
on the implicarioll.\ for the health care system
presented at the S\'mposium on Health Research
Priorities in Canada. Montreal, May 25, 1973.
Montreal. Merck Frosst Laboratories. 1974. 43p.
31. Unions. fact and ml,th. A gUIde to Canadian
labour. Onawa, Publi'hed by the Canadian Union
of Public Employee
, the Canadian Brotherhood of
RdilwdY. Tran\port and General Worker
. 1974.
3 pts. in I.
32. What's been done? Assessment of the federal
gO\'l!rnmenr's implementation of the recommenda-

SEPTEMBER 1974

tions of the Royal Commission on rhe Status of
Women. Ottawa. Advisory Council on the Status of
Women. 1974. 4Op.

GOVERNMENT DOCUMENTS
Canada
33. Dept. of Indian Affairs and Northern Develop-
ment. Ahnut Indians. 2ed, Onawa. Information
Canada, 1973. 133p.
34. Dept. of Manpower and Immigration. Supply.
demand and salaries of new Rraduates of univer-
sities and communiTy colleges, 1973. Ottawa.
Information Canada. 1974. 79p.
35. Health and Welfare Canada. Dental manpower
supply and requirements for Canada. Prepared by

Jawed Aziz and B. Leung. Onawa, 1974 2Op.
36. The health manpower position in Canada. A
repnrt prepared bv William S Hacon for presenta-
tion at the Pan American Conference on Health
Manpower plannrng. ()/tawa. Sep. 10-14. 1973.
Ottawa. 1974. 17p. fHedlth :\1dnpower Report
no.5-73)
37. -. An outline of the ..tudy of medical man-
power in Alberta, by Jav.ed Azid. Ottawa. 1974
lip. (Health Manpower Report no.2-74)
38. -. Physician manpower requirements, by
Jawed Aziz. Onawa, 1973. 21p.
39. -. Report of special project nursing; northern
s.eminars, Sponsored and conducted by Canada.
Health and Welfare Canada, Medical Services

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 12 mg. sennosldes A and B
Average dosage: 2 tablets at bedtIme until normal routine IS estab-
lished. Then 1 tablet at bedtime Dosage may be Inrreased 10 a maximum
of 5 daily if required
Contraindications, Appendicitis. intestinal hemorrhage ulcerative
colotis.
Supply: Bottles of 100 and 500 tablets
Full product Information available upon request @
SANDOZ
DORVAL.
UEBEC
T

"J
" V I:,,""
I 10. 2
'9 3
.- , 8 'w 4
'6 5

Sar ioz Pharmacr

...
n
, Sand

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1

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-
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\

THE CANADIAN NURSE 49
.

accession list

Branch in co-operation with university schools of
nursing and the Canadian Nurses' Association, Jan.,
Feb., and March 1971. Ottawa. 1974. 136p.
40. - . Selected dental manpower educatIOn and
services, Saskatchewan, the Yukon and Norrhwest
Territories. A report on a tour conducted May-June
1973, by Sharon B. French. Ottawa, t973. 19p.
(Health Manpower Report no.6-73)
41. -'unÍ>'ersirv programs to prepare nurses for
an expanded role in Canadian health services, by
Hbako Rose ImaL Ottawa, 1973. 28p. (Health
Manpower Report no.5-74)
42. Ministère de la Santé natlunale et du bien-
être social. Bibliothèque du ministère.lnventaire de.ç
périodiques. Ottawa, 1974. 154p.
43. Statistics Canada. Awards for graduate stud,'
and research 1973. Ottawa, InformatIOn Cdnada.
1974 347p.
44. -. Recensement du Canada, 1971. Ottawa,
1974.3v.

GREAT BRITAIN
45. Joint Board of Clinical Nursing Studies. Outline
curriculum in coronal} care nursing fur state enrol-
led nurses. London. 1973. lOp.
46. -. Outline curriculum in coronary care nurs-

ingfor state registered nurses. London, 1973. lip.
47. -, Outline curriculum in geriatric nursing for
state registered and state enrolled nurses. London,
t973. 16p.
48. -. Olllline curriculum in operatin!? department
nursing for stale enrolled nurses. London, 1973.
I3p.
49. -. Outline curriculum in renal nursing for
state enrolled nunes. London, 1973. 12p.
50. -. Outline curriculum in rellal nursingfor state
registered nurses. London, 1973. I3p.
51. -. Outline curriculum in slOma care nursingfor
state registered nurses. London, 1973. lOp.

STUDIES DEPOSITED IN THE CNA
REPOSITORY COLLECTION
52. Affect changes pre and post abortion, by Linda
McHarg. Montreal, 1973. 15p. R
53. A case study of the learning needs of expectant
parents during the perinatal period, by Heather
Frances Clarke. Seattle, 1972. 102 p. R
54. The consultative process: an inquiry into con-
sultation in nursing, by Edna R. Walsh. New York,
1972. 55p. R
55. A descriplive study of health and related needs
of senior citizens in one housing complex. by Myrtle
Lavina Kirstine. A pilot survey conducted in the
Borough of Etobicoke. Etoblcoke, Ont.. Etobicoke
Dept. of Public Health and Faculty of Nur
ing,
University of Toronto. 1973. 53p. R
56. De.'elopment and implementation of the nurse
clinician role: a report, by Rosemary Prince
Coombs, Ottawa, 1973. 560p.

57. The Development of an interview guide to
identifr nursin!? needs of elderly people living at
home, by Janet Margaret Holder. Toronto, 1974.
108p. R
51\ Elahoralion el evalulllion d'un enseignemenl
prugramme de la melhode sym/JIO-Ihermique destiné
au\ injìrmières, par Solange Lefebvre-Pageau.
Montreal, 1973. 277p. R
59. An naluarion of sllillents and graduales of col-
lege nursing programs in the Province of Alberta, by
Margaret E. Steed. Edmonton, Depl. of Advanced
Education for the Committee on Nursing Education.
Universities Coordinating Council, 1974. 133p. R
60. E.'perience vécue par Ie malade psvchiatrique
lurs de /' elablissement de limites à son comporte-
ment, par Michel Demers. Montreal, 1973. l03p.
R
61. Methods of acquiring knowledge, amount of
knowledge. and compliance wilh care in selected
patients wilh diabetes, by Cora Hinds. Toronto,
1974. 18Op.R
62. Quality of nuning ('{Ire measured by audits of
nursin!? records and palients' perceptions, by
Lenore Isobel Mills. Toronto, 1974. 125p. R
63. Quantir).' and quality of patients' sleep and
sleep-disturbing factors in a respiratory intensive
care unit, by Barbara Ann Hilton. Toronto. 1974.
138p. R
64. Rapport sur les diplômes en sciences de la santé
des etablissements d' ensei!?nement du Canada. par
H. Rocke Robertson, J.F. Houwing el L.F.
Michaud. Ottawa, Association des Universités et
Collèges du Canada. 1973. l84p. R

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50 THE CANADIAN NURSE

SEPTEMBER 1974

classified advertisements

ALBERTA

NURSING C'OORDINA TOR requored for a full tIme day posItIon
at the Fort McMurray General Hospital Appropriate educallOn
and expenence t" the fæld of contmulng educabon prefeoed
At present this IS a 54.bed hospital In a rapdly growIng lown
wIth plans for expansIon to a 3DO-bed community hospital.
Interested persons please apply In writing. stating educatIOn and
past experience. to the Director of NurSing. Fort McMurray
General HOspItal, Box 120, Fort McMurray. Al6erta. TOA IKO.

AEGISTERED NURSES reqUIred for 70 bed accredited active
treatment Hospital. Fulltl"'" and summer relief All AARN per-
sonnel pohcles. Apply In WritIng to the" Director of Nursing.
Drumheller General HospItal, Drumheller. Alberta.

2 R.N:. wanted for Immediate employment at the Two HIlls
Murwcipal HospItal, Two Hills. Altlerta. We follow salary
schedule as set forth tl r the AARN Must be willIng to stay at thIs
k>catlon a minimUm 0 one year. Apply to: Administrator, Two
Hills Municipal Hospital. Two Hills. AJberta.

GENERAL DUTY NURSES requored Immediately to worlc In an
active treatment hasp1tal. Salary and policies as per AARN
Residence avaIlable. Apply: Dorector of NursIng. HardIsty
General Hospital. Hardisty. Alberta.

BRITISH COLUMBIA

PRE-NATAL TEACHERS, required for The Lower MaInland
Chlldbeanng Society, a small, friendly and rapidly expanding

Sb:

.f:ri
P=',

h"em
:

';;,

gramme IS approx. 20 weeks. Small fee given for teaching
classes. Applicants should have had a child by prepared
chIldbirth. EnqUIries 10: L.M.C.S.. 1-1396 Wesl 71 Ave..
Vancouver. B.C., V6P 3B5 or phone' 732.7704

ADVERTISING
RA TES

FOR .\ll

CLASSIFIED ADVERTISING

S 15.00 for 6 lines or less
$2.50 for each additional line

Rates for dIsplay
cd\Jerti\ements an request

Closing dale for copy and cancellation is
6 weeks prior to I st day of publicatian
month.
The Canadian Nurses' AssociatIon does
not review the personnel. policies of
the hospitals and agenCIes advertISing
in the Journal. Far authentic information,
prospective applicants should apply to
the Registered Nurses' Assaciation of the
Province in which they are interested
in working.

Address correspondence to:
The
Canadian A
Nurse Tg

50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P 1E2

SEPTEMBER 1974

I I

BRITISH COLUMBIA

REGISTERED NURSES WANTED FOR FULL Y ACCH
DITED
HOSPITAL CONSISTING OF loo.BEDS. GENERAL DUTY
POSITIONS IN MEDICAL.SURGICAL PSYCHIATRIC AND
ICU.CCU AREAS MUST BE ELIGIBLE FOR B C. REGISTRA.
TlON BASIC SALARY 1973 - $672 00 (NEW CONTRACT
BEING NEGOTIATED) APPLY DIRECTOR OF NURSING
ST JOSEPH S GENERAL HOSPITAL COMOX. BRITISH
COlUMBIA. V9N4B1

REGISTERED NURSES reqUIred for new Senior CItizens
Complex 101.beds for perSonal/Intermediate care; 9.000 sq ft.
Recreation Centre for all Semors in the community. apartment
Unit tor 156 people. Apply to: Administrator. Pent,cton & Dlstnct
Rehrement Servlæ. P.O. Box 501. Pentlclon. Bntlsh Columbia.
V2A 6K9.

REGISTERED NURSES required for a 100-tled acute care
accredited hospItal WIth a 40-bed Extended Care Unrt. located in
the Cariboo regIOn of B.C s central Intenor Vacancies In
OperatIng Room (Out PatIents) maternity and general duly
acute care New graduates welcome. Salary and personnel
policies In accordance With RNABC agreement. $850 10 $1.020
depending on experience Rooms avallahlp In the Nurse..
Residence. Apply In wnlll1Q to the Director of Nursing. G R
Baker Memonal Hospital. 543 Front Street Quesnel. BritIsh
Columbia. V2J 2K7

EXCelLENT OPPORTUNITY lor R.N. GENERAL DUTY
NURSING wl1h part-time administrative responsibilities 1 D-bed
hospItal opened Summer 1973 . Employment commencing
November 1. 1974 with Admlnlstrallve responsibIlities De-
cember 1. t974. SUbmit all particulars of previous experience to.
Administrator Tahsis Hospital. Box 399 Tahsls. Bntlsh Colum-
bia

GENERAL DUTY NURSES for modem 41.bed hospItal located
on the Alaska Highway. Salary and personnel policies In
accordance with RNASC Accommodalton avallatJle In resI-
dence Apply' Director of NursIng. Fort Nelson General Hospital,
Fort Nelson. Bntlsh Columbia.

TWO GENERAL DUTY NURSES WIth experience .n obstetncs
and 0 R required tor a 21.bed hospital In the Soulhern InterIOr
of 8.C LMng-in accommodation available Salary as per
RNABC rates Moderate chmate. good workIng condillons and
recreational faclhtles available Apply giVing full particulars and
relerences In first letter to the Administrator. Sioesn Community
Hospital. Box 129. New Denver Brrtlsh ColumbIa

EXPERIENCED GENERAL DUTY NURSES lor modern
10 bed hospual with doctors offl(.
s 10 hOspital
Situated beautrful west coast of Vane 'uver Island
AccommodatIOn S
O 00 a month Apply Admlnlstra.
tor Tahsls Hospital Box 199 Tahsls British
Columbia

GENERAL DUTY NURSES required for an 87-bed
acute care hospital In Northern B <... HeSIUt:II
fJ
accommodations available RNABC pohc!es In eHect.
Apply to. Director 01 Nursing Mills. Memonal Hos-
Prtal, Terrace Bntlsh ColumbIa. V8G 2W7

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES 'equ"taJ ,,,r small
upcoast hospital "--.J Jry
md personnf policies as
per RNABC contract Sala"es start 56 7 200 for
Registered NursPc;;, 777 for llc pO Practical
Nurses Reslden{..
accommodation $.: uO per month
Transportation paid from Vancouver Apply to
Director 01 Nursing SI GI "ge s Hospital Alert Bay
Bntlsh Columbia

GENERAL DUTY NURSES 8nd LICENSED PRACTlCAL
NURSES for modern 130-bed accredIted hospItal on Vancouver
ISland. Hesort area - home of the Tyee Salmon Four hours
travelling bme to CIty of Vancouver Collective agreements With
Provincial Nursing AsSOciation and Hospital Employees. Union
Residence accommodation available Please dlrectlnqulrl9s to
Director of NurSlnQ Services. Campbell River & Dlstnct General
Hosprtal. 375-2nd Avenue. Campbell River. Bntlsh ColumbIa,
V9W3V1

OPERATING ROOM NURSE wanted for actIVe mo-
dern acute hospital Four Certified Surgeons on
attending staff Experience of tralOlOg desirable.
Must tI.. eligible tor B.C RegIstratIon. Nurses
resIdence available. Salary according to RNABC
Contract Apply to Director of NursIng MIlls Mem-
onal Hospital, 2711 Tetrault St.. Terrace. British
Columbia.

I I

BRITISH COLUMBIA

GRADUATE NURSES requored for general duty and o.R. In a
9& bed hospital with 35 Extended Care beds under constructIOn
RNASC policies and wages In effect Apply In wntlng to The
Director of Nursing. Kltrmat General Hospital. Klflmat Bntlsh
Columtlla

EXPERIENC'ED NURSES (eligible lor B C regIstration) reqUired

II:
9-

d.,:

:s c

efr

;n?ro
S

c

d F

easy access of vaned recreational facilities Excellent Onenta-
bon and ContinUing Education programmes Salary S850 00 to
$102000 Clinical areas Include' Medicine Gene.al and Spe.
clalized Surgery. Obstetncs. Pedlatncs Coronary Care. Hemo-
dialysis. Rehabilitation. Operating Room. IntenSive Care Emer-
gency. PRAC'TlC'AL NURSES (eligIble lor B C license) also
required. App1y to: NurSing RecrUitment Personnel Department.
Royal Columbian Hospital New Westminster Bnllsh ColumblB..
V3L3W7

MANITOBA

REGISTERED NURSES required for 56 bed accredIted hospl'
tal. Pine Falls General HospItal Pine Falls Manitoba Located
85 miles north-east of Winnipeg Residence accommodation with
cooking facdttles 8ViMtabfe Past expenence recognized A.pp1y to
Director of Nursing. Box 2000 Pine Falls General HOSpltdl.
PIne Falls Manitoba. ROE 11010

R.N:s snd LP.N:s reqUIred for new 36-bed hosptal Salary In
accordance wl1h Nurses Assoclallon Agreement. Apply to.
Director of Nursing. Souns Dlstnct Hospital Souns Mamtoba
ROK 2CO

NORTHWEST TERRITORIES

NURSES reqUired for general duty and charge posrtlons for a
73.bed active hoSpital Fully accredIted Nurses re,.dence
available Must be regIStered In a provInce of Canada Apply to
the Director of Nursing. Stanton Yellow
nrte Hospital Box 10
Yellowknife. NOC1hwes\ T erntones

ONTARIO

HEAD NURSE to take full charge for Home with psychlatnc

:

nlt
Uror t
:

IO
h: H
:e

ocl::
r36a
::Zs
from Toronto. Ontano In Claremont. Ontano Apply Claremont
NurSIng Home, R A. No 3. Claremont Ontario Telephone
64
2108

REGISTERED NURSES for 34.bed General Hospital
Salary $706.00 per monlh to $81600 plu. expenence al.
lowance Excellent personnel policies Apply to
Director of NurSing. Englehart & D'stflct Hosp,ta'
Inc Englehart. Ontano. POJ 1 HO

REGISTERED NURSE required ,n beautdu ' fnendly Northem
Ontano as VIP to the resIdents In our (.urslng home These
people need activation. fnendshlp, encouragement. understan-
ding and
ood nursing care We want someone speaal to work
dosely With our Director of Nurses In a new program. Steady
days good startIng salary and other benefits Interested?
Contact Mr G A Bacon. Administrator. Northland Lodge,
Englehart. Ontano. Phone 705-544-8191

REGISTERED NURSES reqUIred for 1 07-bed accredited Gene-
ral HospItal. BasIc salary comparable to other Ontano Hosprtals.
with remuneration for past experience. Yearty Increments. A
progressive hospital amidst the lakes and streams of Northwes-
tern Ontano. Apply 10 Director 01 NursIng. LaVerendrye
HospItal, Fort Franæs. Ontano

OPERATING ROOM STAFF NURSE req...red lor fully accrsCl'
ted 75-bed Hospital. BasIc wage S689 00 WIth conSideratIon for
expenence. also an OPERATING ROOM TECHNICIAN. baSIC
wage $526.00. Call bme rates avaIlable on request. Wnte or
phone the: Director 01 NursIng, Dryden Dlstnct General HospItal.
Dryden Ontano

THE CANADIAN NURSE 51

ONTARIO

THE DEPARTMENT OF CLINICAL EPIDEMIOLOGY AND
BIOSTATISTICS IN THE FACULTY OF HEALTH SCIENCES
McMASTER UNIVERSITY offers a program in the Design,
Measurement and Evaluation of Health Care Programmes
leading to a Master of SCience Degree. Applications are Invited
from practicing health professionals seeking a primary em-
phasIs in Dimeal Epidemiology. and from persons with other
backgrounds who are primanly interested rn Health Care
Research Methods Fellowship support is available for Cana-
dian citizens and landed immigrants. For further Information
please wrole 10: - G.H. Goldsmith. Ph.D. Clinocal Epldemlolog'
and Biostatistics, McMASTER UNIVERSITY Hamllton,Ontaric
L8S 4J9. Applications close on December 15. 1974.

REGISTERED NURSES reqUIred for our ultramodern 79-bed
General Hospital In bilingual commumty of Northern Ontano.
French language an asset. but not compulsory Salary IS $855.
to $1030. monthly with allowance for past experience and 4
weeks vacation after 1 year. Hosprtal pays 100% 01 O.H.I.P..
life Insurance (10,000). Salary Insurance (75% of wages to the
age 01 65 with U.I.C. carve-out). a 354 drug plan and a dental
car,: plan. Master rotation in effect. Rooming accommodations
available in town Excellent personnel policies. Apply to:
Personnel Director. Notre-Dame Hospital. P.O. Box 850.
Hearst, Ontario.

REGISTERED NURSE Wlllited Immediately for a 17.bed
hospolal in Northern Ontario Salary $700 - $825 monthly.
Hornepayne is an exciting and interesting town of 1800
people. Appy to the: Director of Nursing. Hornepayne Com-
:;'

2HOSPllal, Hornepayne. Onlarlc Telephone' (807)

REGISTERED NURSES required for a 12-bed Intensive
Care-Coronary Care combined Unit. Post basic preparation
and/or sUitable expenence essential. Apply to: Personnel
Manager. St Mary's Genera' Hospital 911 Queen's Blvd..
Kltchener. Ontano. N2M IB2.

REGISTERED NURSES With experience lor 37-bed fully accre.
dited hospolal in North Western Ontario Accommodation In
nurses residence available. Appy. Head Nurse. Nipigon District
Memonal Hospital. Box 37. Nipigon. Ontario. POT 2JO

REGISTERED NURSES end REGISTERED NURSES' AS-
SISTANTS required for Nursing Home (Retarded Females)
Good starting salary. Evaluation raises. Please reply to:
Admlnostrator. Mount Forest Nursing Home, 465 Dublin SI..
Mount Forest Ontario. Telephone: AREA (519) 323-1711

REGISTERED NURSES AND REGISTERED NURSINQ
ASSISTANTS for 45.bed Hospital. Salary ranges
include Qenerous experience allowances. R.N.'s
salary $740. to $840., and R.N A:s salary $550 to $625..
Nurses residence - private rooms with hath - $40.
per month. Apply to' The Director of Nursing Gerald.
ton District Hospital, Geraldton. Ontario. POT 1 MO

REGISTERED NURSES FOR GENERAL DUTY, I.C.U.,
C.C.U. UNIT and OPERATING ROOM required tor
fully accredited hospital. Starting salary $697 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

PUBLIC HEALTH NURSES required for generalized prog.
ramme. Salary range $8550 :- $10.250. w
h diHerential for
BScN; generous fnnge benefits. Apply to. MIss E. Flaxman,
Director. Public Health Nursing. Haliburton. Kawartha. Pine
Ridge DIStrict Health Unit. Box 337. Cobourg. Ontano. K9A 4K8

PUBLIC HEALTH NURSE - GREY.OWEN SOUND HE
TH
UNIT has an openong for a qual
ied Public Heslth Nurse. If you
are Interested In obtaining more information about this posl1lon.
please contact: MIss E. Davidson, B.Sc.N.. Director of Nursing.
Grey-Owen Sound Health Unot. County BUilding. Owen Sound.
Ontario, N4K 3E3.

PERU - PEDIATRIC NURSE. Experienced nurse required for
pedlatnc service at Hopl1al Amazomco, Pucallpa. Eastern Peru.
'or 1 or 2 years. Challenging position. Write: Amazonian
Hospolal Foundation. Box 252. Etobicoke. Ontario.

52 THE CANADIAN NURSE

I I

SASKATCHEWAN

MATRON required for 54-bed nursing home. Owned and
operated by the Conference of Mennonites of Saskatchewan.
Applicants must be Reg. Nllses. have some command of
German. and be in good physical health Competitive. negoti-
able wages. For further information and application write: The
Administrator. Herbert Nursing Home, Box 520. Herbert.
Saskatchewan.

UNITED STATES

R.N.'s - SOUTHERN CALIFORNIA - Immediate need exists
for medical-surgical Units Onentatlon and in-service program.
Excellent salary, full paid benefits We will assist you with your
H-1 vISa for ImmigratIOn. A license In California to practise
nursing IS necessary hefore employment Wnte for an applica-
tion to the Calilornia State Board of Nursing Education and
Registration. 1020 N Street. Sacramento. Callfornoa. 958:4

REGISTERED NURSES: JOin your friends In a large expanding
& progressive hospital. Located in the heart 01 California near
the fInest educational and recreational actIVities where the
climate IS mild the year round. Good starting salaries and liberal

J(l
s

:
m

:
:c!a

n

1.. Sutter Hospitals.

RN's end LPN s -- University Hospital North a
teaching Hospital of the Unoverslty of Oregon Medical
School, has openings In a vanety of Hospital ser-
vices We offer competitive sala(les and excellent
f(lnge benefits. InQuires should be directed to Gale
Rankin Director of Nursing 3171 S W Sam Jackson
Park Road. Portland. Oregon. 97201

TEXAS wants you! If you are an RN. exppnenced or
a recent graduate come to Corpus Chnstl Sparkling
City by the Sea a city bUilding lor a better
future where your opportunities for recreatIOn and
studies are limitless. Memorial Medical Center 500
bed. general teact Ing hospital encourages career
advancement and provides in-Service orientatIOn
Salary from 5682.00 to $94000 p<,' month. com
mensurate with education and eXPerrence Dlttprentlal
for evening shifts. available. Benefits Include holi-
days Sl ck leave. vacations paid hospitalizatIOn
health hfe 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 POBox 5280
Corpus Christi. Texas. 78405. .

THE

AND
SHORT
OF IT

.. .WE NEED YOUR
BLOOD. MAKE +
A DATE TODAY.

IHE 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 o. 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

ST. JOSEPH'S HOSPITAL
TORONTO, ONTARIO.

REGISTERED NURSES

630.bed fully accredited Hospital
'Gvides
experience In Emergency. Operating Room,
Post Anaesthesia Room. I ntenslve Care Unit
Orthopaedics, Psychiatry. Paedlatrrcs, Obste:
triCS and Gynaecology. Generdl Surgery and
MedicI ne.
BasIc 2 week Orrentatlon Program and con.
tonulng Active Inservlce Program for all :evels
of Staff.
Salary IS commensurate with preparation and
experience.
Benefits include Canada Pension Plan, Hospital
Pension Plan. Unemployment Insurance.-
Group life I nsurance 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 hohdays - 3 weeks annual vaca-
tIOn after completion of one years service.
APPL Y:

ASSOCIATE DIRECTOR
OF NURSING SERVICE

ST. JOSEPH'S HOSPITAL
30 The Queensway
TORONTO 3, ONTARIO.

SEPTEMBER 1974

Nursin

There's no shortage
of opportunities for
nurses in the sun of
Queensland-the
tropical Statè of
Australia's east coast.
In fact, we need so
many experienced
professionals to staff
hospitals throughout the
State, that we'll fly you
out to a job in the sun
just as soon as you're
ready to leave.
We'll Fly You There
We'll pay your fare
(economy air travel) from
Canada to Queensland. And
we'll throw in an allowance
towards moving expenses.
We only require you
to agree to work in
Queensland hospitals for
at least 12 months.
The hospitals you'll
work in range from
large complexes and
specialist units in major
cities to 40 bed generals
in smaller towns and
centres-with
correspondingly wide
experience and training
opportunities. But they
all have one thing in
common: the superb
climate of Queensland.
From completely
tropical Cairns to the
capital, Brisbane in the
South, you'll enjoy
winters as warm as a
Canadian summer. And
summers like you've
alwavs dreamed about.
Beat the Winter There
You'll be extremely
well paid, with living

quarters available, and
the sort of amenities
you'd imagine for the
tropics laid on:
swimming pools and all.
1 We've set out our

whole offer in a
I straightforward colour
brochure called
. "Nursing in the Sun".
We'd like you to have it,
I free.
" . So, post the coupon
now, to find out all

about how you can get

to the tropics and get
j , . paid for it. Winter
isn't as far away as
"f you think.

I. ' . ." . : Post the coupon to
, The Australian Trade
Commission
I '

.

in I

,

sun.

Suite 500 Guiness
Tower,
1055 West Hastings
Street,
Vancouver. I. B.C.

OR P.O. Box 69.
Commerce Court,
Postal Station,
Toronto. Ontario.
OR Suite 811,
Canadian Imperial,
Bank of Commerce
Building,
1155 Dorchester
Boulevard West,
Montreal 102. P.Q.
Quebec.

@lliJ@@[Jù@Oand
uslralia

.

SEPTEMBER 1974

..Nursing
In the sun.

-.....

"
.. '.
_" .
'_'
- ,.::..t... '"
..
.

_ "
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,;1,......._

I
.: ...... .'
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--',

.
.
'-

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v.......

:.-1. ,,'.:.

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. "

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.................- ...,....
. .
. Please forward free colour brochure to:- .
. .
. .
. Name .
· Address ·
. .
. .
. .
. .
. Province .
II ZipcCKle II
....................r

w

DOH 19

THE CANADIAN NURSE 53

GENERAL DUTY NURSES

Required immediately for acute care gen-
eral hospital expanding to 343 beds plus
proposed 75 bed extended care unit.
Clinical areas include: medicine, surgery,
obstetrics, paediatrics, psychiatry, activa-
tion & rehabilitation, operating room,
emergency and intensive and coronary
care unit.
Must be eligible for B.C. Registration
Personnel policies in accordance with
R.N.A.B.C. contract:
SALARY: $850 - $1020 per month
(1974 rates)
SHIFT DIFFERENTIAL

APPL Y TO:
Director of Nursing
Prince George Regional Hospital
Prince George, B.C.

NORTH NEWFOUNOLAND & 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. Newfoundlana. Active
treatment is carried on m Surgery, Medlcme,
Paediatrics, Obstetrics. Psychiatry. Also.
Intensive Care Umt. Orientation and In.Servlce
programs. 40.hour week, rotatmg shifts. Llvmg
accomodatlOns sup pi ied 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.

PUBLIC HEALTH
NURSES

Required for the Sudbury and District
Health Unit.
Begin(ling September 1974.

APPL Y TO:

Director of Nursing
1300 Paris Crescent
Sudbury, Ontario
P3E 3A3

54 THE CANADIAN NURSE

TH E HOSPITAL
FOR
SICK CHilDREN

"""'"
...,

'-
....

t

,

,

,...

//

Situated inthe stimulating
atmosphere of downtown
Toronto, witl1in walking distance
of the University of Toronto
The largest children's hosPital On
the continent offers the
Registered Nurse opportunities
for development in our Nursing
Department. We have many areas
that will interest the Registered
Nurse who is looking for a
challenging career in paediatric
Nursing
Opportunities for employment in
Intensive Care, Renal Dialysis,
Neonatal Unit, Child and FamilY
Unit, Clinical Investigation
Unit, Operating Room, Cardiac
Surgery, Neurosurgery Isolation
and Orthopaedic surgery. We
have a planned or i entat i on and
staff development programme

The majority of in-patient units
are working the 7 day fortnight
(12 hour shifts) Salaries are
commensurate with experience
and education. Excellent fringe
benefit programme. Current
registration in Onto is required

Applications for General
Duty Positions are invited
PLEASE WRITE TO Mrs.C. MACINNES
The Personnel Co-ordinator
555 University Avenue
Toronto, Ontario, Canada
M5G 1X8
TELEPHONE 366'7242 Ext.1528

ADMINISTRA TIVE
SUPERVISOR

With post graduate courses and experi-
ence relative to nursing administration. An
opportunity to exercise skills of leadership
and to participate in an ongoing progres-
sive management development program.
Applicant should be able to rotate on night
tour of duty.

Apply:

Assistant Administrator (Nursing),
York County Hospital,
NEWMARKET, L3Y 2R1,
Ontario.

THE LADY MI NTO 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 1 CO

REGISTERED NURSES
AND
NURSING ASSISTANTS

Required for 11 O-bed hospital which spe-
cializes in chest diseases, situated in the
beautiful Laurentian mountains and loca-
ted only 55 miles from Montreal. Good
personnel policies and residence accom-
modation available.

Apply:
DIRECTOR OF NURSING
Mount Sinai Hospital
P.O. Box 1000
Ste. Agathe Des Monts, Quebec
J8C 3A4

SEPTEMBER 1974

1+

Public Service
Canada

Fonction publique
Canada

This competition is open to both men and women

NURSE!

At the Department of Veterans Affairs we are sensitive to your needs. Through our
hospitals we are dedicated to providing professional and personalized care to our
patients. We look to our nurses to help us achieve that goal. And we know that
dedication and job satisfaction go hand in hand.
To help us meet your needs, make us aware of your concerns.
A special nurse is available at each of our hospitals in Halifax, London and
Winnipeg ready to talk to you on a personal basis. She will:

* Describe the variety of nursing duties
available at our hospitals;
* Entertain requests for flexible schedu-
les as well as for temporary and
part-time work;
* Talk about training programs and op-
portunities for professional advance-
ment;
* Advise you on relocation;
* Answer all your questions.

So whether you're experienced, or just out of school; whether you wish to work full
or part time; whether you live around the corner or across the country; whatever
your needs, we will do our best to accomodate you. In return, we ask that you care.
Call collect and talk to the nurse who shares your concerns.

IN HALIFAX: Mary Johnson
Camp Hill Hospital
Tel: (902) 423-1371
IN LONDON: Helen Conn
Westminster Hospital
Tel: (519) 432-6711
IN WINNIPEG: Ann Bowman
Deer Lodge Hospital
Tel: (204) 837-1301

SEPTEMBER 1974 THE CANADIAN NURSE 55

POST-GRADUATE
REFRESHER COURSE
In
PEDIATRIC REHABILITATION

.or: Nurses, Physiotherapist, Occupational
Therapists
January 13th, 14th and 15th,
1975
COST: $50.00

Information:
The Education Department,
Ontario Crippled Children's Centre,
350 Rumsey Road,
Toronto, M4G 1R8, Ontario, Canada,
Att'n: Ms. L Hamilton
Ms. N. Geddes

MONTREAL
NEUROLOGICAL
HOSPITAL

A Teaching Hospital
of McGill University

requires

Registered Nurses
for
General Duty
PrevIous experience In neurolOgical nursrng not
required. Actrve rnservlce education programme.

Apply to:
The Director of Nursing,
Montreal Neurological Hospital,
3801 University Street.
Montreal 112, P.O.

DIRECTOR
NURSING SERVICES

Required by 1 aD-bed fully accredited
general public hospital. Excellent
fringe benefits. Salary commensurate
with experience and qualification.

Reply in writing to.

Miss G. Norris
Director Patient Care Services
Wingham and District Hospital
Wlngham, Ontario

56 THE CANADIAN NURSE

ASSOCIATE DIRECTOR
OF NURSING SERVICE
ADMINISTRATION

This 53D-bed teaching hospital af-
filiated with the Queen's University
School of Medicine requires a Regis-
tered Nurse, preferably with a Bac-
calaureate in Nursing Science, to be
responsible to the Director of Nursing
Service for managing the administra-
tive detail of the nursing department.
The successful applicant will have
had extensive experience in a senior
administrative nursing position.

APPLY:
Director of Personnel,
Kingston General Hospital,
Kingston, Ontario.

PETERBOROUGH
CIVIC HOSPITAL

Invites Applications from

REGISTERED NURSES
for
General Duty
in
General Intensive Care Unit
Emergency Department

- Active Inservice Education
Program
- Progressive Personnel Policies
One Year of Experience Required

For Further Information Apply to:

The Director of Nursing
Peterborough Civic Hospital
Weller Street
Peterborough, Ontario

SIMCOE COUNTY DISTRICT HEALTH
UNIT
SUPERVISOR, PUBLIC HEALTH NURSING

for October 1st, 1974.

For progressive generalized public health prog-
ram.
Salary commensurate with experience, good
salary, fringe benefits and car allowance.
Qualifications: a Bachelor's Degree
th prepara-
tion in supervision and administration and senior
level experience are minimum requirements.
Application with references, to be submitted by
September 23rd, 1974, to:

Secretary-Treasurer
Simcoe County District Health Unit
Mldhurst, Ontario
LOL 1XO

GOOD THINGS
HAPPEN
WHEN YOU HELP
RED CROSS

PROVINCE OF
BRITISH COLUMBIA

offers

A PROFESSIONAL CAREER
OPPORTUNITY
THIS POSITION
IS OPEN TO BOTH MEN AND WOMEN

DIRECTOR OF NURSING
COMPETITION NO. 74: 1825
LOCATION: ESSONDALE
SALARY - S16,968 - $19.272
(1973 Rate,
The Mental Health Branch reqUires a well'Quallt,ed person to be
responsible. under dlrectoon, tor the admonlstratlon 01 the
nursing serVices at Rlvervlew Hospital which IS a large
multo-disciplinary Institution proVldong a full range 01 psychlatroc
treatmen\. al1l! medical/surgIcal care for a large on.patient
populatoon Responsibilities also will onclude preparong
budgets, Instllullng progressive In.serVlce training program-
mes. research and acting dS liaison In the communoty agencies
and services ReQu"es registration, or eligible. on the
AssociatIOn 01 Reglstereo and/or Psychlatroc Nurses 01 Brotlsh
Columbia plus a unoverslty degree '" nurSing and lunher
administrative training. extenSive related experience
Obtain appllcallons lrom the PUBLIC SERVICE COMMISSION,
Valleyvlew Lodge, ESSONOALEand return IMMEDIATELY.

SEPTEMBER 1974

REGISTERED NURSES

Registered Nurses required for large
metropolitan general hospital.
Positions available in all clinical areas.
Salary Range in eHect until December
31,1974-
$665.00 - $830.00. Starting rate de-
pendent on qualifications and experi-
ence.

Apply to:
Staffing Officer-Nursing
Personnel Department
Edmonton Genersl Hospital
Edmonton, Alberta
T5K OL4

REGISTERED NURSES

An expanding 23()'bed complex requires
nurses for general duty positions in several
clinical areas. The complex includes 130
beds for active treatment, 50 beds for
extended care and a 50 bed nursing home.
Salaries and personnel policies in accor-
dance with Alberta Association of Regis-
tered Nurses Contract. Apply:

Apply:

Grande Prairie Municipal Hospital
Grande Prairie, Alberta
T8V 2E8

University of British Columbia
School of Nursing

Requires as80Clate or tuIl proIessor to
take complete charge of a large and
successful programme of Continuing Edu-
cation in Nursing.
Master's degree and successful experi-
ence in the direction of continuing educa-
tion essential.
Generous salary and fnnge benefits.

Apply to:

Muriel Uprlchard, Ph.D.
Director
School of Nursing
University of British Columbia
2075 Wesbrook ptace
Vancouver, B.C.- V6T 1 W5

SEPTEMBER 1974

I.

Public Service
Canada

Fonction publique
Canada

THIS COMPETITION IS OPEN TO BOTH MEN AND WOMEN
DIRECTOR OF NURSING
Salary: $10,252 to $12,918
(Plus Isolated Post Allowance)
FROBISHER BA)( GENERAL HOSPITAL
HEALTH AND WELFARE CANADA
FROBISHER BAY, NW.T.
DUTIES: Supervises and evaluates nursing services in all in-patient and out-patient areas;
provides guidance to nursing staff; plans and confjucts orientation and in-service educational
programs; appraises performance of nursing staff and assesses qualifications of candidates
for employment; establishes performance requirements. Assumes overall responsibility for
the hospital in the absence of the Zone Director and Hospital Administrator.
QUALIFICATIONS: Eligibility for registration as a nurse in a province of Canada. Certificate
in nursing service administration, or courses in supervision or unit administration. Some
experience as Assistant Director of Nursing and demonstrated ability to assume
responsibility for organization and management of patient treatment and staff deployment.
Baccalaureate in Nursing is desirable.
Knowledge of the E nglish language is essential.
Forward "Application for Employment" (Form PSC 367-401) available at Post Offices,
Canada Manpower Centres and Offices of the Public Service Commission of Canada, before
September 25, 1974, to:
REGIONAL DIRECTOR
NORTHWEST TERRITORtES REGION
MEDICAL SERVICES
1401 BAKER CENTRE
10025-106 STRE!:T
EDMONTON, ALBERTA, T5J 1H2
Please quote competition number 74-E-1759.
App
intments as a result of this competition are subject to the prOVIsions of the Public
Service Employment Act.

"MEETING TODAY'S CHALLENGE IN NURSING"

QUEEN ELIZABETH HOSPITAL OF :\'IONTREAL
CENTRE

A Teaching Hospital
of McGill University

requires

REGISTERED NURSES

AND

REGISTERED NURSING ASSISTANTS

Quebec language requirements do not apply to Canadian applicants.

. 255-bed General Hospital in the West end of Montreal
. Clinical areas include Progressive Coronary Care,
Intensive Care, Medicine and Surgery, Psychiatry.

Interested qualified applicants should apply in writing to:

QUEEN ELIZABETH HOSPITAL OF MONTREAL CENTRE
DIRECTOR OF PERSONNEL
2100 MARLOWE AVE.. MONTREAL, QUE., H4A 3L6.

THE CANADIAN NURSE 57

ST. MICHAEL'S HOSPITAL
Toronto, Ontario
invites applications from

REGISTERED NURSES

for

INTENSIVE CARE and "STEP-DOWN" UNITS

Planned orientation and in-service programme will enable
you to collaborate in the most advanced of treatment
regimens for the post-operative cardio-vascular and other
acutely ill patients. One year of nursing experience a
requirement.

For details apply to:

The Director of Nursing,
St. Michael's Hospital,
Toronto,
Ont
rio,
M5B 1W8.

THE RELIG IOUS
HOSPITALLERS
OF SAINT JOSEPH

I NVITE 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
438Y2 College SI.
Burlington, Vermont
05401

FORMATION CENTER
4 Toronto Street,
Ottawa, Ontario,
K1S ON2.

58 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

ASSOCIATE DIRECTOR
NURSING SERVICE

Applications are invited for this senior and responsible position in
the Nursing Service Department of our 928 bed fully accredited
general hospital. The duties will be broad in nature and will involve
assisting in organizing and administering the department. Special
emphasis will be placed on planning and development of patient
care programs in coordination with other disciplines and on the
identification and solution of problems related to nursing care.

Candidate must be a Registered Nurse with a degree in Nursing
and must have several years of progressively respo....sible nursing
experience. Salary is negotiable and an excellent range of benefits
is offered.

Please reply with résumé of qualifications, experience and
salary to:

Director of Personnel
Calgary General Hospital
B41 Centre A venue East
Calgary, Alberta
T2EOA1.

SEPTEMBER 1974

CLINICAL SPECIALIST

We require the service of an articulate,
dynamic nurse with a Master's Degree and
a Major in Medical-Surgical nursing in this
239-bed acute hospital.
The nurse in this position will work closely
with our other staff Clinical Specialist, all
Staff Nurses and Medical Staff to further
develop patient centered projects.
The salary for this position is negotiable.

Interested applicants please forward
resume to:
Personnel Director
Red Deer General Hospital
Red Deer, Alberta

REGISTERED NURSES

required
To further develop our family focused

CHILDRENS'
PSYCHIATRIC SERVICE

Day, night and post discharge nursing
followup care planned for patients from 2
to 17 years.
Four week pre-service educational prog-
ramme is scheduled for November 1974

Please apply to:

Director of Nursing
Royal Jubilee Hospital
VICTORIA. British Columbia

NURSING OPPORTUNITY
REGISTERED NURSES

required for a 138-bed active treatment hospital
plus

EXPERIENCED NURSES

for a 5-bed I.C.U.-C.C.u. presently being set up
clinical areas ,ndude - mediane - surgery, obstet-
rics, paediatncs and coronary care.

Residence accommodation alfallabte.
Address applications and enquires to:

DIRECTOR OF NURSING
BLANCHARD-FRASER
MEMORIAL HOSPITAL
KENTVILLE. NOVA SCOTIA

SEPTEMBER 1974

\J'I\- GENER4{
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Quebec's Health Services are progressive I

So

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IS nursing

at

The Montreal General Hospital

a teaching hospital of McGill University

Come and nurse in exciting Montreal

--------------------------------.

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The Montreal General Hospital
1650 Cedar Avenue. Montreal, Quebec HJG IA.c

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 Canadian applicants.

L_______________________________J
THE CANADIAN NURSE 59
"

TEAM NURSING AT ITS BEST

YORK-FINCH GENERAL HOSPITAL situated in North-
West Toronto offers:

- 300 bed suburban community hospital with complete services
in Pa
diatrics, Gynaecology, Obstetrics, Medical/Surgical,
Psychiatry, Coronary Care, Intensive Care, Operating Rooms
and Emergency Departments.
- A Friesen Design enables nurses to spend more time with their
patients as compared to the traditional hospital design.
- Non-nursing activities are delegated to professional support
staff ego Supply Allendants and Administrative Control Person-
neL
- Paid orientation with opportunity for Professional Development
through active In-Service programs.
- Allractive Salaries and Fringe Benefit Programs.
- Cultural Exposure - situated at Hwy. 400 and 401 you are
close to Toronto's finest in Theatres, Cinemas, Social Clubs,
Restaurants and York University.
- Living Accommodation - within walking distance of many
modern apartment, condominium and.s.hopping mall çomplexes.
- 45-60 minutes to Lake Simcoe - Georgian Bay recreational
facilities (Skiing, Boating, Swimming, etc.).

Registered
R.N. '5 & R.N.A.'s should contact:
Recruitment Interviewer
York-Finch General Hospital
2111 Finch Avenue West
Downsview, Ontario

M a'ster the
A rt of
Surgical techniques in a teaching
and research
Hospital in which the most modern
surgical procedures are being
performed.

Applications are invited from Operating Room Nurses who
must be able to supervise OR technicians.

Nurses who wish to take in-service program in mastering
OR techniques will be considered for staff positions.

For Information, apply to:

Anne Bruce, R.N.
Nursing Recruitment Officer
Royal Victoria Hospital
687 Pine Avenue West
Mo.'treal, H3A 1A1, P.O.
Tél.: 842-1251, local 677 or 490

60 THE CANADIAN NURSE

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THE SCARBOROUGH
GENERAL HOSPITAL
invites applications from:
Registered Nurses and Registered Nursing Assis-
tants to work in our 6S0-bed active treatment
hospital and new Chronic Care Unit.
We offer opportunities In Medical Surgical, Paediatric. and Obstetrical nursmg
Our specialties mclude a Burns and Plastic Unit. Coronary Care. Intensive Care and
Neurosurgery Units and an active Emergency Department.

. Obstetrical Department - participation in "Family centered" teaching
program.
. Paediatric Department- participation In Play Therapy Program.
. Orientation and on-going stat! education.
. Progressive personnel policies.
The hospital is located in Eastern Metropolitan T cronto.
For further information, write to:
The Director of Nursing,
SCARBOROUGH GENERAL HOSPITAL
3050 Lawrence Avenue, East, Scarborough, Ontario

THE TORONTO WESTERN HOSPITAL
"THE HOME OF
FRIENDL Y CARE AND PROTECTION"

Invites applications for

general staff nurse positions

An BOO-bed downtown teaching hospital affiliated with the
University of Toronto.
Many specialty services, also general medicine and
surgery.
Salaries and fringe benefits comparable to other similar
hospitals.

Please apply to:

Staffing Co-ordinator
Nursing Service
399 Bathurst Street
Toronto, Ontario
MST 2S8

SEPTEMBER 1974

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Once a Nurse. . .
Always a Nurse
Whether you're a practicing R.N.
or just taking time out to raise a
family, you can serve your commu-
nity by teaching lay persons the
simple nursing skills needed to
care for a sick member of the
family at home.
Red Cross Branches need
VOLUNTEER INSTRUCTORS
to teach Red Cross Care
in the Home courses.
VOLUNTEER NOW AS A RED
CROSS INSTRUCTOR IN YOUR
COMMUNITY
For further information, contact:
Director
National Department of Family
Health

THE CANADIAN
RED CROSS SOCIETY
95 Wellesley Street East
Toronto, Ontario. M4Y 1 H6.

..,.

-

Registered Nurses
and
Nursing Graduates

The emphasis is on the individual Nurse and Patient at the
Johns Hopkins Hospital in Baltimore. Maryland.

If you are an experienced Nurse or a graduate of a 2 or 4 year program then
Hopkins can help you further your career in Medical, Surgical, Intensive Care,
OB/GYN or Paediatric nursing.

Benefits Include:

. An Intensive 5 week orientation program
. Full tuition reimbursement
. Inexpensive dormitory housing on Hospital property
. Visas available In 6 to 8 weeks
. Licensure reciprocity granted

Orientation dates are: September 16, October 21, and November 25, 1974.

For more Information call (collect):
Office of Professional Recruitment
Johns Hopkins Hospital
624 N. Broadway
Baltimore, Maryland 21205
Phone: 301-955-5592

,",\ 1J
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Jewish G
!!
!1J' Hospital

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

SEPTEMBER 1q74

fHE CANADIAN NURSE 61
"

WE CARE

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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 2Rl

u

ORTHOPAEDIC & ARTHRITIC
HOSPITAL

I'V'

43 WELLESLEY STREET, EAST
TORONTO, ONTARIO
M4Y 1H1

Enlarging Specialty Hospital offers a unique
opportunity to nurses and nursing assistants
interested in the care of patients with bone and
joint disorders.
Currently required -
Registered Nurses and Nursing Assistants for all
units
Clinical specialists for Operating Room, Intensive
Care, Patient Care and Education.

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.
1974 Salary Scale $850.00 - $1,020.00 per month
For further information, please write to:
PERSONNEL SERVICES
VANCOUVER GENERAL HOSPITAL
855 WEST 12TH AVE.
VANCOUVER, B.C.

62 THE CANADIAN NURSE

SEPTEMBER 1974

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 hospital is
presently expanding from 126 beds
to 400 and is fully accredited.
Nursing is a profession we respect
and we were the first to plan and
develop a unique nursing audit
system. There are opportunities for
gaining wide experience. for get-
ting to know patients as well as
staff. R.N. salaries range from
$850. to $1020. per month. Credit
allowed for relevant previous hospi-
tal experience.

Situated in Richmond HilI. all
the cultural and entertainment faci-
lities 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 Personnel.

YORK
CENTRAL
HOSPIT AL

RIUI1\10!\D 11111 .
() N I A I{ I ()
L4C 4Z3

SEPTEMBER 1974

Co-ordinator, Nursing
Staff Development:
$11,500 - $13,500.

With the North Bay Psychiatric Hospital MINISTRY OF HEALTH, there is an
opportunity to develop and administer a staff development program for professional and
non-professional nursing personnel. Location: North Bay.
Qualifications: registered as a nurse in Ontario with post-graduate certificate in nursing
education from a university of recognized standing; BScN and a post graduate course in
psychiatric nursing OR completion of at least a one year course at university level which
included the principles of teaching preferred. Candidates must also possess several
years significant nursing and nursing education experience with at least three years
supervisory or teaching experience. Experience in a psychiatric setting preferred.
Please send resumes as soon as possible to: Personnel Officer, North Bay
Psychiatric Hospital, Box 3010, North Bay, Ontario, P1B 8L1.
This position Is open equally to men and women.

CW)
Ontario

Ontario
Public Service

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THIS IS THE WORLD OF CARE:
Providing nutritious food for school children and pre-
schoolers, health services for the sick and handicapped,
facilities and equipment for basic schooling and tech-
nical training, tools and equipment for community en-
deavours. Your support of CARE makes such things
possible for millions of individuals around the world.
One dollar per person each year would do it!

CARE-CANADA 63 Sparks OTTAWA (Ont.) K1 P 5A6

THE CANADIAN NURSE 63
.

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and Welfare Blen-être SOCial \ ,\,
Canada Canada / . \ \,
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I Medical Services Branch I
I Department of National Health and Welfare I
I Ottawa, Ontario K 1 A OK9 I
I I
I Please send me more information on career I
I opportunities in Indian Health Services. I
I Name: I
I Address: I
City: Prey: _

_______________J

.<

64 THE CANADIAN NURSE

Index
to
Advertisers

Septem ber 1 974

Astra Phannaceuticals Canada Ltd. . . . . . . . . .Cover IV

Clinic Shoemakers. . . . . . . . . . . . . . . . . . . . . . . . . . ., 2

Collier-Macmillan Canada, Ltd. ............ .10, II

Davol Canada Ltd. . . . . . . . . . . . . . . . . , . . . . . . . . .15

ICN Canada Ltd. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 6

J.B. Lippincott Company
of Canada. Ltd. ..........,........ .center insert

c. V. Mosby Company, Ltd. ............... .44, 45

MTC Pharmaceuticals .............

.. . .18

Nordic Biochemicals . . . . . , . . . . . . . . . . . . . . . . . .. 9

The Nurses' Book Society

Reeves Company . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

Sandoz Pharmaceuticals

......... .49

Westwood Pharmaceuticals. . . . . . . . . . . . . . . . . . . . .47

White Sister Uniform, Illc. . . . . .5, Cover II, Cover III

Acll'erti.\lnN Manager
Georgina Clarke
The Canadian Nurse
50 The Driveway
Ottawa K2P 1 E2 (Ontario)

A lh'ertiJing RepreJentatH'eJ
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003
1 L'kphonL'. /2151 Mid\\a} lJ-I"'lJ7

Gordon Tiffin
2 Tremont Crescent
Don Mills, Ontario
Telephone. (416)444-4731

Member of Canadian
Circulations Audit Board Inc.

rm:J

SEPTEMBER 1974

YOUR
FASHION CUE
FOR FALL

Style # 3399
Long Sleeve
Style # 3398
Short sleeve

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UUHITE
SISTER
CAREER APPAREL

Style # 3399
Long Sleeves
Sizes 6-18
Royale Rib Tricot Knit
White only
Price S24.00

Style # 43416
Sizes 3-15
Royale Corded Tricot Knit
White, Yellow
Price 526.00

Style # 3398
Short Sleeve
Price 523.00

SHOP IN PERSON AT OUR
NEW BAY STREET
STORE

UNIFORM SPECIAL TV
1254 BAY ST.
(JUST ABOVE BLOOR) TORONTO

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A 11 .
LIMITED C 01Ce
EDITION

Style # 3265
Sizes 10-20
"Royale Spice" 100% Textured
Polyester Knit
White, Blue
Price S33.00

MAIL ORDER DIVISION
372 QUEEN ST. W.
TORONTO M5V 2A3
Please send all mail orders to
Queen St. for fast service

.

New... ready to use...
"bolus" prefilled syringe.
Xylocainé100 mg
(lidocaine hydrochloride injection, USP)

For 'stat' I.V. treatment of life
threatening arrhythmias.

'\

o Functions like a standard syringe.
'ii'
o Calibrated and contai ns 5 m I Xylocai ne.

'\

o Package designed for safe and easy
storage in critical care area

,

o

The only lidocaine preparation
with specific labelling
information concerning its
use in the treatment of cardiac
arrhythmias.

+.L,
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'1-.
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an original from

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s T Ir.

Xylocaine'. 100 mg
(lidocaine hydrochlonde injection U S P)
INnICATIOI\I
-Xvlû(..ainc administered mtra-
venously is speclfil.all\ indicated In the acute
management of( I) ventnl.ular arrt1\.thmias occur-
ring during cardiac mdmpulation. \ul..h a.... cardiac
surgery: and (2) Iife-thrcatcningarrhvthmias. par-
ticularly those which are ventricular in origin. such
as occur during acutc myocardial Infarction.

CO'TRAINDICATIONS Xylocaine is contra-
indicated (I) in patients with a known history of
hvpersensltivity to local ane....thetics of the amide
(vpe; and (2) in patients with Adams-Stokes syn-
drome or with "evere degrees of "inoatrial. atrio-
ventrit.ular or Intraventncular hlm.k.

\\'ARNINGS-Constant monitoring with an elec-
trocardiograph is essential in the proper adminis-
tration ofXvlocaine intravenousl). Signs of exces-
sive depreo;;"ion of cardiac conductivity. such as
prolongation of PR mterval and QRS complex
and the appearance or aggravation of arrhythmias.

hould be followed by prompt cessation of the
intravenous infusion ofthi" agent. It IS mandatory
to have emergenc\' resuscitative equipment and
drugs immedlateh a\ailable to manage possihle
adverse reactions involving the cardiovascular.
respiratory or central nervous systems.
Evidence for proper usage in children is limited

PRECAl'TlO
S-Caution should be emplo}ed
in the repeated use of Xvlocaine in patients with
severe liver or renal disease because aClumulation
ma) OClur and m""y lead to toxic phenomena since
Xylocame IS metabohzed mamly m the hver and
excreted by the kldne). The drug "hould also be
used with caution in patients with hvpovolemia
and shock. and all forms of heart block (see CON-
TRAINDlCATlONS AND WARNINGS).
In pati
nts with sinus brad...."ardla the adminis-
tration ofX\ locaine mtravenouslv for the ehmina-
tion of ventricul,if ectopic beats without prior
acceleration m heart rate (e_g_ by Isoproterenol
or by electric pacing) mav provoke more frequent
and serious ventricular arrhythmias_

AD\ ERSE RF ACTIO""S-Syslemic reactions or
the follov.ing tvpeo;; have been reported
(I) Central Nervous System: lightheadedness.
drowo;;iness: dizziness: dpprehension. euphoria:
tmnitu'ii. blurred or double vision: vomitmg: sen-
sations of heat. cold or numbness: twitching:
tremor
: convulsions: unconsl..iousness: and respi-
ratorv depre""ion and arrest_
(2) Cardiovascular Svstem: hypotension: car-
diovasculdr lollap
e: and bradycardia which may
lead to cdrdiac arre,,"
There have Þeen no reports of cros
'iiensitivity
between XyJocame and procainamide or between
Xylocaine and qumldine.

DOSAGF AND ADMI:IIISTRA1IO
SinRle
Injection: The usual do",e l'ii 50 mg to 100 mg
administered intravenousl) under ECG monitor-
mg. This do"e mav be admml"tered at the rate
of approximatelv 25 mg to 50 mg per minute
Sufficient time o;;hould be aUo",ed to enable a slow
circulation to carr" the drug to the site of action
If the iniudl mJel..llon of 50 mg to 100 mg does
not produt.e a desired re<;ponse. a second dose may
be repedted ""fter 10-20 minute".
NO MORE THAN 200 MG TO 300 MG OF
XYLOCAINE SHOULD BE ADMINISTERED
DURING A ONL HOUR PERIOD.
In children experience with the drug IS limited.
Continuou
Infu'iion: Following a single injection
m those patients in whom the arrhvthmia tends
to recur and who are incapable of receiving oral
anuarrhythmic therap.... mtravenous infusion'i of
X\lol..ame mav be admimstered at the rate of I
mg to 2 mg per mmute (20 to 25 ug/kg per minute
in the average 70 kg man). Intravenous mfusions
ofXylocame must he ddmmistered under constant
ECG monitonn@. to avoid potential overdosa[!.c
and toxicity. Intravenou<ii infusion should be ter-
mmated as soon a'ii the pauent'!;, basIc rhvthm
appear<; to be stable or at the earliest sign
of
Ioxlcit). It sh,-,uld rarelv be necessarv to t."()ntmue
mtravenous. infusions bevond 24 hours. As soon
as possible. and ",hen mdlcated. patients should
be changed to an oral antlarrh"thmi... agent for
main(enance (herapv
Solutions for mtravenou'ii infu
ion should be
prepared by the addition of one 50 ml smgle dose
vial of X)locame 2
or one 5 ml Xvlocaine One
Gram Disposable Transfer S)rin[!.e to I liter of
appropriate solution. This will provide a 0 l'it
solution. that is each ml will contain I m@. of
Xvlot.aine HCI. Thus I ml to 2 ml per mmute
",ill provide I m[!. to 2 m[!. of Xvlocaine HCI per
mmute

The

..1..1
Nurse

.

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October 197 4

_ M 1 55 t'RA LCVER
158 GLIGl ES uST
_
JTT_A".A KIN 5"9

headache

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Style # 3993
Sizes 8-18
Royale Supreme Plain
Tricot Knit
White only.... about $19.00

UUHITE
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CAREER APPAREL

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WHITE SISTER
WORKS WITH A
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Style #43325
Sizes 3-13
Royale Rib Tricot Knit
White only.... about $28.00

Style #3982
Sizes 8-16
Royale Supreme Plain
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White only.... about S28.(

AVAILABLE AT FINE STORES ACROSS CANA[

C-J

new B · OMS'74

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ANA ..._
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BASIC PHYSIOLOGY AND ANATOMY
Redesigned with a handsome new format, this major reVISion of a well
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Coverage of human physiology is expanded; a new chapter is devoted to
body fluids and electroly1es; some 200 drawings are new.
530 pages/illustrated/July 1974
$11.50
Ellen E. Chaffee, R.N., M.N., M. Litt.; Esther M. Greisheimer, Ph.D., M.D.
LABORATORY MANUAL IN PHYSIOLOGY AND ANATOMY
264 pages/illustrated/3rd Edition Revised, Spring 1974
perforated-drilled/paperbound, $5.75.
Ellen E. Chaffee, R.N., M.N., M. Lit!.

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New-
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IN NURSING
This entirely new text by the authors of
Pharmacology and Drug Therapy in
Nursing offers quick, easy access to
information needed for expert patient
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presented in tables and summaries.
700 pages/July 1974/about $10.75.
Morton J. Rodman, B.S., Ph.D.; Dorothy
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by Ihe same aulhors , . .
PHARMACOLOGY AND DRUG THERAPY
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738 pageslillustrated/1968/$10.75.

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A major revision of an outstanding text, with
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450 pageslilluslraled/July 1974
$10.50.
Elinor V. Fuerst, R.N., M.A.; LuVerne Wolff,
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Serving the health professions in
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J. B. Lippincott Co. of Canada Ltd.
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Representing in Canada:
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BALANCE
The nUrse's expanded role in diagnosis, treat-
ment and evaluation of lab lindings Is re-
flected in this edillon. The lalest findings in
Iypes of imbalances, treatments, and medi-
cation are included; each element, deficit
and excess is discussed in greater depth. A
chapter on Fluid Balance in Pregnancy is
enli rely new; other new chapters deal with
routes 01 transport, organs 01 homeostasis,
disturbances of water and electrolytes.
325 pages/illustrated/May 1974
paperbound, $8.75
Norma M. Metheney, R.N., M.S.; William D.
Snively, Jr., M.D., F.A.C.P.

New-
A GUIDE TO PHYSICAL
EXAMINATION
Expertly illustrated, this "how-to" text
bridges the gap bewteen anatomy and
physiology and their application to the
physical examination. Within each body
region or system, three topics are dealt
with: 1) anatomy and physiology basic
to the examination, 2) examination
techniques, 3) examples of selected
abnormalities.
500 pages/ profusely illustrated/ August
1974/ about $15.00.
Barbara Bat88, M.D.
Also available.
PHYSICAL EXAMINATION FILMS
A new series of 12 sound motion PiC-
tures, correlated with the content of
Dr. Bates book. Further mformatlon, in-
cluding prices, is available upon re-
quest.

o New (3rd) Edition-
BASIC PSYCHIATRIC CONCEPTS
IN NURSING
This revised edition focuses on the dynamIcs
of Ihe nurse's role and luncfion, and facili-
tates student progress from the theoretical
to the operational level Many case studies
reinforce basIc psychiatric concepts and
exp:ain the rationale for nursing intervention.
Heavily revised content includes drug abuse,
sexual devlallon, patient management, .ell-
understanding, and recognition of patient
problems.
600 pages/June 1974/$9.75.
Joen J. Kyes, R.N., M.S.N.; Charle. K.
Holling, M.D.

Please rush me the book(sl whose number(sl I have circled

1
4

Name
Address
City Province
o Payment enclosed (send postpaidl
Books may be returned within 15 days

2
5

3
6

Position
Postal Code
o Use my Chargex number
o Charge and bill me

CN-l0-74

.

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THE

LINIU

TIlU.Dl:WAII_S -'0 us p,.,,, 0#' . CANADA "'#.01 IN UIA

SHOE
p, k
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For a compllment8., pair of white . hoeIac:es, folder .howlng all the .mart Clinic .tyl.., and lis. of .tor.. ..lIIng them, ......:
THE CLINIC SHOEMAKERS e Dept. CN-10, 7912 Bonhomme Ave. . St. Loul.. Mo. 83106

The
Canadian
Nurse

ð

A monthl} journal for Ihe nurs

of Canada pubh
hed
in English and French edition<. bv the Canadian Nurses' Association

Volume 70, Number 10

October 1974

17 Nursing Research Is Not Every Nurse's Business ......... .M. Hayes

19 Problem-Oriented Diabetic Day Care ......... .B. King, W. Spaulding

23 Headache. . .. .... ., .. " ...... ...... .... .. ..... . .. . .R. Nelson

27 Energy Sources for
Implanted Pacemakers .............. .S. Tomchishen, B. Goldman

31 Exorcising the Ghosts of the Crimea ......... .T. Group, J. Roberts

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

4 Letters 40 Dates
9 News 42 Research Abstracts
15 In A Capsule 46 Books
36 New Products 48 Accession List
38 Names 63 Index to Advertisers

Executive Director Helen K. Mussallem.
Editor: Vil'l1;inia A. Lindabury . Assistant
Edilors; Liv-Ellen Lockebefl1;. Dorothy S.
Starr. Editorial Assistanl: Carol A. Dwor-
kin . Produclion Assistant: Man Lou
Downes . Circulalion Manager: Berÿl Dar-
linR. Advertising Manager; Georgina Clarke
. Subscription Rates: Canada: one year,
$f"(){); two years. $11.00. Foreign: one year.
$6.50; two years, $12.00. Single copie,:
$1.00 each. Make cheques or money orders
pdyable 10 the Canadian Nurses' Associalion.
. Change of Address: Six weeks' notice: the
old address as well as Ihe new are necessary,
logelher with regislration number in a pro-
vincial nurses' associalion, where applicable.
Nol responsible for joumdls 1'1\1 in mail due
10 errors in addre's.

Manuscript Information: "The Canadian
Nurse" welcomes unsolicited articles. All
manuscripts should be Iyped, double-spaced.
on one side of unruled paper leaving wide
margins. Manuscripts are accepled for review
for exclusive publicalion. The edilor reserves
the right 10 make the usual edilorial changes.
Photographs (glossy prinls) and graphs and
diagrams (dra" n in india ink on white paper)
are welcomed with such dnicle,. The editor
is not commined 10 publish all dI1lc1es sent.
nor 10 indicale definile dales of publicalion
Poslage paid in cash al Ihird class rate
MONTREAL P.Q. Permit No. 10.001.
50 The Driveway, Onawa. Onlario. "'-2P I E2

CCanadian Nurses' Associallon 1974

Editorial I

Two or three times a year, I closet
myself in a corner of CNA library and
browse through some of the early
(1905-20) issues of The Canadian
Nurse. Within minutes, I become en-
grossed in the problems, enthu-
siasms, and aspirations of these
nurses of another era. It's a bit like
eavesdropping on a world long past.
One reads about the "Halifax disas-
ter" of 1917, and of CNA's offer of
"any nursing services that would be
required"; the scarcity of nurses and
doctors in Canada from 1914 to 1918,
as many were in the military; and the
attempts to stem the tide of the
pandemix influenza in 1918.
One learns how to make a curved
surgical needle from a straight one by
". . . catching each end of the needle
with a pair of pliers and gradually
bending it over an alcohol flame." And
one is told why some women become
unwed mothers: "Seeds of immorality
are sown in infancy when wee tod-
dlers are allowed to play on the city
streets insufficiently clad. The child, in
consequence, becomes bold and im-
modest, and early acquires habits that
in later years may lead to immorality."
Even the advertisements are fasci-
nating. One ad describes Glyco-
Heroin - the "ideal heroin product for
disorders of the respiratory tract." No
one seemed overly concerned about
the addictive qualities of this cough
syrup, as the manufacturer offered to
send samples to nurses on request!
Some nurses in the early years had
enlightened, indeed, revolutionary,
ideas about nursing education. Mary
Ard. MacKenzie, CNA president from
1912 to 1914, pleaded with her col-
leagues to start a system of education
on "proper educative lines." Nursing
schools should be in connection with
the educational system of each pro-
vince and should be separate from the
hospital, she said. Their raison d'être
should be the education of the nurse.
MacKenzie had a word of advice for
her colleagues. which sounds as wise
today as it must have then: 'The
whole matter Ishould 1 be considered
calmly - not from the personal stand.
point, but from that of summum bo-
num." -VAL.
THE CANADIAN NURSE 3

OCTOBER 1974

..

letters

{

Letters to the editor are welcome.
Only signed letters, which include the
riter's complete address,
will be considered for publication.
Name will be withheld allhe wriler's request.

Help for those overweight
Peggy Lock deserves a laurel for her
efforts with the overweight persons in
Cochrane, Alberta (""Diet club:' April
1974. page 45). As an individual with a
lifelong weight problem. I know how
difficult it can be to lose weight and
maintain a weight loss.
Those who found Ms. Locke's pro-
gram successful can seek funher help
from T.O.P.S. (Take Off Pounds Sensi-
bly). an international nonprofit organiza-
tion for the ovemeigh!. It has functioned
successfully for 26 years. Each member
must have an individual diet plan and
weight goal recommended by his physi-
cian.
Through this program. I have lost over
50 pounds. and I am working on main-
taining this loss. - Patricia McDon-
ald, RN, Edmonton, Alberta.

Director of nursing replies
In the June 1974 issue of our journal. a
news item on a report prepared by the
Order of Nurses of Quebec, expressing
concerns about the nursing program in the
CEGEP system. was published (page 8). In
the August issue. we heard from nur.,ing
educators (\ellers. page 4).
The news item was widely read and has
been widely discussed. much to the
detriment of the program and its
graduates. To date, we have heard from
neither employers of these nurses nor the
nurses themselves.
As a director of nursing. I am fre-
quently confronted by members of my
own profession. as well as by members of
the community at large. asking for my
reactions to preparing nurses in a college
selling. Initially. when I had no experi-
ence with the product of such a system, I
could answer only what I believed to be
true: that. given a qualified candidate, a
well-planned curriculum. skilled.
teachers, and the necessary clinical and
academic resources. there was no reason
why we could not prepare a nurse capable
of functioning in a variety of situations at
a beginning level. After a year's experi-
ence with the graduates of such a pro-
gram. I am convinced we are on the right
road.
We will always hear the argument that
these nurses are weak in something or
other. I heard this same argument about
newly graduated nurses from hospital
schools. To meet the learning needs of
these nurses. staff education programs
4 THE CANADIAN NURSE

were developed for them. Now the accent
has changed. and we are finding it
necessary to change our approach to meet
a different kind of need. In adapting 10
changing needs and in changing our
approaches, we can expect to hear an
outcry. It means extra work. revising. and
rethinking. It does not, however. mean
that the cause of the hue and cry is
necessarily bad.
Personall y and professionally, I have
great faith in what we are trying to
achieve. As we have more experience
with these young nurses, we will know
beller what changes in their educational
programs will be necessary. In the mean-
time. I believe the approach we have
taken will finally prepare nurses equipped
to adapt to the ever-changing demands
made on them by health ser-
vices. - Roselyn Smith, Director of
Nursing, The Montreal Children's Hospi-
tal. Montreal, Quehec.

Ethics of nursing practice
The council of the College of Nurses of
Ontario discussed at length the section of
the article on .'Ethics of Nursing Prac-
tice" (February 1974). which suggests
that black nurses cannot be reported if
they make errors because this would be
discriminating and the Human Rights
Commission would be called in.
Council members support the views
expressed by the director of the Ontario
Human Rights Commission. The res-
ponse of a fraction of a sample of 22 out
of a population of 100.000 cannot be
considered valid. The statement. how-
ever. can damage the image of this group
of nurses through inference, in spite of.
the editor's footnotes.
Our discipline commillee would like to
remind members of the nursing profes-
sion of their obligation to report evidence
of incompetence or incapacity to practice
nursing to the body charged with respon-
sibility for discipline. In this way, the
public is protected from possible harm
and the individual can often be helped to
overcome problems.
The assumption of responsibility for
reporting a disciplinary mailer is a diffi-
cult personal decision for each member of
our profession to make. I f reports are
based on documented evidence. there is
no danger of charges of discrimination.
- Joan C. Macdonald, Director, Col-
lege of Nurses of Ontario, Toronto.

Ten-year reunion planned
The class of 1965 of Misericordia Hospi-
tal in Edmonton should contact Barbara
Kaup (nee Becher) at 475-6994. or write
to 15012 - 71 Street. Edmonton. regard-
ing the 10-year reunion. - Florence
Strembits/..}', Edmonton. Alberta.

Information about SLE group
Since my article "I've got a wolf by the
ears" appeared in January 1974. I have
noticed two lellers requesting news of
groups for patients with lupus erythema-
tosus.
I have obtained information about a
group called LEANON. headquartered in
Texas. There are a number of local clubs
in various parts of the United States, but
the only one I have discovered in Canada
is in Alberta.
With LEANON's $7 annual fee comes a
quanerly publication called Lupus Life-
line. It covers interesting information
about research on lupus. idea exchanges
from patients. and ideas on megavitamin
therapy. Most articles are in lay language.
as they are wrillen by members: an
occasional letter or article from a doctor
appears. By joining this group. the
member also receives the names and
addresses of others with the disease who
live nearby.
One valuable article that can be ob-
tained through the club is the second
edition of Dr. Haserick's Primer for Pa-
tients wilh Lupus Erythematosus.
The address is: LEANON. Belly Hull.
P.O. Box 10243. Corpus Christi. Texas
78410. U.S.A. - Bonnie Ha , rtiey
Toronto, Ontario.

Wants to correspond
I am interested in corresponding with a
Canadian nurse or midwife. I am 33 years
old, was born in Ireland. and have been
married for 7 years.
Being a career woman. I combine
family life with a full-time post as nursing
officer in charge of a midwifery-
gynecology area at nigh!. My qualifica-
tions include SRN and SCM.
My interests are reading on history.
education, and nursing topics: bridge:
philately: the international business and
professional women's organization: and
current affairs.- D.M. Fell, The Gables,
WeM Butterwick, Sculthorpe, South
H umherside, England.

OCTOBER 1974

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letters

(Conrinued from page 4)
Response to August editorial
I am writing in response to your editorial
of August 1974. I appreciate the fewer
pages in the magazine because I do not
have time to read everything I would like
to. Now you are being selective and
assisting me in this respect.
The present form and content are fine
with me. I would like to see "new
products" and "books" reduced or
eliminated. I barely glance over those
sections. I suggest that letters to the editor
be limited to much fewer words; only
those that are really thought to be
worthwhile should be publi!.hed in their
entirety.
I find case studies most interesting and
infonnative. I have not yet read the
August issue. but the contents of the
articles do not appeal to me very much:
two reports and a nutrition survey.
There has been much good reading in
the pas\. Keep it up! - RN, Neufound-
land (nume withheld on request).

With reference to the editorial
August
1974) about the future of The Canadian
Nurse, my suggestion is to terminate
publication forthwith.
I have always resented the fact that I
had no choice but to !.ubscribe to the
magazine as part of my annual license
fee. I rarely. if ever. find anything of
interest in its contents. Also, when I read
that over $9.000 per month is spent on
mailing charges alone, I can think of
many worthy causes that would be de-
lighted to have that monthly income! That
amount could underwrite bursaries for
advanced education or could be put to use
in medical research. -Margaret McDon-
ald. RN, SRN, RFN, SCM, Quebec.

I am writing in response to the request in
your August 1974 editorial. I can realize
the problem!. in postal rates and the need
to reassess the journal, especially as I am
aware of inflation and the importance of
using funds to the best advantage.
I have found the "books" section
especially useful in a!.sessing whether or
not these books are applicable to my
work. Other nurses I know do likewise.
"New products" keep me abreast of
things I would otherwise overlook. as I
am not nursing in a hospital selling but
should be aware of these products for
educating the public and nurse!..
I agree that to cut the postal rates is one
way to reduce costs: this could be done by
reducing the number of pages or main-
taining the present number and having
6 THE CANADIAN NURSE

issues every 6 weeks instead of every 4.
Looking through the June 1974 issue, I
have the following suggestions: cut back
on the wide headings at the top of the
page to provide more writing space;
reduce the size of some photos; and use
all columns. In the same issue, I found the
article "Helping hands" to be more
applicable to a woman's magazine, such
as Ladies Home Journal. The same
message could have been reduced to a
blurb, with reference to another article on
hand care.
When our journal must be reduced,
while quality is needed to keep nurses
abreast of current topics in nurSing,
articles such as this one should not take
precedence over "new products" or
"books. ..
The article "Nursing where the people
are" (June 1974. page 17) is interesting
and well written. This article is really
valuable, as it is perhaps a forerunner of
what many nurses in the future might be
doing. - Beverlev 1. Marshall, New
Westminster. British Columbia.

Your editorial in the August issue, which
discussed the decrease in size of the
magazine and the high cost of mailing,

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

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OTTAWA, Canada K2P 1 E2

requested readers' comments.
The Augm,t i...!.ue !.eemed particularly
thin, as page!. 24 to 33 in my copy were
missing. I like to see 2 or 3 article.. on
nursing included. as well as Canadian
Nurses' Association news items and
convention reports. I also read letters to
the editor, news. and name!.. Possibly the
sections on research abstracts. books, and
new products could be shortened, and
letters to the editor limited to 200 or 250
word!..
I believe we should continue to pro-
duce our own magazine. As mailing and
printing costs have greatly increased, it
might be cheaper to produce a larger
magazine every 2 months. - Beryl
Ebert, Ilurse consulta1lt, maternal and
child health division of local health
sen'ices. Edfl101lton, Alberta.

I am indeed sympathetic to the plight of
The Canadian Nurse regarding the spiral-
ing costs of publishing today.
Enclosed please find my small con-
tribution of $20 toward publication (a
mere drop in the bucket, I know). I hope
other nurses across the country will
respond similarly. I have been reading
and enjoying your journal for 8 years and
wish to encourage you and your staff to
continue publishing.
I am glad to note in the journal an
increasing awareness of the nurses' con-
tribution, or lack of it, to the womens'
rights movement. I am also gratified to
read letters and articles by readers who
are expressing opinions about the moral
issues of the day.
The present form and content of the
journal seem sati!.factory to me. In the
future, though, I would prefer to see more
articles by nurses concerning how they
have coped with specific problems, such
as those on lupus erythematosus and
serious illness in the famil y, rather than
the cut and dried textbook information
about a certain illness. - Catherine Lee,
Winnipeg, M anituba.

I would like to respond to the request in
the August 1974 editorial regarding the
size of the journal.
I am willing to pay a higher fee for The
Canadian Nurse, rather than !.ee articks,
book review!.. or other item
eliminated.
This is probably one of the few publica-
tions regularly read by nurses - myself
included! - Patricia Rowe, Puhlic
Health Nurse, LaSalle, Quebec.

Office nurses discuss problem
I must reply to the letter in the Augu!.t
1974 issue, entitled "RNs belong in
doctors' offices" (page 4). I could not
agree more with the writer's views as I.
too, have three years of nursing education
behind me and six and one-half years of
" rewarding and satisfying experience."
OCTOBER 1974

I have discovered that the reasons for
not hiring a registered nurse in a doctor's
office are chiefly economic. T.his leads
me to believe that perhaps the main worth
of the physician's practice is, to him,
economtc.
The average physician never considers
that when he leaves his office, he leaves
his practice in the hands of the office
nurse he employs. He leaves to her the
decision as to whether the calls she
receives are urgent enough to disturb him
or can wait until he returns or phones in
for messages.
I cannot recall ever being left with so
great a responsibility in general duty, as
there was always a supervisor, head
nurse, or someone of higher authority
immediately available.
The physician's patients become de-
pendent on the office nurse being there,
and turn to her when the physician is not
available.
With one or two exceptions. I have
found it is impossible to teach a lay
person the importance of the many duties
that must be performed, when that person
does not know the ba<;ic facts: facts about
cross infection and why it happens, the
legal ramifications involved if a certain
procedure is not followed, ami why
certain things happen to patients at
certain times. For this reason, I have
seen a stream of untrained persons rotate
in jobs they cannot understand and are too
much for them in the end.
The answer is to educate the physicians
rather than the RNs, who are well aware of
the need for fully prepared persons in
such a position. We must ask the physi-
cian, "What is the practice really worth
to you?" If the answer is economic only,
he will have to be prepared to watch staff
change and work performed inade-
quately, to say nothing of the damage
done to his practice. - Edwina 1.
Jenkins. RN, Vallcoul'er, B.C.

In answer to the letter "RNs belong in
doctors' offices," there are doctors in my
city who will tedch any person to do
office procedures, and in turn pay her
less money than they would pay regis-
tered nurses or licensed practical nurses.
I wrote about this to our daily news-
paper, which has a column called "Pa-
tients' Guide." The newspaper also ag-
reed that this practice was alright because
the doctor remained totally responsible
for any errors made.

OCTOBER 1974

In this incident. however, members of
my family were the patients. I spoke to
my doctor about his office help drawing
up and giving my family intramuscular
injections completely unsupervised. and
told him that he should do this if he had
no RNs available. The doctor might be
responsible for all procedures, but if there
is an error and my family suffers, the
damage is done.
Is the patient's welfare coming first. or
is it money and another way of cutting
costs?
The registered nurses' associations ac-
ross Canada should take action on this
situation and have it stopped. I really do
not believe office patients are aware that
untrained personnel are doing vital tests
on them. - Eileell Sagman, RN, Vall-
COUl'er, B.C.

I look forward to, and enjoy reading, The
CUlladiall Nurse each month. I am
prompted to write that I am in complete
agreement with Wilinia B. Garbe of
Saskatchewan (Letters, August 1974,
page 4). I am sure that many RNS agree
with her, too. I think that the trend to hire
nonprofessionals and teach them to do
professional nurses' work is illegal and
dishonest, besides being degrading to the
nursing profession.
I agree that the two-year program for
nurses' preparation should never have
been started. I have been nursing for 15
years and these days I find new graduates
who have never catheterized a patient,
have never scrubbed for an operation, and
have never even had the experience of
removing a suture.
Could this sad state possibly reflect on
the two-year programs and the trend for
nurses to be prepared in universities and
not in the school of nursing within the
hospital environment?

As Garbe stated. it is confusing with so
many LPNS. CNAS. RNs, ward
helpers,
aids, ward clerks, and so on. Sometimes
the duties tend to overlap and one
category of worker infringes on another's
duties. For example, a ward clerk on my
ward recently tried to give one of my
colleagues an oral order she had taken
over the telephone from a physician. Let
us strive to upgrade our noble nursing
profession as a whole. - RN. Quehec
(llame withheld Oll request.)

Reader finds article informative
A very informative article on the in-
tluen7a epidemic of 1918 was published
in your December 1973 issue. I would
appreciate receiving 3 copies of the article
- 2 for other persons interested in it.
1 want to express how much help I find
our national nurses' magazine. It is a fine
publication. - Nellie M. Anderson.
Willnipeg, Mallitoha.

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INDICATIONS-Xylocaine administered intra-
venously is specificall\! indicated in the acute
management of( I) ventricular arrhvlhmias OI.:CUT-
ring dUring cardiac manipulation. such as cardiac
surgery: and (2) life-threatening arrhythmias. par-
ticularly thosewhich are ventricular In origm. such
as occur dunng acute myocardial infarction.

COl'oTRAINDlCATIO:-;S-Xylocainc is contra-
indicated (I) in patients with a known history of
hypersensitivity to local anesthetics of the amide
tvpe: and (2) in patients with Adams-Stokes 5)0-
drome or with
evere degrees of sinoatrial. atrio-
ventricular or intraventrIcular block

WAR
INGS ('onstant monnonng with an elec-
trocardiograph is essential in the proper adminis-
tration of X vlocaine intravenously_Signs of exces-
sive depression of cardiac conductivit), such as
prolongation of PR interval and QRS complex
and the appearance or aggravation of arrhvthmias.
should be followed by prompt cessation of the
inlravenous infusion of this agent II IS manddforv
to have emergency n:suscilative equipment and
drugs immedialely available to manage possible
adverse reactions involving the cardiovascular.
respiratory or cenlral nervous systems_
Evidence for proper usage in children is limited.

PRECAUTIONS-Caution should be emplo}ed
m Ihe repealed use of Xylocame m patients with
severe liver or renal disease because accumulalion
may occur and may lead to toxic phenomena. since
Xylocaine is melabohzed mainly in the liver and
excreted by the kidnev_ 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 admmls-
trationofXvlocaÎne intravenously for the ehmina-
tion of ventricular ectopic beats without prior
acceleration in heart rate (e_g_ by isoproterenol
or bv electric pacing) may provoke more frequent
and serious ventricular arrhythmias.

ADVERSE REACTIONS-Svslcmic reactions of
the following types have been reponed.
(I) Central Nervous System: lîghtheadedness.
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 Svstem: hypotension: Lar-
diovascular collapse: and bradvcardia which may
lead 10 cardiac arrest.
There have been no reports of cross senslllvity
between Xylocaine and procainamide or between
Xylocaine and quinidine.

DOSAGE AND ADMINISTRATION SinKle
Injection: The usual dose 15 50 mg to 100 mg
administered intravenously under ECG monitor-
ing. Thi" dose may be admmistered at the rate
of approximately 25 mg 10 50 mg per mlnute_
Sufficient lime should be allowed to enable a :)Iow
circulation to carry the drug to the sÎte of action.
If the initial injection of 50 mg to 100 mg docs
not produce a desired response. a second dose may
be repeated after 10-20 minute".
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 smgle injection
in those patients in whom the arrhythmia tends
to recur and who are incapable of receiving oral
antiarrhythmic therapy. intra"'enous infusions of
Xylocaine may be administered at the rate of I
mg to 2 mg per minute (20 to 25 ug/kg per mmute
In the average 70 kg man). Intravenous infusions
ofXylocaine 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 indicaled. palien15 should
be changed to an oral antiarrh}thmic agent for
maintenance therapy_
Solutions for intravenous mfuslOn should be
prepared by the addillon of one SO ml single dose
vial of Xylocame 2Cf or one 5 ml Xylocaine One
Gram Disposable Transfer SYringe to 1 liter or
appropriate solutIOn This will provide a 0.1%
solution: that is. each ml will contain I mg of
Xylocaine HCl. Thus I ml to 2 ml per mmute
will provide I mg to 2 mg of Xylocaine HCI per
minute.

news

Man. Schools of Nursing Are Asked
To Increase Enrollment By 10%
Winnipeg, Man. - After considerable
pressure from health agencies in Man-
itoba. the minister of health and social
development has requested that schools of
nursing in the province increase their
enrollment by 10 percent this fall.
This request from the Hon. Saul Miller
occurred after many hospitals were forced
to close beds and curtail admissions
because of an apparent shortage of
nurses. Although this occurs each year. it
has affected urban as well as rural
agencies in 1974.
Directors of diploma and baccalaureate
nursing programs in Manitoba met with
Miller to discuss the possibility of an
increase in student enrollment. They
infonned him of problems associated with
this increase, such as a lack of clinical
facilities. classroom space. and qualified
teachers.
So far Miller has not accepted the
position, put forward by the Manitoba
Association of Registered Nurses. that the
problem is more complex than merely
increasing enrollment. The association
has stated that Manitoba nurses' monthly
salaries are $200 lower than those in
neighboring provinces, that working con-
ditions are unsatisfactory. and that there
is limited opportunity for advanced edu-
cation.
:\1ARN claims that these problems have
caused discontent and many nursing
resignations. especially during summer
months.
Miller told the directors of plans to
appoint a study group, which would
recommend possible approaches to in-
crease and maintain the number of nurses
in the province. He indicated that he
would be in contact with various profes-
sional bodies and agencies for sugges-
tions regarding membership for the study
group.

B.C. Govt. Announces Start
Of Resource And Health Centers
Vancoul'a, B.C. - British Columbia is
setting up community human resource
and health centers in 5 areas of the
province. beginning this fall. The estab-
lishment of these centers was announced
in July by Dennis Cocke. minister of
health. and Nonnan Levi, minister of
human resources.
The areas in which these centers will be
OCTOBER 1974

located are the Queen Charlotte Islands,
Houston and Granisle in north central
B.C., Grand Forks-Boundary in southern
B. c., and downtown Victoria.
The first of the centers is expected to
open in Granisle. with one coordinator for
both the Granisle and Houston centers.
Local industry is cooperating in setting up
the Granisle center.
There will be a clinical nurse on duty at
each center, and public health nurses
available for services such as home visits.
Both social and health services will be
provided at the new centers. Each center,
however. might have a different setup.
Operating funds and capital costs for
the centers are being provided by the
government. It is estimated that for the
first year. operating costs for the 5
programs will be about $1.5 to 2 million;
80 percent of this has already been funded
through existing programs, which are to
be incorporated into the centers.
In a 2-volume report entitled Health
Security for British Columhians, submit-
ted to the B.C. health minister in De-
cember 1973, Dr. Richard Foulkes re-
commended that community human re-
source and health centers be "the termi-
nal or local delivery point" of a total
health system in the province. This
report, which was welcomed - with
some reservations - by the Registered
Nurses' Association of British Columbia.
has been passed by the B.C. legislature.
but has not been proclaimed as law.

First Collective Agreement
Signed For Nurses In P.E.!.
Charlottetown, P.E.I. - The Provincial
Collective Bargaining Committee of the
Association of Nurses of Prince Edward

Nursing Studies Index Ready
A new edition of the Index of Canadian
Nursing Studies has been published and
I is now available. The new index.
prepared by CNA staff under the direc-
I tion of Librarian Margaret Parkin. is
cumulated to 1974 There is a charge of
$5 for the index. to cover printing costs.
The Index of Canadian Nursing
Studies may be ordered from the Cana-
dian Nurses' Association. 50 The
Driveway, Ottawa. Ont., K2P IE::!. To
expedite delivery, send payment of $5
with the order.

Island recently signed its first collective
agreement with the Health Negotiating
Agency, made up of representatives of
Treasury Board, the Hospital Services
Commission. and the Hospital Associa-
tion of P.E.I.
This 2-year contract. which covers
some 500 nurses employed in 8 general
hospitals and I school of nursing. runs
from I April 1974 to 31 March 1976. In
1973, the starting salary for a nurse was
$542 per month. The rate at the beginning
of the new contract was raised 15 percent
to $624 per month. In April 1975, the
salaries will increase another 12 percent
to $699 at the basic level and $799 at the
top level for a general staff nurse.
The major breakthrough was in vaca-
tion time Instead of receiving 4 weeks'
vacation after 20 years. in the new
contract RNS receive 4 weeks after 5
years, and instructors receive 4 weeks
after I year.

Univ. Of Edinburgh To Offer
Masters In Nursing In 1975
Edinburgh, Scotland - The department
of nursing studies, University of Edin-
burgh, will offer a 12-month program
leading to the M.Sc. degree in nursing
education. The new program is scheduled
to begin in October 1975.
Candidates for this program must be
registered nurses meeting the professional
nursing requirements of the General Nurs-
ing Councils, or international students
who meet the professional criteria of their
own countries. Candidates must have
baccalaureate degrees recognized by the
University of Edinburgh.
Application for entry to thi
course
should be made between September 1974
and the end of January 1975. Inquiries
may bp. sent to the Department of Nursing
Studies, University of Edingurgh. Adam
Ferguson Building, 40 George Square.
Edinburgh. Scotland. EH8 9LL.

Second Fellowship Is Added
To 3M Nursing Award Program
Genna. Swit;:.erland - A second fel-
lowship of $6.000 (US) has been added to
the 3M nursing fellowship program,
which is administered by the International
Council of Nurses. IOj asked the 3M
Company for this additional yearly fel-
lowship to make it possible for a diploma
nurse to continue post basic studies.
THE CANADIAN NURSE 9
.

New VON uniform is in the pink

m

t.1

v

..,

.Ii

......

Two VON nurse
. Anne McGregor.
left, and Jarime David!.on. right, try
out the Order's new raspberry-colored
uniform in two versions. Heather
Stetchyson of the VON national office
staff. center, models the uniform worn
by nurses in 181)H when the Order was
founded.

(C onlmued from page 9)
Announcing the expansion of this
fellowship program. ICN executive direc-
tor Adele Herwitz said, . 'This . . . means
each year an additional nurse will realize
her dream of being able to take postgrad-
uate studies without financial hard!.hip.
We appreciate this worthy contribution on
the part of the 3M Company."
IC;\J will grant the 2 fellowships an-
nually beginning in 1975. Each fel-
IO\\-ship may be u
ed in the winning
candidate's country or abroad. The fel-
lowship program also includes a prize of
$200 (US) for each national finalist. Each
of ICN'S 71) member associations can
submit the name of one candidate for the
international awards.
Once the ICN member association has
selected a candidate at the national level.
the name of this nurse will be forwarded
to the 3M selection committee. This
committee. composed of members of
ICN's board of directors. will choose the 2
winners. Applications for the 1975 fel-
lowships must be received by (CN by 15
October 1974. Names of the 3M fellows
will be announced in March 1975.
10 THE CANADIAN NURSE

Latin American Nurses At Seminar
Focus On Nursing Legislation
Geneva, Switzerland - Nurses represent-
ing 14 national nurses' associations in
Latin America took part in a seminar on
legislation governing their profession.
held in Bogota, Colombia, I) to 19 June.
The International Council of Nurses
sponsored the seminar with funds from
the Florence Nightingale International
Fund.
This seminar helped the participants
analyze the current situation in their
countries and factors affecting the de-
velopment of nursing. and plan for
meeting the future needs of nursing
through appropriate nursing legislation.
The seminar program was based on the
assumption that to understand the princi-
pal patterns of legislation and promote
nursing legislation in each country, it is
necessary to have sufficient knowledge of
the context in which that legislation
operates.
Factors influencing the development of
nursing in Latin America were detined as:
economic and social development. de-
mographic changes, concepts of health
and the organization of health services.
women's position in society and their
conditions of work. the relationship bet-
ween nursing education and practice. the
qualit} and quantity of care available to
meet the population's needs, the nurse's
role and relationship with other members
of the health team. and continuing and
inservice education.
Participants agreed that nursing legisla-
tion in Latin America is generally out-
of-date or nonexistent. and that the
national nurses' associations should pro-
mote and participate in formulating all
legislation affecting the nursing profes-
sion. By gaining a better understanding of
the factors that influence nursing practice
and education, the participant
believed
they were better able to see the nurses'
role in promoting legislation for their
profession.
The seminar participants expressed the
need for a definition of what each country
means by nursing care and for a better
definition of the role of the nurse, of
auxiliary personnel. and of health person-
nel in general; legislation concerning
practice. education. and social and
economic welfare must be based on these
definitions.
Specific recommendations were formu-
lated to provide a working basis for each
national nurses' association in promoting
nursing legislation.
Dr. Doris Krebs of Chile. chief consul-
tant for the seminar. concluded, "Nurs-
ing legislation is a pattern for action and
development within the nursing profes-
sion. Nurses, through their national
nurse
' association. ;re responsible for
the promotion of forward-looking nursing
legislation. This is the essential message
which has emerged from the seminar.... ..

10, Executive Director Adele Herwitz
called the (CN seminars on nursing legisla-
tion. which have now been held in Poland
and Colombia. "effective mechanisms
for helping nurscs movc thcir countries
toward more effective nursing legisla-
tion." ICN is planning to publish a
complete report of the !.cminar in English.
French, and Spanish vcrsions.

Recommendations on Nurses' Work,
Living Conditions Now Available
Gellem, Switzerlalld - The report of the
joint ILO/WHO meeting on conditions of
""ork and life of nursing personnel is now
available. the International Council of
Nurses (tCN) recently announced.
The World Health Organization IV, HO)
and the International Labor Organization
(ILO), both specialized agencies pf the
United Nations. convened the meeting in
Geneva 19-30 November 1973. Among
the 20 experts invited to the Geneva
meeting ""ere 12 nurses; Margaret Wheel-
er, associate secretary registrar, Order of
Nurses of Quebec. was one of them.
The report contains 162 recommend-
ations covering conditions for effective
nursing practice, education and career,
collective bargaining, conditions of work.
remuneration. social security and social
welfare, health protection. and interna-
tional cooperation.
The ICN has persuaded the International
Labor Organization to place the subject
of the report on its agenda for the 1976
labor conference. At that time. national
representatives to the conference will
decide whether to adopt an International
Convention on nurses' conditions of life
and work. Once adopted. these Conven-
tions have legal force in the countries
that ratify them.
The meeting convened by the ILO/WHO
was the culmination of 6 years' effort
by the International Council of Nurses. In
1967 the ICN pas!.ed a resolution request-
ing the United Nations' labor and health
organizations to work together to prepare
a report that would serve as a guide for
governments, employers. and workers.
Copies of the report in English,
French. and Spanish are available free
of charge from: Executive Director.
International Council of Nurses. P.O.
Box 42. 1211 Geneva 20. Switzcrland.
,

Full Participation Of Women
Is Target Of UN Seminar
Orrawa - There is a basic need to estab-
lish national commissions to ensure the
full participation of women in all sectors
of national life. says Helvi Sipila, the first
woman to hold the position of assistant
secretary-general (for social development
and humanitarian affairs) of the United
Nations.

OCTOBER 1974

Can 3M produce
a personal
stethosco
e
for nurses? Yes we can.

Three of them, in fact, each as personal
as a pair of glasses.
There's the 2-ounce "Littmann"
Nursescope stethoscope, fitting neatly in a
unifonn pocket, and combining the finest
quality' and performance features with
graceful design, in 5 pretty colours.
And 3M now offers two new
stethoscopes for nurses... the "Littmann"
Medallion Nursecope and the Nurses'
Medallion Combination Stethoscope. The
Medallion is available in Goldtone, Silvertone,
Blue, Green or Pink, with colour co-ordinated
tubing, making it ideal for colour coding by
department or for individual identification.
The "Littmann" Medallion Combination
Stethoscope comes in the same colours and
is recommended for nurses who practice in
critical areas.

J

I

Th
reproduction in this book aftel ðn anginal by It:unardo da Vinci. in Turin,
Blbbot
ca Reale IS personaUy yours from 3M and suitable for framing.

To order your personal stethoscope just
call 1-800-265-4439 toll free or write:
3M CANADA LIMITED P.O. BOX 5757
LONDON, ONTARIO N6A 411
ATTENTION: MEDICAL PRODUCTS

3 m
Yes we can.

VB 9460

At a press conference following the
opening of the seminar, Sipila explained
that there has not been more progress
because governments have not considered
equality between men and women
important for economic development, but
as "women's problems that only women
can solve."
According to Sipila, the World Popu-
lation Conference in Bucharest in August
was a turning point in the integration of
women in development. She noted that
for the first time, there was a considerable
number of women among the delegations;
at least 12 delegations were headed bv

news

Addressing the opening 4 September
of the first UN seminar on national ma-
chinery to accelerate the participation of
women - on an equal footing with men
- in national development, she noted
that although "many governments accept
in principle the equality between the
sexes and have enacted progressive
legislation, the situation remains bleak."

in geriatric atonic constipation.
Glysennid'tonight-
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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 12 mg. sennosldes 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
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Supply: Bottles of 100 and 500 tablets.
Full product information available upon request @
SANDOZ
DORVAL, QUEBEC
T

Sandoz PharmaceutICals DIVISion of Sandoz (Canada) Ltd OOl'\lal Quebec

. I
6.,

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"-I t
t2 .. '" -
:;'10' 2
'9 3
8" 4
765

.

---.

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\

12 THE CANADIAN NURSE

women (in fact New Zealand's delegation
was composed entirely of women); and
the solidarity among the women made it
possible to get a number of provisions
relating to the status of women into the
world population plan of action.
"In the first draft of the world popu-
lation plan of action, there were very few
references to the role of women," empha-
sized Sipila. She added that it is sad to
see population policies adopted without
consulting women. "By improving the
status of women, we can affect popula-
tion trends better."
In a statement 5 September, which
introduced the agenda item "general
review of various types of national machi-
nery already in existence," Freda Paltiel
said that economic and social develop-
ment do not necessarily improve wo-
Olens' status.
"Indeed, there is considerable evidence
that, as societies move... through
various stages of industrialization, with
the complex differentiation of role,
women may find themselves occupying a
shrinking . . . domain, and women may
become marginal members of their
society," said Paltiel, who is special ad-
visor (welfare and social) on the status
of women in the department of national
health and welfare. She was Canada's
choice as a resource consultant for the
UN seminar.
Paltiel continued: ., Where women are
not partners in development, they may
become ultraconservative members of
society, fearful of social dislocation. Pos-
sibly, the more complex. . . the society,
the deeper the segregation and the more
pervasive the myth of equality. Hence
the need for a clear mandate, the need
for machinery, the need for resource al-
location. ..
Four major types of machinery to as-
sure women's full participation in national
development were identified at the semi-
nar as: national committees on the status
of women; special bureaus or units
established within a government depart-
ment or ministry; special units within a
trade union; and other machinery.
The debate on these questions is just
beginning, as International Women's
Year does not get officially launched
until 1975. But the UN interregional
seminar was an important step toward
realizing "equality, development.
peace" - the theme of International
Women's Year.

BECAUSE YOU GIVE
ê
SOMEONE WILL LIVE

OCTOBER 1974

KeelJS
11inl 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.

::::--
- --=-
I r,J ,

Saves
)'OU tiIne
Pampers construction
helps prevent moisture
from soaking through
and soiling linens. As a
result of this superior
containment, shirts,
sheets, blankets and
hed pads don't have to
be changed as often
as thev would with
conve
tional cloth
diapers. And when less
time is spent changing
linens, those who take
care of babies have
more time to spend on
other tasks.

to..

Pa
Pel's

"

f

...

\

..

,\
\

'\.

PJl:OCTE:III: . GAMBLE: C"
.IU

lIMe

71,v...;-Bm

MRS. R. F. JOHNSON
SUPERVISOR

n',

=--
CHARLENE HAYNES
--- \.\OLB\{Uut' ,
\1
RS. ---
\
'OHN, L.PN.

GENEROUS NEW GROUP DISCOUNTS on all
Items showo, for group purchases, graduation giftS. favors. etc.
6-11 Same Items, Deduct 10%; 12-24 Same Items, Deduct 15%
25 or More Same Items, Deduct 20%

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boxes on cl1art, clip ttJis section and attach to coupon spare in case of 105s.
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Does 0 Black 0 1 Pin 2.35 0 1 Pin 3.10
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background with pohshed edø: es apply While (wme n.rr.e) (s.tme name)
PlASTIC LAMINATE...slimmer, DWhite t Black
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contrasting core color. Beveled not not D Blue White D 2 Prns 1.95 0 2 Pins 2_90
border matches lettering. apply apply D Cocoa . Letters only Cyme niJmel Iyme niJmel
METAL FRAMED ..Classlc Polished D Black D 1 Pin 2.35 \ D 1 Pin 3_10
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ANEROID SPHYG.
A superb instrument especially designed
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craftsmen in W. Germany. Easy-to-attacl1
Velcro'l cuff, ligl1tweigl1t. compact, fits /
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Excellent Quality Clayton Aneroid Sp"yg. from
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guaranteed 10 years. Slack and c"rome man om-
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tubing, soft leattierette Zipper case. Clayton No_
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nrV'Jl'fl .. . No. CT.l (Speciff Initials), N.. CT.2 (Plain

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TO ORDER NAME PINS, fill out all information In box, top
I right, clip out and attacn to tnls coupon.
\ Please add 50c: handling/postage
I enclose $ I on orders totalling under $5.00
No COD's or billing to individuals_ Mass. residents add 3% S. T_

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all Price

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Famous Littmann nurses' dla-
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diap"ragm. 28" overall Non-rotat-
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*IMPORTANT: New "Medallion" styling includes tubmg In colors to matct!
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No. 2160M) on coupon. Duty free
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Malumum sensitivity from t"IS flOe professional rnstrument. Con.
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SCISSORS and FORCEPS

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in a capsule

Ear protection apartheid style
The June 1974 is
ue of Occupational
Health, published in England. reports that
anti-noise regulations announced recently
in South Africa require employers to
provide earmuffs for \\orkers in factories
and on building si!es.
What makes this regulation stand out.
according to the Sunday Times. is the
requirement that the earmuffs must be
segregated and marked for White. Col-
ored. Indian. or Bantu persons. If ear-
plugs are provided instead. they must also
be segregated.
It is expected that the new regulations
will come into effect in October. They
provide a fine or one )ear imprisonment
for employers \\ ho do not comply.

Woman is reinstated
A \\oman \\ ho \\ao; fired one day after she
began working at the CA
FOR plywood
plant in British Columbia has won a
ruling from the B.C. Human Rights
Commis
ion for reinstatement \\ ith full
backpay at the planl.
Linda Arksey complained to the com-
mission following her firing by a fore-
man. who said. "This is no place for a
\\oman" and "I don't want :you to get
muscles like a man." The commission
found that the compdny had violated the
Human Rights Act.
This report of sexual discrimination
was carried in Canadian Labour Com-
ment in J ul y .

Alcohol weakens muscle"
Research that is being conducted in the
United States and other countries o;hows
that most alcoholics have o;igns of muscle
damage.
This information comes from Dr.
Theodore L. Munsat. professor of
neurology at the Universit} of Southern
California (CSC) school of medicine and
director of the neuro-muscular unit at the
Los Angeles count\-usc medical center.
Hi
\\o
k \\as reponed in the summer
197.t issue of Muscular Dntrophy Repor-
ter, puhlished in Toronto.
Microscopical examinations of muscle
..amplcs from alcoholics have shown
changes in the fibers that remind research-
ers at the L'SC medical center of the
muscular d) strophie
. All the patients
tcsted at this center had heen consuming
high levels of alcohol for a long time and
\\cre patients in the alcoholism \\ard.
Thc researchers belie\e that b) doing
OCTOBER 1974

experiments with rats and by observing
humans. they might find a chemical \\ay
to prevent the muscle damage. :\1unsat
and a pathologist at the medical center are
about to begin a federally funded research
program to learn more about the pattern
of muscle change. which appears to be
related to alcohol.

Help for chokers
A reader from Montreal. Sybil Cooper.
\\as interested to see a ne\\-spaper story
about a new method of saving chokers
lives in The Ga-;,ette 16 July. and. a few
day slater. another item on the same
subject in The Canadian Nurse (July
I 97.t, page 30).
According to The Ga-;,ette story. a
maneuver named after Dr. Henry Heim-

lich of the Cincinnati Jewish Hospital has
been successful in
aving the lives of
persons choking on a mass offood.
"The Heimlich maneuver consists of
standing behind the victim. putting both
arms around him just above the belt line.
allowing head. arms. and upper torso to
hang forward.
"Then. grasping his o\\n \\rist with his
left hand. the rescuer rapidly and strongly
presses into the victim' s abdomen. forc-
ing the diaphragm upward. compressing
the lung. and expelling the obstructing
bolus. ..
Individuals in many parts of the United
States have \\ritten to the doctor about
their successful use of this kind of
technique. He \\ould like to see all
restaurants display a poster showing this
maneuver.

ft i
UN'"

"T alk about putting on airs! Just be
au..e
she was mentioned in "Principles of Microbiology."

rHE CANADIAN NURSE
..

15

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...

Davolchanged suction instruments
just enough to make a big difference.

There's only one difference
between Davol instrumehts and
metal ones.
Davol made them disposable.
So now nursing'staffs save timé
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.
BUILDING ON A CENTURY OF QUALITY ' C
. 0 1874-1974
,) HEALTH CARE PRODUCTS
"'" ... .... ....
,

o

Price?
Davol suction instruments are
priced to make disposability practical.
. avol introduced disposable
suction instruments. Since then
over two thousand hospitals have Q
already converted. \
Apparently, we made a big
difference.
"Dayol Canada Ltd., 1033 Range
View Rd., Port Credit, Ont.,
L5E-1H2 (416)274-5252

OPINION

Nursing research
is not every nurse's business

N URSING RESEARCH IS NOT EVERY
nurse'!> business. In fact, nursing
research is for a minority of intensely
trained nurses. This position is in direct
comrast to that of Lucille Notter, who tells
us that "nursing re!>ean:h is every nurse's
business" and that' 'research in nursing is
not as difficult to under!>tand and evaluate
as nuclear research. "1
Whether it is as "difhcult" as nuclear
research or not, hardly seems to be the
issue. According to Abdellah's definition
of nUßing research. .. ...a systematic.
detailed allempt to di!>cover or confirm
the facts that relate to a specific problem
or problem!> in... nursing."2 the rigor of
nursing research i!> no less exact than
nuclear re!>earch. The subject area iden-
tified in the research is not what deter-
mines difficulty.

E ARLY RESi:ARCH 1:-< :-<URSING \\ AS
characterized primarily by studies
carried out by members of other discip-
lines to build and test the theories that
constituted the predictive principles of
their o\\. n pmfessional practices. 3 As a
result. the nursing profession has gone
through a time when research was used
only for rigidly controlling investigation!.
of an experimental nature, dealing with
manageable phenomcna,4 to a period
when ever) nurse is no\\. to be a
researcher.
Nurse!-. seem to be :>dying that. b)
doing research - even research that
looks only at what nurses are presently
doing - the) \\.ill be able to declare.

[he <tuthor " d grdUudtc of Corm'dll Gencrdl
Ho..pil<tl Schol'\ of !':ur-ing. The L'niver
ity of
\V inu"". dnu the LJmversit} of\\'e..tcrn Ontdrio.
OCTOBER 1974

Marjorie Hayes, R.N., M.Sc.N.

"Nursing is a profession separate from
everything else. Look at us."
Rather. it is a fact that research
methodology is taught. learned. and
practiced. It is not ,. something" inherent
in every nurse. nor is it as simplistic as
the problem-solving method or the obser-
vation skills each student nurse possesses
on graduation.
This is not to deny research as a
function of nursing; but it is only one
function and one that is carried out by
specifically trained persons. Even if the
intricate steps in the scientific approach
and the extensive statistical design could
be accomplished by a large number of
nurses. I doubt if all could relate their
results to the needs of nursing and nursing
practice.
Good nursing research requires educa-
tion in methodology, analysis. and in-
terpretation. Research is serious business.
and a research career demands a rigid
training. s Bixler tells us, "Research is
now regarded as systematic investigation
so planned and conducted as to be
complete and orderly in the analysis and
interpretation of facts. clear in style of
presentation, free from prejudice. and.
\\.hen finished, resulting in some conclu-
sions that are in harmony with the scope
and nature of its stated objectives. . '6

T wo TYPES OF RESEARCH HAVE BEEN
identified. Pure research is a sys-
tematic investigation done without con-
sideration of needs, with the ultimate
satisfaction coming from the pleasure of
intellectual pursuit of learning and the
accretion of Io..nowledge. Applied research
develops from existing problems. from
some dislocation in life situations. and
from a need that is recognized.

The pure scientist has no obligation to
produce useful findings that would
allow him/her to end up with true,
reliable data: the applied researcher. on
the other hand, is committed to concrete
applicable findings. For the most part, the
nurse researcher is required not only to
provide applied research. but also to be a
practitioner of his/her own results.
This requires the nurse researcher to
produce only usable data. Therefore,
descriptive studies have been done by
nurses in the past. 7 These studies have
allowed the nurse researcher "not \0
fail," as it is relati vely safe to describe
events, actions, and feelings. A good
example of this is the large number of
time studies that have been completed on
nursing manpower.
Sound research also requires more than
the application of some established in-
struments. The nurse researcher has to be
cognizant of the difference between \\.hat
is researchable and ."hat compromises
can be made by scientific rigor and within
the confmes of good research. Inadequate
skill in and knowledge of research princi-
ples and research methods lead to an
unhealthy reliance on specific techniques
that are used whether or not they are the
most adequate for a given purpose.
Deficiencies in training. experience.
and slo..ill in formdl research design and
methodology cannot be comp.:nsated for
by the use of consultants. As useful and
necessary as they are, consultants must be
approached with specific problems or
:juestions, and the researcher must be

Bibliography available on request from
the Librarian. CNA, 50 The Driveway.
Ollawa. Ontario. K2P I E2.
THE CANADIAN NURSE 17
.

skilled enough to be able to accept or
reject their ideas. To accept advice
blindly, without understanding it, allows
for error and is not the way to use
consultation.

T HERE ARE NURSES WHO HAVE THE
inclination both intellectually and
emotionally to do research in nursing. It
should be possible to provide formal and
systematic training in scientific research.
In disciplines outside nursing, the doc-
toral program is seen as the ne.cessary
preparation for research. It is the terminal
degree.
In nursing in Canada. the master's
degree is the terminal degree as there are
no doctoral programs in nursing avail-
able. It would, therefore, behoove fac-
ulties of nursing that are graduating
master's-prepared nurses to identify and
select the individuals who show the most
promise in research competence, and
encourage, even subsidize, their under-
taking of further study in research. Others
in nursing need to be provided with
resources for training in critical interpre-
tation ofresearch data.
Nursing faculties in many universities
could provide the resources to facilitate
understanding of research methodology
and data analysis, if they were not already
carrying backbreaking teaching loads that
leave them little or no time to plan and
teach additional courses. Faculties need
time, facilities, and resources to aid the
nursing profession in its reaction to
research.
Notter states, "It is every nurse's
business at least to be informed and react
to nursing research."8 Yet, she states,
"few react." Apparently, nurses do not
know how to react. Obviously, research
is not affecting the day-to-day work of
nurses enough to cause them to react
strongly.
Until nurses are provided with the
opportunities to learn about research,
little critical viewing of research will take
place. As well, institutions, whether
universities, hospitals, or agencies, must
have a budget commitment to research
and a belief in its benefits.

T HE MAJOR PROBLEM FACING A YOUNG
nurse researcher today appears to
be in finding a role model. Not only are
knowledge, skill, and interest essential,
but there must also be someone or some
18 THE CANADIAN NURSE

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group with whom to identify. For one
young nurse researcher, the role models
were two social scientists. 9 This posed
problems for her when she tried to
construct an image of herself in the
future.
The nurse researcher becomes subject
to criticism and abuse by fellow nurses
and b) other professionals. The view
tends to be that the researcher is "too
academic," "too scientific," "not a real
nurse," or .. unaware of nursing prob-
lems" .
Unfortunately, with few readily ob-
served researchers, extensive criticism
from colleagues, little job security, and
fev. financial rewards, nurse researchers
have, in the past at least. turned to the
social scientist for identification, support,
and encouragement. They will continue
to do so unless the profession of nursing
makes a place for them and accepts their
contribution as being vital to the future of
nursing practice.
Surely it can readily be seen that not
every nurse is prepared for the serious
business of a research career. Research
must be done by individuals who possess
the requisite qualifications of: interest,
knowledge and skill, and the ability to
find their own role model and create their
own self-image. Nursing research just is
not and cannot be every nurse's business.

\

..
.1
.
.
.

References
I. Notter, Lucille. Nursing research is every
nurse's business. Nurs. Outlook
II: I :49-51, Jan. 1963.
2. Abdellah. Faye G. Overvie.... of nursing
research 1955-1968, Part I. Nurs. Re.1'.
19: 1:6-17, Jan./Feb. 1970.
3. Downs. Florence S. Ethical inquiry in_
nursing research. Nurs. Forum 6: I: 12-20.
1967.
4. Bixler, Genevieve Knight. Research in
nursing. Amer. 1. Nurs. 50:442-5, Jul.
1950.
5. Diers. Donna. This I believe ... about
nursing research. Nurs. Outlook
18: 11:50-4, Nov. 1970.
b. Bixler. loc. cit.
7. Abdellah, Faye G. and Levine, Eugene.
The aims of nursing research. Nun. Res.
14: 1:27-32, Winter 1%5.
8. Notter, loc. cit.
9. Davis, Marcella Z. Some problems in
identity in becoming a nurse rc'eJrcher.
Nun- Res. 17:2: 166-8, Mar./Apr. 1%8.
OCTOBER 1974

Problem-oriented
diabetic day care

This paper describes the setting, aims, approaches, and initial experiences of
the McMaster Diabetic Day Care Centre, which was established at the
McMaster University Medical Centre, Hamilton, Ontario, in 1971.

Bernice King, B.Sc.N., William B. Spaulding, M.D.,
Alexander D. Wright, M.D.

Until recent years, most newly-
recognized diabetics. and many known
diabetics under poor control. were admit-
ted to hospital for stabilization and
education. This appeared to be a wasteful
use of expensive hospital beds and a
disruption for patients in their home.
school, or work activities.
In 1971, a diabetic day care center was
established as a program of the McMaster
Health Sciences Centre to provide ser-
vices, education. and research oppor-
tunities.
The school of nursing and the medical

chool of McMaster University were
initiating and expanding their teaching
units to provide experience for increasing
numbers of students in nursing and
medicine. as well as for some in social
work and physiotherapy. A diabetic day
care unit could offer great potential for
the education of those \\'ho. when quali-
fied as health professionals, would be-
come responsible for patients with this

M
. King. a graduate of Grace Hospital school
of nursing. Windsor. and the Univeßity of
Windsor. i
the senior nurse at the McMaster
Diabetic Day Care Centre. Dr. Spaulding. .t
graduate in medicine from the University of
Toronto. is director of rhe Diabetic Day Care
Centre and pmfes
or of medicine at the
McMaMer University Medical Centre and IS
on the faculty of medicine at McM.tster
Univer
ity. Dr. Wright, a graduate of Cam-
bridge University. \\as formerly staff ph)si-
cian, Diabetic Day C.tfe Centre at McM.t
ter
University. and was on the faculty of medicine
at McMa
tcr Univer
ity, Hamilton, Ontario.

OCTOBER 1974

common, complex, chronic disease. The
need to learn and practice team care in an
ambulatory setting - often advocated by
health educators but seldom achieved -
could become a reality.
A diabetic <lay care unit could provide
opportunities for research in many areas,
such as collaboration with basic scien-
tists. education of patients, clinical inves-
tigations, and provision of health care to
diabetics.

Service to patients
Clinical services rendered in the day
care unit include assessment. education,
and treatment of diabetes and help with
psychological and social problems that
interfere with diabetic control. We assess
newly-diagnosed and established diabet-
ics. initiate or modify treatment, provide
full education about the disea.,e. and
supervise management until the diabetes
has been adequately controlled.
To meet the needs of patients, we have
formed an interdisciplinary team of two
nurse-practitioners, a nutritionist. a social
worker. a receptionist-secretary. and phy-
sicians with special training in pediatrics.
internal medicine. psychiatry. dnd oph-
thai mology.
The senior nurse practitioner leads the
team. initiates and coordinates the plan of
care for each patient. and decides whom
the patient will see and when. She is
responsible for deploying members of the
team in whatever way is most appropriate
for each patient's problems. Both nurse
practitioners have learned. on the job, to
THE CANADIAN NURSE 19

take a thorough clinical history, and to do
a selective physical examination (devel-
opment and nutrition. skin and append-
ages. vision. fundi, peripheral circula-
tion, and nerve function).
For each patient. an internist or pedia-
tric ian reviews the history, completes the
physical examination, and discusses with
the nurse-practitioner the plan of man-
agement and progress of the disease. If
the patient reveals a problem that requires
a social worker, interviews are arranged
with our team member. The psychiatrist
is consulted when there is serious emotion-
al disturbance or family dysfunction.
Often, the patient's immediate family
take part in diagnostic and treatment
sessIOns.
The nurse, as the coordinator, is the
key member in team communications:
where necessary, she arranges a team
conference to discuss the plan of care for
a patient.
The Hamilton chapter of the Canadian
Diabetic Association, after surveying its
members by questionnaire, identified a
need for the unit to give special attention
to the problems of children and adoles-
cents. These younger diabetics and their
families need help with many aspects of
management, and especially with their

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psychological and social adjustment at
home, school. work. and recreational
activities.
Much of the involvement with juvenile
diabetics and their families centers around
their acceptance of the diagnosis and its
implications. The nurse can assist parents
express their fears, anger, guilt, and
hostility; frequent contact (visits or tele-
phone calls) helps family members to
.. work through" their emotions.
Education continues by follow-up vis-
its arranged with the nutritionist and
pediatrician. The pediatrician supervises
care until the patient is into adolescence,
when transfer is made to an internist in
the unit. Group sessions for adolescents
provide an opportunity to discuss difficul-
ties common to this age group.
Ideally, the diabetic patient should
know more about the idiosyncrasies of his
own diabetes and its management than
any of the attending health professionals.
Therefore, the nurse encourages a patient
to adjust his diet, insulin dosage, exer-
cise, and urine testing himself so that he
regulates his own disease and achieves
independence.
Close contact by telephone and mail is
maintained with the personal physician of
each patient, a brief report being sent

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Nurse explains how information on labels of goods can be helpful in preparing meals.
20 THE CANADIAN NURSE

after every visit. When a patient's condi-
tion has become more stable, or problems
have been resolved. his own doctor takes
over the continuing management of the
diabetes. Follow-up examinations are
made at intervals of six months or a year,
depending on the severity of the disease.
Pregnant diabetic patients receive close
attention. Whenever possible, they are
seen during each visit by the obstetrical
staff in addition to a nurse and physician
from the diabetic unit. Our aim is to keep
the postprandial plasma sugar levels
below 150 mg./ 100 mI. Visits are sched-
uled every week during the latter part of
the pregnancy, and patients are usually
admitted to hospital a few weeks before
parturition.

Pafients learn
The education of patients is undertaken
chiefly by the nurse practitioners and the
nutritionist. On the first visit, each patient
completes a questionnaire designed by the
unit staff to pinpoint areas of ignorance or
misunderstanding about diet, urine test-
ing, insulin, foot care, insulin reactions,
and diabetic coma. Using the results of
the questionnaire and additional informa-
tion obtained during the initial interview,
an educational program is tailored to
individual needs.
The first major area of concentration is
diet. The nutritionist interviews each
patient, takes a full dietary history, and,
in most cases, works out and prescribes a
revised diet pattern. Follow-up visits are
arranged as necessary. If a reducing diet
is prescribed, the patient visits the nutri-
tionist twice monthly until either signifi-
cant weight loss occurs or an inability to
reduce is apparent.
On these visits to the nutritionist, the
patient also sees the nurse to learn about
the nature and day-to-day management of
his diabetes. Pamphlets. a programmed
learning text, and books are assigned for
study, depending on the needs and capa-
bilities of the patient. The staff have
prepared several slide/tape programs that
patients study in the unit. Family mem-
bers are encouraged to attend these
sessions also and, if necessary, evening
appointments are scheduled to accommo-
date them.
Usually, the first encounter with the
nurse results in correction of misinforma-
tion. It is also an occasion to explore the
OCTOBER 1974

patient's feelings abour being diabetic. as
often. until they have been brought into
the open. education concerning diabetes
fails. The nurse records educational pro-
gress so that specific points can be
reviewed and discussed later. as neces-
sary. During the patient's final visit to the
unit. the questionnaire is answered again
to measure the change in his knowledge.

Students learn
Our student education program has
involved nursing. social service. and me-
dical undergraduates. as well as medical
residents. A student. under the supervi-
sion of a nurse practitioner. helps assess
patients. plan management of their dis-
ease and follow progress. This often
includes visiting patients at home or In
residences. such as old persons' homes.

Research integrated
Research has been undertaken in a
number of areas. A hematologist has
determined the oxygen binding capacity
of red blood cells in nonketotic diabetics.
A neurophysiologist has made measure-
ments of motor and sensory nerve
conduction and of motor unit counts.
Summer students have helped devise our
questionnaire for assessing the patients'
knowledge about diabetes, and they have
analyzed the results in terms of such
variables as age, duration of diabetes,
treatment with insulin, and membership
in the diabetic association.
A summer student developed a numeri-
cal scale for evaluating control of diabetes
and used it to determine the effect on
diabetic control of attending the day care
unit.

Our patients and their problems
In all, 232 patients were seen during
the first 27 months of the day care center.
A breakdown of this population according
to age and sex is shown in Table I. The
preponderance of males in the younger
age groups and of females in the older age
group are similar to the overall incidence
of diabetes in the general population. I
Over 30 percent of the diabetics referred
to the clinic have been juvenile diabetic

(that is. diagnosis made before age 21).
The patients were grouped according to
diabetic management after referral to the
day care center: 152 were on insulin
therapy; 77 were controlled by diet. with
OCTOBER 1974

TABLE I

Age and sex distribution of patients on referral to diabetic day care unit

Age (years)
Sex 6-20 21-40 41-60 over 60 All Ages
Male 51 25 29 12 117
Female 33 25 26 31 115
Total 84 50 55 43 232

or without oral hypoglycemic drugs; and
3 were untreated. as the diagnosis of
diabetes was not confirmed.
Physicians referred patients for prob-
lems categorized as follows:
I. Newly diagnosed diabetes of less than
8 weeks' duration;
2. Previously diagnosed diabetes with
problems related to control. diet. or
education, or with a need for general
assessment.
Of our 232 patients, 22 percent. after
being newly diagnosed. were referred to
us for their initial management. Every
effort is made to initiate treatment without
admission to hospital. Ten of our 14
newly diagnosed juvenile diabetics. who
range in age from 6 to 20 years, have
never been in hospital for their diabetes.
We begin insulin therapy while the child
carries on his normal daily activities. and
the nurse visits the home to teach
injection technique and supervise urine
testing.
From our initial assessment and from
subsequent interviews with the patients. a
more complete list of each individual's
problems was obtained. These problems.
identified after referral to our unit. in-
clude: poor diabetic control. obesity.
psychosocial problems, nephropathy. vis-
ual problems, foot problems. and man-
agement of diabetes during pregnancy.
The most common difficulties were
found to be in the area of diabetic control
and education. Obesity and psychosocial
problems were also prominent. but the
organic diabetic complication of nephro-
pathy, visual problems. and foot prob-
lems were not so common. The small
number of pregnant patients retlects the
lack. until recently, of a high-ri!'.k preg-
nancy unit. Following the establishment

of such a unit. which has close liaison
with the diabetic day care center.
community physicians are referring more
pregnant diabetic patients to us.

VVhattheteamlearned
The need for an individual approach to
each patient was fully borne out as the
unit came into operation. Preconceptions
about how the unit might be used were
wrong in several important respects. For
instance. we planned facilities for prepar-
ing meals in the unit and purcha!'.ed
cooking utensils. a refrigerator. and hot
plate. as well as food for breakfasts.
We had assumed that most patients
referred would be ne.... Iy diagnosed -
only 22 percent ....ere. Furthermore. we
thought patients would commonly arrive
before breakfast for supervision of insulin
administration. In fact. more commonly.
one of our nurses .... ould go to the
patient's home to supervise the morning
Injection of insulin. The need to have
patients or their cooking relatives prepare
food under the watchful eye of our
nutritionist has been proven a myth.
In planning a problem-oriented unit
such as ours. it is best to wait until the
patients present their problems before
devising solutions. otherwise one may be
busy solving non-existent problems!
An adaptable approach to the education
of patients proved vital. Although all
patients fill our the same questionnaire.
and although the nurses use a brief li!'.t of
topics a!'. a guide for asse'ising the
knowledge of patients on their return
visits. diverse learning aid!'. and ap-
proache'i have been required.
At one extreme. a patient ....ho 'peaks
little fnglish and reads less. Il1.JY require
verbal instruction. ....ith the help of an
THE CANADIAN NURSE 21

interpreter. At the other, a diabetic nurse,
who has given herself insulin for years.
may learn something from a quite !>ophis-
ticated course of programmed learning. 2
Young children learn from picture books,
or simple visual displays and informal
discussions of these presentations with a
nurse or nutritionist.
Communication within the team is
essential. To facilitate this. regular meet-
ings of the unit are held to exchange
views and information. The senior nurse
practitioner chairs the meetings and
chooses topics for discussion, which
may be presentations of problem cases,
reports of research projects, and the
planning of educational sessions.
Nurse practitioners must have special
characteristics. They should be patient.
confident, keen to learn and to teach, able
to command the respect of patients and
health professionals. and able to discuss
many difficult personal problems, espe-
cially those of teenagers and young
adults. For example, they should inquire
about the sexual adjustments of patients.
realizing that about half the male diabet-
ics are impotent] (but rarely have an
opportunity to discuss this with an infor-
med health professional), and that young
couples - married or otherwise - often
have major concerns about pregnancy,
birth control, and sterilization.
As it takes about six months for a nurse
to learn to assume reasonably indepen-
dent responsibility and exercise good
judgment in matters of management, both
the nurse and her colleagues invest
considerable time and effort to have her
develop the necessary knowledge and
skills. Because initial selection may be
faulty, we have a three-month trial period
with evaluation, before any decision is
made to appoint a nurse permanently.
The role of the nurse is a demanding
one that uses all her skills and requires
flexibility in using them. In a teaching
center such as ours, the nurse practitioner
takes on the added responsibilities of
guiding and teaching nursing and medical
students, residents, and medical practi-
tioners who seek continuing education.
Continuity of care requires fast,
comprehensive communication with fa-
mily doctors. As mentioned earlier. we
have found it essential not only to send an
initial report dictated the day of the first
22 THE CANADIAN NURSE

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A patient learns how to use a slide-tape show. Note that instruction is individualized.

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visit, but one for each visit, record-
ing changes in insulin, oral agents. or
diet. Unless such notes are sent regularly,
the family doctor cannot tell what is
going on and will be unable to advise
his patient adequately. Where speed is
essential, results, such as unexpected
plasma sugar concentrations, are phoned
to the doctor's office.
The quality of care of diabetics in
nursing homes can be favorably influ-
enced. By visiting, a nurse practitioner or
nutritionist can influence almost all as-
pects of diabetic care in an old persons'
home, nursing home, chronic hospital, or
specialized institution, such as a home for
the blind. Dietary care, charting, and the
administration of insulin are only a few
areas of influence. Of course, the nurse
practitioners and nutritionists must have
the initiative to visit, as well as the
determination and tact to discuss proh-
lems with institutional staff.
The unit should be devoted to keeping
patients out of hospital beds. Many
physicians, particularly those responsible
for diabetic children. at first resisted the
idea of beginning insulin treatment or of
treating mild or moderate diabetic keto-
acidosis in a day care unit. Nurse
practitioners and physicians must be
willing to be available nights and week-

,

",
--

ends; furthermore, a few patients are best
kept in the unit all day for surveillance and
overnight if necessary.
Except for major metabolic disturb-
ances, particular complications of diab-
etes, or the management of diabetes at
certain stages of pregnancy, indications
for admitting patients to hospital to treat
their diabetes should be rare.

Summary
Experience during the first 27 months
of the unit has demonstrated that most
newly diagnosed juvenile diabetics can be
managed without admission to hospital,
and nearly all the problems of other
diabetics can be assessed and treated by
the day care center. For a community of
our size diabetic patients, their families.
and their personal physicians have found
the day care center a useful resource.

References
1. Oakley, W.G. et aL Clinical diabetes and
irs biochemical basi.
. Oxford. Blackwell,
1%8. p.235.
2. American Diabetes Association. Learning
about diabetes. A programmed course of
instruction. Ne\\ York. 1969.
3. Ellenberg, M. Impotence in diabetes: the
neurologic factor. Ann. /mern. Med.
75:213, Aug. 1971.

OCTOBER 1974

o

HEADACHE

Headache, although not a disease in itself, can be a symptom of many disease
processes, and some satisfactory explanation for the pain should always be
sought.

Robert F. Nelson, M.D., F.R.C.P. (C)

Headache is so common an experience
that most people who have headaches
visit their physician only when this
symptom interferes with their way of life.
or when relief is not obtained by the usual
"over-the-counter" medications. Most
headache- sufferers, therefore. use
analgesic drugs with little thought to the
cause of their trouble.
Fortunately, few headaches are caused
by serious organic disease, and the
efficacy of symptomatic treatment is
evidenced by the huge quantities of
analgesics consumed annually. Neverthe-
less, it should be recognized that head
pain is not a disease but, like pain
anywhere else in the body, is a subjective
symptom of underlying dysfunction or
damage.
Pain in the chest can arise from the
heart and be a warning of life-threatening
impending myocardial infarction. An al-

Dr. Nelson is an Assistant Professor of
Medicine (Neurology) at the University
of Ottawa and Neurologist at the Otta....a
General Hospital. A graduate of
Dalhousie University, he has had post-
graduate training at the Montreal
Neurological Institute. He is the author of
several articles on headache.

OCTOBER 1974

most equally severe pain ansmg from
"acute indigestion" may only be a signal
of imprudent eating habits of the host.
Similarly. head pain may be a symptom
of life-threatening disease, such as a brain
tumor or meningitis. or be a symptom of
only indiscreet drinking habits of the
hangover sufferer.

Classification
Although the underlying cause of the
headache may often be in the realm of
emotional or environmental stress. the
ultimate mechanism is almost al....a}s
attributable to a structural or biochemical
alteration
The late Dr. Harold Wolff devoted his
life to the study and gathering of informa-
tion on the mechanisms of production of
head pain. This work has been detailed in
his classic book Headache and Other
Head Pain. * Based largely on his ....ork.
the ad hoc Committee on the Classifica-
tion of Headache of the Nationdl Institute
of :'>Jeurological Diseases and Blindnes

(1962) developed the most widel) used
classification of headache. which in-

* Harold G. Wolff. Headache and other
head pain. 3ed.. New York. Oxford.
1972.

THE CANADIAN NURSE 23

cludes some 15 pathogenetic categories.
It is evident from their headings that they
regard headache as a symptom and not as
a disease entity.
It will be seen in Table I that the first
groups are mainly causes of chronic or
recurrent headaches, and other groups are
headache or head pain due to actual
diseases in different pain-sensitive struc-
tures in the head, i.e., symptomatic of
various disease processes.

Vascular causes
Vascular mechanisms are responsible
for the best known forms of headache,
including the migraines. Classical mig-
raine is a well-defined condition causing a
heterogenous group of symptoms that are
referable to the gastrointestinal tract,
visual system. central and autonomic
nervous systems. usually with headache
as the predominant symptom. Migraine
seems to be an inherited condition. but it
is uncertain just what is inherited.
Certain measurable biochemical
changes. such as a fall in serotonin levels,
have been noted in migraine attacks.
Although emotional factors are undoub-
tedly important. environmental factors.
such as food sensitivity. exposure to
bright sunlight. and hypoglycemia. may
be equally important in precipitating
individual attacks. The mechanism of the
pain is related to vasodilatation of the
scalp or intracranial vessels.
Common migraine. or "sick
headaches:' or "bilious attacks" are less
well defined than classical migraine.
have a longer duration, and are. perhaps.
more related to fatigue and chronic
tension. At times they blend into tension
headaches. The mechanism of pain is
again primarily vascular.
Another form of vascular headache.
known as cluster headache, migrainous
neuralgia. or histamine cephalalgia. is the
most severe of the recurrent headaches.
The attacks. which may cause the bravest
and sturdiest of men to writhe in agony
and cry like a baby. are fortunately brief.
seldom lasting more than 20 to 30
minutes. The intense pain felt around or
in the eye probably arises from the
internal carotid artery in the carotid canal.
24 THE CANADIAN NURSE

TABLE I

Classification Of Headache

(National Institute of Neurological Diseases and Blindness - 1962)

1. Vascular Headache of Migraine Type:
(a) "Classic" Migraine
(b) "Common" Migraine
(c) "Cluster" Headache
(d) "Hemiplegic" and "Ophthalmoplegic" Migraine
(e) "Lower-Half" Headache
2. Muscle Contraction Headache
3. Combined Headache: Vascular and Muscle Contrc!Ction
4. Headache of Nasal Vasomotor Reaction
5. Headache of Delusional, Conversion, or Hypochondriacal Stales
6. Nonmigrainous Vascular Headaches
7 . Traction Headaches
8. Headache due to Overt Cranial Inflammation
9.-13. Headache due to Disease of Ocular, Aural, Nasal and Sinusal, DenIal or
other Cranial or Neck Structures
14. Cranial Neuritides
15.' Cranial Neuralgias

It has to be distinguished from acute
glaucoma and intracranial aneurysm. but
recurrent episodes. as often as several
times a day. make it unique.

Muscular causes
Continuous contraction of the scalp and
neck muscles is one of the most common
causes of chronic head pain. This may be
seen in people with occupations requiring
constant vigilance. prolonged reading. or
fixed postures. such as switchboard
operators. computer programmers, or
stenographers.
More often. however, this chronic
muscle tension state reflects a "chronic
emotional tension state." Chronic anxiety
thus becomes manifest as chronic
headache. Depression is another frequent
cause of this type of headache. and
antidepressant drugs. particularly the
tricyclic group (amitryptiline
imipramine). are one of the most
effective forms of therapy for tension
headache. even when depression may not
be apparent.
Yet another type of headache that
involves chronic muscle contraction is the
syndrome of Costen. or dysfunction of
the temporomandibular joint. Although
the cause is generally attributed to an

imbalance of bite or malocclusion. most
cases occur in tense. anxious. often
neurotic women who have already spent a
small fortune on their teeth. I have never
seen this syndrome in an edentulous
lumberjack or a snag-toothed, caries-
ridden laborer.

Disease states
Head pain may be a symptom of
disease in the eyes. ears. nose. air
sinuses, or teeth. Although eye disease.
such as glaucoma or optic neuritis. can
give rise to pain. it is doubtful if
prolonged use of the eyes is ever a direct
cause of headache. Acute or chronic
sinusitis may be extremely painful. but is
usually easily diagnosed.
Surprisingly difficult to diagnose some-
times is dental disease as a cause of pain.
I recall one patient who complained
bitterly of pain in the temple for a week.
before an abscessed wisdom tooth made
itself known by swelling and purulent
discharge. Another youth attributed face
pain to the hallucinogenic drugs he had
been taking. until it was discovered that
he had broken a tooth during his recent
"trip. .. Dentdl pain is probably the
commonest of nerve pains or neuralgias.
but there are many others.
OCTOBER 1974

Tic doloureux or trigeminal neuralgia.
primarily .1 di!.ease of older people, is
experienced as electric-like .,hocks of
pain in the .1rea ,)f distribution ,)f line IIr
more branche!. of the trigeminal nerve.
This lancinating. shooting. electric pain is
a hallmark of the neuralgias. Fortunately.
a relatively new medication. Tegretol
(carbama7epine). effectively controls
most cases.
Patient., in thi!. older .lge group ..Ire
occasionally victims of ..Inmher type of
superficial pain that is readily diM in-
guishable from tic doloureux-the pain of
temporal arteritis. In this condition, the
patients complain of temple pain .1nd of
having exquisite tenderness over the
distribution of the superficial temporal
artery, which is nodular. firm. and
pulsele!.s. The diagnosis is confirmed by
biopsy. Such confirmation is important.
as this is a systemic vascular disease and
may cause blindness if the retinal arteries
are also involved.
Intracranial structures can give rise to
pain. and headaches can also be a
symptom of intracranial disease. Brain
tumor is a relatively rare cause of
headache. Its pain is often disarmingly
mild. Being worse in the honlontal
position. it tends to be worse on awaken-
ing in the '111Jming. \1o!.t "flen it IS
diffuse. but. if localized. the pain .:an be
useful in pointing to the site of the tumor.
There is no ..ingle feature that points to
this !.inister cause. These symptoms are
similar for .111 "pace-occupying lesions.
such a!. ab!.cess and subdural hematoma.
I have found that .,ome patients with
systemic hypertension may report a simi-
lar type of headache that may wake them
from sleep and seem to clear up after they
have been up and about during the
morning. fhere is considerable con-
troversy over whether hyperten!.ion does
cause headache. Although the layman
readily associates "high blood pre!.sure"
with pressure in the head. statistical
confirmation of the relationship between
level of sy!.tolic hlood pressure and head
pain is lacking.
I recall ..eeing a patient. referred for
Bell's palsy. who wa!. ti)und to have
gntde IV retinopathy and a blood pressure
OCTOBER 1q74

of 260/140 due to renal .1rtery .,tenosis.
and who resolutelv denIed ever having
had a headache.
However. in :) patients
een in a series
of 400 referred for headaches. hyperten-
sion seemed to be an important causal
factor. with remission of headache upon
control of blood pressure (See Table 11).
Certain antihypertensive medications can
themselves cause headaches.

Underlying cause treated
In many patients headache may be the
symptom that bnngs the patient to the
doctor. and .,0 other diseases are found.
In many of the!.e the headache is unre-
lated. but in many. management of the
underlying disea!.e lead., to control ot
headache ..IS well !Tahle m. Such under-

lying disease may have been causing a
general feeling of being unwell. ....ith
headache being one of the manifestations
of this malaise.
Restoration of normal metabolism in
two patients brought about immediate
remission of headaches. One man with
uricacidemia. but no gouty symptoms.
had remission of severe headaches when
uric acid levels were reduced hy Zylop-
nm.
The' . pill" headache controversy con-
tinues. but it seems clear that many
women with migraine have worse
headaches - and more frequent
ones - after starting contraceptive
medication, and many others develop
vascular head
lChes for the first time after
starting the "piIL" Fifteen of my patients

TABLE II

Etiology of 400 Consecutive Headaches Seen in Office Practice

Migrainp: Ni'uralgia:
classical )7 trigpminal
common 118 glo",opharvngeal
clu'ler Jh ocupital
complicðtpn 14
lowpr ranal J IntPl lion
chilcJhood 18
Tumor
Muscle contraction:
associatpd with dpprcssion 17 <;ubduraJ
not a
soci.Jten with npprp"lon 'i0
<;inus
Combined Vèl..l ular ,inri
muscle contraction II) Dpntal
Vasl ulðr:
,lrterlll s .! T pmporomannihular ioint
Willis .!
other : 1

3
1
I

7

4

2

<}

'3

4

Headðchps not tvplt..1 ot othpr categories but
epn in pèltipnts
with other condition..

Hvpothyroidism
Hvpoglycpmla
Urlcacidpmia
Contraceptive pills
Epilppsv
Cplia( Di,ea,e

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\

HVpP"PIl
lon
Valvula. Heart [)i
easp
Allergies
Sp(}ndvlo,i

lraumd

I)
2
7
8
"

THE CANADIAN NURSE l')

had an undoubted association between the
contraceptive pill and headache, with
remission of headaches after stopping the
"pill. ..
From the foregoing. it is evident that
headache can be a symptom of many
different disease processes, some serious,
some not so serious. There is a poor
correlation between severity and serious-
ness of cause.
Indeed, the patients who insist they
have had agonizing headache every hour
of every day for decades, unrelieved by
analgesics. most likely do not have an
organic mechanism for their pain. Such
headaches are probabl
on a delusional
basis and, in my experience. the most
difficult of all to treat.
The differentiation of the different
causes of headache is important and often
difficult. Investigation beyond history
and clinical examination may not be
necessary, but some satisfactory explana-
tion for the pain should always be sought.
Ideally. therapy should depend on an
accurate knowledge of the cause. but this
may not always be possible or practical.
In patients in whom headache is the only
or major manifestation of chronic emo-
tional disorder. supportive psychotherapy
and prescription of simple analgesics may
be preferable to prolonged periods of
psychoanalysis.
Frequently, the basic problem is
socioeconomic. with the headache-
sufferer finding himself in an intolerable
life situation that is difficult [0 alter.
Symptomatic treatment may help to make
life bearable and enable the sufferer to
muster his resources to counter his en-
vironmental problems.
Sometimes more than one cause of the
headache can be found. The patient who
knows he has a brain tumor ha
a good
reason to develop tension headaches
I once saw a teenager with a strong
family history of migraine who himself
presented with classical migraine attacks.
His short stature and delayed pubertal
development was a constant cause for
26 THE CANADIAN NURSE

anxiety. It was easy to adopt this
psychodynamic explanation for his
headaches. However, it was discovered
later that his growth lag was caused by a
pituitary tumor. This was probably also
giving him constant headaches, and
treatment of the tumor relieved them. He
has continued to have migraine, and
probably always will.

Nursing role
Few headache patients are admitted to
hospital. and therefore nurses may not be
involved in the management of most of
these patients. When the opportunity
arises. however. nurses may be able to
play a key role. They may be able to
establish rapport in such cases, and an
experienced nurse sometimes seems to
have a sixth sense about the significance
of patients' symptoms.
Physicians are used to interrogating
patients and receiving "yes" and "no"
answers. The patient may try to give an
answer that will please the physician. The
nurse may chat with the patient in a
relaxed atmosphere, and a truer picture
of the problem will emerge.
Unfortunately, nurses too often adopt
the attitude. perhaps subconsciously from
the physician, that, if the patient has no
structural disease or tangible evidence of
abnormality as measured by x-rays or
blood tests. he cannot be suffering real
pain. The patient may be considered a
malingerer, and analgesic medication and
sympathy are withheld.
Pain is pain is pain. It is always a
subjective phenomenon, and the amount
of suffering a person goes through has
little to do with the cause.
The nurse treating the headache suf-
ferer should be sympathetic but not overly
solicitous. Babying such patients often
tends to prolong disability.
Considering the large numbers of peo-
ple involved, taking medication for
headache seldom leads to dependence on
analgesic or sedative drugs, and therefore
the nurse should not withhold medication

from patients suffering from head pain.
There is some risk in masking the cause
of headache (such as when the pain may
be due to tumor or infection). but when
patients are actually under investigation
there is no reason why they should not be
as comfortable as possible.

Summary
In summary. the symptoms of
headache should always be taken seri-
ously. Although the cause may not
always be a serious disease. it should
always be diligently sought. Where the
cause cannot be found, symptomatic
treatment may suffice. Although overall
mortality associated with diseases causing
headache in proportion to the number of
sufferers is not high. the amount of
suffering and the loss of work hours and
efficiency are extensive. Nurses can play
a valuable role in the diagnosing and
management of patients suffering from
the symptom, headache. ,;

OCTOBER 1974

Energy sources
for
implanted pacemakers

A review of energy sources presently available for permanent pacemaker
systems, including the recent application of nuclear power.

Sheila Tomchishen, R.N., and Bernard Goldman, M.D.

Nuclear pacing in Canada began October
1973 at the Toronto General Hospital.
J.T.. a 33-year-old jeweler who ....as born
with a ventricular septal defect, required
open-heart surgery for direct closure on
two occasions due to reopening of the
sutured defect in 1961 and. subsequently,
in 1963. He developed the late onset of
complete heart block with syncopal spells
in 1967. and a trans venous fixed-rate
Medtronic pacemaker was inserted.
In 1970. a pulse-generator replacement
was performed on J.T. on an elective
basis. and he was followed through the
pacemaker clinic. Telephone surveillance
began in November of 1972 and con-
tinued for many months.
At 42 months postimplant. both the
patient and ourselves were becoming
somewhat nervous about prolonged
follow-up. due to a known tendency for
this implanted unit to "run awa)" on

The author is a 1969 graduatc of SI.
Joseph's Hospital School of :-.Jursing. Toronto.
She is currently in charge of the pacemdker
section. operating room, division of car-
diovascular surgery , Toronto General Hospi-
tal. Dr. Goldman, a 1960 graduate of the
University of Toronto. is an assl...tant profes...or
in the depanment of surgery of that universit) .
and a staff surgeon. division of cardiovasculdr
surgery , Toronto General Hospital. He is abo
codirector of the pacemaker evaluation centcr
at the Toronto General Hospital. Toronto.
OCTOBER 1974

energy depletion. Therefore. J.T. was
booked for battery-pack replacement. and
a long-term energy source was consi-
dered, specifically. the isotopic
pacemaker.
The Medtronic Isotopic Model 9000
(Figure J) was inserted on 8 October
1973. J.T. has since been followed
through the pacemaker evaluation center
and has been totally asymptomatic, work-
ing actively and pursuing leisure activity
without concern for his pacemaker. He is
now the vice-president of the TGH
pacemaker club.

Introduction
Cardiac pacemakers emit electronic
impulses of sufficient strength and dura-
tion to cause myocardial cell depolariza-
tion and contraction. Fixed-rate (asyn-
chronous) pacers deliver these stimuli at a
regular interval. regardless of intrinsic
cardiac activity: demand or standby
pacemakers either inhibit (R-wave inhi-
bited) or synchronize the stimulus
(R-wave synchronous) with a naturally
conducted QSR wave. In either pacing
mode. both the "sensing" and pacing
circuits require an energy source.
It was initially hoped that demand
pulse-generators. used primarily in the
standby (inhibited) mode. would last
longer than fixej-rate pacemakers: but the
fixed-rate pacemakers have. in general.
lasted longer, due to simple circuitry.
Since depletion of the energy source
accounts for almost 75 percent of pulse-

generator failures and consequent re-
placements. attention ha<; been directed to
the potential for long-term pacing with
nuclear power.
This paper briefly reviews the energy
sources presently available for implant-
able permanent pacemaker systems, and
attempts to bring into perspective the
recent dramatic application of nuclear
fuels.

Mercury-zinc cell
Conventional pacemakers use the Mal-
lory R:\1-1 "Certified" mercury-zinc-
oxide cell for the power source. Despite
the original estimates of the manufacturer
that these batteries would last five years.
based on calculations derived from the
battery shelf life, almost all pacemaker
models have required replacement much
sooner. At body temperatures and at
nominal load, these bdtteries do not
persist much beyond two years on the
average.
In this cell the zinc anode is separated
from the mercuric oxide cathode by layers
of cellulose and plastic. The cell must be
encapsulated to prevent leakage of the
electrolyte, but permit the e..cape of
hydrogen - a by-product of electrolysis.
Early and premature failures have
occurred because of lost continuity bet-
ween the inner and outer container:
breakdo.... n of the separatol'> bet....een the
inner and outer container: hreakdo.... n of
the separators bet....een anode and
cathode: and short-circuit path... of metal-
THE CANADIAN NURSE 27
.

lic mercury. a reduction product of the
mercuric oxide.
The introduction of silver into the
depolarizer has helped to prevent free
mercury 'ihorts b} amalgamation of the
mercury with silver. Recently. cells of
increased capacitance. which have a
projected longevity of almost 10 years.
have been introduced.

Lithium iodide cell
This solid-state cell represents a new
approach to primary electrical cells. Un-
like the mercury-zinc cell. which has a
corrosive liquid as an electrolyte. this cell
has stable lithium iodide
alt. The high
reactivity of lithium requires isolation
from air and water vapor by hermetic
encapsulation. This seal serves also to
prevent the ingress of body fluids that
has. in the past. interfered with pacer
components.
Since this battery discharge evolves no
gas. no silastic vent in the pacer structure
is necessary. again avoiding a source of
tissue-fluid leakage. The projected lon-
gevity of lithium cell pacemakers is 7 to
12 years. making this an allractive pace-
maker for consideration of long-term
use. I

Biologic energy source

Efforts have been made. primarily on
an experimental basIs. to u
e the biologic
energy of natural moving parts of the
body to produce electricity, Potential
sources from within the body are fuel
cells dnd biogalvanic battery generation.
None of these devices has provided
sufficient amounts of power for practical
consideration. !

Rechargeable systems
Radio-frequency induction coils have
been used extensively in certain centers
and provide an appealing method of
pacing for intants and children. A receiv-
ing coil. buried beneath the skin. is
connected by electrode
to the heart. An
induction coil.
trapped to the skin

urface over the receiver. provides a
28 THE CANADIAN NURSE

-.....

/' -
4;'I1t.
p. TRO t.
"'
UR'::BI: GC"I:<>, NIC,'
eNS ""
O/f
MODEl..' 41..C4ì

"Ii-
.Jød 90 00 l.
,,0
a l.4c, -,.

...

Ii'<

. . ... '"

- . 6 '"

:-r
'
9

t
i
'"

--..,.. ,
......
...
+ '. ,j\- .

'j,J:.

....
r;;Jíto.' , ". ..
- ,:I-! ,--
\.

\
.

"

..

Figure 1: The Medtronic radioisotope-powered pacemaker, broken down into its vital
components. The titanium case, top center, contains the plutonium 238 thermoelectric
battery, middle center: pulse generator circuitry, bottom left; and terminals, bottom right.

continuous energy ",ource from d radio-
frequency power pack worn continuously
by the patient.
The nickel-cadmium pacemaker is to-
tally contained within a pulse-generator
and implanted. acting as a secondary
battery that can be recharged from outside
the body at six-week intervals. Although
this pacemaker is in clinical use at
present. the burden of responsibility on
patients and their families to maintain the
battery charge continues to act as a major
constraint. Other potential problems re-
late to undercharge. overcharge. and the
resultant danger of damage to the cell.

Isotopic energy sources
The conversion of nuclear fuel to
electrical power by a thernlOelectric
generator system offers the potential for

the greate'it pacemaker longevity. (Figure
2) The ideal isotope would have a long
half-life. no significant radiation effects
on adjacent tissues. minimal toxicity if
released in the body. and safe handling
characteristics. The two isotopes in use at
present are plutonium (PU 238) and
promethium (PM 147),
Plutonium is a byproduct of a nuclear
fission power plant and emit:. alpha
particles (helium ions). whicÌ1 have little
penetrating power. It has a long half life
(86.4 years). a high power density. and a
relatively low radiation dose when encap-
sulated. Radiation consists of both neu-
tron and gamma rays. the latter contribu-
ting the major portion of the radiation
level.
Promethium has a high energy density
and produces beta rddiation. but has a
OCTOBER 1974

'ihorter half life (2.7 years). and relatively
high radiation levels - primarily gamma
radiation - when encapsulated.
The Alcatel-Medtronic (French-
American) pacemaker uses PU 238. as
does the AEC-ARCO Nuclear (American)
pacemaker. The Biotronik
MacDonald-Douglas (German-American)
pacemaker uses the promethium fuel
source.
Both the ARco-Nuclear and Alcatel
batteries hold promise of functioning for
at least 10 years and perhaps 20- 30 years.
provided all other components are equally
durable. The Biotronik promethium
pacemaker may last 10 to 20 years as
well.
An important con!>ideration in the
development of nuclear pacemakers has
naturally been patient safety by optimal
radiation protection. Thus. the integrity
of the encapsulation t.as been ensured by
testing against a variety of accidental or
intentional onslaughts. such as impacts.
cremation. compression. and direct
strikes by bullets.
The capsule has maintained its Integrity
at point blank high velocity impact.
temperatures of 1040 0 C. for 2
hours.
and pressures of 30-40.000 Ib!../sq.in.. as
well as shod., and vibration test!>. indicat-
ing that it will survive 30.000 shock!. of
50 G' s.3'4' 5

Discussion and comments
The introduction of nuclear-powered
pacemakers was received with great en-
thusiasm by the public and the press. but
the importance of nuclear pacing may
have been exaggerated. Although even
the best chemical cells will probably not
exceed a pacemaker life expectancy of 10
years. and the outside estimate for nuclear
pacers is 20-30 year
. the natural history
of conduction disturbances must be taken
into account.
It has been stated that the average age
of patients undergoing implantation of a
cardiac pacemaker is 72 years. and less
than 5 percent of these patient!> are under
30 years. The life expectancy of persons
OCTOBER 1974

A,n!S-h1 container

Thermal Insulation

Fuel capsule

Thermoelectric modutt>

ElectrIC outputs
/'

Fuel pellet

Inner capsule
Outer capsule

Fuel Capsule

Figure 2: Alcatel battery and fuel capsule.
The Society Alcate!. Paris, France, teamed
with the French Atomic Energy Commis-
sion, scientists from Medtronic, and Drs.
Armand Piwnica and Paul Laurens to de-
velop this radioisotopic-powered battery.
The battery, about two inches long and an
inch In diameter, is used to operate the
Medtronic Model 9000 pulse generator.

in the pacemaker age group i!> II years.
and about one-half can be expected to die
within 5 or 6 years. 6 Thus. it is estimated
that perhaps only 10-15 percent of the
pacemaker population would be eligible
for a long-term energy !>ource with
nuclear fuel.
More widespread use of nuclear
pacemakers is limited by their excessive
cost. federal regulations regarding
radioi
otopes. environmental impact. and
the limitations of component and elec-
trode durability. Nonetheless. the poten-
tial benefits of a long-lasting pacemaker
in younger patient!. cannot be overesti-
mated with regard to ultimate financial
saving!>. emotional tranquility. and avoid-
ance of repeated operations over the
year!>. with attendant morbidity.

With these thoughts as background. we
have adopted a cautiou!> approach to
nuclear pacemakers. A unifonn set of
guideline!. has been accepted b} those
centers licensed to implant nuclear units
in Ontario (Toronto. London. Ottawa.
Kingston. Sudbury). The critena for
patient selection are listed in Table I and
have been accepted b
the provincial
ministry of health.
At our pacemaker center. effort!. have
been directed to achieve maximum
pulse-generator longevity within the
framework of modem nonnuclear tech-
nology. To this end we have u'ied
endocardial electrode catheters \\-ith small
surface area to provide a high current
density at the tip and thus less current
drain.
Pacemakers with integrated circuits.
hybrid electronics. hermetic encap'iula-
tion. and other spin-offs of aerospace and
missile technology should provide
minimum battery drain. Ventricular syn-
chronous units that seem to drain more
current than ventricular inhibited pulse-
generators have been abandoned. Simi-
larly. asynchronous pube- generators that
demonstrate a lo\\-er than average energy
drain are used when possible for patients
with complete atrio-ventricular dissocia-
tion. or for replacement purpo
ö in
patients with total pacemaker depen-
dency.
Newer pacemakers. with narro" pulse
duration of 0.5 to 1.0 milliseconds. are
used extensively. as greater pulse dura-
tion wastes energy. Recently. pacemakers
with a variable pube duration have been
introduced wherein the pulse width can be
'ihonened by external means to obtain the
maximum energy saving with minimum
pulse duration \\-hen the threshhold is
stable.
Along with the!>e technicologic fea-
tures. we. and others. have emphasized
the need for pacemaker follow-up. The
major effect of intensive follow-up by
frequent telephone tran
mis!>ion ha' been
to increase patient safet
and the longev-
it} of the pulse-generator itself b
accu-
THE CANADIAN NURSE 29

TABLE I
Criteria for Patient Selection for Nuclear Pacemakers

1. The projected life span of the individual, reflecting not only his cardiac but
also his systemic well-being, should be in excess of 10 years, and,
practically, 10 to 20 years.
2. Although younger patients are the prime candidates, any fit individual up
to age 60 is a suitable candidate.
3. Regarding underlying cardiac disease: the most desirable patients are
those with congenital complete heart block, postoperative complete heart
block, or those with idiopathic conduction disturbances, i.e., Lev's or
Lenegre's disease. Individual consideration would have to be given to
patients with myocarditis or cardiomyopathy to determine the stability of
the disease and the prognosis for that person. Heart block associated with
coronary artery disease would not usually be a good indication.
4. The emotional and economic stability of the individual and his family unit
should be secure.

5. The place of residence, the travel needs and mobility of the patient, and
access and willingness to participate in follow-up are important. The
patient must be willing to comply with the manufacturer's and the
government's requirements regarding travel abroad. retrieval of the unit
following death, etc.
6. In the female, consideration should be given to the family history of breast
cancer and the patient's desire for a family. Abdominal implants should be
considered for the young female, due to the common occurrence of
spontaneous breast cancer in the population. It would be wisest to avoid
nuclear implants in women who have not yet borne children. However. we
acknowledge that there is no relationship between the nuclear implant and
either breast cancer or birth defects.

7. Nuclear implants should be used preferably for cardiac pacemaker
replacement. In exceptional instances the nuclear unit can be a primary
implant. The advantage of using nuclear pacers for replacement is the
ability to determine the stability of the disease, the electrode, the
thresh hold , and the patient. Nonetheless. we recognize that primary
implants will be recommended in certain patients.

8. The manufacturers' protocol regarding electrode, polarity, etc., must be
followed.

9. The patient and his pacemaker must be followed closely, and electronic
analysis performed accurately as defined by the pacemaker evaluation
center at the Toronto General Hospital.

30 THE CANADIAN NURSE

rate prediction of impending pulse-
generator exhaustion. By eliminating re-
placement schedules. greater pacer life
and fewer operations may be achieved.

Conclusion
The nuclear pacemaker battery is es-
sentially a low-energy. miniature, im-
plantable power source that will function
in the body for many years; it is
impervious to every conceivable acciden-
tal or intentional damage and is presuma-
bly safe to the bearer and the environ-
ment.
Despite the limitations imposed by
cost. atomic energy regulations. and
component durability. nuclear units will
certainly be useful and important in
cardiac pacing. It is unlikely. however.
that they will occupy a major part of the
armamentarium available to cardiologists
and surgeons interested in pacing. Mod-
ern circuits, combined with adequate
follow-up, will provide most pacemaker
patients with a realistic and safe
pacemaker lifespan. with a minimum
number of operative interventions.

References
I. Greatbatch. W. Chemical power supplies
for implal/Tahle cardiac pacema"er.f. In
International Symposium on Cardiac Pa-
cing. 4th. Groningen. Netherlands. Apr.
17-1'ì. 1'ì73. Cardiac pacing. Proceedings.
Edited by Hilbert J. Th. Thalen. Assen.

ethcrlands, Van Gorcum. 1973. p. 188.
2. Parsonnet. V. Power sourcö fÖr implanta-
ble cardiac pacemakers. Chest 61: 165.
Feb. I 'ì72.
3. Escher. D.J.W. et aL The ideal permanent
pacemaker. In Dreifus. Leonard F. and
Lcikoff. W.. eds. Cardiac arrythmias: the
twentv-fifth Hahnemann Symposium.
N.Y.. Grune & Stratton. 1973. p.607-16.
4. Parsonnet. op. cit.
5. Parsonnet. V. Power sources for implant-
able cardiac pacemakers. Chest 61: 165.
May/Aug. 1973.
6. Furman. S. et al. Pacemaker longevity.
Amer J. Cardiol. 31: III. Jan. 1973. <.d
OCTOBER 1974

Exorcising the ghosts
of the Crimea

What has been commonly noted to be true of nursing practice is also true of
nursing education: in both instances, the prevailing milieu continues to be au-
thoritarian, male-dominated, and militaristic.

Thetis M. Group and loan I. Roberts

The military regime persists in nursing.
Historically. it has only been under condi-
tions of national calamity - war - that
women were even grudgingly allowed any
positions in public institutions of healing.
Thus. it is not surprising that nursing' s
traditions and practices are derived from
military organizations because that is
where nursing itself originated. Even the
education of nurses has been characterized
by a model of military authority. with or-
ders given and carried oul. And it is no
coincidence that the military has always
been J male-dominated institution. thus
constituting a double barrier against wo-
men in the healing .lrtS.
In earlier years this was not the case. For
centuries. women healers of one kind or
another drew patients to themselves by the
excellence of their capabilities. But. as
time went on. religious and ci"il: authori-
ties brought the full weight of malc-
dominated institutions against them. to the
degree that women were almost totally ex-
eluded from any kind of organized or instJ-

Or. Group. whosc basic nursing education \\as
obl,tined at Skidmore College. SaraH>ga
Springs. \I. Y.. and \\ho carned hcr rd.D. l!e-
grec .11 reachers College. Columhia Univer-
silV. :\i. Y " i.. associate professor al Syral'llse
llnivcrsu) School ot \ltlrsing. \le\\ York. Dr.
Rohcns. a sOt:ial psychologisl \\ IIh hcr doc-
torate from Teal'hcrs College. ColulTlhia Uni-
vcrsity. is assistant profðsor III the Deparl-
ment ot I::ducalional Policlcs. Uni\crsity 01
Wjsl'onslll. .\1adison. ,md is panicularl) in-
tert
sted III Ihc prohlclTIs 01 womcn in higher
educallon.

OCTOBER 1 <J74

tutiunalized therapeutic practice. I The
women in religiou.. orders who provided
nursing care lived under vows of total obe-
dience to ecclesial authority. exerci<;ed by
male clerics. Also \\orking against women
in the earlier years was the image of the
"lady" - a delicate creature who could
nut possibl) be granted an intimate
knowledge of the human body.
During the Revolutionary War [U.S.A.].
women were permitted to attend stricken
soldiers. But it was not unUlthe women's
movement. arising out of and joining with
the abolitionist movement in the early
lImOs. that women demanded the right to
engage in the public practice of medicine.
By I H38 \1ary Gove Nichob gave the
first known anatomical lectures to her
o\\n sex and. JX)ssibly in conformance to
the "lady" concept. many of her au-
dience left the room and others fainted on
the sJX)\. 2
Some women. however. were made o(
stronger stuff Elizabeth Blackwell. for
instance. when finally allo\\,ed to study
medicine at Geneva Medical College. \\'a-
ged a fierce battle ((n the right to witness
anatomical dissections. J.4 Even in 1870.
the bailie for anatomical knowledge was
still being ((!Ugh\. -\t that time ElilJ
Mosher. one of the first woman physicians
in Ihe United States. \\,as teaching women
students in segregated anatomy classes at
the University of \1ichigan. Because cur-
rent practice was to block out features of

COP) right June IY7-t. The Amcrican Journal ot
\lursing Company. Reprinted from .'I!I/nillil
Owloo/.., June I Y74.
THE CANADIAN NURSE 31

the human ana!om
with plt:ct:
of brown
papt:r, she hit upon a unique visual aid to
dt:monstrate the kmale anatom
:
She had
ewcd out of colored ,m, and ribbons a
whole
et of bnght-hued internal organ' -
heart. liver. uteru
. ovanð. with vello\N rihhon
íntesl1nc
and red and blue artenes and vem
.
The
e she would drape over hcrself dunng the
Iecture. 5

I::ven before thi
time. however - in
1857 - Elizabeth Blackwell had founded
the New York Infirmar), a ho
pital
completely staffed by women. Less than a
year later, "he introduced a school of nur-
sing, preceding the one established by
Florence Nightingale by three years.
Thus while both Dr. Blackwell and
Florence Nightingale were pioneers in
nursing education, it wa
Dr. Blackwell
who changed the accepted form of reci-
tations and moved her students into
clinical laboratory settings. It was
Nightingale's wort... however (and per-
,haps unfortunately), that was most
influential in developing the nursing prn-
fessHm, rather than Blackwell's. whose
work was not militarily oriented.
Prohahly the clearest record of thc suh-
,ervience of early nursing to thl' militar

regime is found in the biographies of
Florence Nightingale. In one of these. it
i
noted:
She strictly observed offICIal routme. nothIng
heing supplied from the \..lIchell without a re-
4uisitinn
igned b
a doctor !\in nurSl" \Na

permitted 10 give a patient an
nOllrlshment
without a doctors \Nrltten dtrecti{)n
."

It i
clear that if women wanted ((I enter
a sphere of activit
outside the home dur-
ing those early years. the) would have to
accept. in large part. the condition
of the
male in!'.titution
which the) entcred. \\ie
understand thc nece!'.sll
for sub!'.ervience
in that era. But we do not understand the
nursing profession', maimaining that 'uh-
serviem.:e over a hundred vears later. And
we particularl
deplon: the very real pos-
sihility of still another generation of suh-
!'.ervience amI authoritananism.
Few people would dispute thc fact that
an authoritarian !'.Iructure i, not conducive
to a positive educational experience. But,
unfortunatel). when nur!'.mg education
32 THE CANADIAN NURSE

shitted Its professIOnal learnmg base from
st:rvice to educational institutions, it mam-
tained the authorit) model derived from
the hospital hureaucracy and from military
orgam.lallon
. Thi
situation wa!'. remfor-
ced by the fact that American univer
ities
and college
themselve
wert' tm a long
lime hased on Prussian model
of educa-
tion. which were pnmarily authoritarian in
structure and uperation.
Nurse
were thu
caught within. or
hetween. two male-dominated. authorita-
nan institullons. and tht' restncting and
constricting intluence of this situation
continues. In a hospital. dedicated to the
sustenance of life. thi
situation is disas-
trous: in education. dedicated to the free
exploration of ideas. it is intolerahle.

Nursing in the university
Many of the schoob of nursing in our
universitie!'. are still under the direct or
mdirect control of schoob of medtcine or,
if autonomous. arc nevertheless viewed hy
university admmistration as appt:ndages to
them. Either wa), nursmg
choob share
the i
(Jlation that lend!'. to characterize the
medical school in the university. In the
latter mstance. the separateness may be

elf-imposed by medical tacult} to exempt
themselve
from son1l' general umversit

policie
or obtain special economic privi-
lege: in addition. medlcme's hlghl
re
-
pected status within the umversit
givt:
a
different meaning to the Isolation of physi-
cJan
and theIr student-.. Schoob of nur-
smg. huwever. suffer this isolation with-
out the compensating advantages. They
arc separate hut unequal.
For nursc facully members. thi
isola-
tion from the communit
of
cholar
pro-
duces a lonely existence in w hlch the
arc
often perceived a
inferior scholar
in a
st:cond-rate discipline. Thi
isolation is
physical. mtellectual. and often social. Al-
though haccalaureate nursing students
now take liheral arts clJurse!'..they return to
their physicall
segregated facil itie" (hos-
pital. medical and nursing schoob. and
donnitorie
frequentl
form an isolated
unit of the campus I to find fe\N of theIr own
faculty memhers oriented toward integrat-
ing their liberal arts learning InlO the nurs-

mg curnculun, Indeed. somL faculty
memht:rs pen:elvt' the humanities courst:

as simply a means uf fulfilling accredita-
tIon requiremems. And in many univer,i-
tle
thl: students majoring in nursmg have
little interchange with their fellow srudents
in other maJor!'..

Faculty isolation
The nursmg srudems physIcal and intel-
lectual isolation from their peer
Slmpl)
mirrors their faculty's isolation Otten fac-
ing the stigma of practitioner rather than
theoretician. doer instead of thinker. .. un-
credentialed" if the) lack the doctorate.
nur
l' faculty memher!'. are !'.egregated hy
the!'.e presumahl
mferior quahtið and h)
their sex from the rest of thl' facult). In
addition. the
segregatl' themselve!'.. Be-
I ieving themsel ves to be in control of their
own profes!'.ion. they "truggle to maintain
the standard
of the university without un-
derstandmg thl' operation of the univer-
sit). Thu!'.. it is a rare woman administrator
of a school of nursing who Î!'. much more
than a token member on male-dominated
committees. The control of most universi-
tie
is in the hands of men from a variety of
fields. mcluding the presllgious disCIpline
of medicine itself.
Until an association of facult) women
wa
tì.mned at Ollt: universit) " tì.'r instance,
no nurse had ever been a mcmhel of that
universÍl
's division of hiological scien-
ces. a hod) that passed judgment on ap-
pointment. retention, promotion. and sala-
ne!'. of facult
in the school of nursing.
With the advent of target halloting - a
technique u!'.ed frequently h
mall' faculty
but onl) recentl) Icarned h) their female
collcague
- onc nurse finall
\Nas elec-
ted to thc division and. through her. nur-
sing faeult} could at Idst share in decisions
ahout their peer
.
By and large. nursö haVl' heen ahy
-
mall
ignorant ahout the mformal power
manipulation!'. within universities. as \Nell
as thl' formal procedure
in common u
c.
"or examplc. a phy-.ician ma
ottcn hold a
part-time univer,it
appointment a' a cli-
nician He is not noted for his theoretical
advancemcnt of knowledge througt> re-
search: he i
nothing mono or le

th,JI1 a
OCTOBER 1<J74

practitioner. But he i... given full statu... a... a
faculty member .... ith all the righb and
privileges pertaining to that position. A
woman and nurse would find it difficult
to receive such a part-time appointment. to
begIn with. and. second. would prohahly
he denied full facult
statu.... Medicinc....
separatene...... pays off. in thi... instance:
nur...ing"... doe... no\.

Power plays
Nursing education ma) bc within the
mainstream of higher edUl:ation. but rarel)
arc nurse educator.. .... ithm the mainstream
of universit) operation... or politic.... Thu...
they fail to understand the system of' 'col-
legial it) ": a euphenli...m for the old ho
....
club. it is nevertheles... the manner in
which universitie... operate. Thus. the in-
formal communicdtion network of men
within and between departments leads to
the appointment of men to committees and
It> po...ition... of power: it facilitates a va-
riety of technique... of reducing cour...e load
in order It> increase research time and.
finall
. it help... develop a strong cohesive
facult) in a particular department that will
'itand on acadellllc freedom ....henever that
department's policie... are questIoned h

administratiw officials.
The informal technique... of maneuver-
ing for power are cOlllmonl
heyond
redch of nur...e facult
memher... Often
much of their energ) mu...t be devoted to
'iimple survival within the universit): even
more frequentl y. their time is spent legiti-
mizing nursing a... a hona fide proles...ion.
Thc women who hecome administrators in
...choob of nurs ing are I ikely to he pawns of
the men in power. exercising limited. if
any. power of their own. V irginia Cleland
ha... referred to them as .. female Uncle
Toms:' and points uut that "dominance i...
most complete when it is not ewn recogni-
zed. "7
Atone univer...it). ti.Jr example. when a
team from the [L' SI Oep\. of Health. Edu-
cation and ""elfare camc to campus to
investigate charges 01 sex discrimination
leveled at the universit) . the admlIll<;tratof
of the ...chool 01 nursing i... reported to have
indicated thdt she had never e'\.perienced
di...crimination al thi.. universit\ At the
OCTOBER 1<J74

same time. the imestigator.. found over a

3.000 differential het....ecn the salar) of
men and ....omen full profc......ors!
In another instance. when women fac-
ult) and students took a collective stand
on peace in the ahsence ot the dean. the
latter.... return led to a puhlic renunciation
of the collective action. Such high-handed
tactic... b) dean... of other colleges within
the universit) would have been promptly
negated b
acl10n on thc part of the male
facult
memher... In fact. the standard
leadership 'ityle of men in the hetter
institutions has been founded on the prin-
ciple of collegial action at department
levels. That such arbitrary authority could
occur within a school of nursing charac-
terizes it as distinctly different in
authority 'itructure from the other unit... of
the university.

Th(' almighty d()(:toratt'
The 'iituation... described above might
have been prevented were there sufficient
numhers of women in profes...orial ranks.
where real po....er can he exerted against
...uch mi...use of authorit). But in many

ducational institutions. nurse faculty may
remain instructors throughout their entire
career. despitc theÎl puhlication... and re-
gardles... of their cI inical experti...c. ...i mply
hecause the
do not have a doctoral de-
gree. Without thi... .. union card." the\ re-
L .
main in nonprofc......onal po...ition.... Thi...
usuall
mean
that the) have no vote.
since the latter is mosl frequentl) reserved
for professor.... usuall) senior professor....
Ver) often. this situation cause-.. the
leadership in ...chools of nur...ing to he-
comc even more centralized. In mo...t
scholarl
discipline.... there are enough
facult) with doctorates to enahle the
formation of ...eparate department... within
the discipline. True. this is not always
de...irahle. BUI where there is no depart-
mental 'itructure. authorit
can become
centraliLed in the hands of a fe.... admini...-
trators in the dean.... office. Thus. in some
unjversit
schools of nur...ing. a ...mall
group of nursing facult) who arc 01
professorial ran!.. control the rest 01 the
facult) and an: the real ruling: po....er.
Some of them U'ie this po....er ....iscl):

others. arbitraril). In either m'ilam:e.
however. there is lillie the re..t of the
faculty can do ahout i\.
We kno.... of one 'ichool (undouhtedl).
there are others) thai ha... no department...
- only 'leaching areas." None of the
laller has enough profes...ors to estahlish
Ihe tradition
and autonom) of a depart-
ment. The chairpersons (all women) who
head each of the teaching areas have lillie
participation or control in per...onnel mat-
ter... because the) lack doctorate... and
therefore profe-..sorial rank. Thu.... it be-
comes possible for a small group of
nursing faculty to make per...onnel judg-
ments about the people in
ub-disciplines
of nur...ing far removed from their 0.... n
purview. Again. this simpl) reinforces
the military mode of operation within
schools of nursing.

Clinician and/or scholar?
Much of the history of nursing has in-
volved efforts to advance it to professional
statu.... Yet. in mosl school... of nursing.
facult} memher... are recruited d... clinicia
'i
or as technicall) competent in a specific
area - in other word.... techniCian... of high
order. There is nothing wrong ....ith thi....
hut we must point out that it is rare to find
nursing school facult) who have heen re-
cru ited because they are researchers. And.
if the clinician choose-.. to do rescarch or
pursue ...cholarly endeavor.... she disco\er...
that her teaching load leave'i her little time
for such activities.
At most univer
itie.... facult) .... ork far
heyond the required ..W-hour ....eeL This i...
not an unusual state of affairs. What i...
unusual and what marks nursing facult
a...
distinctly different from their wlle.Jgue... in
the humanities and the ...ocial and ph) ...ical
sciences is the di'itribution of their time in
lerm... of teaching. ...ervice. and re...ean:h
and puhl ieation. At one university the t) p-
ical nursing facult} memher ...pend... ap-
proximate!) 20 hour... in the clinical field:
another 20 hour... in tedmteaching and pre-
paration for it: at leasl 10 hour... in commit-
tee work and another 10 hour.. in indi\ i-
dual conference-.. .... ith students.
Thu.... excluding all other factor... ...uch a...
preparing and grading as..ignment.... the
THE CANADIAN NURSE J3

.

.J\erage \\ork ....eek make!'. it prett
diffi-
cult for the dinical facult) member to find
(([lie for re!'.earch. .... riting. and publica-
tion. Virginia Woolf once ,aid that intel-
/cctuab needed privacy and !'.pace of their
0\\ n in \\ hich to produce \\ orks of the
mind. For \\ omen in the I 970!'.. particu-
larl
\\omen \\ ho arc nur!'.ing facult
. thi!'.
philosophy has become nllht critical.

Student isolation
Ju!'.t ..IS the woman faculty member in a
school of nursing IS c.Jught on the treadmill
of routine teaching and !'.upervisory activi-
ties. ,() i!'. the nursing ,tudent too often
caught on the treadmill of worker. rather
than inquirer after knowledge. The student
learns what she !'.ee!'.. and.... hat she see!'. ..III
too often i!'. a !'.tereotyped image. subject to
pO\\erlessness. male authority. and mili-
tar
regimentation. Although the ,tudent
is presumably taught to be a change agent
and leader. she ,oon learn!'. that ,he. like
the women faculty .... ho teach her. is 'ub-
Ject to the bureaucratic ,tructure of the
universit
. the care agencies.... ith \\ hich it
IS .J'!'.ociated. and their 1llIIitary modes of
operation
Seldom does she find the role model of
,cholar or innovator among her nursing
facult) . Removed from many of the major
issues of maioI' concern to her generation.
,he walks In white-,tockinged leg' from
the !'.chool of nursing. to the ho!'.pital. ..\nd
back again. Often. ,he never engages in
real mtellectual debate .md conversation
\\ith students from other di!'.cipline!'.. With
'oclal ..:hange ,wtrling .tround her. she
rarely has a chance 10 become part of it.

Agen( v authority
To the degree that nursing faculty are
subject to the rules and regulations of the
agencIes used for stLdents' learning exper-
iences, the students in turn are subject to
their instructors' incapacities to exert pow-
er .JIId their acceptance of the duthority
l)f these d......ociated institution!'.. Whether
Jcauemia truly control, the devl'lopment
of nursing i!'. a seriou!'.que'tion. University
school... of nur!'.lng. ..:on,idercd by lIlany to
be the leading forces 111 ne\\ development!'.
m nur,ing. ma
In fact be victim!'. oftho!'.e

14

THE CANADIAN NURSE

in!'.titution!'. in .... hich their !'.tudents gain
clinicdl experience - institution!'. that
have never been noted fÒr innovation in
changing the status of either nurses or pa-
tient!'.. If thi!'. is the case. not only is the
po....erlessness of nursing faculty apparent
....ithin the university but also within the
communities and service agencies.
In one university-a!'.sociated community
agency. for instance. students were allow-
ed to interact with the nurses of that
agency only during specified hours. Inter-
action or communication at any other
time wa!'. considered distracting. Not only
was speech curtailed. so were the !'.tudent!'..
One student was scolded for wearing a
purple scarf one cold murning in February.
plus an orange ribbon to tie back her hair.
The responsible faculty member was re-
pmnanded. too.
Student!'. were allowed to have coffee in
this facility - but not from the pink plastic
cup,! In fact. . 'the case of the pink pla!'.tic
cups" became a critical issue for the fac-
ulty member; in her orientation sessions
\\lith each new group of students. she had
to include a warning about the cups. Need-
less to ,ay. nursing students are not stu-
pid: they understand power and they un-
der!'.tand the 'tupid use of power.
In another agency a !'.tudent nurse noted
a medication error and told the phy!'.ician
that !'.he believed he might have prescribed
the wrong medication. He thanked her for
bringing this fact to his attention and had
nothing but praise for the student. But the
director of the agency admonished the stu-
dent for having called the physician direct-
ly. without authorization from the direc-
tor herself. The admonition occurred des-
pite the fact that the student nur!'.e had
contacted her faculty member and receiv-
ed approval from her prior to calling the
physician.
Just a!'. student innovations are severely
frowned upon. so are faculty innovations
\\ ith their ,Iuuents. In another agency. Ihe
clinical faculty member was conversant
with game theory - a !\ophisticaled set of
concepts coming from mathematic!'. and
,ocial ...ciences and extensively used :n
both area!'.. When ,he applied game theory
to the analysi!'. of health problems with her

students. the agency staff and administra-
tion responded with bewilderment. aston-
ishment. and dismay. Apparently. inno-
vations of this t) pe could have no meaning
a!> làr as their limited vi!>ion \\ould allow.
Some faculty members fare well in
agencið becau!'.e they adhere very strictly
to the rules and proper procedures. at the
expen!'.e of their relationship ....ìth their
students and at the expense of innovation
in nursing. Unfortunatel
. the ,tudents
and facult) \\ho reject the non!'.en!'.e of
these practices. whu have the courage (()
try innovative technique!'.. and ....ho be-
lieve that women faculty and students
from universities should .Jssume leader-
ship role!'. in nursing are often considered
troublemakers or. at the vel') least. a threat
to the statu... quo and institutional regula-
tions.

Participation: true or token?
The hallowed halls ot academia are
hollow for many nursing students. The
"critical" i!'.!'.ues seem to be mailers like
residence regulations and dress codes. Tu
wear a cap or not to wear a cap'! Should
culottes be worn in the hospital'! Should
women nurses adapt to the cham!Ïng
styles of women's dothing: hoth in ìheir
personal and professional attire'! '\hould
pant-suits be allowed? To SdY that serious
and brighl young nur
ing ,tudents per-
ceive such committees and such interven-
tion into their private lives as inapprop-
riate is to state it mildly.
Lip ,ervice. at least. is given today to
the idea of ...tudent participation in deci-
sions that affect them. per!'.onalI} and pro-
fessionally . Yet their member!'.hip on
committees is often only a token one. and
they know it - know that they have no
real input imo innovalions in curriculum
or nursing practice.
We talked wilh !'.ome students about this
and found that this tokenism \\as dearly
understood by them. AdministratIve inter-
vention into their lives and the lives of
their facult
. with the latters' decisions
often vetoed dnd their po....er undercut.
wa!'. also very obviou!'. to the ,tudent!'. in-
terviewed. Their disillu!'.iomnent ....J\h the
status quo was total.

OCTOBER 1974

While other students throughout one
university were marching for peace. for
greater involvement in decision-ma"mg,
for the rights of blac"s and other minorit

groups, the nursing school administrators
and some faculty were proud that fe..... if
any, ot the nursing students were in-
volved. The ones ....ho did proclaim peace
as their moral objective or ....ho supported
any of the prevailing student movements
were considered "hippies," and their
position in the nursing school carne under
careful scrutin}. The few facult
mem-
bers who were actually involved in the
strong currents of democratizing educa-
tional institutions were perceived by the
administrators as immature and troub-
lema"ers.
Whether labeled troublema"er or
conformer, students soon learn that a great
deal of their educational experience in nur-
sing involves learning dates. duties, and
procedures, rather than pursuing schol-
arly, intellectual endeavors. To quote
Cleland again. "With traditional prepara-
tion. we prepare a trained dependency cha-
racterized by high predictahility of heha-
vior.' '8 In many institutions the nursing
curriculum seems to go out of its way to
train confonning hureaucrats. The sItua-
tion is best expressed in the words hy one
student, who said"1 have been cheated,
and I graduate with great biaerness."
Time and again, intervie....s ....ith nur-
sing students disclosed an almo...t fanatical
adherence to details and facts by facult}
members. The history of nursing, they
said. became the structure of the American
Nurses' Association and the National
League for Nursing. coupled with "an
erratic list of names and dates," Where.
these students asked, was the history of
women? How did the suffrage movement
influence the thinking of early nursing
leaders? Of what importance were women
leaders in medicine and other professions
to the development ot a professional
image for women and nursing?
These suhjects weren't discussed in
their cla!-o!-oes, the ...tudenh said: instead,
the} were expm,ed to a proliferation of
unrelated materials that they found bc"ing
in relevance fÓr themselves. both as indi-
OCTOBER 1974

viduals and nurses. We can unl} empha-
size again the statement made h) the
hright. ...tralght .. A" ...tudent ....hl\ said she
had heen cheated and that she graduated
with hitterness.

Changing the Crimean mentality
What steps may be ta"en to change the
Crimean mentalit} that still prevails in
nursing'? Literally dozens of ..tudies attest
to the use of an organic model in
educational and other institutions as a
means uf encouraging maximal produc-
tivity and providing a humanizing envi-
ronment. I This model is characterized hy
.I horizontal rather than .I vertical author-
ity structure, an upen communication
network. and total group effort in
decision-making processes.) The Western
Electric studiC!> in 1939 showell clearly
that incentives other than pay, !-ouch as
involvement in small group interaction
Jnd the freedom to ...et one', own wor"
pace, ....ere characteristic.. of optimal
employment.
The re!-oult!-o of these studies could be
applied equall} ....e1lto the university ...et-
ting. The organic model ....ould benefit
nurses as well as their patients. Thus, de-
mocratizing the operation of schools of
nursing ....ould be a first step in the direc-
tion of humani7ing nursing itself.
Second. one can assert .... ith great
strength and conviction the right oft'aculty
women to be treated the same way as fac-
ulty men. This means that relationships
mu!-ot he cultivated bet....een nurses and
women (as well as men) in other disci-
plines to ensure support of each other's
scholarly endeavors to provide women
faculty members with at least an under-
standing. if not a share. in the infonnal
and fonnal. male-dominated. university
operations.
Only \,>hen faculty themselves become
part of the university mainstream \'> ill ...tu-
dents be able \0 join ....ith them. :-.Jursing
school deans and directors need to 100" at
.... hat's going on around them Jnd change
accordingl) . Outdated modes of authorita-
rian operation arc clearly unacceptable in
other schools \'> ithin .I uni\ersity Jnd
,hould be equally unacccptabk \\ ithin

schools of nursing . Furthermore. the ques-
tinnin!!. hrlght. nur...in!! ...tudent nlll...t nol
be IJhded a de\ lant or .I trllublenl,,"el.
Every ellort to engage her in intellectual
inquiry should he initiated and sustained
by faculty and administration ali"e.
And. finally. students. faculty. and ad-
ministrators must all he involvcd in
decision-ma"ing procc!'....es. When this
happcns. the final hlm\ t(1 the military
modality that has so long characterized
both nursing practice and nur...ing educa-
tion \\ ill ha vc been ..true".

References
I. Ehrenreich. l3arhara. and Engli'h. ])emJe.
Witchn. ,Hid" /I'C.\ /111/1.\/1/ \n. \1<:\\ Yor".
(;Ia" \10ulllam Pamphleh. n.d.
, \I ichol... r. L. Vie.llO/' \ I/c/llth HWlllal:
{Ill' Uk /llId Wor/- of Hr.\. Han- Co\'(,
Vie/wis. London. I !i!ih.
3. Flexner. .\hraham. \l('dic(l1 /:"/lc/lti(lll ill
till' Ullitl'" Stwn all/I C(lII(ld(l. \le\\ Y or".
Carnegie Foundalion. 11)10. p. 16h.
4. Rlac"\\cll. Elilaheth. Pimll'l'r Ii or/- ill
Opcllillg thc H('dical Prolé.\.\ÙIIl t(/
II 01//('11. London. E\ery man'... Lihrar).
181)5.
5. \ldìllig.\Il. D.G. -I Dallgl'/'fIII.\ f II'l'ri-
I//clI1: 100 ) c(ln 01 11'01//('11 al tl1(' Ulli\'(,/,-
sity (
f Jlichií!wl. \nn \rhor. The Center
for Cominuing Educalion of \\omen.
l 'ni\cr,il
of \1ichigan. 11)70.
ó. Woodham-Smuh. CeCIl {I,l' LOllely
Cru\llder, .Ihndged edition of I her) Flor-
('IIC(' Vigl1ti/lgal('. \In\ '\ or"- 13alll.\l1l
Boob. p. !i!i. (originall
pllhli,heJ h

\kGra\\-Hill Boo" Co.. 11)51 J.
7 Cleland. Virginì.1. Sex di...crimilulion:
nur-.ing'... mo...( pena...\e pwhlcm. -Jill. J.
V/lI'S. 71: 154
-1547. \lIg. 1<)71.
R. I/Jid.. p. IS.U.

THE CANADIAN NURSE 35
.

new products

{

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

Dispo!lable vaginal SpH
Jlum
A new disposable v(!gìnal speculum from
Welch Allyn Inc. featurts (me-hand con-
trol for both angulation and c'
vation. and
a built-in muc
s harrier. There i
an op-
tional. reusable cordles
fiher optic
illuminator. which can be sterilized.
These specula are aV:.iJable in hoxes of
25, and are individually packaged in
sealed bag".
This product is available from a
number of distributors. including the J.
Stevens and Son Co. Ltd.. 2050 Kipling,
Toronto. Ont.; American Hospital Sup-
ply. 1076 Lakeshore Road East. Missis-
sauga. Ont., L5E 3B6; Ca"grain and
Charbonneau Ltée, 445 St. Laurent,
Montreal. Que.; and Dufort and Lavigne
Ltée. 1227 PI. Lafontaine, Montreal.

--.........-

..

,'-

'-

"'.

."

....

-

"""S, .

.,.

\

..

,

Disposahle \'aginal speculum

Literature Available
o The Ontario Hospital Association has
puhlished a 61-page hooklet entitled
Recipes For Controlled Fat Diets. It was
compiled by dieticians in the Lipid Clinic
at St. Michael's Hospital in Toronto.
This booklet provides a wide array of
recipes. and gives helpful hints for
"hopping. cooking. and eating oul. Each
recipe gives the number of exchanges
used per serving. The booklet supple-
ments the teaching aid. Questions and
AllSwers Ahout Your Fat Diet.
For a copy of this booklet. write to the
Dietetic Services Deparment. Educational
Services Division. OHA. 150 Ferrand
Drive. Don Mills, Ontario, M3C I H6.

o Chick Orthopedic Company in
California ha
puhli.,hed a hrm:hure that
36 THE CANADIAN NURSE

gives information ahout 21 ne\,\ or-
thopedic product". Included are the
Therma-Form knee splint. cervical col-
lar
, sling", splints. and postoperative
apparel. A free copy of the brochure can
be ohtained from Chick Orthopedic, 82 I
75th Avenue. Oakland. Calif. 9462L
U.S.A.

o So You Ha\'e a Foot Prohlem: The
Bunion Story is a 4-page leaflet prepared
by the American Orthopedic Foot Soci-
ety. Aimed at patients and the general
public, thi" illustrated leaflet answers
common questions about bunions and
their management _. both surgical and
nonsurgical. The leaflet can be ohtained
by writing to Henry R. Cowell. M.D.,
Secretary, American Orthopedic Foot
Society, V A Center, 1601 Kirkwood
Highway, Wilmington. Delaware 19805,
U.S.A.

Orthopedic products
Chick Orthopedic, California. has an-
nounced two new products - a tennis
elbow support and a knee splint. The
Therma-form Knee Splint introduces a
new concept in total knee management.
The vacuum-formed plastic splint sup-
ports the knee, at the recommended
degree of flexion, firmly and comfort-
ably. It i" lightweight, ventilated. and
lined with duck-covered foam, thus en-

I
Þ<
.
.
.
.
J .
.

Knn' Splint

suring stable support and patient comfort.
Onl) two sizes are necessary -
small/medium and large/extra large. The
splint comes in four
Iengths to
meet a
variety of support requirements: 12, 16,
20, and 24-mch lengths are available in
the two sizes. Kemovable [mer", an
additional feature especially important in
postoperative care, are available in cor-
responding lengths to fit each knee splint.
The new Tennis Elbow Support is
designed to treat "tennis elbow," "gol-
fers' elbow." and epicondylitis. Firm,
protective support is provided by heavy
cotton duck webbing and a comfortable
foam lining. The Chck Ortho-Pad-Lok
Velcro closure system permits easy appli-
cation using one hand and secure Velcro
closure. Completely washable, the sup-
port is available in one size to fit both
men and women. An 8-inch range of
adjustability allows each support to be
custom fitted to the user.
These products are available from the
J. Stevens and Son Co. Ltd., 2050
Kipling, Toronto, Ontario.

Calcisorb
ICN Canada has introduced Calcisorb
(sodium cellulose phosphate), a ne\,\
concept in the prophylaxis of renal
calculi.
Calcisorb is an ion exchange agent.
which binds calcium and other divalent
cations. By reducing the intestinal absorp-
tion of calcium, it lowers the renal
excretion of it.
It i" recommended that, in addition to
treatment with Calcisorb, patient" be
placed on a diet providing less than 400
mg of calcium a day.
More information is available from
ICN Canada Ltd., 675 Montée de Liesse,
Montreal 377, Quebec.

Kits save time
A new system of prepackaged kit
and
components for surgical skin preparation
has been developed by Davollnc.
The Davol Prepper lodo
hor Handle.
centerpiece of this system, i
basically a
foam !>ponge on a handle. prefilled with
either scrub detergent or anti"eptic paint.
The operator relea"e
the "olution by
snapping a "eal inside the
ponge; flow of
solution into the
ponge i
controlled by
gentl} !>lJueezing the handle.
Davol reports that the ne\\- kits elimi-
nate the need for putting up prepping
OCTOBER 1974

materiah and reprocessing them after-
\\.ard. Abo. the handles dispense Iodo-
phor s()lution
in premeasured amounts.
thus eliminating waste. The Prepper
handle has other advantages. The !'.pe-
cially texlUred sponges. \\.hich are differ-
ent for 'iCTub and paint- give beller
scrubbing and painting action than gauze
sponges: a lint-free operative site is
assured: and the distinctive appearance of
both eliminates confusion \\.ith the sponge
count.
Davol's Prepper handles <Ire individu-
ally packaged. as well as in kits that
contain .ill other elements needed for
presurgical prep. Also included in the
Prepper line are two "dry"' kits for
ho
pitals that prefer to dispense their own
solutions. These kits feature winged
sponges for scrubbing and handled paint
applicators for the antiseptic paint.
For more infonnation. write to Davol
Canada Lid.. 1033 Rangeview Road. Port
Credit- Ontario L5H I H2.

Pacing system analyzer
The new Medtronic Pacing System
Analyzer is a small device. which is held
in the hand to test separately the perfor-
mance of implantable pulse generators
and leads. as well as the performance of
temporary pacing equipment.
The device measures current flow, the
amplitude of the heart's R-wave. and the
pulse generator's output on a digital
readout. It can also pace the patient while
these tests are being performed.
The analyzer is used during pacemaker
implantations and whenever surgical in-
tervention is required to investigate
pacemaker malfunctions. For further de-
tails. write to Medtronic of Canada. Ltd..
6271-2 Donnan Rd.. M ississauga. Ont.

Midstream collection kit
Sage Products, Inc. has developed a new
Midstream Collection Kit. The contents
are packaged in order of use in a clear
blister pack. which allows the patient to
identify the instructions and contents
without touching anything before use.
The kit contains detailed instructions:
three individually packaged soap towel-
elles for pre-delivery preparation: a new
metal screw-top lid, to prevent leakage; a
graduated container with a convenient
spout: and a pressure-sensitive identifica-
tion label.
The completely disposable kit ha
an
airtight. moisture-proof Tyvek cover. The
cap location in the bottom of the kit
insures contamination-free removal by
the patient. The container's wide mouth
provides a large target area. and the
built-in pouring spuut aids handling of the
specimen in the lab. The container's
graduated measure is marked in milliliters
and ounces.
Thi'i product is distrihuted in Canada
by Ingram and Bell. Ltd.. 20 Bond
Avenue. Don Mills. Ontario.
OCTOBER 1 <J74

POSEY LIMB HOLDERS

rhe Po'e) Prm/uct, ,hov. II here are
but " lev. 0/ the m.JllY produch
which compme the complete
Pme) Lme Smce the mtroc/llLtlon
0/ the orlgmal Pmey
alety belt
m 1937, the Pmey Company
has specialized in hospital and
nursing products which provide
maximum patient protection and
ease 01 care. To insure the original
quality product, always specdy the
Posey brand name when ordering.

The Posey Adjustable Limb Holder
never tightens, always providing a
perfect fit. The limb holder is of a
soft, washable material and is avail-
able," either cotton or nylon. #2631
(coUon), $4.80Ipr.

The Posey Disposable Limb Holder
provides desired control at low cost.
#1.526 (wrist), $3.00Ipr. $33.00/dzpr.

þ

The Posey Leather Cuff provides de-
sired containment for the most ac-
tive patient. An added plus is the 24
inch keylock strap. #2204 (unlined),
$3630/pr.

..

---

}
.I

...

The Posey Deluxe Limb Holder has
synthetic fur lining for maximum
comfort and a Velcro closure to in-
sure perfect fit. #2625, $7.05/pr

'"
,

f'''J

.

,

;

",

The Posey Hand Control Mitts þre-
vent patients from remov'"g tubes and
scratching or otherwise '"lUring them-
selves, which is possible when hands
and fingers are not restricted. #2811
(cotton), $9.30/pr.

Send (or the (ree new POSEY catalog - supersedes al/ previous editions.
Please insist on Posey Quality - speci/y the Posey Brand name.

POSEY PRODUCTS Stocked in Canada

ENNS & GILMORE LIMITED

1033 Rangeview Road, Port Credit, Ontario, Canada

THE CANADIAN NURSE
.

j7

names

Hilda Rolstin was recently appointed
director of the division of nursing educa-
tion in the department of nursing. The
Hospital fÖr Sick Children. Toronto.
Ms. Rolstin. a graduate of the HSC
school of nursing. joined the hospital staff
in 1943. She has held many positions.
including that of chairman of curriculum.
She has also written History of the
School of NursinR, an entertaining ac-
count of the earl
days of HSCs nursing
school.

Barbara Racine has
been appointed to the
new position of assis-
tant executive di-
rector (nursing prac-
tice). Roval Colum-
bian . Hospital.
New Westminster.
B.C. Ms. Racine
.A (R.N.. Saskatoon
City Hospital school of nursing; B.Sc.N..
M.H.S.A.. U. of Alberta) previously was
associate director of nursing at the Royal
Alexandra Hospital. Edmonton. Alberta.

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'-

Anne Younie has joined the nursing
faculty at the Lethbridge Community
College, Lethbridge. Alberta.
Ms. Younie (R.N., Royal Alexandra
Hospital school of nursing. Edmonton;
B.N.. McGill U.. Montreal) has devoted
her nursing career to teaching and inser-
vice education at the Royal Alexandra
Hospital in Edmonton, the Jewish Gene-
ral Hospital in Montreal. and the Center
Pavilion Hospital in Houston. Texas; and
to orthopedic nursing at the Methodist
Hospital in Houston.

Marie Loyer has been appointed dean of
the University of Ottawa school of nurs-
ing. effective September I. 1974. She
su'Cceeds Yolande Fournier, who is ta"ing
on teaching duties at the school.

Ms. Loyer (Reg.N..
B.Sc" M.Ed.. U.
of Ottawa; M.A..
M.P.H.. Columbia
U.. New York) join-
ed the faculty ot
nur'iing at the uni-
versity in 1965. prior
to which she had
been engaged in pub-
lic health nursing in eastern Ontario.
Keenly aware of her professional re-
38 THE CANADIAN NURSE

-

\
"

sponsibilities. Ms. Loyer has served on
many nursing education committees and
is a member of several professional
associations. In 1968. she was elected a
fellow of the American Public Health
Association. and is the 1974-75 president
of the Ontario region of the Canadian
Association of Universit} Schools of
Nursing.

Margaret Ruth Page has been appointed
chairman of the school of nursing,
Lakehead University. Thunder Bay, On-
tario.
Ms. Page (Reg.N.. Victoria Hospital
school of nursing. London. Ont.;
B.Sc.N., Lakehead U.; M.P.H.. U. of
North Carolina. Chapel Hill) has had an
extensive nursing career. including gen-
eral and public health nursing. teaching in
hospital schools of nursing. welfare ad-
ministration. and nursing consultation
with the Ontario Ministry of Health.

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Margaret Page

Margaret Neylall

Margaret S. Neylan became assistant di-
rector. educational planning - nursing at
B.C. Medical Centre. Vancouver, on
September I. In addition, Ms. Neylan
will devote one-third of her time to her
new duties as chairman of continuing
education in the health sciences at the
University of British Columbia. a two-
year appointment.
Ms. Neylan (R.N.. Brandon General
Hospital schoul of nursing; B.N.. McGill
U.; M.A., U. of British Columbia) was
president of the Registered Nurses' As-
sociation of British Columbia from 1971
to 1973.

Ginette Bouffard of Quebec City and
Beatrice Jean of Muntreal. two Red Cross
nurses from the blood transfusion service.
are part of the medic/nutritional team of
five that is spending six months in Niger.
West Africa. Financed by the Canadian
International Development Agency, this

Red Cross team will distribute sup-
plementary food to children. pregnant and
nursing mothers. and will give instruction
in basic health and sanitation practices.

Shirley Shantz has been appointed co-
ordinator of nursing at Red Deer College,
Red Deer. Alberta. She came to the
college five years ago. as an instructor of
nursing. becoming acting coordinator in
January 1974.

Formerly. Ms.
Shantz (R.N" Royal
Alexandra Hospital
school of nursing,
Eumonton; B.Sc.N.,
U. of Alberta. Ed-
monton; M.N., U.
of Washington.
Seattle) was on the
teaching staff of the
Royal Alexandra School of Nursing in
Edmonton. Active in the Alberta Associa-
tion of Registered Nurses. she is currently
on the nursing education planning com-
mittee and the subcommittee on nursing
research.

,-.. .

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r

Elizabeth Stanton, who has been produc-
tion assistant to The Canadian Nurse
since 1967. was appointed secretary to
Helen K. Mussallem, executive director of
the Canadian Nurses' Association. Sep-
tember I. 1974.
Mary-Lou Downes, the new pròduction
assistant. was formerly advertising assis-
tant at Colonial Furniture. Ottawa.

Monique Audet
(B.Sc.O.T. Uni-
versitv of Montreal)
has been appointed
head of the depart-
ment of occupational
therapy of the Reha-
bilitation Institute of

. Montreal. She is also
,
a lecturer at the Uni-
versity of Montreal and the author of
several publications.

..,.' J "
, .....
...
--

,

The recipient of the first Judy HIli
Memorial Scholarship is Theresa Landry
of Belledune. New Brunswick. She will
use the $3,500. award to study mid-
wifery in Britain.
Ms. Landry will graduate in 1975 from
Gloucester Maternity Hospital in Britain
OCTOBER 1974

and then Join the medical services branch
of Health and Welfare Canada for posting
to a northern nursing station.

Alena Olga Valdstyn
wa
appointed nur-
sing director of the
Allan Memorial In.
stitute. Montreal. in
March 1974. She has
been associated with
the institute for many
years. Ms. Vald,tyn
(RN.,) Montreal Gen-
eral Hospital SchOOl ot nursing: H.N.,
McGiIl University) has also done exten-
sive work in interactional-process with
Ida Orlando in Boston. and group
dynamic work with the National Training
Laborator) .

.... '"
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'--

locelyn Staynes I
assistant operating
room supervIsor at the Montreal Chil-
dren's Hospital.
M
. Staynes (R.N., Winnipeg General
Hospital school of nursing) has devoted
much of her career to operating room
nursing following her post-graduate
course in operating room technique and
management at the Montreal General
Hospital. She worked in several of the
larger hospitals of Montreal and Toronto
prior to her current appointment.

Gwenith Ruth Frank
of Bateman has been
awarded the Kath-
leen Ellis Prize for
the most distinguish-
ed graduate in the
College of nursing
at the spring convo-
cation of the Univer-
J sity of Saskatch'ò:-
wan. Saskatoon. Saskatchewan.

...... ....

I. }

The Alumnae Association Inc. of the
Royal Victoria Hospital. Montreal has
awarded three bursaries:
Barb<ua McCracken Parr} (1955). to
complete a public health nursing certifi-
cate course at the University of Toronto;
Irene Mitche
on (1958). tó complete a
bachelor of nursing degree at McGill
University; and Karen Whitela" (1968),
to complete a bachelor of arts degree,
with a joint major in sociology and
psychology, at Sir George Williams Uni-
versity, Montreal.

Maureen A. Komlos ha
been appointed
director of the SI. Michael'
Hospital
campus oÎ the George Brown College of
Applied Arts and Technology She suc-
ceeds Sister Marion Barron.
Ms. "'omlo
(Reg.N., SI. Michael's
OCTOBER 1974

schoo
of nursing, Toronto; B.N., McGill
U.; B.A., Sir George Williams U.,
Montreal) has been on staff at SI. Mar) 's
Hospital in Montreal. and an instructor at
its school of nursing. She has been
associate director of SI. Michael's Hospi-
tal campus since 1971

Jane Clattenburg (R.N., Victoria General
Hospital school of nursing, Halifax: Dipl.
Nurs. Servo Admin., Dalhousie Univer-
sity: B.Sc.N., Mount St. Vincent Univer-
sity. Halifax) was elected president of the
Canadian Association of Neurological
ami Neurosurgical Nur,e:-. at its annual
meeting in Sa;katoon. She is unit instruc-
tor of the intensive care unit at Isaak
Walton Killam Hospital for Children.
Halifax. N.S.

Mohamed Rajabally (B. Sc . N . Ed..
University of Ottawa: Ed.M.. State Uni-
versity of New York at Buffalo) has been
appointed assistant director of nursing at
the Weiland County General Hospital,
WeIland. Ontario.

Before coming to
Canada, Rajabally
trained at the Dread-
nought Seamen's
Hospital, London,
and studied psychi-
atric nursing at Bex-
ley Hospital. Kent.
England. He has
been a general duty
nurse at Kingston General Hospital. a
research nurse at McMaster University
Medical Centre, and a nursing instructor
at the Hamilton and District School of
Nursing, now under Mohawk CoIlege of
Applied Arts and Technolog).

4

Walter Sawadsky (B.A., University of
British Columbia) has been appointed
assistant director of personnel services of
the Registered Nurses Association of
British Columbia. He was furmerly direc-
tor of membership services for the Civil
Service Association of Alberta.

Adam A. Rok (Reg. N., Ontario Hospital
school of nursing. Brockville; B.Sc. N.
<Ed). M.Ed., Universit) of Ottawa) is
coordinator of the new two-year R.N.
program at the College of New Caledonia
in Prince George, B.C. He wa, formerly
a staff nurse in a psychiatric unit of the
Royal Ottawa Hospital. prior to which he
was a nursing instructor in the two-year
dipluma program at Vanier School of
Nursing, Ottawa.

Winnifred M. Matheson (B.Sc.N.. Uni-
versity of Alberta) has been appointed
coordinator of nursing programs at Doug-
las College. New WcstminsteL B.C. She
wa
formerl
director of nursing at the
Burnaby General Hospital. Burnaby.

Norma Wylie (R.N..
Saskatoon Cit) Hos-
pital school of nurs-
ing: B.Sc.N.. Uni-
versity of British
Columbia, Vancou-
ver: M.Sc.N.. Uni-
versity of California.
San Francisco), for-
merly director of
nursing, McMaster University Medical
Centre, and associate professor. McMas-
ter University school of nursing, has
accepted a dual appointment in Halifax.
N. S. She is associate professor at
Dalhousie University school of nursing
and project director of the demonstration
patient-care unit of the Victoria General
Hospital.

.....

t

Nancy Poichuk has
been appointed re-
search officer with
the Canadian Nurses'
Association. She
earned her B.Sc.N.
and M.A.Ed. de-
., grees at the Univer-
- sity of Ottawa, with
measurement and
experimentation as her main field of
interesl.

- -

-
_.....

Kay DeJong (R.N.,
SI. Boniface General
Hospital school
nursing: B.N., Uni-
versity
of Manitoba)
has been appointed
continuing education
ad visor for the Man-
itoba Association of
Registered Nurses.
She has an extensive background in
nursing education and nursing service,
her most recent appointment being inser-
vice education coordinator at the SI.
Boniface General Hospital. St. Boniface,
Manitoba.

"

" I
.....

Josephine Giesbrecht (R.N., Victoria
General Hospital. Winnipeg: B.N.. Uni-
versity of Manitoba) has been appointed
director of patient care. Concordia Hospi-
tal. Winnipeg. She has been director of
nursing at Bethesda Hospital in Stein-
bach. Manitoba, since 1959: has been a
member of both Manitoba health organi-
zations pre-accreditation survey teanl.' for
hospitals. and a member of accreditation
survey teams of the Canadian Council of
Hospital Accreditation.

Kay Froese (R.N.. Grace General Hospi-
tal. Winnipeg: B.N.. Universit) of Man-
itoba) wa
appointed director of nursing.
Grace General Hospital, Winnipeg in
October. She was formerly director ot
,taff training and development at Grace
Hospital.

THE CANADIAN NURSE 39

Next Month
in

The
Canadian
Nurse

. Identifying the
Suicidal Person

. The Psychology
of Childbirth

. The Private Self
and the Professional Self

. RNs in Office Practice

ð

Photo Credits
for October 1974

V.O.N. National Office, Ottawa,
ant., p. 10

McMaster University
Medical Centre,
Hamilton, ant. pp. 20, 22

Toronto General Hospital,
Toronto, ant. pp. 28, 29

40 THE CANADIAN NURSE

dates

October 16-19,1974
Joint annual and scientific sessions,
Canadian Council of Cardiovascular
Nurses, Canadian Heart Foundation, and
Canadian ;Cardiovascular Society, Win-
nipeg, Manitoba. For further information.
write to: Canadian Heart Foundation, Suite
1200.1 Nicholas St.. Ottawa, K1N 7B7.

October 1974 & April 1975
Four-week, full-time, postdiploma prog-
ram in coronary care nursing for registered
nurses. Humber College, Rexdale, On-
tario. Part-time, evening program from
November to March also offered. For
further information, contact: Office of the
Registrar, Humber College of Applied Arts
and Technology, P,O. Box 1900. Rexdale.
Ontario, M9W 5L7.

October 23, 1974
Health team conference on "The Art of
Understanding - Care and Caring," Mc-
Master University Medical Centre, Hamil-
ton, Ontario. For more information,
contact: Ms. M. Ford, LC.SLT., Coordi-
nator of Education, Canadian Cancer So-
ciety, 204 Eglinton Ave.. E., Toronto. Ont.
or Dr. D. Kergin, Associate Dean, School
of Nursing, McMaster University, 1200
Main St., W., Hamilton, Ontario.

October 27-30,1974
Winnipeg Centennial Symposium. Theme:
Dilemmas of Modern Man. Keynote
speaker: Alvin Tottler. For information
write to: Winnipeg Centennial Symposium,
60 Osborne Street North. Winnipeg. Man-
itoba, R3C 3A5.

October 27-30, 1974
The first annual congress of the American
Association of LV. Therapists will be held
at the Conrad Hilton Hotel. 720 S. Michigan
Ave., Chicago, III. Mail inquiries to: Sue
Miller, R.N., American Association of LV.
Therapists, P.O. Box 501, Andover, Mass.
01810.

November 4-6, 1974
Order of Nurses of Quebec annual meet-
ing. Queen Elizabeth Hotel. Montreal.

November 25-27, 1974
University of Ottawa school of health

administration seminar on approaches to
and effects of hospital bed closures. For
information write to: Barbara Schulman.
Coordinator, Continuing Education Pro-
gram, School of Health Administration.
University of Ottawa. Ottawa, Ontario,
K1 N 6N5.

December 2-5, 1974
University of Manitoba Health Care Evalu-
ation Seminars to assist professionals to
develop an understanding of methods and
techniques required for demonstration and
evaluation of health care projects. Special
focus will be on the application of social
sciences in health car
research. For
further information, write to: Susan Hicks,
Dept. of Social & Preventive Medicine,
Faculty of Medicine, U. of Manitoba, 750
McDermot Av
., Winnipeg, R3E OW3.

May 26-30, 1975
Canadian Public Health Association 66th
annual meeting, Hotel MacDonald. Ed-
monton, Alberta. Abstracts will be received
up to
ecember 16 by Dr. J. M. Howell,
Chairman Scientific Program Committee.
Sturgeon Health Unit, Box 174, SI. Albert,
Alberta, T8N 1 N3. General inquiries to be
addressed to CPHA, 55 Parkdale Avenue,
Ottawa. Ontario. K1Y 1 E5.

June 1975
St. Joseph's School of Nursing Alumnae,
Victoria, B.C., 75th anniversary reunion.
For further information, write to: Ms. Phyllis
Fatt. 4253 Dieppe Rd.. Victoria. B.C.. V8X
2N2.

June 22-27, 1975
Tenth International Congress of Gerontol-
ogy (and Geriatrics), Jerusalem, Israel.
For further information, write to: Con-
gress, P.O. Box 16271, Tel Aviv,lsrael.

August 11-16, 1975
World Assembly of War Veterans, to
commemorate the 30th anniversary of the
end of World War II, Sydney, Australia.
Pre- and post-convention tours available.
Registration fee: $A. 30.00. For further
information. write to: Assembly Secretar-
iat, G.P O. Box 2609, Sydney. N.S.w.,
2001. Australia. ';,-.
OCTOBER 19/4

Your patients
will amaze
you . . .

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so will retelast

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Your patients will be back to normal in no : ,':ow,,- \.\\. . t
nothing happened. ' ,'
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\
NOT SURPRISING. . ,," " "
RETELAST is so comfortable and gives . : 1 # '- .'
such fast relief. Moreover, RETELAST
t
costs up to 40% less than any other t ,
dressing or traditional bandage. I

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OCTO lABORATORY l TO
\
laval, Quebec
æ CANADA PHARMACAL CO. l TO ,
Toronto, Ontario

DEMONSTRATION
AND FOLDERS
UPON REQUEST

-

research abstracts

fhe folll)\\ ing arc ah
tracts of
tudics

dected fron
the Canadian Nurses'
As
ociation Repository Collection ot

ursing Studies. Ahstract l11anu
cripts
arc prepared hy the authors.

Holder, Janet Margaret. The developmem
of an interview guide to identify
nursing needs of elderly people living
at home. Toronto. Ont.. 1974. Thesis
(M.Sc.N.) U. of Toronto.

The purpose of this study was to develop
an instrument for use by public health
nurses to identify the nursing needs of
elderly people living at home. The
specific objectives of the study were:
I. to develop an interview guid
by
which public health nurses can identify
nursing needs of elderly people living at
home, during a home visit;
2. to test the feasibility of the guide in
identifying expressed and observed nurs-
ing needs of elderly people living at home
in one urban housing development; and
3. to use findings of the test as a basis
for the revision of the interview guide.
Criteria for the measurement of nursing
needs of such elderly people were de-
veloped around six major areas of con-
cern. A patient interview guide based on
these criteria was designed by the inves-
tigator. It was primarily precoded. The
method adopted was that of the semistruc-
tured interview.
The instrument was tested during home
visits to a sample of 50 elderly people
living in one Ontario Housing apartment
building in Metropolitan Toronto.
The findings yielded data that were
pertinent to the assessment of nursing
needs of the respondents. In
4 percent of
the sample it was found that the provision
of public health nursing service could be
expected to produce favorable change in
regard to the health problems identified.
Nursing needs for teaching nutrition
occurred in 60 percent of the sample. and
for teaching or supervision concerning
prescribed medications, in 28 percent.
Also 13 percent could benefit by a
monitoring of their blood pressures. Only
6 percent of this sample needed physical
nursing care.
A rather serious area of nursing needs
was found in the extreme loneliness and
anxiety of 22 percent of respondents. The
prevalence of reported chronic illnesses
and multiprescription drugs being used.
42 THE CANADIAN NURSE

indicated the possible complexities of the
health problems presented by these el-
derly people.
Based on the experience gained in
using the guide. a revised patient inter-
view guide was designed. It is believed
that the use of the guide will contribute to
improvement in nursing care of elderly
people by supplying to staff nurses and
their supervisors the data needed for
planning nursing service on both an
individual and a group basis.

Mills, Lenore Isobel. Quality of nursing
care measured by audits of nursing
records and patiems' perceptions. To-
ronto. Ont.. 1974. Thesis (M.Sc.N.)
U.ofToronto.

This investigation focused on evaluating
the quality of nursing care through pro-
fessional judgments and patients' percep-
tions. Its primary purpose was to deter-
mine the nature and extent of discrepan-
cies between audits based on nursing
records and patients' perceptions of care.
A descriptive survey was conducted to
assess the quality of care of a selected
group of 35 patients with diseases of the
circulatory system, who had recei ved care
from a visiting nurses' association. Data
were collected over a three-month period
by interviewing subjects and auditing
their nursing records.
In this study the variable. quality of
care. was measured in three ways. The
first furnished baseline data about the
quality of care provided by the visiting
nurses' association. This was established
by the Phaneuf Nursing Audit, a 50-item
instrument designed and validated to
measure the quality of nursing care
through a retrospective examination of
the nursing records of patient care.
The second measurement provided pa-
tients' evaluation through their percep-
tions of nursing care. A Patient Audit. a
35-item instrument that somewhat paral-
leled the instrumentation of the Phaneuf
Nursing Audit. was designed to elicit this
information.
In addition. a 35-item Modified Nurs-
ing Audit was derived from the Phaneuf
Nursing Audit so that nurse and patient
assessments of the quality of care could
be directly compared.
The data were analyzed by hand
tabulation. Statistical calculations were
restricted to comparative counts, express-
ed in percentages.

The overall level of care provided by
the visiting nurses' association scored in
the 'Incomplete" range of quality when
rated by the Phaneuf Nursing Audit.
Generally. patients perceived their nurs-
ing care to be of higher quality than that
indicated by an assessment of nursing
records.
The level of agreement between the
Modified Nursing Audit and the Patient
Audit was less than anticipated. A com-
parison of specific a<;pects of nursing care
in relation to high and low agreement
items indicated
n association
between
high level of agreement and high quality
of care. Additional analysis of level of
agreement in relation to the quality of
care revealed no real differences in the
way patients perceived "good." "in-
complete," and "poor" levels of nursing
care.
Due to the nature of the sample and the
lad. of test validity for both the Modified
Nursing Audit and the Patient Audit
instruments. final conclusions drawn
from this study were necessarily tentative
and cannot be generalized. Findings
supported the following:
I. Quality of nursing care of the visiting
nurses' association may be improved by
implementing corrective action in the
lower scoring areas identified by the
Phaneuf Nursing Audit.
2. Quality of nursing care. based on an
audit of patients' perceptions. is higher
than that based on an audit of nursing
records.
3. There appears to be no definitive audit
relationship between level of agreement
and quality ot care.

Kay, Gloria Violet. Pre-cardiac catheteri-
zation information perceived as help-
ful by patients. Toronto. Ontario.
1974. Thesis. (M.Sc.N.) U. of To-
ronto.
This descriptive study was undertaken to
identify information which. if possessed
in advance, would help patients undergo-
ing cardiac catheterization meet their
needs before and during the procedure.
The aims were to provide knowledge
upon which to formulate patient-teaching
programs; and to obtain information thdt
would serve as a guide for nurses in
establishing therapeutic relationships with
these patients.
Subjects were a selected sample of 52
patients interviewed on the patient-care
OCTOBER 1974

eans to meet the
demands of)Our
changing field Í1l
new Mo , texts

New 7th Edition!

Gragg-Rees

SCIENTIFIC PRINCIPLES IN NURSING

This new edition provides a theoretical model, using a
variety of physiological, psychological, and sociological
concepts, for effective application of scientific principles in
daily patient care. Students are given a solid base for
understanding, motivation for independent study, and an
awareness of their role within the framework of the health
care team.

Bt SHIRLEY HAWKE GRAGG, R.N., B.S.N., M.R.E.; and OLIVE
M. REES, R.N., M.A. May, 1974.564 pages plus FM I-X, 7" x 10",
257 illustrations. Price, $10.80.
A New Book! Kramer
REALITY SHOCK: Why Nurses Leave Nursing
This stimulating new book reports fully on an eight-year
study of the problem of "reality shock" among young
graduate nurses and the effectiveness of a new program, the
Anticipatory Socialization Program, in dealing with it.
Through interesting discussions, it provides new insight into
how nurses can deal with this situation and cope with
conflict situations in a growth-producing manner.
By MARLENE KRAMER, R.N., Ph.D. May, 1974. 250 pages plus
FM I-XII, 7" x 10", illustrated. Price, $7.90.

A New Book!
COMMUNICATIONS AND
RELATIONSHIPS IN NURSING

O'Brien

In this new book, the author studies commonalities of
human nature relevant to communication; proceeds to basic
facets of communication skills; and closes with specific
communication problem situations. Topics include self-
awareness, use of appropriate language, and reality percep-
tion. Ten "communications interactions" demonstrate
principles discussed.
By MAUREEN J. O'BRIEN, R.N" M.S. May, 1974. 180 pages plus
FM I-XII, 5y".. x 8y"... Price, $5.20.

\

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'-

A New Book'

Johns

PHARMACODYNAMICS AND PATIENT CARE

Using a unique approach, the author of this new text
presents drug content within the context of patient
problems and demonstrates nursing actions that contri-
bute to effective drug therapy. She shows the inter-
relationship . of physiology, pathophysiology, pharmaco-
dynamics and nursing concepts; stresses drug action in the
body; and studies drugs in groups based on commonalities
of effect.
By MARJORIE P. JOHNS, R.N., B.S., M.S. January, 1974. 337
pages plus FM I.XII, 7" x 10",62 illustrations. Price, $8.95.
A New Book! Bergersen-Sakalys
REV!EW OF PHARMACOLOGY IN NURSING
(Mosby's Comprehensive Review Series)
In an easily understood question-and-answer format, this
new text explores basic pharmacologic action and its
clinical application. Emphasizing major drug categories, it
discusses prototype drugs in each. It stresses the nurse's
responsibility for drug administration, careful observation
of patients for drug effects, and avoidance of error and drug
induced harm.
By BETTY S. BERGERSEN, R.N., M.S., Ed.D.; and JURATE A.
SAKALYS, R.N., M.S. May, 1974. 234 pages plus FM I.VIII, 5y".. x
8y"... Price, $5.50.
New 3rd Edition! Saxton-Walter
PROGRAMMED INSTRUCTION IN
ARITHMETIC, DOSAGES, AND SOLUTIONS

This new edition helps nursing students overcome the
confusion surrounding the arithmetic necessary to safely
prepare and administer medications. Apothecaries', metric,
and household systems of measurement are introduced.
By DOLORES F. SAXTON, R.N., B.S., M.A., Ed.D.; and JOHN F.
WALTER, Sc.B., M.A., Ph.D. June, 1974.66 pages plus FM I.X, 7"
x 10". Price, $4.75.

MOSBY

TIMES MIRROR
THE C V MOSBY COMPANY L TO
B6 NORTH LINE ROAO
TORONTO. ONTARIO
M4B 3E5

research abstracts

units of a large metropolitan hospital 6 to
8 hours postcatheterization, using an
interview guide of closed and openended
questions.
Findings indicate that information pa-
tients perceived to be most helpful could
be classified as a combination of
procedure-oriented and sensation-
oriented information. As expressed by
patients, the types of information desired
prior to catheterization were:
I. knowledge of what to expect,
2. descriptions of sensations to be expen-
enced. 3. reassurance of ability to cope.
and 4. time factors involved in the total
experience.
Four- fifths of the patients reported their
prepocedure information as adequate, but
desired more knowledge about
procedure-associated sensations,
pain/discomfort, and technical aspects of
the procedure as they affect their persons.
The investigator suggests from this that
the patients' hierarchy of concerns are
fear of pain. desire for abil ity to cope, and
knowledge of what to expect.
Ranked in order of patient-perceived
importance, most helpful sources of in-
formation were physicians. other pa-
tients. relatives and friends, and nursing
staff. Almost half the study sample found
nurses neither helpful nor reassuring.
When patients took the initiative in
securing information. they invariably
used interpersonal sources.
The medical literature, which indicates
the procedure to be innocuous and pain-
less. was not substantiated by patient
judgment. Patients assessed pain as mod-
erate during. and moderate-to-mild after
catheterization.
All patients expressed anxiety at some
period in the total catheterization process,
and over half were classified as highly
anxious all the time. Patient.. feared the
unknown, pain, death or incapacity.
possible surgery. and were conceroed
about changes in life-style and in family
economic and general welfare.
During catheterization, patient anxiety
focused specifically on the procedure,
with patients exhibiting alert and watchful
behavior. Subjects expressed grave con-
cern at unexpected events and unusual
cardiac sensations. They feared staff
might make mistakes. and monitored staff
conversation and behavior for signs of
these.
It i!> recommended that: I. patients
undergoing cardiac catheterization re-
ceive well-planned group patient-teaching
programs early in their hospital stay. with
additional attenti0n to individual informa-
tion and emotional needs; 2. nurses caring
for the
e patients increase their know-
44 THE CANADIAN NURSE

ledge about the procedure. develop skills
in recognition and assessment of patient
anxiety, and evolve therapeutic measures
for the provision of reassurance and
reduction of anxiety.

Anderson, Eunice Brataschuk. An exp-
loratory study of the nature of the
patients' understanding of three
selected neurological diagnostic pro-
cedures. London, Ont., 1973. Project
(M.Sc.N.) U. of Western Ontario.

A descriptive pilot study was conducted
to collect data regarding the patients'
understanding of three selected neurolog-
ical diagnostic procedures. A conveni-
ence sample of II adult patients undergo-
ing cerebral angiography, air encephalog-
raphy, and myelography was employed.
The study was set in two neurological
and neurosurgical units in a large general
hospital in south-western Ontario. Tools
used to collect the data were two struc-
tured interview schedules, a graphing
rating scale measuring adequacy of given
information, and a projective word list
summarizing the overall experience dur-
ing the diagnostic procedure.
Questions for which answers were
sought were:
I. Prior to a patient having a neurolog-
ical diagnostic procedure: (a) what are the
patient's sources of information? (b) how
does he evaluate his sources of informa-
tion? (c) what information does he have
regarding the diagnostic procedure? (d)
how does the actual information received
by a patient compare with the potential
amount of information that could have
been received?
2. Following a diagnostic procedure:
(a) how do patients evaluate their overall
experience during the diagnostic proce-
dure and the adequacy of information
they received about the procedure? (b)
what information would they have liked
to have known prior to the diagnostic
procedure? (c) what recommendations
would they make regarding infonnation
that future patients should receive?
Findings revealed that: I. most patients
had a general idea of what the test
entailed, although only three of them
knew the test by name; 2. physicians
provided the most helpful information to
patients; 3. lay sources, such as other

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ommunity needs
the benefit of yoU!
skills and experience.
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nursing and child care courses.
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patients, provided the patients with a
substantial amount of information; 4. few
patients validated with medical personnel
the information they received from lay
sources; 5. physicians and nurses pro-
vided less than 30 percent of potential
infonnation regarding each phase of the
procedure; 6. all patients knew about
three of the 23 potential items of informa-
tion; 7. trends regarding information
patients would have liked prior to the test
could not be established from the data; 8.
there was some indication that patients
should be told about presedation and
postprocedural disc om fort.
Further studies are indicated to validate
the tools and to identify other factors
associated with information needs of
patients.

Beck, Terry Lindsay. A study to examine
and describe nurse practitioner res-
ponsibility for primary health care.
New Haven, Conn., 1974. Thesis
(M.S.N.) Yale U.

A factor-searching and factor-relating
study examined and described nurse
practitioners' responsibility for primary
health care. Observations of 14 nurse
practitioners, including nurse-midwives.
were recorded in 149 patient situations in
three ambulatory settings. Informal dis-
cussions and brief interviews supplement-
ed observations.
Narratives describing patient situations
were qualitatively analyzed. Some nurse
practitioner and patient characteristics
were quantitated.
A common patient care process emer-
ged from patient situations: health prob-
lem, assessment plan, assessment. iden-
tification of findings, problem definition,
prescription. and intervention. Varying
patterns occurred within and among
components.
Major generated categories of respon-
sibility - complete responsibility for
patient situations, partial responsibility
for patient situations, and primary health
care functions only - reflected the extent
of nurse practitioner responsibility for the
patient care process. Within major cate-
gories, subcategories denoted nurse prac-
titioner completion of the process compo-
nents. Nurse practitioners consulted phy-
sicians for assistance with decisions.
Identified factors influencing responsi-
bility were: practice type, standing or-
ders, scope of practice, characteristics of
health problems. nurse practitioner educa-
tion and experience, and physician wil-
lingness to share responsibility.
The findings suggested further studies
to delineate nurse practitioner practice,
identify patient situations suitable for
independent nurse practitioner manage-
ment, and compare nurse practitioners
among situational variables. .

OCTOBER 1974

eans to meet the
demands of ytJur
changing field ill
new Mosby texts

New 2nd Edition!

Lerch

MATERNITY NURSING

This new edition charts, in sequence, the course of growth
and development in the maternity cycle. New information
includes advances in neonatology, fetal and maternal
monitoring and new emphasis on the husband's role in
sharing the birth experience and cooperating in infant care.
By CONSTANCE LERCH, R.N., B.S.IEd.l. July, 1974.432 pages
plus FM I-XII, 7" x 10",189 illustrations, including one color plate.
Price, $11.50.

3rd Edition.

Lerch

WORKBOOK FOR MATERNITY NURSING

Realistically balanced between fundamentals and applica-
tions, this popular workbook correlates technical duties
with personalized, family-centered care. It deals with all
subjects of maternity nursing including nutrition, high-risk
pregnancy, the prenatal clinic, and care of the neonate.
Biological, physiological and psychological aspects of preg-
nancy and parenthood are effectively interwoven.
By CONSTANCE LERCH, R.N., B.S.IEd.l. 1973, 194 pages plus
FM I-VIII, 7%" x 10W', 37 illustrations. Price, $5.55.

A New Book!

Lipkin

PSYCHOSOCIAL ASPECTS OF MATERNAL-
CHILD NURSING

Directed toward the family unit and psychosocial factors
influencing family development, this book considers preg-
nancy, labor, delivery, and postpartum situations in psycho-
social perspectives. It details the pregnant couple, the
postpartum couple, the child from birth to six years and
from six to juvenile, the juvenile. adolescent, and the
terminally ill child.
By GLADYS B. LIPKIN, R.N., M.S. May. 1974.160 pages plus FM
I-XII, 7" x 10", 37 illustrations. Price, $6.85.

\

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A New Book!

Roberts

REVIEW OF PEDIATRIC NURSING

Centeri ng on the fam i Iy. th is new text provides an excellent
review of all essential elements of pediatric nursing. The
question-and-answer format allows students to prepare for
exams and also allows the student or practitioner to review
the basics. Structured around the wellness-illness con-
tinuum, it enables students to consider all aspects of a
particular situation: psychosocial; economic; pathogenic;
diagnostic; nursing management; and much more. A special
section reviews drug dosages.
By FLORENCE BRIGHT ROBERTS, R.N., M.N. March, 1974. 178
pages plus FM I-XII, 5%" x 8%". Price, $6.25.

Bryan

SCHOOL NURSING IN TRANSITION

Specific guidelines are presented for developing, administer-
ing, and supervising modern school nursing 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. community
and school personnel. Problems discussed include health
appraisal and communicable disease care.
By DORIS S. BRYAN, R.N., M.P.H., Ph.D. 1973,204 pages plus
FM I-XIV, 7" x 10",57 illustrations. Price, $8.40.

MOSBY

TIMES MIRROR
THE C V MOSBY COMPANY. L TO
86 NORTHLINE ROAO
TORONTO. ONTARIO
M4B 3E5

.

books

Nursing Care in Eye, Ear, Nose, & Throat
Disorders, 3ed., by William H.
Havener, William H. Saunders, Carol
Fair Keith, and Andra W. Prescott.
459 pages. Toronto, Mosby, 1974.
Reviewed hy LmlÍse Hemming, Clini-
cal lnstrttctor, School of Nursing,
Vancouver General Hospital, and
Man M. Carmichael. Head Nurse,
Ophthalmology, Vancouver General
Hospital, Vancouver, B.C.
The third edition of Nursing Care in Eve,
Ear, Nose, and Throat Disorders is
improved by a better format, more read-
able type, and updated illustrations.
The authors' stated purpose is to present
a book to "assi!>t the nurse in her
expanding role in the health care system,
including outpatient, inpatient and
home-going preparations" and to "assist
the nurse in her development of a plan of
care based upon a better understanding of
the pathophysiology, the treatments and
the related problems of patients with eye,
ear, nose. and throat disorders."
Although there is little new material in
this edition, the section related to eye care
presents a good overview of the more
common eye disorders, their etiology,
and treatment. The material is basic, and
no attempt has been made to present a
study in depth.
The section on nursing care is more
specific. Especially pertinent is the chap-
ter, "Nursing Philosophy, Care and As-
sessment of the Patient with a Visual
Disability. " This book provides a good
introduction to ophthalmic nursing.
The section dealing with ear, nose, and
throat disorders has good detail. Material.
based on an excellent outline of anatomy
and physiology, will prepare the nur
e to
emphasize prevention of disease and to
better under!>tand the disease proces!>. She
will also be better prepared to prevent
complications and to provide home care
follow-up.
A chapter on "Hearing impairment,
the nurse's role" will be useful to any
nur!>e. whatever role in nursing she plays.
Few nursing programs offer adequate
instruction and/or ex perience in eye, ear,
nose, and throat disorders. Keeping this in
mind. this book will be useful to student
nur!>es, practical nurses. and beginning
graduate nurses in eye. ear, nose. and
throat units, and to nurses involved in
public health and home care.
46 THE CANADIAN NURSE

For the book to be fully useful in
Canada, metric values should be noted in
brackets. and organizations to give assis-
tance to the blind should be included with
the American organizations listed in the
appendix.

The Process of Staff Development; Com-
ponents for Change, by Helen M.
Tobin et aL 174 pages. St. Louis,
Mosby, 1974. Canadian Agent: To-
ronto. Mosby.
Reviewed bv Amv M. Zelmer, Assis-
tant ProfeSsor, 'School of Nursing,
University of Alberta, Edmonton. Al-
berta.

This book was written as a guide to those
responsible for developing staff education
or development programs within nursing
service departments. To some extent. the
authors have adopted a "cook book"
approach, but they have also included a
good deal of useful background informa-
tion about motivation, adult learning, and
historical development.
The term" staff development," as used
in this book, covers any educational
activity that contributes directly to per-
formance at work. The authors examine
its relationship to continuing education as
a whole and indicate that not all develop-
ment activities need take place within the
agency. But they do not give much
guidance that would help the planner
evaluate external programs. The bulk of
the content deals with the development ot
orientation and education programs in
large health care agencies.
Nurses who are working in established
programs will probably first turn to the
chapters on design and implementation.
selecting teaching methods and aids, and
evaluation. These provide a brief over-
view of many of the important points to
be considered in day-to-day operation.
Obviously, the scope must be limited
in a book of this size, but I would like to
have seen a more direct comparison
between the costs and the pros and cons
of the various methods discussed: a brief
list of examples of materials suitable for
staff development might also help those
just beginning to develop programs.
The chapter on "future directions"
provides a succinct introduction to some
of the important new issues. including
changing roles of nurses, peer review,

mandatory continuing education. and in-
stitutional licensure. The bibliography is
quite extensive and current. although
American oriented.
This book will be of interest to nur!>es
concerned with development, implemen-
tation. and evalu3tion of orientation.
inservice. and other staff development
programs. The program examples used in
the text presuppose a large agency, but
the same principles would be helpful to
those working in small hospitals and
health agencies.

New Dimensions in Mental Health-
Psychiatric Nursing, 4ed., by Marion
E. Kalkman and Anne J. Davis. 690
pages. New York, McGraw-Hili,
1974. Canadian Agent: Scarborough.
Ont.. McGraw-Hili Ryerson.
Reviewed by G. Harder, Registrar-
Counselor, St. Boniface School of
Nursing, Winnipeg, Manitoba.

This book should be useful to beginning
students and to nurses already experi-
enced in psychiatric nursing. Ten of the
contributing authors are nurses, and the
emphasis is on providing information that
can lead to nursing activities - in the
home, the school, the community at
large. or in the hospital setting. This
contributes to meeting the stated objec-
tive: "To provide advanced content in
mental health-psychiatric nursing which
nurse practitioners need to meet the
demands of new professional roles. .,
Six broad topics are considered: the
historical development of the role of
psychiatric nursing; mental health and six
developmental stages of the life span;
models of treatment; environmental influ-
ences on mental health and mental illness;
psychotherapy and the nurse: and
psychiatric nursing and research.
Different models of the development
and treatment of psychiatric disorders are
presented; among them are medical,
behavioral. and developmental models.
Each model is defined and a full discus-
sion lead
into a section on implications
for nursing.
The nurse is seen as "the key person in
the whole area of prevention." There-
fore, nursing intervention at the primary.

econdary. and tertiary levels is discus-
sed by the authors.
For mental health workers with con-
OCTOBER 1974

eans to meet the
demands of}Our
changing field Í1l
new Mosby text$

A New Book!

Hilt-Schmitt

PEDIATRIC ORTHOPEDIC NURSING

This new book provides comprehensive information from
one source on the care of the pediatric orthopedic patient.
It covers the nursing care requirements, techniques, and the
basic medical and technical background knowledge neces-
sary for this specialty.
By NANCY E. HILT, R.N.; and E. WILLIAM SCHMITT, Jr., M.D.
January, 1975. Approx. 224 pages, 7" x 10", 291 illustrations.
About $11.50.

labunski et al
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 oppor-
tunities 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.S.N.; BARBARA
PURAS STELMAN, R.N., B.S.N.; MARY ANN PUGH
RANDOLPH, R.N., B.S.N.; DOROTHY SAVICH, R.N., B.S. 1973,
331 pages plus FM I-VIII, 7%" x 10%". Price, $6.25.

A New Book!

Morel-Wise

UROLOGIC ENDOSCOPIC PROCEDURES

This is the only nursing tt ;t to offer a comprehensive view
of urologic-endoscopic procedures. Topics include historic
development; the urologic-endoscopic suite; preparations
for urologic procedures; care of equipment; and more.
By ALICE MOREL, R.N.; and GILBERT J. WISE, M.D., F.A.C.S.
May, 1974. 164 pages plus FM I-XII, 6
" x 9
", 172 illustrations.
Price, $10.00.

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t

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"

A New Book!

Conover

CARDIAC ARRHYTHMIAS:
Exercises in Pattern Interpretation
With this new book, you can avert potential cardiac crises
by being alert to the danger signals. Common and rare
patterns - more than 200 - are included to broaden and
reinforce expertise in interpretation of arrhythmias.
Students are prompted to make the step-by-step deductions
that will lead to an accurate conclusion and are supplied
with an analysis of how they could have arrived at a correct
diagnosis. Exercises progress from those dealing with
arrhythmias originating in the sinus node to atrial, ven-
tricular and junctional ectopics.
By MARY H. CONOVER, R.N., B.S.N.Ed. January. 1974.292
pages plus FM I-X, 8" x 10", with 234 ECG tracings. Price, $8.95.

A New Book!

Tobin et al

THE PROCESS OF STAFF DEVELOPMENT:
Components for Change
This new book sets guidelines for establishing or altering
staff education programs and relates staff development to
the overall continuing education effort. Areas discussed
include: the history of staff development; adult learning;
motivation; organization and administration; philosophy;
and learning needs. Sample organizations, teaching plans,
and policies are presented in the appendices. The authors
also show how programs can be modified to fit available
resources.
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 CLARK
SCOTT, R.N., M.A. April, 1974. 174 pages plus FM I-XII, 7" x 10",
21 illustrations. Price, $9.40.

MOSBY

TIMES MIRROR
THE C V MOSBY COMPANY. L TO
86 NORTHLINE ROAO
TORONTO ONTARIO
M4B' 3E5

books

temporary concerns. there are such topics
as gay liberation. dual-career families,
women's lib, and the sexual adjustments
of the middle-aged person who is neither
married, lesbian. nor homosexual.
The outstanding feature of this book is
the list of excellent references. The
authors have searched the literature for
representative points of view. These are
well documented as they are brought I.Ho
focus. An extensive reference list follows
each chapter.
This is a book that both teachers and
students will find valuable.

Reality Shock: Why nurses leave nursing
by Marlene Kramer. 249 pages. St.
Louis. Mosby. 1974. Canadian Agent:
Toronto. Mosby.
Revieu'ed by DorOlhy 1. Kergin, Pro-
fessor of Nursing, McMaster Univer-
sity, Hamilton, Ontario.

This text is a report of the author's
eight-year study on the problem of "real-
ity shock" as experienced by young
graduate nurses, primarily degree gradu-
ates. In addition. an educational program
designed to sensitize the undergraduate
students to attitudes and values in em-
ployment settings and thus reduce the
stress of their later employment is de-
scribed and evaluated.
The overall purpose of the educational
program and related projects was to
reduce exodus from nursing practice and
"job hopping." and to increase retention
of "happy, effective nurses in hospital
settings." The educational program (an-
ticipatory socialization program) was pre-
ceded by a study to determine the initial
effect of work. on the role values of new
baccalaureate graduates.
Students enrolled in University of
California classes of 1969 and 1970
constituted the experimental group; those
who achieved degrees in 1968 served as
controls. The experimental group was
exposed to the educational program. The
latter attempted to provide challenges to
the students' professional value systems,
anticipating that small "immunizing"
doses would assist the nurses. as
graduates. to resolve more satisfactorily
later system conflicts.
The findings indicate that. compared to
the control group, subjects in the experi-
mental group experienced no signirf\:ant
differences in overall withdrawal rate
from nursing as students. But as
graduates they did significantly less job
hopping and remained in hmpital nursing
practice longer during the two-year
folluw-up period.
48 THE CANADIAN NURSE

Instruments administered in the study
Nere designed to assess professional role
:onception, professional and bureaucratic
nodes of organizing work. professional
reading and similar behavior. and the
degree to which changes initiated by
subjects were perceived by co-workers as
being effective. The experimental group
scored significantly higher on the last
three measures. with no significant dif-
ferences between gropus on the first
measurements.
Reality Shock should serve as a useful
reference for students and faculty of
degree and diploma programs in nursing.
as well a<; those associated with graduate
programs. Faculty in all programs mIght
well assess whether or not their graduates
have the skills to cope constructively with
school-work value conflicts. Inservice
educators will be particularly interested in
Chapter 6 by Patricia Benner. which
describes a special "reality shock" orien-
tation program of six seminars, provided
for 16 new degree and diploma graduates
employed in a hospital.
As a research report, the book may be
of use to graduate faculty and students in
considering instrument development and
some of the problems that occur in the
real world of implementing the research
design. As a research study. the report
has a minor defect in the incomplete
documentation of references. Although
references are listed at the end of ea
h
chapter. there is no way of identifying
specific pages, except when direct quota-
tions are used.
For all who have some understanding
of organizational and role theories. thi

book ;hould provide thoughtful reading.

Child Health Maintenance: Concepts in
Family-Centered Care by Peggy L
Chinn. 542 pages. St. Louis. Mosby,
1974. Canadian Agent: Toronto.
Mosby.
Reviewed by Brigid Peer, Maternal
and Child Health Coordinator, Alglm-
quin College Nursing Program, Van-
ier Centre, Ottawa, Ontario.

This is one of the most stimulating
pediatric nursing books to come our way!
The author's stated objectives are "to
provide knowledge about children and
augment the perceptions and total skills
relating to their care, and to increase the
proble;n-solving capacity of the student
and equip the nurse with tools for helping
the child and his family to cope effect-
ively and reach their own realistic goals."
Both these objectives are met in a
comprehensive way.
The delightful illustrations add as much
to the reader's knowledge of children as
the text does. Through
ut the text the
problem-solving approach is used. Every
situation is examined by assessing the
probable needs. strengths, and abilities of

the child and his family. There are no pat
answers or formula-type nursing plans.
but there is a constant reminder of the
need to assess each situation as it arises.
It is a challenging text for basic nursing
students because it breaks away from the
traditional disease-oriented approach to
nursing and forces the student to integrate
knowledge from many sources and find
her own solutions. The natural result of
learning from this book should be for
nurses to become actively involved in
child health maintenance.
This book is highly recommended to all
nurses who are in contact with children.
They will find much to interest and
invigorate them in this readable book.

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 institu-
tions. Reference (R) items (archive 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.
Requests for loans should be made on
the "Request Form for Accession List"
or on a standard Interlibrary Loan form
and should be addressed to: The Library,
Canadian Nurses' Association. 50 The
Driveway, Ottawa. Ontario, K2P IE2.
No more than three titles should be
requested at anyone time.

BOOKS AND DOCUMENTS
I. Actes du Colloque Nutrition IY73, Uni\'ersite
wm/, 19 et 20 octobre. 1973. MOIJtréal. Associa-
lion Canadienne-Française pour I'avancemenl des
sciences, 1973. 145p.
2. Acti\'ité de rOMS en 1973. Rapport annuel du
direcleur general à I' Assemblée mondiale de la
Sante et aux Nations-Unies. Genève. Organisation
mondiale de la santé. 1974. 323p.
3. Almanach clu peuple; petite enC\'c1opedie
française publiée depuis 1869. I05éd. Montreal.
Beauchemin. 1974. 608p.
4. Annual conference, Proceedings. 1973. Ottawa.
Canadian Library Association, 1973. 127p.
5. Annual repvrt vf continuinli education. Van-
couver, Universit} of British Columbia Health
Sciences Centre, 1972/73. 90p.
6. A.uisting the health team: an introduction to the
nurse assistant. by Marcia S. Bregman. St. Louis,
Mosby, 1974. 20Op.
7. Basi< medical-surliical nursinli. b} Mildred H.
Mason. 3ed. New York, Macmillan. 1974. 584p.
8. Between pal/em and health worker. by Thelma
Lee Dorroh. New York, McGraw-Hili, 1974. 262p.
9. Biosraristics.- a foundation F>r anah.ris in thi'
health sciences. by Wayne W. Daniel. New York.
Wiley, 1974. 448p.

OCTOBER 1974

accession list

10. Call me a good thief by Donald Pollock.
St-Huben. P.Q. Transformation information centre,
1973. 427p.
II. Cardiac arrhvthmias, exercises in pattern in-
t
rpretation. by Mary H. Conover. SI. Louis,
Mosby, 1974. 291p.
t2. Case studies of nursing interventIOn, by the
University of Kansas. Dept. of Nursing Education.
New York. McGraw-Hili. 1974. 245p.
13. Communicatio1lS and relationships in nursinfi.
by Maureen J. O'Brien. SI. Louis. Mosby, 1974.
179p.
14. Contemporary issues in mental health nuning.
by 7 authors. Edited by Madeleine M. Leininger.
Boston. Little. Brown. 1973. 196p.
15. Countdown; Canadian nursing statistics, 1973.
Ottawa. Canadian Nurses' Association, 1974. I3lp.
16. Current issues in nuning education. Papen
presented at the eleventh Conference of the COIwcil
of Bacralaureate and Higher Defiree Programs.
Kansas City, NO\,. 14-16, 1973. New York, National
LeagueforNursing. 1974. 51p.
17. Educational s\'stems and the labour market, by
Edward Harvey. Don Mills. Ont.. Longman
Canada. 1974. 223p.
18. Effect;,'e interaction in contemporary nursing.
by Charlotte Epstein. Englewood Cliffs. N.J..
Prentice-Hall. 1974. 174p.
19. Electrocardiography and related coronarv
care; a complete manual for the nurse. by Victor E.
Schulze. Garden Grove. Ca/.. Trainex press. 1974.
248p.
20. Essentials of nursing; a medical-surgical text
for practical nurses. 3ed. Philadelphia, Saunders.
1974. 558p.
21. Fitness, health, and work capacity: interna-
tional standard for assessment, by the International
Committee for the Standardization of Physical
Fitness Tests. New York, MacMillan. 1974. 593p.
22. A guide to oncological nursing. by TJ. Deeley
et a/. Edinburgh. Churchill Livingstone. 1974.
212p. (Livingstone nursing texts)
23. Guide to the 1968-1972 international abortion
research literature. Silver Spring, Md.. Transna-
tional Family Research Institute. International Re-
ference Center. 1973. (75p.
24. Human acid-base chemistry; profirammed in-
struction, prepared especially for The American
Journal of Nursing Co.. Educational Services
Division. New York. American Journal of Nursing
Co.. 1973. 519p.
25. Human de\'elopmem; the span (lfllfe, by George
Kaluger and Meriem Fair Kaluger. SI. Louis,
Mosby, 1974. 33Op.
26. Husband-coached childbirth. by Robert A.
Bradley. Rev. ed. New York. Harper and Row.
1974.214p.
27. Index to Public health nursin/i mafia:ine
1909-1952. Compiled by Lois B. Miller. New
York. National League for Nursing, 1974. 232p. R
28. InteractIOns entre les profirammes de sante et Ie
développement socio-éc01wmiqu,'. Genève. Orgdni-
sation Mondiale de Id S.mte. 1973. 61p. (Its Cahiers
de santé publique no. 49)
OCTOBER 1974

29.lntroductorv chemistrv. a survev of /ieneral,
orfianic and biological chemistry, by Karl F
Kumli. Englewood Cliffs. N.J. Prentice-Hall. 1974.
667p.
30. f.
marrialie necessary? By Lawrence Casler.
New York. Human Sciences Press, 1974. 249p.
31. Mechani.
m of body fimctions. by Dexter M.
Easton. 2ed. Englewood Cliffs, N.J. Prentice-Hall,
1974.50Op.
32. Mental health imenention in the primary
firades, by Ann M. Marmorale, Fred Brown. Ne"
York. Behavorial. 1974. 63Op. (Community mental
health jouma/. monograph series. no. 7)
33. New dimensions in mental health-pS\'chiatric
nursing, edited by Marion E. Kalkman and Anne J.
Davis. 4ed. New York. McGraw-Hili. 1974. 69Op.
34. New horizons in midwifery; proceedings of the
sixteenth triennial conRress of the International
Confederation of Midw;,'es, Washington, D.C. Oct.
28-Nov.3. 1972. London. 1973. 229p.
35. The nurse and the psychiatric patient, by
Margaret C. Bazley et a/. Auckland. Heineman
Educational Books. 1973. 199p.
36. Organizational behavior; conflict and its resolu-
tion. Presentation at 1972 Seminar for Directors of
Nursing Service in the West. New York. National
League for Nursing. 1974. 56p. (NLN Pub. no.
52-1509)
37. Orthopaedic.\plints and appliances. by Joan M.
Kennedy. London. Baillière Tindall, 1974. 20Op.

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38. Pharma('ody"amiu and patient care. b\ Mar-
jorie P. Johns. SI. Louis. Mosby. 1974. 337p.
39. La planification familiale et la formatio1l de.\
infirmières et de.
sages-femme.', par Lily M.
Turnbull et Helena Pizurki. Genève, Orgdnisdtion
mondiale de la samé, 1974. 54p. (Its Cahier, de
sdnté publique no. 53)
40. PreRnann' and family health: a profirammed
text. by Belly Ann Anderson. New Ymk.
McGraw-Hili. 1974. 338p. !Her The childhearing
family. v.l)
41. Proceedings of the Pan American Conference
on Health Manpower PlanninR. Isl. Onawa. Sep.
10-14. 1973. Washington. Pan American Health
Organization. 1974. 128p.
42. Programmed mathematics for nurses, by
George I. Sackheim and Lewis Robins. 3ed.
London, Macmillan. 1974.25 Ip.
43. Readings in child and adolescent ps\'chiatric
nursing, by Claire M. Fagin. SI. Louis. Mosby.
1974. 189p.
44. St. ]meph's School of Numng 1912-1974.
Kingston. Onl., 1974. 65p.R
45. Standards for suicide pre\'ention and crisis
centers. by Jerome A. Mono et al. New Yorio,
Behavioral, 1974. 114p.
46. Support s\,stems and cnmmuniry mental health;
lectures on concept development, by Gerald Caplan.
New York. Behavorial. 1974. 267p.
47. Toward a healthy sexualir\'. by John J. Burt and
Linda Brown Meeks. Abbreviated and rev. ed.
Philadelphia. Saunders. 1973. 247p.
48. Umlofiic endo.
copic procedures. by Alice
Morel and Gilben J. Wise, St. Louis. Mosby 1974.
IMp.
49. Workbook in bedside materni'" nursing, by Inge
J. Bleier. 2ed. Philadelphia. Saunders, IQ74. 207p.

PAMPHLETS
50. Acupuncture - the art of Chinese healing: a
bibliography 1960-197:!. compiled by Beatrice S.
Yuan. Buffalo Health Sciences Library. 1973. 9p.
(HSL publication series: 10-3.)
51. China re\'isited. b} Maxwell S. Stewan. New
York. Public Affairs Commillee. 1974. :!8p. (Public
Affairs Pamphlet no. 505)
52. Convention. Folio of reports. 1974.0Ila"a,
Canadian Nurses' Association. 26p.
53. End of an era; the story of Scarborough General
Hospital. by Fergus Cronin. Scarborough, Onl..
Women's Auxiliary, Scarborough Generdl Hospital.
1974.4Op R
54. The Gonesfeld, Communiry mental health criti-
cal issues text. by Harry Gonesfeld. New York.
Behavioral. 1974. 15p.
55. lnternarional ('o\'enants on human rights. New
York, United Nations. 1%7 reprinted IY73. 35p.
56. The nuninR service budRet. by Edith G. Young.
Papers presented at American Hospital Assoclallon
- National League for Nursing Institute on Nursing
Service Administration. Onawa. Cdnadd. June 20.
1957. Ne" York, Nationdl League for Nursing,
1957. 16p. (League exchange no. 22)
57. Occupati01lal safery and health. B usmess and
technology sources. Vo/. 44. no. 3. July-Sept.,
1973. Cleveland. Cleveland Public Library. 1973.
I3p.
58. Selected li.
t of reliable and unreliable nutrition
references. Toronto. Toronto Nutrition Comminee.
1973 15p
59. You and \'('ur alcoholic parent. by Edilh Lynn
THE CANADIAN NURSE 49

Hornik. New York. Pubhc Affairs Committee,
1974. 28p. (Public Affairs Pamphlet no. 506)

GOVERNMENT DOCUMENTS
Alberta
60. Dept. of Health. Medical ServIces Division.
Health careers. Edmonton, 1974. Iv.
Canada
61. Bibliothèque scientifique nation ale du Canada
Rapport. 1972/73. Ottawa. Conseil national de
recherches Canada. 36p.
62. Dept. of Indian and Nonhern Affairs. Report
1972/1973. Ottawa. Information Canada, 1974.
115p.
63. Dept. of Labour. Women's Bureau. Women's
Bureau '73. Ottawa, Information Canada, 1974.
64. Labour Canada. Economics and Resedrch Divi-
sion. Wage rates, salaries and hours of labour.
1972. Ottawa, Information Canada. 1973. 546p.
65. Ministère de la Santé nationale et du Bien-être
socidL Commission d'enquête sur I'usage des
drogues à des fins non-médicales. Rapport final.
Ottawa. Information Canada, 1973. 116Op.
66. Revenu Canada. Douanes et Accise. Liste des
hôpitaux publics certifiés: noms et adresses des
hôpitaux publics certifiés aux fins de la Loi sur
r accise et la Loi sur la taxe d' accise. Ottawa,
Information Canada, 1974. Iv.
67. Road and Motor Vehicle Traffic Safety. The
breathalizer legislation; an inferential evaluation,
by B.R. Carr. Ottawa. Information Canada, 1974.
118p.
68. Statistics Canada. Continuing education,
1971/72. Ottawa, Information Canada, 1974. 75p.

69. -. Enrolment and staff in schools for the blind
and the deaf. 1973/74. Ottawa, Information
Canada. 1974. I3p.
70. -. Hospital morbidity, N71. Ottawa, Informa-
tion Canada. 1974. 15p.
71. -. Hospital morbidity: Canadian diagnostic
list. 1970. Ottawa. Information Canada. 1974. 77p.
72. -. Public libraries in Canada 1971. Ottawa,
Information Canada, 1974. 55p.
73. -. Surgical procedures GI'ltreatments. 1971.
Ottawa, Information Canada, I <J74. 149p.
74. -. Tuberculosis statistics, vol. 2. 1972. Ot-
tawa, Jnformation Canada, 1974. 4Op.
G. Britain
75. Joint Board of Clinical Nursmg Studies. Outline
curriculum in communiry psvchiatric nursing for
registered nurses. London, 12p.
76. -. Outline curriculum in infection control
nursing for state registered nurses. London. t2p.
77. -. Outline curriculum in the care of the dying
patient and his family. London. lOp.
Ontario
78. Ministry of Labour. Research Branch. Collec-
ti,'e bargaining in Ontario 1973. Toronto. 46p.
U.S.A.
79. Management information systems for public
healthlcommunity health agencies; papers pre-
sented at an invitational conference sponsored
jointly by the National League for Nursing and the
Di''ÎSion of Nursing, Bureau of Health Manpower,
PHS. DHEW. Jan. 8-11, 1973 Washington. D.C. Ne"
York, 1974. 182p.
80. National Institutes of Health. Annual report of
international activities, fiscal year 1973. Prepared

by Fogany International Center. Bethesda, Md..
1974.

STUDIES DEPOSITED IN CNA REPOSITORY COLLECTION
81. An anahsis of the supervisory process in
Middlesex-London District Health Unit in 1973, by
Rosella Cunningham. Toronto, University of To-
ronto, 1974. 167p. R
82. Le nursing à rUni,'ersité Laval; rapport par Ie
Comité spécial de J' Ecole des Sciences Infirmières.
Québec, Université Lavat. 1974. 143p. R
83. Nursing and health care in the community in
Great Britain, Finland, Sweden and the Nether-
lands, by Heather F. Clarke, Vancouver. 1974. 14p.
R
84. Pre-cardiac catherizmion information per-
cei"ed as helpful by patients, by Gloria Violet Kay.
Toronto. 1974. 138p. R
85. Report of the Royal Commission on Nursing
Education. St. Johns, Newfoundland, 1974. 42p. R
86. Report of a pilot project undertaken to de\'elop a
post-diploma program in intensive care nursing,
August 1971 to Au/?ust 1973, by Devamma
Purushotham. Sponsored by the Phy
icians' Ser-
vices Incorporated Foundation. London, Ont.. Fan-
shawe College of Applied Ans and Technology,
1<J74. 173p. R
87. A study of the routine taking of temperature,
pulse and respiration on hospitalized patient>.
Edmonton. Alberta Association of Registered
Nurses. Provincial Practice Committee. 1972. 6p. R
88. A study of user characteristics affecting health
care utilization, by Thelma Potter. Toronto, I <J74.
75p.R

NEW HOSPITAL LOCATED IN SWITZERLAND
NEAR ZURICH - OPENING IN 1975

Request Form
for "Accession List"

Surgery - Medicine- Gynecology

CANADIAN NURSES'
ASSOCIATION LIBRARY

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Send this coupon or facsll'Tlile to
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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.
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DIPLOMA NURSES

who are experienced for the following departments of our 200-bed
hospital:

medicine
operating room
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Request for loans will be filled In order of receipt.
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library.
Borrower ........ ......... ......... ....... ..... .......... ....... ............ .......... .........
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Pie,," write to:

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50

THE CANADIAN NURSE

Date of request .................................... ....................... ......un ....

OCTOBER 1974

I
I

classified advertisements

ALBERTA

MANITOBA

REGISTERED NURSES required for 70 bed accredited active
treatment Hospltat Full tl"'" and summer re
el. All MRN per-
somel policies. Apply in wnbng to the: Director 01 Nursing.
Drumheller General Hospital, Drumheller. Alberta.

REGISTERED NURSES required lor active 2D-bed hospltel.
Salary and policies according to MRN agreement Apply.
AdrTllnlstrator. Myrnam MUnicipal HospItal. Myrnam. Alberta

2 R.N:" wanted lor Immediate employment at the Two Hills
MuniCipal Hospilal. Two HIlls, Alberta. We lollow salary
schedule as setlorth b r the AARN Must be willin9to stay at this
IocabOf"l a minimum 0 one year. Apply to. Administrator, Two
Hills MUnicipal Hosprtal. Two Hills. Alberta.

GENERAL DUTY NURSES required immediately to worl< in an
active treatment hospital. Salary and policies as per MRN.
Residence avaIlable Apply. Director 01 Nursing. HardiSty
General Hospitel. Hardisty. Alberta

The Barons.Eureka Health Unrt reqUires a STAFF NURSE.
P.H.N. prelerred. Salary In accordance WIth qualificatIOns and

:
':

.bl.e

; ;FC't'g

Df&
be

.eTo

8"1 Officer

BRITISH COLUMBIA

REGISTERED NURSES reqUired lor new 25-bed acute care
hospital In Fort St James, B.C Starting salary $850.00+$20.00
Northern aUowance per month. Salanes & personnel poliCies
according to RNABC Contract Apply' Director. Stuart Lake
HospItal. Fort St James, BrdlSh Columbta. VOJ 1 PO or phone
collect (604) 996-8201

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6 weeks prior to 1 st day of publication
month.
The Canadion Nurses' Association does
not review the personnel' policies of
the hospitals and agencies odverlising
in Ihe Journal. for authentic ,"formation,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which .hey ore interested
in working -

Address correspondence to:
The
Canadian
Nurse

ð
Ç7

50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P IE2

OCTOBER 1974

I I

BRITISH COLUMBIA

OPERATING ROOM NURSE wanled tor active mo.
dern acute hospital Four Certified Surgeons on
attending staff. Experience of tralnrng desirable.
Must b.. eligible lor B.C. RegIstration Nurses
residence avaIlable. Salary accord 109 to RNABC
Contract. Apply to: Director 01 NUrstng. Mills Mem-
orial Hospital 2711 Tetrault St Terrace, British
Columbta

GRADUATE NURSES required lor general duty and 0 R In a
98-bed hospital Nlth 35 Extendeo vare oel'Js under CLr U In
RNABC policies and wages In effect Appty In oNntißg to The
Director of Nursing. Kdlmat General Hospital. Krtlmat, Bntlsh
Columbia.

GRADUATE NURSES lor 21-bed hospital prelerably
with obstetrical experience. Salary In accordance
with RNABC Nurses residence. Apply to Matron.
Totmo General Hospital. Totmo Vancouver Island.
B"tlSh Columbia

EXPERIENCED NURSES (elIgible tor B.C. regIStration) reqUired
for 409-bed acute care, teaching hospital located in Fraser
Valley. 20 minutes by freeway from Vancouver. and within
easy access of vaned recreational faclillies Excellent Onenta-
tlon and ConbnUtng Education programmes Salary SB50 00 to
$1020.00. ClinIcal areas Indude' MedicIne. General and Spe-
ciahzed Surgery. Obstetrics. Pedlatncs. Coronary Care. Hemo-
dialysIs. Rehabilitation OperatrnQ Room, Intensive Care Emer-
gency. PRACTICAL NURSES (eligible lor B.C. License) also
requlroo. Appry to: Nursing RecrUitment Personnel Department.
Royal Columbian Hospital. New Westminster. British Columbia.
V3L3W7

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES reqUirpo lor small
upcoast hospital Salary and personnel policies as
per RNABC contract Salafles start at 567200 for
Registered Nurses 5577 75 for Licensed Practical
Nurses Residence accommooatlon $2500 per month
Transportation pau1 from Vancouver Apply to
Director of Nursmg St George s Hospital Alert Bay
Bntlsh Columbia

GENERAL DUTY NURSES lor modern 41-bed hospital located
on the Alaska Highway. Salary and personnel policies In
accordance with RNASC Accommodation available In resI-
dence. Apply: Director 01 NurSing. Fort Nelson General Hospotal.
Fort Nelson. British Columbia

GENERAL DUTY NURSES, lor modern 35 bed hospital located
In southern B C.'s Boundary Area with excellent recreation facI-
lities Salary and personnel policies In accordance with RNABC
Comfortable Nurses's home. Apply: Drroclor ot NurSing. Bound.
ary Hospital. Grand Forl<s. Bflbsh Columbta

TWD GENERAL DUTY NURSES WIth experience In obstetrics
and O.R reqJlred lor a 21-bed hospotal in the Southern InterIOr
01 B C. LIVing-In accommodatIOn available. Salary as per
RNABC rates Moderate climate, good worl<Jng conditIOns and
recreabonallac.,t,es available. Apply. giVIng lull particulars and
raterences in 'Irst latter to the: Administrator. Siocan Community
Hospital. Box 129. New Denver. Brdlsh Columbia

WANTED: GENERAL DUTY NURSES lor mooern 70-
bed hospital. (48 acute beds - 22 Extended Care)
'ocated On the Sunshine Coast. 2 hrs from Vancou-
ver. Salaries and Personnel Policies In accordance
with RNABC Agreement. Accommodation available
(female nurses) In residence. Apply The Director
ot NurSIng. SI. Mary s Hospital. POBox 678. Se-
chelt Bnhsh Columbia.

GENERAL DUTY NURSES reqUired lor an 87-bed
aCUle care hospital In Northern B C. Hesldencè
accommodations available RNABC '-policies In effect.
Apply to: Director 01 Nursing. MIlls. Memorial Hos-
pdal. Terrace. Bntlsh Columbia. V8G 2W7

EXCElLENT DPPORTUNITY lor R.N. GENERAL DUTY
NURSING wdh part. time admlnlstratrve responslbtllbes 1 D-bed
hospital opened Summer 1973. Employment commencing
November 1. 1974 with Administrative responsIbilities De-
cember 1 1974 Subrmt all particulars of prevIous expenence to
Administrator. TahslS Hospdal. Box 399, Tahsls, Bntlsh Colum.
bta

I I

DIRECTOR OF NURSING. Wanted Three (3) RN:s AdmIniS-
trator. New 4(}bed Intense Care t-tome. Sle. Rose. Man
Opening October 1st. Very progressive COiT\mUruty Nurses
Residence. For further Info COntact Gus Arnal - Ph
447-2332 - day 447.2633

3 REGISTERED NURSES tor 3-bed Coronary CareUOII reqUiTed
for 77.bed Acute General HosDltal win be required to do General
Duty as well Rece.,tCor"'n
r .....areeWDer'f'r ç..Po:.5
ntlal 4ppl'./
SI Je t
I<" f
'_ba RIA OB5

R.N:" and L.P.N:" required lor new 36.bed hospital Salary...
accordance with Nurses AsSOClahon Agreement Apply to.
Director of Nursing. Souns Dlstnct t-tospltal Souns. Manitoba.
ROK 2CO.

NOVA SCOTIA

CASE ROOM SUPERVISOR for actIVe Labor and Delivery
Unit, Including operating and recovery rooms Hosprtal serves
as teaching. research and referral center for the province. 3 500
dellvenes per year: 110 beds 150 bassinets C cal expe-
rience and post-graduate training In this spe :1811, andalory.
B N. Degree a definite asset Apply to Drrector NurSIng.

:
e S

I,:r

Ital. 5821 UniverSity Avenue. Halifax

NURSERY UNIT INSTRUCTOR wdh clInical expenence and
post-graduate training In thiS specialty for teaching and
remforclng expert clinical practise to staff In Normal and Special
Care (Premature) Nursery: ability 10 motivate staff 10 develop lull
potential. Apply to: Drrector 01 Nursing. Grace Maternity
Hospital. 5821 Unrverslty Avenue. Halifax. Nova ScotIa B3H
IW3.

ONTARIO

OPERATING ROOM ST AFF NURSE requlr80 lor lully accr80l-
ted 75-bed Hospital. BasIc wage $689 00 WIth conslderatoon lor
expenence' also an DPERATING ROOM TECHNICIAN. baSIC
wage 5526 00. Call tune rates avaIlable on request Wnte or
phone the Director 01 Nursing. Dryden District General Hospital.
Dryden. Ontano.

REGISTERED NURSES lor 34-bed General Hospital.
Salary $70600 per month to $81600 plus experience al-
lowance. Excellent personnel policies Apply to
Director of Nursmg. Englehart & District Hospltat
Inc.. Englehart. Ontano. POJ IHO

REGISTERED NURSES required lor 1 07.bed accredlt80 Gene
ral Hospital. BasIc salary comparable to other Ontano Hospitals
with remuneratIOn for past expenence Yearly Increments A
progressive hospital amidst the lakes and streams of Northwes-
tem Ontano Apply to: Dlreclor 01 Nursing, LaVerendrye
Hospital. Fort Frances. OntarIO

REGISTERED NURSES reqUired lor a 12 bed IntenSive
Care-Coronary Care combined Unit Post basIc preparation
and/or sUitable expenence essential Apply to Personnel
Manager, St Mary s General Hospotal. 911 Queen s Blvd.
Kdchener. Ontano. N2M 1 B2.

REGISTERED NURSES requued lor our ullramoo"rn I!! bed
General Hospotal In btllngual commundy 01 Northern Ontario
French language an assaI. but not compulsory Salary IS $855
10 $ 1 030 monthly With allowance lor past expeflence and 4
weeks vacation atter 1 year Hospital pays 100 0 001 0 HIP.
life Insurance (to 0(0). Salary Insurance (75 0 001 wages to the
age 01 65 with U I. C carve-out) a 354 drug plan and a dental
care pan Master rotatIOn In eNect Roommg accommodallons
aV8Ilable In town Excellent personnel policies Apply to
Personnel Director Notre.Dame Hospital POBox 850.
Hearst Ontario

THE CANADIAN NURSE
.

51

ONTARIO

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS for 45.bed HospitaL Salary ranges
Include Qenerous experience allowances. R.N.'s
salary $740. to $840.. and RN.A:s salary $550. to $625..
Nurses residence - pnvate roonis with bath - 540.
per month. Apply to: The Director of Nursing. Gerald-
ton District Hosprtal. Geraldlon. Ontano. POT 1 MO.

REGISTERED NURSES FOR GENERAL DUTY, J.C.U.,
C.C U. UNIT Bnd OPERATING RDOM required for
fully accredIted hospItal StartIng salary $850.00 wIth
regular increments and with allowance for expen-
ence. Excellent personnel policies and temporary
residence accommodation avaIlable Apply to: The
Drrector 01 Nursing. Krrkland & District HospItal,
Krrkland lake. OntariO. P2N 1 R2.

PUBLIC HEALTH NURSES (QUALIFIED) FOR GENERALIZED
PROGRAMME. AllOWANCE FOR EXPERIENCE AND/OR
DEGREE. USUAL FRINGE BENEFITS. DIRECT ENQUIRIES
TO MRS RET A McBEAN PUBLIC HEALTH NURSING. REN-
FREW COUNTY AND DISTRICT HEALTH UNIT. P.O. BOX 128,
PEMBROKE. ONTARIO. K8A 6XI.

SASKATCHEWAN

GENERAL DUTY NURSES, for 285-bed Rehabili-
tatIon/Extended Care HospItal. Excellent formal week-long
Orientation program plus continuing Inservice Education pro-
gram. 1974 salary range. $707 . $732 . $759 . $787 . $830.
Apply to: Employment Officer. Wascana Hospital. 23rd Avenue
and Avenue G. Regina, Saskatchewan.

GENERAL DUTY REGISTERED NURSES requrred for 22-bed
hospital, situated In South Eastern Saskatchewan on the Trans
Canada hIghway, near lakes and last Oak Ski Resort. Salary
per SUN. and S.H.S.P. Agreements - $707.00-$830.00.
Please apply to: Director of NursIng. Broadvlew Unron Hosprtal.
Broactvlew. Saskatchewan.

UNITED STATES

RN:" - SOUTHERN CALIFORNfA - ImmedIate need eXists
for meðlcal.surgical unIts. Orientation and In-service program.
Excellent salary. full paid benefits We will assist you With your
H-1 visa for Immigration. A license In California to practise
nursing IS necessary before employment Write for an applica-
tIon to the' CalifornIa State Board of Nursing EducatIon and
RegIstration. 1020 N Street. Sacramento. CalIfornia. 95814.

REGISTERED NURSES: Join your fnends in a large expandIng
& progressive hospital. Located in the heart of California near
the finest educational and recreational activities where the
dlmate IS mold the year round. Good starting salaries and liberal
employee benefits. Write: Personnel Dept.. Suiter Hospitals.
2820' L" St.. Sacramento. CalifornIa, 95816.

RN'" Bnd lPN's - Unoverslty Hospital North. a
teachrng HospItal of the UniversIty of Oregon MedIcal
School. has openings in a variety of Hospital ser-
Vices. We offer competitive salaries and excellent
fringe beneflts_ InqUires should be directed to Gale
Rankrn, Drrector of NursIng. 3171 S 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
Clly by the Sea a city burldrrrg 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 568200 10 594000 per month com.
mensurate with education and experience Dlfferenllal
tor evening shifts available Benefits Include holi-
days Sick leave vacatIOns paid hospitalizatIOn
"ealth hte Insurance pension program Become a
vital part of a modern up-la-date hosp'tal write or
call collect John W Gover. Jr Director of Per-
sonnel Memorral MedIcal Center POBox 5280
Corpus Chnstl Texas. 78405

52

THE CANADIAN NURSE

NURSING OPPORTUNITY
REGISTERED NURSES

required for a 138-bed active treatment hospital
plus

EXPERIENCED NURSES

for a 5-bed I.C.U.-C.C.U. presently being set up
clinical areas inClude - medicine - surgery, obstet-
rics, paediatrics and coronary care.

Residence accommodation available.
Address applications and enquires to:

DIRECTOR OF NURSING
BLANCHARD-FRASER
MEMORIAL HOSPITAL
KENTVILLE, t-/OVA SCOTIA

CLINICAL NURSE SPECIALIST

For

MED-SURG NURSING

Required in 254-Bed
Active Care
General HDspital

Qualified Parties Apply to:
DirectDr of Nursing
Moose Jaw Union Hospital
Moose Jaw, Sask.
(306) 692-1841 (Call Reverse)

POST-GRADUATE
REFRESHER COURSE
In
PEDIATRIC REHABILITATION

for: Nurses, Physiotherapist, Occupational
Therapists
January 13th, 14th and 15th,
1975
COST: $50.00

Information:
The Education Department,
Ontario Crippled Children's Centre,
350 Rumsey Road,
Toronto, M4G 1R8, Ontario, Canada.
Att'n: Ms. L. Hamilton
Ms. N. Geddes

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

This
Publication
is 1\,railable in

II(;R()F()It'1

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PLEASE WRITE FOR
COMPLETE INFORMATION

OCTOBER 1974

LECTURERS IN NURSING

STURT COLLEGE OF
ADVANCED EDUCATION

Sturt College of Advanced Education, situated in Adelaide, will begin in 1975 the first tertiary-level Diploma
in Nursing course in South Australia in co-operation with Flinders Medical Centre, a new major teaching
hospital and medical school located on an adjoining campus and with other health agencies in the area. Sturt
College is an autonomous college under the governance of its own Council and is currently engaged in
preparation of primary and secondary teachers. The College is very likely to diversify into other areas of
training for health professions and into social welfare.
The College has appointed Mrs. Anne Pickhaver, B.Sc., R.N.T., S.C.M., at present lecturer in the
Department of Nursing Studies, University of Edinburgh, Scotland, as Senior Lecturer in Charge of the
Department of Nursing.
Applications are invited from nurse educators eligible for registration in South Australia, with appropriate
qualifications as indicated. Each lecturer appointed will have a special area of responsibility, related to his/her
particular preparation and interests. Beyond this, the lecturers will share responsibility for the general activities
within the nursing programme.

Position 1. Nurse with a degree in a relevant social science, e.g. Sociology, Psychology or Social
Psychology, with particular responsibility for the organisation of lectures and tutorials in
Social and Behavioural sciences, and the relating of these studies to nursing theory and
practice.
Position 2. Nurse with a degree in a relevant biological science, to participate in the organisation of
lectures, practical work and tutorials in this area, and in relating these studies to nursing
theory and practice.

Position 3. Nurse with post-basic qualifications in Community Care. Such qualifications mayor may
not include a degree, but the applicant must be experienced in Community Health
nursing, and preferably have had teaching experience in this area.

Lecturer
Assistant Lecturer

Salary Range (per annum):
$9,002 - $12,352
$7,008 - $ 8,601

Appointments will be made within these ranges depending on qualifications and experience. The usual CAE
conditions of appointment and staff benefits will apply.
Applications should include personal details, qualifications, experience and the names and addresses of
three referees from whom confidential information may be sought. These applications should be addressed to:
The Registrar, Sturt College of Advanced Education, Sturt Road, Bedford Park, South Australia 5042, and
marked "Confidential", reaching the College no later than September 30th, 1974. Late applications may be
accepted from overseas candidates.

OCTOBER 1974

THE CANADIAN NURSE 53
.

The Brome-MissisQuoi-Perkins
Hospital

requires

1 Day Supervisor
1 Night Supervisor
Registered Nurses

ptease write to:
Director of Nursing
Brome-Missisquoi-Perkins Hospital
950 Main Street
Cowansville, Quebec
J2K 1 K3

DIRECTOR OF
NURSING SERVICE

Applications are invited for a position of
Director of Nursing Service in a 900 bed
fully accredited teaching and referral hos-
pital in Winnipeg, Manitoba.
A Masters Degree in Nursing Administra-
tion is desirable.
Salary is negotiable.

Reply In confidence to:

EXECUTIVE DIRECTOR
ST. BONIFACE GENERAL HOSPITAL
409 TACHE AVENUE
WINNIPEG, MANn .JBA
R2H 2A6

DIRECTOR
SCHOOL OF NURSING
DIVISION

required for
Accreditated two year and one year R.N.
Diploma programs for regular and special
students respectively
Director is member of senior Hospital
management and reports directly to Ex-
ecutive Director. Appropriate graduate de-
gree and experience desired.
Enquires wilt be treated In confidence.
Personnel Manager
Misericordia General Hospital
99 Cornish Avenue
Winnipeg, Manitoba
R3C 1 A2

54 THE CANADIAN NURSI:

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 hospital is
presently expanding from 126 beds
to 400 and is fully accredited.
Nursing is a profession we respect
and we were the first to plan and
develop a unique nursing audit
system. There are opportunities for
gaining wide experience. for get-
ting to know patients as well as
staff. R.N. salaries range from
$850. to $1020. per month. Credit
allowed for relevant previous hospi-
tal experience.

Situated in Richmond Hill, all
the cultural and entertainment faci-
lities 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 Personnel.

YORK
CENTRAL
HOSPIT AL

RICH\10[\;[) HI) ) .
0:" I ARlO
L4C 4Z3

GENERAL DUTY NURSES

Required immediately for acute care gen-
eral hospital expanding to 343 beds plus
proposed 75 bed extended care unit.
Clinical areas include: medicine, surgery,
obstetrics, paediatrics, psychiatry, activa-
tion & rehabilitation, operating room,
emergency and intensive and coronary
care unit.
Must be eligible for B.C. Registration
Personnel policies in accordance with
R.N.A.B.C. contract:
SALARY: $850 - $1020 per month
(1974 rates)
SHIFT DIFFERENTIAL

APPL Y TO:
Director of Nursing
Prince George Regional Hospital
Prince George, B.C.

NORTH NEWFOUNDLAND & LABRADOR

reqUires

REGISTERED NURSES
PUBLIC HEALTH NURSES

International Grenfell Association provides
medical services for Northern Newfoundland
and Labrador. We
taff four hospitals, eleven
nursl ng stations, eleven Public Health units.
Our main lBO-bed accredited hospital is
situated at St. Anthony, NewfoundlanCl. Active
treatment IS carned on m Surgery, Medlcme,
Paediatrics, Obstetrics. Psychiatry. Also,
Intensive Care Unit OrientatIOn and In.Service
programs. 40-hour week, rotating shifts Livmg
accomodations suppl ied at low cost. PUBLIC
HEALTH has challenge of large remote areas.
ExGelient personnel benefits mclude liberal
vacatIOn and sick leave. Salary based on
Government scales.
Apply to:
INTERNATIONAL GRENFELL ASSOCIATION
Assistant Administrator of
Nursing Services.
St. Anthony, Newfoundland.

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 1CO

OCTOBER 1974

1+

Public Service
Canada

Fonction publique
Canada

This competition is open to both men and women

NURSE!

At the Department of Veterans Affairs we are sensitive to your needs. Through our
hospitals we are dedicated to providing professional and personalized care to our
patients. We look to our nurses to help us achieve that goal. And we know that
dedication and job satisfaction go hand in hand.

To help us meet your needs, make us aware of your concerns
A special nurse is available at each of our hospitals in Halifax, London and
Winnipeg ready to talk to you on a personal basis. She will:

* Describe the variety of nursing duties
available at our hospitals;
* Entertain requests for flexible schedu-
les as well as for temporary and
part-time work;
* Talk about training programs and op-
portunities for professional advance-
ment;
* Advise you on relocation;
* Answer all your questions.

So whether you're experienced, or just out of school; whether you wish to work full
or part time; whether you live around the corner or across the country; whatever
your needs, we will do our best to accomodate you, In return, we ask that you care.
Call collect and talk to the nurse who shares your concerns.

IN HALIFAX: Mary Johnson
Camp Hill Hospital
Tel: (902) 423-1371
IN LONDON: Helen Conn
Westminster Hospital
Tel: (519) 432-6711
IN WINNIPEG: Ann Bowman
Deer Lodge Hospital
Tel: (204) 837-1301

OCTOBER 1974 THE CANADIAN NURSE 55

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 Dia
sis 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

REGISTERED NURSES
lolory Rang" 57,716.59.600
IP."....I, unde,negol,al,on)

LICENSED PRACTICAL NURSES

SOIOfY Rang. $5.880-$6,960
IPleu'nll,unde 1 Ileglll,.loonl

QUALIFICATIONS

-Eligible fOI registration In MOnltoba
-E)lperlence deslroble but not required

ON-GOING EDUCATlDN AND DEVELOPMENT

-Planned two week oneniohon at full solary
-Dynamic tn-serVice education programs
-Opportunity to portlclpale In workshops professlonol association meehngs
and community octlvltles

PROGRESSIVE PERSONNEL POLICIES

-Salary recognizes preparahon and ekperlenee
-Pold vocal.on based on years of expenenc

-D,fferentlol for evening and mght stufts
-Life Insurance and rf!hremen' plans

CLINICAL AREAS

-Inlcllde mediCine, surgery obstè'rICs.. gynecology pediatrics, emergency
and amblliatory ser\lICeS, operating room, intenSive and coronary core lInr'
and 0 rehoblltto..on and e)ltended treatment cen're

Th" full,. occredlled "J] bed ho,p.lollocoted I.... th.. ,outh_e'fe." regIon of MO"Itobo odm..",te'sto the ne..d, of (I
U'''''e'
lt" C,ho of .0000 peopl.. o....d I
the th..d lo.g..,t ho,ol'ol comple. ," the P'o""...c:e

In,...,t..II appl'(a"'
on.., ..,.1. 10

Mr. A. Le.ko
Employment Supervisor
Personnel Department

I

BRANDON GENERAL HOSPITAL

Brandon, Monitobo

.
\. R7A2BJ
,-, \:

r..
'-. :::: I ::::
,___ -' . o. 0 '''' , ___
\
j ::: ,Ii'IÌ""""""""
.
,.::: ." "" " " Ir " " "" '
, ' If "I
\ -;1""" . """'"' 1111
, . # 0..1""""",,/1,
" ..J!!F rII
ííT'-::"'I"
, " L -... ..
- . , I

...

HEALTH
SCIENCES
CENTRE

WINNIPEG,
MANITOBA

. 1. ,

\C- r

"

"

".

-4

,

THIS 1345 BED COMPLEX 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 <It full salary
ON-GOING EDUCATION - Provided through
active in-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 holidays per year
insurance, retirement and pension plans
SPECIALIZED SERVICE AREAS include orthopedics, psyrhiatry, post
anaesthetic, casualty, intensive care, coronary care. respiratory care. dialysis,
medicine and surgery, obstetrics, gynaecology, rehabilitation, and paediatrics.

ENOUIRIES WELCOME
FOR FURTHER INFORMATION PLEASE WRITE TO:
PERSONNEL DEPARTMENT NURSING SECTION
HEALTH SCIENCES CENTRE,
700 WilLIAM AVENUE, WINNIPEG, MANITOBA R3E OZ3

56 THE CANADIAN NURSE

OCTOBER 1974

ALGONQUIN
CONTINUING EDUCATION
HEALTH SCIENCES DIVISION

TEACHER
POST DIPLOMA
NURSING PROGRAMS

Algonquin College is a bilingual
institution serving the Counties of
Renfrew. Lanark, Carleton, Russell
and Prescott. In September. 1974,
several new Post Diploma Nursing
Programs will be launched under the
direction of the Director of Continuing
Education, Health Sciences Division,
and the following full-time position will
be required.
The teacher in the Post Diploma
Nursing Program will be responsible
primarily for clinical and classroom
teaching in the Critical Care Nursing
Programs. Involvement with other
programs, short courses and work-
shops can be anticipated.

MINIMUM QUALIFICATIONS:
- Recent nursing experience in
one of the following areas: in-
tensive care, emergency, recov-
ery room, coronary care, renal
unit, cardiac surgery.
- Baccalaureate degree In Nurs-
ing.
- Experience in teaching prefera-
bly at a post diploma level in
nursing services or education.
- Demonstrated ability to work ef-
fectively with adult learners.
- Bilingualism an asset.
Appointment will be made at one of
the following levels, dependent upon
qualifications and experience:

Assistant Master $8,000 - $13,900
Associate Master$9,200 - $15,800
Master S9,800 - $16,900
(Salary scates presently under negotiation)

Starting Date: As soon as possible
Competition No.: 241-74

Pt8llse apply In writIng, quoting approprIate
competitIon number, to:
The Personnel Office
1385 Woodroffe Avenue
Ottawa, Ontario
K2G 1V8
OCTOBER 1974

1+

Public Service
Canada

Fonction publique
Canada

REGIONAL
NURSING
OFFICER

THIS (,O:\IPETlTlO!'lIS OPEN TO BOTH 'IE"Ij AND \\O\IE:"

DUTIES: Implements and teaches Hospital Officers' Training Course 10
nursing staff: develops in-service education and orientation programs,
nursing service aims and objectives: establishes nursing procedures.
work perfonnance requirements and assessments: initiates nursing stu-
dies and a
sists in recruitment and selection of Nursing Service Person-
nel.
QUALIFICATIONS: R.N. certification from a province in Canada and
a Bachelor's degree in Nursing; ability to teach nursing theory and
practice. implement courses as outlined. evaluate training needs. and
conduct nursing studies.

Salary:
$11 ,057 -$13,998

Forward" Application for Emptoyment" fonn (PSC 367-4tlO). availa-
ble at Post Offices, Canada Manpo\\'er Centres and offices of the Public
Service Commission. IMMEDIATELY to:

Canadian
Penitentiary
Service

CA:"I:ADIAN PE"IjITENTIARY SERVICE
P.O. BOX 10058. PACIFIC CENTRE
700 WFST GEORGIA STREET
V ANCOUVER, B.C. V7Y IC6

Attention: Staffing Officer

Regional Head-
quarter!> (Western)

Appointment as a result ofthis competition is subject to the provisions of
the Public Service Employment Act.

Vancouver. B.C.

Please quote reference 74- V -CPS-t84.

MOUNT ROYAL COLLEGE

invites applications for the position of

CHAI RMAN
NURSING DIVISION

The successful candidate will be responsible for the administration and
control of a nursing program in basic nursing leading to an Associate
Diploma In Nursing, as well as several post basic nursing courses.
QUALIFICATIONS: A masters degree. preferably in Nursing, with
content in educational administration and/or curriculum development.
Eligible for nurse registration in Alberta. Preference for an individual who
has had nursing, teaching and administrative experience.
Salary: Depending on qualifications and experience.
Masters scale for 1974-75 - $13,343 to $20,163
1975-76 - $15,343 to $22,163
Plus Chairmen's stipend of $1200.
Appointment effective as soon as possible.
Send Curnculum Vitae to
F. R. Fowlow
Director. Faculty of Sciences
4825 Richard Road S.W.
Calgary, Alberta
T3E 6K6
Telephone: 246-6312

\
ill
l
I

THE CANADIAN NURSE 57

REGISTERED NURSES

An expanding 23D-bed complex requires
nurses for general duty positions in several
clinical areas. The complex indudes 130
beds for active treatment, 50 beds for
extended care and a 50 bed nursing home.
Salaries and personnel policies in accor-
dance with Alberta Association of Regis-
tered Nurses Contract. Apply:

Apply:

Grande Prairie Municipal Hospital
Grande Prairie, Alberta
T8V 2E8

REGISTERED NURSES

required
To further develop our family focused

CHILDRENS'
PSYCHIATRIC SERVICE

Day, night and post discharge nursing
followup care planned for patients from 2
to 17 years.
Four week pre-service educational prog-
rámme is scheduled for November 1974.

Please apply to:

Director of Nursing
Royal Jubilee Hospital
VICTORIA, British Columbia

REGISTERED NURSES

Registered Nurses required for large
metropolitan general hospital.
Positions available in all clinical areas.
Salary Range in effect until December
31,1974-
$665.00 - $830.00. Starting rate de-
pendent on qualifications and experj-
ence.

Apply to:

Staffing Officer-Nursing
Personnel Department
Edmonton General Hospital
Edmonton, Alberta
TSK OL4

58 THE CANADIAN NURSE

"MEETING TODAY'S CHALLENGE IN NURSING"

QUEEN ELIZABETH HOSPITAL OF MONTREAL
CENTRE

A Teaching Hospital
of McGill University

reqUires

REGISTERED NURSES

AND

REGISTERED NURSING ASSISTANTS

Quebec language requirements do not apply to Canadian applicants.

. 255-bed General Hospital in the West end of Montreal
. Clinical areas include Progressive Coronary Care,
Intensive Care, Medicine and Surgery, Psychiatry.

Interested qualified applicants should apply in writing to:

QUEEN ELIZABETH HOSPITAL OF MONTREAL CENTRE
DIRECTOR OF PERSONNEL
2100 MARLOWE AVE., MONTREAL, QUE., H4A 3L6.

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 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.

OCTOBER 1974

NORTH YORK GENERAL HOSPITAL
INVITES APPLICATIONS FROM:

REGISTERED NURSES AND
REGISTERED NURSING ASSISTANTS
FULL AND PART-TIME POSITIONS

N.Y.G.H. is a 585-bed, fully accredited, active treatment hospital
located in North Metropolitan Toronto offering opportunities in all
services.
The Hospital embraces the full concept of Progressive Patient
Care featuring a Self Care Unit and a Psychiatric Day Care
Program.
Our Nursing Philosophy focuses on the patient as an individual and
recognizes the importance of continuing education for the
improvement of patient care.
An active Staff Development program focusing on individual
learning needs is maintained.

Apply to:

Personnel Department
North York General Hospital
4001 Leslie Street
Willowdale, Ontario
M2K 1 E 1

SOUTH AUSTRALIAN HOSPITALS DEPARTMENT
FLINDERS MEDICAL CENTRE

DIRECTOR OF
NURSING SERVICES

This Hospital is anXIOUS to appoint a Director o' Nursing Services who must be
expenenced In nursing deve\opment and have administrative abl1lty. to aSSist In the
commiSSIOning of this new Integrated teaching hospital and medical school. and later to
assume full responsibility for all the nursing servICes.

THE PROJECT
The Flinders Medical Centre is sauated on the campus of the Flinders UniversIty of South
Australia about 9 miles from the Adelaide city centre. and IS adjacent to a College of
Advanced Education which has agreed to provide a Nursing Diploma Course leading to
State Registration.
The hospital eventually will have 710 patient beds. but the first stage due to be completed
at the end 01 1975 will contaIn 350 beds and the supponlng service depanmenls.
including Out-patients and Operating Theatres and an Obstretnc Oepanment The Centre
will have strong hnks with Community Health Centres.

THE APPLICANT
The successful candidate will be expected to provide creative and innovative leadership
in all aspects of nursing. The poSition offers a challenging opportunity for an ambitious
nurse to playa major part In the aeatlon 01 this exciting new development In South
Australia. and to be the 'Irst appointee to one of the most Important nursing posts In the
State.

QUALIFICATIONS
Essential: Eligible for registration as a General Nurse In South Australia
Desirable: A dipoma In Nursing Administration or equivalent

REMUNERATION
Salary: $15,510 per annum
(J 9,636 Sterling)
($22,410 CanadIan)

Applications and enquiries should be addressed to:
The Administrator - Flinders Medical Centre, - BEDFORD PARK S.A.
5042

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.
1974 Salary Scale $850.00 - $1,020.00 per month
For further information, please write to:
PERSONNEL SERVICES
VANCOUVER GENERAL HOSPITAL
855 WEST 12TH AVE.
VANCOUVER, B.C.

OCTOBER 1974

59

THE CANADIAN NURSE

DIRECTOR OF NURSING

SHERBROOKE HOSPITAL
SHERBROOKE,QUEBEC

Applications are invited for the position of Director of Nursing at
Sherbrooke Hospital, Sherbrooke, Quebec. This is a modern 130
bed active treatment general hospital situated in the heart of the
scenic Eastern Townships, fully accredited and affiliated with the
Faculty of Medicine of the University of Sherbrooke.
As a member of the senior administrative team, this challenging
position requires a nurse with innovative Qualities and ability to
organize, delegate, and direct the work of others as well as ability
to work in close cooperation with, communicate with, and gain
the confidence of others, and enthusiasm for initiating and
following up new ideas and projects.
Required Qualifications include a baccalaureate degree and
registration or eligibility for registration in the Province of Quebec.
Previous experience in an administrative or supervisory capacity is
required. Bilingualism an asset. Remuneration in accordance with
government salary scale. Position available November 1, 1974.
Applications, which will be treated in strict confidence. should
include complete curriculum vitae and related experience and be
addressed to:

GENERAL MANAGER
SHERBROOKE HOSPITAL
375 Argyle St.
Sherbrooke, Quebec

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THE SCARBOROUGH
GENERAL HOSPITAL

invites applications from:
Registered Nurses and Registered Nursing Assis-
tants to work in our 6S0-bed active treatment
hospital and new Chronic Care Unit.
We offer opportunities in Medical. Surgical, Paediatric, and Obstetrical nursing.
Our specialties include a Burns and Plastic Umt, Coronary Care, Intensive Care and
Neurosurgery Umts and an active Emergency Department

. Obstetrical Oepartment - partlclpal/on In "family cenlered" leaching
program.
. Paediatric Department - participation In Play Therapy Program.
. Orlentallon and oR-going slall 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
60 THE CANADIAN NURSE.

CARl BOO
COLLEGE

KAMLOOPS

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BRITISH
COLUMBIA

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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 December, 1974.
Applicants with a Master's Degree are preferred. Minimum
requirements are a baccalaureate degree with experience in
pediatric and psychiatric nursing and teaching and eligibility for
registration in British Columbia.
Attractive salaries commensurate with preparation and expenence.
Apply in writing, stating experience, qualifications and refer-
ences to:

CHAIRMAN OF NURSING
CARIB09 COLLEGE
Box 860
KAMLOOPS. B.C. V2C SN3

OTTAWA CIVIC HOSPITAL
REQUIRES
1) ASSISTANT DIRECTOR OF
NURSING SERVICE

Requirements: Degree ,n Nursing and at least six
years experience as Head Nurse
or Supervisor

2) SUPERVISOR - EVENINGS - NIGHTS

Requirements: Degree in Nursing and three years
experience in Gynecology and
Obstetrics

3) CLINICAL TEACHER -STAFF
EDUCATION

Requirements:

Degree ,n Nursing and at least five
years experience - three of
which should be in a Critical Care
area and two years in teaching

Apply In wr/flng to:
Miss Marjorie Mills, Reg. N., B.Sc.N.,
Assistant Director Nursing Service,
Ottawa Civic Hospital,
1053 Carling Avenue,
Ottawa, K1Y 4E9.

OCTOBER 1974

SUNNYBROOK MEDICAL CENTRE
TORONTO

JOIN OUR
HEALTH TEAM
AND GROW

INVITE YOU

1,20D-bed teaching hospital affiliated with
University of Toronto
Medical Research Centre
Accredited General Hospital
with active and extended care facilities
Inservice training
Residence available. . .
Plus good public transportation

Write today:
..:7 SELECTION OFFICER
PERSONNEL DEPARTMENT
SUNNYBROOK MEDICAL CENTRE
2075 BAYVIEW AVENUE
TORONTO, ONTARIO
M4N 3M5

R.S.V.P.

PATIENTS MATTER
AT THE

Prairie
Province -
Capital
City

PLAINS HEALTH CENTRE

BUT

Experience I
Recognized

REGISTERED NURSES

SO DO YOU

THE RELIGIOUS
HOSPITALLERS
OF SAINT JOSEPH

to share their 300 year heritage of service to the
Church in health. education and welfare services In
the United States, Canada and Franæ
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

FORMATION CENTER
438V2 College SI.
Burlington. Vermont
05401

FORMA TION CENTER
4 Toronto Street,
Ottawa, Ontario,
K1S ON2.

I. C. U.
C.C.U.
O. R.
R. R.

New
Hospital
Opening In
The Fall

I

\
\
,
Air I
Conditioned

Service
Manager
Support

Salary Range:
$707 -$732-$759-$787 -$830

Apply to:
Nursing Employment Officer
Plains Health Centre
4500 Wascana Parkway
Regina, Saskatchewan
S4S 5W9

OCTOBER 1974

Medical
Surgical
HOSP/

THE CANADIAN NURSE 61

WE CARE

ASSISTANT
EXECUTIVE DIRECTOR
NURSING

RESPONSIBILITIES:
To plan, organize and coordinate all activities in the
Department of Nursing Service and the School of
Nursing to meet the needs of this major teaching
hospital.
QUALIFICA nONS:
Preference to candidates with a Baccalaureate Degree
in Nursing and advanced degree in Hospital Ädministra-
tion and/or Nursing.
Previous experience, in Nursing Service, Administration
and/or Education.
REM UN ERA TION:
Negotiable - commensurate with qualifications.
POSITION:
Well established. Available in early 1975 when incum-
bent retires. Reports directly to the Executive Director
Send confidential resume prior to 30 October 1974:
EXECUTIVE DIRECTOR,
UNIVERSITY OF ALBERTA HOSPITAL,
84 A venue and 112 Street,
Edmonton, Alberta,
T6G 2B7.

'9i>

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.

ROYAL VICTORIA HOSPITAL

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
H3A 1A1

62 THE CANADIAN NURSE

/
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OCTOBER 1974

Serve Canada's
native people

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.
In
a well
equiDped
hospital.

I .a. Health and Welfare Santé et Boen-être soclat
...... Canada Canada
,---------------

I MedicClI Services Branch I
I Department of National Health and Welfare I
I Ottawa, Ontario K 1 A OK9 I
I I
I Please send me information on hospital I
I nursing with this service. I
I Name: I
I Address; I
City: ProV: _

----------_____J
oaOBER 1974

Index
to
Advertisers

October 1 974

Astra Phannaceuticals Canada Ltd

Clinic Shoemakers

Davol Canada Ltd.

J.B. Lippincott Co. of Canada. Ltd.

3M Canada Ltd.

\1agic Wand .

C.V. Mosby Company. Ltd.

8
2

.16

.11

7
. . . . . . . .43. 45. 47

Nordic Biochemicals . . . . . . . . . . . . . . . . . . . . . . . .41

J . T. Posey Company
Proctor & Gamble

Reeves Company

.37
.13
.14

Sandoz Phannaceuticals . 12

White Sister Uniform. Inc. .... .5. Covers II. III. IV

At!n'/'t;s;Ilg .\fwwgcr
Georgina Clarke
The Canadian Nurse
SO The Driveway
Otl.ma 1\.21' 11-'2 (Ontario)

A t!n-'rt;.ÜIlg R(' pn's('Ilwtl\'e.\
Richard P. Wilson
'219 East Lancaster Avenue
Ardmore, Penna. 19003
I .:kphon.:. (215) \ 1 ill\\ iI) lJ-I.N7

(ìorùon Tiffin
2 Tremont Crescent
Don Mills. Ontario
Tckphone. (4Ih) 444-4731

Member of Canadian
Circulations Audit Board Inc.

I3æEI

THE CANADIAN NUR
E

bJ

PROVINCIAL ASSOCIA TIONS OF REGISTERED NURSES

Alberta
Alberta Association of Registered Nurse
.
10256 - 112 Street, Edmonton, Alberta,
T5K I Mó.
Pres.: A.J. Prowse; Pres.-Elect: A. Thomp-

on; Vice-Pres.: D.E. Huffman, R. Arcand.
Committees - Staff Nllrse.c V. Zwicker;
SlIpen'. Nllrses: M. LaRocque. Pro
'. Office
Staff - Info. Officer: B. Steed: Diree. Col-
lect. Bargain.: Y. Chapman; Employ. Rei.
Officer: R. Donahue: Nsg. Servo Conslllt.: B.
Sellers; Comm. Ad
'i.HJr: H. COlier; Registrar:
A.R. MacKinnon; Erec. See.: H.M
abin;
Office Manager: M. Garrick; Project Diree.
Nsg. Edllc.: M. Moncrieff.

British Columbia
Regi
tered Nurses' Association of British
Columbia. 2130 W. 12th Avenue, Vancouver.
B.C., V6K 2N3.
Pres.: G. LaPointe; Vice-Pres.: T. Duck. R.
Macfadyen. Committee.ç-Nsg. Edlle.: S.
Roth\\ell: Nsg. Prae.: H. Hanel: Soe. & Emn.
Welf.: A. Sutherland. Staff - Exec. Direc.:
F.A. Kennedy; As.we. Exee. Direc.: K.M.
Smith: Registrar: H. Grice; Asst. Registrar: J.
Small; Direc. Edlle. Serv.: C. Kermacks;
Asst. Direc. Edllc. Serv.: J. McCullagh;
Direc. Nsg. Sen'.: T. Schnurr: Direc. Person-
nel Sen'.: N. Paton; Asst. Diree. Personnel
Sen'.: (Labor ReI.): G. Smale: Direc. Place-
ment Sen'.: M.L Carmack. W. Sawadsky;
Direc. Comlllllll. Sen'.: C. Marcus; Librarian:
J. Molson; Admin. Asst.: J. Holland.

Manitoba
Manitoba A
sociation of Registered Nurses.
647 Broadway Avenue, Winnipeg. Manitoba,
R3C OX2.
Pres.: G.R. Black; Past Pres.: F. McNaught;
Vice-Pres.: \1 McPherson, S. Paine,
Committees - Nsg.: M. McCrady: Brd, of
Eram.: O. McDermOIl. Profess.
Staff - Employ. ReI. Advi.wr: J. Glea
on:
Regisrrar: M. Caldwell; Contino Edllc. Ad-

'isor: K Dejong.

New Brunswick
New Brunswick Association of Regi
tered
Nurses, 231 Saunders Street. Fredericton.
N.B.. E3B IN6.
Pres.: B. leBlanc; Past Pres.: A. Robichaud;
Vice-Pres.: S. Cormier, R. Dennison: Hon.
Sec.: P Stephenson. Committees - Nsg.: Z.
Ha\\kes, S. Macleod; Nsg. Asst.: B. Schyf:
Legisl.: A. Aird: Lrec. Sec.: M.J. Anderson;
Liaison Officer: N. Rideout: Conslllt. Soc. &
Econ. Welf.: G. Rowsell: Registrar: E.
O'Connor: Asst. Exec. Sec. & Registrar: M.
Ru
sell;Edllc. Con.mlt.: A. Christie.

Newfoundland
Association of Registered Nurses of New-
foundland, 67 leMarchant Road, St. John's,
Nfld.. AIC 6A I.
Pres.: E. Wilton: Past Pres.: P. Barrell:
Vice-Pres.: B. Coady, J. Nevitt.
Committees - Nsg. Edllc.: R. Nicholle; Nsg.
Sen.: B.. Schofield; Registration: J. Fairley;
64 THE CANADIAN NURSE

Legisl. & By-Laws: K. Roche: Pllb. Rei.: J.
Walsh; Finance: J, Nevitt: Asst. Exec. Sec.:
A. Furlong: Exec. Sec.: P. Barrell.

Nova Scotia
RegIstered Nurses' Association of Nova
Scotia. 6035 Coburg Road, Halifax. N.S.,
B3H I Y8.
Pres.: Sr. M. Barbara: Past Pres.: M.
Bradley; Vice-Pres.: G. Smith. C. Butler. Sr.
S.M. Roach; Re
ord. Sec.: T. Blaikie: Exec.
See.: F. Moss. Commirtees - Nsg. Edllc.: L
Robinson; Nsg. Serv.: E.J. Dobson; Soe. &
Econ. Welf.: C. Amirault; Consllit. Nsg.
Edllc.: Sr. C. Marie; Consllit. Nsg. Serv.: J.
MacLean: Emplo\'. ReI. Officer: M. Bentley:
Pllb. Rei. Officer: D. Miller: Admin. Asst.:
E. MacDonald.

Ontario
Registered Nurses' Association uf Ontario. 33
Price Street, Toronto. Ontario. M4W IZ2.
Pres.: W.J. Gcrhard: Pres. Elect: N.M.
Marossi. Committees - Socio-Emn. Welf.:
LR. Gusselin: Nsg.: M.1. Boone; Edllcator:
J.P. Robarts: Admin.: \1.L Peart; Exec.
Direc.: L Barr; Aut. Erec. Direc.: D.
Gibney; Diree. Employ. ReI.: A.S. Gribben:
Direc. Profess. Devel.: C.M. Adams; Reg.
Exec. Secs.: M.J. Thomas, F. Winchester.

Prince Edward Island
Association of Nurses of Prince Edward
hland, 188 Prince St., Charlottetown, P.E.I.,
CIA4RlJ,
Pres.: B. Robinson: Past Pres.: E. MacLeod;
Pres. Elect: B. MacEachern; Vice Pres.: S.
Mulligan: Exec. Sec.-Registrar: L Fraser.
Committee,ç -Nsg. Edllc.: K. Kunelius;Nsg.
Sen'.: J. Peters: Pllb. Rei.: H. Wood: Fi-
nance: E. MacLeod; Legis/. & By-Laws: L
Fraser: Soc. & Emn. Welf.: R. Pcrry: Regis-
tration: L. Doyle.

Quebec
Order of Nurses of Quebec, 420U Dorchester
Blvd. W., Montreal. Quebec, H3A I V2.
Pres.: R. Bureau; Vice-Pres.: S. O'Neill, J.
Pinkham (Eng.), P. Proulx, Y. LePage (Fr.);
Hon. Treas.: C. Royer: Hon. Sec.: P.
Boucher. Committees - Nsg. Edllc.: G.
Allen. D. Lalancelle:Nsg. Serv.: J. Hackwell,
R. Dionne; Profess. Sen'.: S. O'Neill, P.
Murphy: School of Nsg.: R. Allu, C. de
Villiers Sauve; Legi.ç/.: M. Masters, C.
Belanger: Sec. Registrar: N. Du Mouchel.

Saskatchewan
Saskatche\\an Regi
tered Nur
es' A
socia-
tion, 2066 Retallack Street. Rcgina. Saskatch-
ewan. S4T 2K2.
Pres.: J. MacKay; Past Pres.: D.J. Pipher;
Pres. Elect: S. Belton; Vice-Pres.: Sr. B.
Bezaire, J. Callaghan. Committees - Nsg..
S. Pankratz: Chapters & Pllb. ReI.: R.
Ledingham: Soc. & Econ. Welf.: G. Hutchin-
son; Exec. Direc.: V. Cloarec; Ref,Ütrar: E.
Dumas: Pllb. Info. Officer: B. Schill: Asst.
Ref,Ùifrar: J. Passmore.

ð

Canadian
Nurses'
Association

Directors

President . . . . Huguelle Labelle

President-Elect. . . Joan Gilchrist

1st Vice-President Helen Taylor

2nd Vice-Presidcnt Margaret McLean

Member-at-Large .Lorine Besel

Member-at-Large Fernande Harrison

\1ember-at-Large . Glenna Ru\\sell

\1ember-at-Large Shirley Stinson

A.J. Prowse AARN
G. LaPointe RNABC
R.G. Black . MARN
B. LeBlanc NBARN
E. Wilton .. ARNN
Sr M. Barbara . RNANS
W. Gerhard . RNAO
B. Robinson . . . .ANPEI
R. Bureau ..ONQ
J. MacKay SRNA

Executive Director

.Helen K. Mussallem

OCTOBER 1974

TAKE ADVANTAGE OF OUR MAIL ORDER...
ITS THE EASY WAY TO FASHION.

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Sizes 3-15
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White ............ $25.00
Blue ............ $26.00

B
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Sizes 3-15
Royale Diamond Tricot K
White only........ $22.00

c
Style #43758
Sizes 5-15
Royale Diamond Tricot I<
White only........ $28.00

;HOP IN PERSON AT OUR
BA Y STREET STORE
OR 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, Onto M5V 2A3
Please send all mail orders t
above address or phone 366-141
for fast service.

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Style #43257
Sizes 3-15
Royale Spice.
100% Textured
Polyester Knit
White. Yellow
About $33.00

Sizes 8-18

Style #43224
Sizes 5-15
Royale Spice.
100% Textured
Polyester Knit
White, Pink. . about $33.00

Royal Diamond Tricot Knit
White ........ about $28.00

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by WHITE SISTER

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Sizes 8-18
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White only about $28.00

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Sizes 5-15
Royale Supreme Plain Tricot
Knit
White only about 518 00

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Style 3467 - 33467
Style 3467 - Sizes 10-20
Royale Corded Tricot
White about $20.f1
Yellow about $22.l
Style 33467 - Sizes 40-44
White, Yellow about $22.0

,",HITE
SISTER
CAREER APPAREL AVAilABLE AT All FINE STORES ACROSS CANADA

I NEW - PROBLEM-ORIENTED NURSING
Woolley, Warnick, Kane, and Dyer
A comprehensive text and how-to book, introducing the
theory and application of the problem-oriented medical
record system. The presentation, based on actual
hospital situations, details the incorporation of the nurse
into a functioning, decision-making medical care team.
As a new role for nurses, with major implications for the
profession, problem-oriented nursing is shown to be
operable on several levels, including the utilization of
paraprofessionals for gathering on-going observations
on chronic patients. In three main sections: the problem-
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the future.
Springer 177 pages 1974 paper $5.25 cloth $8.50

2 NEW -NURSING MANAGEMENT
Price, Franck, and Veith
The management principles today's nurse leader needs
to know in order to plan and maintain efficient delivery
of health care. Suitable for self-instruction, the pro-
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Springer 170 pages 1974 $4.95

3 NEW-THE LIPPINCOTT MANUAL OF
NURSING PRACTICE
Brunner and Suddarth
Designed to be the most useful single volume ever pub-
lished for the nursing profession, The Lippincott Manual
will provide all nursing practitioners wtih instant infor-
mation for immediate application to patient care.
Lippincott 1473 pages illustrated 1974 $21.50

4 NEW-A GUIDE TO PHYSICAL
EXAMINATION

Bates
Expertly illustrated, this "how-to" text bridges the gap
between anatomy and physiology and their application

to the physical examination. Within each body region or
system, three topics are dealt with: 1) anatomy and
physiology basic to the examination, 2) examination
techniques, 3) examples of selected abnormalities.
Lippincott 500 pages illustrated Nov/74 about $15.00
Also available
PHYSICAL EXAMINATION FILMS
A new series of 12 sound motion pictures, correlated
with the content of Dr. Bates book. Further information,
including prices, is available upon request.

5 NEW-MEDICAL CARE AND
REHABILITAnON OF THE
CHRONICALLY ILL
3rd Edition
Bonner
Frequently, various members of the health team have
not known what can be done to help the aged and/or
chronically ill. This new edition of this unique book
answers the need.
Little, Brown 311 pages Oct 1974 $16.50

6 NEW-PATIENT CARE SYSTEMS
Kraegel, Arora, Mouseau, and Goldsmith
Based on a project which won the 1972 Lambert Award,
this new book extends the science of design to the
rational planning of complex health care systems. Ad-
ministrative principles are applied to the hospital set-
ting; patient, environmental and nursing needs are
examined; case studies are used to explore and imple-
ment patient care plans.
Lippincott 150 pages 1974 $10.95

7 NEW-NURSING OF FAMILIES IN CRISIS
Hall and Weaver
This unique book provides an introduction to crisis theory
as a conceptual approach to nursing of families. The
authors include numerous case studies of families who
have experienced maturational or situational crises.
Lippincott 250 pages 1974 $6.50

Please send me the book(s) whose number1s)I have circled

4

o Payment enclosed (send postpaid)
Books may be returned within 15 days

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Toronto, Ontario M8Z 4X7
Representing in Canada:
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Blackwell Scientific Publications Ltd.
Springer Publishing Company, Inc.

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The
Canadian
Nurse

ð

<

A monthl} journal lor the nur
e
of Canada published
in English and French editions bv the Canadian Nurse
' As
ociati()n

Volume 70, Number 11

November 1974

13 The System Needs to be Changed. . . . . . . . . . . .

. . . . N.-M. Dufour

15 Identifying the Suicidal Person
in the Community ............................... P.M. Delbridge

18 Registered Nurses
in Office Practice. . . . . . . . . . . . . . . . . . . . . . . . . S.]. Winter and ].M. Last

21 The Private Self
and the Professional Self. . . . . . . . . . . . . . . . .

L. Besel

27 Lumbar Pain Linked to Hypokinesia

24 Psychology of Childbirth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D. Shields

32 CNA's Response to the Le Dain Commission Report

The vie
<, H,p"E<,
ed in the il
lclE<, il
e tho
e of the ilutho

ilnd do not nece

il
i Iy rep
e<,ent the
policie<, o
vie\v', of the Lilnildiiln "'u

e
' IV,<.ociiltion.

4 Letters 40 Research Abstracts
7 News 42 Books
36 In A Capsule 44 Accession List
38 New products 63 Official Directory

!::xecullve Director: Helen K. \lussallem _
Editor: Viq
inia A, Lindabur
_ A"j,tant
Editors: Liv-Ellen Lockebeq
. Doroth
S.
Starr _ Editorial Assist.lnl: Carol A. Ih.or-
kin _ Production A"istdnt: \Ian Lou
()m.nes _ Circulation Mdnager: Her;1 Dar.
ling _ Adveni,ing \1andger: Geoq
ina Clarke
- Subscription Rates: Canadd' one yedr.
$6.00: two yedrs. $II.O(J. Foreign: one yedr.
$6.50: two yeMs. $1 :!.lKJ. Single copies:
$1.00 edch. Mdke cheque, or money ordei'
pa
dhle to the Cdnddidn Nurse,' A"ocidtion.
_ Change of Address: Six weeks' notice; the
old dddress as well d' the new Me ne,e"ary.
logether with registration numher in d pro-
vin,ial nurses' ds,ociation. where appli'dhle.
Not responsible for joumdh lost in mdil due
to errors in dddress.

Manuscript Information: 'The Canadian
Nurse" welcomes unsoliciled drtides. All
mdnuscriph should he typed. douhle-'pd,ed.
on one ,ide of unruled pdper ledving wide
mMgin,. Mdnusnipts dre aClCCpted for review
lor excluSIve puhlication. The editor reserves
the right to ma!.e the u'udl editorial chdngcs.
Photogrdphs (glo"y prints) dnd grdphs dnd
didgrams (drdwn in india in!. on white paper)
dre welcomed with ,uch Mti,It
,. The editor
i, not commilled to puhlish dll drtides \Cnt.
nor to indi,dte delinite ddtes of puhli'dtil>n.
Postdge pdld in ,d,h dt third da" rate
"10NTR!::AL P.(). Permit
o. 10.001.
50 The DrivcwdY. OlldWd. Ontdrio. ":!P IE:!

CCdnddidl1 Nur",' A"ociatlon 147-1

If only suicide were a germ disease!
Another Salk or Pasteur could identify
the organism and develop a preven-
tive.
Suicide is an important cause of
death in Canadians of all ages. but the
government's New perspective on the
health of Canadians does not mention
suicide in 74 proposals for improving
Canadians' health. This is not a defi-
ciency in the working document; it
.mderlines the difficulty of pinpointing
the causes of suicide.
Although no specific preventive for
suicide is available, intervention is
possible. both for the suicidal indi-
vidual and for his significant others. An
article on identifying and helping suic-
idal individuals appears on page 14.
The author says that cooperative ac-
tion by the health professional and the
family of a suicidal individual makes it
possible to help the family without
delay, should th
person successfully
commit suicide.
An authority on suicide, E.S.
Shneidman, wrote: "A benign com-
munity ought routinely to provide
postventive mental health care for the
survivor-victims of suicidal deaths.
Postvention is prevention for the next
decade and for the next generation.'"
The exact dimensions of the Cana-
dian suicide problem are unknown. It
has been estimated that for each
completed suicide, there are 10 per-
sons who attempt suicide unsuccess-
fully. Research in London. Ontario.
indicates the figure for suicide at-
tempts is much higher. 2
In 1971, 2,559 persons were offi-
cially recorded as suicides in Canada.
If these persons had an average of 2
survivors each, and if a ratio of 1
suicide to 10 attempts is used. we
have over 30.000 persons per year
requiring intervention or postvention in
suicidal crises.
Therefore. practicing nurses fre-
quently come into contact with indi-
viduals who are or will be suicidal to a
life-threatening degree, or who are
survivors of a person who has
suicided. Many skills needed for
suicide intervention and the care of
survivors are within the scope of
nursing.
Suicide intervention and postven-
tion are part of primary care; both can
promote health. - D.S.S.

1. Shneidman, Edwin S.. foreword to Sur-
vivors of Suicide, ed. Albert C. Cain.
Springfield. III.. Thomas. 1972. p.x.
2. Whitehead, Paul C et al. 'Measuring
the Incidence of Self-injury." Paper
delivered at 6th International Congress
on Suicide Prevention, Mexico City.
December 1971.
THE CANADIAN NURSE j

NOVEMBER 1974

letters

{

Lellers to the editor are welcome.
Only signed lellers, which include the writer's mmplete address,
will be considered for publication.
Name will be withheld at the writer's request.

Information wanted
I would like to urge nurses who grad-
uated in the province of Quebec between
1952 and 1966 to answer the question-
naire they received some time ago and
to return it to us as soon as possible. -
B. Lavergne. MD, research assistant.
department of preventive medicine and
epidemiology, Institut de Microbiologie
et d'H.vgiene de Montreal, 53/ Blvd. des
Prairies. P.O. Box 100. Laval. Quebec.

Reader questions CNA decision
I read that the Canadian Nurses' Associa-
tion will invest up to $15.000 in the
Northwest Territories Registered Nurses'
Association (News. September 1974,
page 7). Is the CNA board still unaware
of the mess 40,000 nurses in Quebec are
in because of an organization in which
both the interests of the nurses and the
interests of the public are legally rep-
resented by the same persons?
The answer must be "no." What other
explanation is there for the $15.000
investment in the NWTRNA in its present
circumstances?
Many years ago. Ontario nurses recog-
nized this conflict of interest in their
professional association and permitted
separation of the public protection interest
from their association. The function of
protecting the public was taken over by
the College of Nurses of Ontario. a
statutory body.
The results in Ontario were beneficial
all around. To practice. a qualified nurse
pays only $7 a year (after the initial fee).
which covers the costs of checking her
file once a year. and so on. In the
professional association. deadwood was
eliminated by the association fee, as only
nurses who were genuinely concerned
with nurses' welfare would pay.
In contrast there is Quebec. where to
work as an RN, a nurse has to pay $50 for
her license. What is done with the extra
$44? It is spent on programs and policies
the nurse mayor may not agree with. and
on subsidizing quasi-vacations under the
guise of regional, national. and interna-
tional nursing congresses. True, the nurse
can attend association meetings and voice
objection to established programs.
Nevertheless, she is forced to support
them if she wants to practice nursing in
Quebec.
I do not see how it is possible for a
registrar who is paid by the nurses of the
Northwest Territories, instead of being an
4 THE CANADIAN NURSE

employee of the NWT government. to
have the interests of the public genuinely
at heart. I am disappointed that the CNA
board has agreed to finance this kind of
arrangement. Given the present plan. it
would be better if the NWT nurses were
registered by the office that registers
vehicles. issues fishing licences. and so
on. - RN, Quebec (name withheld on
request ).

CNA should publish magazine
In response to your August 1974 editor-
ial. I certainly think the Canadian Nurses'
Association should continue to produce
its own professional magazine. Nurses
across Canada maintain some identifica-
tion with one another via this publication.
In view of high publishing costs. more
consideration could be given to using
space effectively - possibly by simply

MOVING?
BEING MARRIED?

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otherwise you will likely miss copies.

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OTTAWA, Canada K2P 1E2

listing newly acquired library hoob and
making book reviews available on re-
quest.
Another example of what I believe
regarding the effective use of space is the
five and one-half pages of fun and frolic
photographs accompanying the C:-.JA con-
vention report in the August issue. I
realize the importance of the C\JA report;
however. I feel that those pages could
have been used to greater advantage in
some other way.
In both the February and May issues.
there were examples of expansive charts.
wide margins at the top of pages. and
blank columns. More space would be
made available for nursing topics if space
were used effectively. - Frances M.
Penney, RN. Winnipeg, Manitoha.

Concerned about nursing
I would like to congratulate Wilinia B.
Garbe (Letters. August 1974. page 4). I
heartily endorse all she says.
There are many conscientious doctors
in Canada who employ registered nurses
in their offices. I consider that those who
"train" a lay person to give injections. do
dressings. BPs. and so on are giving poor
medical care in a land that boasts an
excellent health program.
Most of the public do not realize that
these persons are not professionab. and
call them "nurse" - a title for which
they are unqualified. I think the public
should be protected against this type of
"medical" treatment.
This brings up another point I would
like to discuss with registered nurses. In
many countries. the RN has a distinctive
uniform, one that no one else can wear.
so that patients are able to recognize her
status as a professional by looking at her
uniform. I have had numerous complaints
from the public regarding this problem.
and would like to hear nurses' opinions
regarding a special uniform.
I am sorry that the once respected and
noble nursing profession is graduall y
deteriorating and will soon sink to a
frightening low if something is not done
to upgrade the diploma nurses' course
before it is too late. I am disappointed in
our elected representatives for allowing
this "mini" 2-year course at community
colleges to include nursing. Many of
these budding nurses. v. ho hope to have
"RN" after their names in 2 short years.
have told me that they feel cheatcd. -
RN, Onto (name I\'irhheld (JI/ request).
NOVEMBER 1974

o

...........

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Take a close look at syringes.
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BUILDING ON A CENTURY OF QUALITY ' / C
-v; . .1 1874-1974
HEALTH CARE PRODUCTS
.... Ä 'J

310ll0C

AI-
'II

/

MRS. R. F. JOHNSON
SUPERVISOR

CHARLENE HAYNES

- --------\{Uut' \
r-
RS.\1 0L

\
HN
L.PN.

/,

.../u- Paw"

GENEROUS NEW GROUP DISCOUNTS on all
Items shown. for group purchases. graduation gifts. favors. etc.
6.11 Same Items, Deduct 10 0 0; 12-24 Same Items, Deduct 15%
25 or More Same Items, Deduct 200.. A

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IT'S EASY TO ORDER REEVES NAME PINS FOR YOURSELF OR FRIENDS! I
Choose style you want. shown left. Pnnt name (and 2nd bottom left. Attacl1 f)'lra sheet for additional pinS I
line II desired) on dotted lines below Check olller info in NOTE SAVINGS ON 2 IDENTICAL PINS.. . . more cODÙ'ment.
boxes on chart, chp this sechon" and attach to coupon spare in case d. loss.
I
I LETTERING,______________________ 2nd LlNE,________________
: STYLE DESCRIPTlDH METAL METAL BAC:8

:ND LETTERING PRICES
ND. CDLDR FIHISH (Plastl,) CDLDR Enlrmd 1 Lin. fRl....d 2 Lin.s

iIored
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tlWhlte
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0.510

510

MOLDED PLASTIC.. . Simple, smart,
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Smooth rounded corners and edges.

II plnbacb with ""1)' catch

NURSES PERSONA LIZ EO , _
ANEROID SPHYG.

A superb Instrument especially designed
for nurses by Reister Exacta, precIsion
craftsmen in W Germany. Easy to attach
Velcro"ll cuff, lightweight, compact, fits
into soft sim. lealher zIppered case
2"h" x 4" x 7". Dial callbraled
10320 mm., 10.year accuracy
guaranteed 10 ::!::3 mm. Serviced
by Reeves If ever required Your
imlials engraved on manomeler
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A wise anveslment for a hfetime
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No. 106 SDhyg.... 39.95 ea.
BLOOO

'

An outs landing value I Excellent qual-
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Japan Meets all U.S. Gov SpeCS.
::!::3mm accuracy, guaranteed 10
years Black and chrome manometer
cat to 300mm Velcro grey cuff,
black tubing. soH leaU1erette llpper
case measuring 2"h" x 4" x]" Serv-
Iced In USA if ever needed Clayton
No 4 J 40 Nurses Stethescope (less
Imtlalsl and Scope Sack Included (see
below nghll FREE gold Imhals on
case and Scope Sack Here IS a sensl
ble. practical dependable kit Just
right lor every nurse'
No. 41.10 B.P. Set...
32.95 set complete
Sphyg. only No. 108. . . 25.95 with case

Duty free

CAP ACCESSORIES

-_.
CAP TOTE keeps your caps cns
and clean
while stored Or carried. Flexible clear plastic, white

trim, lipper, carrying strap, hang loop. Stores flat Also _
__
fl)r wiglets, curlers, etc. 8"h" dia.. 6" high
No. 333 Tote. .. 2.95 ea. Gold inil. 50,/Tote

WHITE CAP CLIPS Holds caps
.
fumly In place! Hard-to.fmd whIte bobbie pins,

enamel on fane spring steel Seven 2" and four
3" clips included In plashc snap box.
, No. 529 Clips 75c per box (min. 3 boxes)
MOLOEO CAP TACS

Replace cap band instantly T my plastic tac,

.
'\.
damty caduceus Choose Black. Blue. Wtllte "-+
'
or Crystal with Gold Caduceus. The neater ..
way to lasten bands

No. 2DD - SeiDl 6 Tacs. . . 1.25 per set _. \

r=õ'rO
METAL CAP TACS Pair 01 damly

Jewelry-quahty Tacs with grippers, holds cap
n
bands securely.. Sculptured metal, gold finish,

r,,,' approx. %" wIde. Chouse RH. LPH. LVH, RH

' Caduceus or Plain Caduceus. Gift boxed.
11.
f:t No. CT.l (Specify In ilia Is), No. CT.2 (Plain
Cad.) or No. CT.3 (RN Cad.) . . . 2.95 pro
. . I . II I I I

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CDLDR SIZE DUANT. PRICE

ITEM

use extra sneet for additional items or orders.
INITIALS as desired, _ _ _
TO ORDER NAME PINS, I,ll out all inlormalion in box. lop
nght, clip out and attacn to this coupon.
, Please add 50c: handling/postage
e $ Ion orders totalhng under $5.00
or bllhng to individuals Mass residents add 3 ,S. T

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I Send to
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70n

Ac.'-""

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Your
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t Free!
ope Sack

all Price

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Free Initials
with y'OlIr own
Littmann Nursescopef
BRAND

Famous Littmann nurses' dia
phragm stethoscope . . . a fine
precision instrument, with high
sensitivity for blood pressures,
apical pulse rate. Only 2 OIS.. fits
m pocket, with gray vinyl anti. No. 2160 Nursescope incl.
collapse tubing. non-cl1ilhng epoxy Free Initials. . . 16.50 ea.
diaphragm. 28" overall. Non.rotat.
Ing angled ear tubes and chest
piece beautifully styled In choice
of 5 Jewel.like colors: Goldtone.
Silvertone, Blue, Green, Pink..
-IMPORTANT: New "Medalhon" styling includes tubing in colors to match
metal parts. If desired. add $1 ea. to price above; add "Mil to Order
Ho. 2160!!!, on coupon. Duty freee
LITTMANN COMBINATION STETHOSCOPE
Mallimum sensitivity from rhls fine professional Instrument Con.
vement 22" overall length, weighs only 3"h oz. Chrome blnaurals
filled at correct angle. Internal spring. stamless chest piece, 1%"
diaphragm, 11/." bell Remo'Jable non.chlll sleelie. Gray vinyl tubing
Two Imllals
ngL on chest piece
No. 2100 Combo Stelh . ..29.70 ea.

FREE INITIALS! Your initials en
graved FREE on cl1est piece, lend
individual distinction and "elp pre.
vent loss.

SCDPE SACK See special halt.price
offer in Scope Sack box below,
w"en ordered witl1 any scope.

Duty free

LITTMANN PEOIATRIC STETHOSCOPE
Same as above, ellcept smaller chest piece for use wltl1 mfants and
small c"lIdren. D,ap"ragm J
" dia , belli "18". Black tubing. Includes

.e
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a
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CLAYTON OUAL STETHOSCOPE
lightweight dual scope imported from Japan; "ighest _ ...
sensitivity for apIcal pulse rate. CtJromed binaurals
nd

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ear plugs and diaphragm Included. !!! imllals

engraved free Duty
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LIGHTWEIGHT CLAYTON STETHOSCOPE
Our lowest cost preCISion stethoscope I Smgle dlaphraEm U!I," ð,a).
Ch e Blue. Green Red, Silver or Goldtubang and clles lece, silver
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I No. 4140 Clay. sleth . . . 11.9
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CR..A(2) SCOPE SACK neatly carries and protects

Nursescope or any scope. Double.ttJlck frosted
I
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. """";j./ Your own millals help prevent loss.

No. 223 Sacll . . . 1 00 ea. (Deduct 50, when or.
dered with any scope aboveJ. Gold initials, add 50,

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'" White barrel with caduceus Impnnl, aluminum

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No. 001 Penli(ht . . . 4.29 ea. Your Initials enlraved, add 5B, per light

o Gold B

o Silver 0 Satm

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not
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o Black 0 I Pin 2.35 0 I Pin 3.10
o Dk. Blue 0 2 Pins 3.85 0 2 Pms 4.95
o White Csame nafT'e) Csame namel

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DWhlte
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o Blue
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White 0 2 Pms 1.95
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only (same name)

o I Pin 1.85
o 2 Pins 2.90
(same name)

Does
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o Gold
o Silver

Polished
frame
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Does
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apply

White
only

o Black 0 1 Pm 1.25 0 1 Pm 1.85
o Dk. Blue 0 2 PinS 1.95 0 2 Pins 2.90
b.ame name) (same narTle)
------------.

White
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o Black 0 I Pin 2.35 0 1 Pm 3.10
o Dk Blue 0 2 Pins 3.85 0 2 PinS 4.95
(wme namel (wme namel

Ooes
not
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"T'

SCISSORS' and

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Guaranteed 2 years,

LISTER BANDAGE SCISSORS
3 1 /2" Mim-scissor. TinY, handy, slip mto
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No. 3500 3%" Mini. . .. . . . . 2.75
Ño. 4500 4%" size. Chrome only. . . 2.95
No. 5500 5 ' /2" size, Chrome only. . . 3.25
No. 702 7Y4" size, Chrome only. . . 3.75
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Pollst!ed Stainless Steel, straigtlt blades.

r "
No. 705 Sharp/Blunt poinls.. . 2.95
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No. 7104...'2" IRIS Scis., Stainless, Straight... 3.75
No. 712 5Y/' Littauer STITCH Scis.. Stainless. 3.75
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No. 744 Sponge, Serrated, Straight BOI Lock, 9" . .. . 6.80
No. 734 Backhaus Towel Clamp, BOI LDCk, 5112" .. ..3.75

3 inltlill Ingroved on ellJ ebove, edd !IO,o per Instrument.

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news

NGO Delegates At Bucharest

Make World Population Statement

Ottawa - Nearh half of the I AOO individuals "ho allended the World Population
Tribune for nongovernmental organization (NGO) representatives signed a 12-point
declaration in Bucharest. Romania. in August. 1974.
Official delegate
. representing na-

tional governments. allended a World
Population Conference. held simultane-
ously \\ ith the World Population Tribune.
The Conference delegate
approved a
World Population Plan of Action that" ill
be submilled to the United :-.Jations for
ratification. Some 5.000 persons jammed
Bucharest for the
gathering
.
One point in the
GO declaration states:
"Governments should respect the basic
right
of all individuab to have access to
infonnation and means of determining the
number and spacing of their children. By
the year 1985. governments should pro-
vide free information and services to
ensure this right. and adequate education
on population dynamics to all."
The original draft of the official Plan of
Action recommended that governments
make available ."the means to practice
family planning effectively" not later
than 1985. The 1985 target date "as
deleted from the final t;xt. Officials
substituted an invitation to countries that
consider their binh rates .. detrimental to
their national goals" to consider "selling
quantitative goals and implementing
policies that may lead to the allainment of
such goals by 1985."
The 26-member Canadian delegation to
the Tribune included representatives of
such voluntary organizations as the Fam-
ily Planning Federation of Canada. Cana-
dian University Service Overseas (CUSO).
the United Nations Association of
Canada. and Oxfam. The Canadian
Council for International Co-operation
received a grant from the Canadian
government to assist Canddians "ith
travel costs to allend the Tribune.
:\largaret Hilson. Olla"a. "as one of
the CaLnadian delegates to the Tribune.
She is a public health nu
e on the health
division staff of cuso headyuarters in
Otta"a.
"Canada "as the only developed coun-
try I kmm of that sent delegates to the
Tribune at government expen
c." Hilson
told The Calladiall Nurse.
NOVEMBER 19"'4

The number of persons attending the
Tribune made it too large to be a good
forum for discussion. sh; said. HO\\
ver.
the International Planned Parenthood
Federation paid for 7 reporters. "ho put
out a daily paper summarizing discus-
sions for Tribune attenders
.. At the end of the Tribune. indi\ iduals
had a better understanding of" hat other..
were talking about. For L instance. dele-
gates from Asia realized that others "ere
serious about not having more babies. I
felt a change from initial allitudes.--
Hilson said.

She said there "as discussion of
women's rights at the Tribune. as there
"as in th
official conference. The
Tribune's population declaration states:
"The success of population policies de-
pends on the full participation of women.
Women should have the opponunities to
obtain full human dignity necessary for
them to exercise responsible choice as
persons The economic contribution
of women as mothers and providers of
food. both in rural and urban areas.
should be fully recognized."
Commenting on the official confer-
ence. Hib.on ;aid that Canadian govern-
ment officials met with individuals and
groups across Canada to get their views
before going \0 Bucharest. The official
delegation also met 3 or
times with the
\JGO representatives during the Confer-
ence.
On the negative side. Hilson said.
"There "ere fe\" elected representatives,
on the official Canadian delegation: most
were civil servants. and , am surpriscd
that no
tatement or comment has been
issued to the Canadian people by the
official representdtives since returning
from Bucharest.
.., hope the World Population Plan of
Action" ill bc integrated into plan
from
the World Food Conference held this fall
in Rome. You can't talk about people dnd
food separately'" Hib.on ...aid.

She hopes the World Population Con-
ference " ill encourage Canada to develop
a population policy. "Canada's official
delegation should have been more defi-
nite
about population at the Conference.
We are. after all. one of the \\orld's food
growers." Hilson said.

SRNA Recommends Policies
For Nurses In Doctors' Offices
Regilla. Sask. - At its September 1l)7

meeting. the Saskatche\\ an Registered
Nurses'; Association Council approved
personnel policies. including salaries. for
registered nurses employed in doctors'
offices and medical clinics.
SRNA belie\ö that these nurses. as
graduates of approved schools of nursing.
have a background of education and
experience enàbling them to deal with the
physiological. psychological. and
sociological needs of the individual in the
community.
The personnel policies recommend:
. A definite and c1ear-" rillen agreement
bet"een nurse and employer. Lcovering
the various items contained in these
policies: the employer and nurse should
have a COpy of the agreement.
. For permanent part..time employees. the
same benefits. on a proportionate basis.
as full.time employees receive.
. Normal hours of \\ork not exceeding
37 1 /2 hours per week: for overtim

exceeding the normal \\ orking hours each
day. add
ional salary at time and one-half
or time off. calculated at the appropriate
mertime rates in lieu of overtime pay
Employees required to "ork on
scheduled days off should receive double
the regular pay rate.
. T"o consecutive davs off each "eek. If
a statutory holiday fálls on :; scheduled
day off or during the employee's annual
vacation. the employee should get an
additional day off or a day's pay.
. For the first vear of continuou
service
and each vear after.
O "orking dav..
vacation" íth pay .
-
. Led\c of ab
ence \\Ìth pay for au-
thorized allendance at cducational prog-
rams and professional meetings. Leave of
absence for pregnanc
for
to -t months
"ithout change in salar). \\ ith increment
date extended for this period. Holiday s
and ...ick leave should not accrue.
. A definite policy for compdssionate
lea ve .
. Sick lea\e "ith pay granted on the bdsis
THE CA,,\ADIAN NURSE 7

of 1 1 12 days per month and cumulative.
. Recent satisfactory experience and
educational preparation considered when
assessing individual salaries: the first
salary increment after I year's experi-
ence, the second after 2 years. and the
third after 3 years.
. Job descriptions for employees estab-
lished by each agency.
Recommended monthly salary scales
for a general office nurse in step I are $707
in 1974 and $775 in 1975. At the top step
(5). the salaries recommended for nurses
in this position are $830 in 1974 and $900
in 1975. Charge nurses should start at
$815 a month in 1974 and $890 in 1975.
according to S
NA.
The nurses' association also recom-
mends that all salary schedules be re-
viewed annually and adjusted in relation
to the cost of living and other factors.

RNABC To Discuss Funding To Allow
RNs To Provide Primary Care
Vallcouver, R.C. - The Registered
Nurses' Association of British Columbia
is seeking a meeting with Health Minister
Dennis Cocke to
discuss funding that
would permit registered nurses to provide
primary health care.
Registered nurses prepared to give this
kind of care would be the first health

. SILENT
. SMART and
. COMF

...

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professional the patient sees. an RNABC
news release says. The primary care nurse
would work closely with the physician or
a group of physicians. This nurse would
provide services including diagnosis.
physical assessment, counseling. r
ferral.
or home visits.
The provincial government is now
funding an educational program, prepar-
ing RNs for primary care roles. at the
University of British Columbia.
Geraldine LaPointe. RNABC president.
explains that "unless the provincial gov-
ernment can give us some assurance that
financing for
expanded nursing roles will
be available. we would be training nurses
for no practical purpose. ..
At the first falI meeting of RNABC's
board of directors September 20 and 21.
LaPointe said some means must be
developed to coordinate the intake of
applicants to the UBC program with
positions in primary care, available to
nurses on completion of the program. If
this is not done. she warned, the new
course "may have to go into mothballs."
These comments followed a report by
Rosemary Macfadyen, RNABC representa-
tive to the B.C. Committee on the Ex-
panded Role of the Nurse in the Provision
of Health Care.
In other business, the board of directors
adopted a position statement on continu-

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Hetty Bos is our
'Beau
on Duty' winner.
Congratulations.
Hetty Bos, of Humber-Memorial Hospital in Toronto, Ontario, won our
lucky draw for a one week vacation in the Caribbean. Courtesy of Bata Shoes.
Saul Komessar, Bata's Retail Division Vice-President, gave Hetty
her airline tickets and a big envious smile.

B THE CANADIAN NURSE

ing education. which leaves participation
in continuing education on a voluntary
basis. Criteria for registration will focus
on the individual's c
mpetence: explora-
tion of methods by which competence can
be monitored will continue.

Course in Gerontology Offered
Cap Rouge, Que. - A course in geron-
tology wilI be offered next January at Le
Centre de gérontologie et de gériatrie in
Cap Rouge. a suburb of Quebec City.
This course, which has been modified and
adapted to meet the specific needs of
nurses, has been approved by the Quebec
department of education. Any nurse who
has obtained a nursing diploma may
register.
Given within one academic semester.
the program leads to a certificate in
gerontology. Subjects include: gerontol-
ogy, geriatric psychology, methods of
observation. and specialized techniques
of leadership. Tuition fee is $200. and
scholarships are available if the employer
makes the request.
Nurses interested in this course. which
wilI be given in French. are requested to
write Sister Germaine Dupuis. Centre de
gérontologie et de gériatrie: PavilIon
André Coindre. Campus Notre Dame de
Foy. Cap Rouge. Québec. The definite
starting date wilI be announced later.

Enrollment Increases By 100
In N.S. Schools of Nursing
Halifax, N.S. - Schools of nursing in
Nova Scotia opened their doors in Sep-
tember to the largest number of students
in the history of nursing in the province.
A record 583 students enrolIed - 485
in the schools of nursing associated with
the 7 hospitals that administer the 2-year
diploma program. and 102 at the 3
universities. This figure represents an
increase of approximately 100 more stu-
dents than last year.

RNANS Issues Brochure To Clarify
What Is and What Is Not Nursing
Halifax, N.S. - Believing that the role
of the registered nurse in health services
in Nova
Scotia needs clarification. the
Registered Nurses Association of Nova
Sci)tia has issued a brochure entitled What
is lIursing'! What is not nursing? In this
brochure, RNANS puts for!:l a philosophy
of nursing service. a definition of nursing,
and standards of nursing care.
The association hopes that wide dis-
tribution of this brochure wilI encourage
nurses to continue thinking about the
contrihution they can makt to improve
the health of Nova Scotians: to increase
the awareness of government. other
health personnel. and the public about the
role of nursing: and to provide a base for
ultimate changes in the legal status of
nursmg.

(Contil/lled 01/ paRe 10)
NOVEMBER 1974

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Because IOU're on your feet a lot,
don't stand for ' · but the best.
-

Being a nurse means hours of
being on your toes. And on your
feet.
That's why Bata designed
'Beauty on Dutÿ'. A full range of
nurses footwear that can help
you take a long day in
stride.
Soft materials, comfort-
able cushion insoles
and fashions that are
right in step with to-

day's styles make Bata's line
of white nurse's shoes easy on
your feet.
And prices that start as low as
$11 make our shoes just as easy
on your budget.
'Beauty on Duty' shoes
are available at all Bata
Shoe Centres. Come
pick a pair soon.
And start nursing your
feet back to happiness.

ßaIø
GßEAUTY
ON CV UrY

It's a sten in tl1P riuht dirPmon_

I m15o/
fièr.1
discount on any pair of
'Beauty on Duty' shoes.
Just present
this coupon at any
Bata Shoe Centre.
Offer expires
December 31, 1974.

L

,

news

(ColI/ill/l/'ll fro", f'llf?e 8)
As stated in the brochure. R:-.1AI':S
accepts Virginia Henderson's definition
of nursing: "assisting the individual. sick
or "ell, in the performance of those
activitiö contributing to health or its
recovery (or to peac'eful death) that he
would perform unaided if he had the
necessary strength. "ill or knowledge.
and to do this in such a way as to help
gain independence as rapidly as possi-
ble. ..

OHS Working Paper Soon Ready For
Study And Comment By Quebec Nurses
Quehec. P.Q. - Operation Health Sci-
ences (OHSL launched in October. 1972,
by the department of ed ucation of Quebec,
is about to issue a working paper on
educating nurses for an expanded role.
This paper is drawn from the views ex-
pressed by various groups (such as the
Order of Nurses of Quebec) and individu-
als. and from the three documents pub-
lished by OHS: nursing sciences, medical
assistance, and implementation of ne"
roles for the nurse.
On its completion. the working paper
will be widely distributed for three months
to allow interested persons to make com-
ments. The department of education will
decide how the tinal text will be used.
The OHS was created to help universities
plan and coordinate the teaching of health
sciences. Besides forecasting the require-
ments for health workers in each discip-
line. OHS has been commissioned to out-
line the probable evolution of the roles of
health professionals and predict the possi-
ble creation of new professional
categories.
Those responsible for the three
aforementioned documents are: Olive
Goulet of laval Universitv. nursine sci-
ences; Claude lanctÔt of the Univer
ty of
Sherhrooke, medical assistance; and Paul
Bouryue of laval University. implementa-
tion of new roles for the nurse.

ONQ Presents Its 1974-75 Program
Of Educational Activities
Montreal, Que. - For the third consecu-
tive year, the Order of Nurses of Quebec
(O:-.1Q) has sent each of its memhers a provi-
sional program of its educational activities
and meetings for 1974-75.
The brochure. which nurses have been
asked to keep the entire year. contains a
detailed description. in English and
French. of the study sessions to be offered
in several regions of the province, together
with detachable registration coupons for
each activity outlined.
Subjects offered include the following:
10 THE CANADIAN NURSE

] in service education. teaching methods and
techniy ues, gerontology. geriatrics. per-
sonnel evaluation. group animation tech-
niyues. planning ,md organintion of in-
service education, budgeting. ne" trends
in teaching and nursing care, p...ychiatric
nursing. audiovisual aids in education,
and so on.
The brochure also contains infornlation
on several culturo-professionaltours plan-
ned during the year.

UN Seminar Reaches Conclusions
For Achieving Equality of Women
Ottllll'a - A draft report from the 1"0-
week United Nations seminar. held in
September to consider the need for
national machinery to accelerate the in-
tegration of women in development and
to end sex discrimination. contains a
number of general conclusions and re-
commendations.
In establishing national commissions
and similar machinery. certain factors are
seen as essential. Among these are:
. The machinery should be mandated by
the eovernment. at the highest level. and
shoùld be institutionalized to survive
changes of government.
. Where possible, national machinery
,hould be established as an oftïcial
government body, operating closely with
relevant government bodies and non-
governme'ñtal organizations. When it is
set up, it should be announced by the
head of eovernment and the announce-
ment sh(
uld have the widest possible
press coverage.
. The mandate of this body should be
stated clearly and publicly.
. Adequate resources are necessary to
ensure the efficient carrying out of its
functions.
The report notes that activities under-
taken by this type of national body "will
tend to eliminate prejudices and sex
stereotypes, create a ne" and helieI'
image of women' s and men' s roles,
change traditional allitude, and pallerns
of behavior. so as to achieve a more
eyuitable sharing of responsibilities bet-
ween men and women in a more just and
harmonious society. ..
Some of the suggestions from the
seminar refer to the relationship of na-
tional machinery "ith international
bodies. For example: "National machin-
ery should aim at ,eeing that international
conventions are ratified and that com-
mitments made by government are fully
i mplcmented.

BE A +
BLOOD
DONOR

"National machinery should, en-
,me that governments give eyuitable
reprc,entation to women in their delega-
tions to l:IJI1fcrences and meetings of the
U:-.1 and its family of organizations [andl
...hould. through their government,
suggest names of women candidatö for
posts in the secretariats of the organ in-
tion... of the UI\J sy stem. including po,ts at
the highest level. "
Me
llbers of the Canadian delegation at
the seminar "ere Rita Cadieux. Canada's
representative to the UN Commission on
the Status of \\'omen; Martha Hynna.
Privy Council Office; Florence Bird,
Chairman of the Royal Commission on
the Status of Women: Katie Cooke.
Advisory Council on the Status of
Women; Elizabeth Feniak. Manitoba;
Sylvia Gelber. Canada department of
labour; 1\1argaret Hams. Saskatchewan;
Thelma N ichoI...on. department of exter-
nal affairs; Laurette Robillard. Quebec:
and laura Sahia. Ontario.
Canada chose one of the three resource
consultants for the seminar: Freda Paltlel.
,pecial advisor on the social and welfare
status of women. Health and Welfare
Canada. The other consultants were from
Japan and l\1exico.

Chrysler Corp. Nurses Are Ahead
Of Nurses In Public Sector
Windsor, Ollt. - Few nurses in Canada
are organized in the private sector, but
those who are receive more money than
nurses working in the public sector. At
Chrysler Corporation Canada. where the
nurses' benefits reflect those gained by
the United Auto Workers, the most
important factor is a cost-of-Iiving allow-
ance paid every 3 months.
There are 13 full-time and 9 part-time
nurses at Chrysler's Windsor plant. Bon-
nie Reive. president of the nurses' associ-
ation, told The Canadian Nurse that the
cost-of-Iivine allowance for the June to
A
gust yu";-ter was $197, paid in one
lump sum; it will be $260 for the
following yuarter.
A 3-year contract signed by the nurses
in March 1974 gives them a starting
,alary of $902 a month in 1974. During
the first 48 months a nurse works at
Chrysler. she gets a salary increase every
6 months. After 48 months. there is a
yearly salary increase - usually 3 per-
cent; these nurses can also earn an
additional merit increase each vear.
In addition to hospital a
d medical
coverage and a drug plan. the Chrysler
employees begin receiving dental plan
coverage thi, fall.
üne 'benefit for the nur
es at Chrysler.
Reive stressed. wa, "orking a regular
5-day week. They occasionally do over-
time. hut get compensation for it. Al-
though one nurse regularly works the
midnight shift. the other nurses work on
this shift for 2 weeks once a year.
NOVEMBER 1974

NEW
Form u lation ..,.
\a'"

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I Min. InhIbitory Concentration (ppm)
DERMOlAN + Hexachlorophene DERMOlAN with IRGASAN
Staph. aureus 1 1
Salmonella typhimurium 10 1
E. coli 10 1 I

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DERMOlAN al
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DEMONSTRATION
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UPON REQUEST

OPINION

The system needs to be changed!

Job satisfaction can result from a change in the time periods of the present shifts
and from an improvement in the patient assignment and staff patterns.

Nan-Michelle Dufour

NUPiing aspires toward excellence in
patient care. For a nurse to give this
quality care. certain conditions must be
present First. she must have a desire to
help others. Second. as in any
occupation. a certain level of job
satisfactIOn is necessary.
Job satisfaction appears to be a crucial
factor in determining whether the nurse is
ph)sically and psychologicall) able to
give her best to the recipients of her care.
Naturally. job satisfaction is gredter if the
nurse is working in her chosen field and
feels confident in her own abilities.

Shift work
Nurses have a reputation for staying
short periods in one work setting. They
leave for various reasons. but one nega-
tive aspect that is often mentioned is shift
work.
Doe.. the nursing world need to revolve
around the pröent shifts of 0730-1530.
1530-2330. and 2330-0730 hours? Would
three more appropriate time periods be
just as conducive to eftïcient hospital
functioning and yet allo\\ the hospital
nursing personnel to work more "soc-
iable" hours. in keeping \\ith their com-
munit) peers? What if the shifts were to
begin at 0900. 1700. and OIOO'! Think of
the possibilities.
Patients not booked for earl) morning
procedures could be awakened at a
reasonable hour for morning care and
breakfast. After all. why does everyone
need to be awakened b) the night nurse?
Early awakening of patients may not be
the policy in all institutions. but personnel
in many hospitals still feel the patient
must he given the opportunity to \\m,h
before hreakfast.
In the evening. a patient would not

Nan-Michelle Dufour (RN. Ro}al Juhllee
H'''pitdl School 01 \Jursing. Victond. R.C
BN. McGill) i, .In in,tructor at the Sdint J"hn
School of NUf',ing. Saint John. N.H.
NOVEMBER 1974

have to take his h.s. sedation at noo
hours to allow the nurse to chart it and be
off duty on time. She could allow for the
individual habits of the various patients
and still carry out her necessary duties
within the time allotted.
As for the nurses. the day nurse could
enJoy an evening out and still arrive at
work feeling refreshed after a good
night's sleep. The evening nurse could
obtain a full night's sleep and still
participate in afternoon activities before
reporting for work. The night nurse could
attend the symphony or a movie and leave
for her tour of duty at the completion of
the entertainment. In other words. if
nurses worked hours that were more
harmonious with those of non-hospital
personnel. there might be greater job
satisfaction.

Patient load
Patient loads may also have a bearing
on the abilit) of the nurse to give
meaningful care. How many patients can
a nurse safely and adequately care for'!
Nurses cope \\ ith patiènt loads varying
from four to twelve and sometimes more.
Many nurses feel troubled and some
become apathetic when they are unahle to
spend more than the minimal amount of
time giving the basic physical care to one
patient before rushing on to the next.
If staff patterns were improved. espe-
cially during the evening. the care could
be more evenl) spread between the shifts.
Do all patients who require physical
assistance need their baths during the
day'! If the day nurse knew there would be
adequate evening staff. she could more
readily and completely meet each
pdtient's needs. The evening nurse could
give some of the baths and still have time
to complete her specific treatments. And
the night nurse. on duty until ot)OO hours.
could start caring for some of the patients
who an: earl) risers.
With the responsibilities of the three
shifts heing more consistent. the patients

would not be so aware of "how busy the
nurses are." When the nurse is constantly
on the go and obviously has her hands
full. patients tend to be extremely under-
standing; they try to help the nurse by
:. not bothering her." It is the patient's
right and privilege to expect good care
and attention. but many are reluctant to
ask for it if they can manage in a partially
independent manner.
In our present system. patients are
often laheled as demanding or as com-
plainers. In many cases they are anxious
or frightened and want a little' extra time
and understanding. which the nurse does
not have time to give.

Conclusion
Part of job satisfaction depends on life
satisfaction. If work shifts were to coin-
cide with activities in the community or
the plans of one' s nonnursing friends. this
could help create greater personal har-
mony. Might not a nurse. satisfied with
her hours. stay for longer periods in a
given setting? Possibly - and this could
lead to a more stable work force. less
shortage of nurses. and more feasible
patient loads. These factors seem to be
related and significant when looking at
ways to mamtain quality care.
If the nurse is happy. well rested. and
able to carry on outside interests. she will
probably approach her patients in a more
humane. truly concerned. manner. If she
is tired or discouraged. this message is
conveyed to the patient.
Lack of job satisfaction is affecting the
humanistic approach we strive for in
nursing. Nun,es at all levels. and espe-
cially those working althe bedside. have
a responsibility to voice their feelings and
suggestions. As professionals and as
concerned individuals. we should be
proposing logical changes for greater job
satisfaction and the chance to give a
consistently high level of nursing care.
The system needs to be changed!

THE CANADIAN NURSE 13
.

WI fllfl
, r
I .1 1 \\
.
,

We must take a long-term perspective in suicide prevention. This means changing our focus from the suicide attempt
to the period during which the suicidal individual is at risk. The length of the crisis period can vary considerably.
Although suicide ideation may always be with us, successful suicide could become a thing of the past.

Patricia M. Oelbridge

I have done it again.
One year in every ten
I manage it - .
I am only thirty,
And like the cat I have nine
times to die.
This is N umber Three

Sylvia Plath's poem sends
hivers of
apprehension through those of us who
spend part of our lives in contact with
suicidal persons, Suicide has become a

Until November 1974. Patrkia Ddhridge \'\'a

executive director of the Ottawa Di
tre

Centre. d telephone servke for cri
i
interven-
tion. She \,\,as as,ociated \'\'ith the Otta\,\,a
center from ih inception in 196H and. prior to
coming to Canada. was a volunteer with the
Samaritans in I::ngland.
Delhridge ha
joined the staff of "Help the
Aged." a Briti
h organizdtion th.1t is extend-
ing ih work to Canada.
14 THE CANADIAN NURSE

major health problem in today's world;
each day 1,000 individuals take their own
Iives. 2 Suicide is increasing rapidly in
younger age groups. Recent data shows it
to be the second cause of death in 15- to
30- year-olds. 3
Conservative estimates indicate that
there are 8 attempted suicides for every
suicide death. The chances thus become
high that any health care professional
will, at some point in her career. be faced
with a patient who is seriously suicidal.
The suicide statistics of tomorrow depend
on how we cope with this: whether we
stop and listen for the clues that indicate
serious crisis; whether we recognize that
person's feelings of helplessnes" and
hopelessness; and whether we respond by
mobilizing those who can best support
and help the suicidal individual through
an extended crisis period.
Recognizing the suicidal person in our
community is often the easiest part of
suicide prevention. Everyone, at some

time in her life, gtves indications to
friends. family. and others around her
that she is feeling overwhelmed by
problems. is having difficulty in manag-
ing, and feels that life is more than she
can cope with. If the situation continues,
if she is unsuccessful in mobilizing the
resources she needs. and if her sense of
self-worth declines. she ma) start to make
her feelings known by clear verbal and
behavioral clues that can indicate
thoughts of suicide. The clues may.
alternatively. only be indicators of need-
ing understanding and help through a
difficult period. Obviously. it is impor-
tant to respond to either eventuality. The
way we respond will depend to a large
degree on an accurate assessment of the
real feelings behind the situation.
When the presenting problem has in-
cluded a suicide attempt, we have in the
past often used seriousness of intent as an
appropriate measure to determine our
ongoing response. We have assumed that
NOVEMBER 1974

the size of the do.,e consumed. the
thoroughness of precautions taken against
discovery. the volume of the verbal and
behavioral cries for help. someho,-" di-
rectly equal the seriousness of risk. We
may have been influenced by the myth
that those who intend to commit suicide
go ahead and do it without indicating their
thoughts. Research has proven the oppo-
site to be true. Eight) percent of those
who successfully commit suicide have
given clear indication of their intent. 4
Ho,-"ever. the situation still exists
where personnel in emergency depart-
ments give Bro,-"nie points for a near
miss. and seem almost to encourage
future attempts to be lethal. Police and
emergency staff have been known to
comment: "Oh. she's only seeking atten-
tion," or "That dose will never kill you.
you'd better take more next time if you
really want to die." Minor attempts are
often dismissed as manipulation. a way of
getting attention, which is someho....
assumed to be inappropriate and a misuse
of vital services. Although it is under-
standable that priority decisions have to
be made in emergencies. research is
already indicating that patients assessed
as low risk after making a suicide attempt
are, in fact, a high-risk population if
followed for 5 or more years. s
We must
tart taking a long-term
perspective in suicide prevention. This
means moving our focus from the suicide
attempt to the suicide "at risk" period.
which can vary considerably in length. It
may be short and end .... ith a successful
suicide; it may be for a limited crisis
period and be resolved by solving other
problems; or it may cover a number of
years and be highlighted by a number of
suicidal acts.

A violent crisis
Mr. B. can be said to typify the short.
more violent crisis period. Mr. B. is 50
years old. a senior teacher at a small-town
high school. with a background of com-
munity involvement in church. Scouting,
and local politics. His comfortable life
style was shattered when a visit to a
nearby city ended abruptly with an arrest
for indecent exposure.
In the week prior to his court appear-
ance, he seemed highly agitated and
upset. He missed t'-"o days at school and
NOVEMBER 1974

phoned his clergyman. asking him to tell
the principal that a death in the family
necessitated his absence. The clergy man
was concerned at his emotional di"ljuiet
and. after a short conversation. 1\1r. B.
agreed to see him on Wednesday evening.
For the next t'-"o days.
1r. B sy'-
tematically tidied up the details of his life.
He visited his la'-"yer and changed a small
portion of his will. His la....yer. misread-
ing and misjudging his concern. joked
thú.t he .... asn't going to go to Jail for '-" hat
....as. after all, a minor offe'nce.
1r. B.
replied that it '-"as time to put his aìfairs in
order.
He then sent a completed fall program
for his Scout troop to his assistant. '-" ith
extensive detailed notes. His assistant
expressed surprise .... hen he phoned Mr.
B. after receiving the schedule. and he
asked if Mr. B. was planning to resign.
Mr. B. replied that one never kne.... what
the future held. and it was well to be
prepared.
On Wednesday evening, he arrived 30
minutes late for his appointment with his
clergyman. He seemed anxious and de-
pressed and had difficulty in expressing
his feelings. The minister. com:erned
....ith both Mr. B's condition and an
approaching parish meeting, assumed that
the depression related to the recent
bereavement about ,-"hich Mr. B. had told
him. He responded to Mr. B.'s opening
comment that life ,-"asn't ....orth living. by
reminding Mr. B. of hi.. fine record in the
community. pointing out that his Scout
group and many others depended on him
and ....ere influenced b) him. :\1r. B. left
the meeting early. The next morning he
took a gun and shot himself: he died later
that day.

A limited crisis
\1s. G. at 48 al.,o felt that life '-".h
falling apart. Looking back from the
vantage point of her 25th ....edding an-
niversary, she desperately sought some-
thing that ....ould shIm that her life ,-"as
useful and meaningful. Her t....o sons had
married and moved across the continent:
her husband ....as deeply involved in his
'-"ork and frequently travded out ofto'-"n.
One day. ....hile her hushand ....as a....ay
on a three-,-"eek trip. 1\15. G's doctor's
receptionist phoned to ask her to come to
the office for a repeat Pap test. She

reassured :\1s. G. that. although they
....anted the test to he done again. it didn't
ileces"arily mean too much and. a... long
as she dropped by in the next fe,-" days.
there '-"as no great urgency l\h. G.
stayed home for the next fe.... day sand
worried. She telephoned her husband.
\\ ho said he couldn't get ba<.:k until the
end of the.... eeL but she.... a..n't \0 .... ony
as he '-"as ..ure it '-" as nothing Her
children responded in the Sdme ....a).
telling her not to ....orry.
Ms. G. felt angry and reje<.:ted. She
talked to friends. sa) ing she was a burden
to everyone and of no use to anyone. Her
friends pointed out the good life she had
and its many advantages. <.:iting others
who had to cope.... ith immense problems
and tragedies Ms. G's feelings of rejec-
tion increased. She helieved everyone
'-" as denying that her crisis \\ as of an)
imr
Jrtance. thus indicating that she '-" a..
coping in her usual inadequate ....a).
Finally. on Thursda) night. feeling that
no one cared ....hether she lived or died.
Ms. G. phoned her daughter-in-Ia.... in
Los Angeles. asking her to pass on the
message that ..he loved her husband and
sons but wasn't going to bother them any
longer. She took an overdose of 222s. but
....as found by police and taken to hospital.
Her hu,.,band rushed home from the
conference and provided support and
reassurance. For the moment. the crÌ,.,is
.... as over.

A recurring crisis
For Ms. Y.. a suicide attempt ,-"a,., no
great thing. Like Sylvia Plath. she had
"done it again." Her histor)' was one of
rejection and loneliness. Brought up in
foster homes. she kne.... little about her
parents. but she desperatd)' ....anted ((\ he
needed by someone. :\.15. , .... as dn
unmarried mother at 16. and her first
<.:hild ....as adopted. but her ,uhsequent
pregnanq .... as nldrked hy a determina-
tion to keep the child. She nldnaged this.
,-"orking as a mother's helper until her
first sui<.:ide attempt .... hen the child .... a..
taken into the care of the Children's Aid
Societv.

1s. - Y. then picked up the threads ot
life fairly successfully. Ho\\ever. \\hen
she felt that bo)'friends. employers. I\r
professional helpers '-"ere rejecting her.
she attempted suicide. For the past t\\ 0
THE CANADIAN NURSE 15

years, she has managed to maintain a
stable relationship with her boyfriend;
however, this situation has again de-
teriorated and Ms. Y. is in hospital with a
serious overdose. The prognosis looks
bleak.

New scales
If we are to cope effectively with short-
and long-term suicide situations, it be-
comes vital to learn new ways of measur-
ing the suicidal temperature of persons we
contact. Dr. Ed Shneidman, previously
with the Los Angeles Suicide Prevention
Center, suggests using two scales; one of
perturbation, combined with one of
lethality. 6
Perturbation relates to how upset the
individual is, that is, how agitated,
disturbed, depressed, discomposed, and
so on. Perturbation can be rated on a
9-point scale and applies not only to
persons who may be suicidal; it measures
the way an individual is feeling at a
specific time.
The lethality scale relates more specifi-
cally to the likelihood that an individual
will succeed in taking his life. By linking
the two scale!. together, we obtain an
accurate and universal measure that helps
us to select appropriate intervention and
response.
Had these scales been used with Mr.
B., it is possible that both the lawyer and
minister would have gauged high pertur-
bation. This could have been thought by
the lawyer to relate to Mr. B's upcoming
court appearance, and by his minister to
relate to the mythical death in the B.
family. If, however, they had thought to
enquire further and check lethality, they
would have found high lethality: clear
thoughts of suicide, a welI thought-out
plan, and the means at hand to carry out
the plan.
Ms. G. 's perturbation level was also
high. Low lethality at the beginning of the
crisis period increased during the week as
she perceived the response from husband
and sons as a reinforcement of her lack of
importance and her own feelings of
uselessness. Her lethality level rose
further as friends seemed to deny the
validity of her concern. When her initial
attempts to mobilize support and helpful
16 THE CANADIAN NURSE

concern failed, she was forced to show
everyone with the only means she saw as
being available to her - an overdose.
Ms. Y's perturbation and lethality
levels can only be measured by those with
frequent ongoing contact with her. It is
important to provide her with a consistent
supportive network, recognizing that
suicide has become one of Ms. Y's major
defence mechanisms. Unfortunately, it is
one that can quite easily terminate in
death. In fact, Ms. Y. is likely to kilI
herself at some point.

Appropriate action
Once the health care professional, or
anyone coming in contact with a suicidal
individual, has assessed the perturbation
and lethality levels, it is time to decide
what action is appropriate.
Dr. Paul Blachly describes suicide as a
learned, contagious, problem-solving
maneuver. At any time in our lives, we
are likely to run into problems that
distress and involve us and demand
solutions. Dr. Blachly describes us as
turning to our closet of problem-solving
escape mechanisms. The closet is fulI of
boxes - one side of the closet contains
boxes of people solutions and resources:
lawyers, doctors, family, and so on, and
the other side holds boxes of behavior
solutions: marriage breakdown, alcohol.
suicide, homicide, compulsive buying,
and so on. When we find ourselves at the
point of having to come up with some
response to the problems that face us, he
says that we react by pulling out one or
more boxes.'
Which box or boxes we decide on will
depend on a number of factors. It may be
that we are fairly efficient at mobilizing
people resources - support from family,
medication from family doctor, and coun-
seling from a professional agency. Alter-
natively, we may have got into the habit
of using behavioral ways of coping. We
may decide to throw in our job, go on a
alcoholic bender, or maybe the suicide
box seems so appropriate that we use it
instead.
The suicide box may seem appropriate
for many reasons. We may have used it
before and found it useful in making our
needs known. We may have had a relative

or a friend who successfulIy committed
suicide, and thus taboos have been broken
down. Or, alternatively, society may
imply that it is an acceptable way out -
one that pays our debt to society - as in
the WalI St. crash.
Usually the choice of suicide is made
before a helping person comes on the
scene; it is important to remember that to
the suicidal individual, his choice seems
to him to be the only one available. This
is partly because suicide represents an
ordered solution to the chaos and confu-
sion of the problems surrounding him. It
is also due to the narrowing of vision
experienced by an individual as things
start to crowd in on him; suicide appears
to be the only possible solution.
In trying to help the suicidal individual,
we must recognize that he needs consis-
tent. ,.,upportive help and understanding.
We must remember that feelings of
ambivalence - both wanting to live and
wanting to die - are almost always
present. Ventilation can be a valuable aid
to the patient, particularly if the helper
concentrates on the affect of the con versa..
tion as well as the content.
It is important to find out exactly how
the person perceives his situation and to
accept these feelings as a valid expression
of how he sees life at the moment. No
attempt should be made to deny these
feelings, to say: "Oh, you don't mean
that," nor to indicate that these feelings
are only temporary as in "You wilI be
better tomorrow." Feeling suicidal is
frightening; it can be of assistance if the
helper can express verbally her recogni-
tion and understanding of this.
Too often the suicidal individual finds
that persons tend to pass off his feelings,
either because they don't really believe
the feelings exist or because they accept
such feelings as valid but feel inadequate
in dealing with them. They suggest
instead that the person visit his doctor. It
is reported that 60 percent of individuals
who successfulIy committed suicide vis-
ited their doctor in the month before their
death. 8
Referral to medical and psychiatric
help is important for most suicidal indi-
viduals, but it must never be seen as a
transfer of responsibility or passing the
NOVEMBER 1974

buck. Responsibility must be shared by
every person who comes into contact with
the suicidal individual. That responsibil-
ity is to provide appropriate referral and
adjunct supportive help and understand-
ing when it is needed or. if this is not
possible, to ensure that significant others
- relatives, friends. 'and other contacts
- are mobilized to provide it. A suppor-
tive network is vital after, as well as
during. the suicidal crisis period. Some-
times, health professionals are at their
most effective when providing a support
system for the significant others.
Relatives and friends need someone
who can understand their own feelings of
rejection, anger, fear. and inadequacy.
and provide support and emergency help
when required. This will help relatives
and friends to feel that they have re-
sources to cope with both the present
situation and any future situations that
may arise. Relatives and friends can
obtain more effective emergency help if
cooperative action is sought with the
health professional. This kind of in-
volvement can ensure that repeat crises
are identified quickly and appropriate
NOVEMBER 1974

assistance mobilized. It can also ensure
that. should the patient successfully
commit suicide. family members can be
offered help without delay and thus be
aided to achieve a more appropriate grief
reaction.
At some point in every discussion on
suicide. the question is asked: "Should
suicide be prevented?" This usually
hinges on moral and philosophic ques-
tions concerning a person's right to take
his own life, the so-called rational
suicide. An effective discussion on this
subject was summarized by Dr. Paul
Pretzel in his book Understanding and
Counselling the Suicidal Person. He says
that the question for most health care
professionals becomes one of personal
involvement. "Is there such a thing as a
suicide which is acceptable to me? Can I
ever walk away and say 'It's your
decision'? Probably not, but the issue
arises in determining how hard I will try
to prevent the act. "9
For most of us. there is no way we can
ever walk away: however. we are left
with an even more vital and unanswerable
question: "Can suicide be prevented?"

Given man's freedom to make his own
decisions and come up with his own
solutions to problems, my belief is that
suicide as an option can never be wiped
out. However, each act of suicide has a
point when intervention is possible. If we
accept that we each have a personal
responsibility, that "no man is an island,
entire of it self," then each act of suicide
can be prevented. If we stop and listen. if
we recognize an individual's feelings of
helplessness and hopelessness. and if we
ourselves take responsibility for mobiliz-
ing the persons who can best support the
individual through each crisis period.
then, although suicide ideation may al-
ways be with us, successful suicide could
become a thing of the past.

References
I. Plath. Sylvia. Lady Lazarus. Ariel. Faber
and Faber. 1965.
2. McGee. Richard. Houston. Texas. Ameri-
can Association of Suicidology. 1974.
News Release for Silicide Prel'e/lIion
Week.
3. Lalonde, Marc. A new penpectil'e on the
health of Canadians; a workin!? doclll1lellf.
Ottawa. Information C.mada. 1974.
4. Shneidman. Edwin S. et aL Silicide.
Toronto. Canadian Mental Health Associa-
tion. by permission of the National Insti-
tute of Mental Health. U.S. Public Health
Service. N.D.
5. Comstock. E. Treutmellf of sllicidal Pll-
tiellls. Houston. Texas. American Associa-
tion of Suicidology, 1973. (Unpublished
paper. )
6. Shneidm.m. Edwin S. Perturhation .md
lethality as precursors of suicide. Life
Threatening Be/wI'. voL I. no. I. Spring
1971.
7. Blachly. PauL H. Suicide. /n Suicide
symposium. Oxford. Ont.. Oxford 1\1entdl
Health Centre. 1973. p. 28-37.
8. Barraclough. B. et aL The dia!?,w.ffic
classification and psychiatric treafl1lelll (!f
100 sllic ides. Proceedings of the Fifth
International Congress for SuiCide Preven-
tion. Viennd.IASP. 1970.
9. Pretzel, Paul W. Understandin!? and
counselling the suicidal person. Nash-
ville, Tennessee, Abingdon. 1972.

THE CANADIAN NURSE 17
.

The aim of the study reported here was to
establish the extent to which the profes-
sional skills of office nurses were used.
Among our reasons for doing it was some
scepticism about training programs to
equip nurses for an expanded role. We also
wished to confirm the work of Kergin,
Yoshida, and Tidey. who found that regis-
tered nurses working in physicians' offices
in Hamilton. Ontario, devoted less than
one-third of their working time to patient
care and spent almost that much time on
nonprofe
sional activities, which could
be carried out by a person with little or no
training. I
In Canada. as in Britain. training for
new nursing roles has mostly required ex-
tension of existing nursing education.
These training programs aim, in part. to
produce health workers capable of per-
forming time-consuming and repetitive
ta.,ks necessary in office practice, thus al-
lowing more of the physician's time to be

S.mdra J. Winter(B. A.. Carleton Univer
ity) is
a röearch as
i
tant in the Department of
E:.pidemiology and Community Medicine. Uni-
versity 01 Onawa. John M. Last (M.D..
Adelaide Univer
ity). i
chairman of the de-
partment This work was supported by a grant
(RD-IO) from the Ont.!rio Ministry of Health.
18 THE CANADIAN NURSE

Registered nurses
.
In
office practice

The authors surveyed registered nurses working in physicians' offices in one
community. Their study showed that nurses' training and skills are seriously
underused in doctors' offices.

Sandra J. Winter and John M. Last

devoted to aspects of patient care thattrul)
require his skills. Preliminary evaluation
of nurses equipped with this training sug-
gests they may greatly assist the primary
physician. 2 ,3
In any case. existing health manpower
must not be overlooked in the present de-
mand for improved patient care. Training
programs for registered nurses equip them
with many skills that are basic to office
practice. It is useful. therefore. to examine
the extent to which registered nurses are
using their professional skills in primary
c
. .

Method
We attempted \0 survey all English-
speaking registered nurses working in doc-
tors' offices in Ottawa. We eliminated
French-speaking practices. which we felt
desirable to avoid the confounding effects
oflanguage and cultural differences. From
the Yellow Pages of the Ottawa-Hull tele-
phone directory. we compiled a list of
physicians by specialty. and we wrote to
each of them requesting his or her coopera-
tion.
A total of 318 doctors was identified. of
which almost half (162) did not employ a
nurse; an additional 15 decl ined to partici-
pate, either by the doctor's decision or,
more frequently. by decision of the nurse

who felt she could not spare the time. Ot
the remaining 141 practices, some shared
a nurse, reducing to 126 the number of
nurses surveyed.
In addition to registered nurses. the
sample included 22 persons with regis-
tered nursing assistant or similarqualifica-
tion. that is. 17.5 percent of the total
number. Comparisons between the two
groups indicated that they were similar in
most respects. There was no difference in
the overall number or variety of activities
undertaken by the two groups.
We used a self-completed diary to get
detailed information on the nurses' ac-
tivities for a 5-day period and a question-
naire to assess their percept ion of their role
in a doctor's office. The questionnaire was
divided into three sections. the first on
training and past experience of the nurse:
the second on the size, type. and composi-
tion of the practice: and the third on the
nurse's perception of her job.
The diary was a 3-page form on
which possible activities carried out by the
nurse were listed down the left side. and
'" orking hours were divided into IS-min-
ute intervals across the top. Activities
were listed under the categories :>f patient
centered. including social interúction and
general nursing tasks: telephone centered:
practice centered: personnel centered: and
NOVEMBER 1974

TABLE 1

General Practice
Obstetrics/Gynecology
Surgery
Pediatrics
Internal Medicine
Dermatology
Other

Nurses Surveyed, by Doctor's Specialty
Number
51
19
13
11
11
2
19

Percent
40
15
10
9
9
2
15

Total

100

126

a residual category in whi
h nurses could
list other activities. The categories and ac-
tivities were determined by discussions
and pretesting with office nurses in the
University of Ottawa Family Medicine
Centres.

Results
As indicated in Table J, the largest
number of nurses in the sample were those
working in general practices. partly be-
cause general practitioners are more likely
to advertise in the Yellow Pages than are
specialists who may be hospital based.
Most of the nurses in this sample were
aged 25-30. in contrast to the median age
for all Canadian nurses who work in
physicians offices. which was reported as
38 in 1972. 4
Nurses in the sample were born in the
Ottawa-Hull area or elsewhere in Ontario
and typically had trained in this province.
They had lived in the Ottawa area for over
10 years and had been at their present
position between I and 2 years after leav-
ing a position in hospital nursing. Most of
the nurses (77 percenl) were married.
compared to the national average of 64
percent for all registered nurses in
Canada. s
When the nurses were asked to evaluate
a list of possible reasons for their choice of
work. 74.6 percent indicated that prefera-
ble hours of work \\as the most important
reason (Table 2).
Regular working hours. not possible in
hospital nursing. were important to single
and married women alike. Many of the
NOVEMBER 1974

women in this sample did not consider the
shift work involved in hospital nursing to
be a viable alternative for them.
Good working conditions were consi-
dered "very important" by 59.5 percent
and open-ended questions confirmed this
finding. Working conditions most often
cited included friendly staff relations.
pleasant surroundings. respect for the doc-
tor. and a feeling of privilege to be work-
ing for him. A typical response was:
"Most of all. I like the doctor I work for
and enjo} the atmosphere created b} hi.,
working conditions and attitude toward pa-
tients and staff."

Most of the respondents (75.4 percent)
were satisfied "to a very large extent"
with their present job. and another 23.0
percent were satisfied "to some extent. .-
In spite of this. only 9.5 percent felt they
were using most of the skills they had
acquired during their nursing training.
57.1 percent would like more opportunity
to use these skills. and 19.8 percent would
move to another job if the opportunity to
use these skills were greater.
Job satisfaction increased with increas-
ing use of nursing skills: this relationship
\\as constant over age. amount of training.
and specialty. The desire for more oppor-
tunity to use nursing skills shows a slight
decrease with age and length of time in
present employment. possibly because the
more ambitious leave an unsatisfactory
job.
Diaries were analyzed to compare per-
ceived level of skill needed on the job to
actual activities of a workweek. Duties
were categorized as nursing or clerical and
other. according to the amount and type of
skill needed to carry them out. The mean
percentage of nurses' activities that were
actually nursing duties was 26 percent,
even less than the Hamilton study.6 and
onl) II percent of the respondents indi-
cated that more than half of their activities
were those in which any nursing training
was needed.

TABLE 2

Reasons for Choosing Office Nursing*
Number
94
75

Preferable hou rs of work
Good working conditions
Continuing patient care,
personal responsibility
Change from hospital work
Always wanted to be an
office nu rse
No other nursing jobs available
Have been away from nursing,
good way to reenter field

Percent
75
60

47
46

37
37

8
7

6
6

4

3

*The question did not elicit ranks for reasons, hence more than one
alternative could be in the most important category

THE CANADIAN NURSE 19

Almost 20 percent of the sample (22
persons) spent their entire workweek in
clerical and other activities, including
housekeeping duties, cleaning examining
rooms, and conversing with patients. This
percentage was similar for registered
nurses ( 17 percent) and registered nursing
assistants (19 percent). It also appears that
job responsibility, as measured by percen-
tage of duties that required some nursing
training, did not increase with amount of
time on the job (Table 3).

Discussion
It appears from these results that one
possible solution to the health manpower
shortage is being overlooked. Although
many private physicians assert that they
are forced to turn away new patients due to
a lack of time, the trained nurses in man}
practices are not being given the opportun-
ity to use the skills they have learned,
which would permit the doctors to make
more efficient use of their time and skill.
The respondents' perceived use of nursing
skills as indicated in the questionnaire, as
well as actual use of these skills through-
out a 5-day workweek. clearly showed un-
derutilization. Responses to questions
measuring job satisfaction correlated
closely with perceived use of available
skills, suggesting that nurses would prefer
increased responsibility in the office set-
ting.
There are many tasks for which nurses
are trained and which they could perform
with as much expertise as the doctor.
Many of the nurses included in this sample
were not carrying out even the most basic
duties for which they were trained, such as
measuring height and weight, or taking
temperature.
One reason for this appears to be the
exce
sive amount of clerical work and
housekeepmg that must be undertaken by
the nurse when there is no clerical help in
the office. Activities such as filing, bil-
ling, telephone referrals to specialists, and
cleaning examining rooms take up much
20 THE CANADIAN NURSE

Amount of Activity Requiring Nursing Skills
Time on present job Amount of daily activity in which nursing
skills are necessary
11-30% 31-50%
9 6
15 13
14 10

under

0-10%
7
13
3

over

1 year
1-5 years
5 years

TABLE 3

over 50%
5
4
2

of the nurse's time if she is the sole emp-
loyee in the practice. She is unable to a
-
sume nursing duties, which waste much of
the physician's time, unless someone else
is employed for routine clerical work. Le

than half (45 percent) of the nurses worked
in offices in which there was also a full-
time secretary or receptionist. The reason
given for many nurses' refusal to take part
in the study was that they were alone in the
office and could not spare the time.
The mean percentage of nurses' time
spent in nursing tasks was 22 percent
where she was on her own and 30 percent
where there was abo a secretary or
receptionist. This was still much less than
it could be, but it indicate
that a clerical
assistant improves, to some extent. the
use of the nurse's time.

Summary
In summary, the results indicate a seri-
ous underutilization of nursing training
and skills in doctors' private practice. This
is only one aspect of a more general prob-
lem facing the nursing profession today.
that is. a need to define more clearly the
role of the nurse in the health care team.
It is a problem that has been recognized
in the hospital setting but has yet to be
studied in terms of office nursing. Discus-
sion with the physicians might be helpful
in discovering their altitudes to the nurse's
role in the office and soliciting their help in
working toward a solution to the present
misuse of professional training.

References
I. Kergin. ["Irothy J. ct al. A sTl/ch' (!( nl/HC
acTiviTie.\ in priman' care seTTings. Hamil-
IOn. Onlario. McMa,ter Univc"ilY Schllol
of Nu"ing, 1972.
2. Lees. R.E.M. Physician time-saving b)
employme..t of expanded-role nurse, in
family p. _.ice. CCII/ad. Med. Ass. 1. lOR:
7: R71-5. Apr. 7. 1973.
3. Spitzer. WJlterO. and Kergm. Doroth) 1..
Nurse prac.itioners in primar) care. I. The
McMaster University educational program.
Canad. Med. A.H. 1. IOR:!ì: 991-5. Apr.
21. 1973.

4. Canadian Nurse,' Association. COI/IIT-
down; Calladian nUHing .
taTistil'S 1973.
Onawa. 1974. p. 6.
5. Ibid.
6. Kergin et al. op cit.

NOVEMBER 1974

h-

-

t "'I,
.

.
.
-'
, ---
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,\ .

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. . .
, .
\ . .
f
.

,
. .
:\ 1 0
"

.

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--.

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..

self

d the professional
an self

,
,

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\ '

.

. .

\

't.

-1:....-

--\

.

..

-

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--

.....

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..... "

Using eight territories of self as identified by Coffman, the author shows how the
private self of a nurse may be affected by the constraints and opportunities of her
professional work environment.

Lorine Besel

\\ hat opportunities does a nurse have to
expre
s a "self' in relation to others in
her v. ork environment? The framework
for this discussion is Goffman's Ter-
ritories of the Self. I Many insights can be
derived from an exploration limited to the
spatial aspects of the negotiation of a
"self' in an interpersonal environment.
GotTman identifies ei!!ht territories of

Lorin
B
sd ISI. Boniface Hospit.ll school of
nursing. Winnip
g; B.:"I.. \.kGilil : M.Sc..
Bo'ion l'.) is director of nursing .It the Ro) al
ViLlorid Hospital. Montreal. .Ind assistant
prot
"()r. McGill [' school of nursing. She
"as elected memher-.It-Iarge on Ihe C:"IA
board I,f direl"tors for 11)74-76, r
prcsenting
nursing pr.lctice. This .Irtid
is .Id.lptcd from a
pdp
r presented by Besel at the 11)74 C .In.ldian
Nurse" A......ociation convention.

NOVEMBER 1974

the self - eight territories in which the
individual moves and relates. through
which his self may find expression, and
which. in ethological terms. he lays claim
to and defends.
A private self in a public domain
exercises a fair degree of control as to
hov. the self can be expressed in the
territorial context. Taking each of these
eight territories of self. here is how. as
nurs
s. our private selves may be affected
by the con..traints and opportunities of our
professional work environment. Goffman
points out: "In general. the higher the
rank. the greater the size of all territories
of the self and the greater the control
dlroSS the boundaries." 2 Status and rank
are recurrent themes in this examination.
o Personal Space: "The space surround-
ing an individual. within which an
entering 'other' causes the individual to

feel encroached upon. . . . "3 Such factors
as local population density. purpose of
the approacher. fixed seating e4uipment.
and character of the social occasion can
all influence radically what is seen as an
offense. 4
Tolerance of intrusion involves differ-
ences in "proximity" zones. such as inti-
mate distance. personal distance. social
distance. and public distance. It is a kind
of life bubble that surrounds each of us.
Intrusion into the personal life bubble
is accompanied by feelings of discomfort
and anxiety. We have all stepped back
when someone stood too dose: \\e know
the feeling. Nurses are subject to double
trouble on this. The nature of our work
causes us to intrude on another's personal
space as we give treatments. dre
s
wounds. and so on. This leaves u.. open to
the fight reactions of patients - their
THE CANI\PIAN NURSE 21

intru
ion into our bubble - as any nurse
in an emergency department can tell you.
As a private self. the individual can
avoid the anxiety by controlling one's :-.elf
and not engaging in activity that intrudes
upon another's space. or by turning and
running away from the dnxiety of
another's incursion into one's own space.
The professional self. however. rob
the
real self of this control element. Instead.
the nurse must learn techniques for
handling not only her own anxiet}. but
that of the patient - in either of the
two situations.
Con
idering the question of status and
ran"- in this context. we reach the
conclusion that. among all health profes-
sionals, only nurses have so little control
over intrusion into personal space. Medi-
cal staff. physiotherapists. or occupa-
tional therapists who must touch the
bod y. and thus intrude into the patient' s
personal space. manage to do so on an
appointment basis. thereby achieving

ome modicum of control in this
anxiety-provoking situation.
Some nursing maneuvers to achieve
control leave a bad taste in the mouth. for
instance. assigning these patients to per-
sonnel of lower rank. such as orderlies.
Other maneuvers appear to be role defini-
tions that do not lock the nurse in a
geographical location or a time slot where
personal space intrusions are unavoida-
ble. Does loss of control over personal
space lead to low-nmk assignment'! Or
does low-rank assignment lead to lo
s of
control in this dimension of the territory
of the self?
D The Stall: "The well-bounded space to
which individuals can lay temporary
claim. po
se
sJOn being on an all-or-none
basis."5 Stalls provide external. easily
visible. defendable boundaries for a spa-
tial claim. 6
For our private selves. the areas to
which we can lay claim are numerous and
varied - a
eat on a bus. a beach towel on
a beach. a seat in an auditorium. and. if
you are a patient. your bed. The profes-
sional self is more limited in claimant
opportunities. Few nurses have offices:
those who do have often acquired them
22 THE CANADIAN NURSE

through rank assignment. that is. nurse-
teachers or head nurses.
The large majority of nurses share a stall
as a group. for instance. the nursing sta-
tion. They frequently exert little control
over those who will enter that stall. at what
time, or for what purpose. (Note that I did
not say they have little controL) It is even
common for a high ranking doctor to have
his stall. such as a chair in which no one
else will
it and which everybody knows is
his. within the nursing stall. Only
$1O.OOO-worth of expensive plumbing ins-
tallment will prevent nurses from losing
the utility room as their last "stall" of
refuge.
D Use Space: "The territory im-
mediately around or in front of an
individual. his claim to which is respected
because of apparent instrumental
needs. "7
As a private individual. certain cour-
tesies are accorded you regarding the
space you use to accomplish certain
activities. Few individuals will breach the
communication line between you and
another person. If you play golf, someone
will stand bac"- and. perhaps. even keep
quiet while you swing your club.
What of .. use
pace" in the profes-
sional work domain? Only in teaching
and in community work has nursing
achieved any degree of control of use
space. In a busy hospital environment.
nurses experience few courtesies regard-
ing their use space. Their nursing care
plans are moved from desk to counter to
de
k as others move in. Few hospital
personnel respect the curtain when a
nurse is working with a patient. The
problem is not that nurses can't have
control of their use space. but that we
don't insist on it. If we don't. we must
as"- ourselves why.
DThe Turn: This involves taking your turn
at space. or . "the order in which a claimant
receives a good of some kind relative to
other claimants in the situation.' '8 Rules
and norms are involved in this negotiation,

uch as women and children first or first
come. first served.
As private individuals. we have all
stood in lineups for the theater. and taken

a number to be served at the pastry
counter. In this situation. a certain equal-
ity is achieved by being a stranger. This
equality disappears in the work environ-
ment as rank and status come into play.
Any nurse who has patiently slid her tray
along the hospital cafeteria line on her
brief lunch hour can describe her reaction
as residents and interns slide in and out of
the line and get there first.
D The Sheath: "The skin that covers the
body and. at a little remove. the clothes
that cover the skin."9
We are afforded opportunities for self-
expression in our private lives by choice
of clothes or use of makeup. We have
onl} recently. however. begun to assume
control of professional self b} modifica-
tion in uniforms. Once more. rank plays a
part: high-ranking nurse professionals are
most evident as being out of uniform.
D Possessional Territory: .. Any set of
objects that can be identified with the self
and arrayed around the body wherever it
is''IO. for instance. handbags. gloves.
cigarettes. or objects that may be left in
stalls.
Outside of a thermometer or a bedpan.
there have been few possessions that. in
the public view, symbolize a nurse' s
professional self at work. Although ther-
mometers and bedpans still represent us
in the funny ge!-well card industry, we
ourselves have largely given these pos-
sessions to the lower rank caretakers,
such as nursing assistants. We seek to
carry possessions like stethoscopes and
black bags. that is, possessions more
closely resembling those of persons of a
higher status and rank, the medical staff.
D Information Preserve: "The set of
facts about himself to which an individual
expects to control access while in the
presence of others. . '11 There are several
varieties of information preserve. such as
the content of the mind. and control over
queries that are seen as intrusive or nosy;
contents of pockets or purses. and control
over what others have a right to ascertain:
biographical facts about the individual.
and control over divulgence. There is also
information to be controlled over reveal-
ing of self through dress or behavior.
NOVEMBER 1974

Information about our private self is
less and less in the control of the
individual. In contrast to the lack of
control over expression of self in other
areas, the professional role of the nurse
introduces control to the point of anonym-
ity. (I am excluding special situations,
such as psychiatry and community work.)
Uniforms, of course, offer this type of
control. Name tags ma) not include a first
name, only an initial, and the extent to
which nurses forget to wear their name
tags or to introduce themselves makes me
wonder whether some nurses don't seek
such anonymity. This may, on the other
hand, be behavior imitative of persons of
higher rank and status; well-known fig-
ures in the work environment, such as
medical staff and high-ranking adminis-
trative personnel, do not often wear name
tags.
o Conversational Preserve: "The right
of an individual to exert some control
over who can summon him into talk and
when he can be summoned; and the right
of a set of individuals, once engaged in
talk, to have their circle protected from
entrance and overhearing by others.'"12
As a private self, we can be relatively
certain that we need speak only to whom
we want, when we want, and where we
want. This is not so for the professional
self. Outside of psychiatry and commun-
ity wor"-. it is not common for nun,es to
have control over even their conversation
with patients. Unless they are of high
rank. nurses are commonly summoned
for discussion by others. Further, most
conversation of nurses at wor"- is not
protected from entrance and overhearing
by others.
Thus, in each of the territories of self,
we see a marked variance between the
private self and the professional self in the
ability to exert claimant control. What
does this mean for the profession?

Meaning for profession
We tend to equate a good self-image
with a sense of security and well-being.
As a private self. the range of territorial
preserves used for the expression of self
may well be constrained by the personal-
NOVEMBER 1974

ity. For example, a timid person will
choose unobtrusive clothing or shrink
back and not object upon the intrusion of
personal space.
The constrictions in our expression of a
professional self and our lack of control
over the many territories of the self may
be related to the power and rank problem
- and that may, in turn, be related to
femaleness. At least, our past acceptance
of these restrictions might be so related.
No matter how they are occasioned, if the
restrictions on the expression of a profes-
sional self are unwillingly accepted, there
is a sense of insecurity and a definite
feeling of non well-being.
As we strive to overcome this malaise.
we appear to be caught between two
cultures in nursing: the self-less and the
self-ish. I use this not in the judgmental
sense but in the sense of focus.
Here are a few sentences from a letter
of application (a real one) written 20
years ago: "When I see people ill and
helpless because of neglect, poverty or
just sheer carelessness. it makes me long
more and more to give adequate care to
the sick."
Today's letter of application as"-s for
specific information on hours. weekends
off, and inservice training.
Perhaps each is only a matter of the
style of the time. but if we got a letter li"-e
the first, we would laugh at it today" Yet
it is important to note that 20 years ago
the professional self allowed no expres-
sion of a private self; the current theme
encourages the expression of a private
self.
In many instances. the two are incom-
patible. Large teaching hospitals arc
prime examples of where the contlict is
raging - within the individual (as both a
private and a professional selt). within
nursing itself. and at the interface be
t\\een nurses and other professional
groups. Still. as one writer pointed out.
only open conflict allows for the kind of
interaction that leads to resolution.
Some of our efforts to feel sure of
control over professional self are accomp-
lished by interjecting and expressing the
private self in the professional context.

For instance, we may make a thing about
a uniform or sheath but make no effort to
gain a stall that is needed, or ignore
intrusions into our use space, or go along
docilely as summoned by anyone and
everyone. To the extent that we do so, we
convey a professional self that has ac-
cepted a "one down" position in relation
to another. Is this stance an expression of
a "self'-image? If so, what is !O be said
about that .. sel f' - image?
References
I.Goffman. Erving. Reillriom ill puNiL
Nc\\ Yor!.., Harper & Row. 197 I. Chapter
2. pp.2!ì-61.
2.1bid.. p. 40.
3.1bid.. p. 29.
4.1bid.. p. 31.
5.tbid.. p. 32.
6.Ihid.. p. 34.
7.Ibid.
8. Ibid. p. 35.
9. IbiJ.. P. 38.
10. Ibid.
I I. Ibid.
12.Ibid.. p. 40.

THE CAN
IAN NURSE 23

Psychology of childbirth

While waiting for her child to be born, a woman must accept the fact of
pregnancy, believe in the exist
nce of a baby, visualize her baby, and prepare
herself to mother the child. However, these four psychological tasks of
pregnancy are not necessarily completed at childbirth.

Pregnancy is a developmental stage in a
woman's life, not unlike puberty or the
menopause. In puberty the girl attains the
capacity to reproduce. Through preg-
nancy, the woman att
ins motherhood.
Menopause brings further maturity and
regression of the capacity to bear chil-
dren.
All three stages are normal and all
involve profound physiological events
and changes associated with mobilization
of emotional energy. In pregnancy this
emotional energy is related to the reacti-
vation of old conflicts, and the intrapsy-
chic reorganization necessary to become a
mother. t
Because pregnancy is but one life event
in the midst of many. a woman' s response
to her pregnancy can be altered by other
important life situations that arise simul-
taneously. These create additional stress
that may cause problems in adjustment.
Such events as the husband's loss of
job. the family's transfer to a new city, or
the death of a parent could impede a
woman's achievement of the tasks asso-
ciated with pregnancy. Another influence
on pregnancy is her past life experiences.
Other factors are her own degree of
maturity, stability, and security. The
attitude and behavior of the father of the
child toward her and the pregnancy are
also impoI1ant.
Finally, outside events can impede the
successful attainment of the tasks of
pregnancy. For example, a married wo-
man (gravida 6 para 5) delivered a
healthy. full-term infant. which she im-
24 THE CANADIAN NURSE

Donna Shields

mediately placed for adoption. Her hus-
band had commi!ted suicide when she
was about 30 weeks pregnant with this
child and, although she had a warm
relationship with her other five children,
this added stress proved too great to allow
her to mother this sixth child.

Tasks of pregnancy
A woman's first task in pregnancy is to
establish that there is a pregnancy and to
incorporate this knowledge into herself.
The second is to establish that a baby
exists. The third, closely related to the
second, is to accept the separation from
self and from fantasy of a new, separate
individual. The fourth. and last. task is to
mother the new individual and adjust to
other role changes. such as from wife to
wife and mother; and from mother of one
child, to mother of two or more children.
Not all these tasks are completed at
one time and most occur continuously
throughout pregnancy. The role of mother
is an evolving one and usually is not
completely achieved until several
months, or even years. following deli-
very. However, the role change is proba-
bly stabilized when a woman sponta-
neously identifies herself as someone's
mother.
Generally. the process is accelerated in
the multigravida, as she has already made

Donna Shields (B.Sc.N.. U. of Toronto;
M.S.N.. Yale University) is assistant profes-
sor. faculty of nursing. Universit} of Toronto.
Toronto. Ontario.

st:veral of the initial changes, However,
this does not always follow, and the tasks
must be achieved with each pregnancy
and each child, for the fact that a mother
has successfully mothered one child does
not guarantee that the tasks will be
completed in succeeding pregnancies.
How then does a woman complete these
tasks and what behavior does she mani-
fest while doing so?

Pregnancy is real
In the first trimester, the patient at-
tempts to establish that a pregnancy
exists. Disbelief and a feeling of unreal-
ity, reinforced by the lack of any obvious
signs of pregnancy, characterize the pe-
riod. The patient. in an attempt to
reinforce the idea that she is pregnant.
looks for evidence of the pregnancy in a
variety of ways. She may closely examine
her body for changes, or assume cul-
turally acknowledged signs of pregnancy,
such as nausea and vomiting, or a craving
for unusual foods.
She seeh confirmation from the doctor
and, when it is received, reacts with
surprise even when the pregnancy has
been planned. This is .the "not me, now
now" response described by Rubin. 2
Thus a woman's initial response to
pregnancy usually contains both positive
and negative elements.
Gardiner also describes this response
when he says: "Pregnancy at this early
stage, possessing no objective tangible
evidence of reality, is identified in the
minds of these women as an abstract
NOVEMBER 1974

concept or fantasy which, if pleasant, can
be accepted or. if unpleasant. rejected and
eliminated without involving censorship
of the conscience."3 This normal res-
ponse allows many women to abort
during the first trimester without any
serious emotional sequelae. It may also
cause some women to delay seeking
medical care. or an abortion. until the
second trimester.
However. as the woman progresses to
the second trimester. fatigue, constipa-
tion, and her enlarging abdomen and
breasts help to established in her mind
that there is a pregnancy. Some women
never do accomplish this. and periodically
a young. usually single. girl in labor
arrives in the emergency department
denying any knowledge of her pregnancy
or even of labor. This girl has neither
accepted nor established in her mind that
there is a pregnancy.

Child is real
In the second trimester when the baby
begins to be active. the idea that a baby
exists takes shape, further reinforced if
the woman can palpate the fetus or hear
the heart beat. However, the baby is still
ill-defined:' Is it a boy or a girl. or even
twins'? Will it look like her or her
husband, or one of her disliked relatives?
In trying to further define this baby. she
seeks out all kinds of old superstitions and
events. If she has heartburn, this baby
will have hair. and so on. Rubin sees this
behavior as the normal human response of
striving to complete an incomplete idea. 4
And so the woman constructs in her mind
a fantasy baby. the image of which she
carries throughout the latter part of
pregnancy.

Child is a separate individual
Unfortunately, these fantasies can lead
a woma'1 to picture a baby quite different
from the one she is actually carrying.
Therefore. having accepted that there is a
baby, she must then accept it as a new
individual. separate from a representation
of herself. separate from a representation
of her husband, and separate from the
fantas y baby. S
This mental process, probably begun
NOVEMBER 1974

early in the second trimester of preg-
nancy. is not completed until the post-
partum period. It is helpful to the
woman. in completing the tasks of preg-
nancy, to experience labor, to watch the
birth of her child. and to see and examine
it immediately. This confirms the reality,
for now she knows there was a baby
inside her - she saw it delivered, and
began to identify it as a separate indivi-
dual even as it was being born. Usually it
takes two to three days postpartum to
fully identify the baby. In addition. many
women experience a sense of disbelief for
a few days following delivery.
A patient may suddenly doubt that a
baby really exists. or even that she had it.
She may make trips to the nursery, or ask
for rooming-in just to see this baby. to
help deai with the feeling of unreality.
This may be a primigravida who has
related to her pregnancy only as a
pregnancy. has never really believed that
a baby existed. and is now confronted
with the reality.
To achieve the third task - ,>eparating
the new baby from fantasy and represen-
tations of others - may take several
hours, days. weeks. or years. If the real
baby is very different from the fantasy
baby. a mother may have difficulty in
accepting the new child.
Even happy women may mourn the
loss of the expected baby before they can
accept the real baby. One woman report-
ed feeling sad every time she walked
down the ward and saw anything blue.
She had had a girl and felt a normal loss
for the desired, expected boy. Unfortuna-
tely. some women never re<;olve these
feelings and cannot move on to accept
their new child as it is.

Mothering the child
rhe fourth task. mothering the child,
may begin during pregnancy ""hen a
woman feels warm and motherly toward
the fetus. To such a woman the fetus-
child is very real. and others. who do not
appreciate her feelings. can be a source of
frustration to her. For other women such
feelings do not begin until the postpartum
period.
A primigravida. in particular. may not

feel any strong sense of love for her new
child, and may be quite indifferent to it
for a few days. When this is so. many
women feel guilty and ashamed and begin
to doubt their capacity to be mothers. It
helps when they realize that this is normal
and that. in a few days (and sometimes
months) a sense of mothering and love
will come.

Moods of pregnancy
Many pregnant women experience irri-
tability, periods of sadness. and elation
during pregnancy and seem unable to
control their emotions at times. This can
be marked during labor and in the initial
postpartum period, due partly to the
profound physiologic changes of these
periods and partly to equally profound
intrapsychic changes.
Throughout the experience of child-
birth, the pregnant woman appears to
become more introverted and passive. 6
This change begins toward the end of the
first trimester. increases until about the
seventh month. peaks again during labor.
and gradually tapers off during the post-
partum period.
During this time. the woman demands
more affection and love.
The loving. giving wife and mother
now needs to receive rather than give. and
the love and affection appears to be stored
for later giving to the child. Caplan
suggests that, if the woman docs not
receive the love and support she requires,
it may hamper her future ability to give
love to the child.7 It thus becomes
important that a woman have the love and
support of her husband and family at this
time. 8
However. the family often find her
altered moods difficult to cope with and
may withdraw support which. in turn.
makes her more irritable and demanding.
The patient and her family need an
interpretation of these changes to help
them understand that the process is
normal and temporary.
The most extreme introversion and
m,)()d change are usually seen during the
fin", I hours of labor and delivery. The
imllh'diac} of the situation leaves a
woman little energy for anything but
THE CANADIAN NURSE 25
.

getting the job done, and she draws into
her
elf a
her energies are mobilized to
cope with the stress.
Under this stress. some women can be-
come frustrated. ho
tile. or supplicating.
Frequentl) the hu
band is the person
most vulnerable to these mood changes.
Thus. he needs help from the nurse in
under
tanding hi
wife's response.
In the postpartum period the patient' s
introversion expands to include the baby.
and gradually. over the next few days or
weeh. she becomes more outgoing.
However. during this period. other family
members may feel neglected and jealous
of the ne.... baby.

Ego-Id equilibrium
In mo
t pregnant women, there is a
change in the ego-id equilibrium. 9 This
change usually begins during the
econd
trimester and ends approximately two
weeks po
tpartum. During pregnancy. the
ego (conscious) often becomes preoccu-
pied with other tasks, and relaxes its
control over the id (subconscious), allow-
ing unresolved conflicts to come
forward.
This ma) be important if. for example.
the woman has seriou
confl icts about her
role as a mother. She questions what kind
of mother she wants to be. or will be. If
she i
dissatisfied with mothering a
she
saw it in her family. or as she perceives it
for herself. the conflict may create anx-
iety. Sometime
this conflict is not
really faced until the postpartum period.
when the woman is forced to assume
mothering tasks.
Depending on her personality, the
support
he receives. and the strength of
her conflicts, she may resolve the crisis in
a positive way. If not, she may suffer an
emotional disturbance in the postpartum
period.
Old conflicts are not necessarily related
only to mothering but may arise from any
unresolved material in the person's buck-
ground. Frequently associated with sex-
uality - pregnancy is, after all. unde-
26 THE CANADIAN NURSE

niable evidence of sexual activity on the
part of the pregnant woman - these
conflicts may center around guilt feelings
about masturbation. pre- or extramarital
affairs. or
ex in general.
The reactivation of the unresolved
material in the person's background leads
to anxiety, and as the gravid woman
progresses in her pregnancy she becomes
more anxious. This anxiety is most often
expressed as fear - fear for her safety
during labor and delivery, fear for the
well-being of the baby, and fear that she
will be unable to love the child. Although
many of these fears are based on real
possibilities. the anxiety is often greater
than the possibility of an event occurring.
It is this increased anxiety. stemming
from old conflicts, that intensifies the
fears and makes them appear to be linked.
usually as punishment. to past events.
Since women show a marked increase
in dream activity during pregnancy and
parturition, 10 a ready medium is provided
for the emergence of conflictual material.
should it exist.
If you really listen to pregnant women,
you will hear them express some of this
material For example, if a patient re-
marh that she had a nightmare in which
she felt she would be unable to love her
child. the nur
e should encourage her to
talk about it and reassure her that many
women have these fears. Few women
recall their conflicts following pregnancy
becau
e the ego-id imbalance corrects
itself. and much of the content sinks back
into the
ubcon
cious.

Conclusion
All the changes mentioned occur in all
women to a greater or lesser extent. and
are quite normal. Because of them,
pregnancy requires significant adaptation
on the part of an individual. and is a time
during which equilibrium can be dest-
royed. or regained. Thus. pregnancy is
frequently regarded as a time of increased
susceptibility 10 crisis. Fortunately. mo
t
women confront this life situation and

cope with it quite adequately.
However. some 'will have periods of
disequilibrium or emotional disturbance
associated with pregnancy. For them the
changes may work in their favor. Because
they are usually so willing to deal with
this material. intervention is effective.
Thus, a patient who has experienced a
severe emotional disturbance frequently
resolves the problem in a relatively short
time and resume
a balanced state, often
as a more mature individual. Hence. these
psychological processes render pregnancy
a developmental event for most women,
one that assists them to realize a further
dimension of themselves.

References
I. Bibring. Grete L. Some considerations of
the psychological processö in preg-
nancy. PsydlfJallal. Stl/dy Child
14:113-21. 11)59.
') Rubin. Reva. Some cognitive aspects of
childbearing. III Bergerson. Beny S. et
al.. eds. Cl/rrell1 COllceptS ;11 Clillical
lVl/nilll!, vol. 2. St. Louis. Mosby. 1969.
p.327-31.
3. Gardiner. S. Psychosomatic Aspects of
Obstetrics. III Willidllls. John Whitridge.
Willia/ll.I' Ohstetrin, 13 ed.. by Eastman
and Hellman. Ne.... Yorio.. Appleton-
Century-Crofts. 1%6. p.346.
4. Rubin. op. cit.
5. Bibring. Grcle L. el al. A sludy of Ihe
ps}Chological processes in pregnancy and
of the carliöt mother-child relationship.
Psydw(//llIl. Sll/dy Child 16:1)-72. 196 I.
6. Caplan. Gerald. All approach to CO/ll-
1I11t1/;ty Melltal Health. London. Tavi-
stod.. 1%1. chap. 3 & 4.
7 Ibid.
8. Ha....ard. L.R. Somc psychological dS-
pCLts of pregnancy. Midll'il'l'.1 ClmJ//.
82:232. July. 11}61).
I). Caplan. op. cit.
10. Ha\\ard. L.R. 50111\; psychological as-
pecls of pregnancy. Micb'-;I'es Chroll.
82:336. Oct. 1961).

NOVEMBER 1974

Lumbar pain linked to
hypokinesia

Physical inactivity can result in chronic lumbar pain, a condition that is often
brought on by the individual. Good habits of movement and certain exercises can
prevent pain, strengthen the muscles of the vertebral column, and create a sense
of physical fitness.

The nurse has a professional responsibi-
lity to be the picture of health. She should
be a living adveI1isement of good
physical condition, and she should be
capable of teaching its principles to
others.
As nurse
in an orthopedic unit. these
considerations had particular significance
for us. Were we really pictures of health?
Did we actually set good examples of
physical fitness'? Did we, in fact. know
how to teach others about good physical
condition'?
Our concern took us to the library and
to sessions on physical fitnes
. We also
conducted an inquiry into the physical

tate of some of our colleagues. From our
study there evolved a regime of exercise

designed to prevent or relieve muscular
pain.

Study of nursð
A random sample of about 100 nurses
became the object of our inve
tigation.
Their responses ..howed that participation

Nurses of Ihe correclive orthopedic dep.lr-
Imenl of Ihe Cenlre hospilalier de rUnivcrsil':
Laval CCHUI) prcparcd Ihis P.lPCr. It \\.IS
originally prcscntcd as .In inservice cducalion
prog r .I1ll. and in \ pri I 11)74 \\ as offcrcd 10
sevcr.ll nurscs of Districll). Order 01 Nur.cs of
<.)ucbec. \1arielle Prave. a nursc. inilialcd Ihc
projcct. lIIuslr .II ions are b} S}I vie. of CHUL's
dcp,tnmcnl of gr.lphic ans.

NOVEMBER 1974

in sedentary activities. such a<; watching
television. listening to music, visiting
friends. reading. and studying took pre-
cedence over those calling for physical
exertion, such as walking, spoI1s. danc-
ing. and so on.
Of the
e 100 nurses, 41) percent
pent
less than 4 hours per week in sports
during the summer; 7 percent rated their
physical condition as poor, 13 percent as
mediocre. and 36 percent as average.
In addition:
. 83 percent had. over a period of a year.
experienced: strc
s. nervous tension (70
percent); despondency or depression (16
percent); persistent agressive behavior
(33 percent); and difficulty in tackling
anything requiring physical exeI1ion (14
percent).
. 35 percent repoI1ed that they frequently
could not enjoy leisure-time activitie..
bec.lUse they were physically exh,lU
ted
after a normal day's work.
. 40 percent thought their eating habit..
were un
atisfactory. and I
percent
thought them to be mediocre or poor.
. 31) percent
moked heavily (10 to 30
cigarettes a day).
. 20 percent con
idered their weight
above normal.
. 1m percent had alread} experienced
back pain; half of thi.. number had had
frequent or vcr) frequent epi
odð of back
pam.
Phy
ical inactivit) contributes to obe-
sity. lumbar pain. fK)
tural defects, COfO-
THE CANADIAN NURSE 27
.

nary disease, some psychosomatic condi-
tions, certain mental illnesses, and an
inability to cope with physical emergen-
. ]
Cles.
This discussion is limited to the pro-
blem of back pain arising from poor
physical conditioning.

The figures
An increasing number of individuals
are compl-aining of back pain. Swedish
researchers have estimated that approxi-
mately 2,000,000 work hours are lost
annually due to this problem. 2 According
to one set of statistics, 28,000,000 Amer-
icans had to have special treatment for
lumbar pain in one year. 3 Obviously, this
conditvon is costly to society in terms of
work loss, days of illness, hospitaliza-
tion, medical care, and, of course. suf-
fering.
In our unit, about 50 percent of the
patients have symptoms related to the
dorsolumbar area. :Y1oreover, the results
of our survey 'ihowed a high frequency of
lumbar pain among nurses.
In 1965, Smith repOI1ed that only I
person in 10 with lumbar pain could
attribute it to some structural defect. 4
The mO'it frequent cause was weak,
poorly conditioned muscles. A study by
Krauss and Raab in 1961 anticipated
Smith's findings. 5 Out of 5,000 patients
in two New York hospitals. more than 80
percent treated for pain in the dorsolum-
bar region exhibited muscular deficien-
cies.

The facts
The predisposing factors of lumbar
pain fall into two main categories:
I. Anatomical or Structural: Only I in
10 diagnosed dorsolumbar conditions has
an underlying pathological state such as
scoliosis, ..pondyloli'ithcsis, kyphosis, ar-
thritis, degenerative intervertebral discs.
inj ury. and so on.
2. Postural or Functional: A total of 9
in 10 ca"es of lumbar pain fall within this
category. One or more of the folio"" ing
28 THE CANADIAN NURSE

conditions contribute to this type of
lumbar pain:
Obesit.\', with its attendant effects on
posture and the lumbar mechanism. 6 (Ab-
dominalthickening is of special concern.)
Habitual poor postllre at work, at
school, in a car, at the theater, watching
television, sleeping, and so on. This can
eventually lead to persistent pain due to
cumulative strain in the lumbar area. 7
Poorly executed body movemellts.
These can give rise to severe pain in the
particularly delicate articulations of the
lumbar spine. 8 Occasionally. chronic
pam may ensue.
Muscular weakne.u resulting m poor
pelvic position and lordosis.

Preventive measures
Prevention lies in correction of postural
or functional defects, such as the follow-
mg:
Obesin'
A study carried out in Quebec City in
1972 under the dire.:tion of Micheline
Darisme, Centre de recherches en nutri-
tion, Laval University, demonstrated that
in the socioeconomic area under study, 50
percent of the population was obese or
overweight, although the caloric intake
was distim:tly lower than recommended
levels. 9 It was concluded that the preva-
lence of poor physical fitness was not so
much from overconsumption of food as
from a general lack of exercise, Besides,
it has been shown that physical activity
can more effectively reduce adipose tis-
sue than diet can.
By correcting or preventing obesity,
physical exercise promotes healthy mus-
cles in the lumbosacral area. If need be, a
low caloric diet can be used in conjunc-
tion with exercise.
Poor Posture
In the standing posll1on. the most
frequent postural defects are the follo-
wmg:
A sagging, hollow back. with pelvis
tilted forward. abdomen protruding; the
cervicodorsal spine is arched, with chin

pushed forward, rib cage drooping; the
knees are hyperextended. Such positions
displace the center of gravity. In the
process of re-establishing balance, there
is exaggeeration of the lumbar curvature,
and additional strain is placed on one or
other of the anterior longitudinal. ileofe-
moral. or posterior popliteal ligaments.

Ways and means
There are two main points to be
considered in the control of muscular pain
arising from improper posture.
I. Maintenance of good body alignment:
- cervical spine slightly concave
- dorsal spine slightly convex
-lumbar spine slightly concave
- sacral spine slightly convex
-knees not hyperextended
- abdomen held in
- pelvis neither tilted forward nor relaxed
posteriori y.
To test your own posture again'it these
rules, see if your muscles feel tired after
you stand for a while. In the absence of
muscolo-skeletal pathology and if you are
standing correctly, there should be no
fatigue except in the triceps muscle of the
calf of the leg. 1o At the same time, the
spinal column. the pelvis, and the knees
are being properly supported by the an-
terior longitudinal. ileofemoraI. and post-
erior popl iteal ligaments respectivel y.
With the pelvis in the proper position, lor-
dosis, ""hich causes dorsal muscular
fatigue. is corrected.
2. Maintenance of proper pelvic posi-
tion:
This entails mastery of a "seesaw"
movement of the pelvis that permits the
individual to maintain correct position.
The following exercises help to achieve
such control. A fringe benefit is the
diminution of lumbar lordosis. which, in
turn, promotes improved relaxation of the
dorsolumbar muscles.
Each exercise is one step toward
achieving good posture. Eventually. you
need oniy think about it.
NOVEMBER 1974

Exercise 1
Lying flat on the back with knees flexed.
flallen the abdomen and pu
h lumbar
spine against the floor.

Exercise 2
Assume the same position as in exercise
I. When the back touches the floor
completely. lower the legs slowly, keep-
ing the back in position.

Exercise 4
St.md with your back against a wall.
knees bent so that the lumbar spine is
pressed firmly against the waIrs surface.
Slowly raise yourself to full height.
keeping the spine in position.
NOVEMBER 1974

Exercise 3
Alternately, arch your back (like a cat)
and then make it hollow.

Exercise 5
Repeat exercise 4 in front of a mirror. but
without the wall for support.

THE CANADIAN NURSE 29

Poor habits of movement
Let us revie\\< briefly the principle
of
movement to be ob
erved in reducing
lumbar strain: II
. The broader an obJect"
base. the
greater is its
tability.
. When the line of gravity falls outside
the supporting base of a body. energy
expended to maintain balance increases.
. The stronger the mu
cles. such as those
of the thighs. arm
. and abdomen. the
greater the exertion they can withstand.
If. when a per
on stands. the body is
bent forward. the erector muscles of the
spine in the lumbar area are completely
relaxed. 12 They remain so at the begin-
ning of movement toward an upright posi-
tion. At this point the ligaments and
Intervertebral di
cs bear the brunt of the
effort frequentl) resulting in back strain
and ruptured intervertebral discs.
Contraction of the stabilizing abdomi-
nal musclð before exertion protect
the
ligaments and joints from strain.
Balance is most easily maintained by
broadening the base of support in the
direction of the movement to be made.
In
ummary. the most effective use of
the body implies: minimum expenditure
of energy; good alignment of the head and
trunk. which should move .is one unit:
avoidance of spinal twisting; dependence
on leg muscle
for greatest exertion; and

ynchronization of movements and dis-
tribution of muscular effort. 13

Muscular deficiencies
To offset muscular inadequacies. we
should develop and/or maintain muscle
strength and resistance in the thighs.
pelvis. dorsolumbar area. and abdo-
men. 14 The abdominal musculature plays
a particularly important role as it forms
the anterior component of the pelvic
girdle. and as
i,ts in protecting the spine
and holding it straight. In addition. strong
abdominal musculature reduces lordo
is.
The following exercises are designed to

trengthen the abdominal muscles at both
their superior and inferior points of
attachment.

Exercises to
Irengthen abdominal muscles
Eterc;se I
Lie flat on the back. knees slightly
flexed. arm
extended along the sides.
Keeping legs still. raise the lrunk and
arm, so that the arms touch the knees.

Eterci.
e :2
Same po
ition a, for exercise I. except
that arm
are cro
,ed behind the head.
Keeping forearm
in position. raise head
and trunk until the head touches knees.
30 THE CANADIAN NURSE

Ex. 1

Ex. 2

Ex. 3

NOVEMBER 1974

Ex. 4

Ex. 5

<

\,

Ex. 6

...

NOVEMBER 1974

Exercise 3
Same pO'.ition as for exercise I. except
that arms are extended above the head.
Complete the exercise. keeping arms
extended.

Exercise 4
Same position as exercIse I. R,Ú..c
trunk and arms. Then move the right
shoulder and arm diagonally to\\-ard the
left, and at the same time try to touch the
right knee with the Icfl hand. Repeal.
alternating sides.

Er:erci.ç(' 5
Lie flat on the floor, raise the legs
slightly, and alternate feet horizontally in
scissors-like fashion.

Exercise 6
Same position as in exercise 5. e'((.:ept
that legs are slightly more elevated. Move
legs as if pedalling a bicycle.

Conclusion
Hypokinesia. a condition resulting
from physical inactivity. is prevalent in
our society.]5 Nurses suffer its discomfon
to the same degree as general population.

References
I. Bouchard. Claude and Brunelle, Jean. FII
1I/00/I'el11ellT; pour I'otre cOllditioll phni-
que, pourlfuoi, COII/II/('IIt. Quenec. Pclic.lI1.
11)70, p. 67.
2.Aslrand. Per-Olof and Rodahl. "'.!are
T l'.\1hoo/.. (!r I\'or/.. phYSlOlogl'. TOWllIo,
McGraw Hill. 11)70, p. '271.
3.Bouchard. op. cit.. p. 79.
4.lbid.
5.Krau... Anne H. and Ra.!n. Wilhelm.
Hypokillctic dise(l.H'; di,H'(I.H's produced hi
lad of l't:erci.H'. Springfield. Ch.!rles
Thomas. 1% I. p.I3-II).
6. Bouchard. op. cit.. p. R2.
7.Ibid. p. 84.
R.Ibid.
I).L'ohc..ilc men.!cc les Qu.=hcc.,is surIoUI p.!r
manque de c('nnai"ances en nUlrilion. Au
ril de.\ el'ellell/t'lIT\ 9:20:R-9, Fen. 7. 1974.
10.cailliel. Rene. LOll' had paill .'.I'lldroll/e
Philadelphia. O.!vis. 11)68. p. 26.
II. Winler,.,.
1arg.!rel C .!mpnell. p,."t,','til"
body II/echallics ill daih lilt' alld lIunillg: a
II/l/ll/{(li .fi'r 1/I(l'.\e.\ (lml theIr CO-II.tI/'/"e/,.'
London. Saunders. 11)52. p. 27.
12.\\orJ..s. Ronal.! F. Hin" of lifting .md
pulling. AII/er J \u/'\. 72:2:260, Fd,.
11)72.
13. \\ïnlers. "p. cit.. p. ]2.
14.R,'uchard. op. cit.. p. 85.
15.Grenier. R.=jean. L'h
p""inelisme: I.! m.!-
ladie du ,.,iì=cle. Ullioll \Ill/. CtllI.
103:3:483, \I.!rch 11)74.
THE CANADIAN NURSE 31

CNA's response
to the
Le Oain Commission Report

CNA's brief to the Minister of National Health and Welfare, Ottawa, on the final report of the
commission of inquiry into the nonmedical use of drugs, presented July 17, 1974.

HIGHLIGHTS
The association does not share the pessimism of the rep<lrt on
the subject of attemps to treat and rehabilitate drug users. CNA
suggests. rather. that the solution to the problem lies in tal-..ing
a different approach.
D The association is among those who have serious misgiv-
ings about methadone maintenance and believes that. if the
methadone control program instituted by the federal govern-
ment is continued. it will require a more flexible interpretation.
D The chemical analysis of illicit drugs should be permitted to
be carried out freely and without interference, as this offers a
measure of protection to both habitual users and those who
may eventually become users.
D Despite the fact that it is difficult to assess accurately the
results of drug education programs. it is essential that these
programs be continued and strengthened in every way
possible.
D The media should be required to refrain from promoting the
use of over-the-counter drugs and medicines. Advertising of
these products should be regulated.
D Client participation is essential to the success of innovative
services, which also need to improve the training of their staff.
Financial support for these services remains a serious problem.
and should be assured by all levels of government.
D CNA supports the recommendation of Marie-Andrée
Bertrand to establish a permanent commission for the
<;upervision of the medical use of drugs. Among other steps,
the association supports greater control and supervision of the
medical use of drugs; enforcement of regulations concerning
prescription drugs: better labelling; and the establishment of a
planning committee and an information center.
D Doctors and nurses also should be better trained in drug
uses.
D A positive result of the commission' s work has been to
elevate the question of drug usage to national stature.

Thi, brief IS ba,eù on opinion, .md surw}, of group' of nurse, from
vdrious region' ofCanaùa.
32 THE CANADIAN NURSE

GENERAL COMMENTS
The Final Report of the Commission of Inquiry into the
Non-Medical Use of Drugs covers 1,148 pages. A quick
glance at the table of contents provides a glimpse of the scope
of this document. The Final Report provides infonnation on
the subject of all the drugs. except cannabis, covered in its
19n report, and covers the social, medical. and legal
problems posed by the nonmedical use of drugs. Useful to
laymen and professionals alike. the report is assuredly a
valuable reference source that any library should have in its
collection. The association's only regret is that the report of the
commission, created in 1969, has lost some of its impact.
CNA abo feels that the report contains too many descriptive
details. and that its recommendations are sometimes too
vague, or even nonexistent.
Nevertheless, C
A hopes that many persons will become so
familiar with the report's content that it will replace bool-..5 of
lesser quality that have contributed to much public confusion
on the use of drugs for nonmedical ends. Because of the
complexity of the report. the association will limit its
comments to the following subjects, basing them on the
experience of several groups of nurses.
I. Treatment and rehabilitation.
2. Illicit "street drug" analysis facilities.
3. Drug education.
4. The mass media.
5. Innovative services.
6. Additional conclusions and recommendations of
Marie-Andrée Bertrand.
7. Education of health personnel.

Treatment and rehabilitation
"On the whole. \\e found the outlook for treatment,
particularly of drug dependence. to be a discouraging one."
(Final Report. p. 147.)
This statement sets the tone for the 31 subsequent pages.
Such a pessimistic viewpoint. the association feels. can only
have a harmful effect on the decision., of governmental bodies
NOVEMBER 1974

that are required to allocate funds for treatment and research
projects. Despite the support given these programs by the Le
Dain Commission, and in view of the lack of results obtained
to now, the CNA feels the report' s pessimistic declaration can
have a negative influence on governments that are seeking to
reduce. or at least not to increase, their budgets for such items.
On another level. the a'
sociation has found many doctors,
social workers. and counselors are poorly disposed to treat
drug users. mostly because to date their attempts have not had
much success. The pessimism of the report will not likely
stimulate further attempts on their part. If this pessimism is
justified. the users of drugs will continue to be found in
psychiatric hospitals. in prisons. and on the streets. and to be
dependent on drug maintenance programs. The report clearly
sees the possibilities of treatment as discouraging.
This association would have liked to have seen greater stress
placed on the idea of treatment itself. In Difficulties in Treating
the Drug Abuser, 1 Stanley Einstein argues that treatment
difficulties are related to the fact that the person aiding or
treating the user believes that treatment should confonn to
principles and ends determined by those in charge of research
and treatment. and not by the persons needing help. These
same persons who aid the user determine the success of
treatment without consulting those treated. The pen,on needing
drugs is seldom allowed to participate in the whole process of
intervention. treatment and rehabilitation. Rather than the
possibilities of treatment. it is our own approaches to. and
attitudes and suppositions about. the problem that are
discouraging.
The commission assens that the main difficulty lies in the
treatment of dependency. In the association's view. this is not
the main problem. Rather. an attack on the roots of the illness
is needed. that is. on our society's abuse of drugs in general.
The incidental use of mood-changing substances is common.
Eliminating this unfortunate habit will. at the same time. settle
the problem of individual dependence. The additional recom-
mendations of Marie-Andree Bertrand are in agreement with
this view and with other points the association sets out in the
following sections on the media and on education.
Although the report does stress the importance of rehabilita-
tion and prevention. and the need to have additional qualified
staff in the treatment phase. it makes no recommendation a.. to
preventive programs or staff training programs.
As asserted in the report. there is no doubt that if treatment
of individuals i'i attempted instead of locking them in or u
ing
other inefficient sanctions. the number of treatment units of all
sorts. including methadone control. must be increased. In
addition. probationary and social rehabilitation staff must be
increased. Faced with such a recommendation. the members of
NOVEMBER 1974

CNA can only' .vonder if they are ready to meet the present
demand in genel "al hospitals.
Based on pre' lious experiences, e
pecially in Nova Scotia's
Victoria Genera I Hospital. the CNA expresses a number of
reservations as t( ) the methadone maintenance program.
The report ad .nowledges there is still much research to be
done on the subj. ect of methadone. Marl}' questions remain to
be settled before considering a replacement opiate program.
These studies incl ude the level of neutralization, long-term and
secondary effects As the report concedes. methadone is not a
cure.
However. if it is necessary to expand this program. the
association recom mends that metbadone control staff. their
clients. and those familiar with the drug world be given their
say in working 01 It federal and provincial regulations. CNA
hopes that they wil I help to set up less strict federal regulations
that will allow grea ter flexibility at the provincial level.

Illicit "street drug" . Inalysis facilities
This section rai ses the possibility that a "street drug"
analysis program c0uld provide an adequate basis for
controlling the qua lity of drugs available from illicit market
distributors. The
lIIalysis of illicit drugs certainly has an
important effect on the black market. A seller of adulterated
drugs can immedia t ely be put out of business if it is easy to
obtain a precise an.,lIysis of his merchandise. Sl)cial workers
and hospital emerg cncy
taff through such analyses can be
better prepared to treat reactions of the u.'ier. Moreover.
analyses can serve to demY!itify drugs and lead U'iers to
examine their use of illicit drugs.
The report states on page 196: "The deliber,Ite mixture or
adulteratIOn ot sin gle drugs with other chemicals or the
substitution of more dangerous ohemicals for an a lIeged drug is
relatively rare in Ca 11ada. ..
The experience of CNA in the Halifax reg.ion does not
confirm this view. I: )ver the past five years. Dr. M. Segal and
Dr. H. Ellenberger have found that. at a giveI'! lime, up to 80
percent of the sam pIes analyzed had been adulterated and
contained dang Croll s ingredients, such as phencyclidine or
amphetamines.
The association i
;, in complete agreement \\-ith recommenda-
tions to promote bet ter coordination and identification of drugs
at the national level . and for freedom 10 analyze drugs \\ ithout
interference from pc ,lice or public officials.

Drug education
Most of the pres cnt documentation questions the value of
drug education pro]
rams. UnfiJr1Unately. as indicated in the
report. there are stil ,I no techniques to evaluate the effects on
THE CAtli/ADIAN NURSE 33

behavior of such programs. \leverthele

. even working
blindly. there is a need to make supposition
. to develop and
implement programs. and to study their results (lbjectively.
Although the report does not contain any f: oncrete recom-
mendations on this subject. it should be cor nmended for its
research in this difficult area. The report sta t es that only six
percent of the Toronto secondary school stude' nts queried were
sati
fied \\ ith the drug education given i r I their schools.
Whatever the rea
on fOf this low figure. th I: finding should
encourage school boards in other regions (1 f the country to
examine what they are doing in the drug educ, Ition field.
The report found that. generally. drug edu ('ation was part of
health and hygiene courses. In 20 percent of t he school boards.
these were connected with other matters. Sll ch as orientation.
C\IA would like to see drug education in!.. ;:grated into such
subjects as science. literature. biology. Hnd history. This
would help to demystify drug usage. rv I oreover. teachers
\H1Uld feel more at ed
e discussing drugs in the context of

ubiects \Ùth which they are familiar.

The mass media
If nonmedical drug U5e poses such a problem in our
society. it i
becauçe we are accustomed to ( 'onsuming all sorts
of medicinö and drugs. The ma
s media help to perpetuate
this life ..,tyle. Whik empirical data on tht' positive effect of
drug advertising on drug use are lacking. i I is clear that mass
media advertising UOð convey the iml J ression that drugs
provide an insta'.lt
.olution to daily problc rns and tensions. as
the report conclude, on page 221:
"We recomrnend that effective control
, be established over
the nature and quantity of Ihe adve r tising directed by
pharmaceut ical manufacturers and othf 'J' distributors at the
medical profession. including the us' e of 4iamples. The
Federal Go vernment should take steps, in consultation with
the pharrrldceUlical industry, to en,.: ourage a general
reduction in thi
kind of promotion."
Unfortunately. the report does not menti 0 n what steps would
have to be tak,:n. The report goes on to COlllment: "Generally.
self-regulation is to be preferred to gO'/t:rnment regulation
because it can adjust more flexibly ,Ind realistically to
operating necessities." (p.2:!1)
Although ',his ma) be true. one may a L'> k who is going to
ensure thë,t drug manufacturers are going t Co effectively inform
the public on the dangers of the abuse of l .(:rtain drugs. on the
imeraction
drugs may have. and just when this will be done.
As nur
es. we o;ee at fir
t hand the problems created by
over-the-counter medicines. These met I icines often react
adverse!} on patient
who are alreddy tal, ing other drugs on
pre
cription. Prolonged u
e of such mt. dicines. without a
doctor's approval. also concerns health pro c
sionab. The CNA
34 HIE CANADIA''I,i NURSk:

believes that an imerprofessional committee should be created
1.0 regulate advertising for over-the-counter medicines and to
compel manufacturers to indicate on labels the detailed
:omposition of their product.

Innovative services
The association agrees with the opinIOn expressed in the
report that innovative services should not become too large and
should ensure the participation of their clients in all aspects of
their programs. including decision-making.
A form of
elf-evaluation must be anticipated to adapt
services to constantly evolving needs. The association wishes
to stress the importance of involving clients in the evaluation
of services.
The lack of success of certain services can be explained by
this absence of evaluation and participation of the client.
[he report
hould have given more prominence to training
staff for innovative services. It is possibl) because of this lack
of training that innovative services staff have problems in
being accepted by profes
ional workers in the drug area.
The association has little to say about the part called' 'NMUD
Policy and Administration." However. CNA wishes 10
emphasize again the importance of the participation of
cliemele and innovative services personnel in regional i'o\1UD
(nonmedical u
e of drugs) structures. It is important that
regional offices remain small enough to maintain a link
between programs and their cl ientelc.
The report does not deal with training programs for N\1UD
staff. Such programs
hould try to foster and encourage
organizational and human relations skills.
Innovative services usually
uffer financial strain
. The
uncertainty of funding affects staff morale and. hence. the
quality of service. The report mentions that certain depart-
menb reluctantly continue to fund innovative services created
as a result of federal grants. This association wonders why
regional NMUD representatives could not study the means to
help innovative services establish better relations with gov-
ernment departments.
There is also much to be done with respect to the
relationship between innovative services and provincial and
municipal governments. This association strongly
upports the
recommendation that the federal government take steps to see
Ihat provincial and municipal governments give their financial
and moral support to innovative services through cost-sharing
arrangements. or some other mechanism.

Additional conclusions and recommendations
of Marie-Andréè Bertrand:
"My most urgent recommendation i
that a permanent
Commission for the supcrvi
ion of the Medical Use of
NOVEMBER 1974

Drugs be established at the earliest possible moment. under
the authority of the Governor-General-in-Council. to
examine the prescribing practices current in the medical
profession and rectify them." (p. 252)
The CNA is in complete agreement with the need to establish
a commio;sion to supervise the medical use of drugs and
medicines. In a survey of a group of nurses. 70 percent of
those who replied were in favor of setting up such a
commission. while only 6.7 percent were opposed to it. The
majority of nurses supporting such a step felt it is too easy to
obtain prescriptions for drugs and medicines, that doctors tend
to prescribe too large quantities of medicines, and that patients
often continue to take these after their illness is cured.
This is not a new problem. A Nova Scotia Registered
Nurses' As;,ociation special committee on Drug Prescription
Dependency presented a report on over-the-counter
medicines. 2
The recommendations of this special committee could help
establish measures to correct this situation. The committee
recommended:
D o;trict control of the distribution of medicines in small
hospitals. clinics, and other health centero; through well
worked-out policies:
D strict application of regulations concerning prescriptions
and drug preparation;
D labelling of all medicines sold by prescription with the
name. quantity . and dosage:
D the setting up at all hospitals of a convalescence planning
committee, chm..en from doctors. nurses. pharmacists, and
social workers. to ensure that patients are well informed on the
subject of drugs:
D the establishment of a center to collect and disseminate
information on the use of drugs and medicines to curb the
abuse of prescribed drugs and medicines.
:--Jurses must be careful to refrain from dispensing medicines
too liberally to their patients. These are now almost considered
part of routine care. Nurses mUst accept their responsibility in
this field and adequately fill their prevenÜve role.

Education of health personnel
"The federal government should explore, with the provin-
cial governments and the various medical bodies, ways in
which medical sl:hools and assol:iations I:an improve the
edul:ation of physil:ians with respect to general. as well as
treatment. aspects of nonmedical drug use. ,. (p. 205)
Of d group of nuro;es consulted on this recommendation. 76
perl:ent agreed that dOl:tors need better education in this field.
As for themselves, 85.7 perl:ent of the nurses queried felt that
nurseo; necd more education than dOl:tors on thi... subjel:t
hecause. mOst often, it i... nurses who establish the first contal:t
NOVEMBER 1974

with the patient. These nurses also thought they were in an
ideal position to help the community understand the effects of
drug use. Even though they considered their present contribu-
tion valuable. the nurses nevertheless regretted not being more
effective. due to their lack of information and training in this
field.
This association supports this recommendation and hopes
that the nel:essary training will be undertaken through
collaboration of governmental bodies and as;,ol:iations of
physicians and nurses.

CONCLUSION
As explained at the beginning of the brief. the final report is
a long and complex dowment. As the association "nowo; of
only one drug study initiated by the nursmg profession. and as
theo;e findings are limited in their application, CNA will restril:t
ito; I:omments to the above areas.
The Commission of Inquiry has opened discussion on a
subject that. to date. has been more or less taboo. This debate
was I:haral:terized by understanding and broad mindedness.
The publil: hearings held from coast to coast in Canada allowed
people to say things never before stated openly. In this way.
people were able to come to regard drug use more ohjectively,
to bring the matter into the open. and to subject it to the same
critical scrutiny as other forms of human behavior.
The report has demonstrated clearly the unbelievable
complexity of the problem and established the fal:t that there
are no simple answers to it.
Canadian nurses ad.nowledge their share of the responsibil-
ity concerning the drug problem and will spare no effort to
meet the I:hallenge presented by the Le Dain Report.
The association would like to thank the federal government
for allowing it to express its views on a report that direl:tly
concerns the health of the nation and hopes that thl:se
observations will he useful.

References
I. EinMein. Stanley and Quinones. Mar". DiJjìcu/f;, s i" Treafi"1i fhl'
Drug Ahll.H:r. College of Medicine and Dentistr} of Ne" Jersey.
Nc\\ar". N J.. IY72.

Registcred Nurses' Association of Nov.1 ScotiJ. Report of the
Special Committee on Drug Dependency on Prescription and
Ovcr-Ihc-Coulller Drugs. Jul} IY73.

THE CANADIAN NURSE 35

in a capsule

Information on family life
A number of publications relating to
family life are available from The Vanier
Institute of the Family. 151 Slater Street.
Ouawa KIP 5H3. These include:
D The SenJing Professions, a bilingual
report of a seminar that explored the
effects of professionalism on family life;
35 participants represented professions
and users of professional services. The
complete report costs $1.50.
D Catalogue of Canadian resources on
the family. which contains more than
1.000 listings. is available for $7 a copy.
A catalogue of 1973 additions. containing
a 50-page package of new listings in most
sections. can be ordered at $1 a package.
D Family life education survey series:
Part I - Family Life Education in the
Media of Mass Communication. $1; Part
II - Family Life Education in the
Schuols, $1; and Part III - Family Life
Education in Vulunta1'\' Associations. $2.
D Reflections of the Family, a report of

the institute's annual meeting containing
content from sessions on man. woman.
child. the elderly. art, and communica-
tions. $1.50.
D The Changing Family Concept. text of
a speech given by Jacques Gagné, assis-
tant executive director of the Vanier
Institute. Copies are free of charge.

New design proposed for ICU
Intensive care units should be redesigned
from open wards to a series of cubicles.
with a wash sink near the entrance to each
cubicle. Infection safety codes for hospi-
tals should also be established. according
to Dr. Harold Laufman. professor of
surgery at Albert Einstein College of
Medicine in New York.
Among Laufman's reasons for the new
design are that it would provide good
surveillance and easy access to patients.
and the wash sinks would make it
possible for personnel to wash their hands
after visiting each patient. Each cubicle,

'-L-

0\O\U'W ll

J'UN lOR
NuR'3ItJß
I<lT
Gß

36 THE CANADIAN NURSE

"Quick! Show a happy face or she'll start nursing us back to health."

he adds. should have windows high
enough so that one patient cannot see the
next while lying in bed.
In an editorial in the September 1974
issue of SurRery. GynecoloRY & Obstet-
rics, Laufer also says the units he
proposes could be made of low-cost
prefabricated walls, such as those re-
commended for coronary care units. He
recommends at least 120 square feet for
each cubicle to allow for adequate space
around the bed for any type of emergency
care.
Laufer believes that his design would
make hygiene practiced by hospital per-
sonnel easier to effect. although he notes
that neither architecture nor
antibiotics
alone can solve the problem of the high
degree of infection. which has been found
to occur in ICUs.

Even the blind ski in Norway
When it comes to skiing in Norway, no
one is forgotten. An annual winter sports
game for the disabled features a remark-
able event: a downhill ski race for the
blind.
Each year this race attracts more than
400 participants, induding companions.
Norwegian Red Cross volunteers, who
are a
ong the racing partners of the
competitors, spend the winter helping
their handicapped partner prepare for the
race. This training also helps break down
the person's isolation from the outside
world.
Panorama, a publication of the League
of Red Cross Societies, reported this
unusual event in its third issue of 1974.

Alert nurses revive woman
Three Toronto head nurses - Karen
A very, Carol Moran, and Doreen
Craig - deserve special mention after
their fast action revived a woman kneel-
ing on a sidewalk with a "heart ailment."
Their application of the resuscitation
techniques they nonnally use in the
cardiovascular department of the Toronto
General Hospital was described in The
Globe and Mail.
., You often wonder how you' d react in
an emergency. We just reacted as if it had
happened on the tloor. . it was just thf'
same:' said Karen Avery. She and the
other two nurses had pushed their way
through a crowd - that was helplessly
watching the woman. those heart and
breathing had stopped - revived her,
and got her to the hospital. There she
made a complete recovery
NOVEMBER 1974

he
A
!O
of ñursin Chi ""

\

CHILD HEALTH MAINTENANCE: Concepts in
Family-Centered Care
Providing a clear delineation of the nursing process in the children's health
care arena, this text presents concepts inherent in maintaining or restoring a
child's health in view of his family and environment. A unique conceptual
framework of competency development helps students see each child as an
integrated whole - affected as a total individual by health management and
intervention.
By PEGGY L. CHINN. R.N., Ph.D. March, 1974. 542 pages plus FM I-XII, 8" x 10",
214 illustrations. Price. $13.15.

A New Book!

Chinn-Leitch

CHILD HEALTH MAINTENANCE: A Guide to
Clinical Assessment

This outstanding new companion to the above text provides basic informa-
tion 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 assess-
ment, 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 J. LEITCH, R.N., Ph.D. March,
1974.122 pages plus FM I-VIII. 8" x 10",20 illustrations. Price. $5.20.

New 2nd Edition!

Anderson

WORKBOOK FOR PEDIATRIC NURSES

This unique workbook provides students with an effective study guide during
their clinical experience in pediatric nursing. Through a series of simulated
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, principles oriented and
stress growth and development.
By NORMA J. ANDERSON. R.N. June. 1974. 200 pages plus FM I-X. 7%" x 10Yz", 21
illustrations. Price. $6.05.

perceptively

described

.
In new

New 6th Edition!
Matheney-Topalis

PSYCHIATRIC NURSING

Emphasizing the development of inter-
personal skills. this new edition con-
siders all aspects of the nurse's role
with the psychiatric patient. Up-to-
date information 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 TOPALIS. R.N., Ed.D. Guest
Contributor: JEANETTE A. WEISS. R.N..
M.A. July. 1974. 440 pages plus FM I.XIV.
7" x 10". illustrated. Price. $9.40.

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Patient Bathing System

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Patient bathing system
A new bathing system for disabled
patients, called the Arjo B-2 Patient
Bathing system, has been imported from
Sweden by Will Ross, Inc., Milwaukee.
It is available in Canada from National
Hospital Supply Co. Ltd., 1000
Lakeshore Rd. E., Mississauga. Ontario.
This bathing system is recommended
for use with geriatric. physically hand-
icapped. and severely retarded patients,
including tho
e with little or no muscle
tone and those with a lack of muscular
controL
Included with the bathing system are
the Patit'nt Stretcher Trolley and tub with
control console. The trolley features
'itainless steel and fiberglass construction,
accurate and safe hydraulic height ad-
justment, and a centrally located steering
device for easy handling. The tub, also of
stainless steel, includes automatic temp-
erature controls and has the advantage of
38 THE CANADIAN NURSE

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fast filling and drainage.
The Arjo bathing unit is part of the full
line of Arjo systems for patient transpor-
tation, bathing, and physical therapy.

Four products from Pharbec
Pharbec Inc., MontreaL has announced
the availability of a new product called
Sedalone (Methaqualone HCI 200 mg) on
the Canadian market.
Sedalone, which is indicated in treating
insomnia. usually induces sleep in 10 to
30 minutes, and produces a restful sleep
of 6 to 8 hours. Patients usually awake
easily, without evidence of posthypnotic
central nervous system depression or
"hang over."
This yellow capsule is available In
bottles of 100 and 1,000.
Pharbec is now selling four products.
The other three are Survit (hexavitamin
capsules N .F.); Isobec (amobarbital tab-
lets U.S.P. 100 mg); and Promabec

(promazine HCI tablets N.F. 50 mg).
The company's head office is located at
4012 Cote Vertu, MontreaL Que. H4R
IV4.

Literature available
An instant reference wall chart, which
gives emergency procedures and hazard-
ous properties for dangerous chemicals, is
available from General Scientific Equip-
ment Company, Limekiln Pike and Wil-
liams Ave.. Philadelphia, Pa. 19150.
U.S.A.
By glancing at this chart, a person can
tell why a chemical is dangerous, its
relative degree of danger. and how it
should be handled. The chart also gives
precautions that should be taken in
storing, handling, and disposing of these
chemicals, plus general first-aid proce-
dures for handling emergencies.
This chart measures 35 x 45 incht:s, is
printed on 4 colors. has metal mountings
for hanging, and large type for easy
reading.

Uro sheath for males
The Bard disposable Uro sheath is an
external device designed to help eliminate
trauma to the urethral tract and minimize
risk of infection. It is made of soft,
lightweight latex with a molded adapter at
the distal end. The sheath easily connects
to Bard leg bags and other urinary
drainage receptacles. A foam strip with
adhesive backing is included to aid in
positioning the sheath.
For complete details, write to C.R.
Bard (Canada) Limited, I Westside
Drive, Etobicoke, Ontario, M9C IB2.

..,

Uro Sheath
NOVEMBER 1974

A New Book!
Whaley

UNDERSTAND ING
INHER !TED
DISORDERS

Basic concepts of inherited
diseases are introd uced in this
text by first presenting gen-
eral principles and then out-
lining their applications and
ex c e ptions. Corn prehensive
coverage includes: the
physical basis of inheritance;
gene transmission in families;
single gene disorders; chromo-
some aberrations; and more.
By LUCILLE F. WH.
LEY, R.N.,
M.S. June, 1974. 220 pages plus
FM I-XII, 6Y," x 9Y,", 121 il-
lustrations. Price, $11 .50.

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New 3rd EditIOn!

Havener et al

NURSING CARE IN EYE, EAR, NOSE, AND THROAT DISOF.lDERS

This new edition emphasizes the nurse's expanding role in the health care system. It
offers vital assistance in the assessment role and I n the development of nursing care
plans based on thorough understanding of the pathophysiology, treatment and related
problems of patients with eye, ear, nose and throat disorders.
By WILLIAM H. HAVENER, B.A., M.S.(Ophth.I, M.D.; WILLIAM H. SAUNDERS, B.A., M.D.;
CAROL FAIR KEITH, R.N., B.S.N., M.S.; and ARDRA IN. PRESCOT1f, R.N. March, 1974. 460
pages plus FM I.VIII, 6)1;,.. x 9Y,", 357 illustrations. Price, $,12.35.

New 6th Edition!

Carini.Owens

NEUROLOGICAL AND NEUROSURGICAL NURSI NG

Highlighted by extensive revisions, this new edition appears as 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; in-depth treatment of cerebrovascu lar disease; etc.
By ESTA CARINI, R.N., Ph.D.; and GUY OWENS, M.D. April, 1974. 416 pag.
s plus FM I-XII, 7"
x 10", 145 illustrations, including 2 in color. Price, $11.85.

New 8th Edition!

Larson.Gould

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 total

hip and knee joint replacement. Other areas discu ssed incl'Jde: care of patients in casts,
traction, and braces; surgical patients; arthritis; bone tum ors; and more.
By CARROLL B. LARSON, M.D., F.A.C.S.; and MJ\RJORIE GOULD, R.N., B.S., M.S. April,
1974.488 pages plus FM I.XII, 7" x 10",672 illustrations. Price, $12.10.

A New Book!

Knelsl-I'mes

MENTAL HEALTH CONCEPTS IN MEDICAL-SURGICAL
NURSING: A Workbook

This workbook aids the student in an inter/rated curriculum in nursing by applying
concepts of mental hea,lth psychiatric nursinq to car mCj for adult patients with medical
and/or surgical problell1's. Case studies help the studr m ( become more adept at '.:Issessing
needs, planning care, and evaluating effectivE:ness of nursing actions.
By CAROL REN KNEISL, R.N., M.S.; and SUE ANN A MES, R.N., M.S. Sept
'mb'd", 1974. 160
pages plus FM I-X, 7%" x 10Y,", 23 illustrations. F'rice, $5 .80.

,

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THE C V MOSBY COMPANY.
86 NORTHLINE ROAD
TORONTO. ONTARIO
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I"esearch .:lbstract
s

The fo)J"w ing a re ab
tracts of studiö
clected
from the C 'anad ian NUßö' A

ociation Re-
pository Cm 'Iecti on of Nursing Studies. Ab-

tract n1dnu!>C ript
are prepared by the authors.

Paquette, Clai. .e. . Personal history of per-
sons comp. 'ail ling of back pain: A
psycho.wc;.ll app
oach. Seattle.
Wash.. 197.
. ThesIs (M.A.) U. of
Washington.

This study was c( ml 'erned with the "per-
sonal history" of ,t S 'elected sample of II
individuals comph lir, ling of chronic, in-
tractable, mechanil 'a] back pain. where
either the patient's r 'esponse (pain be-
havior) to the stimuh IS (tissue pathology)
seemed to be greater tt. Ian the observable
stimulus. or where. f.'V, en after the sup-
pression of the stimL'h IS, t
e response
remained unextinguishe'd . ThIS study was
an attempt to secure infonnation on
possible contributing fa,
I 'ors in chronic
pain. The study framewOl'k used concepts
from transactional analy
,\'s and primal
therap} .
The purposes of t he project
were: I. to study factors
) ossibly con-
tributing to chronic pain thrall 'gh analysis,
comparison. and synthesis of themes
emerging from the personal I listories of
patients seen at the University of
Washington Hospital pain c1i. nic. who
complained of chronic. inti "actable.
mechanical back pain:
2. to trace the orientation of I 'Jarental
influences on the persons. from chIldhood
into adulthood:
3. to open up new avenues to I lUrses
and other health professionals in de aling
with chronic sufferers and in helpin g in
the management of their pain.
The data were coIlected by means ( ,f a
slightly modified "personal histl1 ry
form" developed by researchers in trar.'. <;-
actional änalysis at the Illinois Institute () f
Applied Psychology in Chicago. The'
questionnaire comprised 55 questions
concerned with biographical data, paren-
tal influences. patient's view of self. and
additional fe,
lings. comments, and sug-
gestions.
The findings were that anger. guilt.
manipulation. unresolved losses, and de-
pendency were Ihe major characteristics
of the psycholo
ical profiles of the
patients in the sample. The "basic posi-
40 THE CANADIAN NURSE

tion" of all of them was 'Tm not OK:
You're OK." For only one patient was
then
evidence of typical parental mes-
sage s having direct relationship with pain
and suffering. The data indicated that all
patients in the sample might have bene-
fited fmm psychotherapy along with their
medical treatment.

O'Leary, A. ,'1orah. An assessmellT of
patients' activity, I.nowledge and am:-
iety qfter prosthetic aort/;c valve re-
placement. Toronto. Ont. 1974.
Thesis (M .Sc.N.) University of
Toronto.

The purpose of this study is to dem,m-
strate the need fo;- nursing interven.lOn
during the convalescent and Icehabilitative
period following prosthetic replacement
of the aortic val"e. It was part of a larger
follow-up study by the sur

eons of the
cardiovascular division of the Toranto
G
neral Hospital.
Fifty patients were interviewed and
questioned about I'heir pre- an d postopera-
tive vocational. n;:creational, and house-
hold activities. The patient's level of
knowledge about his therape utic regimen
was ascertaineJ, and each patient com-
pleted an anxiety te Sl.
The majority of ,patients w
re found to
do the same amoun t of, or Ie ss. physical
activity postoperati vely compared with
that done preoperati vely. Les:-; frequently
allempted, strenuo us activ ities were
shown to be done by fewer patients
postoperatively. The actual level of activ--
ity was lower than that expected in most
cases. Of the 20 pat ients in "Je\\< York
Heart Functional Clæ;s I, 40 loercent (8
patients) were less acti've.
At the time of the int,-;:rview, :\6 percent
(19) of the patients were unemployed.
The percentage of unernployed is larger
than that in centers with active vocational
rehabilitation programs.
The patients were f(lund to have in-
complete information about pre:,cribed
diet and medications. and received little
. 'Suidance concerning the appropria Ie level
ü of activity during and after con vales-
c ence.
The anxiety level of patil'nts. as deter-
mil. led by the psychologic al test com-
pletcd by each patient. had a mean value
that wa'.; lower than the est ablished test

values. The mean value of tests com-
pleted by the patients who indicated
dissatisfaction \\' ith the effect of their
surgery was grea ter than the mean of the
remainder of the patients.
Recommendat1Ons include the estab-
lishment of an ongoing program of group
teaching to prepare the patient to return
home. In addi1jon, there is need for
individual instruction as indicated by
observed differe'nces in the patient's age,
education, and subjective need for in-
struction.

Gower, Philip Edwin Thomas. MUTual
withdrawal: a study of staff-paTienl
communica.rion patterns. New Haven,
Conn., 1974. Thesis (M.S.N.) Yale
University.

The purpose of thi!. study was to assess
the effect of two different nursing inter-
ventions in reversing occurrences of
mutual withdrawal of patients and nursing
staff on an inpatient psychiatric ward.
Fram a simple questionnaire completed
by the staff, sociograms of the communi-
cation pat',erns of three wards were
obtained, and used as the experimental
input to the staff of the first experimental
ward. Sim ilarly, the nursing staff of the
second experimental ward saw the
sociometric diagram for their ward, but in
addition, for a limited time, had the
opportunity to discuss and plan new
nursing interventions with the researcher
as an objective consultant.
Demographically, the differences
among the staff of the three wards were
not statistically significant. After adminis-
tering th.
questionnaire a second time
when seven weeks had elapsed. scores for
all three wards for before :wd after were
compared. using a complex analysis of
variance. No significant change was
found to have occurred in the two
experimental wards. A high degree of
variance was noted within each ward's
responses.
The stable nature of a psychiatric
ward's communication patterns. where
both staff a nd patients had been together
for a long time prior to the study, along
with the rather short and limited experi-
mental input that was employed, were
suggested as the most probable causes of
the failure t..) change.

NOVEMBER 1974

New 2nd Edition!

Agu ilera-Messick

CRISIS INTERVENTION: Theory and
Methodology
This book presents the historical development of crisis
intervention, describes the theoretical base, and examines
sociological factors which influence the psychotherapeutic
process. Factual discussions describe events which may
precipitate a crisis and introduce practical methods for
intervention.
By DONNA C. AGUtLERA, R.N., M.S.; and JANtCE M.
MESSICK, R.N., M.S. April, 1974.154 pages plus FM I-XIV, 6%"
x 9W', 13 illustrations. Price, $6.30.

A New Book!

PRIMARY NURSING: A Model For
Individualized Care

Marram et al

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; bureau-
cracy and nursing care delivery; male-dominated society;
etc.
By GWEN D. MARRAM, R.N., Ph.D.; MARGARET W.
SCHLEGEL, R.N.; and EM O. BEVIS, R.N., M.A. May, 1974. 174
pages plus FM t-XII, 6" x 9",23 illustrations. Price, $6.25.

"

th

:,::;;":'
way of
PROS:"'EM-ORIENTED MEDICAL
RECORD IMPLEMENTATION: New 2nd Edition'
Douglass-Bevis
Allied Health Peer Review

This book provides a set of guidelines
for the nurse and allied health pro-
fessional in the use of P.D.M.R. in
order to reduce confusion, duplication
of effort, omission and commission of
needless work in patient record keep-
ing. The text shows that by using the
Weed method, patient information can
be organized as a scientific document
and audited as a collection of the
patient's data base.
By ROSEMARIAN BERNI, R.N.; and
HE LEN READE Y .R.N., M.S. October, 1974.
184 pages plus FM I-XIV, 7" x 10",14 illus-
stralions. Price, $6.25.

NURSING LEADERSHIP IN ACTION:
Principles and Application to
Staff Situations
Expanded and thoroughly updated, this new
edition continues to emphasize that leadership
is learned behavior and that every nurse can
organize her knowledge, skills, and experi-
ences to maintain a high quality of leadership.
Discussions provide a theoretical framework
and practical methods for utilizing admin-
istrative principles in daily nursing activities.
By LAURA MAE DOUGLASS, R.N., B.A., M.S.;
and EM OLIVIA BEVIS, R.N., B.S., M.A. April,
1974. 214 pages plus FM I-XII, 7" x 10", 17
illustrations in 17 figures. Price, $6.05.

A New Book!

READINGS IN CHILD AND
ADOLESCENT PSYCHIATRIC NURSING

Bringing together almost all written material presently
available in the field of child psychiatric nursing, this
volume is the only one presently addressing itself
specifically to the nurse's therapeutic role with
emotionally disturbed children and adolescents. This
book is developmentally organized, beginning with a
total frame of reference, and includes a wealth of
clinical examples.
Edited by CLAIRE M. FAGIN, Ph.D., R.N.; with 32 contributors.
January, 1974.190 pages plus FM I-XIV, 6" x 9", 10 illustrations.
Price, $6.05.

A New Book!

O'Brien

COMMUNICATIONS AND
RELATIONSHIPS IN NURSING

In this new book, the author studies commonalities of
human nature relevant to communication; proceeds to
basic facets of communication skills; and closes with
specific communication problem situations. Topics include
self-awareness, use of appropriate language, and reality
perception. Ten "communications interactions" demon-
strate principles discussed.
By MAUREEN J. O'BRIEN, R.N., M.s. May, 1974. 180 pages plus
FM I-XII,5W' x 8Y,". Price, $5.20.

.

,

.
nursln

MOSBY

TIMES MIRRDR
THE C. V MOSBY COMPANY L TO
B6 NORTHLINE ROAD
TORONTO. ONTARIO
M48 3E5

.

books

Primary Nursing; a Model for Indi-
vidualized care, by Gwen D. Marram
et al. 174 pages. St. Louis, Mosby.
1974. Canadian Agent: Toronto.
Mosby.
Rn'iewed by Wendy Gerhard, Assi.f-
tallt Profe'uor, Faculty of Vursing,
The University of Western Ontario,
London, Ollt.

A text. whÍ\:h has as ih purpose the
di
cussion in depth of a !.ystem that
achieves the highest quality of nursing
care and an efficient means of providing
this care. should be exciting and should
stimulate the reader to \', ish immediately
to implement such a system. An unfortu-
nate framework. ho\\ever. and far too
many typographical errors make perse-
verance difficult.
The authors define primary nursing as
the distribution of nursing so that the total
care of an individual patient is the
responsibility of one nurse. not many
nurses. Part I presents a refreshing view
of nursing"s professionalization within a
bureaucratic system and in the social
context of today. Nursing is issued the
challenge of accountability. and the au-
thors offer primary nursing as a model.
In Part II. the authors attempt to
de..cribe the nature and scope of primary
nursing. Not until the conclusion of the
sectio; does one finally begin to under-
stand the model. The premises upon
\\hich the model is based become clear.
but the authors present their descriptions
of the various components in an awk-
ward. almost tedious. fashion.
The final section reports on some
compari..ons of the effects of this model
on patients and staff. and contrasts are
made with other nursing modes. The
authors point out some weaknesses in the
research but convey their belief that this
mode satisfies their purposes.
The authors' sincere interest in
patient-centered care. and their desire to
share a modality that permits. in fact
demands. this kind of orientation are
obvious in the book. The model appears
to achieve the purpose for which it was
designed. but the successful achievement
by the author... of their purpose is not as
apparent.
Clinici,\ns and nursing administrators
at allievel'i who are committed to change.
and who can wait until the whole is
42 THE CANADIAN NURSE

completed before appreciating the parts.
will find many intriguing ideas in the
book. A student. particularly one in the
beginning stages of a program. would
find that the book requires a rather
sophisticated knowledge of related litera-
ture.

Technical Nursing of the Adult; Medical,
Surgical, and Psychiatric Approaches,
2ed.. by Sandra B. Fielo and Sylvia C.
Edge. New York. Macmillan. 1974.
Re\';iewed hy Kathryn Revell, Nursing
Department, Gram "'facE wan Com-
munity College, Edmontoll, Alberta.

The authors indicate that this text has
been prepared to help meet the learning
needs of the technical nursing student in
the associate degree program in the
community college setting. The intent.
therefore. is to provide a basic and
practical text
In the preface. the authors state that
they have identified "broad content areas
from which principles of safc. know-
ledgeable care can be delimited." The
material comprises 10 separate units.
The first two units provide a back-
ground for the remainder ot the book. The
first unit. for instance. discusses con-
cisely. yet adequately. the interpersonal
basis of nursing and the nature and
treatment of common mental illnesses.
The second unit. entitled "Common
Factors in the Care of Patients," briefly
discusses pain, immobility. inflamma-
tion. and operative intervention. All these
topics would certainly require supplemen-
tary material to help the student develop a
thorough understanding of the subject
matter.
The remaining eight units cover patient
problems. using the pathophysiological
conceptual approach. The treatment of
the subject matter in these is not always of
sufficient breadth and depth for a techni-
cal nursing student. For example. infor-
mation concerned with gynecological
problems would have to be supplemented
with infornmtion from another text. At
times the emphasis is on the what and the
how. rather than the why. The text is
most explicit on what to do and how to
manage a broad range of skills.
Each unit begins with the normal. and
progresses to th'é abnormal. The informa-
tion is easy to comprehend. is organized

in logical sequence. and is well supported
with up-to-date references. The text is
supplemented by excellent tables, charts.
and illustrations. which facilitate acquisi-
tion of information. Specific nursing
intervention is listed and discussed con-
cisely at appropriate places throughout
the text. This infonnation is placed in
grey-tinted boxes to emphasize its impor-
tance.

Communication in Nursing Practice, by
Eleanor C. Hein. 242 pages. Boston.
Little. Brown. 1973. Canadian Agent:
Toronto, Lippincott.
Rn'iewed hy Jessie M. Hassell, Quo
Vadi.f Campu.f, Humher College,
Etohicoke, Omario.

This book. in some 230 pages. contains a
basic guide to communication and its role
in the art of nursing. The author has
chosen the concept "to use variety to
meet variety'" This book could be useful
to the beginning student in nursing arts. to
the student as an introduction to the
psychiatric nursing process. or to the
graduate who needs to attain increased
awareness of the therapeutic nurse-patient
relationship.
In using the term "interview" the
author has
made it clear that the therapeu-
tic relationship implies a goal-directed
interaction. Although she does not
minimize the difficulties of acquiring
skills in communication at a professional
level. she makes it clear that '"the
resulting proficiency brings with it a
greater sense of being a nurse."
Diagrams are used to clarify principles
of communication - the process. the
nursing event. the therapeutic communi-
cation. Illustrations are chosen from
patients in the medical-surgical area. the
psychiatric field. and the family in the
community .
In the chapters dealing with know-
ledge. attitudes. and sociocultural influ-
ence. we find a section most effective to
help both the graduate and undergraduate
nurse develop ability to learn about
themselves and so use their experience
and environment to improve the quality of
the therapeutic nurse-patient relationship.
This book could well be described as
the problem-solving approach to the
therapeùtic relationship and as such is one
of the more effective guides to this
NOVEMBER 1974

books

important area of nursing practice.
In view of the broad but occasionally
shallow coverage. this book should in-
terest teachers and students as a sup-
plementary or complementary text. rather
than as a primary source for technical
nursing care of the adult patient.

Contemporary Issues in Mental Health
Nursing, edited by Madeleine M.
Leininger. 196 pages. Boston. Little.
Brown. 1973. Canadian Agent: Lip-
pincott. Toronto.
Reviewed bv Thelma M. Brown. Assis-
tant Chairman, Nursing Department.
Ryerson Poly technical Institute.
Toronto. Ontario.

The book presents a timely and appropri-
ately eclectic view of issues. trends. and
problems in mental health.
The contributors are nurse scientists
with doctoral studies in varied disciplines
(anthropology. sociology. psychology.
psychiatry. and education). Their dif-
fering perspectives force the reader to
look at mental health nursing in its broad
and ever-changing context
and to think
anew about the direction of mental health
nursing practice. education. and research.
In part one. M. Leininger "sets the
stage" for the book by identifying some
major factors influencing mental health.
She discusses the concept of life-stresses.
the search for new titles to delineate new
conceptual dimensions. and changes in
the "how. where. to whom. by whom"
aspects of mental health care.
In "Anthropological Issues in Mental
Health Nursing", Osborne presents fiN
the harmonic elements between anthropol-
ogists and nurses. and then the anthropol-
ogical issues in community mental
health. In his article. Osborne succinctly
differentiates institutional psychiatric
nursing. community psychiatric nursing.
and community mental health nursing.
J. Auger. in part four: "Physiological
Issues in Mental Health Nursing." provi-
des a thorough and lucid consideration of
mind-body relationships and psychophy-
siological issues. An extensive review of
research vanables has been incorporated.
and the reference list is excellent.
Key historical developments are rev-
iewed by G. Sills in five major eras -
the last one being the community mental
health era. I %0 to the present. The focus
of each era is related to nursing. but the
legislation citeJ is. of course. American.
M. Leininger concludes this collection
with "Humanistic Issues in Mental
Health Nursing." She presents the need
and challenge to maintain d humanistic
NOVEMBER 1974

approach to patient care. always giving
concern to the quality of human life and
uniqueness of man.
This is an impressive collection of
papers by nurse scientists. The impact of
the readings is both encouraging. for we
have come far. and challenging, for the
questions are clearly posed.

Maternity Nursing, Zed.. by Constance
Lerch. 432 pages. Toronto. \1osby,
IY74.
Reviewed by Genevieve Appleby. Nursing
Department. Ryerson Polytechnicallnsti-
(Ute, Toronto. Ontario.

This is a book suitable for a beginning
student. The subject is presented in a
simple and direct manner. making it easy
to read. Generally. broad overviews are
given with minimal detail. This approach
should lead the student to further enquiry
from other sources.
The writer centers her attention on the
patient. focusing on the needs of the
individual mother. Her concern for
family-centered maternity care is appar-
ent throughout. especially in sections on
cooperative childbirth. However. her ap-
proach to marriage and the family is
generally a traditional one.
Reference is made to the community
and to the nurse's role in this setting, but
the author does not give sufficient em-
phasis to such developments as storefront
clinics. Little mention is made of the
health problems related to immigrant
families. On the other hand. she does give
allention to the nurse's role and responsi-
bility as a teacher.
The book is divided into four units. It
proceeds in a chronological order from
the preparatory phase for pregnancy to the
last phase. which is the care of the
neonate. Each unit is set out as a complete
study of that phase. including anatomy,
physiology. psychological and educa-
tional aspects. and nursing care. Also
included in each unit are the high risks
related to that phase.
The author describes all the above
aspects simply and briefly. However.
more detail in some of those areas would
help the student to get a better grasp and
deeper understanding: for instance. her
description of the woman's psychological
adjustment to pregnancy and her discus-

St.John Ambulance

needs Registered Nurses to volun-
teer their services to teach Patient
Care in The Home. Will you help?
cont
<tL"" 0
St.
n
bulance

sion of the saline test for family planning
is too simplistic.
The chapter on nutrition is too broad.
again not giving necessary details. For
example. the controversy regarding
sodium intake during pregnancy is not
mentioned. However. Ms. Lerch de-
scribes a good regime for self-care at
home. breaking it down definitively into
suitable activities for each of the first
three weeks.
For students who will be involved in a
follow-through study. the author has
outlined an excellent guide for planning
care. Also. the section about combined
mother and child care should be helpful to
a beginning student.

accession list

Publications recentl) receiveJ in the
CanaJian Nurses' Association libraI') arc
available tJ/llo(/1I - \\ ith the exception of
items marked R - to C",'" membas.
schools of nursing. anJ other institullons.
Items marked R include reference anJ
archive material that doc,> I/Of go out on
loan. ThèSes. also R. are on re"er\'e anJ
go out on Interlibrar) Loan onl) .
Requcsts Ii.)r loans. maximum .3 at a
time. shoulJ be maJe on a stanJarJ
Interlibrar) Loan Ii.mll or on the .. Re-
quest Form for Accession List'. prinleJ in
this issue.
If you \\ ish to purchase a book. contact
your local bookstore or the publisher.

BOOKS AND DOCUMENTS
I. Action ;', nursing; progress in professional
purpose, by Jerome P. Lysaughl. New Yorl-..
\1cGraw-Hill, 1974. 368p.
:! BacÅgroullll documellIs fvr Pall Amer;''''1 COIl-
ference on Health Ml/Ilpo" er, 1st, Ollllll'G, Sl'p.
IO-N. IY7}. Washinglon. Pdn Amencan Health
Organization. 1974 3v in 4.
3. Basic paeclilltrics for nurses, by A.L S
ir'.
London, Pitm.ln Medical. 1973. l27p.
4. ClIre a1ll1 mallllgl'lllelll oj l'tCl'pIÙmal childrell,
b) Juanita 'W. Fleming. :-.lev. Yor\... Appkton-
Century-Crofts. 1973. :! 1 :!p.
S. Child hecl/th maillle,umCl': ('olleep'"' ill f"'"i/\--
celllereci ('(Irc', b
Pegg) L Chinn. SI. Lou".
Mosby. 1974. S4:!p.
6. Craig'
cllre of Ihe Ile",/,' horn infalll, b\ A.J.
KedY .Ind D.M. Morg.ln. Sed. Edinburgh. Chun:h,1I
. Livingslone. 1974. 4H4p.
7. Curriculum allll imtruC1Ùm III llurSIll!!, bv
Virgini.l C. Conk). Boston. lillie. Brown, 1973
673p.
8. C"lOlog/('lIl ."'n'/n'
ill Olllllrio. Toronto. On-
tario Council of Health. 1973. 17Sp.
9. DireClOn of CI.,-,oc/lllioll.\ ill Cm","CI. b
Brian
Land. Toronlo, lJniversity of Toronto. 1974. 393p.
R
10. Ewillg, 1",';'1/1 allll ,hill!!: II p.,,,'holo!l" of
lIppc'tile'., , by D.lniel C.lppon. Toronto. lJm\e""
01
Toronlo. 1973. IIHp.
THE CANAr>lAN NURSE 43

Next Month
in

The
Canadian
Nurse

o Relief of Pain
in labor

o Cardiac Unrest

o Caring Begins in
The Teacher-Student
Relationship

o When You Make
Your Own Tapes

ð

Photo Credits
for November 1974

Miller Services, Toronto, Ont.,
cover, p. 14, 17, 21

44 THE CANADIAN NURSE

accession list

II. Economic aspects of health care, compiled by
John B. McKmlay. Ne" York, Prodist for the
Milbank Memorial Fund. 1973. 353p (Milbank
resource books)
12. Education for expanded nursmg roles ill prim-
ary health care; a proposal. Vancouver. lJniver
ity
of British Columbia. School of Nursing. 1973. Iv.
13. Eléments d'hÜwlogie, par Gerrit Bevelander.
SI. Louis. Mosby and Paris. Maloine. 1973. 335p.
14. En attendant bébe, par Claude Lepage et
Fanchon Pagès. Paris. Parents-Mercure de France.
1973. 422p.
15. Em'ironmelltal qualitv and health. Toronto.
Ontario Council of Health, 1973. 36p.
16. Essentials of nursing research. by Lucille E.
Notter. New York. Springer. 1974. 147p.
17. Essentials of nutrition and diet therap_\', by Sue
Rodwell Williams. SI. Louis, Mosby. 1974. 342p.
18. Evaluation des centres de santé. par Milton I.
Roemer. Genève, Organisation mondiale de la
Santé. ]973. 48p. (Organisation mondidle de la
Sante. Cahiers de Santé publique no. 48)
19. Everything you should know about law and
marriage, by F.A.R. Chapman. 2ed. Toromo,
Modem Canadian Library, 1974. 158p.
20. Facts about nursillg. 197Z{73. Kansa
City.
Mo., American Nurses' A
sociation. 1974. 272p.
21. Goal analysis, by Robert F. Mager. Belmont.
Cal . Fearon. 1972. 136p.
22. A handbook of venereal diseases, by William
M. Platts. 2ed. Christchurch. N.Z.. Peryer. 1972.
12Op.
23. Health education theorv and practice ill cancer
control. Geneva. International lJnion Against
Cancer, Committee on Public Education, 1974.
105p. (lJICC Technical report series, vol. 10)
24. In service education kit. Winnipeg, Manitoba
Association of Registered Nurses. 1974. I v.
25. Labour code. Halifax. Council of Maritime
Premiers. 1973. 53p.
26. List of periodicals in the World Health Organi-
zation Library. I Jan. 1974. Geneva, World Hedllh
Organization. 1974. 471p. (Its Library acquisitions
vol. 27. special issue). R
27. Materia medica and pharmacology for IIurses,
by Josias Samuel Peel. 8ed. Christchurch. N.Z..
Peryer. 1974. 206p.
28. Mental health .
ervices personnel. Toronto,
Ontario Council of Health, 1973. 39p.
29. Mosbv's review of practical nursing. 6ed. SI.
Louis. Mosby. 1974. 359p.
30. Mounr à r hñpttal, pM Maurice Berger. Paris.
Centurion, 1974. 219p.
31. The tILltion's nurses: the /972 im'entof'\' of
registered nurses. Prepared by Aleda V. Roth and
Alice R. Walden. Kansa
City, American Nurses'
A
sociation. 1974. 125p.
32. Nursing and the nephrology patiem; a svm-
posium on current trends and issues, edited by
Lowanna Schlotter. Flushing, N. Y.. Medical Ex-
amination Publishing Co.. 1973. I3lp.
33. Nursing of children; afami/v-centered guide for
study, by Debra P. Hymovich. 2ed. Philadelphia.
Saunders. 1974. 432p.
34. On hecoming a Homan, by Mary McGee

Williams and Irene Kane Ncw York. Dell. 1969.
159p.
35. Organizational issues in the delh'en of health
sen'ices. compiled by Irving K Zola. New York.
Prodist for the Milbank Memoridl Fund. 1974.
393p. (Milbank resource book
)
36. Patient di.
charge alld 'referral pltl/lning
whose responsibility? Papers presented at the
workshop" Patient discharge and referral plannmg"
held at Birmingham, Alabama. Dee. 1973.. New
York. National League for Nur
ing. Council of
Hospital and Related Institutional Nursing Services.
1974. 73p.
37. Pedllltric phy,
ical diagnosis for IIurses, by
\1ary Alexander and Marie Scoll Brown. New
York. McGraw-Hili. 1974. 275p.
38. Pharmacie, par J. Chaleon et J.F. Breton.
Paris, Maloine. 1973. 285p. (Diplôme d.Etdt
d'infirmière)
39. Pharmacologie pratique à /' U.fage des
élèves-infirmières. Epreu,'e de connai'u(mces
thérapeutiques pour Ie Diplåme d'Etat. par
Jean-François Robert. Paris. Lamarre Poinat. 1973.
319p.
40. Physical mallagemellt for the quadriplegic
patient. by Jack R. Ford and Bridget Duckworth.
Philadelphia. F.A. Davis. 1974. 392p.
41. Politics alld la... in health mre polin, compi led
by John B. McKinlay. Ne" York. Prodi
t for Ihe
\1ilbank Mcmorial Fund. 1973. 404p. (Milbank
resource books)
42. Population questions; a colltribution to World
populalÍon year. Geneva. Inlernational Council of
Voluntdry Agencies, 1974. !Hip.
43. The practicum in teacher education. Ottawa.
Canadian Teacher's Federation. 1973. 65p. (Bib-
liographies in education no. 39)
44. Programmed illsrruction ill arirhmeric, do.\-
ages, and soiutions. by Dolores F. Saxton and John
F. Walter. 3ed. SI. Loui
, Mosby. 1974.
45. Proposed scope of practice for chiropodist.
ill
Ontario. Tomnlo. Omdrio Council of HCdlth. 1973.
16p.
46. Psychiatric nursing. a hasic mallual. by Annie
Laurie Crawford and Barbara Bormg Buchanan.
Philadelphia. Davi
. 1974. 89p.
47. Relevé sur r e(lucaricm pour la ,'ie (Ie famille.
Ottawa. InMitut Vanier de la Famille. 1973 (v .3: Le

organismes hénévoles et r education pour la vie de
famille)
48. Repertoire des a"-,ocÙlIÙ",,, du Canada, par
Brian Land. Toronto, lJniversity of Toronto, 1974.
393p. R
49. Reporr of commitree on healrh research. To-
ronto, Ontario Council of Health, 1973. 204p.
50. Report if rhe 20rh meering of the Sourhem
Regional Education Board, Council on Collegiate'
Educarion for Nursing. Oct. 3 r - N(w. 2. 1973.
Arlama. Georgia. Atlanta. 1973. 155p.
5]. Research methods ill healrh care, compiled by
John B. McKinldY. New York. Prndi\t lor the
Milbank Memorial Fund, 1973. W6p. (Milbank
resource books)
52. A rn'iew of rhe Omario healrh insurance plall.
Toronto. Ontario Council of Health, 1973. Rip.
53 Review of pharmacololi\ ill II/Ir.\irrli. by Belly
S. Berger
en dnd Jurate A. Sakdlys. S.. Louis,
Mo
by. 1974. 233p. (Mo\b}'s comprchcn\jve re-
view series)
54. Review (if the Omario Paf'('ost Program
Toronto. Onlario Council of Hc..lth. 1973. 16p.
NOVEMBER 1974

55. A rn'ieu af The reporT af The cammitTee on The
cOl1/munir\' healTh cemre projecT. Toronto, Ontario
Council of Health. 1973. Bp.
56. The saccharine disease; condiTions caused by
The taking of refined carbohydraTeS, such as sugar
and white flour. by Thomas Latimer Cleave with a
forward by D.P. Bur"lII. Bri
tol. Wright, 1974.
200p
57. Scope of pracTice and educaTional requirements
for chiropractors in 01lTarin. Toronto. Ontario
Council of Hedlth, 1973. 41p.
58. Self-rT/ldv gUIde jor nUTrITIOn and dieT Therap.\',
by Sue Rodwell Williams. SI. Louis. Mosby, 1974.
207p.
59. Sodal implimTÙI1/.r of de\'elopme1lTs in biomed-
ical .,,'iences. Toronto, Ontario Council of Health.
1973. 14p.
60. Sound .rn and The axing heart; sex in The mid
and laTer \'ears l\'iTh .\pe' ific reference to cardiac
problems, by Lee Dreisinger Scheingold and
Nathaniel N. Wagner. New Yor", Human Sciences,
1974. ló8p.
61. STren. faTigue eT dépreSfÍ<m If'homme eT les
axressÍ<ms de 10 ,'ie quotidienne), par Pierre
Bugard. Pari
. Doin. 1974. 2v.
62. STru,TUre and funcTinn in man, by Stanley \\.
Jdcob and Clarice A
hworth Frdncone. 3ed. To-
rontu. Saunders. 1974. ó30p.
63. SlIIdv guide and workbook in medical-surgical
nuninx for pracTical nUr.fes. by Clairc Brackman
Keane. 2ed. Philddelphia. Sdunders, 1974. 251p.
ó4. Tous responsables de notre
ame. Education eT
poliTiqu,' de la sa1lTé. p..r Jdcques Bassol. Paris.
Re
ma. 1974. 237p.
65. WaiTing for yaur child, hy Yvelle Pralle
Marche"dult Montré..l. Habitex. 1973. 188p.
66. What e\'l'r\'
upen'isor should kno.... edited b}
Lester R. Billel. 3ed. Tornnto. :\1cGraw-Hill. 1974.
756p.
67 Women; a bibfiograph\' on Their educaTion and
,'areers. by Helen S. Astin el .II. New York.
BehavIoral. 1974. 243p.
68. Work IS ,/angaOl'.\ to your healTh. A hal/(/book
of healTh ha:ard.r in Th,' I\'ork place and whaT mu
can do abo", Them, by Jeanne M Stellman New
York. Vintage Books. 1973. 448p.
69. Workbook for pediarric nurses, by Norma J.
Anderson. 2ed. SI. Louis. Moshy.1974. 19!)p.

PAMPHLETS
70. Ann'diwTÙm of haccalau,,'aT,' and I1/WTer.r
degree programs in nursin/l.; a comprehensive
re'.ie.... by Dornthy Ozimek. New Yor"- National
Ledgue for Nursing. 1974. 21p. (NLN Pub.
no.15-ISI9)
71. An'redill1t;oll progrcll1l for (.ommunl
"ursinl?

en'ices. New York. Ndtional League tor Nursing,
n.d. pdJl1.
72. The aundaTe dexree pra<tiTinner and nursinx

en'i<'e needr;
UPI)lemerJ/, by Eva Jedn Law. New
Yor"- National League for Nursing. Council of
Ho
pital dnd Related Instilutiondl Nursing Services.
1974. ItJp. (NLN Puh. nu.20-1504S)
73. The baccalaureaTe xral/uaTe in nurring: ...hal
,/oes .mdeT\ ('{pecT! By Dorothy Ozimek. New
York. Ndtiondl Le.!gue for Nursing, 1974. 8p.
(NLN Pub. no. 15-15201
74. Emplownem ancl U.\e of ph\'.f/( ian' I a.HHta1lT.f.
A 1iuide for phuidans. Chicdgo, American Medical
Associdtion, Depl. of Health M..npuwer, Divi
iun
of Medicdl Prdctice. 1974. 16p.
NOVEMBER 1974

75. Guide pour 10 redaction d'une consTiTuTion eT de
règlemems d' une A.fSnciaTion naTionale
dïnfirmières. Genève, Sui
se, Con
eillntemalional
des Infirmières. 1971. 7p.
76. Guidelines on imer-hn.rpital Transfer of pa-
Tiems. Vancouver. Registered Nurses' A
sociation
of British Columbia, 1973. 26p.
77. /nfirmière; une profession defavorisee. Pour-
quoi? Genève, A
sociation Sui
se des Infirmières et
Infirmiers Diplômés. Section de Genève, 1974.
33p.
78. InsTiTuTional licenrure . . . A profe.uinnal iden-
TiTV crisis. Albany, New York State Nurses'
A
sociation. 1974. 27p.
79. ImeraCTion process analvsis. Ollawa. Canadian
Teachers' Federation. 1974. 2!)p. (Bibliographies in
education no.4l)
80. ImerpreTers' services and The role of healTh
care volumeers. Chicago, American Hospital As-
sociation. 1974. 35p.
81. The Merric Sysrem; a selecrive hibliograph)' of
gOl'ernmem publicaTions. Bowling Green, Ohio.
Bowling Green State lJniversily. Library. Govem-
ment Document
Services. 1973. 4p. (BGSl' Library
Bibliographic series. no. I I )
82. MicroTeaching. Ollawa. Canadian Teachers'
Federation. 1974. 14p. (Bibliographies in education
no.40)
83. Nursing's accrediTaTion program. New York,
National League for Nursing. 1974. pam.
84. Nursing's comribuTion and commiTmem, joim
staTemenT of . . . . American Nurses' AS.fOciaTlOn
and NarÍ<mal League for Nursin/? New York.
Interorganization Committee for Implementation,
1974. pdm.
85. Proceedings of The InsTiTuTe on long Term care,
OB.A. Cemre. Don Mills, Om., Jall.2/-22. /974.
Don Mills. Ont., Ontario Hospital Association.
1974. 97p.
86. Regulatory ag,'ndes - The effecT on healTh care
insTiTUTions. Papers pre
ented at the seventh annudl
meeting. Oct. I 1-12.1973, Sdn Francisco. Cat. New
York. Ndtiondl League for Nursing. Council of
Ho
pital and Related Institutional Nu
ing Services.
1974. 35p. (NI N Pub. no.20-1514)
87. Repnrt of The Joim TLl'/II'HO meeTing on condi-

HJlI"
OFF
\
ACE
\

()\\ 11.\ PI)\ ! I
had ugl} ,upertluous hair... wa"
unlovcd .. di"clluraged. I ried m.m}"
thing.... . . even razor". Nothing was
,ati"factor)'. Then I dcveloped a "im-
pie. painlc
s. ine'l.pen"i\c. nonelectric
mcthod. It ha" helped thou"allll" Will
hcauly. I(,w. happine". :\I} I RIT
hool-... "'What I Did .\holll Supa-
tluou" Hair" c'l.pl.tin, method. :\lailed
in plain envelopc. !\bt) I rial Oller.
\\'rile i\lme Anncltc I an/cltc. 1'.0.
Box 610. Dcpl. C- 498 Add.tidc SI.
1'.0.. I oronto :!IO. 0111.

....

,

LOVE ", I".f.'

1Ions of ...ork and life of nursing personnel, Geneva,
/9-20 Nov., 1973. Geneva. InternatIOnal Labour
Office, 1974. 25p.
88. Report on a STudv of The roles and sTrUCTure of
The Sa.rkaTchewan RegisTered Nurses' AssociaTion.
by Sheila Ward. Regina. 1974. l!)p.
89. Scholarships and In(Jns for beginning educaTiun
in nursing. New York. National League for Nurs-
ing. 1974. lip.
90. A shnrT CUT to venereal disease educaTion. by
Joseph Chiappa and Gelolo McHugh in consultation
with William F. Schwartz. Saluda. N.C., Family
Life Publications, 1973. 18p.
91. Sodium resTricted dieTs can be delicious.
Montreal. Standard Brands Limited, 197'!. 38p.
92. Supen'ision of Ihe eThics of clinical research
in\'esTigaTÙms in insTiTUTinns. London. Royal Col-
lege of Physicians. Committee on the Supervision of
the Ethics of Clinical Re
earch Investigations in
Institutions, 1973. 7p.
93. This is rhe Narinnal League for Nursing. New
York, National League for Nursing, 1974. 8p. ("I N
Pub. no.14-1532)
94. To combaT child abuse and neglecT, by Theo-
dore Irwin. New York. Public Affairs Committee.
1974. 28p. (public Affairs Pamphlet no.508)
95. Voluntary sTerili
aTion, by Elizabeth Ogg. New
York. Public Affairs Committee, 1974. 28p. {Public
Affairs Pamphlet no.507)
96. Yearbook /973. Aleppo. Syria, MiniMry of
Health, School of Nursing. 1973. 27p.

GOVERNMENT DOCUMENTS
Canada
97. Conseil national de recherches Canada. Comité
assucié sur les crilères scientifiques concemantl'état
de I'environnement. RapporT d'acTi\'lTe jarJI'ier
/974. Ollawa, 1974. 5Op.
98. -. Un résumé de crirères sur la radioacTi,'iTe
dans /' erJI'ironnement. Ollawa. 1974. 45p.
99. Consumer and Corporate Affairs. Proposals for
a lie'" nOT{or-profiT corporaTions la.... for Canada.
Ollawa, Information Canada. 1974.2\.
100. Depl. of Labour. Accident Prevention Divi.
sion. OccupaTional safeTy and healTh; selecTed
holdings of Technical Libran'. Olldwa. Intormdtion
Canada. 1974. 13!)p.
10 I. Environment Canada. ReporT, /973. Ollawa.
Information Canada, 1974. 45p.
102. Health and Welfare Candda. Danxer
one m
The kiTchen. Ollawa. Information Canada. 1972.
16p.
103. -. Nursing wiTh medical sen-ices. Ottawa.
Information Canada. 1974. 28p.
104. Information Canada. PhUTOS Canada. Olldwa.
1974. 415p. (ltsCatalogueno.5)
105. Ministère de la santé nationale et du Bien-étre
social. Manuel du consommaTeur ,lirecTÍ<m gétrérale
des alimems eT des drogues. Ollawd, Queen's
Printer, 1970. 22p.
106. -. Direction Générale des Services
Médicaux. RapporT du projecT special des somr
il/firmiers (semil/aires du Nord), reali.\(' sous le.r
auspices de la. . en collahoraTicm a"ec le.r ecoles
universiwires des soins mfirmiers eT /'AnociaTicm
des Infirmières du Cal/ada, jarJI'. ,fe,'. eT murs /971.
Ottawa, 1974. 146p.
107. Mnislry of State for Science and Technolog}.
Federal sciemific resources 197:!-74. NuTUra/ and
humall sciences. OItaw.!. Informalion C..ndda.
1973. 95p.

THE CANADIAN NURSE 45
.

108. National Library ot Canada. Calladian library
directory. Onawa. Information Canada. 1974. Iv.
109. National Research Council of Canada. As-
sociate Comminee on Scientific Criteria for En

vironmental Quality. Problems and selection of
topin for compilatioll of cause/effect data. Report
lIumber one of the .mbcommittee on biological
phellomella. hy C Quadling. Onawa, 1973. Sip.
110. Puhlic Archives of Canada. Guide to Cana-
diallmillistries smce COllfederation. July I, 1867 -
Apr. I. 1973. Onawa. Information Canada. 1974.
268p.
III. Revenue Canada. Customs and Excise. Cer-
tified public hospital list: IImnes and addresses of
certified b(ma fide public ho.<pitals for purposes of
the Excise ACT a/J(I the Excise Teu Act. Onawa.
Information Canada, 1974. Iv.
112. Santé et Blen-être social Canada. Comité
consultatif sur I' Assurance-hospitalisation et les
services de diagnostic. Rapport du Groupe de
trami/ sur la classificatioll des soins aux malades.
Ottdwa, 1973. 129p.
113. Secretary of State. A leisure study - Canada
1972, by carol Kirsch. Brian Dixon and Michael
Bond. Published for Arts and Culture Branch, Dept.
of the Secretary of State, Gov't, of Canada.
Toronto. A.E. Design and Culturcan Publications.
1973. 240p.
114. Statistics Canada. IlIstructiollS and definitions
for the allnual return of hospitals, 1972. Onawa.
:!v.
Olllari()
115. Health Planning Task Force. Report. Toronto,

t974.77p.
116. Ministry of Community and Social Services.
Handbookfor counsellors of newcomer.<; a guide to
governmelll alld c()mmuniry services for c()unsellors
and teachers ofnewcomers. Toronto, 1974. ISOp.
Quebec
117. Ministère des Affaires Soclales. Direction
Génerale de r Agrément. Service de la Sécurité des
Etablissements et des Mesures d'Vrgence. Guide
and prototype of hospital disaster plan. Quebec,
n.d. Iv. .
118. -. Guide et archétype du plan hospilalier
d'urgellce. Québec. n.d. 43p.
Saskatchewan
119, Dept of Public Health. Annual report,
1972/73. Regina. 1974. 94p.
U.S.A.
120. Department of Health. Education and Wel-
fare. Effectiveness and efficiency of nursin/l. educa-
ticmprogram. Bethesda. Md., 1973. 3v. in I.
121. National Cancer Institute. Itiforl1lati(11l ac-
tivities and services. Bethesda, Md.. V.S. Dept. of
Health. Education and Welfare, 1973. 106p. ((U.S.)
DHEW Pub. no. (NtH) 74-543)
122. National Centre for Health Statistics. IlIIerna-
tional classification of disease.<, adapted for u
e in
the United Slates. 8th revision. Washington. For
sale by the Supt. ot Docs.. V.S. Govt. Print. Off.,
1967. 670p. (Public Health Service Pub. no. 1693)
123. National Institutes of Health. Alii/cancer a1l-
ellls recentlv developed in the People's Republic of
China; a review, b} CP. Li. Washington. Supt. of
DHEW Pub. no. (NtH) 74441).

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ton, U.S. Dept. of Health, Education and Welfare,
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STUDIES DEPOSITED IN THE CNA REPOSITORY COLLEC-
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125. An assessmelll of patiellls' acth'ity. kn()wledge
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126. Emluation of the BO\-1e Street COl1lmuniry
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emluation) submitted to the BSCSC Board by Helen
Simmons, Shirley M. Stinson and Clark B. Hazlen.
Edmonton, 1974. 129p. R
127. Mutual withdrawal: a studl' of staJj:patient
communication patterns, by Philip Edwin Thomas
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128. Les preoccupaticms des Í1rfirmières. Rapport
final. Etude preparée pour I' AIIPV pdr Claude Gousse
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NOVEMBER 1974

46 THE CANADIAN NURSE

I
I

classified advertisements

ALBERTA

ONTARIO

REGISTERED NURSES requ"ed lor 70 bed accredited active
treatment HospItal Fulltl'Tle and summer relief. All AARN per-
sonnel policies Apply in writing to the: Director of Nursing.
Drumheller General HospItal, Drumheller, Alberta

2 R.N:. wanted lor ImmedIate employment at the Two Hills
MunIcipal Hospital. Two Holis. Alberta. We lollow salary
schedule as set lorth blthe MRN Must be willln(jto stay at this

,i,
t

n
c

7i

it
'.

OY
i

.

Administrator. Two

GENERAL DUTY NURSES required ImmedIately to work in an
active treatment hospital. Salary and policies as per AAAN.
ResIdence available. Apply: Director 01 Nursing. HardIsty
General Hospital. Hardisty. Alberta

PUBLIC HEALTH NURSES required lor Vegrevllle Health Unit
at MaIn OIIice In Vegrevllle and Two Hills Sub.Ollice. B Sc..
D.P.H.N prelerred. or R.N. with related public health expen.
ence. Apply Supervisor of Nurses. Vegreville Health Unit,
Vegreville. Albe'1a. TOB 4LO.

BRITISH COLUMBIA

OPERATING ROOM NURSE wanted lor active mo-
dern acute hospital. Four Certified Surgeons on
attending staff. Experience of trammg desirable.
Must b.. eligIble for B.C RegIstration. Nurses
residence avaIlable Salary according to RNABC
Contract. Apply to: Director of Nursmg. Mills Mem-
orial Hospital 2711 Tetrault St.. Terrace. British
Columbia.

ADVERTISING
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in the Journal. For authentic information,
prospectIve applocants should apply to
Ihe RegIstered Nurses' Association of the
Province in which they are interested
In working

Address correspondence to:
The
Canadian
Nurse

ð
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50 THE DRIVEWAY
OTTAWA, ONTARIO
K2P 1 E2

NOVEMBER 1974

I I

BRITISH COLUMBIA

REGISTERED NURSES requ"e<J lor new 25-bed acute care
hospItal In Fort SI. James. B C. Starting salary $850 OGl- $20 00
Northern allowance per month Salaries & personnel policies
accordIng 10 RNABC Contract Apply' Director. Stuart Lake
Hospital Fort St James. Bntlsh Columbia VOJ 1 PO Or phone
collect (604) 996-8201.

EXPERIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES required for small
upcoast hospital Salary and personnel policies as
per RNABC contract Salanes start at 567200 for
Registered Nurses. $57775 for Licensed Practical
Nurses Residence accommodation 52500 per month
Transportah
n paid from Vancouver Apply to
D"ector of Nursing St George s Hospital Alert Bay
Bntlsh Cnlumbla

GENERAL DUTY NURSES lor modern 41-bed hospital located
on the Alaska Highway. Salary and personnel policIes In
accordance with RNASC. Accommodation available In resi-
dence. Apply: Director 01 Nursing. Fort Nelson General Hospital.
Fort Nelson. BritIsh Columbia.

TWO GENERAL DUTY NURSES with expenence in obstetrics
and O.A. reqUired for a 21-bed hospital In the Southern Intenor
of B C living-in accommodation available. Salary as per
RNASC rates. Moderate climate. good working conditions and
recreational faclhtles available. Apply. giving full particulars and
references In first letter 10 the: Administrator. Siocan Commumty
Hospital. Box 129, New Denver Bntlsh Columbia

GENERAL DUTY NURSES required lor an 87-bed acute care
hospital In Northern B. C. residence accommodations available.
RNABC policIes In effect Apply to. Director 01 Nursing, Mills,
Memonal HOSpital, Terrace. Bntlsh Columbia. V8G 2W7.

GRADUATE NURSES required lor general duty and OR In a
98.bed hospital with 35 Extended Care beds under constructIon.
RNABC policIes and wages In effect Apply In wntlng to: The
Director of Nursing. Klhmat General Hospital. Krtlmat. Brilrsh
ColumbIa.

EXPERIENCED NURSES (eligible lor B.C. registration) required
lor 409.bed acute care. teaching hospital located In Fraser
Valley. 20 minutes by freeway from Vancouver. and within
easy access of vaned recreational facilities. Excellent Orrenta-
tion and ContInuIng Educallon programmes. Salary $850 00 to
$1020.00 Clinical areas Include: MedicIne, General and Spe.
clalized Surgery. Obstetncs Pediatncs. Coronary Care. Hemo-
dialysIs. Rehabilitation Operating Room. Intensive Care. Emer-
gency PRACTICAL NURSES (eliqlble for B.C. Llcensel also
reqllJred Apply to Nursing Recruitment. Personnel Department.
Royal Columbian Hospital New Westminster. British Columbia.
V3L 3W7

NOVA SCOTIA

NURSES FOR INTENSIVE CARE UNIT. Poslllons eXist for
REGISTERED NURSES In a 5-bed IntenSive Care Unit In
Hlghlanc1 View RegIonal Hospdal. Amherst. Nova Scotia.
Modern unit opened In March of this year Experience preferable
but consideration will be gIVen to applicants wishing to undergo
training. Liberal fnnge benefits. For further details please
Ä
ntHa

g
'Ãæ'&

e
!\I

gd VIew RegIonal HospItal.

QUALIFIED NURSES required Immediately for regIonal hOSpi-
tal In Amherst. Nova Scotia Fully accredited hospItal provIdIng
acule general care. For further details please contact the:
PersonnelOllice, Hoghland VIew RegIonal HospItal, AMHERST.
NOVASCOTIA B4H IN6.

ONTARIO

OPERATING ROOM STAFF NURSE requ"ed lor lully accredi-'
ted 75-bed Hospital BasIc WdC}e 5689 00 with conSideration for
expenence, also an OPERATING ROOM TECHNICIAN, beslc
wage $526.00 Call time rates available on request Wnte or
phone the Director of Nursing. Dryden District General Hospital.
Dryden Ontarro

I I

REGISTERED NURSES lor 34.bed General HospItal
Salary $850.00 per month to $1.02000 plus expenence al.
lowance. Excellent personnel policies. Apply to:
Director 01 Nursing. Englehart & D,strict Hospital
Inc., Englehart, Ontano. POJ 1 HO.

REGISTERED NURSES are required Immediately tor our
32-bed complex and achve treatment hospital located in
beautilul Northern Ontano. Our starling salary IS $856.00
monthly with allowance for past expenence and 4 weeks paid
vacation after one year Hospital pays 100 0/ 0 of OHIP. excellent
penSion plan and ten statutory holidays per year For more
Information on this challenging and rewarding position. phone
collect, (807) 868-2442 or wrIte: Director of Nursing. Horne-
payne CommunIty Hospital, Hornepayne Ontano

REGISTERED NURSES requored lor our ultramodern 79-bed
General HospItal In blhngual community of Northern Ontario
French language an asset. but not compulsory Salary IS $855
to $1030. monthly with allowance for past expenence and 4
weeks vacation atter 1 year. Hospital pays 100 0 0 01 0 HIP .
Life Insurance (10.000). Salary Insurance (75 0 o of wages to the
age of 65 with U.I.C carve-out), a 354 drug plan an" a dental
care plan Master rotation In effect Rooming accommodations
available in town. Excellent personnel policies Ap
y to
Personnel Director. Notre-Dame Hospital POBox 850.
Hearst, Ontario

REGISTERED NURSES requ"ed lor a 12.bed Intensive
Care
Coronary Care combined unit Post basic preparahor"J
and/or sUitable experrence essential. Apply to Personnel
Manager. SI. Mary s Genera' Hospital 911 Queen s Blvd.
KIIchener. Ontano. N2M 1 B2

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS tor 45-bed Hospital Salary ranges
Include Qenerous expenence allowances R. N s:
salary $740. to $840.. and R N A. s salary $550 to $625.
Nurses residence - private rooms with bath - $4'")
per month. Apply to' The Director of Nursing. Gerald.
ton Dlstnct Hospital, Geraldton. Ontano. POT 1 MO.

REGISTERED NURSES FOR GENERAL DUTY, I.C.U.,
C.C.U. UNIT and OPERATING ROOM reqUIred tor
lully accredIted hospital Starlong salary $850.00 with
regular Increments and with allowance for expen-
ence. Excellent personnel policies and temporar

residence accommodation available Apply to The
Director of Nurslno. Kirkland & District Hospital
K't1<land Lake. Ontario. P2N IR2.

PUBLJC HEALTH NURSES (QUALJFIED) FOR GENERALIZED
PROGRAMME. ALLOWANCE FOR EXPERIENCE AND OR
DEGREE. USUAL FRINGE BENEFITS. DIRECT ENQUIRIES
TO MRS. RETA McBEAN. PUBLIC HEALTH NURSING. REN-
FREW COUNTY AND DISTRICT HEALTH UNIT POBOX 128
PEMBROKE, ONTARIO K8A 6X1

I I

SASKATCHEWAN

REGISTERED NURSE (1) Salary according to SUN Union
agreement ResIdence Sask PenSIon Plan. Apply Mrs D
Smart D.O N.. Maldstone UnIon HospItal Maldstone Sf'S'
katchewan. 80M 1 MO

GENERAL DUTY NURSES: for .!85-bed Rehablh.
tallon/Extended Care Hospital Excellent formal week long
Orrentatlon program plus continuing (nservlce EducatIOn pro-
gram. 1974 salary range: $707 . $732 . $759 . $787 - $830
Apply 10' Employmenl ()fhcer. Wascana Hospital 23rd Avenue
and Avenue G Regina. Saskatchewan

I
I DIRECTOR OF NURSING SERVICE tor a 160'bed Convales.
cent Center In a progressive Umverslty and Medical Center
community In Vermont. has an Immediate opening for an
Innovative R N who has demonstrated administrative abilities
A B S. degree preferred but nol essential Salary commensurate
with experience and qualltlcatlons. Generous fringe benefllS
Send resume or contact. Mr. Donald Dunkle Director of
Operations Burlington Convalescenl Center. 300 Pearl Street
BurlIngton, Vermont, 0540t Telephone 1-802658-4200
THE CANADIAN NURSE 47
.

UNITED STATES

UNITED STATES

R.N:s - SOUTHERN CALIFORNIA - ImmedIate need eXIsts
for medical-surgical UOitS Orientation and In-service program.
Excellent salary. full paid benefits We will assist you with your
H-1 visa for ImmigratIOn A license In California to practise
nursing IS necessary before employment. Wnte for an applica-
tion to the" California State Board of Nursmg Education and
RegIstratIon. 1020 N Street. Sacramento. Callforma. 95814

RN's and lPN's - Unoverslty HospItal North a
leaching HospItal ollhe Unoverslty of Oregon Medical
School. has opemngs In a vanety of Hospital ser-
vICes. We offer competitive salanes and excellent
fringe benefits Inquires should be directed to Gale
Rankm Director of Nursing 3171 S W Sam Jackson
Park Road. Portland, Oregon. 97201 .

TEXAS wants you! II you are an RN. expenenced or
a It;....ent graduate come to Corpus Christi Sparklmg
City by the Sea a city bUildIng for a beller
future where your opportunities for recreation and
studies are limitless Memonal Medical Center 500-
bed general leaching hospital encourages career
advancement and provides In service onentatlon
Salary from 568200 to 594000 per month com
mensurate with education and expenence Differential
for evenmg shifts available Benefits Include holi-
days sick leave vacations paid hospltahzatlOr.
hf'alth hfe Insurance pension program Become a
vItal part of a modern up-Io-dale hospital wnte or
call collect John W Gover Jr Director of Per

onnel Memonal Medical Center POBox 5280
Corpus Chnstl. Texas, 78405

ITINERANT PUBLIC HEALTH NURSE POSITIONS - Open In
several areas of Alaska Require travel to group of villages to
provide pnmary heallh care servICes Accredited public health
nursing preparation required. preference given to public health
nursing. outpost nursing. or nurse practitioner experience. High
salaries. liberal frrnge benefits Contact: Alrlle Bruce. Assistant
DHe' NursIng SectIon, D,v o. Public Health. Pouch H.06E.
Juneau Alaska USA 99811.

PUBLIC HEALTH NURSE - ST ATE OF ALASKA -with MCH
experrence to direct Maternal and Infant Care PrOJect 10 Juneau.
Alaska. CompetItive salary. Art equal opportunity employer
Contact: Margaret Crawford. MCH Nursing Consultant. Depart.
ment of Health & Social Services. Pouch H-06B. Juneau,
Alaska. 99811

FREE SERVICE BY AUTHORIZED HOSPITAL REPRESEN-
TATIVE FOR QUALIFIED R.N:s WANTING U.S.A. OR CANA-
DIAN NURSING POSITIONS VISA. TRAVEL AND ACCOM.
MODATION ASSISTANCE ALSO. CONTACT' PHllCAN PER.
SONNEL THE MEDICAL PLACEMENT SPECIALIST, 5022
VICTORIA DRIVE, VANCOUVER. B.C., V5P 3T8. TEL
327.9631: TELEX: 0455333

COMMUNITY PSYCHIATRIC CENTRE
DOUGLAS HOSPITAL CENTRE

Opportunity for
NURSES

and

NURSING ASSISTANTS

to join the teams on our admission and short-
term treatment units. either anglophone or fran-
cophone.
These in-patient units are part of our expanding
Community Psychiatric Centre, responsible for
the mental health of both the anglophone.and the
francophone population of the cities of Verdun
and LaSalle, and the districts of Ville Emard and
Pointe 51. Charles.
For further Information, p/8IJBe contact:
Miss Hélène Berthelot
Community Psychiatric Centre
6875laSalle Blvd.
Verdun, Que., H4H 1 R3
Tel.: 76Hi131, Ext. 453

48 THE CANADIAN NURSE

nurses

who want to

nurse

AI York Central you can join an
active. interested group of nurses
who want the chance to nurse in its
broadest sense. Our hospital is
presently expanding from 126 beds
to 400 and is fully accredited.
Nursing is a profession we respect
and we were the first to plan and
develop a unique nursing audit
system. There are opportunities for
gaining ,,'ide experience, for get-
ting to know palients as well as
staff. R.N. salaries range from
$850. to $1020. per month. Credit
allowed for relevant previous hospi-
tal experience.

Situated in Richmond Hill. all
the cultural and entertainment faci-
lities of Metropolitan Toronto are
available a few miles to the
South . .. and the wimer 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 Personnel.

YORK
CENTRAL
HOSPITAL

RICII\10ND 1111 L.
()1\:r\RIO
L4C 4Z3

ST. MICHAEL'S HOSPITAL
Toronto, Ontario
invites applications from

REGISTERED NURSES

for

INTENSIVE CARE
and "STEP-DOWN" UNITS

Planned Orientation and In-serVice programme will ena-
ble you fa collaborate In the most advanced of treatment
regimens for the post-operative cardia-vascular and
other acutely III patients. One year of nursing experience
a reqUirement

For details apply to:
The Director of Nursing,
St. Michael's Hospital,
Toronto, Ontario,
M5B 1W8.

NORTH NEWFOUNDLANO & LABRADOR

requIres

REGISTERED NURSES
PUBLIC HEALTH NURSES

InternatIonal Grenfell Association provIdes
medical services for Northern Newtoundland
and Labrador. We stall four hospital s, eleven
nursing stations. eleven Public Health units.
Our maon IBO.bed accredited hospital is
situated at St. Anthony, Newfoundlam1. Active
treatment IS carned on on Surgery. Medicone,
Paediatrics. Obstetrocs. PsychIatry. Also,
Intensive Care Unit. OrientatIOn and In-ServIce
programs. 40.hour week. rotating shifts. Llvong
accomodations supplied at low cost. PU8l1C
HEALTH has challenge of large remote areas
Ex
ellent personnel benetits onclude liberal
vacatIon and sIck leave Salary based on
Government scales
Applv to:
INTERNATIONAL GRENFELL ASSOCIATION
Assistant Administrator of
Nursing Services,
SI. Anthony, Newfoundland.

GRANT MacEWAN
COMMUNITY COLLEGE
Edmonton, Alberta, Canada

NURSING INSTRUCTOR

DUTIES: To instruct our new Certificate Pro-
gram in Occupational Health Nur-
sing.

QUALIFICATIONS
Bachelor of Nursing Degree (Master s prefer-
red)
Certificate in Occupational Health
Work experience in Occupational Health
Teaching experience
For Application Form - write, wire or catt:
Personnel Office
Grant MacEwan Community College
P.O. Box 1796
Edmonton, Alberta. T5J 2P2
Canada
Tel.: (403) 425-8810

NOVEMBER 1974

REGISTERED NURSES

An expanding 230-bed complex requires
nurses for general duty positions in several
clinical areas. The complex includes 130
beds for active treatment, 50 beds for
extended care and a 50 bed nursing home.
Salaries and personnel policies in accor-
dance with Alberta Association of Regis-
tered Nurses Contract. Apply:

Apply:

Grande Prairie Municipal Hospital
Grande Prairie. Alberta
T8V 2E8

THE MENTAL HEALTH TEAM
PLANNED FOR THE COMMUNITY
OF HAPPY VALLEY/GOOSE BAY

has a vacancy lor a
Registered Psychiatric Nurse
The successful applicant will participate in the
diagnosis, assessment and care of patients with
psychiatric disease.
Salary will be commensurate with provincial
rates and the candidate will be eligible for the
Labrador allowance.
Comfortable residential accommodation is avai-
lable if required.
Please submit applications to:
MlssM. Leach
Director of Nursing
Paddon Memorial Hospital
Happy Valley, Labrador
AOP 1EO

The Brome-Missisquoi-Perkins
Hospital

requires

1 Day Supervisor
1 Night Supervisor
Registered Nurses

Please write to:
Director of Nursing
Brome-Mlssisquoi-Perkins Hospital
950 Main Street
Cowansville. Quebec
J2K 1K3

NOVEMBER 1974

SWITZERLAND

EXPERIENCED OR NURSES: For our operating room in our
new hOSpltallr'J Frauenfeld/Swltzeriand, reqUired urgently This
modem hospItal. 30 miles NE of Zurich has 120 general surgery
beds and exceUent worl<mg atmosphere. The spoken language IS
German. but fluency is not required. as lessons are available at
the language school in the city. living-in accommodation IS avail-
able on request. Apply to: Director of Nursing ServICe. Kan-
tonsspital Frauenfald. CH-8500. Frauenfald. SwItzerland.

St.John Ambulance

needs Registered Nurses to volun-
teer their services to teach Patient
Care in The Home. Will you help?
con
<tLnl 0
St
n
bulance

Get what you've
always wanted
frODl nursing.

t..l

-

Like the chance to work and travel the world.

You've given a lot to nursing. With
Medox, you have many ways to get
some back.
For instance, in your own city, you
can spend mOre time doing what you
want to do. Work as many shifts as
you wal1.t. Accept a wide variety of
assignments.
Or, if you wish, expand your
professional and personal experience
far beyond one hospital, one city,
even one country. Because with
Medox International* you can work in

any city in the world where Medox
operates.
We'll make sure your licence is
valid. We'll even arrange travel and
accommodation. It's a great way to
live and learn.
Be a Medox nurse. And make
things happen.
*for information about our
"Travel the World" program, write
MEDOX Travelling Nurse Co-Ordinator,
Plaza 37, 4 Place Ville Mdrie, Montreal,
Quebec.

[ MEDOX ]

a DRAKE INTERNATIONAL company

CANADA. USA. UK . AUSTRALIA

THE <-ANAl) N NURSE 49

CLINICAL NURSE SPECIALIST

For

MED-SURG NURSING

Required in 254-Bed
Active Care
General Hospital

Qualified Parties Apply to:
Director of Nursing
Moose Jaw Union Hospital
Moose Jaw, Sask.
(306)692-1841 (Call Reverse)

NURSING OPPORTUNITY
REGISTERED NURSES

reqUired for a 138-bed active treatment hospital
plus

EXPERIENCED NURSES

for a 5-bed I.C.U.-C.C.U. presently being set up
clinical areas include - medicine - surgery, obstet-
ncs. paediatrics and coronary care.

Residence accommodation avaitabte.
Address applications and enquires to:

DIRECTOR OF NURSING
BLANCHARD-FRASER
MEMORIAL HOSPITAL
KENTVILLE, NOVA SCOTIA

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 1CO

50 THE CANADIAN NURSE

-

= --
-- - -----
..... --:: . - . - . - ... = . . ..".....,...
-I. ..... -

.. ..
-"",--""-- ---4r .,

_ - - t. .

Prairie Hmpital
L earning Centre
A pplied Arts & Sciencc College nearby
I n Provincial Capital. University Centre
N c\\ly built - to open Fall/74
Single Rooms. Air Conditioned

H iring Policies Progressive
E very Opportunity for Staft Development
A II Activities directed toward better Patient Care
L earning directed toward Gentle, Intelligent Nursing
T he Support of Service Managers, Ward Clerks. Service Aides
Health Program for Employees

C lean. Fresh Air
E valuation of Quality of Care and Performance of Personnel
Nurses Needed
T 0 Staff Medical. Surgical, Emergency. LCU.. CCU.
Recreation - Swim, Skate, Ski, Concerts. Ethnic Culture Groups, Tennis
E xpcrience Recognized in Setting Salary

(RANGE: $707-$732-$759-$787-$830)

Apply to:
NURSING EMPLOYMENT OFFICER
PLAINS HEALTH CENTRE
4500 WASCANA PARKWAY
REGINA, SASKATCHEWAN
S4S 5W9

NOVEMBER 1974

DIRECTOR OF NURSING

The County 01 Bruce General HospItal. an accredited.
10S-bed. active treatment hospital will have a vacancy
November 1, 1974 (present Director IS retiring)
Accountable to the Administrator for achievement of
hospital patient care objectives through planning. dlrect-
In9 and controlling the provision of nursing services
EducatIOn and training should Include R.N. With post-
graduate education preferrably a Bachelor of Nursing
Science
Education and expenence should Indicate progressive
thinking. leadership skills. the abilIty to successfully
implement change. and the ability to develop and
maintain constructive relationships with all professional
and management staff
Reply in confidence giving full details regarding educa-
tion. experience. lob related accomplishments and refer-
ences to.

Administrator
County of Bruce General Hospital
Walkerton, Ontario
NOG 2VO

MONTREAL
NEUROLOGICAL
HOSPITAL

A Teaching Hospital
of McGill University

requires

Registered Nurses
for
General Duty
PrevIous experience m neurological nursmg not
required Active mservice educatIon programme.

Apply to:
The Director of Nursing,
Montreal Neurological Hospital,
3801 University Street,
Montreal 112, P.O.

REGISTERED NURSES

Registered Nurses required for large
metropolitan general hospital.
Positions available in all clinical areas.
Salary Range in effect until December
31, 1974-
$665.00 - $830.00. Starting rate de-
pendent on qualifications and experi-
ence.

Apply to:
Staffing Officer-Nursing
Personnel Department
Edmonton General Hospital
Edmonton, Alberta
T5K OL4

NOVEMBER 1974

:\
\.þ.\. GENEN-tl
a
[j v.

!oI.J

iE

oJ1
-

r;;
'L ....
'Ó Ó'

-1
,,

'() rEACH\
(,

Quebec's Health Services are progressive!

So

.

IS

nursing

at

The Montreal General Hospital

a teaching hospital of McGill University

Come and nu rse in exciting Montreal

.t ,Cl

/
D\
,
I',i
"'tE"""

The Montreal General Hospital
1650 Cedar Avenue, Monfreal, Quebec H3G IA4

Ple.ae tell me obouf hospital nursing under Quebec's new concepf of Social and
Preventive Medicine.

Name

Address

Quebec language requirements do not apply fo Canadian applicants.

________________________________J
THE CAN AD AN NURSE 51

REGISTERED NURSES

AND

NURSING ASSISTANTS

required for 11 O-bed hospital which specia-
lizes in chest diseases, situated In the
beautiful Laurentian mountains and loca-
ted only 55 miles from Montreal Good
personnel policies and residence accom-
modation available.

APPL V:
DIRECTOR OF NURSING
Mount Sinai Hospital
P.O. Box 1000
Ste. Agathe Des Monts, Quebec
J8C 3A4

REGISTERED NURSES

required
To further develop our family focused

CHILDRENS'
PSYCHIATRIC SERVICE

Day, night and post discharge nursing
followup care planned for patients from 2
to 17 years.
Four week pre-service educational prog-
ramme is scheduled for November 1974.

Please apply to:

Director of Nursing
Royal Jubilee Hospital
VICTORIA, British Columbia

DIRECTOR OF NURSING

Applications are invited for the position of
Director of Nursing in a modern fully
accredited 95 bed hospital. Successful
applicant will be responsible for all nursing
services including in service education.
Challenging position for one with adminis-
trative training and experience in a senior
nursing position.
Salary is negotiable and will be com-
mensurate with training and experience.

Apply:
W.F. Thompson
Administrator
Douglas Memorial Hospital
FORT ERIE, Ontario
L2A 1Z2

52 THE CANADIAN NURSE

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

CONESTOGA COLLEGE OF APPLIED ARTS AND
TECHNOLOGY

CHAIRMAN
NURSING PROGRAM

Applications are invited for Chairman, Nursing
Division at the Stratford Centre of Conestoga
College of Applied Arts and Technology.

The Chairman has the academic admimstra-
tive responsibility for the Division which includes
130 full-time Nursing Diploma students and 18
faculty and staff members.

Candidates must be a Registered Nurse and
possess a minimum of a B.Se.N. degree.
Academic experience is desirable.

The incumbent to be appointed on or before
January 1, 1975.

ApplicatIons, In wrItIng, shoutd be for-
warded to:

The Perso-"nel Department,
Conestoga College ot Applied Arts
and Technology,
299 Doon Valley Drive,
Kltchener, Ontario.

THE LADY MINTO HOSPITAL
AT COCHRANE
invite applications from

REGISTERED NURSES
($850 - $1020)
GRADUATE NURSES
($785 - $930)
54-bed accredited general hospitaL
Located in Northeastern Ontario.
Good employee benefits that include shift diffe-
rential and 100% premium paid health plans.
Send Inqutr/es and appt/catlons to:
MISS E.lOCKE
Director ot Nursing
The lady Minto Hospital at Cochrane
P.O. Box 1660
Cochrane, Ontario, POL 1 CO

GENERAL DUTY NURSES

Required immediately for acute care gen-
eral hospital expanding to 343 beds plus
proposed 75 bed extended care unit.
Clinical areas include: medicine. surgery.
obstetrics, paediatrics, psychiatry. activa-
tion & rehabilitation, operating room,
emergency and intensive and coronary
care unit.
Must be eligible for B.C. Registration
Personnel policies in accordance with
R.N.A.B.C. contract:
SALARY: $850 - $1 020 per month
(1974 rates)
SHIFT DIFFERENTIAL

APPL Y TO:
Director of Nursing
Prince George Regional Hospital
Prince George, B.C.

INTERNATIONAL MISSIONARY
TRAINING HOSPITAL
DROGHEDA, CO. LOUTH, IRELAND

TUTOR

required at above hospital. Salary in
accordance with Hospitals Commis-
sion scale. Superannuation Scheme
in operation.
Apptlcal10ns to:
Matron
International Missionary Training
Hos pita I
Drogheda, Co. Louth, IRELAND
Please quote ret. C.N.

NOVEMBER 1974

1+

Public Service
Canada

Fonction publique
Canada

THIS COMPETITION IS OPEN TO BOTH MEN AND WOMEN

MEDICAL-SURGICAL SUPERVISOR
Health and Welfare Canada
Charles Camsell Hospital
EDMONTON, ALBERTA
Salary up to $12,918.

The CHARLES CAMSELL HOSPITAL in EOMONTON invites applications from
candidates eligible for registration as a nurse in a Province of Canada with
supervisory experience in Medical-Surgical nursing to supervise six nursing stations.
It is deSirable that interested candidates have a B.Sc. in nursing or courses in
Administration.
Proficiency in the English language IS essential.

Apply immediately on (
orm PSC 367-4110) "Application for Employment" available
at Post Offices, Canada Manpower Centres. Charles Camsell Hospital and offices of
the Public Service Commission of Canada, and return it to the following address:

DIRECTOR OF HOSPITAL PERSONNEL
CHARLES CAMSELL HOSPITAL
12815-115 AVENUE
EDMONTON, ALBERTA

Please quote competition number: 74.E.1741 in all correspondence.
Appointments as a result ot 'hIs competition are subject to the provIsions of the
Public Service Employment Act.

T(TRSES
for
O\TERSEL\S

Experienced nurses needed to work in Bangladesh. Latin
America. and Africa. Become involved in preventive.
curative and training health programmes.

T \\ 0 year contracts \\ ith CUSO.

Transportation costs paid.

Contact:

CUSO HEALTH - 10
15 I Slater Street
Ottawa KIP 5H5

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.
1974 Salary Scale $850.00 - $1,020.00 per month
For further information, please write to:
PERSONNEL SERVICES
VANCOUVER GENERAL HOSPITAL
855 WEST 12TH AVE.
VANCOUVER, B.C.

NOVEMBER 1974

THE CANADIAN NURSE 53

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-
qical 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

WE CARE
;;J

f
fì\
1
"

)i\
f

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.
P;anned staff development programs.

Please address all enquiries to:
Assistant Administrator (Nursing)
York County Hospital,
NEWMARKET, Ontario,
L3Y 2R1.
54 THE CANADIAN NURSE

-'

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-y
THE SCARBOROUGH
GENERAL HOSPITAL

invites applications from:
Registered Nurses and Registered Nursing Assis-
tants to work in our 650-bed active treatment
hospital and new Chronic Care Unit.
We otter opportumties 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" teachmg
program.
. Paediatric Department - particlpallon In Play Therapy Program.
. Orlenlallon 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 the" 300 year heritage of service to the
Church In health. education and welfare services In
the United States, Canada and France
to share the" 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,
K1S ON2.

NOVEMBER 1974

NURSING POSITION

MINING COMMUNITY
CENTRAL YUKON

Applications are invited for the position of NURSE at Clinton Creek
Cottage Hospital.
Preference will be given to applicants with experience in obstetrics. A
good general nursing background, including the ability to deal with
accidents is required.
Salary is based on a R.N.A. B.C. standards.
Clinton Creek, a community of 500 people, is 400 road miles northwest of
Whitehorse and 60 miles from Dawson City.
Benefits include one month annual vacation with travel allowance,
subsidized accommodation in modern townsite with retail store, good
recreation facilities and airport.

Reply to:

Dr. D. Ruddock
Clinton Creek Cottage Hospital
Clinton Creek. Yukon Territory
YOS 1 EO

"MEETING TODAY'S CHALLENGE IN NURSING"

Ql.'EE
ELIZABETH HOSPITAL OF MO"JTREAL
CENTRE

A Teaching Hospital
of McGill University

requires

REGISTERED NURSES

AND

REGISTERED NURSING ASSISTANTS

Quebec language requirements do not apply to Canadian applicants.

. 255-bed General Hospital in the West end of Montreal
. Clinical areas include Progressive Coronary Care,
Intensive Care, Medicine and Surgery, Psychiatry.

Interested qualified applicants f,hould apply in writing to:

QUEEN ELIZABETH HOSPITAL OF MONTREAL CENTRE
DIRECTOR OF PERSONNEL
2100 MARLOWE AVE., MONTREAL, QUE., H4A 3L6.

NOVEMBER 1974

1
*
.

ENJOY
NURSING
AT
VICTORIA
HOSPITAL
LONDON
ONTARIO

Apply To:-

Director of Nursing,
Victoria Hospital,
London,
Ontario,
N6A 4G5.

Name: ................

Address:

Rey.N. D

R.N.A.D

THE CANADiAN NURSE 55

YORK-FINCH GENERAL HOSPITAL

DIRECTOR
NURSING SERVICE

A qualified Director of Nursing Service is required
immediately to assume absolute responsibility for the
overall direction, supervision and control of the Hospital's
nursing service. The position, reporting to the Adminis-
trator, also involves participation in the policy decision-
making process as a member of the senior executive.
The successful applicant will have a Bachelor of Nursing
Science degree and a minimum. five years in senior
administrative positions. Salary will ue commensurate with
qualifications and experience.
York-Finch General Hospital is a fully accredited 314 bed
Friesen concept Hoscitallocated in Northwest Metropolitan
Toronto.

Detalted resumes starting salary requirements should be submttted to:

ADMINISTRATOR
York-Finch General Hospital
2111 Finch Avenue West
TORONTO, Ontario
M3N 1 N1

THE DEPARTMENT OF
NORTHERN SASKATCHEWAN

is developing new health programs to re-
spond to the unique health needs of northern
people.
Nurses are required to make use of their full
range of nursing skills and abilities to initiate
and develop new programs in conjunction
with a growing range of allied health and
social service personnel.

HEADQUARTERS:
Various locations throughout Northern
Saskatchewan.

Please direct applications to:

MR. STU KERR
PUBLIC SERVICE COMMISSION
1820 - ALBERT STREET
REGINA, SASKATCHEWAN

NOTE: Please quote competition number cc8532.

SCHOOL OF NURSING
McGill UNIVERSITY

BACHELOR OF SCIENCE IN NURSING
A three year BASIC program
. general and professional courses with nursing
experience in McGill Teaching hospitals
. entrance Quebec CEGEP or the eqUivalent
BACHELOR OF NURSING
A two year program for Graduate Nurses study of
. nursing in various fields of practise in Hospitals
and Community Health Centres
. teaching and supervision
(Last year for new admissions 1975-76)
MASTER OF NURSING
Teachers of Nursing in the rapidly expanding college
system for Nursing Education.
One calendar year for nurses graduated from basic
baccalaureate programs (4-5 year integrated
program). For further particulars write to:

MASTER OF SCIENCE (APPLIED)
Options:
(1) Specialist in Nursing in all clinical fields (Nurse
Clinician), including the expanded function of
Nursing in Family Health and Community Health
Centres.
(2) Research in Nursing and Health, including
evaluation of health care and delivery systems.
Two academic years for nurses with a B.N. or
B.Sc.N.
Persons with a B.A. or B.Sc. in social or biological
science are eligible following successful completion
of a Qualifying Year in Nursing.

DIRECTOR, SCHOOL OF NURSING, McGill UNIVERSITY
3506 UNIVERSITY STREET, MONTREAL 112, QUE.

56 rHE <-ANAOIAN NURSE

NOVEMBER 1974

M aster the
A rt of
Surgical techniques in a teaching
and research
Hospital in which the most modern
surgical procedures are being
performed.

Applications are invited from Operating Room Nurses who
must be able to supervise OR technicians.

Nurses who wish to take in-service program in mastering
OR techniques will be considered for staff positions.

For information, apply to:

Anne Bruce, R.N.
Nursing Recruitment Officer
Royal Victoria Hospital
687 Pine Avenue West
MUlltreal, H3A 1A1,p.n.
HI.: 842-1251, local 677 or 490

CARl BOO
COLLEGE

KAMLOOPS

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OOP
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",:) S C

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 December, 1974
Applicants with a Master's Degree are preferred. Minimum
requirements are a baccalaureate degree with experience in
pediatric and psychiatric nursing and teaching and eligibility for
registration in British Columbia.
Attractive salaries commensurate with preparation and experience.
Apply in writing, stating experience, qualifications and refer-
ences to:

CHAIRMAN OF
URSING
CARIBOO COLLEGE
Box 860
KAMLOOPS, B.C. V2C 5N3

NOVEMBER 1974

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· · · · when
somebody
cares.

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I .f.
t _"5/ Medical Services Branch I
I 1
l' Department of National I
r
i'& "" Health and Welfare
I ''f Ottawa, Ontario K 1 A OK9 I
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I Please send me more information on nursing I
I opportunities in Canada's Northern Health Service. I
I Name: I
I Address: I
City: Prov: _

---____________J

1+

Heatth and Welfare Sante et Blen-être social
Canada Canada

THE CANADIAN NURSE 57
.

MONTREAL CHEST HOSPITAL CENTRE

A TEACHING HOSPITAL AFFILIATED
WITH
McGill UNIVERSITY

DALHOUSIE UNIVERSITY

invites applications for

SCHOOL OF NURSING

Applications are invited for the position of Professor and Director
of the School of Nursing. The position carries responsibility for
the School, including administration of the Baccalaureate and
Master's Programs, recruitment of faculty, budgeting, etc. It is
expected that the candidate would have completed a doctorate,
and have had clinical, nursing education and administrative
experience. She or he should be available on July 1. 1975.

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS
FOR GENERAL DUTY

Apptlcatlons, with Currlcutum Vitae, shoutd be sent to

Please apply to:

Dr. A.M. MacDonald
Dean of the Faculty of Health Professions
Dalhousie University
Halifax, Nova Scotia,
by January 1, 1975

DIRECTOR OF NURSING
MONTREAL CHEST HOSPITAL CENTRE
3650 ST. URBAIN STREET
MONTREAL, QUEBEC, H2X 2P4

SCHOOL OF NURSING
THE UNIVERSITY OF VICTORIA
VICTORIA, B.C.

Faculty Positions
Applications are invited for several faculty positions in the newly established School of
Nursing. Postbasic programmes leading to undergraduate (B.S.N.) and graduate (M.S.N.;
M.Sc. & Ph.D.) degrees will commence in September 1975. Appointments may be made at
the ranks of Assistant, Associate, and full Professor with starting salaries depending on
qualifications and experience.
Duties will include teaching at the undergraduate and graduate levels, some supervision of
clinical work, participation in the planning and development of an innovative curriculum, and
research.
Successful candidates must be able to take up their appointment on or before 1 July 1975. It
is hoped that it will be possible to announce the name of the Dìrector of the School by 1
January 1975.
Applications for faculty positions, including a complete curriculum vitae and the names of at
least three referees, should be sent as soon as possible and not later than 31 January 1975
to:

Dr.J.M. DEWEY
Dean of Academic Affairs
University of Victoria
Victoria, B.C., V8W 2Y2
from whom further information concerning the School may be obtained.

58 THE CANADIAN NURSE

NOVEMBER 1974

What's a big company
like Upjohn doing
in nuning 5 ' rvic ' 51

(Simple. We're in it to help you and here's how.)

If you're a Nursing Supervisor we can complement your staff
when shortages occur by providing competent R.N .'s,
R.N.A.lC.N.A.lL.P.N.'s or Nurse Aides.

If you're a nurse interested in working part-time to supple-
ment your family's income, we offer you the opportunity to
select hours and assignments convenient to your schedule,
not ours.

If you're a Discharge Planning Officer or Home Care Co-
Ordinator, we are a reliable source for home health care
with whom you can trust your outgoing patients.

If you're an inactive nurse temporarily out of touch with
nursing, we can offer patient care opportunities which will
enable you to re-enter your profession,

We think that it is important for you. the Registered
Nurse. to understand why The Upjohn Company's
subsidiary. Health Care Services Upjohn Limited,
has become.involved in nursing. Our concept of
part-time nursing services has proven to be an
important adjunct to the delivery of health care.
Our interest is in assisting the Medical and Nursing
Professions by providing additional qualified
R.N:s, R.N.A./C.NA/LPN:s and Home

----
GmD
-.-

Health Care Personnel to serve the commu-
nity.1f you would like more information about
the work that we are doing across the country
and how we can help you, contact the Health
Care Services Upjohn office nearest you.
Ask for the Service Director. She is an R.N.,
and you'll both be speaking the same lan-
guage. Look for us in the white pages and in
the yellow pages under "Nurses Registries:'

HEALTH CARE SERVICES UP JOHN LIMITED

With 15 offices to service you across Canada

Victoria
Vancouver
Edmonton
Calgary
Windsor

388-6639 London 673-1880 Ottawa
731-5826 Hamilton 525-8504 Montreal
423-2221 St. Catharines 688-5214 Trois Rivieres
264-4140 Toronto East 445-5262 Quebec City
258-8812 Toronto West 239-7707 Halifax
(Operating in Ontaño as HCS Upjohn)

238-4805
288-4214
379-4355
687 -3434
425-3351

DALHOUSIE UNIVERSITY

SCHOOL OF NURSING

Applications are invited for the position of PROFESSOR or
ASSOCIATE PROFESSOR OF NURSING to coordinate the
Master's Program in association with the Director of the School It
is expected that the candidate would have completed a doctorate,
and have had clinical, nursing education and research experience.
The appointment includes teaching in the graduate and undergra-
duale programs, and provides opportunity for research and
professional services. The candidate should be available January
1, 1975, or by arrangement.

Applications, with CurrIculum Vitae, should be sent to

Dr. A.M. MacDonald
Dean of the Faculty of Health Professions
Dalhousie University
Halifax, Nova Scotia

Applications are invited from qualified persons
to fill the position of:

NURSE II

on our Child Psychiatry Unit

Applicants should have considerable knowledge of professional
nurSin!;pheory and practices as applied to Psychiatric Nursing, with
the abdl
y to direct the nursi
g. activities of the Unit, as she will be
responsible for the supervision of the professional and non-
professional nursing personnel on the unit, which includes an
In-Patient Day Care Programme. Advanced courses or special
training in Psychiatric Nursing would be an asset.
Salary in accordance with existing nursing salary scales.
Excellent benefits, include 20 working days annual leave, 9
statutory holidays, accumulated sick leave, Pension and Group
Life & Health Insurance Plans.

Applications stating experience, qualifications, etc., should be
forwarded to:

DIRECTOR OF PERSONNEL
THE DR. CHARLES A. JANEWAY CHILD HEALTH CENTRE
PLEASANTVILLE, ST. JOHN'S
NEWFOUNDLAND

HEALTH
SCIENCES
CENTRE

WINNIPEG,
MANITOBA

-

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THIS 1345 BED COMPLEX 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 ':It full salary
ON-GOING EDUCATION - Provided through
active in-service programmes in all patient care areas
opportunity to at1end 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 holidays 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, rehabilitation, and paediatrics.

ENQUIRIES WELCOME
FOR FURTHER INFORMATION PLEASE WRITE TO:
PERSONNEL DEPARTMENT, NURSING SECTION
HEALTH SCIENCES CENTRE,
700 WILLIAM AVENUE,.WINNIPEG, MANITOBA R3E OZ3

60 THE CANADIAN NUR
t:

NOVEMBER 1974

SPECIAL NURSES
FOR SPECIAL PATIENTS

If your nursing experience has become just a
matter of daily routine, then it's time to think about
it
Maybe you feel that your patients are just num-
bers. . . that your involvement with them is too
limited. . . that you are ready for a change because
you no longer feel the same sense of achievement
and personal commitment in your present posi-
tion.. .

Right now, our Nurse Coordinators in Winnipeg,
London and Halifax are standing by for your phone
call. They will be pleased to give you further
information on the variety of distinctive job benefits
and they can even look into specific requests you
may have... such as having working hours
arranged to suit your needs.

Now it's really time to think about it!

If you are thinking about a new approach to
nursing, then you are ready to become a special
nurse for specIal patients.
The patients at Department of Veterans Affairs
Hospitals across Canada need special care.
In these hospitals. nurses work in well-equipped
surroundings where specialized treatment is pro-
vided in a pleasant atmosphere. They are special
nurses.
DV A hospitals offer job security in a congenial
climate that encourages nurses to give psycholo-
gical as well as physical care to their patients.

Call collect:

Halifax:

London:

Mary Johnson
Camp Hill Hospital
Phone: (902) 423-1371
Helen Conn
Westminster Hospital
Phone (519) 432-6711
Ann Bowman
Deer Lodge Hospital
Phone: (204) 837-1301

Winnipeg:

The nurses are employees of the Public Ser-
vice of Canada which provides:
. Excellent pension plan
. Favourable working hours
. Attractive fringe benefits
. Relocation expenses
If you are ready to consider this new approach to
nursing, why not discuss it frankly with our own
people who have been specifically assigned to
help you.

For information about employment
in Department of Veterans Affairs Hospitals
elsewhere in Canada, call collect:
Susan Champion
Department of Veterans Affairs, Ottawa
Phone: (613) 992-3248

All positions are open to both men and women.

1+

Public Service
Canada

Fonction publique
Canada

NOVEMBER 1974

THE CANÃOIAN NURSE 61

Tommy will never make the Leafs.
He has Cerebral Palsy.

Applications are invited from qualified persons
to fill the position of

INSTRUCTOR II
(Child Psychiatry)

You can help Tommy by
understanding more about
cerebral palsy. By realizing
cerebral palsy for what it is:
a break in the line of com-
munication between the
brain and the body's mus-
cles. And by understanding
that Tommy and the kids
like him can be helped to
lead useful and' rewarding
lives. For further information
write to George Armstro'19,
Maple leaf Garden.
O'1t nr -, "-

....

,

DIRECTOR OF PERSONNEL
THE DR. CHARLES A. JANEWAY CHILD HEALTH CENTRE
PLEASANTVILLE, ST. JOHN'S
NEWFOUNDLAND

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The successful applicant will be required to teach a post basic
course in Child Psychiatric Nursing, prepare lectures, assign-
ments, and evaluations.

QUALIFICATIONS
Preference will be given to applicants with a Baccalaureate Degree
in Nursing or other discipline related to Child Psychiatry. Expe-
rience in Paediatrics desirable.

Salary on the scale of $9.440.00 - $11,999.00 per annum.
Excellent working conditions, 20 days annual leave, 9 statutory
holidays, accumulative sick leave, Pension and Group Life &
Health Insurance Plans.

Apptlcatlons /n writing stating quallf/catlons. education. etc., shoutd be
forwarded to:

vi
,

Canadian Cerebral Palsy Association

ASSIST ANT
DIRECTOR

Required for 2 year independent diploma program in nursing. Enrollment-
255 students 25 full-time faculty members
DUTIES: to assist the director in administrative responsibilities
QUALIFICATIONS: Masters degree preferred.
Experience in teaching and curriculum development. At least one year's
experience in nursing service.
Apply to:

Miss Anne D. Thorne,
Director-Saint John School of Nursing,
Beaverbrook House,
Coburg Street,
Saint-John, N.B.

62 THE CANADIAN NURSE

NOVEMBER 1974

PROVINCIAL ASSOCIATIONS OF REGISTERED NURSES

Alberta
Albena Association of Rcgistered :--Iurscs.
10256 - 112 Street. Edmonton. Alberta.
n", 11\16.
Pres.: A.J. Pro\\,sc: Pre
.-Elect: A. Thomp-
son: Vice-Pres.: D.E. Huffm.1n, R. Arcand.
Committees - Sra[f Nllrses: V. Z\\ic\.,er:
Silpen'. Nurses: :\1. LaRocque. Prol'. OJjice
Stuff -Illfo. ()fJìcer: B. Steed: Dine. Col-
lect. Bargaill.: Y. Chapman: Emplo\', Rei.
()ffker: R. Donahue: Nsg. Sen'. COllsult.: B.
Sellers: Comm. AlllÙor: H. Cotter: RegÜtrar:
A.R. :\1acKinnon: Etee. See.: H.:\1. Sabin:
Office Jfallager: M. Garrick: P/'(
iecT Dil ec.
Nsg. Educ.: :\1. Moncrieff.

British Columbia
Registered Nurscs Association of British
Columbia, 2130 \\. 12th A \cnue. Vam:ou\er.
B.C.. V6K 2:'\i3.
Pre
.: G. LaPointe: Vice-Prn.: T. Duck. R.

1adad}cn. Committees - N\g. EdIlL: S.
Roth\\cll: \\g. Prac.. H. Hanel: Sac & EcoTl.
n'l'I.f.. A. Suthcrland. Staff' - Exec Direc..
I-.A. Kcnned}: A
.wc Etee. Direc.: "'.:\1.
Smith: Registrar: H. Gricc: Asst. RegiHrar: 1.
Small: Din'c. l:.dllc Sen'.: C. Kcrmacks.
A.\.\t. Direc h/ilc Sen'.: J. McCullagh:
DiT ec. .vsg. Sen'.. T. Schnurr: Din'c PersoTl-
TIel Sen. :--I. Pawn: Aut. Direc. PersoTlTlel
Sen'" (Lahar Rel.l: G. Smale: Direc Place-
lIIelll Sen'.: :\1.L Carmack. W. Sa\\adsk}:
Dirt'c CO/IIII/IIT/. Serl'.: C.
Iarcus: Lihmria/l'
J. :\10bon:Admill. Asst.: J. HolI.1nd.

Manitoba
Manitob.1 Association of Registcrcd
urses.
ó47 Broad\\ay Avenue. Winnipeg. Manitoba.
R3C OX2.
Pres.: G.R. Blad,: Past Pres.: F. :\1cNaught:
ViCl'-Pre.
.. :\1. :\1cPhcrson. S. Painc.
Committees - N
g.: :\1. :\1cCrad}: Brd. oj
E wm" O. :\Ie Damot t. Profe.u.
SU!tf - Fmploy. Rei. Ad\'isor: J. Glcason:
Registrar: M. Cald\\ell: ContiTl. EduL 4d-
l-isor. K. DeJong.

New Brunswick
Ne\\, Bruns\\ iei-, Association of Registcrcd
:-':urscs, 23\ Saunders Strcct. hcdcricton.
'J.B.. UB 1:--16.
Pn'.\.: B. LcBl.1nc: Past Pres.: A. Robichaud:
Via-Pre.\.' S. Cormicr. R. Dcnnison: HOI/.
See.: P. Stcphcnson. Committel'.\ - ,Y.Ig.: /.
Ha\\kes, S. :\1acLeod: ,V\'i. .4.\.\1.: B Sch}f:
Ll'gisl.: A. Aird: En'L See.: I\1.J. Andcrson:
Liai.ml/ OtJìcer: N. Ridcout: COl/.\lIlt. SO(. &
rcO//. We(f.: G. R(m scll: RegiHrar: E.
O'Connor: Asst. FIt'c. Sec & RegÜtrar: :\1.
Russell: Edllc. ('OTl.llllt.: A. Chri...tie.

Newfoundland
Association of Registcred :--Iurses of :--Ie\\,-
timndl.1nd. 67 LeMarchant Road, St. John's.
:--Ind.. AIC6AI.
Pres.: R. Clcgg: Pt/
t PreL: P B.1rrctt:
Vin'-Pn',\.. B Coad}, 1. ;";e\itt.
COIl/mitten - Nsg. FdIlL: R. Nichollc: .V.'.,!.
Sa\'.. B. Scbofield: RegistratioTl: J. F.1irlc}:
NOVEMBER 1974

Legi.r/.6: B\'-Ll/In: "'. R,)chc: Pllh. Rei.: 1.
Walsh: FiTlt/llce: 1. :--Ic\Ïtt: A.nt. E\ec. Sec.:
A. Furlong: Etee. See.: P. Barrctt.

Nova Scotia
Rcgistcred Nurscs' Association of 'JO\ a
Scotia. 6035 Coburg Road. Halifax. :--1.5..
B3H I YR.
Pre
.: Sr. M. Barb.1ra: Past Pre.r.: :\1.
Bradlc}: Vice-Pres.: G. Smith, C. Butler. Sr.
S. :\-1. Roach: Rel'tJrd. See.: T. Blaikic: E rec.
See.: F.
10ss. Committees - N.\'g. Edue.: L
Robinson: :\isg. Sen'.: E.J. Dobson: Soe. &
EClm. Welf.: C. Amirault; COIISllIt. \'.\g.
Fdue.: Sr. C. :\1arie: COllslllt. .\'.rg. Sen'.: 1.
MacLcan: Employ. ReI. n.fJìcer: :\1. Bentley:
Pub. Rl'l. OJjïcer: D.
1iller: Admill. A.w.:
E. :\lacDonald.

Ontario
Rcgi
tered Nur
ö' Association of Ontario. 33
Price Street. Toronto. Ontario. :\14W IZ2.
Pres.: \\ .J. Gerhard: Pres. E/eer: :'11.:\1.
'\Iarossi. Committees - Socio-Ecoll. lI'elf.:
LR. Gossclin: ,Vsg.. :\1.1. Boone: EduClltor:
J.P. Robarts: Admill.: M.L Peart: E\ee.
Diree.: L Barr: Asst. Ern. Diree.: D.
Gibnc): Direc. Emplol'. ReI.: A.S. Gribben:
Direc. Pn1l'.H. Dl'I'el.: c.:vt. Adams: Reg.
Etec. Sen.: :\1.J. Thomas. F. Winchestcr.

Prince Edward Island
As...ociation of Nurses of Prince Ed\\ard
1,land. 188 Prince St.. Charlottetown. P.E.1..
CIA 4R9.
Pres.: B. Robinson: Pmt Pres.: E.
1acLeod;
Pre.\. Elect: B. MacEachern: V/('e Pre.r.: S.
Mulligan: Etec Sec.-Registrar: L Fraser.
Commirtees -Nsg. Edllc.: K. Kunelius:.Vsg.
Sen'.: J. Pett:rs; Pllh. ReI.: H. Wood: Fi-
IIllllce: E. MacLeod: Legisl. & By-Lwn: L
Fraser: Soc. & Ecoll. Welf.: R. Perr): Regis-
tratÙm: L Doylc.

Quebec
Ordcr of Nurses of Quebec, 4200 Dorchester
Bhd. W.. :\10ntreal. Qucbec. H3A I V2.
Pre's.: R. Burcau; Vice-Prt'L S. O' Ncill. 1.
Pinkham (Eng.). P. Proulx, Y. Le Page (Fr.):
H(III. Trell.\.. C Ro}cr: H(III. See.: P.
Boucher. Committees - N\g. Edllc.: G.
Allcn. D. L.1lancctte:.v.rg. Sen'.: J. Hack\\cll.
R. Dionne: Pn1f'.\.\. Sen'.. S. O'Neill. P.
:\Iurphy; School (1 VIg.. R. Atto. C. dc
Villicrs SaU\c: Legi.\I.. \1. \Iasters. C
Bclangcr: See. Regi.l-trar: 'J. J)u \1ouche!.

Saskatchewan
Sas"atchc\\'an Rcgistcrcd :--Iurscs' As...ocia-
lion. 2066 RClallac" Slreet, Regina. Sas"alch-
c\\'añ. S4T 2"'2
PreL J. Mac"'.1}: PlI.\t Pre.\.: D.J. Piphcr:
Pl'l's. Elect: S. Bclton: Vice-Pre.\.: Sr. B.
Bczaire. J. Callagh.1n. Committee.\ - N.lg..
S. Pankratz: Chllpten & Puh. Rei. R
Lcdingham: SOL 6: F('(III. Wclj.: G. Hutchin-
son: F \t'C Dire(.. 'Ii. Cloarcc: Rc
i.\trar: E.
Dum.1s: Puh. 1I!lo. OJjïcl'T: B. Schill: 4.\.1t.
Rcgi.\trllr: J. Passm(lrc.

ð

Canadian
Nurses'
Association

Directors

Presidcnt Huguctlc L.1belle

President-Elect. Joan Gilchrist

bt Vice-Prcsident . Helcn Ta} lor

2nd Vice-Presidcnt :\Iargare! :\1cLean

:\Iember-at-Large . .Lorinc Scsel

\1embcr-at-Large Fern.1ndc Harrison

Mcmbcr-at-Large Glcnna ROIl scll

leIllber-at-Largc Shirlc) Stin,on

A.1. Pnm se . AAR:\
G. LaPointe . R;..;ABC
R.G. Black .. :\IAR:\
B. LcBlanc :\BAR\;
R. Clegg AR:\:--I
Sr. \1. B.rrbara R;\;-\KS
\\ . Gcrhard RKAO
B. Robinson .. ..A
PFI
R. Burcau .O\lQ
J, :\1.1d\..1} . . . . SR \, -\

Executive Director

. .Hcll:n "'. \1uss.lllem

THE CAN..tDlAN NURSE

bJ

Index
to
Advertisers

November 1974

Bata Limited .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.9

Clinic Shoemakers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Davol Canada Ltd.

HCS Upjohn Ltd.

59

Lanzette Products

45

J.B. Lippincott Co. of Canada. Ltd.

Medox

49

C.V. Mosby Company. Ltd.................................. 37.39.41
MTC Pharmaceuticals Limited . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. II

Nordic Biochemicals

12

Reeves Company.
Schering Corporation Limited ..... . . . . . . . . . . . . . . . . . . . . . . . . 64. Cover IV

White Sister Uniform. Inc. ........................ ..... Covers \I & III

Ac/n'l',i.\il/g .''v1 WICl I:(T
Georgina Clarke
The Canadian Nurse
SO The Driveway
OUa",a K2P I E2 (Ontario)

I

A c/,'('rti.\Úlg Repr('Sel/tlltf\'e.\
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003
I dcphonc. (215) \1 id\\ a) l)_1
l)7

Gill don Tiffin
2 Tremont Crescent
Don Mills. Ontario
-I dcphonc. H 16)

-4731

Member of Canadian
Circulations Audit Board Inc.

mE

64 THE CANADIAN NURSE

CoriCidin'D'

2

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.
A vailable in blisters of 12
and 24, and botdes of 100 tablets.
Coricidin 'D' Medilets: Each orange-
pineapple-flavored multicolored tablet contains:
0.5 mg chlorphemramine maleate U.S.P.,
80 mg acetylsalicylic acid and
2.5 mg phenylephrine HC\.
Available m boxes of 24 Medilets m a
child's protective package.
INDICATIONS:
Symptomatic relief of nasal congestion and
other discomforts associated with smusltls,
colds and allergic or vasomotor rhinitis.
CONTRAINDICATIONS:
Sensitivity to any of the components,
patients receivmg MAO inhibitors
PRECAUTIONS:
Administer withcaretopatients with hyper-
tensIOn. cardiac disorders, hyperthyroidism,
diahetes 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-
mmed. 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
anti histaminic therapy.
Rarely. prolonged therapy with antihista-
mme-containing preparations can produce
blood d yscrasias.

5

6

ADVERSE EFFECTS:
Drowsiness, dizziness, nausea, increased
Irtltability or excitement may be
encountered.

DOSAGE:
Coricidin 'D': Adults: I tablet every 4
hours. not to exceed 4 tablets m 24 hours.
Children 10 to 14 years: 1/2 adult dose:
under 10 years: at discretion of physician.
Coric idin 'D' Medilets: 2 to 6 years:
1/4 to I Medilets: 7 to 12 years: I to 2
Medilets. Each dose may be repeated every
3 to 4 hours, but not more than 4 Medilets
should be gIven m one day to children 2 to
6 years, and 6 Medilets to child:en 7 to 12
years. Li,!,it rreatrrent to 3 days. The recom-
mended dosage should not be exceeded
except on a physician's advise.

[)Ct.1IIlJ mh'rma'uln.... 3\;J:lbhlt." .1'
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SCHERI:'I.G CORPORATlO:-; U\lITI:D
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( PMAC )

NOVEMBER 1974

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1254 BAY ST.
(Just above Bloor) TORONTO

I SCHERING I

Howto'tatch"a cold.

,

Surprise a cold right at its onset with
Coricidin '0' for adults and Coricidin '0'
Medilets * for children. You can recom,
mend these products knowing they will
provide relief from aches, pains and
fever plus decongestant action.
Coricidin '0' and Coricidin '0'
Medilets contain Chlor, T ripolon

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.
COriCidin'D!

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for GROWTH

OPPORTuniTIES

-In kn0ll Jk
:=rl(]ç

In (Jwor0n0.S,
-ln .skills

A New Book!

Story

CAREER MOBILITY: Implementing The ladder Concept In
Associate Degree And Practical Nursing Curricula
An excellent model of the "ladder" concept program, this new book presents
guidelines for adapting existing programs and modifying curricula in institutions
having both Associate Degree and LPN/L VN programs. Course structure,
content and unit hours are completely outlined in useful tabular form. Existing
texts, particularly suited to the program, are cited.

By DONNA KETCHUM STORY, R.N., B.S., M.A. February, 1974. 206 pages plus FM I-XII,
6'%" x 9'%", 9 illustrations. Price, $7.10.

A New Book'

Bregman

ASSISTING THE HEALTH TEAM: An Introduction For
The Nurse Assistant

This new text clarifies the role of the nursing assistant. It includes basic
instruction in anatomy, physiology, vital signs and patient needs. The normal,
healthy person is first examined. Then, the superbly illustrated text considers
the effects of illness on the patient, how illness can be observed, and how to
provide care.

By MARCIA S. BREGMAN, B.S., R.N. May, 1974. 200 pages plus FM I-XIV, 7" x 10",190
illustrations. Price, $6.85.

New 2no Edition!

Lagua et al

NUTRITION AND DIET THERAPY REFERENCE DICTIONARY

More than 3,500 words entries relating to technical and scientific aspects of
nutrition and diet therpay are contained in this compact reference. Encyclopedic
treatment of terms and a dictionary format simplify your search for informa-
tion. Subjects cover dietary standards; basic food groups; classification of
carbohydrates, proteins, and lipids; and more.

By ROSALINDA T. LAGUA, M.NoS.; VIRGINIA S. CLAUDIO, Ph.D.; and VICTORIA F.
THIELE, Ph.D. July, 1974. 330 pages plus FM I-XII, 7" x 10",7 illustrations. Price, $10.25.

New 3rd Edition!

Hoeller

SURGICAL TECHNOLOGY: Basis For Clinical Practice

This new edition clarifies the-basics of operating room technology, from broad
conceptual aspects to application of the latest technical advances. It defines the
technician's role on the surgical team and clearly describes the duties involved.
Highlights of this new edition include: basic anatomy; surgical techniques; duties
of the instrumenter and circulator; patient preparation; and more.

MOSBY

TIMES MIRRDR
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By MARY LOUISE HOELLER, D.C., R.N., B.S.N.Ed.; with 5 contributors. August, 1974.
386 pages plus FM I-XII, 7" x 10", 295 illustrations. Price, $11.50.

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{

DECEMBER 1974

THE CA"'ADIAN NURSE 1

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patieNce aNd uNderstaNdiNg al/lI enr Jr{J

Your Clinic Shoemaker

The
Canadian
Nurse

ð

A month Iv journal for the nurses of Canada published
in English and French editions bv the Canadian Nurses' Association

Volume 70, Number 12

December 1974

15 Caring Begin

in the Teacher-Student Relationship .................. .0. Mesolella

17 ReliefofPai'l in Labor................................. .P.A. Field

24 Admission Unit Dispels Fear of Surgery. . . . . . . . . . . . . . . . . . . .H. Prsala

27 Report:
CNA Directors Meet in Ottawa. . . . . . . . . . . . . . . . . . .N. Blais, A. Hanna

31 Cardiac Unrest

. . . . '.' . . . . . . . . . .J. McLeod

34 Patient's Information Base:
A Key to Care ..........................

. . . . . . . . .L.A. Robinson

37 Mildred Jones Walks Again.. . . . .. ....... ..... . . .. .... B. Burtetal

38 When You Make YourOwnTape ................ ........N.Briant

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

4 Letters 44 Dates
7 News 45 Research Abstracts
40 Names 46 A.V. Aids
42 New Products 47 Accession List

Exe(,utive DlreUor: Helen k. Mu",dlem .
Editor: Virginia A.. Lindahury . AssIStant
Editors: Liv-Ellen Lo(,keberg, Dorothy S.
Starr. Produ(,lIon A"IStant: Mary Lou
Downes. Circulation Manager: Beryl Dar-
ling . AdvertlS,"g Manager: Georgina Clarke
. Subscription Rates: Canada: one year.
$1> 00; two years $11.00. Fore'gn: one year.
$6.50; two years, $12.00 Single copies:
$1.00 each. Make (,heques or money orders
payable to the Canadian Nurses' Association.
. Change of A.ddress: Six weeks' notice; the
old addre" as "ell a' the new are ne(,essary,
together with regIStration number '" a pro.
vmnal nurses' d
"'onallon. when:' dppllcable.
Not responSIble lor lournal, lost '" ma,l due
to error.. in adrlre.-..s

Manuscript Information: "The Canad,an
Nurse' welcomes unsoliCited. article' All
manuscnpts should be typed. double-,paced.
on one Sid.. of unruled paper leaving' wide
margins. Manuscripts are accepted for review
for exclusive publi(,ation. The editor reserves
the nght to make the usual editorial changes.
Photographs (glossy prints) and graphs and
diagrams (drawn in India ink on white paper)
are welcomed with such art Illes. The editor" not
committed to publish all arlldes sent
nor to indicate definite date, of public ation.
Postage paid '" cash at third lIass rale
MUNTREAL. P.Q Permll No. 10001
50 The Driveway, Ottawa Untano K2P 1 E2

Canadian Nurse, Assouation ''174

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DECEMBER 1974

letters

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letters to the editor are welcome.
Only signed letters, which include the writer's cümplete address,
will be considered for publication.
Name will be withheld at the writer's request.

More about office nurses
I wish to reply (0 the lener' 'RNs belong in
doctors' offices" (Aug. 1974). Graduate
nurses are essential in a doctor's office. It
is ironic that, although nurses feel they
must give unquestioning devotion and
support to all doctors, some of these very
doctors will use lay staff to do a nurse's job
if it is cheaper. When the MD needs a
trained nurse's assistance, he can use the
nurses in the emergency departments of
the hospitals - free.
A graduate nurse with a B.Se.N. degree
who has been inactive for five years is
required to take a refresher course of some
duration and at considerable expense to
nurse again. She also has to pay fees to her
nurses' assOl:iation. Isn't it wrong that a
person with no medical training should be
able to take a job in a doctor's office and be
trained on the job?
These lay persons are giving injections,
doing "pap" tests, and other medical
treatments that graduate nurses are not
legally allowed to carry out.
If there is no need for a nurse to be
trained, we should stop fooling ourselves
and stop wasting time and money on train-
ing. If there is a need for a nurse to be
trained. then nurses should have the sup-
port of their professional organization and
the medical profession to maintain a high
standard of patient care.
Perhaps nurses should he required to
display their certificates of qualification
(as do other professionals) before a patient
is subjected to treatment in a doctor's of-
tïce. - Margaret Fredeen, B.SeN.,
Sa.\'katoon, Saskatchewan.

Aerosol sprays dangerous
As nurses concerned about public health,
we should all be aware of the ecological
damage that the use of aerosol sprays is
apparently doing to our environment. A
recent article in Time states that the gases
used in aerosol spray containers are
proven contributors to the reduction of the
ozone level that surrounds our atmos-
phere.
I have never been a spray user, but was
prompted to write this letter after attempt-
ing to buy my familiar white liquid shoe
polish and tinding it now neatly "aerosol
containerized!" Whatever happened to
the simple things'! As consumers, should
we accept these changes without some
thoughtful investigation'! - Thelma J.
Clarke, Victoria, B.C.
4 THE CANADIAN NURSE

Against smoking
Marc Lalonde made a number of com-
ments in your magazine about health care
and smoking. (January 1974, p. 19.) I am
pleased that he is concerned about this
issue and the issue that I feel is related: the
rights of the nonsmoker to a smoke-free
environment.
Research has clearly shown that the ef-
fects of tobacco smoke are not limited to
the smoker, but may have many unpleas-
ant and/or deleterious effects on the non-
smoker who is passively breathing the
same smoke. Montreal's Society to Over-
come Pollution (STOP) has been one group
that has documented this in a paper I
helped produce, entitled ' 'Tobacco Smoke
Pollution. " (Available at 50c per copy,
from STOP.)
While I was involved in the research for
this work, I became concerned about how

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BEING MARRIED?

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otherwise you will likely miss copies.

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From Your Last Issue
OR
Copy Address and Code
Numbers From It Here

NEW (NAME) IADDRESS:

Street

City

Zone

Prov.!State

Zip.

Please complete appropriate category:
D I hold active membership in provincial
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reg. no.!perm. cert.! lie. no.
D I am a Personal Subscriber.
MAIL TO:
The Canadian Nurse
50 The Driveway
OTTAWA, Canada K2P IE2

this information affected people who use
health care facilities. I do not have infor-
mation on facilities outside the hospital,
but the situation within Montreal hospitals
does not at present seem very bright. This
may change, as we are presently undertak-
ing a public campaign for segregated
smoking areas in Montreal's health care
facilities.
At present, however, no hospital seems
to have segregated smoking facilities.
That is, they do not limit smoking to
specific, enclosed areas. Many hospitals
do not appear to have any regulations at all
about smoking, other than those required
by law for safety reasons. Still others may
have regulations. but they are not enforced
vigorously.
I would be interested in hearing from
nurses in all parts of Canada about what is
happening in their area. I am interested in
all aspects of health care. Does your area
have well-established policies'? Are there
problems in enforcement'! Are staff mem-
bers who smoke willing to cooperate in
these policies'? Are any attempts being
made to provide tobacco-free inpatient
rooms for multi-bed units'? I would be will-
ing to write up the responses I receive to
these and other related issues. -Rosalind
Paris, B.Sc.N., Chairperson, Tobacco
Smoke Pollution Committee, 2052 Ste.
Catherine St. West, Montreal, Quebec.

Accepts challenge for fitness
The Canadian Nurses' Association resolu-
tion "to explore ways of developing a
plan of action to sensitize nurses to
life-styles conducive to optimum health"
("Stand up and be tested!" Septembcr
1974, page
S), aroused my intcrest.
Such an awareness promotes physical
fitness and involves a personal commit-
ment to change in life-style by the nurse.
In today's society, with its emphasis on
passivity and sedentary living, many
Canadians are unfit and overweight.
Health Minister Marc Lalonde rec
ml-
mends, in A Ne>>' Penpective on the
Health of Canadians, that the public
accept more responsibility and become
more active in matters affecting their
health, I agree that Canadians need to be
motivated to take part in more physical
activities.
This challenge can be met by the nurse
in her role in the community. She brings
to the situation an awareness 01 her own
lïtness, added to her skills in assessing,
DECEMBER 1974

counseling, education, and knowledge of
physical and social sciences. Within her
realm are the solutions to the problem of
Canadians' lack of physical fitness: pub-
lic health education. health promotion.
and health maintenance.
As a founh-year nursing student at the
Universit} of Calgary. I accept the
challenge for fitness - both personally
and professionally. Parry Spice,
Calgary, Alherta.

POSEY FOR PATIENT COMFORT

The new Posey products shown
here are but a few included in the
complete Posey Line. Since the
introduction of the original Posey
Safety Belt in 1937, the Posey
Company has specialized in
hospital and nursing products
which provide maximum patient
protection and ease of care To
insure the original quality product,
always specify the Posey brand
name when ordering.
The Posey "Swiss Cheese" Heel
Protector has new hook and eye
fasteners for eaSY-application and
sure fit. Available in convoluted
porous foam or synthetic fur lin-
ing. #6121 (fur lining), #6122
(foam), $5.40/pr.

Problem getting degree
I read with great interest the letter from
the RN in Edmonton r:::garding her efforts
to get her degree in nursing (Letters,
Sept. 1974). Apart from a few differ-
ences, her experience along those lines is
so similar to mine that I almost thought I
had written it.
Initially. I was very enthusiastic about
getting my degree in nursing. But. before
I became too fru!,trated in my efforts, I
decided to channel my enthusiasm into
something equally challenging, and have
found it very worthwhile. HoweveL I
occasionally have a faint twinge of regret
that my original enthusiastic effort came
to naught. - Marcella Stel'e1ls-Guille,
Edmonton, Alherta.

.
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More response to editorial
This is my reply to your editorial in the
August. 1974 issue. I would like to read
more articles of educational value. For
example. r d prefer to read case studies;
reports on conditions. drugs, and so on;
and new concepts in nursing approaches
or educational techniques, rather than
"interest" reading matter. such as nurs-
ing in Cuba or northern Canada, or
"surveying the nation's nutrition. "
I suggest that vou delete the section on
"names."' I sometimes get the feeling
that I subscribe to a gossip magazine
rather than a professional one.
News, books. and so on keep us in
touch with current happenings and litera-
ture, which are vital to a professional.
I must admit that I find NursinR 74 and
the American JournaL of Nursing superior
maga/ines in my position as a prac-
tical nurse instructor. - Anne Luke.
Montrose, British Columhia.
..

The Posey Foot Elevator protects
pressure sensitive feet by keeping
them completely off sheets. A
washable flannel liner protects the
ankle. Soft polyurethane foam ring
with slick plastic shell allows pa-
tient to move his foot freely.
#6530 (4 inch width), $8.70.

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The Posey Foot-Guard with new
'T' bar stabilizer simultaneoUSlY
keeps weight of bedding off foot,
helps prevent foot drop and foot
rotation. #6412, $23.10.

..

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,

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The Posey Elbow Protector helps
eliminate pressure sores and fric-
tion burns. Three models are avail-
able. #6220 (synthetic fur w/out
plastic lining), $6.00/pr.

The Posey Ventilated Heel Pro-
tector helps prevent friction and
skin breakdown while allowing
free movement. The newly devel-
opei closure holds hee l protector
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news

Federal Nurses' Dissatisfaction

Is Defi ned I n Recent Study

Ottawa - :\Iurses employed in the federal public service show "a serious amount of
dissatisfaction." an occupational study of these nurses concludes. The greatest dissatis-
faction expressed by the nurses concerns salary. followed by concern about whethertheir
skills are being properly used and about their opportunities to progress in their careers.
Concerns expressed to a lesser extent
\\-ere in relation to the opportunity for
professional development. nur!.e/man-
agement relations. quality of supervision.
and the physical \\-ork environment.
An Interdepartmental Comminee on the
Nursing Group \\-as !.et up to conduct this
stud} after an arbitral award in October
1973 met \\-ith strong protest by federal
government nurses. Members of the
committee included three nurses:
Huguene Labelle. principal nursing of-
ficer. Health and Welfare Canada: H.
\1cDonald. nursing officer. medical ser-
vices branch. Health and Welfare Canada:
and V. Rivard. director of nursing. Queen
Mary Veterans Hmpital. \10ntreal.
The committee's 44-page report. re-
leased in August 1974. recommend
ways
of dealing with nursing problems. For ex-
ample. concern v. as expressed by nurses in
ho
pital positions (who represent 75 per-
cent of federal nurses) regarding their need
to spend time doing clerical \\-ork. clean-
ing. portering. and the work of nurses'
aides and orderlies.
The report recommends that. where
possible. nurses' time should not be spent
on such nonnursing dutie
: rather. work
units should be staffed in a way that pro-
vides an appropriate combination of nur!.-
ing and other skills.
But, "where a nur
ing unit i
too small
or isolated to be provided with administra-
tive and other ,upport staff. and the sup-
port is not available locally. .. the commit-
tee
ays consideration 'ihould he given to
planned visits of
upport service person-
nel. arranged at the zone or regional level.
Another problem mentioned in the re-
port concerns con
ultants. "Thc duties.
responsibilitie
. and authorities of nurses
engaged as consultants in planning. re-
search. or evaluation appear to need
clarificdtion so consultant
may operate
more succe
sfully as part of the manage-
ment team."
Although the
ubJect of nurse-
DECEMBER 1974

management relations ranked hUh In order
of areas drawing critical comment. the
committee savs "it deserves careful atten-
tion. particuÍarly since it represent, un-
favorable comment from nearly half of
those who responded. . . ."
According to the report. the nurses gen-
erally believe that management is respon-
sible for their having to perform non-
professional duties. for failing to encour-
age and maintain recognition of nursing as
a profession. and for not protecting nurses
from having to assume doctors' respon-
sibilities.
The comminee's respon
e to this in-
cludes the suggestions that:
. greater effort he made to improve com-
munication between management. ad-
ministration. and nursing:
. attempts be made to familiarize the nurs-
ing staff with principles of management
and the process of budgeting of resources
- both financial and human: and
. managers be encouraged to v.elcome the
ideas of nurses in the planning. organiza-
tion, and operation of health services.
Management is also called on to "rec-
ognize the ,trong potential of some profes-
,ional nurses as candidates ,for training and
promotion into administrative and other
areas of employment." This recommenda-
tion in the report relates to the nurses'
evaluation of the current situation regard-
ing career progression: 46 percent con
i-
dered it poor, and 38 percent considered it
good.
An interesting comment on
alary i

made in the report. "Salary ranked sixth
among the factors that influenced nurses to
join the federal service . It was. how-
ever. the area in which expectations were
'least well met' after nurse
had joined the

ervlce.
These nurses believe their salaries "are
not comparable to the outside sector. and
identify salary a
the factor most detrimen-

tal to the image of nursing in the federal
government. "
The report of the interdepartmental
comminee is based on information from
1.089 questionnaires completed by nurses
and 351 individual. face-to-face inter-
vie\\-s with federal nurses.

CNF Directors Propose Changes
In Fee, Board, Committee Size
Ottawa - Directors of the Canadian
Nurses' Foundation. (CNF) reaffirmed
their belief that the Foundation is viable.
and proposed changes to make its opera-
tion more efficient. The CNF board met in
Onawa 22 October 1974.
Bylaw changes will be presented to
Foundation members at the annual gen-
eral meeting in April 1975. to be held in
conjunction with the Canadian Nurses'
Association annual meeting in Ottawa.
The proposed changes include: raising
the Foundation's regular membership fee
from $5 to $10: reducing the size of the
CNF board of directors to 5 from the
present 9. and providing for directors to
be chosen from C"-IF membership: and
reducing the size of the selections com-
minee. which a\\-ards CNF scholarships.
to 3 members from the present 7.
At the CNF annual meeting in Winnipeg
19 June 1974. CNF members passed a
resolution a...king the CNF directors to
propo'ie changes required to reduce costs.
and to reviev. membership structure.
board structure and activities. and ad-
ministrative policies and procedures.
(News. Augu'itI974. page 7.)
A 'itreamlined procedure for handling
CNF scholarship applications was ap-
proved b} the directors at the October
1974 meeting. All documents will be sent
to an applicant in re
ponse to her request
for funds: it will he the applicant's
re
ponsibility to return the necessary
fonns \0 the CNF.
"This is expected to cut down signifi-
cantl} on CNF expenses," Barbara Ar-
chihald. assistant secretary-treasurer of
CNF. told The Canndian Nurse.
Officers of the CNF board for 1974-5
are: Helen Taylor. Montreal. president:
Marilyn Riley. Halifax. vice-president:
and OJA Executive Director Helen K.
Mussallem. secretary - treasurer. Direc-
tors learned that the capital trust fund
amounted to $68.429.99. as of 10 Oc-
tober 1974.

THE CAr.ADlAN NURSE 7

Thc scholarship fund. from which
aw,ifd.. are made until the income from
the capital trust fund will provide scholar-
ships. ",as $37.148.49. on 10 October
1974.
"There will definitely be scholarshi ps
a\\arded in 1975,"' Archibald said.
.. Based on information from nurses
across the country. they believe the
Foundation is important in providing the
means to enable nurses to return to
university. The eNF directors believe
nurses should encourage eaeh other by
maintaining membership in the Oil'. We
hope more nurses will become eNF
mcmbers." eN
President Helen Taylor
told The Canadian Nurse.

Cardiovascular Nurses Reelect
Officers At 2nd Annual Meeting
WinnipeR, Man. - At its second annual
mceting. held 16 October 1974. the
Canadian Council of Cardiovascular
Nun,es (CCCN) reelected E. Joan Breakey.
Toronto. as chairman for 1974-5.
The eeCN annual meeting and scien-
tific sessions \\ere held in conjunction
with the Canadian Cardiovascular Society
and the Canadian Hean Foundation.
15-19 October at the Winnipeg Inn. The
nurses' group is a council of the Canadian
Heart Foundation.
eeCN members also reelected the treas-
urer. Jane G. Wilson, Toronto, and the
recording secretary. Cecile Boisvert.
Montreal. Carolyn J. Stock welL Wind-
sor. Ont.. was elected vice-chairman. and
Marielle Hubert. Sudbury. Ont.. was
named membership secretary. All posi-
tions were filled by acclamation.
In her report to the eeeN annual
meeting, Breakey said the priority of the
council in 1974-5 will be continuing
education for nurses. In an interview. she
told The Canadian Nurse that the council
has recently appointed a representative to
the Canadian Heart Foundation's profes-
sional education committee. This group
fosters continuing education for profes-
sionals. at the provincial level.
Wilson. in the treasurer's repon.
pointed out that all administrative costs
associated with the council's activities
were paid by the Canadian Heart Founda-
tion. ceeN annual dues of $10 per
member cover costs of board and commit-
tee meetings. and the annual meeting.
including simultaneous translation and
travel expenses of provincial representa-
tives to the annual meeting.

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8 THE CANADIAN NURSE

The eee," research committee reponed
to the annual meeting that it believes
"nursing research directly related to
patient care and clinical nursing problems
should have top priority. in contrast to
studies related to nurses themselves. for
example. learning needs of nurses in a
panicul,if ..etting. All aspects of care -
acute, preventive. rehabilitative - and
nursing care for all age groups ..hould be
studied. ..
Membership in the eCCN is open to any
registered nUPie who is interested in
cardiovascular nursing. The council has
about 400 membcrs at the present time.
Provincial representatives for the COI11-
ing year are: Shirley Stokes. British
Columbia; Magin Dixon. Alberta; Toni
Beerling. Saskatchewan; Marilyn
Whitely. Manitoba; Leslie Key. Ontario;
Hélène Milot. Quebec; Peggy Howell.
New Brunswick; Jean Petrie. Nova
Scotia; Judy Lougheed. PH; and l\1argaret
Burke. Newfoundland.

N.B. RN Was Not Negligent
Supreme Court of Canada Rules
Ottawa - In an unanimous judgment
handed down 1 October 1974. thc Sup-
reme Court of Canada ruled that a New
Brunswick nurse was not negligent when
she injected two cc. of Bicillin into the
deltoid muscle of a patient's left arm.
(News. January 1974. page I
).
The Supreme Court judgment reverses
the decision of the Appeal divi'iion of the
Supreme Court of Ne\\ Brunswick. \\ hich
ordered Cheryl Wilcox to pay the patient
$49.321 in damages.
Wilcox. an RN at Saint John General
Hospital when the alleged negligence oc-
curred. had been instructed by the doctor
who treated the patient for pneumonia to
give the injection. The patient later de-
veloped gangrene on the fingers and
thumb of his left hand; pan of the fingers
and most of the thumb had to be ampu-
tated.
Whereas the N. B. appeal division found
sufficient evidence to support the conclu-
sion that the gangrene would not have de-
veloped in the absence of error in adminis-
tering the injection. the Supreme Court of
Canada said in its judgment . "there was
ample medical evidence to support the
finding that the injection was given with-
out any fault on the part of Mrs. Wilcox."

Nursing Students Can Write Exams
After 2 Years in UBC Degree Program
Vaflcmü'er, R.C. - The University of
British Columbia has announced that stu-
dents who complete the first two years of
the ne\\ four-year baccalaureate program
in the school
f nur'iing can become regis-
tered nurses.
This is now pos'iible because thc Regis-
tered Nurses' Association of British

Columbia has given its approval for stu-
dents, who have completed the two years.
to write the examinations for registr
tion.
Muriel Uprichard. director
of uSCs
school of nursing. said she was delighted
with RNASCs approval. She noted that.
because the new degree program only
qarted in the fall of 1973. students will not
be able to write the f{\;ABe exams before
the summer of 1975.
The UBe school of nursing has received
morc than 300 applications from RNs \\ ho
want to enter the third year of the new
program. Uprichard said.
After examining the new UBe nursing
program. R'\JASCs committee on approval
of schools of nursing said it was" impres-
sed and excited by the fashion in which the
whole program is developing." and that
nurse., graduating from this program
would be watched with interest.
The program''i aim is to prepare ..tu-
dents for work in community and prcven-
tive health care. and hospital care for acute
and long-term illness.

McGill Sets Up Research Unit
in Nursing and Health Care
M()ll1real, Quehec - The school of nurs-
ing. McGill University. has recently re-
ceived a National Health Grant to set up a
research unit in nursing and health care.
The main concern of the unit is the de-
velopment. study. and evaluation of
nursing's expanded functIon in health care
and its provision. particularly in primary
care settings.
Under thc research unit. demonstration
projects in various settings will study the
function that nursing can perform and the
.. interlocking nature of roles that nurses
with different types of basic preparation
undertake in accomplishing this func-
tion, .. according to Dr. Moyra Allen. pro-
fessor in charge of the research unit.
The McGill unit will recruit researchers
to participatc in a multidisciplinary ap-
proach 10 health problems. It will also give
and receive consultation. develop inter-
professional and interdisciplinary research
studies. and coordinate research functions
in the health care field. which have par-
ticular relevance for nursing.
The National Health Grant will be used
to employ staff for the operations and
management of the research unit. includ-
ing technicians to video-tape nursing in ih
variou'i roles (to be used as research pro-
ject data). and to develop kdrning re-
sources for preparation of researchers.
Allen invites nurse clinicians or nurse
researchers who wish to participate in
health care research to contact the research
unit.
Effective September IY74. the master's
program at McGill nursing school was re-
vised to offer two options: nurse clinician
and nurse researcher. (Ncws, January
1974. page 15.)

DECEM8ER 1974

Systems Approach To Integrate

Health Care: Science Council

M01lfreal, Quebec - At the U. of l\10ntreal 16 October 1974. the Science Council of
Canada introduced its Report No. 22, "Science for Health Services." at a gathering of
representatives of professional organizations. labor unions. university faculties, scien-
tists. and the public. Huguette Labelle. C'IA's president. presented the CNA response to
the I 44-page report. Highlights from the association's response are printed on this page.
The Science Council report's first re-
commendation is that health care in
Canada be reorganized into an integrated
system with the utmost practical speed.
using a systems approach.
According to the report. "satisfactory
health indicators . . . are essential for the
proper application of the systems concept
that would lead to the optimum develop-
ment of health care." It calls for present
work on health indicators to be intensified
to identify and begin use of improved indi-
cators.
The report notes that "classic health
indicators have been life expectancy and
maternaL neonataL and infant mortality
rates . . . . There is a need for a set of
indicators representing various hcalth
problems amenable to health care. which
can be used for monitoring the effective-
ness of the health care sy
tem in greater
detail.
"The health indicators that have been
used in the past fail almost totally to meas-
ure the state of a nation' s health in terms of
emotional and social effects of illness or
death."
The Science Council report says: "The
satisfactory evolution of the health care
system that we envisage will require the
development of computer-based health in-
formation systems." It recommends the
development of standardized health (in-
cluding health care) records as a prercquis-
ite for a computer-based health informa-
tion system.
The report sa}s the t\\;O common objec-
tions to such a system are based on two
misconceptions: fear of invasion of pri-
vacy. and fear of amount of v. ork and cost
to place all health care records in elec-
tronic storage. The report says. "At pres-
ent. more people suffa from lack of in-
tonnation about their health problems and
their treatment. for example. drug reac-
tions, than from improper disclosures of
health information."
The question of cost is ans\\ered b} the
repon: "The information that is alread}
routinely stored on computer tapes for ac-
counting purposes \\;ould be sufficient for
a verv useful health information system. if
it w
re more accurate mcdicall
than is
needed for accounting. and if belier provi-
sions were made for linking records from
different sources pertaining to one person.
or relatcd records pertaining \0 different
persons. for example. relation by common
DECEMBER 1974

disedse. occupation. neighborhood, or by
familv relation.'-
Th
repon recommends that immediate
steps be taken on a national level to put
into linkable form all records of birth. am-
bulatory care. hospitalization. and death in
Canada.
The repon states that a further redefini-
tion of the roles of health personnel is
required. \\;hich would reduce the formal
restrictions of the services that can be per-
formed by the various personnel. More
emphasis should be placed on the know-
ledge and skills gained as a result of con-
tinuing education and inservice training.
the report says.
It also recommends expansion of the
roles and responsibilities of public health
personnel. and integration of their work
v. ith other health personnel and services.

The repon supports the selection of
community hedlth centers as a "major
vehicle for the operational testing of vari-
ous new approaches to health care practice
and administration." It notes that such
testing should be carried out on a much
enlarged scale if significant progress is to
be achieved.

N.S. Nurses and Administrators
Get Together at Summit Conference
Greenwich, N.S. - Directors of nursing
and administrators from 33 Nova Scotia
hospitals worked together at a summit
conference 25-27 September 1974. This
was the first meeting of its kind held in
the province.
In a final recommendation, the group
called for its concerns about the lack of
coordination among training programs for
nursing care personnel. the lack of com-
munication between health services
groups. and the lack of continuing educa-
tion programs in small hospitals to be
communicated to the health manpower
committee.
Some 60 persons participated in the
conference. sponsored by the Registered
Nurses' Association of Nova Scotia and
the Association of Hospital Adminis-
trators. On hand to assist the participants
were resource persons from the Leader-
ship Institute of Holland College, Char-
lottetown. P.E.I.

(Conlinued on paRe 12)

CNA Response to Report No. 22

The Canadian Nurse,,' Association supports the following general principles con-
tained in Report No. 22. "Science for Health Services." that:
. health care in Canada must be reorganized into an integrated system;
. more attention should be given to the protection of health;
. an increase in the funding of health care research is indispensable; and
. a major research and development effort is needed in the area of promotion and
maintenance of health.
The Canadian Nurses' Association would like to point out. hov.ever. that. while
the Repon sets out to describe the requirements of health care and the shortcomings of
the present structure. the solutions it suggests do not address the fundamental
problems.
CNA would have liked to be presented with analysis and recommendations that deal
more specifically \\;ith, for example:
. the problems l!f accessibility and use of resources. which are treated only at the
level of general principles;
. mental health. which receives perfunctory attention; and
.the clients' point of \Îew. v.hich is lacking.
C"A notes that the report is not consistent in giving a \\; ide and general meaning to
"health CdfC delivery." The Report states that the terms "health care delivery" will
be used" . . . in their broadest meaning, extending far beyond the treatment of
sickness and even medical care in general. .. It soon becomes evident that these good
intentions do not inspire the authors throughout the Report.
The entire section on health information systems is based on the problem-oriented
approach. the medical record, and so on. Even the recommendation on health
education is supported by such considerations as patients' compliance with therapeu-
tic rcgimen. The research problem in this area is defined as' 'finding the determinants
of unhcalthy behavior."
The Association recognizes the usefulness of the application of science and
technology to the health care system, along the lines suggested in the Report.
Hov. ever. C:'I;A hesitates to endorse the use of a single approach to solve all the
problems of the health care system.

THE CANADIAN NURSE

9

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Health System Changes Discussed
At Nursing Admin. Section, OHA
Toronto, Onto - Change!. in the health
care system. which will benefit the
patient. were discussed at a meeting of
the Ontario Hospital Association (OHA)
section of nursing administrators on 29
October. The OHA met at the Four
Seasons Sheraton Hotel in Toronto 28-30
October 1974.
"In a publicly funded health care
system. every patient and eve!) health
professional has a responsibility for the
education of health professionals. There
can be no two-class system of teaching
and nonteaching health care facilities.
"By basing education for doctors and
nurses throughout the health care system.
everyone benefits except possibly the
health care administrator - who loses hi!.
own power base:' Dr. Fraser Mustard
told the nursing administrators' section.
Mustard is dean of the medical faculty.
McMaster University, Hamilton, Ont.; he
was chairman of the provincial
government's Task Force on Health Ser-
vices in Ontario, v.hich produced the
"Mustard Report."
He said that a patient seeks certain
benefits in a health care service; among
the!.e are: that it is covered by insuranc

so that health care costs him nothing at
the time it is provided; that someone
shows concern for him as an individual by
providing communication and making it
easy for him to gain access to the system;
and that there is continuity in care.
.. Public expectations are a tough
issue:' Mustard said. Changes in the
health care system require g
ouping of
health professionals to provide com-
prehensive health care. "Where such
groupings have been tried, there is no
problem with acceptance of the primary
care nurse. If the group is bIg enough. it
can include a physiotherapist. a denti
1.
and a pharmacist," he said. Such a
grouping provides acces!.ible. continuou

care that can be compassionate if group
members wish to make it so.
Mustard said the patient can benefit if
the community shares in such changes,
and if the health professionals accept their
role change.
"Nurses may not have the same blin-
deD> as doctors: but we need to look at the
skills of others and our own best contribu-
tion." Laura Barr said. Barr. executive
director of the Registered Nurses' Associ-
ation of Ontario. was a member of a panel
of nurses re!.ponding to Mustard'!. re-
marks.
Re
earch is an important aspect of the
Mustard report.
he pointed out. and
12 THE CANADIAN NURSE

] nurses must support the development of
more nurse-scientists, and must gain
pmct'" in ,,"In"'ng "nd ",ing re"",,,h.
Another panel member, Kay Marshall,
saw problems for the secondary sector,
such as hospitals. "Money is limited;
when emphasis moves to preventive
health care, funds must come from
hospitals." Marshall is director of nurs-
ing. Belleville General Ho
pital.
There will be a time overlap, she
aid.
.. We may change life-style of young
people and children, but it will take a
generation. In the meantime. we must
provide both preventive and acute health
care. "
Marshall said it is difficult for the
community to plan for centralized health
services; it must be done from above. "It
is time for the body politic to stop
appeasing everyone and make decisions
that will be good for the health of
Ontarians," she !.aid.
"Where does the nurse in a health care
setting such as those envisioned in the
Mustard report get support and guidance
with nursing problems?" asked Mary
Bawden, the third panel member. Other
health professionals can give support in
many areas. but the nurse needs the help
of other nurses, tüO.
"We need a technical structure to
provide communications between the
nurses in health group A and those in
group or community B," she said.
Bawden is nursing team leader at Univer-
sity Hospital. London, Ont.

Patient Education is Theme
Of CCCN Scientific Sessions
Winll/pel?, Mon. - Scientific sessions of
the Canadian Council of Cardiovascular
Nurses. (CCCN) held 16 October. 1974.
centered on patient education.
Barbara Redman, professor and as-
sociate dean of the U. of Minnesota
school of nursing, Minneapolis, Minn..
said patient education is becoming a
specific part of nurse practice legisla-
tion. a part of care for which nurses are
accountable. We need to develop stan-
dards of care in patient education. !.he
said.
She described 3 levels of patient
education that she has defined tentatively
a!. acute education needs, preventive
education needs. and maintenance educa-
tion needs.
An educational need is acute when lack
of understanding is causing psychosocial
anguish and/or physical danger. she said.
Preventive education needs are present
when a condition of considerable threat is
highly likely to occur to an individual or
group who have little skill for handling it.
Needs for maintenance education occur
as persons living with medically derived
alterations in their living patterns require
continuing learning, or a!. normal de-

velopmental alteration.; occur.
"We are more liable to malpractice for
omission of a!.!.essment of learning needs
than for commis
ion of errors in- teach-
ing," Redman said. "The confusion
about patient education nur
e!. have is
common to other health disciplines. Nurs-
ing is in a position to provide leader
hip.
"Nursing i!. vulnerable. We have ad-
vertised ourselves as providing the
psycho
ocial component of care. Do we
deliver it?"
Nicole David. associate profe
sor at
the U. of Laval school of nursing,
Montreal. discussed preparing childr;n
for .;urgery. A teaching program mu!.t he
adapted to the child'!. developmental
level.
he said. A child of 3 years or less
is prepared only the day before
urgcry. It
is more important to !.ay who will be with
him on his way to the OR and in the OR
and RR. than why certain things are done.
A child of 4 io 7 years ca';- be prepared
over 2 or 3 days. David
aid. The
predominant facto'r for this age i!. why
each procedure is done. .. He needs a
concrete ansv.er to a concrete que!.tion,"
she said. "Otherwise. he will !.upply hi

own answer. ..
Children of 8 years and over need
explanations involving anatomy and
physiology: they have a desire to learn
and to master knowledge. Their pal1icipa-
tion must be empha
ized; children of thi

age fear Ims of control over themselve

and the situation. David caulioned her
audience not to forget the second stage of
teaching: to have the child transmit the
information back to the nUl'ie
o she can
correct any misinformation. When the
child makes additions and comments in
his return of teaching. he v. ants a
response, perhaps a correction of his
fantasie
. David 'iaid,
In a workshop on 18 October, Joan
Breakey. Toronto, discussed use!. of the
intra-a()rtic balloon pump in treatment of
cardiogenic
hock. The device is
patient-dependent. triggered by the
patient's KG and timed by peripheral
arterial pressure. The pump is used as
emergency treatment and has its max-
imum effect in 36 hour
.
The three-segmented balloon is in-
'ierted into the aorta through a cutdov. n in
the femoral artery; when the pump is
triggered, the balloon fill
v. ith helium,
the middle segment filling first. and then
the two end sections. The balloon pre-
vents back-flow in the aorta and augments
dia
tolic pre!.
ure. forcing blood into the
extremitie
and the coronary arteries. It
deflates just before systole.
For the pump tõ be effective, the
patient mu
t have an aortic valve that
function!. ....ell, an ECG
trong enough to
trigger the device. and peripheral pres
ure
for timing it. The intra-aortic balloon
pump is u
ed to support patient!. v.ith
myocardial infarction and un
table an-
gina. Breakey said.

DECEMBER 1974

Today's Youth Independent
And Thoughtful, Spock Tells OHA
Toronto, ant. - Dr. Benjamin Spock,
noted pediatrician and author of Baby alld
Child Care, told a general session of the
Ontario Hospital Association (OHA) that
youth today is "cxtraordinarily indepen-
dent and thoughtful of others." The OHA
met in Toronto 28-30 October 1974.
"One thing the adolescent insists on is
that he not be associated with children."
Spock said. Hospitals should have
facilities specially for this age group, he
said.
He also advised hospitals to reach out
to the community and to invite youths to
volunteer their services to hospitals. . 'It is
valuable for them to be in the world and
serving people, and not only in school."
he said.
''I'm thankful we've got this genera-
tion of young people, of whom a fair
proportion are willing to look at problems
and seek answers'" Spock said. Few
youths today are willing to be political
activists. he said: they are impatient for
quick results and are not convinced of the
efficacy of political activism. "The phase
of 'to the barricades' has passed: there is a
swing to the center, but I hope the idealism
is not gone."
Sinc'é he retired from the medical
faculty of Western Reserve University in
Ohio, U.S.A.. in 1967. Spock describes
himself as .. a full-time political person.
associating with youth much of the
time. ..

Montreal Area Nurses Vote
To Switch Union Affiliation
Montreal, Que. - The 4,500-member
Montreal Nurses Alliance (MNA! voted on
October 3. 1974. to disassociate itself
from thc Fedération des Affaires Sociales
(FAS) and join the Fédératiun des Profes-
sionnels Salariés et Cadres du Quéhec
(FPSCQJ.
This decision results from alleged
interference by thc fAS in an attempt to
weaken the MNA as an independent union.
and the opinion that the intcrests of the
:\INA would be better served by the FPSCQ.
Memhers of the FAS are largdy nonmedi-
cal hospital employees, v. hilé the FPSCQ
counts governmcnt professionals, such as
lawyers. engineers. social \\<orkers, and
physiotherapists. among its members.
Both groups belong to the Confederation
of National Trade Unions (CNTU).
According to the \IN..... the October
referendum is only a tïrst step. Separation
from the FAS requires an appe.!1 to the
national officc of thc ("'\iTU to discuss
methods of transfer and to request an
amendment of M:-JA'S conslitulion.
A document madc public al the time of
the rderendum reaftinns \1
A's contÏ-
dence in, and its intcntion to stay v. ithin
thc framework ot the C'\iTU.
DECEMBER lq74

CAUSN Tests Tool To Evaluate
University Nursing Programs
Ottawa - The Canadian Association of
University Schools of Nursing (CAUS"I)
agreed, at a council meeting held in Cal-
gary 9 October 1974, to test the critcria it
has developed to evaluate university nurs-
ing programs.
The 6 members of the CAUS"I accredita-
tion committee will act as aClTeditation
visitors for the first test. They are: Susan
French. McMaster: Elizabeth Logan and
Moyra Allen, McGill: Jeannine Beaudr).
U. of Montreal: Caroline Pepler. U. of
New Brunswick; and Pcggy-Anne Field,
U. of Alberta.
"The trial run of the evaluation tool will
be held before Christmas'" Eileen Moun-
tain. CAUS
's execulive secretary, told
The Canadian Nurse. Shc said several
university schools volunteered to help test
the evaluation tool. and an unnamed
school was selected.
"CAüS
plans to share its findings with
nurses as rapidly as possible." Mount.!in
said.
The CAUSN council met during a joint
meeting of 5 university health associa-
tions, held at the U. of Calgary Health
Sciences Centre. 5-9 October. Over 350
persons attended the one and one-half
days' joint meeting on the theme. "Re-
sources, responsibilities. and education."

Joining with CAUS:-" wae Canadian as-
sociat
ms of: medical colleges, teaching
hospitals. deans of pharmacy. and univcr-
..ity schoob of rehabilitation.
C .'\US:-; officer!'> forthe next 2 \; cars ""ere
electcd during the October council meet-
in!!. Ruth l\1cClure. U. of Alherta. is
CAl'S'\i president for 1974-6. Other offic-
er.. are: Dorothy Kergin, \k\laster.
vice-president: Elizabeth Logan. \1cGill,
pa<;t president: Arlene Aish. Queen's.
treasurer; and Colleen Stainton. U. ofCal-
gary, secretary.
In addition to CAUSYs officer... its
council ineludes the dcan or director of
each university school of nursing, chair-
men of CAUS"I committees. and the presi-
dent and one other member from each reg-
ional group.
Presidents of C ....US:-J.s 4 regions are:
Marlenc Weese. U. of Saskatchev.an.
v. estern region; Mane LO'oer. U. of Ot-
tawa. Ont
rio region. Coícttc Gendron.
Laval. Quebcc Region: and Jacqueline
Legcr. U. of Moncton. Atlantic region.
C....L.S"I committees include: constitution
and bvla\\;s. chaired b\ JOY Winkler. U. of
Maniíoba; accreditãtio
. \\ ith Su..an
French. McMaster. a.. chairman; and an ad
hoc committee on structure. chaired by
Joan Gilchri..t. \1cGill. C .'\L'S'\ \\; ill abo
have a sludies committee. \\ hose chairman
has not yel been chosen.

I
( '

=- "I I.. i
)

S,-)

"There's a guv outside who ".mts to presl'nt the hospil<ll wilh .1 m'\\ \\ing."

THE CA ADIAN NURSE 13

CANADIAN NURSES' ASSOCIATION
ASSOCIATION DES INFIRMIÈRES CANADIENNES

INDEX
of Canadian Nursing Studies

,

,
REPERTOIRE
des études canadiennes
sur les soins infirmiers

Compiled by CNA Library
Compilé par Ia bibliothèque de I'AIC

()ttavwa,()ntario
August,1974

$5.00

Cari ng begi ns in

OPINION

the teacher-student relationship.

If students feel they are relating to an open, caring instructor, they begin to trust.
They trust the instructor and, more important, they gain confidence in their o"n
perception of situations.

Daphne Walker Mesolella

There is a gro\\ ing concern today. re-
flected clearly in our nursing literature.
that the compassionate nurse is all too
often absent from the bedside. From both
within and without the health professions.
we hear echoes of the basic question.
., Who cares?"
As a patient myself. recently. I found
myself asking. "Where is she? Where is
the nurse who feels. and who cares about
me as a person'!"
Tragically. evidence is accumulating
that the qualities we desire in a nurse are
exhibited in beginners. but 'are generally
suppressed by the time our studenh
graduate. Clearly. our responsibility as

Daphne Walker
Iesolella. (R.N. Royal
Victoria Hospital ,chool of nursing. Montreal;
B.;-O;.,
kGill Umvel'iitv. Montreal;) was
Senior Instructor at Dougla, Hospital. Verdun.
Quebec. "hen she \Hote this article. Presently
d profe,siondl Ireeldnce "riter residing in
H,'uston. Texas. she is the author of article,
publi,hed in both The Canadiall Nllne and the
Americall JO/lrllal of N/lrsiIlX.
DECEMBER 1q74

educators is to free our students' potential
for providing creative. concerned. nursing
care to all their patients.

Instructor as role model
Student nurses are faced with a multitude
of anxiety-provoking life situations that
their non-nurse peers may never encountcr
- or. at the most. will experience with
only a few persons. and probably spread
out during their lives. not crammed into
two. three. or four years. Each new situa-
tion offers the young student a choice. She
may perceive it as an opportunity to learn
and to gro". or it may seem to her so
threatening that she begins developing de-
fenses against what frightens her.
In the beginning. the student turns to the
person formally designated "to help" -
her instructor. The response she receives
initially. and continues to receive. condi-
tions her to what she does about those
perceptions.
By being caring. open individuals with
students. I believe we can set an example
of the behavior that will enable them to
provide good nursing care. During each

encounter with a student. an instructor
teaches not only by her words. but also by
her actions. She either reinforces the
learner's desire to increase her knowledge
of self and others. or she encourages it!'>
suppression.
If the student feels accepted; if she can
freely express her feelings without fear of
being judged; and if she experiences a
growing confidence in her abilit} to tackle
potentially traumatic situations in the hope
of reducing her fear of the unknown. she
will be wilh her patients as her instructor
has been with her. In this sense. the
teacher is a role model. She tcaches effec-
tive interpersonal relationships by her own
example with her stuûents.

Caring for the student
A few years ago. I had the opportunit} to
work with a nurse who created a ward
Jtmosphere in \\hich students seemed to
blossom. She demonstrated a remark.!ble
Jegree of caring in her contacts \\ ith those
.;tudents assigned to her team. She kne\\
them as individuals and wa., familiar with
their likes and dislikes and the characteris-
THE CA
ADlAN NURSE 15

tics that made each unique. This was only
one of the ways, although perhaps the
most fundamental, that she communicated
to them, .. I care about you as a person, not
only the student nurse part of you."
Observing the consequences of this
nurse's behavior. I was reminded that stu-
dent nurses need to feel special. need to
feel that they are more than cogs in the
huge wheel of a hospital organi7ation.
Further, feeling cared for enables the stu-
dent to care for her patients with a tender
concern. .. A person who cares about him-
self has been cared for in the past and is
being cared about in the present by
others. "*
Caring involves more than acknow-
ledgement of a person's being; it somehow
implies a trust of her ability to become, to
realize her potential. I remember one stu-
dent who remained totally silent for sev-
eral weeks in ward clinics. During one of
our encounters, she told me that so many
instructors had criticized and analyzed her
silence that she now felt frozen in her at-
tempts to communicate in a group. I hon-
estly felt her silence was attentive and sup-
portive for her more verbal peers. I told her
so, adding that) knew she would contri-
bute a great deal to group discussion when
she was ready.
A few weeks later, she began to express
her ideas in the group - at first with con-
siderable timidity, but gradually with
more assurance. Commenting on her
growth in our last encounter, she stated: .. I
believe I was able to open up because I felt
no pressure to do so. You expressed your
acceptance of me, and also your belief that
I could change."

The encounter
An encounter is any situation where two
people share their real selves with each
other. At best, it is an unpredictable and

* Sidney M. Jourard, The Transparent Self.
New York. Van Nostrand Reinhold. 1964,
p.119.
16 THE CANADIAN NURSE

spontaneous meeting in which neither
knows at the outset what will transpire
between them. Any meeting of teacher and
learner has this potential; few achieve it.
A successful encounter results in
growth. of both instructor and student.
because whenever two souls meet and
touch each other, meaningful learning
occurs. An encounter does not necessarily
take place during an interview s\:heduled
by the instructor; it may take place
however, if the instructor is able to cast
aside preconceived ideas of agenda and
roles.
Roles tend to stereotype the behavior of
persons attempting to enact them. The per-
son who sees herself enacting the role of
nursing instructor during her wort..ing
hours puts on certain attitudes and be-
havior as she dons her uniform each morn-
ing. If we truly believe what most of our
curricula advocate - namely, that each
human being is unique - then we had
better stop playing the role of instructor. as
that denies our belief. It restricts and con-
fines behavior to the limits prescribed by
the role.
If an instructor retains a professional
distance from her students, denying her
basic human impubes, she may remain
silent with an upset student when thc most
helpful intervention might be the verbal
acknowledgement of her feeling response
to the other's predicament. Equally
growth-inhibiting is the practice of casting
our learners into precast models of (he
student role.
The obvious consequence of roles in-
teracting with roles, instead of people with
people, is the development of superficial
communication. Since no genuine ex-
change of ideas and feelings occurs, sig-
nificant learning does not take place.
If students feel thcy are relating to an
open, caring teacher, they begin to trust.
They trust the instructor and, more impor-
tant, they gain confidence in their own
perception of situations and in their ability
to face and work through difficult interper-
sonal relationships. In short, they (rust

themselves. They are not afraid to ques-
tion. to seek. Thcy grow.
If the instructor preplans what she be-
lieves should transpire during a meeting
with a student. she eliminates the possibil-
ity of a meaningful encounter. Genuine
communication is spontaneous: it fJows
from the needs of both people during the
time the) may share.
For vital learning to occur, the com-
munication must be relevant to the needs
of the student. This requires the student's
equal participation in the definition. pur-
suit, and evaluation of learning goals. She
may have to wort.. through problems un-
known to the instructor prior to the meet-
ing, before she is free to consider areas the
teacher believes important. Forcing the di-
rection of studcnts' learning usually re-
sults in regurgitation of the same material,
or worse, complete apathy to the entire
learning process.

Conclusion
My experience with students constantly
reinforces these beliefs. Whenever.
through anxiety or fatigue, [begin playing
the role of teacher with them. ) find that the
most [ can communicate is facts, which
could more efficiently be gained from
books. Moreover, I discover a strange
feeling of alienation or loneliness encom-
passing me, as I realize that) am estranged
hoth from myself and from them.
Conversely. the more I shed my de-
fenses and allow myself simply "to be"
with them, the more exciting our meetings
become. I alwa}s leave a true encounter
with a feeling of joy. Something real has
transpired. which has changed both of us.
It has lifted us beyond ourselves. We have
learned. ':':'

DECEMBER 1974

Relief of pain

.
In

labor

Although the physician is responsible for ordering the drugs a patient receives
during labor, it is the nurse who observes the mother's progress and who must
decide whether the order is adequate. Therefore, the nurse's judgment is vital; it
should be based on a knowledge of the causes of pain and on an understanding of
the appropriate use of both psychological measures and medications for the relief
of pain.

Peggy-Anne Field

-

Almost all women
uffer
ome degree of
pain in labor. varying from discomfort to
an unbearable
ensation. It is the nurse
who normally asse

es the degree of pain
experienced by the patient and who
decides whether the patient is able to
cope. or v.hether intervention i
needed.
To intervene effectively. the nurse mu
t
under
tand the pathway
of pain. the
psychological aspects. and the use and
selection of drugs in labor. It is to these
dimensions that we now turn.

Pathways of pain
It is probable that the pain of the fiN
stage of labor is primarily due to the dila-
tation of the cervix and the stretching 01
the lower uterine segment. and that the
contraction of the body of the uterus pla}

only a minor part in the production 01
pain. The impulses generated by the
stretching and contractions are transmit-
ted to the hypogastric plexus and along

.. \
... "-
..
..
.

Peggy-Anne Field (R.)\,.. Addenbrooke's
Hospital school of nUßing. l:ngldnd; S.CM.;
B.N.. McGill:
.N.. Univcrsit) of\\ashmg-
ton. Sedltle. W dshington) is Associate Profe
-
sor. School of Nursing. University of Albcrta.
Edmonton.
hc expresscs hcr thanks to
Victorid lieglcr and Jedn Sok..itnc. Their
librdry research.on this topic. \\. hile thcy \\.ere
students in the Advanced Prdctical Ob,tctrics
Progrdm. providcd the bdSls for much ot this
drtide.

DECEMBER 1974

the sympathetic nerve fibers to the post-
erior roots of the eleventh and tv. cIfth
thoracic nerves. Sensations may abo be
conveyed by the pelvic parasympathetic
nerves that enter the
pinal cord at the
second. third. and fourth
acral segments.
Pain in the second stage of labor i

mainly attributable to the distension of the
lower birth canal. the vulva. and the
perineum. The sensations travel diredly
from the pudendal nerve along sensllry
pathways to the spinal cord.
In the third stage oflabor. pain i<; due to
the dilatation of the cervix by the placenta
and the contractions of the uterus. At this
point. there is no pain in the perineal reg-
ion unless an epi
iotomy has been done.
All methods of analgesia or anesthesia
block the transmission of pain impuJ..ö at
some point in the normal pathway. In addi-
tion. some distort the perception of pain. A
basic know ledge of the mechanisms by
which pain is transmitted is necessary to
understand in what v. ay psychological
support or medications can alleviate the
patient's pain.

PSYlhological aspects of pain
The fear-pain-tension syndrome was
first described by Grantly Dick-Read in
1933. He believed that most ....omen ap-
proach lab,lr with fear and anxiety be-
cause of ignor.mce. prejudice. and misin-
formation. The re
ult is mental ten'iion
which. in turn. leads to tension in muscles.
including those of the lower uterine <;cg-
THE CA
ADIAN NURSE 17

men\. Tension in these muscles can pre-
vent normal cervical dilatation. can cause
pain. and can delay labor.
Pain intensifiers during labor include
fatigue (anemia with a hemoglobin below
7011 from 33 to 34 weeks on). depression.
disappointment. and fear. The amount of
pain may also be modified by the
individual's previous experiences. pre-
natal education. emotional
tability. par-
ity. fetal size and position. and the emo-
tional support provided the woman by
those attending her in labor.
Fear may provide a protective
mechanism; however. if allowed to prog-
ress unchecked. fear-pain-tension may
have a marked negative effect on labor.

Psychological analgesia
Over the last 20 to 30 years. health per-
sonnel and patients alike have begun to
realize the importance of psychological
preparation for labor. Today. a variety of
classes for psycho-physical preparation of
the mother is available.
In these classes. the mother is helped to
understand the process of pregnancy and
labor in an effort to dispel fear. Operant
conditioning is used in many types of
preparation to increase the pain threshold.
and an explanation is given on the meth-
ods of pain relief available during labor.
Relaxation and breathing exercises are
taught. which help relieve muscular ten-
sion. Such tension could impede the des-
cent of the fetus. delaying labor and pro-
longing the
tretching of the lower seg-
ment and dilatation of the cervix. so in-
creasing discomfort.
Today. the husband is being incl uded
more and more frequently. and his pres-
ence during labor is encouraged He can
provide psychological support and en-
couragement. helping to relieve the ten-
sion and loneliness produced by a new and
strange environment.
Prenatal preparation has evolved mainly
from two psychophysical methods. natural
childbirth and psychoprophylaxis. Al-
though the approaches differ. they have
the same basic rationale: to reduce fear and
tension. therefore reducing pain. Two
other techniques that may be classified as
psychological analgesia are hypnosis and
abdominal decompression.
The positive attitude of the nurses. and
the
upport given by them to mother
in the
labor room who have been prepared by
18 THE CANADIAN NURSE

psychoprophylactic methods. are essential
for success. Nursing care and support are
still the key factors in reducing the need for
analgesia in labor.
The nurse mu
t make judgments if and
when a prepared patient needs medication.
Although no woman should be forced to
have sedation. the nurse must be able to
interpret to the patient the advantages of an
analgesic when it is needed to help her
progress in labor.

Use of drugs in labor
Although the length and severity of
labors differ. most women need some
form of analgesic during labor. Each labor
should be evaluated individually. and de-
cisions must be made on the use of sys-
temic medications. regional or block
analgesia or anesthesia. and inhalational
analgesia or anesthesia.
There is no technique or agent that is
always better than any other. and the best
results are invariably obtained by using a
combination of drugs and techniques. The
prime consideration when choosing a drug
for pain relief at any stage of labor must
always be the safety of the mother and the
fetus.
The "pain threshold" is the point at
which an individual's senses recognize
pain. The aim of the management of pain
in labor is to raise the patient's pain
threshold to a level where pain and dis-
comfort are acceptable. Thi
level oftoler-
ance should be maintained in labor. bear-
ing in mind that pain increases as labor
progresses.
If pain is inadequately controlled. the
patient will lose confidence in both the
drug and the nurse. Her mental stress and
anxiety level will rise. thu
lowering her
pain threshold, This means that a drug
dosage that would have been adequate ear-
lier may no longer be effective. Giving too
small a dose of a drug, or giving it too late.
are the most common causes of U1l.mtisfac-
tory analgesia.
At all times. the efficiency of drugs in
raising the pain threshold must be weighed
against the undesirable side effects they
may produce in the mother and fetus or on
the progress of labor. In the mother. preex-
isting conditions (such as heart disease or
diabetes) or complications of pregnancy
huch as bleeding or toxemia) may affect
the drugs she can have or the fetal toler-
ance to drugs.

The fetus itself will be affectcd by drugs
if labor is premature. if there is placental
insufficiency. rhesus incompatibility. or
any other condition that may already
create a ri
k of fetal hypoxia, The nur
e
must always consider these factor
when
assessing the sedation she will give and
when judging the mo
t appropriate time
for medications to be given.

Selection of drugs
Early First Stage
Frequently. the patient arrives at the
hospital early in the tirst stage of labor.
The cervix may be thick and may be di-
lated only I cm. The patient's need atthi

time may be for rest to avoid fatigue before
the onset of the active phd
e of labor.
Sleep may be the major need in the middle
of the day as well as during the night. and a
sedative may be necessary to ensure thi
.
The tense. anxiou
patient may need a
mild tranquilizer to help her relax. Some
examples will help illuo;trate this:
M .G.. Gravidd I. Para O. i
admined al 7:()lJ
A.!'.t Her memhrane
ruplun:d .II 4:00 A \1
and o;he i
having irregular eontraction

every 7 to 10 minute
. On eXdmination. her
cervix i
thiek and I em. dilated. She ap-
pear
rclaxed but tired.
At this point. Seconal 100 mg. or
Nembutal 200 mg. would be
uitable. as
her major need is for reo;t before labor
becomes well established.
B.R.. Gravida II. Para I. i
adrnined at 7:00
A.M Her mem"ranc
arc intact. On exami-
nation. her cervix i
effaced. multip
o
.
Contraetion
are moderate. ever} 5 to 7
minutes, and arc not diströsing hcr. She i

breathing well but hold, her hand
tight and
is ,orne" hat anI( iou
. She
tate,: "I had a
vcr} rapid labor la
t time."
As B. R. has a history \)f rapid labor last
time. sedation i!\ not appropriate as her
labor is likely to proceed rapidly again.
She is assessed a
being tense. although at
this point she i
managing with her
breathing. Consideration should be given
in one's a
scssment to the administration
of Sparine 25-50 mg.. or Largactil 25-50
mg.. or a similar tranquilizer. (See Tah!c\'
1 alld :!.)

Middle First StaKe
From a cervical dilatation of 4 cm. to 8
cm.. the patient is con,idered to be in the
active phase of labor. Contractiono; \\, ill be
stronger and more frequent. cervical dila-
DECEMBER 1974

TABLE I

Use of Analgesia in Labor

FIRST STAGE

SECOND STAGE

Early First Stage Middle First Stage

Late
First
Stage

Cervix 0-4 cms Cervix 4-8 cms Cervix 8 cms
Contractions minimal Contractions increasing in to Full Dilatation
discomfort strength and frequency
I
I
I
Sedatives I Analgesics Analgesics (Primigravida)
Hypnotics Tranquilizers Inhalational Analgesia
Tranquilizers
Paracervical
I Block'
Abdominal Decompression
Continuous Epidural
Hypnosis - Psychological Methods
'I
I I Infiltration
I Pudendal Block
Epidural
(1 dosalle\

tation nonnally more rapid. and labor is
established.
Tranquilizers should not be used alone
in this stage of labor. If they are. the pa-
tient can become restless. confused. and
uncooperative. However. the pain
threshold can be raised and the dose of
narcotic analgesic reduced by administer-
ing a tranquilizerwirh a narcotic analgesic.
DECEMBER 1974

D.R.. Gravida I. Pdra O. has been in labor
for three hour.,. She ha, become very rest-
le

and seems to have difficulty coping
with her o.:ontraetion'i. On examination. the
cervix i.. thin and 4 em. dilated. Contrac-
tions are q. 4 min
. x 50 ,ec,. The fetal heart
i
regular. 124.
Here.Oemerol 100 mg. could be used.
or a combination of Oemerol 50-100 mg.

and Sparine 25-50 mg. One must assess
the patient's body size when detennining
the dose of a narcotic. What is sufficient to
secure pain relief for a 95-pound patient
will generally be inadequate for a
200-pound woman.
Oemerol takes approximately 20 min-
utes to be effec.tive. For effective medica-
tion. one must estimate patient discomfort
and administer the drug before distress and
loss of control become evident.
P.D.. Gravida III. Pam II. is admitted in
strong labor. Her contractions are q. 3 mins.
)( 45-50 sees. She is grasping the bed \\'ith
each contraction and moaning. On examina-
tion. her cervix is 5 em. dilated. The fetal
heart is regular. 130.
Here we have a patient in advancing
labor. She needs immediate sedation be-
fore any further examinations. Nisentil
30-60 mg. would be the drug of choice. It
works rapidly and lasts I IIz to 2 IIz hours.
Although it is more likely to cause fetal
depression than Oemerol if given in re-
peated doses. for this patient a single dose
of analgesic would seem to be all that \\,ill
be needed.

Late First Stage
If we return to the patient P.O.. we fmd
that an hour after receiving the Nisentil.
she has feelings of rectal pressure. On ex-
amination. her cervix is found to be a rim.
The fetal heart remains regular. P.O. has
difficulty in restraining herself from push-
ing as the presenting part is low.
Inhalational analgesia. such as Entonox
(premixed nitrous oxide. 50%. and ox-
ygen. SO?e). Trilene. or nitrous oxide and
oxygen. may be given. All inhalational
analgesics should be self-administered by
the patient. using a hand-held apparatus.
The patient's hand will drop before the
level of anesthetic is reached and she will
not become unconscious.
The nurse needs to make sure that the
mother understands ho\\, to use the inhala-
tional analgesic. Inhalation must start at
the onset of the contraction if blood levels
of nitrous oxide are to be maximal at the
pea\... of a contraction. By keeping her hand
on the fundus. the nurse can tell the mother
when she should start using' 'the gas. .. At
no time should the nurse hold the mask in
place. and it must never be strapped on the
patient's f.tce. The concentration of ni-
trous oxide to oxygen should not exceed
60' (: 40'( .

THE CANADIAN NURSE 19

As P.O. had Nisentil 100 mg. an hour
previously. a narcotic antagonist. such as
Nalorphine 5-10 mg.. or Levallorphan
0.5-1 mg.. should be considered to
counteract any depressant effect the
Nisentil may have had on the fetus.

Second Stage of Labor
In the second stage of labor. when the
patient must push with her contractions.
her rerception of pain will frequently de-
crease. as she has another focus. The pain
experienced now is mainly attributable to
the distension of the lower birth canal and
is transmitted by the pudendal nerve. At
this time. an inhalational analgesic may be
used during contractions.
If an episiotomy is to be performed,
local infiltration of the perineum with 10
cc. of I or 2lJo Xylocaine may be carried
out by the physician. If any operative pro-
cedure. such as mid or low forceps. is
anticipated. a pudendal block is the most
common fonn of anesthesia. This knocks
out the pudendal nerves, relaxes the pelvic
floor. and allows greater ease in manipula-
tion of the fetus.
Some hospitals use general anesthetics
for operative procedures. but in such cases
the risk to both mother and fetus is in-
creased.
K.S.. Gravida II. Para I. has been transfer-
red to the delivery room. Her cervix is fully
dilated and the anus is pouting. but the
presenting part cannot be
een. She hds not
received analgesics during her rather rapid
labor but is now saying. "Nurse. please
give me
omething."
It is too late to give this patient narcotic
analgesics. Entonox. or a similar inhala-
tional analgesic. would be appropriate.
(Table J shows the appropriate period for
administration of inhalational analgesics.)
R.S. does not progress in the second stage.
The doctor examines her and states that the
fetal head is in a transverse position. and
forceps will have to be used to rotate it.
Here. the probable anesthesia of choice
would be a pudendal block, using 20 cc. of
1% Xylocaine or Carbocaine. depending
on the physician's preferences.
B.D.. Gravida I. Para 0, received Demerol
100 mg. 3 hours before her cervix reached
full dilatation. In the case room she pushes
well and the presenting part descends. but
the perineum is tight and an episiotomy may
be needed.
When the perineum is thinned out. it
can be cut without pain and, therefore.
analgesia may not be needed. Normally.
however. a local anesthetic. such as 10
20 THE CANADIAN NURSE

,cc. of Xylocaine 1% is injected fanwise
into the tissue. The area is then anes-
thetized for suturing.

Alternative forms of analgesia
Paracervical Block: When a multi-
gravida is pushing prematurely. or if the
patient's cervix is rigid. the doctor may
use a paracervical block. This is the infilt-
ration of a local analgesic into the nerve
plexus at the junction of the cervix and the
vagina. It is not a popular method as the
Xylocaine may be absorbed by the fetus
and can cause bradycardia. Table I shows
the common period of administration of a
paracervical block.

Epidural Anesthesia: This is the intro-
duction of an anesthetic into the extradural
space surrounding the spinal cord. It
knocks out sensory impulses without in-
hibiting motor nerve activity. This is an
excellent fonn of pain relief in any patient
where labor is prolonged or is causing the
individual excessive pain.
Because of the difficulty of the techni-
que. it needs an expert to administer the
anesthetic, and so can usually be given
only in centers with resident anesthetists.
Severe hypotension can occur with subse-
quent interference with the placental blood
flow and the risk of fetal anoxia.

Spinal Anesthesia: This is usually indi-
cated only for caesarian sections. as it in-
terferes with the motor nerves. and the
patient will need forceps delivery if spinal
anesthesia is used. When operative deliv-
ery is necessary. it will not cause fetal
depression and is, therefore, preferable to
inhalational anesthesia.

Drug idiosyncracies
Trilene is decreasing in favor as an inha-
lational analgesic. but is still used almost
exclusively in some hospitals. If it is used
within two hours of Demerol. fetal
tachycardia may result. Trilene must never
be used in an anesthetic apparatus where it
may flow over soda lime. as it undergoes
chemical changes that can harm the pa-
tient.
Nallorphine and Levallorphan should
not be administered to a newborn when the
mother has had a general anesthetic. They
will cause further depression. even if the
mother has had a narcotic drug in labor, if
administered under these circumstances.
If an epidural anesthetic seems indi-
cated by the patient's condition, it is inad-
visable to administer a standing order for

tranquilizers until the patient has been as-
sessed by the obstetrician. Tranquilizers
may cause hypotension. and this can be
aggravated by epidural anesthesia and the
anesthesia may have to be delayed.
The effect of diazepam (Valium) on the
fetus is also under study. It is highly
cumulative in cord blood and may cause
cardiac and respiratory depression in the
newborn.

Summary
By keeping the mother infonned of her
progress during labor and by encouraging
her to take the medication ordered. the
nurse can reduce the need for analgesics.
Although it is the physician who orders the
drugs a patient is to receive in labor. it is
the nurse who observes the mother's prog-
ress and who must decide whether the
order is adequate.
"Standing orders" may not always be
appropriate. and the physician must be
contacted and given evidence of the need
for alternative medication. The nurse's
judgment is vital; it is enhanced when
based on a knowledge of the causes of pain
and an understanding of the appropriate
use of both psychological measures and
medications for the relief of pain in labor.

Bibliography
Bonica. John J. Principles and Practices of
Obstetric Analgesia and .Anesthesia.
Philadelphia. Davis. 1964.
Bowes, W.A. The Effects of Obstetrical Me{ll-
cation on Fetus and Infant. Chicago, Uni-
versity of Chicago Press, for the Society for
Research in Child Development, 1970.
(Monograph)
Burnett. Clifford W.F. The Anatomv and
Physiology of Obstetrics.- A Shorr Textbook
for Student.
and Midwive.
. London, Faber
and Faber. 1953.
Dasser, C. and O'Connor, J. Continuous
epidural block for obstetrical anesthesia.
Amer. J. Nun. 60:9: I 296-9, Sept. 1960.
McCaffery, Margo, Nursing Management of
the Patient with Pain. Philadelphia,
Li ppi ncott. c 1972.
Plantevin. Odile M. Ana:gesia and Anaes-
thesia in Obstetrics. London. Butterworth,
1973.
Read. G.D. Childbirth Without Fear. led.
'\Jew York. Harpers, 1953.
Riffel, Hugo D. et aL Effect of meperidine and
promethazine during labor Ohst. Gynecol.
42:5:738-45. Nov. 1973.
Thiery. M. and Vroman. S., Paracervical block
dnalgesia during labor. Amer J. Ob.
t.
Gvnecol. 113:7:988-1036, Aug. 1973.-30-
DECEMBER 1974

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23

Admission unit

dispels fear of surgery

Preoperative teaching reduces a patient's anxiety, apprehension, and sense of
helplessness, and promotes his cooperation and recovery post-operatively. This is
the aim of the admission unit of the Halifax Infirmary.

Mo!>t healthy persons have worries that
tend to increase when ìlIness attacks.
Needless to say. the patient who is facing
surgery experiences such worries
even more acutely.
Preoperative teaching reduces a patienfs
anxiety. apprehension. and sense of help-
lessness ,md promotes his cooperation and
recovery postoperatively. Nurses are
aware that preoperative teaching tends to
he segmented on a busy surgical unit and is
often the first item to be discarded under
the pressure of work.
To counteract the patient's anxiety and
lack of preoperative teaching. the Halifax
Infirmary estahlished an admission unit in
February. 1973. It admits only patients
scheduled for elective surgery. and
preop
rative teaching is one of its planned
activities. As far as can be ascertained. it is
the first unit of its kind in Canada.
It sound., quite simple now. after nearly
two years. to say. "The unit was estah-
lished." but it took many months of think-
ing. preparation. hesitation. doubt, and
enthusia!>m he fore the unit became a real-
ity. A.. there was no example to follow. we
made mi.,takes. as do all beginners. but we

Helena Pr,alJ fR. N., Halif;)x InfirmJry .,chool
ot nur-.ing) i., head nUr'>e of the Admis
ion Unit
of the Halifdx Infirmdry. She welcomes
ug-
gc,lion' 10 develop ne\\ and improved pl,\n'.
24 THE CANADIAN NURSE

Helena Prsala

also experienced the excitement and chal-
lenge of a new venture. However. our
motivation to care for the patient as a
whole person was always present. and is
stìlI the most important feature of our
program.
The admission unit is on the seventh
floor of the Halifax Infirmary. in a hright.
sunny location overlooking Halifax Har-
bor. We can accommodate 26 patients. the
daily average being 18, and their stay in
the unit is usually four to five hours.
Patients are admitted to our unit for any
type of elective surgery. as long as their
general health permits them to he am-
hulatory. Occasionally. we have ade-
quately cared for paraplegics. amputees.
and the mentally retarded. As the Halifax
Infirmary does not have a pediatric unit,
we do not need to accommodate children
under 14 years of age.
Some examples of the elective surgery
performed at the Infirmary are: hysterec-
tomy. dilatation and curettage. tuballiga-
tion. prostatectomy. nephrolithotomy.
cholecystectomy. gastrectomy. sym-
pathectomy. lohectomy, meni<;cectomy.
total hip replacement, and ligation, strip-
ping. and excision of varicose veins.
Two registered nurses, one certified
nursing assistant. and one ward clerk
comprise our staff. They usually work
from m
oo to 1600 hours, hut. if all pa-
tients are not discharged to their hospital

rooms by 1600 hours, one of the nurses
will stay with them. No patients are kept
overnight. However. the lounge IS some-
times used in the evenings for group ac-
tivities under the direction of the hospital's
activity center.

Aim of program
Our first aim is to help the patient
scheduled for elective surgery adjust to the
hospital environment and alleviate his fear
of the unknown. Consequently. as soon as
possihle after he enters the unit, the patient
is informed ahout the length of his stay in
the admission unit and the types of tests
and preoperative preparations he will
undergo there.
He is then shown all the admission unit
facilities. They include a treatment room,
a quiet room where he may lie down, TV
and smoking rooms, and a kitchenette.
Patients are encouraged to maintain their
independence. They enjoy making tea or
coffee for themsel ves and ,me another. and
this mundane task helps them relax and to
feel more "at home," as many of them
have commented.
The admission routine itself (tempera-
ture, pulse. respiration. hlood pressure.
preoperative preparation. and so on) is
done according to requirements common
to most hospitals, and there is no need to
go into details here. However. I would like
to stress that these items are not considered
DECEMBER 1974

..

..
,!
..
' ..
. -_...
..
@I . ., ·

.

'1l
,*)

.

v
a"c

I
1

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._.
.-

,".-

,
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".

.:
(

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l

....

".
· þÞJ
tt;

A"þ;"J''!!' ,
'.

...

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,
-.

...

.....

The author teaching a patient how to do leg movements postoperatively.

-

"routine" by our staff We try to remove
any mechanistic aspect from our perfor-
mance, and to personalize the admission
procedure, In this way we reduce anxiety
and demonstrate our interest in a patient as
an individual. The admission period thus
becomes our key time for interaction with
the patient.

Patients need information
Because most of the surgical patients
have little knowledge of what will take
place, their need for information is obvi-
ous. The patients appreciate advice, in-
struction, and correction of any miscon-
ception!. they have, and they are encour-
aged to express their doubts, fears, and
interest.
They are informed about the time of
their operation and the expected length of
hospitalization; this factor seems impor-
tant for preoperative patients because they
can then place limits on unpleasant experi-
ences and prepare for them mentally. If the
patients are interested in the anatomic
structure and physiology of involved or-
gans or the surgical procedure, these are
explained in simple terms, but the choice
is always the patient's.
Deep breathing, coughing, and moving
exercises are not only demonstrated and
taught, but the need for doing them is
explained and rea
surance given that it is
safe to perform them. As we stress that the
DECEMBER 1974

'"

-- I

patients' participation during the treatment
is essential for its effectiveness, they de-
velop a sense of active control over their
situation and greater readiness for realistic
coping with threatening experiences. A
patient's questions relating to different as-
pects of the operation and recovery are
-answered frankly, and this seems to in-
itiate a good relationship between the pa-
tient and the nurse.
Another attempt to reduce general ap-
prehension and ensure better cooperation
of the patient is to present a slide show.
This includes the information about neces-
sary preoperative tests. preoperative
medication. recovery room, IVs. and
other postoperative routines. It also serves
to acquaint the patient with the members of
the health team who may be in contact with
him, for example. the physiotherapist.
dietitian, Victorian Order nurse, clergy-
man, and social worker. Positive re-
sponses to this slide show have encour-
aged the development of another that con-
sists of direct instructions to the patient on
deep breathing, coughing, and moving. It
will help the patient retain knowledge of
exercises taught earlier and, by using vis-
ual and oral reinforcement, foster coopem-
tion in the postoperative period.

Nurses appreciate admission unit
The unit staff have heen a
ked by other
nurses with doubt, curiosity, and almost

disbelief: "Do you really like working in
the admission unit? Isn't it ju
t routine
work? Don't you miss nursing?"
The reply of each of us would be: .. We
like to work in the unit very much. There i!.
both challenge and variety."
If nursing means meeting the needs of
patients with different surgical. medical.
and personal problems, adjusting to those
needs, and then choosing the hest indi-
vidualized approach to put the patient at
ease, to minimize his tension. and provide
him with important knowledge. there i

every reason to believe that we are giving
nursing care. We are encouraged in this
belief when our patient!. return to make
positive comments about the unit and give
us a fe\\ word
of appreciation.
There are. of course. patients who do
not care for the present setup; they would
prefer the privacy of a single room from
the time they arrive at the ho!.pital. There
is little we can do to change the general
approach except to respect these patients
and make their !.tay in the admis
ion unit
as short and pleasant a
possihle. How-
ever, most patients appear to appreciate
the contact with others, for it brings a
feeling of togetherness and gives them an
opportunity to express their fear of
surgery. This helps to alleviate their isola-
tion and tension.
Finally. it is significant that nurses on
the surgical units found this system quite
THE CAJl,jADIAN NURSE 25

r

,),
\

t

#'

....

, "
111111111 III þ
ill
I
I ...
.
1:' 'J ......

, . . "."
..........

-

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f :
,.í
,

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- t
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r ,...
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,
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,
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.-

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J'
.,1

II

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,
"Putting the pieces together" is the aim of the admission unit, so patients may see the total picture

practical. according to their positive
comments. TIle admission unit helps to
relieve the pressure of work on the surgical
floors by performing many of the time-
consuming procedures such as preps and
admission routines and also ensures that
explanations are given and teaching is
done. The surgical unit nurses can. be-
cause of this. devote more time to their
postoperative patients.
Evaluation
Because of the uniqueness of the admis-

ion unit. \\e needed some scientific data
to evaluate its effectiveness. A research
study to determine this was developed re-
cently. Results should provide a variety of
fal:ts that will help appraise the present
program and lead to suggestions for im-
provement. This study should be com-
pleted in a few months.

Bibliography
BinI. Bridn. PS) chologlcdl a
pects of preopera-
tive amI po
topcrdtivc care. Allier. J. Nun.
55:6R5. June 1955
26 THE CANADIAN NURSE

#

Cassady, June R. and Altrocchi. J. Patients'
concerns about surgery. Nurs. Re.L
9:4:219-21. Fall 1960.
Dyche. Elsie Ruth (Yvans) A srud
' to explore
the effect of a planned. preoperative nurs-
ing i'isit, with post-operative reinforce-
ment, on the amount of analge.fic u.fed
pvst-operarÌl'ely by cholecystectomv pa-
tients. Seattle. 1966. (Thesis (M.N.) -
Washington)
Egbert. L.D. et aI. Reduction of postopemtive
pain by encouragement and instruction
of
patients. New Fn!!1. J. Med. 270:16:825-7,
Apr. 16, IY64.
Healy, Kathryn M. Does preoperative instruc-
tion make a difference'! Amer. J. Nurs.
68:1:62-7. Jan. 1968.
Janis. Irving Lester. Psychvlv
ical StreH:
Pnchollnalwic (Ifill Behm'ioral SlUdie,\' vf
Sur!!ica/ Patients. New Vorl... John Wiley
& Son
. I Y6!t
Lindeman. Carol A. and Van Aernam. B.
Nursing intervention with the presurgical
patient: the effects of
tructured and un-

tructured preoperative teaching. Nun.
Re.\'. 20A:319-32. Jul)/Aug. 1971. -

-. Nursing intervention with the presurgical
patient: effectiveness and efficiency of
group and individual preoperative teaching
- Phase two. Nun. Re.f. 21:3: 196-209
May/Jun. I Y72.
Schmitt. Florence C. and Wooldridge. P.J.
Psychological prepamtion of surgical pa-
tients. Nurs. Res. 22:2: I OX-16. Mar. / Apr.
IY73.
Taylor. Carol. III Hori;:o/ltlll Orbit: Hospital.\
and the Cult ojEffìâenc.\', New Vorl... Holt.
Rinehart & Winston. c J 970,
Weiler. M C ashe I. Sr. Po
toperative patient

evaluate preoperative in
truction. Amer. 1.
Nun. 6X:7:1465-7. July. IY6X.

DECEMBER 1974

I

Report

CNA Directors Meet

in Ottawa

The directors of the Canadian Nurses' Association concluded their three-day meeting in
Ottawa, Oct
b
r. 23 to 25, without reaching a consensus on the Association's 1975 budget or
goals and priorities for the 1974-76 biennium. Decisions on the two closely related and
fundamental questions will be taken at the next meeting in February 1975.

Anne Hanna and Nicole Blais

Action on Resolutions from 1974 Annual Meeting
Delegate
to the 1974 Canadian Nurses' Association annual
meeting in Winnipeg were presented \\- ith a total of 16
resolution
. which originated from a wide variety of general
membership concerns. Uf this total. three were ruled
out-of-order and two others were defeated when put to the
vote.
. Implementation of the remaining II resolutions is proeeed-
mg. Step
taken to implement three of them were reported to
the CNA directors at the recent fall meeting. These were:

Resolution 5
"That until such time as there are sufficient individuals with
research ..kills. the Department of National Health and Welfare
be urged to engage sufficient qualified staff to provide. upon
request. adequate multidisciplinary consultative services to
persons engaged in the develop'ment and implementation of
health-related research projects. .
Action:
The minister of National Health and Welfare. in answer to a
letter from CNA informing him of this resolution and asking for
action. ack!1owledg
d that "the limiting factor in effecting the

ec
s.sary mc.rease m the research effort is the shortage of
m
lvlduab with the requisite research training and skills." He
pOlllted out the availability of National Health scientist
on a
consu!tant basis. rhe. CNA is now investigating the availability
of assistance for nursmg research projects.
Resolution 6
T
at ,<"NA .board of directors give priority to continuing
publIcation ot the Nursing Studies Index."
Action:
Copies o
'the 1974
ursing Studies Index. published ..ince
the con
en
lon. are available from C:'-IA. The price is $5.00 to
cover pnntmg costs.

1 hl' oIulholS are \\.ilh Ihe CNA Informal ion Services. Olla\\.a.
DECEMBER 1974

Resolution 10
."Tha
(he CNA adopt the practice. to the extent possible. of
usmg given name and surname only for all identification
purposes.
Action:
This r
solution was tra
smitted to CNA staff and has already
resulted m some changes m forms of address for the journals.
corre
pondenee. and reports.

At. t
eir
ctober meeting. the CNA directors acted upon the
rem
!mng eight resolutions passed by voting delegates. In
a
dlt.IO
. t,hey. heard a report on a survey of possible
dlscfllm
atlon mvolved in abortion procedures. the subject of
a res.olullon ruled out-of-order at the June 1974 meeting.
Dlrector
concluded that four of the resolutions expressed
concer!1 s dlr
ctly related t<,1 the study of nursing practice and
e
ucallon. Smce these subjects are expected to form the basis
ot the goals and priorities accepted by the Association for the
coming biennium. discussion of these resolutions was deferred
so it could be placed within the context of the overall CNA
program. The four resolutions - Numbers I to 4 - involve
proposals to:
I. sensitize or raise the level of awareness of nurse
to
life-styles conducive to optimum health;
. 2: establish guidelines for standards for preparation. con-
t!numg competence. to practice. responsibilities. legal protec-
tlOn. and remuneratIOn tor the nurse m the expanded role;
3.
evelop guideline'i for standards of ongoing education as
a reqUirement for registration/licensure; and
4. en
ourag
t
e development of programs for registered
nurses m genatnc and long-term care in some Canadian
colleges and universities.
Directors took the following action with respect to the other
resolutions:

Rewlwion A
.. Whereas voting delegates at the annual meeting of the CNA
THE CAÑADIAN NURSE 27

need time in which to conscientiously examine proposed
re
olutions: be it re,olved that the mechanism be refined
\\-hereby all resolutions are called for prior to the annual
meeting and that they be made available to the voting delegates
in advance of the annual meeting."
Action:
The CNA directors accepted responsibility for reminding
their jurisdictions of the importance of submitting resolutions
as early as possible before a general meeting. Since existing
procedure permits the resolution
committee to circulate copies
of the resolutions to voting delegates prior to voting. directors
agreed that this practice should be followed whenever
possible.

Resolution B
"Whereas C\IA membership includes both men and women;
be it resolved that the CNA board of directors request the
minister of Consumer and Corporate Affairs to anTend the
Letters Patent of the CNA so that the French title will read
rAs
ociation des Infirmières etlnfirmiers du Canada."
Action:
Since this change would affect the Letters Patent. Seal of the
Corpordtion. and official letterhead. the staff was asked to
report the e,timated costs to the CNA directors' February 1975
meeting.

Resolution 8
"Whereas nurses who for reasons of conscience refuse to
take part in abortions are facing serious prejudice
(Hamilton-Ajax). . . be it resolved that CNA take all necessary
measures so that Bill C-256 is sanctioned by the incoming
parliament. "
Action:
Although this resolution was ruled out-of-order at the annual
meeting, a memorandum was circulated by CNA to provincial
nurses' associations requesting information on incidents where
nurses were known to have been discriminated against because
of abortion procedures. None of the respondents provided
documentation to support the concerns expressed in this
resolution. Three provinces - Alberta. Ontario, and Nova
Scotia - provided statements of belief on the right of the nurse
to abstain from participation in the procedure of therapeutic
abortion.

Resolution 9
, 'That the CNA directors be asked to consider that the annual
meeting and convention held biennially not exceed three days,
including busine
s, educational. and professional sessions."
Action:
Directors learned the results of a survey of voting delegates
carried out since the 1974 CNA annual meeting and convention
to determine their reactions to the convention. More than
one-half of the delegates responded. They indicated unanim-
ou, agreement on the need to increase the amount of time spent
on business. compared to the general sessions. Moreover. they
were against the policy of scheduling a "free day" in the
middle of the convention week. Most delegates indicated they
had been well-informed by CNA on convention procedure.
In the light of this survey. the CNA directors voted to again
hold a four-day convention in 1976. but to schedule the "free
day" for the final one so that delegates may leave earlier if
they wish.
28 THE CANADIAN NURSE

Resolution /2
"That the present fee structure be discontinued as of the
annual meeting of the CNA in 1975: and that an ad hoc
committee be established to investigate alternative fee struc-
tures. ..
Action:
The ad hoc committee set up to meet the terms of this
resolution presented its report to the directors, recommending
one of three possible formulae for fee structures. Directors
accepted this formula and will present it to the provincial
associations for study and discussion. A response is ex pected
before I February 1975. In the meantime, CNA staff will
prepare an estimate of probable revenue based on predicted
provincial membership. A change in the fee structure and rdte
requires the approval of delegates at an annual meeting.

Re I ort of the Executive Director: Highlights
The following report is a resume of work carried out on
behalf of the membership since the annual meeting in
Winnipeg; it covers only highlights of this period and does not
contain references to projects reponed elsewhere.

CNA committees and joint committees
CMA/CHA/CNA/Joint Committee
A meeting of this committee, composed of executive
officers of the three associations. met at CNA House 3 October
to discuss: community health services; hospital accreditation;
medical records (system or problem-oriented. computerized or
manual); proposed joint research project. developing roles and
titles in the current literature; nursing manpower needs in
hospitals: report on health computer information bureau: and a
review of the follow-up of the Mont Gabriel (Health Action
72) conference.
Joint Committee on Extension Course
in Nursing Unit Administration
The finance committee will review the financial operation of
this joint operation to determine if an increase in fees is
necessary. The joint committee will also consider offering this
course in the French language to nurses in Zaire and Haiti.

International organizations
The next meeting of the Council of National Representatives
of the International Council of Nurses will be held in Singapore
4-8 August 1975 and will be attended by the CNA president and
executive director.
No replies were received from provincial nurses' associa-
tions in response to CNA'S invitation to nominate candidates for
the 1975 3M Fellowship awarded by ICN.

Government departments
An official response by CNA to the publication of A New
Perspective on the Health of Canadians will be submitted to
the minister of National Health and Welfare in the near future.
Commenting on the report. CNA president Huguette Labelle
said that it would be necessary for CNA to determine how some
of the concepts presented in the report could be applied by
nurses in their practice. She pointed out that it is one thing to
react, but quite another thing to act upon new information.
The Secretariat of International Women's Year (Privy
Council) has advised CNA that it is receiving requests for
DECEMBER 1974

funding of projects connected with the celebration of IWY. To
date. CNA has not learned of any proposals from nursing
organization...

Motions Passed by CNA Directors
In a series of decision.. taken during its three-day fall
meeting. CNA directors moved to:
o develop a distinctly Canadian code of ethics for the
nursing profession;
o become a member of the newly formed Canadian Council
on Smoking and Health;
o become a co-host and co-sponsor of the IXth International
Conference on Health Education; and
o withdraw its official support for "mandatory"accreditation
of all health agencies.

Code of ethics
The motion that "CNA develop its own code of nursing
ethics" follows a recommendation of the executive committee
and is based on the principle that a professional code should
reflect the society being served. The code will be developed in
the light of existing and proposed relevant statements.
including the International Council of Nurses' Code of Ethics.
1973; the CNA statement of ethics of nursing research. 1972;
and provincial legislation and policies. Two provinces -
Ontario and Quebec - will receive special attention in the
preparation of the proposed code. since they are in the process
of meeting provincial requirements for legislative approval of
similar statements.

CCSH
The Canadian Council on Smoking and Health (CCSH) \'-as
founded 16 July 1974. with the support and cooperation of
CNA. One of its principal aims is the allocation of activities and
responsibilities among the various provincial councils. local
councils. and individuals involved in anti-smoking programs.
The Council's first meeting is scheduled for 26 January 1975
in Winnipeg. Membership fee for CCSH is $100 annual.ly. and
membership entitles an association to two representatIves on
the Council. and one vote.
Health education conference
The IXth International Conference on Health Education of
the Public will take place in Ottawa 29 August to 3 September
1976. It is being planned by the Canadian Health Education
Specialists Society and will take place under the auspices of
the International Union for Health Education. the World
Health Organization. and other international agencies. The
purpose of the meeting will be to extend and improve the
health education of the public nationally and internationally.
Co-sponsorship of the conference involves financial support of
the venture; CNA directors voted minimum support of $50.00
for the time being.
Each co-host will be entitled to appoint one representative to
an organizing committee. which will meet three times between
now and August 1976. and will receive a conference
newsletter and have its name included in the official
conference program.
Accreditation
The decision of the CNA directors to withdraw official
support for "mandatory" accreditation of health agencies was
based on conflict between the position statement accepted by
o,JA in October 1970 and April I ')73 and the policy of the
Canadian Council on Hospital Accreditation. \'-hich supports a
voluntary approach to accreditation. CNA wac; admitted to full
membership in the CCHA (the fifth member) in March 1973.
DECEMBER 1974

Directors requested that the CNA position stalement be
removed from the Folio of Statements di'itributed to provincial
associations by the CNA one year ago.
nd Economic Welfare

Requests from five provincial nurses' associallons. ana
increasing public support. have combined to encourage CNA
directors to renew their support for changes in the Canada
Pension Plan to allow for lowering the retirement age to 60
years.
At their recent meeting. the directors approved plans to
submit a brief requesting changes in the cpp to a parliamentary
committee that will review the legislation. The C'lJA submis-
sion will deal with several aspects of the CPP and will be
prepared by a ....orking party that is no.... studying the Jt'or"-illg
Paper 011 Social Security ill Canada. Glenna RowselL CNA
member-at-Iarge for social and economic welfare. reported to
CNA directors 'õn the group's recommendations. The brief ....ill
recommend the following changes:
I. that the government establish a plan over the next five to
seven years. \'-hich will eventually lower the CPP retirement
age to 60 years; .
2. that the government immediately take action to provIde
for an actuarially reduceJ pension available at 60 years;
3. that the government remove discriminatory clauses from
the legislation; and
4. that the government upgrade the plan to equal the Quebec
Pension Plan.
In January 1973. CNA directors concluded. on the basis of a
report from the member-at-large for social and economic
welfare. that CNA would not receive public support from other
major employee-employer groups for lowering the retirement
age to 60. Since then. five provincial associations - R
AO,
SRNA. MARN. RNABC, and NBAR
- have pa'ised motIons
requesting CNA to support the change. At the same time. the
federal government is now in the process of preparing a new
Bill. The CNA working party \'-ill take the proposed changes
into account in its brief.

Social Security
In her report to the CI"A directors. the member-at-large for
economic and social welfare indicated that there are several
other areas of social security where the organized nursing
profession could make an important contribution to improve
the welfare of Canadians. Among the inequities and problems
being discussed by the working party stud)'ing the War"-illg
Paper 011 Social Securityfor Canadialls are:
. difficulties in obtaining manp()\\er funding for retro.lining
nurses;
. lack of coordination and communication among agencies
and individuals within the social securit)' s
'item;
. inadequate nursing home care for gerio.ltric and long-term
patients.
The \'-on..ing party proposes to continue its stud
and to
recommend changes in the system so that C'I, -\ memocr'i and
directors can take appropriate action.
Goals r' nties Budget. n,
Three major decisions that will have long-term result.. in
terms of C'lJA gro....th and development in the 197.t-76
biennium ....ere deferred by directors until Februar
1975. The
three areas that the director'i believed required further ..tud

and information are closclv relateJ. and decisions taken in one
area.... ill have a bearing o
the others. The)' include: the c""A'S
goals and priorities for this biennium. (he annual budget. dnd
propo..ed changes in (he fee rate.

THE CA, ADIAN NURSE 2'l

Goals and priorities
Following lengthy discussion. directors requested further
study of the objectives. terms. and programming involved in
plans for the 1974-76 CNA program.
Budget
The 1975 budget was the second deficit budget to he
proposed to the directors since the move into CNA House in
1966. A revised budget. including a statement of fixed and
variable costs and comparing 1974 (actual) and 1975
(proposed) estimates. will be prepared for the February 1975
meeting.
Fee structure
Directors also postponed a decision concerning a unit fee
rate for provincial associations. although they accepted an
alternative fee structure proposed by an ad hoc committee set
up to consider both questions. A decision on the rate will not
be made until the provinces have reacted to the proposed new
fee structure and until further information has been obtained on
the budget and program for the biennium.
The formula for fee structure accepted by the director
has
several features:
o it results in a slightly higher(4
) revenue;
o it permits all member associations to share in a sliding
calc.
and is considered most acceptable to all provinces;
o it allows for future member associations. such as the North
West Territories. to be admitted under the same fee levy
structure.
The proposed formula would involve an assessment on
provincial associations of <me-half of the accepted unit fee for
the first 250 members; three-ljuarters of the unit fee for
membership from 25 i to 1.000; one unit for membership from
1001 to 15.000: three-quarters of a unit for membership from
15.001 to 25.000; and one-half unit for membership ahove
25.00 I.
According to the terms of Resolution 12 from the 1974
annual meeting. provincial associations are being asked to
respond to the proposal before I February 1975. so that the
directors can propose a new fee structure and rate at the 1975
CNA annual meeting.

'e rom.,

PNO, Health and Welfare Canada
The principal nursing officer. Huguette Lahelle. reported
that the federal-provincial advisory committee (to the confer-
ence of deputy ministers) on standards has been given a
mandate to promote and coordinate the development of
guidelines in the health care field. which would have sufficient
flexibility to meet the needs of each provincial jurisdiction.
Several governments have already identified the development
of standards as a priority. according to the principal nursing
officer. Professional associations will be asked to help set
these standards. and the suggestion was made that CNA might
wish to consider this area of activity as a priority during the
next two years.
Federally Employed Nurses
The report of the Interdepartmental Committee on Nursing.

et up one year ago to conduct an occupational study of federal
government nurses. is now available. Health and Welfare
Canada will attempt to find solutions or conduct further
exploration of the issues raised in the report.
Nun'in!? Employment Study
The federal-provincial advisory committee on manpower
and the nursing manpower committee have recognized the
need for a study on nurse employment and nurse utilization in
30 THE CANADIAN NURSE

Canada. As a re...ult. the Health Manpower Directorate has
invited the Center for Economic Studies. University of
Montreal. to develop a protocol for such a
tudy. to he
reviewed by ajoint steering group of these two committees.
National Health Grants
The inforn1ation manual of the National Health Grants has
been revised. and an information program to Introduce the
changes is being planned.
New Committees
Several new committees and task force" arc of __peci.tl
interest to nurses. including: the sub-committee on health
promotion: committee on infection control in hospitals;
advisory committee on community health - a \\-orking group
on health services for the elderly: proposed federal-pro-
vincial working group to develop an information system for
community health services: advisory committee on community
health - working groups on preventive program... and home
care programs.
During discu
sion of the new committees. CNA director'i
expressed concern over the inadequacy of nursing input at the
governmental level. They pointed out that many of the nursing
consultant po
itions in the public service are unfilled. and
dgreed that a letter should be 'ienl to the minister of National
Health and Welfare. expressing C!\IA'S hope that appointment'i
will be made in the near future.

Special Committee on Testing Sl'rvice
Chairman Helen Grice reported that representatives of the
Testing Service had met \\-ith the president and executive
director of the Order of Nurses of Quebec in July to discus
the
development of RN exams in the French language and ON<,)"s
participation in the procö
. The ONQ representatives have
offered their French exam to CNATS for use \\-hile a
comprehensive exam is being developed. The offer will he
discussed at the November meeting of the CNA TS.
Two new appointments to the special committee on testing
service were approved by the directors: Eva M. O'Connor.
NBARN. and Donna Humphries. AARN. Three nurses were
reappointed: Pauline Crevier. ONQ, Jean Dalliel and Elsheth
Geiger. RNAO.
Special Committee on Nursing Research
Members of the nursing research committee have offered to
provide a program in nu;sing re
earch to provincial as
ocia-
tions that reque
t it for their annual meetings. Expen
es will be
paid by the association receiving the service. The purpose of
the program is to sensitize nurses to research activities and to
give them some basic skills in the area.
The research committee intend
to explore the possihility of
conducting an inquiry into research reported in the French
language. since much of thi
important literature is not
available to all nurses in Canada. The Committee i
al
o
studying the feasibility of a research project to develop a
method of predicting Canadiannur
e requirements.

Canadian Council on Hospital Accreditation
Helen Taylor. recently appointed CNA representative on the
CCHA. informed CNA directors that the number of nur
e
surveyors is continuing to increase. to the great
atisfaction of
nursing directors. In fact. long-term care institutions are
frequently surveyed only by nurses. The CNA representative
reported that Quebec now has its own survey teams and
procedure. to meet the provi.'iions of legislation on health and
social security. Health care facilities in the province \\- ill be
subject to this supervision. The CCHA. on the other hand.
continue
to support the principle of voluntary accreditation.
DECEMBER 1974

Cardiac unrest

John Mcleod SRN, RMN

\1r. Camp .... a'i night
taff nur
e on a
medical.... ard I once.... or!,ed on and.... hat
he didn't "no.... about monitoring equip-
ment and cardiac arröt hadn't heen
invented.
At ever) opportunity (and there \\ere
man) - Mr. Camp ....asn.t exactl)
dedicated to the more mundane aspects of
the job) he ",ould gaze catatonic-li"e into
the monitor screen

earching for ir-
regularities and furthering his "no.... ledge
- "mm ledge thai had gained him quite a
reputation throughout the hospital and
.... a'i much
ought after b) )oung house-
men and nursing colleaguö.
And .... henever there .... a
a cardiac
arre
t, Mr. Camp \\a... one of the first to
be
ummoned.
This obsession for gazing into monitor
screens dldn't exactly endear him to those
\\orking directl) under him ....ho had to do
all the "real" \\or". often single handed.
And with all the adulation he received. his
sense of imJ
)rtance began to gnm out of
all proportion. Then there came a hlo\\
.... hich brought 1\1r. Camp back do.... n to
earth.... ith a terrible thud.

Crash call
On the night in question. a ne.... patient.

1r Smith, had heen admitted ju
t a... the
night staff took over. He \\ as diagno
ed
a
a coronary. hut not bad enough to
require monitoring. So. apart from hur-
riedl) pre
sing t....o 1\10gadon tablets into
his hand. Mr. Camp bare!) noticed his
pre
ence - he ",a
far too preoccupied
....ith Mr. Bro....n in the side room ....ho had
"heart bloc"" and. in Mr. Camp'

e
timation. would almost certainl) need
re
uscitating before the night .... a
out.
Therefore. it came as no surprise ....hen.
at 2 A.M.. he ....a
disturbed from his ",rit-
ing by urgent sounds of a buzzer being
pressed three time... - the signal for
cardiac arrest.
1\1r. Camp "ne.... .... ithoutloo"ing \\ here
the call came from and he left the office
immediately and made
traight for 1\1r.
Brown.... side room. But the patient ....as

Ieeping peacefull) and hi
cardiorator
reading ",as steady
1r. Camp ru
hed
into the ward to fmd his trembling young

Reprinted. \\<ith pcrmi"ion. from ,\/lni"g
Time.\, Jul
IX. I1J74.
DECEMBER 1974

:7

junior staring at the apparentl) lifelö

figure in the bed. 1\1r. Smith's bed!
Mr. Camp felt a lump come up in his
throat. For a fe.... seconds he .... a
com-
pletel) thnm n. He s"'allo....ed hard. \\ h)
didn't I observe him more cJosel). he
thought desperately.
He composed himself and went into
action. .. Put a cra'ih call out im-
mediately:' he ordered. pulling the pil-
hm s out from under the patient'
head
.... ith one hand and giving him a resound-
ing thump mid-sternum .... ith the other.
With that the "collapsed" patient sat
bolt upright in the hed. glared at 1\1r.
Camp for a fraction of a second. then
delivered a well-aimed blo.... to hi
ample
gut. sending him spra", ling on top of an
elder!) patient in the next bed.
The old man emitted a horrible
hrie"
and started punching ineffectually at the
gros
frame of the .... inded Mr. Camp.
.. Do leave orf:' he groaned. "Find yer
0.... n hleedin' bed."
By no.... the ....hole ....ard was a....a"e and
on top of that the .. cra'ih call" team ar-
rived in various
tages of undress: a ph) si-
ciano a
urgeon. an anesthetist. t....o night
si
ters and the theatre porter pushing an
anesthetic machine. When the) disco-
\- ered it .... a'i a false alarm. all e) e
turned
accusingly in
1r. Camp's direction. But
all he could do .... as dutch his abdomen
and groan.

, /
D1

"Fi"d \'(I/Ir Oil'''
bleetli,,' bed!"

H)steria - the) concluded. Convert-
ing hi
bloomer into gut ache becau
e he
can't face up to It.

The outcome
When Mr. Camp e\ entuall) recovered
they all had a good laugh at hi
("(pen
e
All. that is. except
1r. Smith and hi

elderl) neighbor. The) \\ere mo
t indig-
nant. And
o \\ere the relatives.
The da) si
ter had a terrible job
explaining. first to the old man''i daughter
\\ hen she demanded to "no\\ \\ h). \\ hen
she had been a,sured that her father .... a

mentall) sound. he had just given her a
tale about
omebod) tr) ing to get into bed
.... ith him dunng the night. It couldn't he
true. Could it'!
And Mr
. Smith \\ anted to "mm \\ h).
.... hen her husband \\ a

upposed to be
having rest. \\ as he afraid to go to sleep
for fear of being attac"ed in the middle of
the night. \\ hat "ind of hospital.... as this
an).... ay?
One good thing came out of it all.
Although
1r. Camp i
still \ery intere...ted
in his monitor'i. he no\\
pends a good
deal more time .... ith the other patients
And. ....hen occa
ilmall) hi
head get
..I
little .mollen. there'
u
uall) ,omebod)
there to nudge him and "' hi
per: ..
1r
Camp. remember the night.. ..

THE CA"-ADIAN NURSL 31

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Every nurse can -and should -be involved in research, as
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The nurse's expanded role in diagnosis, treatment and evalu-
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Included are th
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Chapter end tables and summaries present factual data and
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THE PRACTICE OF MENTAL
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A Community Approach
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Patient's information base:

a key to care

All information a patient gathers about his illness contributes to his information
base and is used by him in reacting to his illness. Therefore, the health team
should not only improve its own input into a patient's information ba
e, but
should also become aware of information gathered elsewhere. SU<.h awareness
can help determine the kind of intervention a patient needs.

Patient teaching and the need to plan thi

aspect of care are eon
idered important.
yet studie
indicate that patient
often
po

es
little knowledge of their disea
e
or its treatment. I.
Pratt found that
patient
do have considerable information
and. further. that they learn much of it
from source
other than the health team. 3
This paper. based on a
tudy of II
cardiac patients. altempt
to shed further
light on the fa
cinating proce
s by which
patient
accumulate and use information
relative to their illnes
situations.

Study is donI.'
Eleven cardiac patients wae inter-
viewed during their ho
pitalization and
folio\\- ing discharge. Intervie.... s were un-

tructured and their content .... a
subse-
quently analyzed to identify the informa-
tion patient
used in asse
sing their illness

ituation
. 4
Patient
obtained information from ...ix
source
. and all information contributed
to their total information base (Table I).
The information \\-as of two types: that

Lel.la RI'!'Hn...oõ1 (R.'\.. \\innipeg General
H,"pit.tl "'1'hl.oll.1 nur...ing: H.:\.. Univcr"'l1
of
\Ianill.h.t: \1.Sc (-\ppl.). \kGill Lll1i..er...it
)
i... lIur...ing co,'rdinator of the regional re...pir.lI-
or
l'ill" pn>gral11 .It 'it JI"eph'... Ho...pil.11.
H.unilll.n. Ontario. She collected d.lla for .hi...
..rlide \\ hile a ...tlllknt .11 \k(jill Ulli\er...il
.
34 THE CANADIAN NURSE

Leola A. Robinson

gained through personal experience (in-
ternal sources). and that provided by
others (external sources).
Internal sources of information ....ere a

follows:
I. Past symptoms or illness - informa-
tion derived through symptoms. treat-
ment. or recovery from past epi
odes of
sickness.
2. Pln'siolo?ical.féedhacÁ - informa-
tion inferred from physiological indi-
cants. "uch as symptoms or activity
tolerance.
3. Factor.\' ill olle's l(fl' situatioll -
informatil1n gained through a
"'C'-o...illg
one's family
ituation. job. or living
habits.

External ...ource" of information \\-ere:
I, Thl' hl'lilth team - information
received directly through in...tructions and
explanantions: or indirectly through ob-
...ervation
.
2. The plthlit. media - information
from newspaper article.... and radio or
television program
.
3. Others with Ill'art disease - infor-
mation gained from other
klllm n previ-
ou>;ly or met.... hill' in hospital.
Patient
dre.... on the
ix information
source
. in different ....ays (Table 2). They
u
ed
ome information sourcð fre-
quently. or at length. and called on
information gleaned from pepitmal ex-

perience (internal
ources) more heavtly
than on intilfluation provided by otha

(external
ources).
:'I1ot only did patient
use different
information ...oureð. but the information
gained from each ...ource varied in nature.
As a re
ult. ....hen the total information
ba,c for each patient \\.IS considered.
three different ..vie....... of illnös" ....ere
identified:
I. Optimistic - information from all
M)UrCÖ "een a, encouraging.
2. ('Ilcertaill - information from some
,ouree' ...een a., encouraging. and from
others. a... di
couraging.
3. Peuimistic - information from all
sourcö interpreted as di
eouraging. Of
the cleven patient
. tï\e had an optimistic
.. ie..... fÒur an uncertain vie..... and one a
pe'i
imi
tic vie.... of their illne...
.
Progres
. a
indicated by the medical
e\dluation and the resumption of former
activitiö. wa... positively a

I'ciated .... ith
the view of illne'i
held by p.ltients. That
i
. patienh \\-ith an optimistic ..ie\\- of
their illne

did ....ell. and patiel1l
\\-ith a
pe
simistie or ulll:ertain vie.... did no\. To
illu
trate. the information ba
e and pro-
gre...s of one patient will be de'icribed.

Thl.' patient
Mr. Dhabi. a 55-year-old Egyptian.
had li..ed in Canada for five years. He
.... a
married and had three grown chil-
DECEMBER 1974

TABLE I
Informational sources contributing to
a patient's information base

Health team management
and advice

Public
Media

Others with
heart disease

1 .--/
Information base
/ 1

Life situation Past Physiological
illness fpedbac k

dren. Prior to hi<; illness. both he and his
v. ife had v. orked. he as an office clerk.
she as a factor} worker. Mr. Dhabi \
as a
ljuiet-spo"en man. who smiled frequently
a' he talked. His English was undepitand-
able. although he sometimes invented
v.ords. such as "nervosity."
He had had a myocardial infarction a
year he fore coming to Canada. after
v. hich he convalesced at home for three
months. Six weeks hefore his current
admission. he had had another myocar-
dial infarction requiring hospitaliLation.
During that ,\omission. :\ok Dhabi ,uf-
fered a cardiac arrest and v. <I' uncon-
scious for 48 hours. Two days after
returnmg home. he experienced shortness
of breath and chest pain. He was readmit-
ted to hospital. The v.riter met him tv.o
da}s later.

Mr. Dhabi's information bdse

1r. Dh.\bi drev. on five of the SIX
mformation sources identified m the
study:
I. The health team - Mr. Dhabi paid
careful allention to information given him
by the health team. In fact. he sometimes
appeared deep in thought. almost trance-
like. as he descrihed this information. He
DECEMBER 1':174

followed instructions exactly. and could
not understand why he had been "at-
tacked again. ..
To illustrate. on his return to clinic one
month after discharge. Mr. Dhabi de-
scribed some instructions he had been
given:

"\I
doctor told me not to he nenou' if I
;,-1 "Ihll( \,f 'In:
l1h'- 11,,-' h"'''-,,'d 11th' lh...
distance a' if thinking deepl
.) 'Tm to take a
nitrogl:-cerin and then lie do" n. ,md kt m

breath come ea,y. and relax." (He h'oked at
the intervie"er.J .., ou 'ee. hefore I "a
\cr

ncrvou,. and il made things \\orse'" (lie
looked into the di'tance dgain.) . 'Then. if thl'
pam doe'n't go a"ay after thrce nilroghc-
erins. III e,11I Ihe police amhulance .
2. Life .\;t//LH;O/l - Mr. Dhabi \.\Ikeo
ahout his joh in relation to his illness. in
every interview. An order clerk in an
office equipment firm. he checked incom-
ing orders and monitored sales records for
all salesmen. This hecame quite hectic at
times. In the first inteniew he 'itated:

"1 think I "ill ""mt to change 111\ joh. I
"orry quile a hit dnd I don't Ihink I ,hould
ha\e that kmd of prcssure anymore."

A con'iistent theme \\ a'i that \\ hatcver
joh he did. he wanted to he able to
manage it \\ell.
The topic of finances also recurred.
After becoming ill. Mr Dhabi received
unemployment insurance. He hoped to
per<;uade a doctor to \Hite a leller
indicatinr! his continued inahility to return

Table 2
Information sources used by patients in the study
External Sources Internal Sources
Patients
Health Others with Public Past Life Physiological Total
Team Heart Disease Media Illness Situation FeedhacJ..
A x x x x x 5
B x x x x x 5
C x x x x x 5
0 x x x x 4
E x x x x x '}
F x x x x x '}
G x x x x x 5
H x x x x 4
I x x x 3
J x x x x x 5
K x x x 3
Total 11 6 3 8 10 11 4q
M

THE CANADIAN NUR
E 35

to work. He repeatedly went over the
rules for unemployment insurance, and
once stated: "You know. it's not so easy
in this city. .-
3. Physiolugical feedhack - When
Mr. Dhabi came to the clinic the second
time, he made a long comment that
illustrates the importance he placed on
this information source:

"Well. I"m prelly good: I get very tired
though. I take my breakfast and [ have to rest;
I go for a walk for 10 or 15 minute
and [ have
to rest. I get dizzy in the head. and dS soon a
I
feci that way I have to lie down and take a
nitrogIYl:erin. Then I rðt and I feel beller. But
I notice my memory is not very good. 1"11
sometime
think of something I "ant to tell
my \\ife and it will be gone. and I used to be
perfel:t. AI
o. \\hcn I \\rite. it is very slow.
and I don't
ee too well. I don't know \\hy. If!
\\,atl:h t.:levi
ion. I hecome dizzy if it i

emotional: then. I have to lie down. Now. as
far a... my job is concerned. I kno\\ I l:an't do
it. the "ay I feeL"
4. Puhlic media - Mr. Dhabi used a
newspaper article he had read to explain
what had happened to him. This article
pointed out that indigestion was a fre-
quent cause of heart attack. On the basis
of this he said. ,. From now on. r m going
to eat in frequent. small amounts."
5. Past illnesses - Mr. Dhabi talked of
the experiences of his most recent heart
attack and. on one occasion. referred to
the heart attack he had had six years
previously:
,,' \\ a... allad.ed for the fir
t timc
ix years
agn, and [ \\,'" treated at home for three
month
. Then I "ent back to my office and
took thing... pretty easy. For six year... I had no

ymptom... of a hcart attack at dlL dnd my
docto", told me I \\a... fine and had nothing to
\\, orry about. . .

In talking of hi
recent two days at
home. he pointed out that his numerou

visitors had contributed to his relapse.
This time he planned to be less active
w hen he went home.

Conflicting Information
When Mr Dhabi's lotal information
ba...e is considered. it can be !.een that he
had an uncertain view of his illness. That
is. some information was optimistic and
some pes
imistic. For example, the health
team as!.ured him he could resume his
36 THE CANADIAN NURSE

previous life and gave him guidelines.
which he followed diligently; he learned
from a newspaper article that a modified
eating pattern would be helpful; and he
had successfully recovered from an attack
six years before. On the other hand,
although he followed instructions care-
fully, his illness recurred after two days at
home, In addition, he did not "feel" like
himself - he was frequently dizzy, his
writing was shaky, and he could not see
as well as he had. Further, his life
situation did not allow him to ease back
into his job gradually as he had done in
the past, and he was afraid he would fail.
The uncertain view of his illness,
which resulted from this conflicting in-
formation. was associated with unfavor-
able follow-up progress when his medica!
evaluation and return to former activities
were looked at.
Clinical signs seemed favorable: ab-
sence of chest pain. shortness of breath,
jugular venous distension. and cardiac
murmurs; a clear chest to auscultation; a
regular pulse of 72; and a blood pressure
of 105/88. However, Mr. Dhabi was seen
as a management problem because he had
been slow to return to normal activities.
In fact. the comment on the medical
record was: "Should be advised to work.
He seems to have the personality to
develop a cardiac neurosis.'-
From the signs monitored by the
doctor. this seemed like a reasonable
impression. Yet. we know that Mr. Dhabi
was considering additional information
inputs. He was cautious about his future
because he experienced symptoms that
signaled problems in relation to his job.
This man required more than advice to
return to work and is one patient who
would benefit from a more comprehen-
<;ive follow-up. This would allow the
health team to: more fully assess the
neurological aftereffects of his cardiac
arrest; assist him in making the temporary
adjustments in his life made necessary
because he is convalescing and out of
work; and help him work out possible
alternatives in reestablishing a useful life.

Implications
Mr. Dhabi was described as an exam-
ple of one of the II patients under study
to illustrate a number of points:
. patients acquire information from a
variety of information sources;

. each patient acquires a unique informa-
tion base from these sources;
. information from one source may not
be supported by information from
another, and the patienl halance
this
information him
elf;
. the health team is an important source
of external information for most patient!..
However, external information is not as
frequently used as information gained
from personal experience: and
. a patient's information base provides
clues as to his future progress.
The last point give!. the health It:am a
useful tool in planning care. Patients with
an optimistic view of their illness made
favorable medical progress and success-
fully returned to former activitið. Such
patients may need only straightfomard
guidelines and instructions.
Patients such as Mr. Dhabi. who have
an uncertain or pessimistic vie\\ of their
illness, do not make as favorable a
medical progress or experience as suc-
cessful a return to former activities. They
require additional measures. such as
individual guidance, easy access to the
health care team. and/or intervention into
factors that adversely affect their view of
the illness.
Awareness of the information ba<;e that
a patient possesses to identify the "vie\\
of illness" can guide the health care team
in assessing which patient!. require addi-
tional measures. In this way. intervention
that is directed toward an individual's
needs is possible.

References
I. Nordwich. Irene Erika. COllcerns of car-
diac patienT.f re!?ardill!? thC'Ír ahilin' to
implemenT the prescribed drL/!? themp\'.
London. Ont., 1970. (Thesis 1M. Sc. N.)
Western Ontario)
2, Royle. Joan Aileen. A .mllly of selected
myocardial illfarctioll parient.\ alld their
families: kllOll'led!?e of ami attitudes to-
ward heart disea.fe and prescribed
therapy. Toronto. c (1}7 '2. (Thesi!.
(M.Sc. N.) Toronto)
3. Pratt. Loi
. Ho\\ do patienl
learn about
disease'? Social Pmblel//\ 4:29-40. July
11}56.
4. Robinson. Leola Anne. 1,!lormmioll
wilized b,' e1el'en cardiac patienTs al/d the
rellltÙJIl.\'hip ({ thÜ inli/rmal/ol/ to pm!?res.\
after dÜchar!?e.
1ontreaL )n3. (Report
(M.Sl:. (Appl)) McGill)

DECEMBER 1974

-

Mildred Jones walks again

A cerebrovascular accident brought Mildred Jones to an active treatment hospi-
tal. Seven student nurses, using nursing care plans and behavior modification,
encouraged her to return to independence.

Brenda Burt, Marlene Law, Laurie Machan, Cathy Macklin, Dianne Nesbitt, Beth
Read. and Cheryl Wiebe.

Mildred Jones. 73 years old. lives with her
aging husband in a three-story house. Her
only daughter lives in the same town.
M.J. \'vas admitted to a medical floor in
a general hospital after suffering a mild
cerebrovascular accident. Her left leg was
quite v.eal.. and her left arm was affected.
but to a lesser degree. Her other health
problems included arthritis, particularly in
her knees. v. hich made ambulation dif-
ficult. and gross obesity that led to prob-
lems of hygiene. In fact. her skin was
broken in many areas, especially where
tv.o sl..in surfaces met. such as under the
breasts and in the groin. A putrid odor
pervaded her room.
For M.J.. good hygiene had to be given
priority if we were going to be able to
encourage people to take an interest in her
and persuade her to care for herself. She
had not been in a bathtub for many years
and was frightened by the idea. After a few
transfers in the Hoyer lift. however. she
looked forward to being immersed in the
warm. soft \'vater. In this way we were able
to clean the perineal area thoroughly.
M.J. benefited from the bath oil in the
tub. which kept her skin from becoming
dry, made the water soft. and smelled
sweet. We dried her skin well and applied
powderto prevent further skin breakdown.
As well as cleansing the patient. the tub
bath provided us with an opportunity to
have M.J. start moving her legs while im-
mersed some very necessary
physiotherapy.
Physiotherapists visited every day and
talked to us about goals for our patient's
care. The therapists said that M.J. would
cooperate but needed a lot of encourage-
ment to walk and do exercises. "She ap-
pears lazy and, although she wishes to get
hetter. she put" forth only average effort."

The ,lUthors are IÏrst-)>edr students at Conestoga
College. Guelph. Ont,trio. They dcknowledge
the guidance of their teacher. Jean Morris.
DECEMBER 1974

they reported. Two people were needed
for support at first. but later M.J. used a
walker and progressed more favorably
with it.
Posture was an important consideration
when M.J. walked, as she tended to look at
the floor. By giving her a goal. she was
encouraged to look up toward it. and walk
a bit farther each time. As her walking
improved. we stopped giving her a bedpan
and insisted on her walking to the bath-
room each time she asked for one.
When about to sit down. M.J. had to be
reminded to pull the walker in close to the
chair and to back up until her legs touched
it. This enabled her to sit down gently.
rather than to "fall" into the chair. which
she tended to do because of arthritic knees.
The occupational therapist also visited
our patient and decided that she would
benefit from visiting the kitchen area in the
occupational therapy department. Here.
the therapists could assess her ability to
function at home and encourage her to
perform activities of daily living. They
found that M.J. was not too interested in
this area. and we discovered that her hus-
band usually prepared the meals. This lib-
erated woman was too smart for us!
As M.J. was very sociable, she showed
a keen interest in most recreational ac-
tivities suggested. She began to braid a rug
and later enJoyed playing bridge with other
patients.
Walking to the sunroom was her ulti-
mate goal. and the telephone near it was an
additional reward, as her husband had
promised her the money to call her best
friend if she would walk that far.
We made a chart to provide encourage-
ment and to rekindle her interest in walk-
ing. This was in the form of a poster of the
hall. with footsteps leading to a huge sun
and a telephone. As M.J. progressed down
the hall, the footsteps were colored in with
red. We hung the poster in her room.
where it could easily be seen and where
everyone would notice it.

Progress seemed slow. Everyone ap-
proached her differently, and no real re-
sults seemed evident after the first week.
The nursing staff began to complain and
M.J. appeared to be a bit "stubborn."
We decided a conference v.as needed.
and the team leader and registered nursing
assistants attended. To open communica-
tion we asked the team who attended her
much more often than \'ve did. to express
their feelings about her. They said they
were discouraged and found it difficult to
relate to her as someone in need of re-
habilitative care. We discussed rehabilita-
tive principles. and decided to implement
any goals that were suitable.
We tried to be consistent in setting goals
and planning care to provide comprehen-
sive. individualized care throughout each
24-hour period. In our care plan we in-
cluded: discouraging use of the bedpan,
encouraging v.alking - in fact \'ve planned
three walks per day - careful àttention to
posture. and proper use of the walker.
Each success brought consistent praise.
and each failure was treated in a matter-
of-fact manner. This type of behavIOr
modification. where our patient was given
lots of positive reinforcement and no nega-
tive reinforcement. was experimental for
us. but proved effective in this instance.
From this experience. we learned hov.
effective team work can be and hov. to
formulate and use nursing care plans.
Furthermore. v.e had some opportunity to
try behavior modification. Besides. we
saw ourselves functioning as a group. not
only in caring for M.J" but also in prepar-
ing this paper. It also served to consolidate
our knov.ledge of rehabilitation. v. hich \\e
recognize as a continuous process that
must begin in the active treatment setting.
M.J. left our hospital and proceeded to a
rehabilitation unit. having a good start to-
v.ard her long-term goal of once more
functioning independently in her ov. n
home. We thank her fÒr her contribution to
our education.
THE ANADIAN NURSE 37

When you make your
own tape...

r
c-
ì
r ....
, -

. ,{"

'.
'.I; ,.::

Besides being a useful teaching tool for patients, the home-made
tape is fun to assemble. A real team effort is needed, along with
a sense of humour and a fair amount of patience and ingenuity.

Nora Briant

Nurse: Mr. Parsons. let me give you
this booklet. It's about heart attacks, and I
think it will help you understand what the
doctor said.
Mr. Parsons: That's fine. nurse. I can't
see those small words though.
Nurse: That's okay - Iïl go through it
with you. The first part tells how the
heart. . . oh, excuse me, I have to
answer that buzzer.
QUl'sf;on: When did the nurse get
back'! How many more exits were there'!
How did Mr. Parsons feel'!
There are many examples like this.
where a patient is unable to read for some
reason, and the nurse tries to help him
with his health teaching. Sometimes the
....rilten ....nrd just is not adequate and the
patient does not learn.

Making the tape
Part of my time in in<;ervice edw:ation
is spent buying teaching materials for
staff and patients. So. when the head

Nora Briant (RN. The Montreal General
Ho"'pital School of Nursing) \\a... a nursing
education l:oordinator at the We...tern Memo-
rial Hospital. Corner 13 roo" . NewlÙund-
land. \\ hen ...he \\ role Ihi... article. She is
pre...entl} slUdying for" bal:helor of nursing
degree at the University of New Bruns\\ic".

38 THE CANADIAN NURSE

nurse on the medical floor wanted a
patient-teaching cassette about heart at-
tacks. she came to me. There wasn't
anything suitable on file, but I had the
idea that we could make one ourselves -
which sounded exciting. The head nurse
agreed with this, so I asked two RNs in the
coronary care unit for their help.
We started by deciding who the tape
was for: any patient who cannot read. for
whatever reason. and who is unfamiliar
with hospitals or medical terminology; it
is for patients who have had a recent
myocardial infarction and for those who
are convalescing.
We made a li<;t ot the topics to be
included and sought some specialized
help: a dietitian was asked t'.) cover the
food aspect. and an internist was to write
about .. after you go home." The ccu
nurses and I wrote on several topics and
put it all together into one big script.
There were several repetitions and to,)
much unnecessary information in our
tape. As we figured that
O minutes'
concentralion would be the mO'it \\c could
expect from the patient, \\e decided to
reduce the content. We cut it by about half
and made a special effort to "eep the
vocabulary simple. Copies of the script
were given to the ccu nurses and doctors
and to nursing administration for criti-
cisms and suggestions.

DECEMBER 1974

I became the babysitter - but not a satisfactory one.

The final material was put in dialogue
form because of the variety of voices it
would give the listener. Two nurses, the
internist, and the dietitian all read parts.
Each speaks with a slightly different
accent, and this, too, added variety in
listening.
Not everyone could be available at the
same time, so our taping was done in bits
and pieces. This left a few clicks and
dunks on the tape. After many false starts,
due to people laughing, we conquered our
shyness.

Rock-a-bye baby
One RN came to the hospital on her
time off. and, for want of a babysitter.
brought her three-month-old baby. As I
was only watching the taping session, I
became the bahysitter - but not a
satisfactory one. When the infant started
to cry. I wa.. frantic to keep the sound off
the tape. Talking, cooing, and
humming were completel} ineffective.
Another nurse observer came to my aid
with jiggling and rocking. I quieti} left
and found some business elsewhere.
When I returned in about 10 minutes, I
realized my replacement's charm had
worn off, because the baby had been
DECEMBER t<<}74

transferred. Still crying, he wa, on a bed
in the EEG lab across the hall, being
minded by the staff there. Mother, baby.
and EEG staff were relieved when the
taping session broke up minutes later.

T ape Outline

Topic:

Heart Attacks

Introduction:

General

Suhtopics:

Function of the
heart and vessels

How the heart
is damaged

How we know
it's damaged

While in hospital

Diet implications

A tier you go home

çummar\':

With optimistic tone.

r-.tost hospit.Jl., have small. soundproof
booths for didating We decided against
using a booth because of the rötricted
space. Any quiet room is probabl} ade-
quate. Ours did not have much furniture
in it, so there ....as a .:ertain amount of
echo effect. A fe.... heavy blankets draped
around the room helped to reduce this
problem.

Home-made vs bought tapes
We used simple equipment: a cassette
tape recorder and tapes. These are cas) to
use and easy on the budget. One tape ....as
marked with the title and one was for
practice. The person taping would tryout
her part. then listen to it on the practice
tape first, before pUlling it on the final
tape. We did this because we feared
someone might accidentally erase part ot
the good tape. As you know. this has
happened dsc\\herc - although in our
case it wouldn't make the headlines.
Although the tape sounds a bit
amateurish, .... ith a fe\\ hesitations and
clicks, the patients don't mind. I believe
they feel pleased that \\'(' made it for
'hem. They recognize the voices and
lames of staff.
We have used this tape ....ith booklets,
Nithout booklets, in 'he ccu and on the
.vard: we have played it for patients
)efore they go home and for family
members The tape can be repeated as
often as needed. It invites que'itions and
discussion and. therefore, fills thc bill
perfectl y.
The real bonus in a home-made tape is
the stimulation it gives the staff. It calls
for team effort and new idea" provides
job satisfaction, and encourages neative
nursmg. All in all. !,' sa.... orth\\ hiIc
project!

.
THE CANADIAN NURSE J9

names

Louise Too (R.N.. Royal Alexandra Hos-
pital school of nur
ing. Edmonton; B.N..
McGill University; M.S.. University of
Colorado) was recently appointed ex-
ecutive director of
the Manitoba Asso-
ciation of Registered
Nurses. She brings
to her new position
experience as com-
mittee coordinator
and employment re-
lation... officer for the
Alberta Association
of Registered Nurses, and chairman of the
Canadian \jur
es' Assuciation'
commit-
tee on socio-economic welfare. She has
also been a member of the CNA board.
Tod was formerly consultant in hospital
nursing, health insurance division of the
health programs branch. Health and Wel-
fare Canada.

:1\

....

Arline T. Kirkpatrick, (R.N., SI. Mary's
Hospital school of nursing, Montre-al) has
been elected vice-chaini1an of the Nova
Scotia section of the Nurses' AssoCiation
of The American College of Obstetricians
and Gynecologists (NA^COG).
She was installed during the Associa-
tion's Annual District I Conference held in
October in Halifax.
Kirkpatrick is a nursing instructor in
obstetrics at the Halifax Infirmary school
of nursing and is presently working toward
a bachelor of science degree in nursing at
Mount SI. Vincent University. Halifax.

..

4

;.
A . J . K ir/...patrick

L. F ergusun

Lorna Ferguson (B.N.. McGill Univer
ity)
has been elected Chairman of the Quebec
Section ufThe Nursð' Association of The
American College of Ob<;tetricians ,md
Gynecologi
t
(I\JAACOG).
She \\a... installed during the Associa-
tion's Annual District I Co
ference in Oc-
tober in Halitax.
Ferguson is obstetrics supervi
or at the
Je.... ish General Hospital in Montreal.
40 THE CANADIAN NURSE

Andrea Baumann and Cornelia Ann
Gibson have joined the school of nursing
of the University of British Columbia as
assistant professors.
Ms. Baumann (Reg. N., Nightingale
School of Nu:-sing. To:-onto; B.Sc.N.,
University of Windsor; M.Sc.N., U. of
Western Ontario, London) has been a
staff nurse with the Victorian Order of
Nu:-ses and the depa:1ment of health in
Tomnto and an inst:-ucto:- at Wellesley
Hospital in Tomnto and at the Victo:-ia
Campus of FanshaVve College in London.
Ms. Gibson (B.S.N.. U. of California,
Los Angeles; M.P.H., University of
Michigan, Ann Arbor), following three
yea:-s as staff nu:-se ....ith the U.S. A:-my
Nu:-se Co:-ps. has been engaged in public
health. She has been with the health de-
partments of Los Angeles County,
Washington. and the City of Portland.
Her most recent appointment was as
c:-ippled child:-erl s consultant .... ith the
Ohio ';tate depa:1ment of Vvelfa:-e, Colum-
bus, Ohio.

Carol Kotlarsky
Dworkin (B.J.,
Carleton University,
Ottawa) has accepted
the position of print
media officer with
the Ministry of State
for Urban Affairs.
She has been edito-
rial assistant with
The Canadian Nurse since early in 1969,
interrupted for a few months in 1970 to
fulfill her dream to travel in Europe. She
and her hushand have just returned from an
extended holiday in Israel.
Keenly interested in journalism, Carol
is an active member of the Media Club of
Onawa.

, !

Judith Anne Ritchie (B.N., Unive:-sity of
NeVv B:-unsVvick; M.N., and docto:-al can.
didate. Unive:-sity of Pittshu:-gh) has been
appointed assistant pmfesso:-, faculty of
nu:-sing. Unive:-sity of NeVv BrunsVvick.
She ....as fo:-me:-ly a clinic.}1 inst:-ucto:- In
nu:-sing at UNR. Concu:-ænt Vv ith he:- stu.
dies. she ha... been clinical specialist, de-
pa:1ment of psychiatry, Childæn'
, Hospi
tal of Piu<;bu:-gh. and :-esea:-ch inst:-ucto:-,
pediatric nursing, U. of Pittsburgh. She
has had articles published in the

atemal-Child Nursing Juurnal.

Jeanette MacDonald, (R.N.. SI. Joseph's
General Hospital school of nursing,
VegreviIle, Alberta) who has been work-
ing at Charles Camsell Hospital in Ed-
monton, and Wynne Turner, (R.N. Calgary
General Hospital, have arrived in In-
donesia to serve a two-year tour of duty
with MEDICO. a service of CARE.
They are stationed at a hospital cumplex
in Surakarta (Solo). in the province of
Central Java. as part of a 17-member
CARE-MEDICO team supported by Cana-
dian donors. In addition to training Indo-
nesian nurses. they will help upgrade pa-
tient care.

...

l

i
,
1\
W. Tumer

J. MacDonald

Julia Dianne Quiring (R.N., Emanuel
Hospital, Portland, Oregon; B.S., U. of
Oregon, Portland; M.N., Ph.D., U. of
Washington, Seattle) has been appointed
associate professor, school of nursing,
University of British Columbia. For the
past several years, she has been engaged
in professional teaching, her latest ap-
pointment having been assistant professor
and undergraduate curriculum chairman
at Pennsylvania State University. Univer-
sity Park, Pa.

Elizabeth Yallowega (R.N., Winnipeg
General Hospital; B.A., University of
Manitoba) has been appointed assistant
administrator, nursing. of the Grace Gen-
eral Hospital, Winnipeg. She has been
head nurse at the Winnipeg General
Hospital, clinical coordinator at the To-
ronto General Hospital and, most recently,
assistant director of nursing, Grace Gen-
eral Hospital, Winnipeg.

Susan Reimer (Reg. N., Hamilton General
Hospital school of nursing; Dipl. Ad-
vanced Public Health, University of To-
ronto; B.Sc.N.. University of Western
Ontario, London) has been appointed an
DECEMBER 1974

In'ipector of the Council of the College of
Nurses of Ontario. For the past seven
years. she was on the faculty of the
Hamilton and District School of Nursing.
now part of the nursing division of the
Mohawk College of Applied Arts and
Technology.

Gerda Höjer, president of the Interna-
tional Council of Nurses 1947-1953. died
in Sweden June 20. 1974. She was
executive secretary of the Swedish Nurses
Association for 12 years hefore hecoming
its president in 1945. in which capacity
she served until 1960. She was also a
member of the Swedish parliament from
1949-1960.

The New Brunswick Association of Regi'i-
tered Nurses has announced the recipients
of five scholarship awards:
Valerie Hagerman (B.N.. University of
Ne\\ Bruns\\ick) of Nackawic is enrolled
in the master's program. University of
Toronto. with psychiatric nursing as her
field of study. Hers is an NBARN scholar-
ship of $1.000.
Bertha Lee Dunham of Millerton is in the
basic nur'iing program at UNB and Mona
Savoie of Balmoral in the basic nursing
program at the University of Moncton L .
both under an NR-\RN 'icholarship,of $500
each.
Roberta Maclean, R.N., of Black River
Bridge and Gail Storr, R.N., of Fredericton
have been awarded the Muriel Archibald
Scholarship of $5()() each. Both are enrol-
led in the degree program for registered
nurses at UNB

Isabel Black ha'i re-
tired from her posi-
tion of principal
nurse consultant re-
search and analy-
sis division. Ontar-
io Department of
Health. Before join-
ing that depart-
ment about 30 years
years ago. she had worked with the Vic-
torian Order of Nurses and at the Tuber-
culosis Sanitarium in London. Ontario.
Dr. Black studied nursing at the
Victoria Hospital school of nursing in
London. and public health nursing at the
University of Western Ontario. She earned
her bachelor of science and master of arts
degrees at Columbia University and was
honored by a doctorate in nursing at the
University of Ottawa. She is currently
vice-chairman. national nursing commit-
tee of the Canadian Red Cross Society.
and a member of the RNAO committee on
nursing research.
Her man) nonnursing interests will SU'i-
tain her in retirement. of which literature
and gourmd cooking arc hut t\\o.
DECEMBER 1<<}74

New members of the faculty of
Lakehead University school of nursing.
Thunder Bay. have been announced:
Margaret I. Boone (Reg. N.. Mack Train-
ing School for Nurses. St. Catharines:
B
Sc.N.. Lakehead Univer;;ity; M.S.
(Maternal-Child Health) Boston Univer-
sity) IS assistant professor. maternal-child
nursing. Her most recent appointment has
been that of clinical nurse specialist at the
Hospital for Sick Children. Toronto.
Aileen Norah O'Leary (Reg.N., Toronto
General Hospital 'ichool of nursing.
B.Sc.N.. M.Sc. N.. University of To-
ronto) is dssistant professor. Her most re-
cent appointment has been that of
medical-surgical nursing teacher at York
Regional ScLhool of NU;'iing.

Joan T. Lawrence has
been appointed di-
rector of nursing at
Bums Lake & Dis-
trict Hospital. Burns
Lake. B.C. A grad-
uate of Royal North
Shore Hospital.
Sydney. Australia,
she has had several
years experience as general duty nurse in
hospitals in Canada. New York. and Ger-
many. The last position held was evening
supervisnr at Dawson Creek and District
Hospital. Dawson Creek. B.C.

,-
--

Þ.nnehMarie Levesque
(R.N., Montreal Gen-
eral Hospital school
.:; of nursing; B.SeN..
U. of Western
Ontario. London) is
the new nur'ie-in-
charge of the Victo-
rian Order of Nurses,
Stratford. Ontarin.
She has been a general duty nurse at SI.
Joseph's Hospital in London. and has. dur-
ing two successive summers. worked at
the Whitehorse General Hospital and at the
Inuvik General Hospital

The Order of Nurses of Quebec has
announced scholarship recipients for
1974-75:
Louiselle Bouffard (R.N" HÔpital Ste-
Jeanne d'Arc; B.N.. U. of \ilontreal) has
entered the master's program in nursing
administration. University of Montreal.
Andrée Bourdon (R.N., Hôpital
Notre-Dame: B.N.. U. of Montreal) ha'i
entered the master's degree program in
psychiatric nursing and mental health.
University of Montreal.
Yoland
Gui>rk (B.N., U. of Montreal)
has entered the master's program in
nur'iing education. Univer...ity of
Montreal.
Thérl>s(, Charpentier-Poupart (Reg. N..
St. Michael's Hospital school of nursing,

Toronto: B.N. Laval University.
Quebec) is in the master's program Ìn
medical-surgical nursing. University of
\1ontreal.
Margaret Gertler (R. N .. SI. Mary's
Hospital. :\1ontreal) is in the bac-
calaureate program (matanal and child
health) at McGill University. Montreal.
Mary Angela Sutherland is completing
her studies toward a baccalaureate in
public health nursing at McGill Univer-
sit). Hers is the Gabrielle
Charbonneau-Lavallée award. in memory
of the noted public health nurse and
teacher who lo,;t her life in 1972.

Gloria Stephens (R.!\.. Victoria General
Hospital. Halifax). a past president of the
B.C. Operating Room Nurses groupofthe
Registered Nurses Association of Briti,h
Columbia. is this year's \\inner of the In-
novative Nursing Award. established by
the Vancouver Metropolitan District.
RNABC An operating room instructor at
St. Pau!"s Hospital. Vancouver. she was
honored for her work on the BCORN"
committee to review operating room stan-
dards.

Jean Cummings ha, been appointed busi-
ness manager for the Manitoha Associa-
tion of Registered Nurse.... a position th.lt
encompassð office control. publicity. and
general financial matters. She comes to
MAR\! with extensive experience in the
health tield. school administration. and
business.

Hilda Smith (R.N.. Dauphin General Hos-
pital school of nur,ing) ha, retired <.Iher
more than 30 year'i of dedicated service to
nursing in 1\lanitoha. She \\as tilr mall\
year.. ,
dministrator and director of nursing
<.It the Minnedo,a District Hospital and.
more recentl}. 0\\ ing to recurrent poor
health. worked a... general dutv nUf';e in
smaller 'þ,r,pitals of the area. Sh
nov\ coil"
Strathdair home.

Ona Me Dt'rmott
(R. N.. Royal Jubilee
Hospital. Victoria;
B.N.. Universitv of
Manitoba: 1\{S.,
Univer...it} of Minne-
sota. :\'1inneapolis)
has been appointed
coordinator tilr the
licensed practical
nurse program of A

iniboine Communit

Colle!!e. Brandon. Manitoba. Her imme-
diate fa'ik is \(1 formulate cour,;e structure
and content.
She V\.IS formerly director of the schllol
of nursing. Misericordia Hospital. Winni-
peg. Manitoha. ..
HtE CANADIAN NURSE 41

c...
, )

new products

{

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

.

......."
I .r

Mol'

-.

"..

........

'-

,t'!

Mini-Bottle drug system
The Mini-Bottle drug delivery system for
Ketlin (sodium cephalothin) is available
from Eli Lilly and Company (Canada)
Ltd.. P.O. Box 4037. Station "A".
Toronto,Ont. M5W I L I.
Thi<; Mini-Bottle. which is compatible
with most delivery systems for intraven-
ou<; medications, offers flexibility without
increased co
t. The system can replace
some IV equipment now in use. and is
adaptable to pharmacy admixture and unit
do<;e programs. Potential medication er-
ror
and sources of contamination should
be reduced with this product. according
to the company.
Two
izes - a 2g and a 4g Mini-
Bottle - are available.

New Pharbec Product: Hematic
Pharbec ha<; announced that Hematic is
now available. Hematic is indicated for
iron deficiency anemia and nutritional
deficiencies. Each 10 ml contains: iron
ammonium citrate. 200 mg; liver fraction
No. I. 50 mg: Vitamin B I. 2 mg; Vitamin
B2. 2 mg: Niacinamide 20 mg: Sorbitol
300 mg, Alcohol 10 percent.
Hematic i<; availahle in bottles of 12
and 80 oz. The DIN number is 295132.
Pharbec'<; he.Jd office i... at 4012 Côte
Vertu ,Montreal. Que. H4R IV4.
42 THE CANADIAN NURSE

Specimen container
Sage Products. Inc.. has developed a
metal screw-top lid for the Sage sterile
specimen container. When properly tight-
ened. this lid prevents lea"ing of specimen
or accidental contamination.
This specimen container of clear plastic
can be used to collect urine
pecimens.
sputum. stools. and tissue. and to store
and transport microscope slides. Contain-
ers' squat design prevents tipping and
makes them easy to stack for storage. The
wide mouth provides a large target area.
The specimen container is completely
disposable. A label shows sterility. if
unbroken. and is affixed for easy notation
of patient name. room number. and
doctor name.
For infonnation, write Ingram and Bell
LId.. 20 Bond Avenue. Don Mills.
Ontario.

- Sdqe'

.

--
--,

-"'I

DR ___
-------

\A('I

Specimen COllfa;ner

"AII-in-one" wheel, commode, and
shower chair
Lumex. Inc., has introduced a corrosion-
resistant. multi-purpose chair that offers
safety and comfort to patients. Thi
"all-
in-one" wheel. commode, and shower
chair efficiently combines mobility with
bathroom area functions.
Easy mobility is provided by 24"
heavy-duty VersaGuard-coated rear
wheels with hand rims. 5" front swivel
casters. and rear push handles. Rust-proof
toggle brakes adjust to compensate for tire
wear.
For the commode function, the chair has
a soft cushion. open front toilet seat. and
bedpan holder.
The multi-purpose chair unit features

'I

,

push-button adjustable. 3-position drop
arm
with molded. high-impact plastic
armrests. and a heavy-duty dacron back
rest pennitting access to the patient's back
for showering. Hook-on. adjustable, and
removable swing-away footrests. each
equipped with leg strap and heel loop.
facilitate patient transfer.
Information is available from the
Lumex Canadian subsidiary, Bercotec.
Inc.. 11422 Albert Hudon Blvd..
Montreal Nord 462. Quebec.

New medical skin cream
The new Posey skin cream. contammg
methylbenzethonium chloride and natural
vitamins A and D. guards against diaper
rash. urine scald, diarrheal dermatitis. rec-
tal itch. minor burns. and
kin abrasions. It
was originally formulated to protect the
skin under long-term limb holders and re-
straints.
The cream's pleasant <;cent makes it
popular among nurses for softening the
hands after ....orking with abrasive materi-
als.
For further information. contact: Enns
and Gilmore Limited. 1033 Rangeview
Road. Port Credit. Or:tario.

Disposable swabs and swabsticks
West Chemical Products. Inc.. has' de-
veloped Prepodyne swab
and swabsticks.
single-use swabs and applicator tips for
professional medical per
onnel. They are
especially useful in departments of urol-
ogy. surgery. gynecology. and outpatient
clinics. when small-area microbicidal ac-
tion is indicated in preparing the skin for
DECEMBER 1974

intra\ enous, imramusculaL or subcutane-
ous injections.
Both Prepodyne products are lethal to a
wide variety of microorganisms, including
antibiotic-resistant staphylococcus
strains. escherichia coli, proteus vulgaris.
pseudomonas aeruginosa, salmonella
typhosa and many others. The color left by
the Prepodyne swabs and swabsticks
clearly delineates the area treated. For in-
formation write: West Chemical Products.
Inc.. 42-16 West Street. Long Island City,
New York 11101.

-

I

...

'
;; ,
, \

Raney scalp clip rack
A new clip rack for Raney scalp clips
securely holds up to 24 clips for easy
loading or removal either by hand or with
the Raney clip applying forceps. This
rack is useful in surgery and for storing
and sterilizing Raney clips.
Additional information may be ob-
tained from Sparta Instrument Corpora-
tion. 305 Fairfield Avenue. Fairfield.
New Jersey, 07006, U.S.A.

Remote control mobilizer
The Mobilizer from the Medical Products
Division of Diamondhead Corporation
renders patient transferring gentle and
safe, and makes more efficient use of staff.
Operating a remote push button control
switch, one nurse can transfer the heaviest
and most sensitive bum patiem without
discomfort. The mobilizer uses II unique
frictionless transfer surface that glides be-
tween patient and bed surface. No "slid-
ing" sensation or movement is felt by the
patient. In effect, the new transfer surface
has replaced the bed surface. Then. a push
of a button moves the surface back to the
mobilizer. carrying the patiem with it. The
attendant can then replace the side rail.
release the wheel brakes, and move the
patient to his destination with ease. where
the process is reversed.
The Mobilizer is ideal for general floor
use within hospitals, for specialized appli-
DECEMBER 1974

cations in the surgical recovery room, in-
tensive care. coronary care, emergency.
maternity. bum care, orthopedics, physi-
cal therapy and x-ray departmems. The
mobilizer also provides a valuable service
in extended care centers, nursing homes.
clinics and anywhere hard-press
d. over-
v.orked staff must be used more effi-
ciently.

10bilizer units are available v. ithout
capital investment to all authorized medi-
cal facilities through a convenient lease
plan. They may also be leased with option
to buy or purchased outright. For informa-
tion, write. Medical Products Division.

Diamondhead Corporation. 200 Sheffield
Street. Mountainside. Nev. Jersey 07092.

Vigilon urological pack
This pack features a one-piece cysto
drape with built-in finger COI made of
soft. antistatic vinyl material. The drape
is complete with attached leggings. cysto
screen. and fenestration cover. Included
in the pack are two àb<;orbenttoweh. tv.o
radiopaque plastic clips. and a table cover.
For information. v.rite C.R. Bard.
(Canada) Ltd., I Wests ide Drive,
Etobicoke. Ontario :\19C I B2.

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 12 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: Bonles of 100 and 500 tablets.
Full product information available upon request.

SANDDZ@
DORVAL. QUEBEC
.

Sandoz PhaflT1aceutlCals DMsKm of Sandoz (Canada) ltd Dorval Quebec

.,

.. .-
--...

,

-- -

"
fJ" l q 124
1( /' 2
9 3
8 . 4
76 5

..

-

...

\

THE CANADIAN NURSE 43

Next Month
an

The
Canadian
Nurse

o

An Experiment With
The Ladder Concept

o

Drug Administration Times
Sho
ld Be Reexamined

o

Saskatchewan Air
Ambulance Service

Photo Credits
for December 1974

Halifax Infirmary.
Halifax. N.S.
pp. 25.26

44 THE CANADIAN NURSE

I dat es

January 13-15, 1975
Pediatric rehabilitation refresher course for
nurses, physiotherapists, and occupa-
tional therapists. For information write: The
Education Department. Ontario Crippled
Children's Centre, 350 Rumsey Road,
Toronto, Ontario, M4G 1 R8. Attention: L
Hamilton or N. Geddes.

January 27-31, 1975,
March 3-7, P}75, or
June 23-27, 1975
A five-day conference to provide nurses
caring for the newborn an opportunity to
increase their knowledge in the care of the
premature and newborn infant. For infor-
mation write: Director of Nursing Educa-
tion, The Hospital for Sick Children, 555
University Avenue, Toronto. Ont. M5G 1 X8.

February 7-9, 1975
Canadian University Nursing Student As-
sociation annual meeting at University of
Toronto, Toronto. Theme: Interdisciplinary
Health Education, For information write:
Marilyn Rae. Chairperson, 1975 Confer-
ence Planning Committee, CUNSA, Univer-
sity of Toronto, 42 Fulton Avenue, Toronto,
Ontario, M4K 1 X5.

February 19 and 20, 1975
Institute on nursing home care to be held
in Toronto under sponsorship of six as-
sociations, including RNAO. For informa-
tion, write: Educational Services Division,
Ontario Hospital Association. 150 Ferrand
Drive, Don Mills, Ontario M3C 1 H6.

March 5-7 or 12-14, 1975
April 16-18 or 23-25, 1975
Pediatric nursing conferences designed to
assist graduate nurses to become more
knowledgeable about common pediatric
problems and nursing approaches cur-
rently practiced. For information write:
Director of Nursing Education, The Hospi-
tal for Sick Children, 555 University Av-
enue, Toronto, Ontario. M5G 1 X8.

March 23-28,1975
Association of Operating Room Nurses
22nd annual congress is to be held at
Dallas Convention Center, Dallas, Texas.
For information write: Association of
Operating Room Nurses, Inc., 10170 E.
Mississippi Ave., Denver, Colo., 80231,
U.S.A.

April 3, 1975
Canadian Nurses Association will hold its
annual meeting at the Chateau Laurier,
Ottawa, Ontario.

April 21-25, 1975
Refresher course for nurse-midwives at
University of Alberta school of nursing. For
outline of program and registration form,
write: Continuing Nursing Education, The
University of Alberta, 12-103 Clinical Sci-
ences Building, Edmonton, Alberta, T6G
2G3.

April 27-30, 1975
First national conference of the Association
for Practitioners in Infection Control at the
Sheraton Chicago Hotel, Chicago, Illinois.
Membership in APIC is open to physicians,
surgeons, nurse epidemiologists, micro-
biologists, respiratory therapists.
pathologists, pharmacists, and house-
keepers. For information write: Julia K.
Rowan, Chairman, Public Relations, APIC,
3324 Craig Drive, Hammond. Ind. 46323.
U.S.A.

May 18-21, 1975
Combined annual meeting of the Canadian
Tuberculosis and Respiratory Disease As-
sociation and the American Lung Associa-
tion, to be held at the Queen Elizabeth
Hotel, Montreal. For information write:
Claire Martin, President of Nursing, Sub-
committee, Canadian TB and RD Associa-
tion, 12175 Taylor Street, Montreal,
Quebec H3M 2K1. Telephone: (514)
336-5725.

June 11-14,1975
The annual meeting of the Registered
Nurses Association of Ontario will coincide
with RNAO'S 50th birthday. The meeting
and anniversary celebrations are to be at
the Royal York Hotel, Toronto, Ontario.

August 11-16, 1975
World Assembly of War Veterans, to
commemorate the 30th anniversary of the
end of World War II, Sydney, Australia.
Pre- and post-convention tours available.
Registration fee: $A. 30.00. For further
information, write to: Assembly Secretar-
iat, G.P.O. Box 2609, Sydney, N.S.w.,
2001 , Australia. '"",'
DECEMBER 1974

research abstracts

Hinds, Cora. Methods of acquiring
1..1/011 ledge, amo/lnt oj knowledge. and
compliance with care in seleaed pa-
tients lI'ith diabetes. Toronto, Ont.,
1974. Thesis (M.Sc. N) U. of To-
ronto.
Forty-two medically diagnosed male and
female diabetic patients participated in
this descriptive investigation conducted in
their homes.
This study assessed influence of teach-
ing method on kno",led!!e necessary for
self-care, how much patìent knew about
his condition, and his degree of
compliance with treatment. It also identi-
fied factors that might improve nursing
care to diabetic patients.
Two groups of patients were studied:
the one group-taught, the other indivi-
dually instructed. There were 6 black and
36 white participants, 45 percent of
whon1'were male and 21 percent under 45
years of age. Twenty-six percent of the
patients were diagnosed under I year, 33
percent between I and 5 years, and 41
percent between 5 and 13 years. Twenty-
six patients were on insulin, and 16 on.
oral hypoglycemic therapy. Six patients
had had less than grade 7 education, 7 had
had some college or post high school
education.
A diabetic education center provided
the group-taught patients. A hospital
diabetic clinic and 2 official public health
agencies provided the others. Subjects
responded to a 58-item semi-structured
interview guide. Their knowledge and
performance of some skills needed for
self-care were scored on two areas of the
diahetic regimen: urine testing and medi-
cation. Response validity was based on
patient reporting and performance.
Findings did not suggest one method of
teaching diabetics was better than the
other. but indicated some advantages in
each.
Patient-; lacked knowledge and per-
formed poorly on areas ot the regimen
dealing with urine testing, which were
crucial to management of the disease. In
many instances they failed to recognize
danger signals and the appropriate action
needed. Compliance with treatment in
this area was correspondingly poor. Nine-
teen patients did not know the names of
their urine testing material, 3 used wrong
reagent striP'> to te.,t urine. 7 had
di.,colored Clinnest tahlets, and 2 had no
testing material.
Participants demonstrated gredter
kno",ledge and compliance scores on
DECEMBER 1974

insulin administration and oral hvpogly-
cemic therapy, with a slightly higher score
for oral medication. Of the 16 patients
on oral medication. 12 did not kmm the
name of their pills.
Those responding to the question on
insulin administration were not confused
in the use of U80 and U40 syringes. but
were concerned about using syringes
where each gradation represented two
units of insulin. This anxiety was express-
ed by all who had beén prescribed
uneven doses of insulin.
Sterilization and injection techniques
used by these patients showed they had
less than optimal knowledge in these
areas.
Reasons given for noncompliance va-
ried, for instance, breakdowns in the
health professional/patient communica-
tion system had occurred, orders given
the patient conflicted with his life-style,
or health professional reinforcement was
lacking.
Findings suggest a need for wntinuous
assessment and Elanned follow-up of
diabetic patients If they are to attain a
high level of self-care.

Cunningham, Rosella. An analysis of the
supervisory process in Middlesex-
London district health /lnit. Toronto.
Ont., 1973 Study. U. of Toronto

The aims of this study are: I. To explore
the supervisory process as carried out in
this health unit. 2. To determine the most
effective methods of supervision as per-
ceived by staff nurses and supervisors. 3.
To identify factors related to satisfaction
and dissatisfaction of nurses with the
work situation.
The population sample consisted of all
nurses employed by the Middlesex-
London District Health Unit who ",ere at
work during the first and/or second week
of July 1973.
The 85 participants included 5 super-
visors. 7 coordinators. 51} public health
nurses, 7 registered nurses. 6 health room
assistants. and I registered nursing assis-
tant.
A four-pdrt questionnaire was designed
to elicit information about the conduct ot
supervision in this health unit. Part A
requested infÒrmdtion about the nUßc.
her age, preparation, and a general
overview of her perception of the
agency's philosophy. goal!.. and climate.
Part B eliciled facts about supen,ision:

frequency. type. method. et cdera. Parts
C and D had many similar questions:
those in Part C being directed to the
person being supervised and those in Part
D. 10 the supervisor. All participants
completed three parts: A. B. and D if
supervisors: A. B. and C if not.
The questionnaire was mass adminis-
tered and. on completion. each partici-
pant was interviewed to provide an)
further information related to the three
purposes of the stud) .
The findings ....ere:
. More than one-quarter of the nUßes
were less than 30 years old, and 41
percent had held their present position
less than one year.
. Many nurses are uncertain about the
philosophy and objectives of this agency.
. The majority of the staff describe the
nursing leadership as "participative" and
perceive there is group participation in
decision making. They state nursing goals
are set by the director of nursing.
. The public health nurses see their main
role as "health teachers to individuals:'
or "providing continuity of care."
. Data indicate the present frequency of
supervision is satisfactory. The individual
supervisor-nurse conference. the must
frequently used type of supervision. is
considered the most valuable method.
Little time is spent preparing for these
conferences. and for the most part they
deal with day-to-day problems. ",ith little
long-term planning for staff development.
. The majority of staff rate their super-
visors above average. but many feel
supervisors should be involved in some
clinical work. This ",ould not only
promote better understanding and main-
tain skill in practice. but also facilitate
one important role of the supervisor. that
of role model.
. There is some overlap of the functiun uf
coordinator and supervisor. Criteria for
the appointment of coordinator should be
reviewed. Data indicate that every effort
should be made to develop highly effec-
tive groups in this type of organization.
. Although data indicate that satisfaction
.... ith the ",ork situation is relatively high.
some factors that militate against this
were identified: I. Prohlems ",ith com-
munication. 2. Perception of fa\oritism
(special privileges). 3. Fdilure to under-
stand the team concept.
Recommendations ",ere made in rela-
tion 10 planning.. implementing. dnd
THE CANADIAN NURSE 45

evaluating supervision. as well as to
organization of staff. communication,
dnd change
Recommendations for research In-
cluded:
I. Exploration of functions and re-
sponsibilities of the nursing supervisor in
official health agencies. The current
project explored this process in one
agency with five supervisors.
2. Delineation of criteria for selecting
nursing personnel in official health agen-
cies.
3. Determination of criteria for the
delegation of work to different categories
of workers in nursing.

Clark, Kathleen M. Participation bv nurses
in indeperJdent and dependent cOrJ-
tinuinR learning acti
'ities.
Vancouver, B.C. 1974. Thesis
(M.A.) U. of British Columbia.

The purposes of this slUdy were to
describe and analyze the participation of
nurses in continuing learning activities.
their reaMJnS for engaging in continuous
learning, their attitudes toward continuing
nursing education, and their
socioeconomic characteristics.
The study was designed to investigate
not only nurses' involvement in conven-
tional forms of planned systematic educa-
tional programs. such as courses, work-
shops, and conferences (dependent learn-
ing activities), but also their active
participation in individual. self-directed
learning situations, such as reading, and
learning packages (independent learning
activities) .
A questionnaire was administered in
group sessions and by mail to 220
randomly selected female registered
nurses who were employed full-or part-
time by five general hospitals in the
Greater Vancouver area of British
Columbia. The hospitals were of medium
size (300-700 beds) and each had a direc-
tor or coordinator of in service education.
Each respondent participated in at least
one of the continuing learning activities
accessible to nurses during the year
(September I, 1972 to September 30,
1973) but, on the average. the group
participation rate was less than half the
total possible score Nonetheless. it was
established that the respondents engaged
in significantly more independent than
dependent learning activities.
A factor analysis of S. B. Sheffield's
Learning Orientation Index determined
that this group of nurses did possess the
three basic learning orientations described
by e.O. Houle. butothattheir reasons for
participating in continuous learning could
be more precisely defined as learning,
occupational. professional. societal,
sociabilitv, interactive. and relief from
boredom'and fru...tration. In addition. the
respondents were found to have a favor-
46 THE CANADIAN NURSE

able attitude to continuing nursing edu-
cation that related significantly to their
participation scores.
Other factors related to the nurses'
participation in continuing learning ac-
tivities included the psychological vari-
ables - learning, sociability, profes-
sional, and interactive orientation - as
well as the following socioeconomic
charzcteristics: number of preschool chil-
dren, university educational experience,
position. employment status, and length
of current employment.
As a result of multiple regression
analyses, three of the learning orienta-
tions and the attitude of nurses toward
continuing nursing education were found
to be better predictors of the respondents'
participation scores than were certain
socioeconomic factors. The nurses'
favorable attitudes toward continuing
nursing education emerged as the mO'it
efficient single predictor.

Paul, Denise. Comportemellls théra-
pewiques de l'infirmière: perception
du malade mental. (Therapeutic be-
havior of the nurse as perceived by the
mentally ill patient.) Montreal,
Quebec, 1973. Study (M.N.), U. of
Montreal.

The author studied the patients' perception
of the therapeutic behavior of the nurse in
the psychiatric hospital setting. These be-
haviors fall into four categories: I. re-
sponse to physical needs; 2. help in
socializing; 3. support; and 4. coun-
seling.
The patients, 92 in number, were drawn
from 10 nursing units of the same
'psychiatric hospitaL They made some of
their perception of therapeutic behavior
through the critical incident technique by
describing the activity of the nurse. and by
choosing those behaviors that they found
most important from a list of activities.
Data collected revealed that the patients
preferred the behavior of the nurse who
fell into the support category and that they
were satisfied with the nurse's response in
relation to this support role.
In the area of response to physical
needs, it seems that the patients receive
more than they expect from the nurse. Dis-
satisfaction of the patients seems greatest
on the level of facilitation of socializing.
Their expectations are higher than the re-
sponses they obtain from the nurse.
Finally, the patients consider counsel-
ing to be important and seem satisfied with
the way the nurse fills this role. '-:':'

+ Roll up
your sleeve
to save a life...

A V aids

1

FILMS

Educational Film Distributors Ltd. (285
Lesmill Road. Don Mills, Ontario. M3B
2V I) has announced the availability of
the following films:
Sm(( Goes to the HospiTal (color. II
min., 1974), aimed at children and
parents, explains hospital procedures so
that children will not fear going to a
hospital.
Who Stole the Quiet Day? (color, 16
min., 1974). gives some of the effects of
noise pollution on our ears.
Foods: Fads and Facts (color. I7
min.) is aimed at those 12 years of age and
over.
Liquids Can Burn (color, 13 min.), is
intended to acquaint viewers 10 years of
age and over with the dangers of flamma-
ble liquids, including turpentine, paint
thinner, charcoal lighter fluid, dry clean-
ing fluids, and solvents.
Give Him Air (color, 18 min.), a film
that can be rented or purchased, identifies
5 main causes of death due to loss of air
analyzes them in terms of actual situa

ions, and demonstrates the rescue tech-
niques for each. The five causes are
breathing a substance other than air,
blockage of the breathing canal. tongue
obstruction due to shock and uncon-
sciousness, damage to the chest, and
puncture to the lungs from a stab wound.
This film was produced by the Ministry of
Defence in the United Kingdom for lay
audiences. as well as professional groups.

OBest Friends (35mm and 16mm, color,
5 minutes 41 <;econds) is a comic cartoon
aimed at those who have succumbed to
the insidious cigarette and at those who
haven't- yet.
Produced by the National Film Board
for Health and Welfare Canada, this
amusing film might help young viewers
hesitate before deciding to smoke. Ac-
cording to the NFB. "if you cough when
you laugh, maybe you should see it
again. ..
Find out more about this film from the
National Film Board of Canada, P.O.
Box 6100. Montreal. Quebec.

o A number of Churchill tïlms have
recently been revised and updated be-
cause of the demand for them. They
include Food and Growth (12 minutes,
color), aimed at the elementary and junior
high school levels: and Half a Million
Tee/wRers . . . Plus (I7 minutes). a film
that describes the prevalence of venereal
disease among teenagers, uses animation
to trace the progress of gonorrhea in the
male and female. and describes the
progress of syphilis.

DECEMBER 1974

These and other Churchill production

on the human bod, are a\-ailahle from
Gordon Wall Filmi. X65 Sheppard Av-
enue West. Downsvie..... Ontario.

AUDIO CASSETTE PROGRAM
DAne.... audio cas
elle program has been
produced for members of hospital infec-
tion control commillee
. Casselles and
supportive material explain hospital-
tested techniques designed to improve the
performance of cross-infection control
programs.
Included in the program are print
material and five cassettes: an accom-
pan} ing study guide contains charts and
sample forms. The program features a
series of self-paced quizzes and related
dssignments to help assure master} of the
mataial.
The material. which is intended for use
in small groups or for individual instruc-
tion. is recommended for admini
trators.
nur
ing staff. and all members of infec-
tion control committees.

10re information is available from
Teach 'em Inc.. 625 North Michil!an
Avenue. ChIcago. Illinois. 60611.

VIDEO CASSETTE PROGRAM
- A smokinl! clinic called "I Kicked the
Habit". is a'Vailable on video cassettes
from Mediascience Ltd. (728 Bay Street.
Toronto. Ontario. M5G INS). Five one-
hour video sessions. together with as-
sociated literature. comprise a clinic.

1aterials supplied include attendee book-
lets. ho"pital manual and promotion
mailer. self-testing kits. diplomas. and
smoker questionnaires. The 5 video ses-
sions can be supplied on 3/ 4 -inch U-matic
video cassette. I-inch or 1/ 2 -inch Sony.
Ampex. or IYC

FILMSTRIPS
[ Educational Materials and Services
Limited (115 Nugget Avenue. Agincourt.
Ontario) is the Canadian representative of
Parents' Magazine Filmstrip set,;. This
sound and color filmstrip series on child
development and behavior is comprised
of sets that include five color filmstrips.
one 12-inch record or three audio tape
ca
...ettes. a discussion guide. and five

cript booklets.
Some of the topics dealt with by the
e
filmstrip sets are prenatal care. the first 18
months. everyday problem
of young
children. preparing the child for learning.
and the child'
relationship .... ith the
family.

Library Loan Servicc
\... '....'..11. mail in!! of mall:rial all /Olll/
hI) Ihe lihlaJ'\ \
III he cunaikd ,I\
'r
Ih
' Ihllid.)\ mailing ,ea"III. I ".m... \\ ill
//O( I'
' m.
ilcd ')UI
therd,'rc. h
.t\\
'
'n
Decemher 9. IY73 and Januar} 5.
1975.
DECEMBER 1974

accession list

Puhlications recentl) n:cei\ed in the
lanJdian \Jur...e.... A......ociation lihrJr
are
.1\ ailable Oll/Olill - \\ ith the e'\eeptionof
item... marked R - to c,-\ memher....

chools of nur...ing. and other tn...titution....
Item... marked R include reference and
archive material that doe
1101 go out on
loan. The...e.... al.,o R. are on re...ene and
go out on Interlihrar
Loan onl

Request... t,)(' loan.... ma'\imum 3 .It a
time. .,hould he made on a .,tandard
Interlihrar
Loan f\lrm or ,)11 the .. Re-
quöl Form for Acee......ion Li...t" prinled in
thi... i......ue.

BOOKS AND DOCUMENTS
I. Alllle Frallds all aU/uhiographl', b} Florence
(Rhein) Bird. Toronto. Ctarl-e Imin. c1974. 3:!4p.
:!. AI/nrwl II/t'elil/f>( of Cal/adial/ Mt'dical A.
sU(ia-
rull/. Rt'porls 10 Ihe Gt'l/eral Coul/d/. 1974.
Toronto. IIYp.
3. Basic pt'dÙ;lric IIursil/f>(, b
:\Iar} P. Hamilton.
Saint LnUl
. Mn'b). 11J74. 4ROp.
4. Bt'wlld ,hefler. A SlutI\- of .\'HA - ji/llmle(1
huu
il/f>( jur Iht' elderI\-. OIta....a. C.ulddian Coum:il
on Social Dc\elopmenl. cl97J. 47Yp.
5. Calladial/ allllual rt'l'ie,,' of pOlilics alld pllhlic
llJjain, edited by John T. Sd
....ell. Toronto. Un;\.
of Toronlo Pr.. IY74. 31JRp.
6. Commoll sellse 1'1 child rt'ari'IR. b} Erna ",nght.
:-.Ie.... YorL Han. cl973. D:!p.
7. CaslS al/d respollsibilil\'jur ht'allh care fllcililit's
al/d lIlallpu"er. OIla....a. Progre'si\e Cnn'ervallve
Pdn
ofCandda. IY74.
R. CremillR a dill/ale fur IIl1nillg rt'search. Filial
report 1963-1971. Schlotleldt ROle/la :1.1. Cle\e-
I.md. Ca\e \\e,lem Reserve Universit}. Frances
Pd}ne Bolton Schonl of NUf'ing. cl973. 130p.
Y. E.\1t'lI/ial, of ahdomil/al OIlOII" care, b} Hen-
rene. Hnne\I}. Nc.... York. Spnnger. clY7:!. Y3p.
10. FIt'un Unulit"IIIt'.L lIolice
h/llgraphiqllt's
d'llllllt',mes elàt's de.
T",u-Ri\'ières, b} Ur\uline'\
de, TrOl
-Rivière
. En vente au mondslère. Trol'-
Ri\ièrcs. P.Q.. IY06. 37Rp. R
II. GlIide pour 10 dl'llllln ht' IIurSIl/f>(. Þ\ Dorolh\
I\t Smilh i\tnntre..1. Librdiric de I'Uni\er,ite de
MonlrédJ. IY74, 61 p.
12. Tht' i/lllolllilllhlt' Illd\' doclon. b) Carlou..
H..cl-er. Toronto. Clarke tr.... in. c 11J74. :!5<lp.
13. Tht' ill/emllliOlwl ISI/ IIIt'lric SHll'lI/ ll/lll ho" /1
"orA\, by R.,Þen A. HopI-in,. 1 Mz.m... Ca..
PnlYl11ctric Senice'.lnc.. IY74. clY7J. :!R7p.

Registered Nurses
Your community needs the benefit
of your skills and experience. Volun-
teer now to teach Patient Care in
The Home and Child Care in The
Home Courses. 0

txJ

14. III/erpersol/lli chllllgt' A ht'hl/lioral IIp(Jro<,,h
10 IIl1nil/f>( prlll I/l t'. b\ \I.."ne I: L,'om". ..nd Jo
Anne Ho"le\ "lie.... 'orl-. :\t'Gr...... HIlI. ,IY74
IR:!p.
15 Tht' /lII'Bihft' Chllil/: lli"'(I\t' , pil\1t'c1 Oil In
urherirwlCf, b) I:IiZdbt:th Jnll} Chic..gn. NeI...nn-
Hall. cllJ7:! 21 Rp.
16 Lilli"'l/ IIunll/f>(: P
)( holof>(Í< III llf/prolld, 10
pill/t'1I/ cart'. b} Li,.. Robin,on Phll..ddphla. /- 4
D..if'. c IY74. :!3Rp.
17. The life of S,r n ,lIilllll o.,lt'r. b} Hane\
Cu,hing. Oxford. Clarendon. IY:!5 :!\
IlL \1l11wgemell/. Ill,A" rt"p""'lhiliries. prUll/l'"
b} Peler F. Drucker. "lie.... Yorl- HMper dnd Rn.....
clY7J. R31Jp.
19. UÙroorgarlÍ
II/' lllld hlllllllll dl\t'iI't'. Þ) I:rn"t
A. :\1e}er Nc.... York. Apple[on-Ct"ntul) Croll,.
clIJ74.45Ip.
:!O. MOl, W't' il/j'rllliert', par Segolène Lclebure
PMis. St,'cl- cl973. IIRp.
21. A lie'" louk (II COIII""'"" ellllh Ulli> t'run coop-
t'raIÙm. Rt'purl UII II st'millllr 'pomort'd h, flit'
C"IIIlIlol/l1t'ullh FlIllllcllllÙ", '" Ihe 1"'1/I1I1t' 01
Dt"'elopII/ell/ SWlllt',. Londnn. 11J74. 1J7p
:!2. PIlls qll'lIl/ girt'. Ellldt' ,ur les lugt'IIIt'III' p,,"r
penol/llt's <Îget's ed!lit" "'liS /' t'gide lit' III 11Il
,wliOlwlt' sllr /' hahilaIÙ",. OI[a.... a. c I y7 3
KSp.
23. Proceec/illg\. AI1lt. rÙ un \'lIr
es' A,\,\(I( 1011011
H(l/lSe uj Delel(lllt'.\, IY7:!. Ne.... Yorl-. IY74 R6p.
:!4. Periodic ll/
1973. On......d PuÞ),c Llbr..r). <}Op
R.
:!5. Pt'rlod'qlles 1973. Olld....a Bibhothe<jue puÞh-
<jue.IJOp.R
:!6. Pro< t'edillf>(s uf Iht' llll",wl IIIt't'lir'f>( uf ClIIllIdiwl
Medical AS.\f,ciaIÙm iJ,dlldillf>( Iht' Irtmll" liolll "I
Ihe Gelleral COUI/< if. OIla....a. I Y74 13!<p.
:!7. QueSI for a projt'SS/UII: Tht' hislon (If Iht'
VallCOlll','r Gt'lleral Hospiwl School of '\:lIn/ll.
. b)
Nora Kell). Vancouver. Vdncuuver General H"'PI'
tal. School of "IIur,ing. Alumnae "'''''clarion,
d97J. 174p. R
28 Le rt'f>(rullpt'I/It'III des Sl iellct's dt' la ''''lIt' II
/'Ullil'enile L<I\'ol Rapl/On llu Cl'milt' 'pl'áulilollr
It's SÔell(es dt' 10 Slllll<, Quebe
. Uni"er
ite Ld,.ll,
1 yn I :!
p.
29 Reporl of Ih.. Popllllllioll COIlI/ál 1973 'e....
York. 1974. 151p.
30 Rt'porH 10 HUll" oj Dt'lel(lll.... 1972 7-1 "IIt"\\
YurL Americ..n Nu"",' A"ou..tion. IY74 12õp
31. A rejetIrch \114l1\' Ull .u ;ell( e ("O'''",UIII( (11101' h)'
Ore\t Dub..,. .md Li'd "t..nel 011...... d. \hm..tr, "t
s[..t". Science dnd Technolog\, Iyn 501'
3
. La fl'uwlill' lOll..t'pl< to"dam,'lIIall\. I'olf't"r-
..nl A. Kdtchad,'uridn el Don..ld 1 Lunde. tr..duc
linn p..r LJ CMdrn." Den et I: R"""I1lIJn
Montreal. Le, Edilion... HR"'. dY74. 5\3p.
.n. Stlciol It'l ur'" for Callada 1<;7
, rt'port tlf Iht'
TenA Fort e Oil S", ial Selllrill 'II rhl Calla,I","
Co/ml il ,m So< illl D, 1 t'lopm""1 Olla"a. Can..dl..n
Council on S.'ci..1 OC\dopment. IY73 IRYI'
34. St'rual ril(hl
"'Ill re'pOll\lhili"e
of Ihe /IIt'I/'
will- retarde,l. Pro< eedlllf>(' of Ih, l'OI!ltrt'IIl t' Oil Ih,
ril(hH 01 Iht' rt'Wrtlt'.1 J..r prole"i",,,,t-, 1,,,rt'lIh
\/lIdt'IIIS. The 4meric..n "'",'ciation on \lent..1
Deficienq. Regl,'n Y. :\c......rL Uni\er"l\ 0'
Deld....dre. IY7J 155p.
35 5rllll(hlwik .from prlSOll. b\ Lon ToroL 'c....
h l rl-. Hum.m Scicn
', . Pre". dY74 14:!p.
.
6 SlIn'l\'l,n of ...,ie ,dt', cdiled b\ AIÞen ( (\In
Springlrdd.lIl.. Th"l1ld'. clY7:!.
O
p
.n. 1 l dlllical 1I11nillf>( tht' "dllll \Il dit al "n,
THE CANADIAN NURSE 47

<,al al/d p>\( hialric approaches, 2d cd.. by Sandra
Ficlo .md Syhid C I:dgc. Nc", Yorl-. MdcmiJian.
c'l Y7.t 6YXp.
PAMPHLETS
J!i. Cal/adial/ re",'Tiol/s tu th., Faure report. Ot-
taWd. Cdnddidn Commi
sion for L 'iiI
l'(). IY73. !ip.
.W Chal/xil/X lexal allil/Illn: Ih., e}jeet of the 1m,'
Ul/ I/unil/g. Paper presemed to Ihe opel/ jurum
"C/wI/XiI/X L"gal Allilude.." Nalional League for
:'IIo"ing. Biennidl ConH:ntion. :\1inncdpolis. :'\1dY
6-10. IY73. Ne" Yorl-, National League for
1\ur'mg. c I Y7.t. 20p.
.to. COl/ciliatiol/ rapport dll Colloque .mr Ie droit et
ft's ..en'in'.' .WCÙIlH par ra{J[Jort a la proCf'dllre dll
di\'(,ne 1Il1 Cal/ada. Ollall'a, jall\'. 1973. ('I'td"a.
In,lIIuI Vanterde la tamille, 1<)73. IHp.
.t I. Cmlcilialiol/ re{",rl oj semitlClr 011 the lall' al/d
.w,.;al service." a.' applied to di1-orce proct'l'ding.. in
Cal/ada, Olla>l'a, Jal/. IV73. Onawa. Vanier In,ti-
IUlcoflheFdmily. IY73. 17p.
.t2. Crilaia jor the e,'alull/ÙIII oj ,e/lOol> oj
IIIlnil/g. Ona"a. Canadidn AS"ICialion of Univcr-
,ity School, of Nu",mg. I Y73. 3p.
.t3. Fil/al report 01/ p,.,,,.itlce-II'ide-accredilation
pro}l'''. Dee. I, IV70-Nm'. .W. IVn, Winnipcg.
\Ianitoha Health Orgdnizdtions Incorpordlcd. IY74.
J6p.
44. Guide lor p/,,'sid/ll/s in dl'lermil/itlf>( jill/e.'.. to
111'/1'1' /I motor ,'ehide, Onawa. Canddian !\Iedical
A"ocialion. 1 Y74. .t3p.
45. Mellwire all mil/i..tere d".. AJj/lire..' .w";/lft,> >111'
ft'.' X/lrderies. Quebec Cily. Corpordlion des Infir-
mière, de Id region dc ()uchec. I Y74. Dp
46. R/lpport de 1/1 Societe Cal//ldÍ<'llIIe de
Crimil/oloxie. Otld\\a. 11J74.
.t7. R/lpporl <llIlIIlel dll C o1l.\eil nm/ldit'll ,Ie
/),','eloppemell1 w,.;al 1974. Una"d. 24p.
.tH. R/lp[Jort d,' la Rellnioll cOllþ,itlll' .'"1' Ie..'
cOl/ditio,,", lie Iral'lÚI et Ill' la ,'ie dll perwIIIIl'1
illjirmier, Gel/t'I'e, 19-30 ,w,'emhn' 19n. Genè\e,
Orgdni,alion intcrnatiundle du Travail; Organisalion
lIIondiale de la santé. I Y74. 21Jp.
.t'J. R/lpport Sommaire de la COl/faellce Na1/lIll/lle
C/II/adielllle Sur L'AIIIIl'e MOlldiale De La Popula-
1/01/. It'. 10 et II mm IV74, Olll/l\ll, Om/lrw.
Ona\\ a. Con,eil Cdndd,cn pour la cooperation
inlcrnationale. 11J74. 6p.
50. Reauio1l.\ ('(madielllle. /III apportj/lre. Otta"'a.
Commi"ion cdnddiennc pour rUnc,co. I Y73. Xp.
51. Rel/lwtlllll al/d t'\ercÜe for 'ICItllr/l1 chilt/birth.
hy Hclcn He.trdmdn. Edinburgh. Churchill Living-
,tonc. I Y7!. 31 p.
52. Report nj Cal/adial/ COIII/,.;1 on !w('/al De-
,efopmeIl11974. Ona"a. 24p.
53. Report of Cal/adiall Criminolox" alld Correc-
1/"''' A\.\od/lIÙIII. Ond"'a. IY74
5.t. Report oj C/Illadi/lll Rehahilitation COIIII,.;I for
Ihe Di./lhl,'d 1973. Tornnlo.
55. Rl'port oj fh,' QIIl'l'II" Nllnmli !twillll" 1973.
London. 11J74. 20p.
56 Report to pro,'itwial "'",1/";1 uj Albata A.'s", ia-
1/lm '1 Rexi>teretl Nllr>e.'. Mell1al Health Ta,/"
Commillee Edmonton. Alhena As,oclation of
Registcred Nur,c,. IY73. 16p.
57 !>eml alll/llal reporl oj COUl'Xe '1 Ph. ,,";/111.\
/111.1 Surg"'III' '10mario. May I Y74. Tornnto. 22p.
5H. sp,',',he, from Sl'Inillar OIl M""Xil/f>( Medical
"dUCflli"'l al/d Commlmll.. Ho>pit/ll Can'. O.H.A.
(l'IlIrl, LJOI/ Mill.. Om" \.1l1\ ('j 1974 I monto.
I )ntdrio Ho'pildl A"Oc'dllon. I Y74. I v
'i'l. I .ltItemell1 of the re\fJmnihill1le.. /llId qllalin-
48 THE C.ANADIAN NURSE

l"llliulI.\ lor 1 ariou,\ f1usitioll.\ in lellm Ill" .\lIIX.
Toromo. Regl\lered NursC\ AssocIation 01 Unlano.
I1J73. .:!Op.
60 SUllllllan n'po", oj Callatlwll NlIIiollal COlljer-
l'lI(,(, jor It urld P Opl/iallOIl Year Mal' f()- I I, 1'ì74.
Ollall'a, 01/1" 11J74. 5p.
61. SI/perl'l.,wll. Ulla" a, Cdnddlan I cdchc" Fed-
eration. 1<)74. 16p.
62. Whlll Ü BCORN(j. pnpared bl' the PrOlillt'Íal
Ereclllh'e. Vancouver, Brilish ColumbIa Operating
Room Nurses Group, 1<)74. 12p.

GOVERNMENT DOCUMENTS
ClIIwda
63 Canada Council. A itl to the humamtie> allll
\'O";als,.;ell< e.\. Olla"d. I <)7.t. 23p.
64. Con.eil des Arts du Candda. AIde /II/I'
IllIlIIllllites et auI' s,.;ellce.. so.-;ale... Ottawa. I Y74.
24p.
65. Dcpanment of EXlcrnal AffaIrs. C'II//ldian
repre>"IITt1ti,"'s ahroatl. Olla"'d. Inforn1dtion
Canada. 1<)74. R
66. -. Diplomlllic corp> alld cO/Blllar alld uther
repres"lIlali,'es ill Callada. 1974. Ona"a. Inlnrmd-
lion Canada. I Y74. I; I p. R
67 Depanment of Lahour Labuur stalldards III
CamIlla. 1973. Ollawa, Infnrmdtion Cdnada. IY74.
<)<)p.
61;. -. Waxe rain, mlarie..' alltl hOllr> oj labour,
197.1. Ollawd.lnfnrmation Canada. 11J74. Iv.
6Y. Economic Council of Canada Calldide model
1.0: lahmlr supply alld demoxraphic I'ariahles,
b} Wolfgdng M. \IIing. Ollawa. 11J73. 23p.
70. Environment Canada. Callada alld the hlllllall
elll'inmme1l1. A contribulion b} Ihc govcrnment of
Canada to the Conference on Human Environment.
Slockhoim. Sweden. June IY72. Ollawa. IY72.
1J2p.
71. Informalion Canada. Canada. Ihe anllual
lIallllboo/" uj presel/t condilio/B alld re.-e1l1 progre>> ,
1974. Olla"'a. 1974. 3.t.tp. R
72. -. Callada; la re"II" /lilli/Idle de." cOllditiollJ
anllelle.. et des proxrè., recellU, 1<)74. Olla"a.
11J7.t. 3.t4p. R
73. \1ini'lère de Id ,antc nationale eI du bìen-
lre
,ocial. Le.\ meclìnunellu el /lOU.\. OU,'"d. Intonna-
lion Canada. 11J71. 16p.
74 Mini,tère de, Affdires cxlcrieures. Corp> dip-
I0l11lllìque 1'1 rtÞprtÞ
t.'nllll1u ("(IIl.\II./uìrl'.\ 1'1 ilL/lre.\ (Ill
Callada. Olla"a. Information Canadd. 11J74. 73p.
R
75. -. Repre.
elltal/1s ,III Callada a [',.trallger.
Ona"'a.lnformatlon Cdnada. 11J74. 6.tp. R
76. Mini'lère dc, po,te,. Normn de> pOltes
Canada; IlOllI'elles 1I0rme> applicahle> all traile-
mell1accelére ,III ('(",rrier Ottd"a. 1<)72. 2Hp.
77. Mini,tère du Travail. 1 aliI' de >alaire. trlllle-

St.John Ambulance

needs Registered Nurses to volun-
teer their services to teach Patient
Care in The Home. Will you help?
cont
çL"" 0
St
n
bulance

mellu et heure.' de tral'lIil, 1973. Olla"'d. Informa-
IlonCandda. 1<)74. Iv.
78. Post Otficc Dcp!. Callada po.wl ,,'wlldard..';
Ilell' >wlldartl} 10 }treamlillemail proct'.\siIlX.
Ollawd. 1<)72 2Hp.
71J. Santé et Bien-être social Canadd. Documel/1a-
tioll >ur r hl'gièlle alimel/1aire 1'0111' les infirlllières
hygièllÜles. Olla"'a. Informalion Canada, 11J73.
73p.
80. Sdence Council of Candda. Report, 1<)73{74.
Ona"'a. Information Canada, 11J7.t. 37p.
81. Statlslics Candda. ESlimales of employees bl'
provillt't' alld illtlU,,'I'!', 196/-/972 Ollal'a, Infor-
mation Canada. 11J74. 45p.
H2. -. Hmpital morbidit\': Canadiall diagnostic
list. 1<)71. Olld"a,lnf'>rIlldtion Cdnada. 11J74. 71Jp.
H3. SlallStique Canada. Estimatiuns du 1I0mbre
d' elllplo..'es par pnll'ince et par imlu.'trie,
1961-1972. Olla"a. Information Canada. 1Y74.
7Yp.
84. -. La morbidite hospitalière: li.\1e ((Jlladiemle
de diaglw.'tics, 1971. Onawa. Information Canddd.
11J74. 79p.
C oillmbia
85. Minislerio de Salud Publica. Macro-
diaWtO.\tico de ellfermaa. ESllldio lIa,.;onal de la
silllacÙm de ellfermera ell sitllacion de enfermera ell
Colllmhia. BOgotd. 1<)72. HHp.
Ullited SWtes
H6. Fostering Ihe groll'illg need to learn. Monog-
raph. and annotated bibliogrdphy on conlinuing
cducation and health mdnpower. Syracuse. New
York. University. Rodville. Md. lor U.S. Buredu
of Division of Regi'JOal Medical Programs. Bureau
of Health Re,ources Developmenl, I Y73. 160p.
1;7. Center for Disease Control, Venereal Disea,e
Branch. Cllrre1l1 literatllre "" ,'enereal tliseaJe,
1<)74, IIU. I. Atlantd. Ga., 11J74. 65p.
HH. Nalional Center for Health Slalistics. National
amblilawn medicille care Sliney. backgrowld /llId
melhotlology. United Slates 11J67-72. Bethesda.
Md.. 1<)74. 76p.
!l1J. - NlIIiollal ambulalOn medical care Sllrv<'\':
HmplOm classificatlOl/. Belhesdd, Md q 1<)74. 35p.
IJO. National Inslilulcs 01 Health. StatÜliml rejer-
ence bo.ok o.j illlernaliollal aCli,'itit'> , jÙcal I'ear
1973. Prcpared by Inlcrnalional Cooperdtion and
Geographic Studies Brdnch, Fogarty Imernalìonal
Cenler. Belhesda. Md.. 1<)74. 52p

STUDIES DEPOSITED IN CNA REPOSITORY COLLECTION
IJ I. 'vlln<llg edllcatioll alld rexistration; statistical
report, 1973, T own to , College of Nurses of
Onlano. 11J74. 41 p. R
1J2. Per>onal hi>wn 'if penollJ complaining uf
back pl1ill: a p.n,,'hosocial /lpproach, by Claire
Paquellc. Seallle, 1<)72. 163p. R
1J3. Tllnw,'er 'if IlllneS <II hmpit/lls: a sllldy 'if a
>en'ice org/llli
ation, b) Florcnce Strildeff.
Townlo, 11J74. 2X7p. R

AUDIO VISUAL AIDS
Y4. Canddian Nu",es Associalion The leaj alld Ihe
IlIIlIp. (Motion picture) Momredl. Arnon Roger,
Ballen LId.. 11J70. 20 min. sound. colour. 16mm
<)5 Ndtional Conference on Nur,es for Community
Service. OndWa 13-16 Nov. 1<)73. Proceedinf>(s. 6
reels (5 in.) 17/HI ps. 12U min. mono. Double trdck.
<)6. A"ocialion dcs Mcdecin, de Langue frdnçdise
du Canada. S"'lOlIle,1 >eree 2, 110. I. :\.10ntreal.
1974. I ca"ene.

DECEMBER 1974

classified advertisements

I

ALBERTA

REGISTERED NURSES reqUIred lor 70 bed accredited aCltv<
treatment Hospital. FuU ti_ and su"'""" re'el. AU AARN per.
sonnel policies. Apply In wnllng to the Direct'" 01 NursIng.
Drumheller General Hospital, Drumheller. Alberta.

2 R.N.'. wanted lor Immediate employment at the Two HiUs
Municipal Hospital. Two Hills. Alberta. We lollow salary
schedule as set lorth b r the MRN. Must be wIUm9to stay at !hIS
location a minimum 0 one year. Appty to: Administrator. Two
HlUs Municipal HoSpital. Two HIUS, Alberta.

GENERAL DUTY NURSES reqUired lor 50-bed hospital in cen-
tral Albe"". hall way between Calgary and Edmonton on maIn
highway Salanes and personnel policies as set by AARN
agreement. Residence accommodaUon available. Contact Mrs.
E Harvie, R.N.. Administrator. Lacombe General Hospital.
Lacombe. Alberta, TOC ISO

BRITISH COLUMBIA

OPERATING ROOM NURSE wanted lor active mo-
dern acute hospital. Four Certified Surgeons on
attending staff. Expenence of training desirable.
Must bE- eligible lor B.C. Registration. Nurses
residence available. Salary accordmg to RNABC
Contract. Apply to: Director 01 Nursing. Mills Mem-
orial Hospital, 2711 Tetrault St.. Terrace, B"tlsh
Columbia.

ADVERTISING
RA TES

FOR All
CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additional line

Rates lor display
advertisements On request

Clasing dale for copy and cancellation is
6 weeks prior to 1st day 01 publication
month.
The Canadian Nurses' Assaciation does
not review the personnel' palicies of
the hospitals and agencies advertising
in the Journal for authentic information.
prospective applicants should apply to
the Registered Nurses' Association 01 the
Province in which they o,e interested
in working

Address correspondence to:

The
Canadian
Nurse

Q

50 THE DRIVEWAY
OT.rAWA ONTARIO
K2P J E2

DECEMBER 1974

I I

BRITISH COLUMBIA

GRADUA TE NURSE Immediately required lor a modern 10.bed
hospital In Port Alice. The Community is situated on the North-
western lip of Vancouver Island. surrounded by mountain and
over1ooklng Neurotses Inlet. Plenty of recreational faCilities. Ac-
commodation available for singles only. Please reply: NurSing
Supervisor, Port Alice Hospital, Box 69 Port Alice. British Col-
umbia, VON 2NO.

REGISTERED NURSES requored for new 25-bed acute care
hospital In Fort SI. James, B.C Startmg salary $850.(){,j- $20.00
Northern allowance per month. Salanes & personnel policies
according to RNABC Contract Apply: Director, Stuart Lake
Hospital. Fort St James, British Columbia. VOJ t PO or phone
cotlect (604) 996-8201.

REGISTERED NURSES and LICENCED PRACTICAL

c
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:bre:
'

dence Apply to: Director 01 Nursing. Queen Chartone Islands
General Hosp
al. Queen Charlone City, British Columbia. VOT
ISO.

EXPERIENCED NURSES (eligible lor B.C. registration) requored,
tor 409-bed acute care. teaching hospital located In Fraser
Valley, 20 minutes by freeway from Vancouver. and within
easy access of varied recreational faCilities. Excellent Orienta-
tion and Continuing Education programmes Salary $850.00 to
51020.00. Clinical areas include' Medicine. General and Spe.
clallzed Surgery. Obstetrics. Pediatrics. Coronary Care, Hemo-
dlalvsis, Rehabilitation, Operating Room. Intensive Care. Emer-
gency PRACTICAL NURSES (eli!jible for B.C. Licensel also
reQl1lred. Apply to. Nursing Recruitment. Personnel Department.
Royal Columbian Hospital. New Westminsler. Bntish Columbia.
V3L3W7

EXP!::RIENCED GENERAL DUTY NURSES AND
LICENSED PRACTICAL NURSES required lor small
upcoast hospital. Salary and personnel policies as
per RNABC contract Salanes slart at 5672.00 for
Registered Nurse
. 557775 lor Licensed Pracllcal
Nurses Residence accommodation 52500 per month
Transportar..,;n paid from Vancouver Apply to
Director of Nursing St George s Hospital Alert Bav
Bntlsh Cnlumbla

GENERAL DUTY NURSES lor modem 41-bed hospnallocated
on the Alaska Hig,way. Salary am personnel policies in
accordance with RNABC. Accommodation available in reSI-
dence. Apply: Dorector 01 Nursing, Fort Nelson General Hospital.
Fort Nels(Jn, Bntlsh Columbia.

GENERAL DUTY NURSES, lor modern 35.OOd hospital located
In southern B.C. s Boundary Area With excellent recreation faci-
lities Salary and personnel policies In accordance with RNABC
Comlortable Nursess home. Apply: o.rector 01 Nursing. Bound.
ary Hospttal. Grand ForkS, British Columboa

GENERAL DUTY NURSES required lor an 87.bed acute care
hospt1a'in Northern B.C. residence accommodatIOns aval1able.
RNABC policies In effect Apply to: o.rector 01 NurSing. Mills.
Memonal Hospital. Terrace, Bntlsh Columbia. V8G 2W7

MANITOBA

REGISTERED NURSES - Churchill Hea"h Centre New ap-
proach to health care Vaned clinical opportunities for advance-
ment. Salary 5910 OOfmonth: subsidized accommodation: 20
paid vacation days per year. Vacancies also available for
L.P.N:s. Salary 569500fmonth. Apply to. Director 01 Nursing.
Churchill Health (;entre. Churchill. Manotoba. ROB OKO.

NEW BRUNSWICK

THREE FACULTY MEMBERS needed July 1. t975. to replace
faculty members gOing on one-year sabbatical and two-year
study leaves Preparation and expenence deSirable In maternaJ-
Infant and In medical-surgical nursing. Increasing enrolment will
perm
relentlOn 01 nghl p8Tsons at end 01 these penods. Extras
we have to oHer are an eXCltu"tQ new curnculum approach. a new.
well.equlpped self-Instructional laboratory. a new hospttal. and
the advantages of loving In a OOauldul. small City. Address' Dean,
Faculty of Nursing The University of New Brunswick. Frederic-
ton. New Brunswick

I I

NOVA SCOTIA

NURSES FOR INTENSIVE CARE UNIT. Poslt",ns exist lor
REGISTERED NURSES m a 5-bed IntenSive Care Un
.n
Highland View Regional HospRal. Amherst. Nova Scotoa.
Modern Unit opened In March of this year. Experience preferable
but consideration will be gwen to applicants wishing to undergo
training. Liberal fnnge benefits For further details please

M
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d View Reg",nal Hospital.

aUALIFIED NURSES reQuored Immediately for regional hoSpl-
talln Amherst. Nova Scotia. Fully accredited hospt1al providing
acute general care. For further details please contact the
Personnel Office. Hoghland View Reg",nal HospRal AMHERST
NOVA SCOTIA, B4H 1/116

C.N.A:s, Nursing Attendant, O.T. Aides. Psychiatry wanted.
Newly established Day Hospital In Communrty Mental Health
Centre Emphasis placed on Therapeuhc Community Unique
opportunities. No shltt work. Mondays through Fndays. hours
9 00 a.m. to 5.00 p.m. Please apply to: Dr. Edmond Ryan Execu-
tive Director, Cumbertand Mental Heallh Centre. 88 Chartes
Street. Amherst, Nova Scotia

REGISTERED NURSES and PSYCHIATRIC NURSES, General
Staff positions available In this modern 270-bed psychiatric hos-
pital. located In the AnnapoliS Valley Onentahon and Inservlce
provided Excellent personnel policies Salary according to scale
For further Information direct InQulnes to The Director of Nursing
Kings County Hospital. Walerville Nova Scotia

ONTARIO

DIRECTOR OF NURSING wanted lor a 62-bed. active treat-
ment hospital Expenence in Nursing Administration In a small
hospital essenllal Position open March 1. 1975. Present
Director retiring. Please apply to: The Administrator. Clinton
Public 'iospttal. Cfinton. Ontar",. NOM 1 LO

DIRECTOR OF NURSING reqUIred by expanding accredited
300-bed ChroniC "'ness and Convalescent Hospital located In
Northwest Metropolitan Toronto Please reply In confidence to
Director of Nurses. The Toronto Hospital Weston. Ontario
M9N 3M6

OPERATING ROOM STAFF NURSE required lor lully accredl'
ted 75-bed HospItal BasIc wage $689 ()() With consideration lor
expenence: also an OPERATING ROOM TECHNICIAN, baSIC
wage $526 00 Call time rates available on request Wnte or
phone the. Director 01 Nursing. Dryden Dlstnct General Hosp
al
Dryden. Ontano

REGISTERED NURSES lor 34-OOd General Hospttal
Salary 5850.00 per month to 51.020 00 plus expenence al-

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rlctPtf

pl\
i
Inc.. Englehart. Ontano, POJ 1 HO

REGISTERED NURSES and REGISTERED NURSES' AS-
SISTANTS required lor Nursing Home (Retarded Females).
Good starting salary. Evaluallon raises Please reply to
Administrator Mount-Forest Nursing Home. 465 Dublin Street.
Mount Forest. Ontano Telephone . Area 15t9) 323.2140

REGISTERED NURSES required lor our ultramodern 79.bed
General Hospital In bdingual cor:.lnumly of Northern Ontano
French language an asset. but nol compulsory. Salary IS $855.
to $1030. monthly With allowance lor past expenence and 4
weeks vacation atter 1 year Hospital pays 100 0 0 ot U HIt-' .
Lole Insurance (10.000). Salary Insurance (75 0 001 wages to the
age 0165 with U.I.C. carve-out). a 35, drug plan and a denial
care plan Master rotation In eHect Rooming accommodallons
available In town Excellent personnel policies Apply to
Personnel Director Notre.Dame Hospital, POBox 850
Hearst. Ontario.

REGISTERED NURSES required lor 1 07.bed accredited Gene-
ral Hospital Basic salary comparable to other Ontano Hospitals.
with remuneration for past experience Yearty Increments A
progressrve hospital amldstlhe lakes and streams of Northwes-
tem Ontano. Apply to' DlreClor of NursIng. LaVerendrye
Hospital. Fort Frances. Ontario

THE CANADIAN NURSE 49

ONTARIO

REGISTERED NURSES AND REGISTERED NURSING
ASSIST ANTS lor 45.bed Hospital. Salary ranges
Include Qenerous experience allowances R.N. s"
salary $740. to $840., and R.N A. s salary $550. to $625.:
Nurses residence - pnvate rooms with bath - $4'").
per month Apply to: The Director 01 Nursing, Gerald.
ton Dlstnct Hospttal Geraldton, Ontario, POT 1 MO.

REGISTERED NURSES FOR GENERAL DUTY, t.C.U.,
C.C.U. UNIT and OPERATING ROOM required for
fully accredited hospital. Startmg salary $å50 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 & Dlstnct Hospital
KirldandLake. Cntano, P2N 1R2

PUBLIC HEALTH NURSES (QUALIFIED) FOR GENERALIZED
PROGRAMME. ALLOWANCE FOR EXPERIENCE AND/OR
DEGREE. USUAL FRINGE BENEFITS, DIRECT ENQUIRIES
TO MRS RETA McBEAN PUBLIC HEALTH NURSING. REN.
FREW COUNTY AND DISTRICT HEALTH UNIT, P.O. BOX 128,
PEMBROKE. ONTARIO. K8A 6X1.

PUBLIC HEALTH NURSE required lor a progressive Health Unit
In Southwestern Ontano. Apply: Ms. Anne McBnde B.Sc.N..
Supervisor 01 Nursmg. Perth Dlstnct Health Unit 24 St. Andrew
Street. Stratford. Ontano N5A 1A3.

QUEBEC

TWO REGISTERED NURSES FOR CHILDREN'S CO-ED
CAMP - JUNE 20TH TO AUGUST 19TH - PREFER SEASON
- $700. PLUS TRAVEL-LAURENTIAN REGION - DOCTOR
ON STAFF - EXCELLENT FACILITIES WRITE: JOE FRIED-
MAN DIRECTOR YM.YWHA & NHS OF MONTREAL. 5500
WESTBURY AVENUE. MONTREAL. QUEBEC. H3W 2W8.

SASKATCHEWAN

TWO REGISTERED NURSES required lor Immediate duty In
9.OOd hospital 35 moles NW of Saskatoon. Saskatchewan. Star.
tlng wages - 5707 per month with attractive Increments Room
and board - $90 per month Apply: Director 01 Nursing. Borden
Union Hospital. Borden. Saskatchewan.

GENERAL DUTY NURSES, Inr 285-bed Rehabill.
tatlon/Extended Care HospttaL Excellent lormal week-long
Orientation program plus continuing Inservice Education pro-
gram. 1974 salary range: $707 - $732 - $759 . $787 - 5830.
Apply to: Employment Officer. Wascana Hospital, 23rd Avenue
and Avenue G, Regina. Saskatchewan

UNITED STATES

RN's and LPN's - University Hospital North a
teachmg Hospital 01 the University 01 Oregon Medical
School. has openings In a variety of Hospital ser-
vices. We offer compelilive salaries and excellent
fringe benefits. InQuires should be directed to Gale
Rankin Director of Nursing. 3171 S W Sam Jackson
Park Road Portland, Oregon 97201.

R.N. 's - SOUTHERN CALIFORNIA - Immediate need eXists
for medical-surgical units Onentatlon and in-service program.
Excellent salary. full paid benefits We will assist you with your
H-1 visa for Immigration A license In California to practise
nursing IS necessary before employment. Wnte for an applica-
tion to the California State Board of NurslOg Education and
Registration 1020 N Street. Sacramento. Califorma, 95814

ITINERANT PUBLIC HEALTH NURSE POSITIONS - Open In
several areas of Alaska Require travel to group of villages to
provide pnmary health care Services. Accredited public health
nursing preparation required' preference Qlven to public health
nursing. outpost nursing. or nurse practitioner experience. High
salanes. liberal fnnge benefits. Contact: Alrlle Bruce. Assistant
Chlel Nursing Section D,v 01 Public Health Pouch H-06E.
Juneau, Alaska USA 99811

50 THE CANADIAN NURSE

I I

UNITED STATES

TEXAS wants you! If you are an RN. experienced or
a recent graduatL come to Corpus Christi Sparkling
City by the Sea a city bUilding for a belter
future where your opportunities for recreatIOn and
studies are IImllless MemOrial Medical Center 500-
bed general teaching hospital encourages career
advancement and provides in-serVice orientatIOn
Salary from 568200 to 594000 per month. com
mensurate with educatIOn and experience Dlfferenllal
for eventng shifts available Benefits Include holi-
days sick leave vacations paid hospitalizatIOn
health II Ie Insurance pension program Become a
vital part of a modern up-to-date hospital write or
call collect John W Gover Jr Director 01 Per-
sonnel Memorial Medical Center POBox 5280
Corpus Christl. Texas. 78405

I I

UNITED STATES

FREE SERVICE BY AUTHORIZED HOSPITAL REPRESEN.
TATIVE FOR QUALIFIED R.N:s WANTING U.S.A. OR CANA.
DIAN NURSING POSITIONS. VISA. TRAVEL AND ACCOM.
MODATION ASSISTANCE ALSO CONTACT: PHILCAN PER-
SONNEL. THE MEDICAL PLACEMENT SPECIALIST. 5022
VICTORIA DRIVE. VANCOUVER. B C.. V5P 3T8. TEL.:
327-9631: TELEX: 0455333.

SWITZERLAND

EXPERIENCED OR NURSES: For our operating room In our
new hospital In Frauenfeld/Swltzerland. required urgently_ This
modern hospital. 30 miles NE 01 ZUriCh has 120 general surgery
beds and excellent working atmosphere. The spoken language IS
German. but fluency IS not required. as lessons are available at
the language school in the city _ Living-in accommodation IS avail-
able on request. Apply to. Director of Nursing Service, Kan.
tonsspttal Frauenleld, CH.8500, Frauenleld, Switzer1and.

Get what you've
always wanted
&001 nursing

1.:'
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/

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Like a wealth of professional experience to enrich
your career.

Nursing has a lot to offer. Remember?
But sometimes you can get so stuck in
a rut you almost forget those exciting
challenges that made you choose a
nursing career in the first place.
With Medox, you can revive those
challenges.
Since Medox serves almost the
entire spectrum of nursing services,
you can get more variety of
assignments in a month than you
could in a year back in that

comfortable rut. Operating room.
Intensive Care. Cardiac Unit. Pediatric
care.
There's more to nursing than
punching a time clock.
With Medox, there can be a lot
more

The word of our "Travel the world"
program is getting around. Ask for details
next time you calL

[MEDoX]

a DRAKE INTERNATIONAL company

CANADA. USA. UK. AUSTRAliA

DECEMBER 1974

HEAD NURSE
INTENSIVE CARE UNIT
REQUIRED IMMEDIATELY

Baccalaureate degree preferred
with broad nursing experience.
Remuneration will be consistent with ex-
perience.
Present salary range $11,976.00 -
$14,040.00 per year
January 1st 1975 - $12,756.00 -
$15,180.00 per year
Generous fringe benefits.
Apply in writing sending complete re-
sume to:
Director of Personnel
Stratford General Hospital
Stratford, Ontario, N5A 2Y6

NURSING
FELLOWSHIP

(Two (2) Years - Minimum
$6,000.00 per annum)
To study at Master's level
in a clinical nursing speci-
ality in respiratory disease
at a recognized University.
Application process to the
University must have been
started by February 15t,
1975.
For further information and appli-
cation form please write, before
February 1st, 1975, to:
The Nursing Consultant,
Canadian Tuberculosis and
Respiratory Disease Association,
345 O'Connor Street,
Ottawa, Ontario, K2P 1 V9

DIRECTOR OF
NURSING

Required for an accredited 158 bed acute
care hospital.
Preference will be given to applicants with
practical experience at the senior nursing
administration level combined with B.Sc.N.
degree andlor othBr formal education in
the field of nursing administration.
Salary commensurate with training and
experience.
Applications, stating experience, educa-
tion, references and salary expected
should be directed to:
G. Cranford. Administrator
Prince County Hospital
SummerSlde, P.E.I.
C1N 2A9

DECE"'BER 1974

,

A great
place to
",ork...a
fun pla

to live.

Many girls will tell you Toronto
is a fun place to live. But have
you heard about the new
Northwestern General Hospital?
We'll soon be opening a new
120-bed facility designed to
the Friesen concept.
Besides ideal nursing
conditions. the benefits we
provide are what you would
expect from a progressive
expanding hospital.
We have openings for RN's In
all areas and are particularly
interested in applicants for our
intensive care units.
Our Director of Nursing
will gladly give you all Hie
information you want to know
About our hospital and even
about Our city.

NORTHWESTERN GENERAL HOSPITAL
2175 Keele St. Toronto. Ont

REGISTERED NURSES

Required
For fully accredited recently expanded 200-bed
hospital, situated on beautiful

LAKE OF THE WOODS

Starting salary $850, increasing to $915 January
1, 1975 and $945 April 1, 1975.
Allowanæ given for past hospital experience
Shill differential and annual increments.
Vacancies in medical, obstetrics and progressive
coronary care units.
37'/2-hour week.
Excellent personnel policies.

Apply In writing to:
Mrs. B.G. Schottroff
Director of Nursing
Lake of the Woods District Hospital
Kenora, Ontario

REGISTERED NURSES

AND

NURSING ASSISTANTS

required for 11 O-bed hospital which specia-
lizes in chest diseases, situated in the
beautiful Laurentian mountains and loca-
ted only 55 miles from Montreal Good
personnel policies and residence accom-
modation available.

APPLY:
DIRECTOR OF NURSING
Mount Sinai Hospital
P.O. Box 1000
Ste. Agathe Des Monts, Quebec
J8C 3A4

REGISTERED NURSE

We have opportunities here for an experi-
enced registered nurse. Our nursing
salaries are established through agree-
ment with the A.A.R.N.

We have a very active 230-bed hospital in
Central Alberta. If you are interested in
more information regarding Red Deer and
the Red Deer Health Care Complex

please write or call:
Personnel Director
Red Deer General Hospital
Red Deer, Alberta
Tel.: (403) 346-3321

THE CANADIAN NURSE 51

CLINICAL NURSE SPECIALIST

For

MED-SURG NURSING

Required in 254-Bed
Active Care
General Hospital

Qualified Parties Apply to:
Director of Nursing
Moose Jaw Union Hospital
Moose Jaw, Sask.
(306) 692-1841 (Call Reverse)

FISHERMEN'S MEMORIAL
HOSPITAL

req uires

REGISTERED NURSES

for
GENERAL DUTY

Applications from Operating Room and Obstetn-
. cal Unit Nurses are especially invited

Apply to

The Director of Nursing
Fishermen's Memorial Hospital
Lunenburg, Nova Scotia

ASSISTANT DIRECTOR
OF NURSING
The fully accredited 220 Bed WOODSTOCK
GENERAL HOSPITAL
Invites applications from interested persons for
the Position of Assistant Director of Nursing. The
Position is a part of the Senior Administration
Team and will present a challenge to a nurse with
the ability to organize, delegate duties, and direct
the work of others. The successful applicant will
possess enthusiasm for initiating and fallowing up
new ideas and projects.
Qualiftcations needed are a - B.Sc.N. or an
equivalent combination of experience and educa-
tion, plus progressively responsible experience in
Nursing Administration and Registration or eligi-
bility for Registration in The Province of Ontario.
The Salary will be attractive and is Negotiable in
accord with experience and qualifications.
Applications, in confidence, shouta be
submitted to:
PERSONNEL OFFICER
WOODSTOCK GENERAL HOSPITAL
270 Riddell Street
WOODSTOCK, Ontario

52 THE CANADIAN NURSE

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 hospital is
presently expanding from 126 beds
to 400 and is fully accredited.
Nursing is a pwfession we respect
and we were the first to plan and
develop a unilJue nursing audit
system. There are opportunities for
gaining wide experience. for get-
ting to know patients as well as
staff. R.N. salaries range from
$850 to $1020. per month. Credit
allowed for relevant previous hospi-
tal experience.

Situated in Richmond Hill. all
the cultural and entertainment faci-
lities of Metropolitan Toronto are
available a few miles to the
South . .. and the winter and
summer holida) 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 Personnel.

YORK
CENTRAL
HOSPIT AL

RI( 1I\10,,-n 11111.
O;\. I \RIO
L4C 4Z3

PUBLIC
HEALTH
NURSES

Required for the Sudbury and
District Health Unit.

Apply to:

The Director of Nursing
Sudbury and District Health Unit
1300 Paris Crescent
Sudbury, Ontario
P3E 3A3

THE MENTAL HEALTH TEAM
PLANNED FOR THE COMMUNITY
OF HAPPY VALLEY/GOOSE BAY

has a vacancy for a
Registered Psychiatric Nurse
The successful applicant will participate in the
diagnosis, assessment and care of patients with
psychiatric disease.
Salary will be commensurate with provincial
rates and the candidate will be eligible for the
Labrador allowance.
Comfortable residential accommodation is avai-
lable if required.
Please submit applications to:
Miss M. Leach
Director of Nursing
Paddon Memorial Hospital
Happy Valley, Labrador
AOP 1EO

HOSPITAL MANAGEMENT
OPPORTUNITY

New senior position in hospital in the sunny
Okanagan Valley. The Vemon Jubilee Hospital
increasing in 1975 to 155 acute and 100 extended
care beds require manager of Central Supply De-
partment. The successful applicant will require
nursing and/or related central supply department
experience and training, initiative and manage-
ment abilities.

Apptlcatlons outt/n/ng quat/flcat/ons, experI-
ence and salary expected should be forwarded
to:

Director of Personnel
Vernon Jubilee Hospital
Vernon, British Columbia
V1T 5L2

DECEMBER 1974

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Our new Medical Center-
a body of steel, but it needs
your heart of gOld.

Cedars-Sinai has been expanding so rapidly that we're building
a whole new medical complex.
Now we need nurses to help fill those facilities. Nurses who will
bring us the experience, professionalism, dedication and
compassion every hospital needs.
We offer you the chance to work and learn with a large,
dedicated staff in one of the world's foremost teaching hospitals.
You will go through a detailed orientation program and
continue to grow professionally through our comprehensive
inservice education program.
There is another benefit we have that few other hospitals can
match. For your free time-Los Angeles, California.
Join Cedars-Sinai NOW! Ask about our air transportation and
tuition aid plans.
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P.O. Box 54265, Los Angeles, Calif. 90054 U.S.A.
Name

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Address
City
Nursing School

State Zip
.
Yr. Graduated

PUBLIC HEALTH NURSE

required for

EXPANDING HEALTH UNIT

GENERALIZED PROGRAMME - CITY
AND RURAL RESPONSIBILITIES. AL-
LOWANCE FOR EXPERIENCE AND/OR
DEGREE. GENEROUS FRINGE BEN-
EFITS AND CAR ALLOWANCE.

APPL Y:
DIRECTOR OF NURSING
ALGOMA HEALTH UNIT
235 WELLINGTON STREET WEST
SAULT STE. MARIE, ONTARIO
P6A 1 H6

The Brome-Missisquoi-Perkins
Hospital

requires

1 Day Supervisor
1 Night Supervisor
Registered Nurses

Please write to:
Director of Nursing
Brome-Missisquoi-Perkins Hospital
950 Main Street
Cowansville, Quebec
J2K 1 K3

REGISTERED NURSE
CRITICAL CARE PROGRAM

The St. Michael's Hospital Campus of the George
Brown College's Nursing Division announces the
offering of an Indepth program, utilizing an "holis-
tic" approach to the care of the critically-ill patient.
Advanced theory is closely correlated with ad-
vanced clinical practice.
The program - 5 months in duration - is offered
twice annually, in February and August.
One year's recent nursing practice and current
registration as a nurse is mandatory. Enrolment
limited.
For further InformatIon, contact:
The Reglstrør
St. Mlchøel's Hospital Cømpus
The George Brown College
P.O. Box 1015, Støtlon 'B'
Toronto, M5T 2T9
Phone: (416)-967-1212-locøl 269

54 THE CANADIAN NURSE

COLLEGE OF
NEW CALEDONIA
A comprehensive regional College in
Prince George, British Columbia, re-
quires

NURSING
FACUL TV
Positions available as of April, 1975 to
help develop a new two year R.N. Dip-
loma Program. This program will begin
in September 1975. Applicants should
be prepared to teach basic nursing
concepts and skills at the diploma
level.
We offer:
Excellent fringe benefits
Relocation allowances
Excellent salary commensurate
with qualifications
Qualifications:
Masters or Baccalaureate
Degree in Nursing.
Experience in Bedside Nursing.
Apptlcants should submit ø currIculum vItae
and names of three references to:
Dr. F.J. Speckeen, Principal
College of New Caledonia
2001 Central Street
Prince George, B.C.
V2N 1 P8

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

REGISTERED NURSES

required for

- modern 45 bed acute care general hos-
pital in Southwestern B.C.
- R.NAB.C. Contract in effect
- 1975 Salary $942.00 - $1,112.00
(Cost of Living Adjustment to be applied
March 1, 1975)
- Recognition for prevIous experience
- Residence available

Please Contact:
Director of Nursing
Nicola Valley General Hospital
Merri", B.C.
VOK 2BO

THE IZAAK WALTON KILLAM HOSPITAL
FOR CHILDREN
HALIFAX, NOVA SCOTIA

I

Offers B 12-week
POST BASIC
PAEDIATRIC NURSING PROGRAM

for

REGISTERED NURSES

CLASSES ADMITTED
JANUARY,MAY,SEPTEMBER

For further Information and detail write'
Associate Director of Nursing Education
THE IZAAK WALTON KILLAM HOSPITAL
FOR CHILDREN
HALIFAX, Nova Scotia
B3J 3G6

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GIVE THE GREATEST GIFT OF ALL
GIVE THE GIFT OF LIFE

+ BE A RED CROSS BLOOD DONOR

DECEMBER 1974

Positions in the US.A.

The Mount Sinai nurse is an
open-minded, free thinking, self-
starting individualist who keeps
looking for new and better
ways to do things. She brain-
storms, consults with doctors,
exchanges ideas. She is a Clini-
cian, Catalyst, Teacher and
Agent for Change. She even has
a designated time to confer with
the Director of Nursing; to ex-
change views,air problems,seek
answers and define solutions.

Above all, she is warm,
friend I)!, compassionate, consid-
erate. And startlingly efficient.
This kind of nurse can only flour-
ish given the right type of profes-
sional environment. And rv10unt
Sinai is a natural for this type of
nurse. If you like to think. discuss.
innovate, initiate and stand on
your own two feet, we'd like to
meet you. l\lount Sinai needs
this kind of nurse and this kind of
nurse will thrive at Mount Sinai.
Fill in the coupon today and let's
see what kind of new standards
we can set for your career.

When
higher
standards
of nursing
are set
mount sinai
nurses
will
set them

A representative of
The Mount Sinai Medical
Center will be in Toronto &
Montreal in January, 1975.

Judith Nathan, R.N.
Nurse Recruitment Administrator
THE MOUNT SINAI
MEDICAL CENTER OF NEW YORK
Box 199B, Fifth Ave. and 100th St..
New York, N. Y. 10029 USA
o I am interested in meeting your
representative-Please send further
information & dates.
o Please send literature.

CN-12

NAME
ADDRESS

CITY
PHONE

STATE
& ZIP

.

REGISTERED NURSES

An expanding 230-bed complex requires
nurses for general duty positions in several
clinical areas. The complex includes 130
beds for active treatment, 50 beds for
extended care and a 50 bed nursing home.
Salaries and personnel policies in accor-
dance with Alberta Association of Regis-
tered Nurses Contract. Apply:

Apply:

Grande Prairie Municipal Hospna'
Grande Prairie, Alberta
T8V 2E8

REGISTERED NURSES

Registered Nurses required for large
metropolitan general hospital.
Positions available in all clinical areas.
Salary Range in effect until December
31,1974-
$665.00 - $830.00. Starting rate de-
pendent on qualifications and experi-
ence.

Apply to:

Staffing Officer-Nursing
Personnel Department
Edmonton General Hospital
Edmonton, Alberta
T5K OL4

GENERAL DUTY NURSES

Required immediately for acute care gen-
eral hospital expanding to 343 beds plus
proposed 75 bed extended care unit.
Clinical areas include: madicine, surgery,
obstetrics, paediatrics, psychiatry, activa-
tion & rehabilitation, operating room,
emergency and intensive and coronary
care unit.
Must be eligible for B.C. Registration
Personnel policies in accordance with
R.N.A.B.C. contract:
SALARY; $850 - $1 020 per month
(1974 rates)
SHIFT DIFFERENTIAL

APPL Y TO:
Director of Nursing
Prince George Regional Hospital
Prince George, B.C.

56 THE CANADIAN NURSE

"MEETING TODAY'S CHALLENGE IN NURSING"

QUEEN ELIZABETH HOSPITAL OF MONTREAL
CENTRE

A Teaching Hospital
of McGill University

requires

REGISTERED NURSES

AND

REGISTERED NURSING ASSISTANTS

Quebec language requirements do not apply to Canadian applicants.

. 255-bed General Hospital in the West end of Montreal
. Clinical areas include Progressive Coronary Care,
Intensive Care, Medicine and Surgery, Psychiatry.

Interested qualified applicants should apply in writing to:

QUEEN ELIZABETH HOSPITAL OF MONTREAL CENTRE
DIRECTOR OF PERSONNEL
2100 MARLOWE AVE., MONTREAL, QUE., H4A 3L6.

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THIS IS THE WORLD OF CARE:
Providing nutritious food for school children and pre-
schoolers, health services for the sick and handicapped,
facilities and equipment for basic schooling and tech-
nical training, tools and equipment for community en-
deavours. Your support of CARE makes such things
possible for millions of individuals around the world.
One dollar per person each year would do it!

CARE - CANADA 63 Sparks OTTAWA (Ont.) K1 P 5A6

DECEMBER 1974

ST. MICHAEL'S HOSPITAL
Toronto, Ontario
invites applications from

REGISTERED NURSES
for
INTENSIVE CARE
and "STEP-DOWN" UNITS

Planned Orientation an(] In-serVice programme Win ena-
ble you to collaborate ,n the most advanced of treatment
regrnens for the post
operatlve cardio-vascular and
other acutely III patients. One year of nursing experience
a reqUirement

For detalts apply to:
The Director of Nursing,
St. Michael's Hospital,
Toronto, Ontario,
MSB 1 W8.

NORTH NEWFOUNDLAND & LABRADOR

requ"e

REGISTERED NURSES
PUBLIC HEALTH NURSES

International Gren(ell AssociatIOn provides
medical services for Northern Newfoundland
and Labrador. We staff four hosPitals, eleven
nursl ng stations. eleven Public Health Units.
Our main IBO.bed accredited hospital IS
situated at SI. Anthony. NewfoundlanQ. Active
treatment IS carried on '" Surgery, Medlc,"e.
Paediatrics. Obstetrics. Psychiatry. Also,
Intensive Care Unit. Orientation and In.Service
programs. 40.hour week, rotating shifts. Llv,"g
accomodatlOns 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,
SI. Anthony, Newfoundland.

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 1CO

DECEMBER 1974

---....

Some nurses are just nurses.
Our nurses are also
COmmissioned Officers.

Nurses are very special people In the Canadian Forr
They earn an Officer's salary. en:
y an Officer s pr''',1 qes
and live In Officers' Quarters (or In cIvilian accommodation It thE
prefer) on Canadian Forces bases all over Canada and In man}
other parts of the world
If they decide to specialize they can apply for postgradl dtf'
training with no loss of payor privileges. Promotion IS baspd 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 lob
For full information. write the Director of RecUttmg an1 Selrc
tlon National Defence Headquarters Ottawa Ontario KIA OK2

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Cet involved with the
canadian Armed Forces.

DIRECTOR OF
PEDIATRIC NURSING
DIRECTOR OF
QB/GYN NURSING

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()lrP( tor ot f'..ur"mg ml ll')) ') )hI)

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THE (ANMJIAN NUR
F '>

DIRECTOR OF NURSING

Applications are invited for this. position in .a forty
ed
acute hospital presently planning expansion to sixty
beds.
We serve an increasing population of 4500 from a
modern active community with all services and excel-
lent recreational facilities. Successful applicant will
be responsible for all nursing services including in-
service education.
We have a nursing staff of 21 and a Medical Staff of
three physicians including a general surgeon.
Fringe benefits include four weeks paid vacation
after one years service increasing to five weeks after
three years service, Group Insurance and Pension
Plan. Private suite in modern residence available. Air
transportation paid on hiring and for two vacation
trips a year.
Salary is negotiable and will be commensurate with
training and experience.

Apptlcatlons and Inquiries shoutd be directed to:
R.J. KING,
Administrator,
MUNICIPAL HOSPITAL,
Box 360,
Uranium City, Sask.
SOJ 2WO

NURSE CLINICIAN
(Clinical Nurse Specialist)
for the area of medical-surgical nursing is required at:

TRAIL REGIONAL HOSPITAL
an active 238 bed referral hospital located in the heart of the West
Kootenay skiing country. This is an area noted for the accessibility
of all forms of outdoor activity.

JOB SUMMARY
A non-supervisory position with direct responsibility to the Director
of Nursing.
The successlul applicant will work closely with the Charge Nurses
to
. Assist staff In determining priorities of care
. Develop therapeutic nurse-patient interaction
. Co-ordinate nursing inservice programmes
. Orientate new nursing personnel
This is a day-duty position with weekends off, however, some
flexibility in hours of work is anticipated.
aUALIFICA TIONS
. Clinical expertise and teaching skills
. Ability to develop interpersonal relationships
. Preparation at University level preferred
. Registrability In B.C. is required

SALARY: (commencing January 1975) $1350.00 per month

Apply In writing to:
DIRECTOR OF NURSING
Trail Regional Hospital
TRAIL, B.C. - V1 R 4M1

58 THE CANADIAN NURSE

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THE SCARBOROUGH
GENERAL HOSPITAL

invites applications from:
Registered Nurses and Registered Nursing Assis-
tants to work in our 650-bed active treatment
hospital and new Chronic Care Unit.
We offer opportunities in Medical. SurgIcal. Paediatric. and Obstetncal nursing.
Our specialties include a Burns and Plastic Unit. Coronary Care, Intensive Care and
Neurosurgery Units and an active Emergency Department

. Obstetrical Oepartment - participation In "Family centered" teaching
program.
. Paediatric Oepartment- 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

POST GRADUATE
COURSES

The following courses in this modern 1200 bed teach-
ing hospital will be of interest to registered nurses
who seek advancement, specialization and profes-
sional growth.

. Cardiovascular-Intensive Care Nursing. This
is a 22 week clinical course with classes
commencing in February and September.

. Operating Room Technique and Manage-
ment. This 24 week clinical course commences
in March and September.

For further Information and detalts, contact:

Recruitment Officer - Nursing
University of Alberta Hospital
Edmonton, Alberta T6G 287

DECEMBER 1974

WE CARE

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HOSPITAL:
Accredited modern general - 260 beds. Expansion
to 420 beds in progress.
LOCATION:
Immediately north of Toronto.
APl\RTMENTS:
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.

NtJRSES
fOI-
O\TERSF.ll\S

Experienced nurses needed to work in Bangladesh. Latin
America. and Africa. Become involved in preventive,
curative and training health programmes.

T\\-o year contracts \\-ith CUSO.
Transportation costs paid.

Contact:

('USO HEALTH - 12
151 Slater Street
Ottawa KIP SHS

DECEMBER 1974

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INTERNATIONAL
DEVELOPMENT
RESEARCH CENTRE

Research Associate Awards
for Professionals

The International Development Research Centre offers ten
awards for training, research or investigation to Canadian
professionals/practitioners for tenure during 1975-76.
The Award
Stipend
Travel costs for award holder & family
Travel in the field up to
Research costs up to
And/or actual training fees

$17,500
variable
$ 1,000
$ 2,000
variable

The candidate
1- The professional with no specific experience in inter-
national development. who wishes to devote one year
for research, training or investigation in the field of
international development with a view to pursuing a
future career in this field.

2- The professional already working in the development
field who wishes to improve skills or requires a period
for research.

All applicants must be Canadian citizens or have a mini-
mum of three years landed immigrant status, have
approximately ten years of professional experience, and
be at least 35 years of age,
Research and training areas
Possible fields of interest: agriculture, food and nutrition
sciences, information and communications, population
and health sciences, rural-urban dynamics, social sciences,
technology transfer, education, engineering, etc.
Tenure
To begin .before January 1976 for one year only.
Applications
The application forms may be obtained directly from the
Centre. They must be submitted by February 28 to:

Research Associate Award,
Social Sciences and Human Resources Division,
International Development Research Centre,
P.O. Box 8500,
Ottawa, Ontario, Canada,
KIG 3H9

Announcement of awards will be made May 1st, 1975.
The International Development Research Centre is a cor-
poration established by an Act of the Canadian Parliament,
May 13th, 1970. The Centre also offers Research Associate
awards for mid-career professionals from developing count-
ries, for Ph.D. Thesis Research and for Travel and Research
in International Development.

.

THE CANADIAN NURSE Sq

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EMPLOYMENT OPPORTUNITY
PROVINCE OF
PRINCE EDWARD ISLAND

PUBLIC HEALTH NURSE I

THE !;OV(.""UIT OF THE
'IOVU'CE or P. E. ISUMD

DEPARTMENT OF HEALTH
REPLACEMENT

POSITION - VARIOUS AREAS OF THE PROVINCE: This is professional
public health nursing worle The employee performs public health nursing
duties and participates in health conferences and carries out physical in-
spections and immunization 01 infants and pre-school children, discusses
findings with mothers, makes referrals to doctors as indicated, and main-
tams clinical records. The employee also performs such specialized
casework duties as investigation of medical and social factors, assembling
of case history material, and interpretation of services, and other duties as
required.
aUALIFICATION: Applicants must have graduation from a recognized
school of nursing, supplemented by completion of a diploma course in public
health nursing, and some experience In professional nursing work.
SALARY RANGE: $7,840 - $9,350
Competition No. 10451717

ApplIcation forms may be obtained by writing the Civil ServIce Com-
mission, P.O. Box 2000, Chartottetown, PrInce Edward Istand. When
returnIng the apptication forms, please refer to the approprIate com-
petition number.

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 Nursmg, 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

60 THE CANADIAN NURSE

THE DEPARTMENT OF
NORTHERN SASKATCHEWAN

is developing new health programs to re-
spond to the unique health needs of northern
people.
Nurses are required to make use of their full
range of nursing skills and abilities to initiate
and develop new programs in conjunction
with a growing range of allied health and
social service personnel.

HEADQUARTERS:
Various Locations throughout Northern
Saskatchewan.

Please direct applications to:

MR. STU KERR
PUBLIC SERVICE COMMISSION
1820 - ALBERT STREET
REGINA, SASKATCHEWAN

NOTE: Please quote competition number cc8532.

DALHOUSIE UNIVERSITY

SCHOOL OF NURSING

Applications are invited for the position of Professor and Director
of the School of Nursing. The position carries responsibility for
the School, including administration of the Baccalaureate and
Master's Programs, recruitment of faculty, budgeting, etc. It is
expected that the candidate would have completed a doctorate,
and have had clinical, nursing education and administrative
experience. She or he should be available on July 1, 1975.

ApplIcatIons, wnh CurrIculum Vnae, should be sent to

Dr. R.M. MacDonald
Dean of the Faculty of Health Professions
Dalhousie University
Halifax, Nova Scotia,
by January 1,1975

DECEMBER 1974

Dr Welby is a
NURSE

. . .

It seems clear from
watching this program
that poor Dr Welby is
spending 2/3 of his
time NURSING.

The nursing profession at
the ROYAL VICTORIA HOSPITAL
is concerned about this.
We are reviewing nursing
roles in depth in this
teaching hospital center,
and we feel that we can
relieve Dr Welby of his
non-doctoring functions.

You are invited to join
an extensive change
program in the nursing
profession at the
ROY AL VICTORIA HOSPITAL.

Areas where you can be a
part of the change program
are, Medical and Surgical
Specialties, Intensive Care
Areas, Operating Room,
Psychiatry, Obstetrics,
Emergency and Ambulatory
Services.

No special language
requirement for Canadian
Citizens, but the opportunity
to improve your French is
open to you.

For Information, Write To:

Anne Bruce, R.N.,
Nursing Recruitment Officer
Royal Victoria Hospital
687 Pine Avenue West
Montreal, Quebec, Canada
H3A 1A1.

DECEMBER 1974

worth
looking
into...

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federal public
serva nts.

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Heallh and Wpltarf' Santf' et Blen-elre sc lal
Canada Canada

,---------------

I Medical Services Branch I
I Department of National Health and V\felfare I
I Ottawa, Ontario K 1 A OK9 I
I I
I Please send me Information on career I
I opportunities in this service I
I Name: I
I Address: I
City: Pray: _

______________-J
THE CANADIAN NlJRSE 61

invites applications for

DIRECTOR OF NURSING
CHILDREN'S HOSPITAL
VANCOUVER, B.C.
The fully accredited Children's Hospital is a member of
the British Columbia Medical Centre which is in the process
of constructing new facilities within the next five years.
It is a Pediatric teaching institution associated with Uni-
versity of British Columbia and Community Colleges in
Pediatric Nursing.
The Hospital is innovative in its concepts of child care
and has developed contemporary programs which include
a Diagnostic Centre for the multiple handicapped child, a
Care-By-Parent Unit, a Day Care Surgery program, and
Travelling Clinic.
Candidate must have several years progressive Pediat-
ric administrative experience. Other qualifications being
equal. the candidate with a Masters Degree in Nursing will
be given preference.
Liberal fringe benefits. Salary is negotiable.
The present Director of Nursing is retiring.
Apply In writing by December 31, 1974, to:
Mr. J. W. Short
Administrator
Children's Hospital
250 West 59th Avenue
Vancouver, British Columbia
V5X 1 X2
CANADA

MONTREAL CHEST HOSPITAL CENTRE

A TEACHING HOSPITAL AFFILIATED
WITH
McGill UNIVERSITY

REGISTERED NURSES
REGISTERED NURSING
ASSISTANTS
FOR GENERAL DUTY

Please apply to:
DIRECTOR OF NURSING
MONTREAL CHEST HOSPITAL CENTRE
3650 ST. URBAIN STREET
MONTREAL, QUEBEC, H2X 2P4

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.
1974 Salary Scale $850.00 - $1,020.00 per month
For further information, please write to:
PERSONNEL SERVICES
VANCOUVER GENERAL HOSPITAL
855 WEST 12TH AVE.
VANCOUVER, B.C.

62 THE CANADIAN NURSE

DEUMIJER 1974

REGISTERED NURSES
are invited to apply tor positions in

. NEUROLOGY
. ORTHOPAEDICS
. RENAL DIALYSIS
. MEDICINE AND
GENERAL SURGERY

DALHOUSIE UNIVERSITY

SCHOOL OF NURSING

at

Applications are inVited for the position of PROFESSOR or
ASSOCIATE PROFESSOR OF NURSING to coordinate the
Master's Program in association with the Director of the School. It
is expected that the candidate would have completed a doctorate,
and have had clinical, nursing education and research experience.
The appointment includes teaching in the graduate and undergra-
duate programs, and provides opportunity for research and
professional services. The candidate should be available January
1, 1975, or by arrangement.

Toronto
General Hos p ital
O n i vers i ty
Teaching Hospital

Dr. R.M. MacDonald
Dean of the Faculty of Health Professions
Dalhousie University
Halifax, Nova Scotia

. located in heart of downtown Toronto
. within walking distance of accommodation
. subway stop adjacent to Hospital
. excellent benefits and recreational facilities

Applications, with Curriculum Vitae. should be sent to

apply to Personnel Office
TORONTO GENERAL HOSPITAL
67 COLLEGE STREET. TORONTO, ONTARIO, M5G 1L7

ASSIST ANT
DIRECTOR

Required for 2 year independent diploma program in nursing. Enrollment-
255 students 25 full-time faculty members
DUTIES: to assist the director in administrative responsibilities
QUALIFICATIONS: Masters degree preferred.
Experience in teaching and curriculum development. At least one year's
experience in nursing service.
Apply to:

Miss Anne D. Thorne,
Director-Saint John School of Nursing,
Beaverbrook House,
Coburg Street,
Saint-John, N.B.

DECEMBER 1974

.
THE CANADIAN NURSE 6]

SIMCOE COUNTY DISTRICT HEALTH UNIT

DIRECTOR,
PUBLIC HEALTH NURSING

For progressive generalized public health programme.
Salary commensurate with experience, good fringe
benefits and car allowance. .
QUALIFICATIONS: Bachelor's Degree with several
years experience as Director or equivalent.
APPLICATION: with name of references to be submit-
ted to the:

Secretary-Treasurer
Simcoe County District Health Unit
County Administration Building
Midhurst. Ontario
LOL IXO

by December 31, 1974.

T FIGHT THE T
LUNG CRIPPLERS

Emphysema Asthma Tuberculosis Chronic Bronchitis Air Pollution

....
fJ .'

USECHR
TMASSEALS

It's a matter of life and breath.

&4 THE CANADIAN NURSE

Index
to
Advertisers

December 1974

Canada Manpower Centre . . . . . . . . . . . . . . . .Cover III

Clinic Shoemakers . . . . . . . . . . . . . . . . . . . . . . . . . . . . .2

Davol Canada Ltd.

.......... .6
.57

Depanment of National Defence

Greyhound Lines of Canada Ltd. . . .. ............, I

Holli
tcr Limited.. ......

....... .... ..10& II

International Development Research Centre ....... .59

J.B. Lippincott Co. of Canada Ltd. . . . . . . . . . . .32 & 33

MedoX

........................... .50

The C. V. Mosby Company Ltd.

. . . Cover II

Po:>.ey Company

............ .5

Procter & Gamble . . . . . . . . . . . . . , . . .. . .Cover IV

Sandoz (Canada) Ltd ........ . . . . . . . . . . . . . . . . .43

cI\'('/'ti.\il/g .\JcII/ag('/'
(ìcorgina Clarl,c
The Canadian Nurse
SO The Driveway
Otl,l\\-a "-21' I E2 (Ontario)

A cln'rl isi fig Rl' prl'.\('I/llIli 1'('.\
Richard P. Wilson

19 East Lancaster Avenue
Ardmore, Penna. 19003
I dcphllnc. (
15) :\.Jid\\<I} l)-I..JlJ1

Gordlln lïfJïn
2 Tremont Crescent
Don Mills. Ontario
rckphllnc. (.t I h) 444-4731

Member of Canadian
Circulations Audit Hoard Jne.

Iæl.:J

DECEMBER 1974

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