History of Nursing in Pacific Canada

Report of proceedings of the annual convention of the British Columbia Hospitals' Association. British Columbia Hospitals' Association 1925

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     Officers and Executive Committee of the
British .Columbia Hospitals' Association for the iYear
1925-26.
Honorary President—The Hon. Wm. Sloan, Provincial Secretary Parliament Buildings, Victoria, B. C- '
Honorary Life Member—Dr. M. T. MacEachern, American College of Surgeons, 40 East Erie St., Chicago, 111.
President—Dr. G. B. Brown, Earle Block, Nanaimo, B. C.
First Vice-President—Geo. Haddon, Business Superintendent, Vancouver
General Hospital, Vancouver, B. C.
Second Vice-President—H. W. Birch,  Secretary, Prince Rupert General
Hospital, Prince Rupert, B. C.
Treasurer—J. H. McVety, 714 Richards St., Vancouver, B. C.
Secretary—E. S. Withers, General Manager, Royal Columbian Hospital,
New Westminster, B. C.
Members of the Executive Committee in addition to the above.
For Vancouver Island—C. E. Wilson, Central Building, Victoria, B. C.
For Vancouver—Rev. Father O'Boyle, 646 Richards St., Vancouver, B. C.
For Coast Mainland—Miss G. M. Currie, North Vancouver Hospital, North
Vancouver, B. C.
For Fraser Valley—R. L. McCulloch, Chairman, Abbotsford-Sumas.Mat-
squi Hospital, Abbotsford, B. C.
For Yale-Cariboo—R. A. Bethune, Secretary, Royal Inland Hospital,
Kamloops, B. C.
For Okanagan—G. Binger, Secretary, Kelowna General Hospital, Kelowna, B. C.
For Kootenay West—Miss A. McArthur, Superintendent, Kootenay Lake
General Hospital, Nelson, B. C.
For Kootenay East—Mother Nazareth, St. Eugene's Hospital, Cranbrook,
B. C.
For Grand Trunk Pacific—J. H. Thompson, Prince Rupert, B. C.
CONVENORS   OF   STANDING   COMMITTEES,   AND   THEREFORE
MEMBERS OF THE EXECUTIVE COMMITTEE:
Medical   Affairs—Dr.   F.   C.   Bell,   General   Superintendent,   Vancouver
General Hospital, Vancouver, B. C.
Business Affairs—S. C. Burton, Kamloops, B. C.
Nursing Affairs—Miss Harrison, Prince Rupert General Hospital, Prince
Rupert, B. C.
Constitution and By-laws—C. H. O'Halloran, Central Building, Victoria,
•B   O
Municipal Affairs—J. J. Banfield, 327 Seymour St., Vancouver, B. C.
—3— Officers, 1924-25
Honorary President—The Hon. the Provincial Secretary, Victoria, B. C.
Honorary Life Member—Dr. M. T. MacEachern, Chicago.
President—Charles Graham, Cumberland, B. C.
First Vice-President—Dr. G. B. Brown, Nanaimo, B.  C.
Second Vice-President—E. S. Withers, New Westminster,  B.  C.
Secretary—Ethel Johns, Vancouver, B. C.  (Resigned).
Treasurer—George Haddon, Vancouver, B. C.
EXECUTIVE COMMITTEE:
George McGregor, Victoria Geo. Binger, Kelowna
Rev. W. P. O'Boyle, Vancouver. Geo. Johnstone, Nelson
Dr.  Geo. Darby, Bella Bella. Mother Nazareth, Cranbrook
Dr. A. D. Buchanan, New West'r. M. L. Grimmett, Vancouver
Harry Birch, Prince Rupert.
CONVENORS OF STANDING  COMMITTEES:
Medical Affairs Dr. F.  C.  Bell, Vancouver
Business Affairs R. A. Bethune, Kamloops
Nursing Affairs Pauline Rose, Nanaimo
Constitution and By-laws J. H. McVety, Vancouver
Municipal Affairs J. J. Banfield, Vancouver
—*l THE CONVENTION
The Eighth Annual Convention of the British Columbia Hospitals*
Association was held in.the St. John's Ambulance Hall, Nanaimo, B C
on August 20th, 21st and 22nd, 1925. The spacious hall, which was
generously loaned for the occasion by the Western Fuel Corporation of
Canada, proved an admirable auditorium, and the sessions were all well
attended by the many enthusiastic delegates who gathered in Nanaimo
for the event.
The
gates:
following institutions were represented by one or more dele-
Bute Street Hospital, Vancouver.
Chemainus General Hospital.
■Chilliwack General Hospital.
Columbian   Coast   Mission   Hospitals.
Cumberland General Hospital.
Kelowna General Hospital.
King's Daughters' Hospital, Duncan.
Ladysmith General Hospital.
Matsqui-Sumas-Abbotsford   General   Hospital.
Nanaimo General Hospital.
Nicola Valley General Hospital, Merritt.
North Vancouver General Hospital.
Provincial Royal Jubilee Hospital, Victoria.
Prince Rupert General Hospital.
Royal Columbian Hospital, New Westminster.
Royal Inland Hospital, Kamloops.
Roycroft Private Hospital, Vancouver.
St. Eugene's Hospital, Cranbrook.
St. Joseph's General Hospital, Comox.
St. Joseph's Hospital, Victoria.
St. Luke's Hospital, Powell River.
St.  Mary's Hospital, New Westminster.
St.  Paul's  Hospital,  Vancouver.
Vancouver General Hospital.
Vernon Jubilee Hospital.
West Coast General Hospital, Port Alberni.
The following Women's Auxiliary groups were represented:
Chemainus General Hospital.
Ladysmith General Hospital.
Nanaimo General Hospital.
North Vancouver General Hospital.
Provincial Royal Jubilee Hospital, Victoria.
St. Joseph's General Hospital, Comox.
St. Joseph's Hospital, Victoria.
Vancouver General Hospital.
West Coast General Hospital, Port Alberni.
The following public and professional bodies were represented:
The Provincial Government.
The British Columbia Medical Association.
The Graduate Nurses's Association of British  Columbia.
The City Council of Nanaimo.
The Workmen's Compensation Board.
The  Surgeon-Commander  "H.M.S.   Capetown,"
-5^ MORNING SESSION—THURSDAY, AUGUST 20th
The meeting was called to order at 10.20 a.m. by the President, Mr.
Charles Graham.
The Hon. Wm. Sloan, Provincial Secretary, welcomed the delegates
to the convention and made an instructive survey of the Hospital situation in British Columbia. (See Bulletin No. 4).
His Worship Mayor V. B. Harrison of the City of Nanaimo expressed
the appreciation of himself and his fellow citizens that the City of Nanaimo had been selected as the convention centre for this year and assured the delegates of a hearty welcome.
Mr. J. J. Banfield made suitable reply to these addresses of welcome.
A letter was read from Dr. M. T. MacEachern, Director of Hospital-
Activities of the American College of Surgeons, and Past-President of this
Association, expressing his regrets at being unable to attend this Convention, and his best wishes for its success.
PRESIDENTIAL ADDRESS
Ladies and Gentlemen—In tendering my second address as president,
permit me to thank the members for the honor and confidence in reelecting me.
The year has been uneventful from the executive point of view, the
only business of importance being the appointment of a special committee with Mr. J. J. Banfield as Chairman to interview the Union of B.
C. Municipalities in connection with resolutions passed at the Convention
last year.
The principal matter under consideration was the old story of the
responsibility of municipalities in the matter of the care of indigent patients.
Our committee after interviewing a committee from the Union procured from them a promise to lay before the Union the proposals of our
Association.
This committee has also drafted a resolution on the matter which
was forwarded to the various hospitals with the request that they instruct their delegates, so that some action may be taken at this session.
This will be taken up at the proper place on the programme.
The committee on Constitution will also have some suggested
changes, particularly with regard to election of executive members from
the districts.
One of the pleasing functions of the convention will be the laying
of the corner-stone of the new General Hospital here, which ceremony
will be performed by His Honor W. C. Nichol, Lieutenant-Governor of
British Columbia, and I am sure that the delegates will he out in full
force.
I must express our very great regret at the departure of Miss Johns
for new fields. I think I can say without fear of contradiction that Miss
Johns was the greatest asset that the Hospital Association had. She
filled the office of Secretary for several years in an exceptional manner,
always giving her best to the Association. I am sure that I voice the
sentiments of toe members in expressing deep appreciation of. her work
and that our very best wishes go with her in her new field of endeavor.
Dr. Bell has prepared a very splendid programme for us, and I hope
that the various papers submitted will arouse keen discussion, as they
are all on timely topics.
I hope that the convention will be as successful as in previous years
and that the visitors will go away with pleasant recollections of their
visit to Nanaimo.
CHARLES GRAHAM,  President.
Minutes of the last convention were taken as read.
Due to the resignation of Miss Johns as Secretary, there was no
secretarial report.
The Treasurer, Mr. George Haddon, submitted his report as follows,
which was adopted:  o
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—8— Nominating Committee—The Chairman appointed Mr. A. P. Glen
with power to add to his Committee.
Resolutions Committee—The Chairman appointed Mr. J. J. Banfield,
convener, with Messrs. G. E.  Street and   George  McGregor.
Scrutineers—The Chairman appointed Mr. Harry Birch with power
to add to his Committee.
The chairman announced that the registration of delegates was under
the charge of Miss Morrison of Victoria and urged all delegates to register.
Mr. McVety announced that. Miss Ellis of the Vancouver General Hospital was confined to her bed through illness and would unfortunately be
unable to attend the Convention, and it was resolved that this Convention
wire to Miss Ellis expressing sympathy and regrets.
CONFERENCE OF WOMEN'S AUXILIARIES
The following written reports and discussions took place under
the presidency of Mrs. Fiskin, president of the Women's Auxiliary of the
Vancouver General Hospital. Mrs. Sail, of the W. A. of St. Joseph's
Hospital, Victoria reported as follows:
The Ladies' Auxiliary of St. Joseph's Hospital, Victoria, formed for
the purpose of assisting in the work of said Hospital, begs to submit
the following report on the year's activities.
Various linens, made up and marked, to the amount of fourteen thousand, eight hundred and fifty (14,850) were the result of the' weekly
meetings held every Friday afternoon at the  Hospital.
Six Fowler spring beds were presented to the Institution.
The final payment of five hundred and ninety-seven dollars ($597.00)
was made on the screens which are now placed on all the hospital windows.
The usual bursary was presented at the nurses' graduation.
To   meet  these  expenditures,   the  following  activities   contributed."
Half the proceeds of the Angus Campbell "Fashion Show" on October
29th 1924.
A Sale of Work on the 13th of November 1924.
Tag Day, June 13th, which netted nearly One Thousand Dollars
($1,000.00).
The Ladies' Auxiliary is now entering upon its fifth year of existence
and, because of the hearty and loyal co-operation always displayed by
its members, it promises to reach a record old age in peace and prosper-
it. Mrs. Bryant, of the W. A. of St. Joseph's Hospital, Comox, reported
as follows:
The annual meeting of the Ladies' Auxiliary to St. Joseph's Hospital,  Comox, was held at the Hospital on March 26th, 19'24.
At this meeting the ladies decided to buy and pay for a Star
Ambulance, starting with a donation of Four Hundred and Twenty-eight
Dollars and Twenty-five Cents ($428.25) out of the General Fund,
forming a separate ambulance fund. Each camp in the district donated
something toward the fund, helping the Auxiliary achieve their object,
and several of the citizens made small donations. The ambulance cost
about Eleven  Hundred  Dollars ($1,100.00).
The Annual Garden Fete was held in June, and was very successful,
the receipts being $707.60, and the expenses $87.15, leaving a profit of
$620.45.
—9— A  whist drive was held in Booth's Hall on September 29th, resulting
in  receipts  $47.70 and expenses $16.40, leaving  a  profit of $32.30.
It is one of the aims of the Auxiliary to hold a Produce Week in aid
of the hospital, usually in November, which has always been well responded to.
Another of the ladies' efforts is to look after the sewing, meeting
once a month for this purpose, and some of the members take sewing
home with them.
The Auxiliary holds three electric light bonds of one hundred dollars each which bring an interest of eighteen dollars per annum.
Receipts for the year ending Feb. 3rd, 1925 $1,001.40
Expenditures for the year ending Feb. 3rd, 1925       867.95
Balance in Bank for the year ending Feb. 3rd, 1925      133.45
The Auxiliary equip the hospital with linen every year, the new wing
being equipped with linen, pillows, comforters, dressing gowns, awnings, etc., to the value of $704.28.
Our membership consists of about thirty-five, working in harmony
with the Sisters for the good of the sick. Mrs. E. Grossman, of the
W. A. of the Chilliwack Hospital, Chilliwack, reported as follows:
The objective of the Auxiliary for last year, namely, the raising of
funds for an X-Ray machine, was accomplished by a well-planned drive
for funds throughout the Fraser Valley.
This machine, costing about $2,100.00, was installed early in the
year and has given good satisfaction.
One of the wards has been set aside as a case-room, and furnished
with a special bed and an instrument sterilizer.
The usual supplies of linen have been furnished, also linoleum for
the case room, china for the wards, porcelain table for the operating room
and a wringer.
Besides our town membership of 110 we are affiliated with women's
organizations in the country districts, some of whom give twenty-five
dollars yearly, besides responding to appeals made for bottled fruit and
supplies served at the Fair.
Mrs. G. B. Brown of the W. A. of Nanaimo Hospital, spoke of the
extensive work carried on by that organization. She stated that their
annual budget was about $3,000.00. that their membership consisted of
64, which was divided into committees of six.
Mrs. Fiskin, of the W. A. of the Vancouver General Hospital, explained the activities of that organization, and said that their work
centred chiefly in the Infants' Hospital, in Social Service work, and follow-up work after discharge from the Hospital.
Others who spoke on the work of the Women's Auxiliaries were
Miss McKenzie and Mr. McGregor, both of the Provincial Royal Jubilee
Hospital, Mrs. Sanderson of the Ladysmith Hospital, Mts. Reid of the
Chemainus Hospital, and Mrs. Beardmore, of the Roycroft Private Hospital, Vancouver.
The Chairman expressed pleasure at seeing representatives from
the North Vancouver Hospital, which institution recently joined the
Hospital Association, and assured them of a hearty welcome into the
activities of the Association.
At 12:30 luncheon was served in the Convention Hall under the
auspices of the Nanaimo Kiwanis Club, when a very interesting address
wtis given by Dr. J. MoDermot of Vancouver, Secretary of the B. C Medical Association, bearing in the main upon a scheme of State Health Insurance.
—10— AFTERNOON SESSION—THURSDAY, AUGUST 20th
The afternoon session commenced at 2 p.m. with a report from the
committee on Constitution and By-laws, by the convener, Mr. J. H.
McVety, who moved a recommendation, seconded by Mr. Sivert and
carried, that an addition be made to the constitution that the various
hospital districts provided therein should include the names of all the
hospitals situated in each district for the guidance of those voting on the
election of members to the Executive Committee. \
On the motion of Mr. McVety, seconded by Mr. Binger and carried,
it was resolved that the provisions of Article 10 of the Constitution be
suspended until noon tomorrow.
As Convener of the Committee on Business Affairs, Mr. R. A.
Bethune of Kamloops introduced Mr. S. C. Burton of Kamloops, who read
a paper on the subject of a hospital tax to cover payment of public ward
treatment.     (See  Bulletin   No.  2).
In discussing the contents of the paper, Mr. McVety asked the
writer his ideas as to the collection of the tax and the cost thereof, and
in reply Mr. Burton stated that his idea would he to place the operation
of the principle under the Workmen's Compensation Board.
Mr. J. J. Banfield, as Convener of the Committee on Municipal Affairs, submitted a report which excited much interest and discussion.
Mr. Banfield reported that his committee had had several interviews
with the executive of the Union of B. C. Municipalities, and had eventually received their endorsation of a scheme for relief to the financial
difficulties of the hospitals. The proposal was that a special committee
with governmental authority be formed, consisting of three members,
representing the Provincial Government, the Union of B. C. Municipalities, and the B. C. Hospital's Association, who should receive reports
from all hospitals as to the number of hospital days treatment rendered
by them to patients from all and sundry municipalities, and, basing the
recommendation upon the figures for the year 1923, assessing each municipality eighty-five cents (85c) per diem, for the total number of days
treatment rendered to patients from each district, and it was shown that
this assessment would take care of the loss sustained by the Hospitals
of the Province for that calendar year.
Mr. Banfield further read a communication from the Hon. the Provincial Secretary, stating that if this scheme receives the endorsation of
the Hospital Convention and the Union of B. C. Municipalities Convention
that he will recommend legislation to that effect.
Moved by Mr. Banfield, seconded by Mr. McCulIoch, that the report
be adopted.
An amendment was moved by Mr. Marshall of North Vancouver, and
seconded 'by Mr. Birch of Prince Rupert, that the proposals as set forth
in Mr. Banfield's report lay on the table for one year.
The amendment failed and the motion carried, with the following
desiring their dissension recorded: Mr. Sivertz of Victoria, Mr. Marshall
of North Vancouver and Mr. Birch of Prince Rupert.
Moved by Mr. Sivertz, seconded by Mr. McVety and carried, that this
convention declare itself in favor of a health insurance principle, and
that a committee be appointed to draft proposed legislation and submit
1 the same to the executive.
The session adjourned at 5 p.m. to attend the function of the laying
of the corner-stone of the new Nanaimo hospital building, by His Honor
the Lieutenant-Governor of British Columbia, which impressive ceremony was materially augmented by the presence of the officers and
company of H.M.S. Capetown, who acted as a body-guard to the representative of the Crown.
The delegates then attended a reception at the Hospital as the
guests of the Board of Directors.
—11— MORNING SESSION—FRIDAY, AUGUST 21st
The Committee on Medical Affairs submitted their programme, under
the presidency of Dr. F. C. Bell, convenor.
Dr. H. E. Young, Provincial Health Officer, gave a short address in
connection with Public Health and Preventive measures in the Province
and told the Convention of the work which his department is doing in
this connection. He made very favorable comment on the resolution submitted by Mr. Banfield at the first day's session and expressed the opinion
that legislation in accordance therewith would prove to be a big step in
the welfare of hospital and public health service in the Province. He paid
tribute to the interest that the Hon. Wm. Sloan, Provincial Secretary,
has evidenced in connection with hospital matters, and assured the
delegates that they might always expect intelligent sympathy from the
Minister. He urged an extension of activity on the part of the Hospitals in
the training of nurses to care for infectious diseases. Dr. Young stated
that the average cost to the Government of a case of small-pox was
about $600.00. He said that in his opinion infectious hospitals should
be wards of the general hospitals, and stated that the Government allows
one dollar per day for such cases in addition to the usual per capita
grant.
In response to enquiries as to the extra dollar per day, Dr. Young
stated that this is paid out of the appropriations of the Board of Health
for extra nursing.
Miss Randal expressed herself in accord with Dr. Young's views, and
contended that many of the hospitals in the Province are providing facilities for the practical training of nurses in infectious diseases.
Dr. Young suggested that this convention pass a resolution and submit the same to the Provincial Board of Health, asking that infectious
cases be treated in the same manner as tubercular cases as regards extra
financial assistance.
Dr. D. J. Millar, medical referee of the Workmen's Compensation
Board, delivered an address on the subject of "The Physical Basis on
which compensation awards are made," as follows:
Mr. President, Ladies  and Gentlemen:
When this subject was suggested to me, I found some difficulty in
deciding just exactly what physical basis might mean, particularly in
reference to hospital work. As I am neither qualified or authorized to
deal with the legal basis, I take that what is intended is that I give you
an idea as to the proper basis from a Medical point of view and outside
of legalities.
It is not my intention of inflicting upon you the reading of a paper.
I agree with a recent speaker, who stated that in his opinion 90 pgr cent,
of all papers should never have been written and of the remainder, 90
per cent, should never have been read. As a rule papers are much too
theoretical and abstract and therefore, I prefer to simply talk to you
with an occasional glance at the notes, which I have made to guide me.
On former occasions you have had talks from one or the other of our
Commissioners and therefore, will have learned of the Workman's Compensation Act and its manner of administration. As you are also aware
the administration has been placed in the hands of a Commission of
ttaee, who are in continual session at Vancouver and who occasionally
hold sessions elsewhere throughout the province for the convenience of
workmen and  others interested.
I think I should mention the ideals of the Act as they appear to me.
Firsts To mend or restore the damaged and broken human machinery
of industry.
—12— Second. To assist in maintaining the injured workman and his dependents during'the period of disability, or in the event of fatal injury
in the absence of the wage1 earner. To fulfil those ideals is the prime
object of the Commissioners and( it is to tell you something of how we
go about this that I mainly confine myself in this paper.
The staff engaged by the Board have been organized into different
departments to deal with each particular phase of the work of administration. It does not require undue use of the mental faculties to visualize the work involved in collecting three million dollars from employers,
scattered throughout this vast province, and in turn paying out this
money, wisely and justly, particularly when the amounts collected and
disbursed are made up of small sums. The awards are made after receipt of certain necessary information, such information being received
in the shape of forms and reports and filed at the Boards office.
We will commence with the incident of an accident occurring to a
workman while employed, wheter or not it is sufficient to disable him.
At once he must report the occurrence to his superior, that is the foreman, boss or other persons authorized to receive such reports. He will
supply this officer with complete information as to the occurence. He will
complete the claim form, which gives his version of the accident, particulars of wages, etc. The employer is required to file a report of the
information he has obtained of the accident and injury. The workman,
if he requires medical aid, will report to his surgeon,' who will report
his findings to the board, on primary surgeon's report. When the three
reports have been filed they are assembled into one cover and constitute
the file for that particular accident. This is given a claim! number,
which identifies that  particular file\ for future office   action.     It may
'- be that one or more of these reports are delayed for various reasons
and this delay is the usual cause of delayed decision of the Board upon
a claim.    When a file is thus completely assembled it is referred to the
; Board for a decision or award.
A claim may be allowed in full or in part, it may be suspended
owing to incomplete evidence or it may be rejected. When a claim is rejected it can only be re-considered when written application is made by
the workman that he has new evidence or proof to submit. A claim
suspended may come up for re-consideration at any time new matteT relative to it is received. So much for the routine handling of the claims,
which I mentioned mainly to impress upon you the necessity for, first,
obtaining, if possible, the claim number and referring to it in all communications you send  to the Board;  second, to  show you the necessity  for
I separate communications for each claim, so that it may reach the proper
tfile in the office.
In considering a workman's claim there are three main points which
require attention: First, is he covered by the Act; second, is accidental
cause of injury proven; third, is there proof of disability resulting from
alleged accident.
The first is a board question. The second is legal but the nature of
the injury may offer some proof or substantiate to some degree the
problem of whether or not accident has occurred. The third question is
purely a medical one, although sometimes the workman may continue to
work when the medical findings would indicate that he should be disabled from work.
Our method of obtaining the proof of disability is first by the primary surgeon's report, second by progress report rendered from time to
time and thirdly the final surgeon's report.
The payment of compensation for time lost in a claim which has
been favorably considered, is made on receipt of medical evidence for
the period of disability.
—13— You ean therefore see that payment ;eannot be made on the primary
surgeon's report unless that report has been rendered at a date -somewhat later than the time workman stopped work.
A claim is terminated in three ways: First, fatal; second, recovery;
third, partial permanent disability settlement. In a fatal case, time lost
is paid up to the date of death and further consideration of claim given
on the filing of an application for dependency.
The question of recovery is one of our big ones. Hardly any two
persons hold the same idea as to when they are fit to return to work and
even surgeons differ widely in their opinions. A great many influences
are at work, such as conditions of labor, general character of the workman and of the attending surgeon, the sympathy or lack of sympathy of
the employer and the part of the anatomy injured. I need not attempt to give you the reasons for delay in return to work, these are well
known to you. You know of coal mines, working part time. Longshoremen, also only working part time; doctors who fear to offend the
workmen; certain forms of laboring work, where physical fitness must be
of the high order. .
Permanent partial disability settlement is made when the" workman's condition has been treated to termination and where progress towards recovery can be said to be at a stand still. The estimation of the
amount of permanent disability present is sometimes difficult. Basis of
permanent partial disability awards is industrial impairment, that is, to
what extent lias the wage earning been impaired. We all know that
hardly any of us is 100 per cent, efficient and therefore, the basis is not
in comparison of the perfect physique but rather of the average working
man.
The amount allowed in any case will depend upon the wage, age and
expectancy. Pension payments represent future loss of wages and are
therefore payable monthly.
Under  certain conditions  the  Board  grants  assistance  towards re- [
establishment, particularly in boys, who may have sustained amputation,
when they are encouraged to procure education or some occupation suitable to their altered physique.
You have frequently heard of the large amounts of money said to be
surplus. In case some of you are not aware of the true facts, let me explain that this reserve represents the sum of money taken from the
current funds and placed aside to make future pension payments. It,
therefore, is in no sense a surplus.
In addition to awards to workmen for time lost, we find the Board
making awards for Medical Aid. These awards are made direct to surgeons, hospitals and other sources of service to workmen. The surgeon's!
account is considered on the 'basis of what it is expected he would ask
the workman to pay himself. The board have provided a list of fees, in
ordinary procedures, for guidance.
In the case of awards to hospital, the per diem rate of $2.50 per
day is for public ward treatment, plusi the ordinary requirements foT
treatment, excepting X-ray and special serums, etc. Occasionally special nurses and special accommodation must be supplied the patient. In
those cases the accounts are considered on the 'merits of the case, that
is, if it is shown that extra attention.is necessary, then the Board may
make the necessary award   to cover  the cost.
It should be borne in mind, that the position of debtor and creditor
does not exist between the doctor and the Board, or the hospital and
the Board and I have already explained that the Board's decision is only
rendered after all necessary facts have 'been obtained, in other words,
the Board is in the position of a Court or Judge, making awards afters
hearing certain evidence and arriving at cetrain findings.    It, therefore,
—14— behooves the hospital and surgeons to co-operate as closely as possible,
otherwise there may be the misuse of the hospital and the regretable
incident of the Board refusing to find an award for hospital care, in
whole or in part.
There is a tendency on the part of some workmen to remain in
hospital as long as possible, particularly single men. This is easy to
understand, because they are then relieved of the necessity of sustaining
themselves -during the period of their hospitalization, providing that
they can get their hospital accounts paid. We find in some cases workmen prefer to stay in the hospital at their own expense, rather than in
a hotel or boarding house. We also know that in some sections arrangements have been made with the workmen to give them hospital and
surgical care under contract and that for their $1.00 or $1.50 per month,
which is collected from the workmen they expect and in some cases are
allowed to stay in hospital, when there is no need, from a treatment
point of view.
Hospital accounts may be rendered to the Board monthly and the
account for each case must be separate and show clearly the) date of
admission and of discharge and if there are any expense for extras they
must be fully explained. If X-ray is charged the* report for X-ray findings must either have been previously sent in or must accompany the
account. In connection with X-ray, we notice a considerable variation
in the way the reports are handled and in the way service is rendered.
We would suggest that when the surgeon requires X-ray at your hospital that he be required to fill a requisition and that, whoever interprets
the X-ray should immediately after doing so, report in writing his find-
In closing, I wish to thank you kindly, for the honor of having oeen
invited to speak to you and to assure you also that we appreciate the
co-operation you have given the Board in the past and to express the
wish that our good relations may continue in out future dealings.
Dr. G. A. B. Hall, Nanaimo, read a paper on "The Regulations which
Directors of a Hospital Should Expect the Medical Practitioner to Accept."  (See Bulletin No.  6).
Dr. H. W. Hill, Vancouver, read a paper on "Laboratory Examinations, and Equipment for Small Hospitals." (See Bulletin No. 1).
Dr. A. S. Lamb gave a resume of his work on behalf of the Government in connection with tubercular care. He pointed out that preventive
measures in connection with tuberculosis had cut the death rate in such
cases in two in the past twenty years, and urged continuation and extension of such preventive measures.
On adjournment of the morning session, luncheon was served in the
Convention Hall, under the auspices of the Nanaimo Rotary Club, which
proved to be a most congenial gathering. The outstanding feature of the
luncheon was an address delivered by Mr. C. Graham, President of the
Hospital Association, as follows:
Mr. President of the Rotary Club, Ladies and Gentlemen,—
On behalf of the British Colufbia Hospitals' Association, permit me
to thank you most cordially for your very kind hospitality to us strangers
among you.
I am not exactly a stranger among you, having called this fair city
home for several years, and have been a more or less frequent visitor
among you since then.
I wish to extend to Nanaimo congratulations on having at last made
a start on that much needed institution, the new hospital. There was no
question of the necessity for a modern hospital here, the present one having served its -time and a new and modern building was necessary, in
—15^ order to provide a suitable place for the proper treatment of accident and
disease.
My first connection with hospitals, and my first interest in them,
dates from the time when I was a patient in your local hospital in 1907.
While taking no active part here, I became interested as a result of my
experiences and have maintained that interest since.
It is my intention, if I may be permitted, to address my remarks to
the members of the Rotary Club, our hosts today, on hospital service.
In the early days hospitals were established for the care of the sick
poor, but they have now broadened out to meet the need of all classes.
The general public at one time looked upon hospitals as a place
where their friends were sent to die.
It is true and doubtless always will be true that there is a fairly
large percentage of deaths in hospitals. This is mainly due to the fact
that practically all cases of serious accident and severe illness are sent
there, as it is known that only there will they receive the skilled attention
that is necessary if there is to be any hope of their recovery.
The first hospitals were supported entirely as charitable institutions,
and even though they have broadened out their service to meet the needs
of all classes, the public today still support their hospitals largely from
the charity viewpoint, but the consciousness of self interest is gradually
growing.
We have reached the stage where the public is demanding that all
hospitals whether large or small be equipped to give the best possible'
service to those that are sick. Health, relief from pain, from disability,
from fever and anxiety, and postponement of death are the hospital
service, and how successful each one is  can readily  be determined.
Somehow people expect more from a hospital than any institution
can possibly give. Visitors' to hospitals sometimes go away with the
impression that the staff are indifferent and don't care. Accident, disease,, operations and death, are commonplace occurrences to hospital
employees. Anxious friends, heart-broken relatives, eager enquiries, are
all part of the day's work, and what is routine in any walk of life too
often receives routine treatment, even though it may be the unusual and
momentous to the other parties concerned.
I believe that some of the difficulties of the hospitals arise from
their neglect to procure proper publicity. The good work done is not
heard of, because, we fail to bring it out. Yet our failures or supposed
failures, are put in the limelight, by the friends of dissatisfied patients
or by the patients themselves. In their weakened condition there is no
limit to the attention that the patient expects. As a general rule, the majority of complaints have very little foundation in fact. It is well known
that the sick mind is not the normal mind, a person suffering acutely
from accident or disease has not the proper perspective with the result
that trifles are magnified to major proportions, and the, hospital and
staff suffer in reputation accordingly.
People seldom visit the hospital except when they have a friend or
relative there). At that time their mind; is generally too much occupied
with the condition of their friend to receive any other impression.
To get the proper perspective on hospital work you should visit the
hospital at otheir times, when the mind is free to observe what is being
done and how it is done. You should become' acquainted with your
hospital. It should be regarded as a public utility as it possesses all the
characteristics. It is essentially a public utility filling a definite public
need.
The difference between efficient and inefficient operation is the
difference between life and death. It should be your chief interest then
to see that our hospitals serve the community in the most efficient way.
—16— Probably the greatest difficulty the hospitals meet with in the rendering of efficient service, is the lack of revenue from a permanent
source, suficient to ensure the maintenance of the highest standards of
food, equipment, and staff.
The Boards of Management have to struggle year after year with a
totally inadequate revenue, in an effort to give the public the service
they expect, yet seem disinclined to pay for, and have also to carry large
accounts for indigent patients who are totally unable to pay. It seems
absolutely impossible to convince a well man or woman, that they may
some day require the services of a hospital. The average person does
not get the proper viewpoint towards a hospital and its functions and
place in community life. If they did there would not be any financial
problems to solve, and they would be equipped with the latest and best
appliances for the treatment of disease.
No institution has greater significance to the community than the
hospital, /when once a proper understanding is established. An effort
should be made to create a pride of achievement and active support of
the hospital as an economic asset to the community.
You gentlemen are banded together with an ideal of service, to
make brighter and better the lot of those who are unfortunate enough
to require assistance. Did it ever occur to you that the only thing the
hospital has to offer is that same service; service to suffering humanity?
They are constantly trying to improve that service. They will be greatly
helped by your active assistance. Won't you include hospital work as
part of the service you are rendering? No work is more worthy of your
best efforts.
I would urge upon you the necessity of knowing your hospital and
what it is doing for your community. Your conception of it will undergo
a radical change, and .from a state of antagonism or indifference, you
will grasp the relation of the institution to your community1 and the
power it can make for health. When you once get the proper perspective of this great work we will be able to count you among the many
workers   for   better   hospital   service.
Whether the hospital be viewed as a technical or a humanitarian
institution, the hospital system must be recognized as one of the best
fruits of our Christian civilization, a practical contribution of grace and
goodwill to the amelioration of suffering and the betterment of life.
AFTERNOON SESSION—FRIDAY, AUGUST 21st
The Chairman called upon Miss Pauline Rose, as convenor of the
committee on nursing affairs to conduct the proceedings.
Miss Cuddy, of St. Joseph's Hospital, Comox, read a paper by Sister
Superior of St. Joseph's Hospital, Comox, on the subject of "The Small
Hospital from the Viewpoint of the Superintendent. (See Bulletin No. 3).
In discussing this paper Miss Randal urged that Boards of Directors
give a greater degree of support to hospital superintendents.
Dr. J. McPhee of Nanaimo, read a paper on "The Small Hospital from
the View-point of the Doctor," and Mr. R. McCulloch of Abbotsford spoke
on the same subject from the view-point of a Director. (See Bulletin No.
3).
The Rev. Father O'Boyle discussed these papers in a very interesting
manner.
Miss Lee, R.N., of Nanaimo, read a paper on "Public Health
Nursing." (See Bulletin No. 5).
—17— A letter from Mrs. Beardmore of the Roycroft Private Hospital regarding the standard of nursing education was referred to the attention
of Miss Randal.
Moved by Mr. Haddon, seconded by Mr. Carr-Hilton and carried that
the.recommendation of Dr. Young regarding the extra financial assistance
for infectious cases be referred to the executive committee with power to
act.
The session adjourned at 5 p.m. and proceeded to the home of the
Hon. Wm. Sloan and Mrs. Sloan, who received the delegates at a social
function.
At seven o'clock in the evening the delegates were entertained with
a boat ride through island channels adjacent to Nanaimo, on invitation
of the Directors of the Nanaimo Hospital.
MORNING SESSION—SATURDAY, AUGUST 22nd
Dr. G. B. Brown, Vice-President, presided and expressed the regrets
of the President, Mr. C. Graham, that he had been called away on
business.
A discussion took place on the advisability of pooling the travelling
expenses of delegates to future conventions, and the matter was referred
•to the Executive Committee for consideration.
Invitations for the 1926 Convention were received from Vernon,
Prince Rupert and Vancouver, and as the result of a ballot vote, Prince
Rupert was selected as the next Convention City.
A wire was read from Miss K. W. Ellis acknowledging this Convention's expression of sympathy and sending her best wishes for the success of the Convention.
Hearty votes of thanks were extended to: Miss Johns, for her
services as secretary. Dr. MacEachern, for his telegram and good
wishes. The Press, for their courtesy in reporting proceedings. To all
those who contributed to the success of this Convention, namely: The
Nanaimo Hospital Board, Dr. and Mrs. G. B. Brown, Miss Pauline Rose
and the Hospital Staff, Hon. and Mrs. Wm. Sloan, Women's Auxiliary of
the Nanaimo Hospital, Western Fuel Corporation of Canada, Miss Morrison of Victoria, Kiwanis Club, Rotary Club.
Resolved that the matter of transportation to Prince Rupert be left
in the hands of the Executive.
The election of Officers resulted as follows:
Hon. President Hon. Wm. Sloan, Provincial Secretary
President Dr. G. B. Brown, Nanaimo
First Vice-President Geo. Haddon, Vancouver
Second Vice-President H. W. Birch, Prince Rupert
Treasurer J. H. McVety, Vancouver
Secretary E. S. Withers, New Westminster
EXECUTIVE COMMITTEE:
'C. E. Wilson, Victoria, Vancouver Island District.
Rev. Father O'Boyle, Vancouver, Vancouver District.
Miss G. M. Currie, R.N., North Vancouver, Coast Mainland District.
R. L. McCulloch, Abbotsford, Fraser Valley District.
R. A. Bethune, Kamloops, Yale-Cariboo District.
G. Binger, Kelowna, Okanagan District.
Miss A. McArthur, R.N., Nelson, Kootenay West District.
(Mother Nazareth, Cranbrook, Kootenay East District.
J. H. Thompson, Prince Rupert, Grand Trunk District.
—18—  THE COLUMBIAN COMPANY. LTD
Printers and Bookbinders
New Wwtminster, B.C.

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