History of Nursing in Pacific Canada

[Lecture Notes, 1926 - 1932] Johns, Ethel 1932

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  Qrv.B.
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Marvin
SUPERVISION IN SCHOOLS OP NURSING
Ed. 192 G (no.l)
Suggestions for Students
Each student is responsible for:
1. Contributing satisfactorily to the class
discussion of the session.
2. Passing acceptably a midterm new type examination as a test of reference readings.
3. Submitting the written work required from
time to time.
(O
4. Doing her share of work in the successful
development of one of the group projects
wherein a study made by all is submitted
in writing, and reported upon in class by
the chairman of each respective group.
5. Developing an out of class examination due
the last week of school which will indicate
one's ability to incorporate the whole
substance of the course.
Ed. 192 G (no. 2)
Some Conditions Affecting the Management
of the Hospital Ward (or Floor): \
Marvin 2
1. Suggest some of the important character-
^ istics of a hospital which make it a desirable field for laboratory practice in
nursing for students in a school of nursing
References:
a* A Curriculum for Schools of Nursing
616 N2133 (rev.1927) pp.17-43.
b. Nurses,Patients and Pocket Books -
Burgess 616 C735 Ch.XX pp.434-450.
o
How Can We Care for the Patient and
Educate the Nurse?  Nutting, Mod.Hosp<
1923, Vol.XXI, No. 3.
2. Upon what special condition is the most
skillful and most effective nursing care
of the hospital patient dependent?
References:
a* Teaching Nursing by the Application of
the Case Study Method - Effie Taylor.
Mod. Hosp. Dec.1928
106 Dodge -
International Council of
Nurses.
b. Ward Administration - Sellew Ch. XI♦
o
d.   wara Aaminis*cra-cion -  sexiew un.  ajl# \
Marvin 3
o.  Gave  of the Patient - Peabody 616 p. 31.
o
d. In Hospital - Henley.
e. Physician and Patient - Emerson 616 Em3.
Read the Introduction,and a few chapters.
f. Recall your own experiences.
3* Name the conditions existing in the hospital ward (or on a floor) which undermine or
promote the educational opportunities of
the student nurse?
o
a. T«C«Record, Nov. 1916 - Vol 17,pp.405-
416•  Education for Initiative and
Originality - Thorndike.
b. Nursing and Nursing Education.in the U.S
616 C73 pp.297-318.
c. The Head Nurse: Her Responsibilities and
Preparation - M.M.Marvin - Quarterly
Bulletin - Ohio State Nurses1 Associa-
S~\ rion 106 Dodge.
d. Reflect on your own experiences.
v : ) Marvin 4
Ed. 192 G (mo. 3)
( )   Comparison of the Positions of the Hospital
Head Nurse and Supervisor and some Problems
in Relation to the Work of Each:
1. What are some of the outstanding differences between the positions of the hospital
supervisor and the head nurse at the present time?
References:
o
Preliminary Report of Sub-Committee on
the Duties,Qualifications and Preparation of Supervisors and Head Nurses.
33rd.Annual Report,N.L.N.E. 1927 -
pp. 132-135.
2. Using the check list found in folders in
106 Dodge consider carefully the purposes,
and analyze the functions of these two
groups of hospital workers.  After studying the survey read Part 1 and Part 11, pp.
140-148, 34th.Annual Report N.L.N.E. 1928.
"The Position and Preparation of the Super-
r\   visor and Head Nurse."
.
Hand in a list of 15 duties listed belonging to each group individually,and 15 be-
l     longing to both (total of 45 duties). (— — "~ "l
Marvin 5
3. Familiarize yourself with the more impor-
\^)   tant problems in connection with the hospital supervisor and head nurse of the
present day.
The Nursing Education Bulletin,
Aug* 1928, Vol. 1.
No. 2. Conference Reports pp.26-29
and 34-38
4. Try to get a conception of the job and
qualifications of the hospital supervisor.
o
Supervision of Vocational Education -
Wright and Allen.   371.44 W932.
Chapters 1,111 and IV.
Ed. 192 G (no. 4)
A Few Tools for Building the Educational
Program of the Ward:
"I envy for our medical students, the advantages enjoyed by the nurses who live in
f^\   daily contact with the sick."  Osier.
Note:  The references mentioned below overlap somewhat.  Each may suggest
several kinds of teaching rather Marvin 6
than one.
o
1. The Case Method Assignment:
References:
a. Teaching Nursing by the application of
the Case Study Method.  Effie Taylor
(A good argument for case method of
assigning patients although a previous
reference).
o
Mod. Hosp. Dec. 1926.
International Council of Nurses,
1926, 106 Dodge.
b. Teaching and Supervising of Surgical
Nursing. Margaret Tracy, 23 Annual
Report, N.L.N.E. 1926.  pp. 121-126.
c. Nursing and Nursing Education in the
U#S# 616 c 73 pp.297-318.   (A previous
reference but not against the argument
against the specialization method.)
o
2. The clinical method of teaching.
a. A Case Method of Teaching Nursing.
Sarah Parsons, A.J.N. Sept. 1911. Marvin 7
(These are in reality, clinics given
by physicians for nurses.)
b. Holmes, O.W.  Medical Essays. Vol.IX.
610.4 H73.
Scholastic and Bedside Teaching,
pp.272-311.
c. Osier - Acquainimitas and other addresses.   610.4 Os 5.
The Hospital As a College, Ch. XVI.
pp.329-342.
o
Be prepared to put an outline on the board
of a 15 minute nursing clinic which a head
nurse might conduct profitably for her
s tudents.
3. The use of the case study method.  See
unit course and outlines.
4. Submit a brief description of not more
than 100 words each, of four different
methods not mentioned above, a head nurse
Y^\    could use in teaching a ward. Outline of the Topics for Discussion in the
O Un3-t Course U192g, the Case Study Method of
Teaching Nursing:
1. What are Our Problems in Relation to the
Use of the Case Study Method in Nursing?
References:
a. 35th Annual Report of the N.L.N.E.
1929 pp. 165-173.
o
b. The Case Method of Teaching Systematic
Medicine - Cannon Vol. CXL11 Vol. 2 -
Boston Med. and Surgical Journal.
2. How Preventive Aspects of Disease can be
Taught to Student Nurses Through the Use
of the Case Study Method.
References:
o
31st.Annual Report N.L.N.E.1925 pp.133-138
Principles of Pub.Health Nursing in the
Undergraduate Course. Amelia H. Grant.
3. The Nursing Case Study from the Standpoint
of the Social Worker. Marvin    9
References:
o	
a* What is Social Case Work - Richmond,Mary
b. What is Hospital Social Work - Jessie
Beard. A.J.N. Vol.XXlll pp.743-1922-
1923.
c. The Social Worker in the Hospital Ward-
Elsie Wulkop Houghton Mifflin.
4. The Case Method of Teaching Law.
^^ References:
a. Rev. of Prof. Diceyfs article,
The Nation, June 8, 1899.
b. Inductive Method in Legal Education,
Keener, 1894, Am.Law Review 1928.
5. Important Points to be Considered in Teaching a Student to Build up a Case Study.
I (£\   a. What suggestions would be helpful to
students in connection with the gathering of data?
See Hand Book of Organization and Method
3^rHo|!>ltal Social Service Margaret S. larvin 10
b. What are the special uses of a direc-
Q    tion sheet?   (See basket,106 D.)
c. Suggest the advantages and disadvantages
of an especially printed form on which
the student writes the case study?
(See basket 106 D.)
d. Each student who is in hospital(Nursing
182) is expected to submit a case study
written as a result of direct experience
with patients. Others are expected to
write a critical evaluation of three of
of the case studies found in the basket
in 106 D.
References:
a. Jensen, Student Handbook in Nursing
Case Studies.
b. See add. references in basket, 106 D.
6. Points to be Considered in the Introduction
(~\    of the Case Study in the Nursing School.
a. Read critically the purposes and outline
of the course in "A Curriculum for
School of Nursing"pp. 116-119. Marvin 11
b. What methods are valuable to use in
\_J applying the content outlined in the
course suggested in "a", to the various
services in the hospital?
c. What arguments are there for making a
collection of various kinds of case
studies in a single department such as
the medical or surgical?
• o-
References:
^ The Family - Jan.1930 Vol.X p 259.   "The
Relative Value of Case Study and Statistics
d. What use is made of the grade given to
the student for a case study written in
a department such as the surgical?
e. Case studies written by students are
due.  Critical evaluation of case
studies, due.
7. Limitations of the Use of the Case Stixdy
^\    Method in Nursing.
a. Suggest as many as' you can.
j o
I
Marvin 12
Discussion of References suggested Below the Outsine of the Course.
a. Each student to submit as many references as she is able to find which would
be helpful as supplements to the list
printed in the book.  Do not confer
with eachother on the suggested ad*-
ditions.
8. Discussion of the case studies submitted.
Final summing Up of All the Educational
Advantages of the Case Study Method in
Nursing.
References:
a. The Value of the Case Study Method in a
Large Hospital. The Trained Nurse and
Hospital Review, Jan. 1927.
b. Teaching and Learning Through Experience.
Harmer.  31st. Annual Report N.L.N.E.
1925, pp. 124-132.
o o
Marvin
NATIONAL LEAGUE OF NURSING EDUCATION
1928
The Position and Preparation of the
Supervisor and the Head Nurse
A head nurse is often expected to assist
the physician with very special diagnostic j
measures, like the encephalogram or to
help with.difficult therapeutic treatments
such as, a pneumothorax or a spinal irrigation.  Besides helping with these treat-
^-^ ments she must always be alert to see that
^^ every other treatment is carried out.
Moreover, we usually turn to this same
head nurse to teach new or difficult treatments which for certain reasons can never
adequately be explained or demonstrated in
the classroom,as,for example,lavaging or
gavaging the infant; observing the effects
of the Alpine light treatment; guarding
the patient who has radium implanted; regulating the Harris drip into an open abdominal cavity; or giving the tepid pack
to the maniacal patient.  Students should
never be expected to give treatments of
this kind on the strength of a classroom
discussion or demonstration, and the head
nurse is the most logical person we have o
o
Marvin 2
to depend upon,
Housekeeping:
Another responsibility of the head nurse
is related to the housekeeping.  The super
vision of present day help, of the ward
itself, the floors and walls, the furniture, the care of expensive up^to-date
equipment and other supplies like blankets,
linen, rubber goods, are dependent upon a
knowledge of the scientific principles of
good housekeeping.
Clinical Specialty:
Of prinary importance is a broad knowledge
of her clinical specialty, such as medical
or surgical diseases, in order that she
will be able to think and act intelligently in relation to her patients1 needs.
Assisting the physician with treatments or
demonstrating them to the students each re-|
quires an expert knowledge of the nursing
procedures, as well as a high degree of
skill in giving them.  Even with these
(^\    skills she may still fail if she cannot
plan and manage the work of the ward as a
whole, getting the work done in the least
time in the best interests of all concerne
This has 'always been one of the criteria
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Marvin 3
of a good head nurse.  Add to these, success in managing people, the ability to
teach and develop students who are dependent upon her to connect the rest of their
educational program in the school with
this particular practice,and then perhaps,
we may have some conception of what the
job of the head nurse involves.
Development:
Many of our good supervisors and head nurses in the field tell us that it takes
directed training to assume the obligations
of the positions they find themselves in.
Our problem is to supply this need. A few
brief suggestions will be made in connect
tion with this one of which is staff education that might be defined as a "tenta-
tive program for developing workers on the
job in which they are engaged as full time
workers".
Bellevue Experiment:
During the last two years, an experiment
r") in staff education in relation to supervisors and head nurses was carried on in
the Bellevue School of Nursing in New
York City.  As it was my privilege to
have the opportunity of joining in this ^1
Marvin 4
experiment, I shall try to discuss it in
some detail and tell you some of the results.  With the exception of an occasion
al joint meeting the supervisors and head
nurses met separately.  The head nurse
body was a group of about fifty graduate
nurses representing many schools.  While
attendance at classes was not compulsary
everyone was urged to be present, and the
roll was always taken.  Altogether over
thirty meetings, quite informal, were held
in the Nurses Residence, from six-thirty
to seven-thirty in the evening, once per
week, with attendance ranging from twenty-
eight to forty-five, the average for the
year being thirty-two.
The subjects for discussion varied consider
ably as it was expected that they would de
velop in accordance with the needs of the
group.  To impress the head nurses with
the importance of the educational program
in the whole school classes began with a
discussion of a few principles of teachingJ
f*\    These were immediately applied to concrete
kinds of ward teaching already in existencd
such as the morning and evening reports,
the introduction of the new student to the
service, or the technique of giving a
• • ^
Marvin 5
nursing clinic.  After the purposes, and
\J   methods of each kind of a class were talked
over in class, each was demonstrated by
groups of head nurses, some acting as though they were students in the class.  Immed
lately after each demonstration, there was
criticism and discussion until it seemed
as though every person present ought to
have been able to work out some kind of a
similar plan which she could put into oper
ation in her own ward.
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One series of classes dealt with the subject of housekeeping problems which at
times were conducted by the supervisors
most concerned with these activities.
The instructor of nursing practice gave
three evenings of valuable demonstrations
which the head nurses asked for in order
that they might learn some of the new procedures and discuss old ones about which
there was controversy.  The plan of special supervision of younger students, principles underlying the grading system used
in the school, explanation and discussion
of the newly adopted efficiency slips,some
principles of scientific management applied
to ward administration were taken up, termi
nating with a brisk discussion on their o
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Marvin 6
part of the qualifications of a good head
nurse.
These meetings did not take the place of
the small departmental meetings which each
supervisor was expected to have with her
own head nurses.   It was thought that discussion of the whole group of head nurses
on general ward management problems would
be stimulating and helpful and at the same
time not in any way interfere with the good
relationship which each supervisor had with
her own head nurses.
While it is impossible to measure results
from that kind of an experiment there were
some noticable changes in attitude and work;
These meetings helped to make the head nurses feel that they had a definite obligation of keeping well informed about the
clinical material in their own wards because they were expected to share this with
their students.  Perhaps it made them
appriciate still more the rich material
they had to draw from.  Of course some ward
teaching had always been done, and in many
cases exceedingly well, but generally speak
ing, as a whole, it began to take a more
definite and a better organized form. o
Marvin 7
Some head nurses who had previously felt
k_)   no responsibility toward teaching reacted
enthusiastically, showing marked teaching
ability.  While it was never expected
that fifty trained head nurse teachers
would result, it is true that the amount
of teaching was multiplied many, many times
This not only represents a development of
head nurse, and a gain for the student,but
better care for the-patient.  One unlooked
for and very helpful result of these free
and informal discussions was the precipitation of many problems affecting- ward
management which were straightened out
by the director of the school. Many misunderstandings were thus cleared up in a
very satisfactory way. In the second
year, another significant change was noticed in relation to the stability of the head
nurse group. It would be impossible to
say just how much the development of the
educational program contributed to this,
but the fact remains that there were comparatively few resignations in some of the
larger departments. The head nurses realized where the supervision was best in„
the school so was the nursing. When they
were able to see this relationship, most
of them, not all, were moved to contribute o
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Marvin 8
their part to the whole program.
At Teachers College in New York an experiment will be tried next year in developing
a combined program for the head nurse.
Six hospitals in or near New York have cooperated by offering certain wards as fields
where the students under the joint supervision of hospital, and college will secure
their practice.  Three afternoons a week
will be reserved for these students to go
to the College for class work which will
consist of courses in psychology, comparative nursing methods, hospital housekeeping
ward management, and elements of public
health, all of which will be carefully coordinated v/ith their field experience.
The course will extend throughout the eight
months of the college year and will represent from sixteen to twenty points of credit which may be applied to the supervision
major should the student wish to return
for future work. ■\
^TENTATIVE STANDARDS FOR HOSPITAL SCHOOLS
Q   OF NURSING SEEKING CONNECTION WITH A
COLLEGE OR UNIVERSITY
INTRODUCTION:
These standards are suggested for Hospital
Schools of Nursing seeking connection with
Colleges or Universities in order that the
hospital portion of the nursing course may
be recognized and given credit toward a
Bachelor's degree.  The Committee wishes
to emphasize that these standards are neither final mor complete, but rather tentative and minimum and whenever possible
higher standards should be sought.  They
are based on the following objectives:
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OBJECTIVES:
1.  The Nursing School a real school, with
Education its prinary purpose.
•^-Foot-note.  These standards have been compiled from the Survey of the Lincoln School]
of Nursing, the Curriculum of the National
League of Nursing Education, the Proceedings of the Conference on Nursing Schools
connected with Colleges and Universities,
and the deliberations of the Committee.
2.  The Nursing School economically inde-
pendent and able to provide all the essen- o
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tials for a sound educational program in
nursing.
3.  A paid staff in the hospital to make
it possible for the School to carry out a
well balanced education program without
sacrificing either the patient or the
student.
4. Size of student body regulated in accordance with the educational resources
which the school can command, and the conditions of supply and demand in the field.
5. Quality of product rather than quantity
especially in view of the present over production of nurses for rank and file posi*-
tions and the great scarcity of nurses for
more responsible positions.
6. Preparation for general practice to in-j
elude the elements of public health nursing so that specialized post-graduate traid
ing is not needed to fit graduates for
f\    staff positions in visiting nursing services.
7. Basic course to provide a sound foundation on which student ma?/ later build for - 3 -
teaching, supervisory, or administrative
(^ work.
8. Basic course to be on an optimum not a
minimum educational level.
9. Waste of time and effort to be reduced
by cutting dowm non-educational routine
wherever possible.
10. Nursing to be interpreted in the broader sense as including^ care of common mental
^^^ conditions, care of patient's environment
^ J   and disease prevention, as well as bedside
care.
11. Preparation to be for future as well as
immediate responsibilities of student and
for practice in different kinds of homes
and communities.
12. Preparation to be well-rounded emphasizing the sciences and the social aspects
as well as the practical art of nursing.
13. Instruction and discipline of the type
to produce not merely trained but educated
professional nurses, fitted to adjust to a
wide variety of situations, to practice on ■4-
a professional basis and to continue grow-
(3 inS after the period of training.
14. All students encouraged to develop as
far as they can and special efforts made
to attract and develop potential leaders.
15. Student nurses to be not only teachers
of health but examples of health and whole-)
some living.
o
16.  Nursing practice to be steadily improved through the application of knowledge and through the stimulation of
initiative and creative ability of students
and staff.
FACULTY ORGANIZATIONS:
1-.  That the faculty should be organized
on a basis recognized by the university
for faculty membership; that other appointees not qualified for faculty work should
be considered members of the educational
staff, and would be expected to qualify
f~\   by further academic preparation for promotion to faculty rank.
2.  That the faculty should have the power
to prescribe the curriculum and the
: o
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conditions under which students live and
work in hospitals, such as hours of duty,
length of assignments in various services,
supervision of students at work and in
residences.
3*  That the faculty should have the power
to recommend students for degrees and
diplomas.
^FACULTY PREPARATION:
1♦  Principal of the School of Nursing:
a. The head of the school should have the
same rank as the head of other departments
and should qualify academically for that
rank.
b. Graduation from an accredited nursing
school.
c. Registration in State in which school
is located.
d. From three to five years in educationall
and administrative experience in schools
of nursing.
^•Foot-note. In certain instances it may be
desirable to modify the educational require
ments of one or more members of the faculty
where their experience and the standards of
their work are such as to entitle them to
special consideration. - 6 -
2.  Assignments:
^J a.  Minimum of two years work beyond high
school in college or normal school,
b.  Graduation from an accredited nursing
school.
c*  Registration in State in which school
is loaated.
d. A minimum of two years educational and
administrative experience in schools of
nursing.
o
3.  Instructors:
a. Minimum of two years work in college
or normal school.
b. Graduate of an accredited school.
c*  Registration in State in which school
is located.
d*  Special preparation in the subject
matter she is to teach and methods of
teaching in nursing schools.
4.  Supervisors:
a.  Not less than two years of college or
equivalent.
~V b.  Graduation from an accredited nursing
school.
c. Registration in State in which school
is located.
d. Experience as head nurse. o
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e.  Special knowledge of clinical subjects
j   of services supervised, and knowledge of
educational and teaching methods.
* 5.  Head Nurses:
a. High school graduation or equivalent.
b. Graduation from an accredited nursing
school.
c. Registration in State in which school
is located.
d. Private duty, general duty or assistant
head nurse position for one year before
appointment, or previous educational or
administrative experience.
e. Special preparation to be secured as
rapidly as possible
6.  Faculty Rank:
As soon as possible all faculty members
should qualify academically for the rank
to which they are entitled.
TEACHING LOAD:
Subjects - Not more than three allied
subjects.
Class Hours - Not more than 18 hours weekly
(Laboratory equivalent of class hour, in
accordance with the practice of the
associated college.) )
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Teaching should be of College grade and
^J worthy of College credit.
BUDGET:
That members of the faculty be appointed
as administrative officers or as a committee to prepare a budget subject to the
usual form of approval of the university,
and that the budget allow at least the
minimum amount for expenditure on the education of student nurses as is allowed
other similar groups of students in the
university.
ENTRANCE AND GRADUATION REQUIREMENTS:
That students of nursing, both degree and
diploma, meet the entrance requirements
accepted by the college or university and
that exceptions be handled by the Committee
on Admissions; also that degree students of
nursing meet the graduation requirements of
college or university; diploma students
meet college or university requirements
for certification.
CURRICULUM:
1.  Minimum of class work should at least
equal that outlined in the National League
of Nursing Education Curriculum in which o
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825 hours are devoted to formal instruction
and 6250 hours to practical work.  The
ratio is therefore about one hour of instruction to 7.5 hours of work.  Enrichment
of the hours of theory should be made as
rapidly as possible.  Of equal importance
to the total number of hours of formal in-
struation is the proportion of time assigned to the main subject groups.   In the
N.L.N.E. Curriculum, for example, approximately 25fo  of the time is devoted to the
basic sciences, anatomy and physiology,
chemistry, bacteriology and psychology;
63/b to the practical art of nursing and
clinical subjects and the remaining 12$ to
the general professional subjects, history
and ethics of nursing, modern social and
health movements, survey of the nursing
field and professional problems.
2.  Sequence of subjects and services -
the first essential in arranging the materials in a curriculum is that they should
be put in the best possible learning order.
Fundamental skills and ideas which are to
be used continuausly should come as early
as possible.  Theory and practice should
proceed together and should support and
strengthen each other.  The more general
j - 10 -
subjects and experience should come before
/") the special and the simpler and less complicated duties should precede the more
difficult and responsible duties.  There
should be a definite progression from one
level to another with enough new experience
to keep the student interested and working
up to her capacity in tasks of increasing
difficulty.  There should be no period
when she is simply marking time or repeating over and over work already familiar to
her.
-m^ 3.  Correlation of theory and practice -
' )   Although it is not always possible to have
theory and practice concurrent, it is desirable to have theory precede practice by
not too long a time.  In any event, the two
should be very definitely related, and for
that reason it is preferable to have supervisors in charge, of each of the clinical
departments assume responsibility for class
room teaching as well as for practical
training in their special branch of work.
^^ 4.  Distribution of assigned work - In
planning the curriculum for any school, the
hours of theory and practice including
study, should be so distributed that the
student load is neither too heavy nor too o
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light at any time.  It is not desirable,
however, that the hours of class work shouH
be evenly distributed throughout the three
years.  There are so many things that the
young student must understand and so many
techniques that she must master before she
is ready to assume responsitility for the
care of sick people, that it has been
found to be a better educational plan and
also more economical for the hospital to
concentrate the major portion of the formal
class room instruction in the first year,
with due allowance for the correlation of
theory and practice,with the remainder distributed between the second and third years
Time for study must be definitely provided
for or the teaching will be of very limited
value.  In most professional schools two
hours of study for one of class would be
the minimum but since nurses are presumably doing some study of a practical kind
when they are in the wards, the minimum
has been set at one and one half hours of
study for each hour of class.  This should
f\   be definitely provided for in the student's
schedule, the assigned time for class,
study, and ward practice not to exceed
fifty-seven hours weekly. —  "N
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5. Required clinical services should in-
Q elude medical, surgical, pediatric and
obstetric nursing in both wards and outpatient departments.  Clinical experiences
in communicable, psychiartic, and specialties, as eye, ear, nose, and throat nursing
should be included as soon as suitable
courses under proper conditions can be
secured*
6. The National League of Nursing Education Curriculum should be referred to as
a guide for sequence in assignment.to each
service, as well as length of assignment.
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7.  The theoretical instruction and practical experience of each student should be
comparable to that of all the other students in the same class.
HOURS:
It has been found advisable to divide- the
curriculum into periods in which theory
predominates and periods in which clinical
practice predominates.  In each period it
is advisable to provide as frequent as possible a full free day for the student.
During clinical practice periods the following weekly schedule is advocated: "N
- 13 -
Nursing Practice    42 hours
(^)    Class 6 hours
Study _9 hours
57 hours
VACATIONS:
At least four weeks within each 12 months,
HEALTH:
Some system of health examinations as for
other college students.
o
RECORDS:
Records should be so kept as ifcro show what
the student actually has received in both
theory and practice.
CLINICAL FACILITIES:
A- hospital should have an acute general
service and a daily average census of 50
patients in order to carry out the outline*
program.* It is probable that affiliation*
for special services will need to be provided.  The number of students enrolled
yearly should not exceed the number that
/~\    can secure adequate clinical experience,
wholly obtained in the home hospital
service.
*-Foot-note. An acute service is one where
the number of admissions per bed per year
averages from 12 to 20 or over. o
' \
- 14 -
PHYSICAL FACILITIES:
\J   Classrooms, Demonstration room, Laboratories and Library for students1 use during
hospital portion of the nursing course
should be equal to those provided by the
College or University for students in other]
courses.
HOUSING AND LIVING CONDITIONS:
It is hardly possible to overestimate the
importance of the conditions under which
student nurses live and work.  These conditions affect most deeply their health, .
spirit, and general power to handle their
work efficiently or to derive benefit from
the professional course offered.  Among
the essentials which should be provided
in students1 residences are single rooms
for all students.  Double rooms should be
used only when absolutely unavoidable and
should be looked upon as a temporary and
undesirable expedient.  Student nurses
acquire their professional preparation
under peculiarly difficult and exacting
■ conditions, and are subject to certain
/^v strains and responsibilities which do not
obtain in most other professional fields.
They need, when off duty, the quiet and
privacy of individual rooms.  These rooms
should be comfortable and should be - 15 -
supplied with good beds, writing tables,
^^ shelves for books and papers, and always
be provided with good lights.  The standards of living for the student must be
stich as she will be expected to apply in
the homes and institutions in which she
works and teaches.  These standards include
the maintenance of orderly and hygienic
surroundings and immaculate personal
Cleanliness.  The lavatories should provide
ample facilities for this, and not less
than one bathroom for five students is
O looked upon as meeting modern requirements
The dietary should be especially adapted to
students engaged in arduous work involving
physical as well as mental strain and such
disruption of normal life as night duty or
unusual duty  usually brings.  No body of
persons in the hospital needs more careful
consideration on this point than the staff
of student nurses.  There should be a care-j
fully worked out menu and the food should
be well selected, well cooked, and attractively served.  Specially arranged quarters|
should be provided for students on night
duty to ensure protection from noise and
other disturbances.  There should be suitable reception and sitting rooms and such
service as is necessary in maintaining a
o - 16 -
1
o
dignified, orderly, attractive, and home-
^^ like household.  A number of schools are
now employing social directors, or house
mothers, to look after those aspects of the
students1 home life to v/hich the principal
and staff cannot possibly give much attention owing to their other engrossing duties
Definite provision is thus made for developing a wholesome and stimulating social
life, and for the introduction of outside
interests which the student nurse particularly needs.
ORGANIZATION AND ADMINISTRATION:
The immediate control or interests of the
School of Nursing shall be vested in a
Special Committee made up of:
Representative of the Governing Board
of the Hospital
Representative of the Medical Staff
Superintendent of the Hospital
Principal of the School of Nursing
Representatives of the Faculty of the
College or University with which the
School is aiming to establish connections
Representative women prominent in education
al, social, and civic work.
This Committee has expressed itself and
voted disapproval of any school of nursing - 17 -
announcing a university connection until
Qy   such time as the existing school has been
brought into substantial agreement with
the standards as recommended in this report
AGENCIES ACCREDITING COLLEGES:
Christian Education - Handbook for 1928
(obtainable from the Council of Church
Boards of Education in the United States,
111 Fifth Avenue, New York City) contains
the most concise and useful compilation of
data of standards for colleges which the
Committee has been able to find.  These
standards are listed under the various
agencies that accredit colleges and universities.  The Committee is of the opinion
that the faculty of any school of nursing
considering an academic affiliation should
familiarize itself with the standards of
the agency that accredits the college or
university with which it is seeking connection.
o o
o
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/~\    Growing tendency to discontinue email
schools and substitute graduate service.
Survey Iteporta:   218 schools of nursing
in Canada* latest figures,170, showing
that almost fifty schools have been
/not
closed. ought to be^very
much less, possibly slightly higher.
Quote, Agnew'a article in rThe Canadian
O Nurse
New techniques in administration made
necessary by this movement.  Head peper
Ontario HSspital Association. To be
discussed later.
o AFfTUATIOI? AID 30AHD3  OF  SXAIfflTKHB
O
inspectors of schools of nursing ought
to be able to settle the help in arranging affiliation.      If no resources
in the Province concerned an inspector
can report upon institutions which have
necessary facilities, teaching and
clinical.to offer.
o
\_ New trends in Education:  Curricula
construction first interest in Canada
and U.S.at present time.
Changes to be expected:  Emphasis on
public health throughout course.  Kmphasis
on mental hygiene and basic psychiatry
throughout course.
Orientation course^:streased:  Attempt to
(~)get away from measuring courses in terms of
hours.
Symposium matter:   Quote Bats&n In C.N.
New techniques in actual procedures;
neurological, urologicnl, etc.
Affiliations:  Btreaa0*1 communicable
f~\  and ohildrens.   More careful introgation
needed.
V UadaAwiJ
B±
I*
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eB>uA<i-jp-t-stf :       -nu/KjCLrtj- 73KHP3 IN P3I7AT5 3UTY
~\    Shortening of day and corresponding
reduction of fee:	
This movement gaining slowly but surely
all over the country - quote 7.O.H.
Alumnae "Quarterly" also articles by
Jones,in The Canadian Nurse.
Community nursing bureaux: Movement
") progressing very slowly but seems to be
gaining ground.   Probably slowed up by
political changes and uncertainties
as to state health insurance project.
Calgary co-operative still working.
Specialization:   ^his field still
unexplored.   ilention possibility in
neurological field and also psychoatrie, Sduaational:  Steady demand in most
provinces for refresher courses which would
give opportunity for administration of new
techniques.
Considerable criticism of failure of school*
of nursing to prepare nurses for private
duty.   So far concrete suggestions have
not been available.     Not for private
nurses to crystallize their thinking and
to develop capacity for teaching.
■
Combined Hospital and Nurses:  Growing
display  of private nuraes to accept work
on a salary basis.
o ^o,diur^a>  "UOma/nffljrslfa.
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