History of Nursing in Pacific Canada

Report of proceedings of the annual convention of the British Columbia Hospitals' Association. British Columbia Hospitals' Association 1927

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  Stanley Brock Limited
860 Cambie Street, Vancouver, B. C.
DISTRIBUTORS OF:
National MARKING MACHINES
Wyandotte Yellow Hoop SODA
Procter & Gambles' Amber and Ivory SOAPS
Greenbank's  LIME
REPRESENTING:
THE CANADIAN LAUNDRY MACHINERY CO., LTD.
Factory:   Toronto, Canada.
— COMPLETE WAREHOUSE STOCKS —
Estimates and suitable layouts furnished for INSTITUTIONAL PLANTS
Hospital Cotton
Cellu  Wadding
D. & G. Catgut
Hospital Sheeting
Hospital Furniture
Sterilizers
Invalid   Chairs
Water  Beds
RUSTLESS STEEL    SURGICAL    INSTRUMENTS
Clinical Thermometers
Hospital Water Bottles Sterling Rubber Gloves
Vim Syringes Vim Rustless Hypo Needles
Canadian Surgical Supplies Ltd.
775 Burrard Street
Vancouver, B. C.  536 Smythe Street
Complete Laboratory Equipment for Hospitals
HOSPITAL SUPPLIES
STERILIZING EQUIPMENT
FISHER $ BURPE LTD.
X-RAY AND
PHYSIOTHERAPY APPARATUS
Phone: Sev. 3685
Vancouver, B. C.
AL
KILLS GERMS
All  disinfectants  which  are black  and turn white  when
diluted with water are decomposed and rendered
useless when mixed with lime or salts or
even hard water
USE   IZAL   AND   DISINFECT   WITH   CONFIDENCE
Hygiene Products Limited
Vancouver, Calgary. Winnipeg, Toronto, Ottawa and
Montreal 730 Richards St.,
Vancouver, B. C.
To the Hospital Executives:
Dear Sir or Madam—
May we take this opportunity of expressing thanks
for the business entrusted to us during the past year, a
service which was a pleasure to us and we sincerely
hope was acceptably and satisfactorily rendered.
In keeping with recent developments we now announce the introduction of a new and higher standard of
Surgical Scissors—English Handforged Stainless Steel
Scissors.
Handforged Surgical Scissors were first introduced
in Canada by the Stevens Companies two- generations
ago and acquired a reputation for superiority.
Now we believe we have exceeded this standard and
respectfully submit this latest achievement for your consideration—Surgical Steel Scissors, Handforged and
Stainless. In addition we also shall have Scalpels of the
same Super-material at an early date.
We can now supply Stainless Steel Forceps, Haemo-
stats and Tweezers in the more generally used patterns.
It may also be added that Stevens Stainless Steel
Hypo Needles have already met with approval since they
were introduced some months ago and are becoming
more and more popular with increasing demand, so much
so we anticipate a reduction in price early in the new
year because we expect to enlarge our contracts.
You may probably find a trial order would prove
quite economical.
Enquiries are respectfully solicited for any Surgical
Equipment, with the assurance of our endeavor to serve
you faithfully and acceptably.
B. C. STEVENS CO. LTD. f    ~/^*'^^^^
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§11
I Officers  and   Executive  Committee   of   the   British   Columbia
Hospitals Association for the Year 1927-28:
Honorary President—The Hon. Wm. Sloan, Provincial Secretary, Parliament
Buildings, Victoria, B. C.
Honorary Life Members—Dr. M. T. MacEachern, American College of Sur-
.geons, 40 East Erie Street, Chicago, 111. J. J. Banfield, 327 Seymour
Street, Vancouver, B. C.
President—George Haddon, Business Superintendent, Vancouver General
Hospital, Vancouver, B. C.
First Vice-President—J. H. McVety, 714 Richards Street, Vancouver, B. C.
Second Vice-President—R A. Bethune, Secretary, Royal Inland Hospital,
Kamloops, B. C.
Treasurer—Miss G. M. Currie, R.N.. Superintendent, North Vancouver Hospital,, North 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—Dr. E. M. Pearse,  Superintendent, Provincial Royal
Jubilee Hospital, Victoria, B. C.
For Vancouver—Dr. E. J. Gray, 207 Hastings Street West, Vancouver, B. C.
For Coast  Mainland—G. W. Marshall, Director, North Vancouver Hospital,
North Vancouver, B. C.
For  Fraser  Valley—R. L. McCulloch,  Chairman, Abbotsford-Sumas-Matsqui
Hospital, Abbotsford, B. ('.
For Yale-Cariboo—M. L. Grimmett, Director, Nicola Valley General Hospital,
Merritt, B. C.
For Okanagan—Mrs. E. A. Wilniot, R.N.,   Superintendent   Kellowna    General
Hospital, Kelowna, B. C.
For Kootenay West—Miss A. McArthur, R.N., Superintendent, Kootenay Lake
General Hospital, Nelson, B.  C.
For Kootenay East—Mother Nazareth, St. Eugene's Hospital, Cranbrook, B. C.
For  Grand  Trunk  Pacific—H. W. Birch,  Secretary, Prince  Rupert General
Hospital, Prince Rupert, B. C.
Convenors of Standing Committees and therefore members of
the Executive Committee:
Medical Affairs—Dr. P. C. Bell, General Superintendent, Vancouver General
Hospital, Vancouver, B. C.
Business Affairs—George McGregor, Director, Provincial Royal Jubilee Hospital, Victoria, B. C.
Nursing Affairs—Miss Mabel F. Gray, R. N, Department of Nursing and
Health, University of British Columbia, Vancouver, B. C.
Constitution and Bylaws—C. E. Wilson, Central Building, Victoria, B. C.
Municipal Affairs—R R Burns, Director, Vancouver General Hospital, Vancouver, B. C. THE CONVENTION
THE TENTH ANNUAL CONVENTION of the British Columbia Hospitals
Association was held at the Empress Hotel, Victoria, B. C, on September
8th, 9th and 10th, 1927.
The following institutions were represented by one or more delegates:
Campbell River General Hospital.
Mission Memorial Hospital, Mission City.
Armstrong Hospital.
Nicola Valley General Hospital, Merritt.
Prince Rupert General Hospital.
Royal Inland Hospital, Kamloops.
Nanaimo General Hospital.
St. Eugene's Hospital, Cranbrook.
St. Mary's Hospital, New ^Westminster.
Kelowna General Hospital.
Chemainus General Hospital.
Matsqui-Sumas-Abbotsford Hospital, Abbotsford.
King's Daughters' HospitaL Duncan.
Ladysmith General Hospital.
Cumberland General Hospital.
St. Luke's  Hospital,  Powell River.
Vancouver General Hospital.
Provincial Royal Jubilee Hospital, Victoria.
Prince George Hospital.
St. Paul's Hospital, Vancouver.
St. Joseph's Hospital, Victoria.
St. Joseph's Hospital, Comox.
- Royal Columbian Hospital, New Westminster.
West Coast General Hospital, Port Alberni.
Barr Maternity Home, Victoria.
North Vancouver General Hospital.
Chilliwack General Hospital.
The following Women's Auxiliaries were represented:
St. Joseph's Hospital, Victoria.
Provincial Royal Jubilee Hospital, Victoria.
St. Paul's Hospital, Vancouver.
St. Joseph's Hospital, Comox.
Prince Rupert General Hospital.
Prince George Hospital.
St. Luke's Hospital, Powell River.
-  Chilliwack General Hospital.
Campbell River  General Hospital.
West Coast General Hospital, Port Alberni.
Chemainus General Hospital.
King's Daughters' Hospital, Duncan.
The following public and professional bodies were represented:
Provincial Government.
University ,of British Columbia.
Victoria City Council.
Nanaimo City Council.
Victoria Graduate Nurses' Association.
British Columbia Medical Association.
—6— Morning Session, Thursday, September 8th.
The meeting was called to order at 10.20 a.m. by President Mr. George
Haddon, who introduced Mayor Pendray.
Mayor Pendray extended to the delegates a hearty welcome to the City of
Victoria. He referred to the splendid hospitals of which the City of Victoria
is justly proud, and complimented the hospitals on the splendid work which they
are doing in this Province.
The President, in a few well chosen words, acknowledged the kindly welcome of His Worship and expressed the hope that he and any of his Council
would attend the sessions of the Convention. Mr. Haddon added that the
Lieutenant-Governor will be present at 10 o'clock tomorrow morning, and
stilted that Premier MacLean regretted his inability to attend.
Telegrams were read from Dr. Lapp and Dr. M. T. MacEachern, expressing
regrets at their inability to attend the Convention, and wishing it every success.
ANNUAL REPORT OF THE PRESIDENT
To members of the
British Columbia Hospitals Association,
Ladies and Gentlemen:—
I have much pleasure in calling to order the Tenth Annual Convention
of the British Columbia Hospitals Association.
Before proceeding, I must refer with deep regret, to the death of Mr.
fJ. N. Aitchison of New Westminster, which occurred in June last. Mr. Ait-
chison, at the time of his death, was President of the Board of Directors of
the Royal Columbian Hospital, was keenly interested in hospital work, and was
a strong supporter of this Association. If you remember, he welcomed the
delegates at a luncheon held at his Hospital at the close of last year's Convention. The Association has also lost a very great friend in the death of the
Honorable Mr. Oliver, Premier of the Province, which occurred a few weeks
ago. Mr. Oliver, at all times, showed great interest in the hospitals of the
Province. He received delegations from this Association with extreme kindness, and st rough' supported the present legislation relating to the payment of
the per diem rate by Municipalities.
In accordance with the decision arrived at at last year's meeting, regarding the holding of all future Conventions of this Association at the Coast,
•your Executive Committee decided upon Victoria for this year's meeting.   The
satisfactory attendance of delegates today shows that the Executive's action
meets with the approval of all.
The Executive Committee has held several meetings during the past
year. Much routine business has been transacted which will be referred to
in the report of the Secretary. I wish, however, to particularly refer to the
following. Firstly, the question raised by the Municipalities of the Lower
Mainland who desire increased representation npon Hospital Boards, and
secondly, the reported effort to be made by the Union of Municipalities for a
reduction in the per diem rate now chargeable against Municipalities for the
care of their patients. Your Executive has opposed, most strongly, any increased representation as suggested by the Municipalities, feeling that the
Act as now constituted, provides ample representation from organized districts. The executive will also oppose any suggestion for a reduction in the
per diem rate referred to, and in order to be fully prepared, has requested statistics from the hospitals of the Province which will enable the Committee to more strongly represent its case to the Government in the event of the Union of
Municipalities pressing its claim. This Association has fought a long time to
secure a more equitable arrangement of payment from the Municipalities,
particularly from those districts wherein no hospital is established, and we
must prevent any concerted action to alter the present legislation unless it
is to increase rather than to decrease the per capita rate.
The question of State Health Insurance, which was raised at the 1925t-:
and 1926 Conventions, and which was referred to the Executive Committee for
its consideration, was tabled for the time being, it being the opinion of the
members that the present time was not opportune to bring this matter forward.
A request was received early in the year from the Canadian Medical Association requesting a representative from this Association to attend a Conference
which was to be held in Toronto for the purpose of appointing a joint study
committee of the Canadian Nurses Association, the Provincial Hospitals Associations, the Provincial Medical Associations and the Canadian Medical Association, to consider matters of mutual concern. Miss Gray, Chairman of
the Nursing Section, who intended being in the East during the date set for
the meeting, very kindly agreed to represent the Association. Miss Gray, no
doubt, will report on her observations.
I cannot let this opportunity pass without referring to the most unfortunate situation existing in Nanaimo which, as you probably know, has resulted
in the closing of the hospital in that City, with no immediate prospect of it
being re-opened or the new building, which was nearing completion, being finished. Surely the Citizens of Nanaimo must realize, by this time, that their
hospital is an Institution which cannot be measured alone by dollars and cents,
and that they will come to the assistance of the Directorate and furnish the
necessary funds to complete the building in order that proper and up-to-date
hospital service may be given to the sick and needy of that district.
The programme prepared for you is one which, I feel sure, will be most
interesting, and should bring out questions of vital interest to all the hospital
representatives of the Province. I trust, therefore, that you will enter freely
into the discussions and that this meeting will result in great good for yourselves, for the Institutions which you represent and for hospital work generally.
GEORGE HADDON,
President.-
On motion the report was adopted.
The Secretary reported that copies of the Report of Proceedings of the
1926 Convention had been distributed to all the hospitals and on motion it
was resolved that the same be adopted.
ANNUAL REPORT OF THE SECRETARY
To the President and Members of the
British Columbia Hospitals Association,
Mr. Chairman, Ladies and Gentlemen:—
My report as Secretary is very brief, as the activities of your Executive
will be related to you in the report of the President.
Your Executive Committee have met together five times during the year,
and on each occasion there has been a very good attendance.
Circular communications have been sent to all the Hospitals in the Province on matters which were considered worthy of drawing to their attention.  04
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-10— The following Committees for the Convention were appointed by the Chair:
Resolutions Committee—Dr. Gray, Mrs. La Pierre, Rev. Antle.
Nominations Committee—Mr. Birch, Mrs. Wilkes, Alderman McAdam.
A letter was read from the Junior Red Cross Committee of the Canaldian
Red Cross Society, requesting the co-operation and assistance of this Association in its work for handicapped children of the Province. The letter
stated that their funds consisted of membership fees of 25 cents per annum
from such children as are able to contribute, the purpose being to provide
remedial care for children who are the victims of ill health and poverty, and
they asked that the hospitals co-operate by granting the lowest possible rate
for the care of such patients.
Several delegates spoke of the
Cross are carrying on.
splendid social service that the Junior Red
Moved by Mr. Bethune, seconded by Mr. Birch and carried:
That the letter be received and acknowledged, expressing to that
organization an appreciation of their good work, pointing out to them
that the hospitals at all times are prepared to care for the poor and
needy free of charge when necessary, but regretting that the hospitals
have no power to make a reduction in their tariff rates.
On behalf of the Vancouver General Hospital, Dr. Bell submitted the following resolution, which was referred to the Resolutions Committee:
Recognizing that the uniform rate of payment for its hospital cases at
present obtained by the Workmen's Compensation Board applies inequitably to the service and treatment given by the larger hospitals of
British Columbia, this Convention endorses any action which these institutions may take individually or collectively towards securing payment
commensurate with the treatment given. »
CONFERENCE OF WOMEN'S AUXILIARIES
Mrs. Rhodes, President of the W. A. of the Royal Jubilee Hospital, Victoria, presided.
Reports were received and discussed from the various Women's Auxiliaries,
as follows:—
Mrs. La Pierre for the Chilliwack Hospital Auxiliary—
The Chilliwack Hospital Auxiliary report a very successful year with a
membership of one hundred and twelve, and the active support of the whole
district, the gross receipts last year were $1,493.00. We have raised our
money by membership dues, sale of cooking, an anniversary tea and the generous offerings of some twelve organizations, some with cash, others fruit and
the odd articles of furnishings, and we serve meals for three days each year
at the Agricultural Fair, but owing to wet days, we will not this year make
our usual profit.
At the last Convention, we were inquiring about an operating table, a very
suitable one was purchased at a cost of $350.00 and since the operations in a
year are around two hundred, we feel grateful to have been able to provide
this very necessary equipment. The two sets of Fowler bed springs purchased (similar to those we were privileged to see at the St. Paul's Hospital,
Vancouver) were apparently very necessary, as one set was put to use shortly
—11— after arriving. We have also bought two laundry carriers, a Compression
Imobilizing Device for the X-Ray, cork linoleum in the halls of the Nurses'
Home. The linen supplies, curtains for both hospital and home and for
the nursery requirements amount to between eight and nine hundred dollars
per year. We are proud of our nursery with its eight little cots, quite
often all full, having had ninety births there la'st year..
Ou Hospital Day the Auxiliary decorate the hospital and home and act
as hostesses in the home, making the visitors welcome with tea and refreshments.
At Christmas we supplied decorations for the nurses to make the institution and the home take on the Christmas spirit, each patient and member of
the staff receiving a little gift with our greeting card attached. This was the
first time we had done this, but from the many expressions of apprecation we
have had, I am sure it will not be the last. We raised a special fund for
this, with a sale of cooking and afternoon tea served  at it.
We were delighted in April to extend our best wishes accompanied by a
silver entree dish, to Miss J. I. Smith, our most efficient and charming Matron
who is now Mrs. David Hill, a valued member of our Auxiliary.
Throughout the year, some twenty dollars was spent in flowers sent to
our-sick members; many times we are assured that the message of love
and sympathy they convey at such a time is very much appreciated. We also
felt like adding our small token of esteem in a wreath sent by us at the tragic
death of the late Dr. J. C. Elliot, one not only respected because of his medical skill, but also on account of his rare musical talent which he was ever
ready to use for the benefit of others, and especially so for the hospital auxiliary, and we know his many kind deeds will not soon be forgotten.
MRS. L. A. LA PIERRE,
President, Chilliwack Hospital Auxiliary.
Mrs. Parsons, for the Prince Rupert Hospital Auxiliary:
The work of our Auxiliary is to help the General Hospital when needed.
Among the work we have done is the furnishing of Obstetrical Room with
latest appliances to help patients and medical staff. The walls were enameled
and heavy linoleum laid on the floor. We also built and furnished a small
Laboratory in the basement of the hospital which is now kept up by the
Board of Directors.
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Two Public Wards were fitted with heavy linoleum at a cost of $385.00.
also purchased two Morris chairs; an aluminum tray service, flat silver,
cutlery, and a piano for the nurses. When the new Nurses Home was
t, the Auxiliary spent $400.00 on furnishings and made all the window cur-.
s. We also provided table linen, tray cloths, bedspreads, sheets, pillow
s, scarfs, towels, curtains, patients' dressing gowns, shirts, bed jackets,
umonia jackets, socks, slippers, binders, doctors' caps and gowns and niate-
for nurses dresses and aprons. With the exception of nurses uniforms,
se articles were made up by the Auxiliary. We have also a Women's Auxiliary
rd, which is kept up by the Auxiliary. This year a new hardwood floor
i laid. There is a donation of $25.00 or more given each year for Christ-
> Cheer for patients in Public Wards. Last year a fund was started for
ew Maternity Wing.
Mrs. French, for the Provincial Royal Jubilee Hospital, Victoria:
During the past four years the Women's Auxiliary have gradually  enlarged their routine of work and in addition to keeping the linen closets well I supplied, extra dishes and all the little comforts that mean so much to hospital
routine have been undertaken by us.
1923—We fitted the hospital with silver plate to the value of $1,526.00,
. and also voted $500.00 for the new greenhouse.
1924—We  paid  over  to  the Board $6,527.63 for the  furnishing  of the
Obstetrical Suites, 408, 409 and 410, and also the linoleum for the South Wing,
/ $420.00 for tiling the ground floor and $731.00  for linoleum  for  the same
floor.
1925—$2,500.00 for furnishing five rooms on 4th floor and $360.00 for
I Sun Room; linoleum for Medical Ward, $120.00.
1926—Sound-proof doors, $156.58; linoleum for Laboratory, $213.84; remodeled Fleming Ward, $210.00; standard lamps and waste baskets, $146.30.
1927—Three wheel chairs, $170.63; two sewing machines, $82.90; incubator,  obstetrical bed,  electric breast pump,  etc., $632.00.
Our Tag Days for the years recorded above produced the following results:
1923    $1,021.26.
1924         853.00
1925         704.11
1926    1.129.52
1927    _  1,010.03
.There are many more things which I might mention but this will serve to
give an idea of what the Women's Auxiliary are striving to do.
Mrs. Miller, for St. Joseph's Hospital Auxiliary, Victoria:
The Ladies' Auxiliary of St. Joseph's Hospital was formed in 1921, with
a membership of about 100. Since then the roll has increased its length until
it now numbers one hundred and twenty-seven (127).
The main purpose of the Auxiliary as outlined in the Constitution and
Bylaws is to assist in the work and the upkeep of St. Joseph's Hospital where
and when most needed.
A brief summary of the work accomplished since the organization of the
= Association may be interesting—
Pieces of linen handled, that is, made and marked, or mended....69,700
Cash received on Annual Tag Days $5,023.60
Cash received from other sources: dues, sales, etc  4,186.69
Articles purchased or installed in Hospital in these five years: 1 Obstetrical Bed; 1 Infant Incubator, 1 Electric Bake Oven; window screens for the
entire hospital; 76 Fowler bed springs (adjustable); 60 aluminum trays for
patients' meals; 75 aluminum coffee pots for patients' trays; 126 chart holders;
floor linoleum amounting to $191.00. Presently purchasing: 3 Sterilizing Drums;
floor linoleum for four corridors.
The reclaiming of gauze is also done at odd times, and approximately
$300.00 has been saved to the Hospital by this homely work.
Mrs. Hayden, for the Prince George Hospital Auxiliary:
Financial Statement for year ending December 31st, 1926—
Receipts:
Balance in bank, February 1st, 1926 $162.92
Membership fees      39.00
Dances, Teas, etc  474.95
Donations      55.76
Liquor  Store       20.50
Tagging at Stampede      48.40
Rent of dishes      11.75
Total  Z $813.2S
—13— Expenditures:
Hospital  supplies   $583.87
Auxiliary expenses   173.61
Cash in bank      54.90
Cash  in  hand   - 90
Total   expenditures    $813.28
Mrs. McCuaig, for the Campbell River Hospital Auxiliary:
The Sisters of St. Ann took over the Campbell River Hospital (which had
been closed for some years) in February, 1926, and the Women's Auxiliary
re-organized and became active again in October, 1926.
The Auxiliary undertook as their objective, the payment of the Victor
X-Ray unit, and by the means of two bazaars and several dances, a total sum
of $1,735.00 was raised which, after the deduction of expenses, made it possible
to turn over to the Hospital the sum of $1,100.00.
Campbell River is actually a very small community, so that the membership
of the Auxiliary is relatively small, consisting of only 14 members, but Campbell River is the centre of a number of large logging camps and the Auxiliary's
efforts to raise funds by bazaars and dances have met with great success.
There is another large logging company coming into our district, and with the
prospect of development work in connection with the Campbell River Water
Power, an addition to the Hospital will become imperative and a larger scope
of work for the Auxiliary to undertake.
While the membership of the Campbell River Auxiliary is small, the
members are most enthusiastic and regard it as a privilege to be identified
with  the work.
Mrs. Dack, for the St. Joseph's Hospital Auxiliary, Comox:
This year we arc happy to say we have made a lot of money. We put
on two whist drives,' a fancy dress ball, and also the owner of the moving
picture theatre at Courtenay gave us the receipts of two nights' shows. In
the Spring we put on a Children's Bazaar and did very well. In June we had
our Annual Garden Fete in the Hospital Grounds and it was, as usual, a
great success, although we did not have a raffle this year. We took in $670.00,
which was the best yet.
The improvements we made to the Hospital this year are as follows r
Frigidaire plant, costing $625.00; putting new floor coverings on several rooms
at a cost of $90.00; linen costing $310.9S; surgical supplies at $92.00, and the
Auxiliary gave $25.00 towards a new Fire Truck.
At our Annual Meeting held in January we found we had made a little
over $2,200.00 in our year's work.
The Produce Week held last November was better than ever. The pro-
luct donated was valued at $282.00".
The Auxiliary voted $100.00 for dishes as it was always necessary for us
to borrow sufficient for our dinner held at the Garden Fete. We purchased
10 dozen cups and saucers, IS dozen plates, three sizes; one dozen sugar
and cream bowls, and one dozen salad bowls. The sugar, cream and salad
bowls have not yet arrived. Wherever possible we purchase our supplies
locally through our own stores at Courtenay and Comox. We would more
than welcome any new suggestions or ideas.
—14— Mrs. Wilkes, for St. Paul's Hospital Auxiliary, Vancouver.
I beg to present the following report of the activities of the Ladies'
Auxiliary of St. Paul's Hospital for the past year.
We have had our regular weekly meetings throughout the year, with an
average attendance of 17 members. Our work has been as usual, the conservation of the used gauze, sterilized by which means we effect a saving
of approximately $25.00 each week, and with the approach of the fall season,
when the attendance is better than during the summer, we have commenced
sewing, as some of the ladies prefer that work, so we are making sheets, pillow cases, table cloths, and other articles for use in the hospital wards.
Our annual Tag Day was a succes
day.    The result was $2,900.47.
as we were favored with a glorious
We have assisted the following organizations with their tag days: The
Amputation Club, the Western Association for the Blind, the Great War
Widows and Orphans Society, and the Tubercular Veterans!
We held a very successful bazaar last October in the lecture hall of the
hospital, the result being $3,700.00. But we must not take all the credit for
this. The Alumnae Association of St. Paul's Hospital worked in conjunction
with us. Indeed, had it not been for the co-operation and great enthusiasm of
the nurses, both graduates and students, we could not have had such good
results. The nurses' booth was a wonderful collection of beautifully-made
articles of every description, both useful and ornamental. We also served
supper which was a very popular feature.
We have been able to assist the Sisters in their social service work,
visiting the poor with them, collecting clothing, and helping to find employment for some of the many out of work, who call at the hospital. At our
weekly meeting we serve tea at a charge of 10 cents. We call this our charity
box which the Sisters use for their poor.
Mrs. Price, for the King's Daughters' Hospital Auxiliary, Duncan.
The Scattered Circle of King's Daughters is the Auxiliary to the hospital
at Duncan. Their work consists of assisting the, institution in every possible
way. Last year $746.00 was spent in different ways at the hospital. This
amount being raised by various means, namely: Two Flower Shows, and a
Seed Sale, Annual Bazaar, Tag Day and Linen Shower.
The sewing for the institution is all done by the Auxiliary. This is arranged by meetings held at members' homes, once or twice' a month, and in
this way the new articles for use in the hospital are made. A few years ago
it was found necessary to build a Nurses' Home. In order to do this, a mortgage was placed on the Hospital for $3,000.00. The Scattered Circle, or
Auxiliary, has assumed the responsibility of paying off this debt. At the
present date the amount has been reduced to $1,800.00, and we hope, by the
end of the present year, to make a further reduction.   .
Mrs. Reed for Chemainus Hospital Auxiliary:
The Women's Auxiliary to Chemainus General Hospital is not particularly
strong numerically but what it lacks in numbers is more than made up in
devotion and hard work. The chief aim of the Auxiliary is to supply patients
in the hospital with comforts also to keep the hospital supplied with linen,
cutlery, china, etc.
The funds of the Auxiliary are raised usually by means of an annual ball
and garden fete, but this year the fete was shelved in favor of a sale of work followed by a pierrott show put on by the local musical society .which was
successful from every point of view.
Business meetings are held once a month with an average attendance
of fourteen.
' During 1926 an increase in the supplies to hospital was necessary owing to
the growth of the town and consequent increase of population.A new maternity
ward and nursery were added!, the furnishings of which were supplied by the
Auxiliary.
There being no representative from Sinithers. the following report was
read from Mrs. Campbell on behalf of the Bulkley Valley District Hospital:
January—Eleven sheets and one dozen towels were made for the hospital.
February—Three Tablecloths, 12 dish towels, 5 flannelette banders and! 6
nightgowns, made by the Auxiliary.    A children's masquerade dance was given.
March—Twenty-eight sheets, 10 bath towels, 24 napkins were provided.
April—Twelve T bandages were made.
May—A provision shower was held on Hospital Day, a tea was given during the afternoon, and a dance in the evening.
June—Six flannel infants' binders, towel racks, one electric light shade,'
one hospital door curtain, covers for hot water bags, and 14 pneumonia jackets
made.
July—Three congoleum rugs, linoleum, felt and brass binding were bought
for the hospital; mending was done; 14 pillow slips made; and three dozen
cheesecloth bandages and sponges. Refreshments for the Annual Picnic given
by the Hospital Board, were canvassed for and provided; a fur coat donated
to the Board! was raffled by the Auxiliary. A dance was given in aid of the
Hospital Board.
August—An attempt was made to form classes (Red Cross) in Home
Nursing; 30 pillow cases were made.
October—A dance was given on Hallowe'en.
November—More and better water was provided for the hospital and
piped to the nurses' home.
The question of Auxiliary membership fees in the Association was discussed, and it was moved by Mrs. Robertson, seconded by Mrs. Brown and
carried:        „
That" the  matter  be  referred  tor the  Committee  on  Constitution  and
Bylaws, with a recommendation that these membership fees be reduced.
* As Chairman of the Programme Committee, Dr. Bell spoke of the increased interest which was being evidenced in the work of hospital auxiliaries
and on his recommendation it was resolved:
That a standing committee be appointed on Women's Auxiliaries' activities.
On adjournment at 12 noon the delegates attended a luncheon at the
invitation of the Rotary Club, where a very interesting address was delivered
by Mir. W. B.. Lanigan on his observations at the Conference on Pacific Relations recently held in Honolulu.
—16— Afternoon Session, Thursday, September 8th.
On behalf of the Committee on Constitution and Bylaws, Mr. Wilson
reported as follows:
September 8th, 1927.
To the President and Members of the
British  Columbia Hospitals Association,
Mr. Chairman, Ladies and Gentlemen:—
In submitting the report of the Committee on Constitution and Bylaws
there is little to say apart from the amendments to the Constitution and Bylaws
which it will be necessary for this Convention to make in order to carry out
the principle of pooling travelling expenses, which was adopted at the last
Annual Convention and actually carried into practice by 17 hospitals.
In view of the fact that one delegate can record the entire vote of the
hospital he or she represents, and in order to fairly equalize the cost of representation at the Annual Conventions this Committee recommends that the
pooling principle shall apply to the expenses of one delegate only from each
hospital holding an institutional membership.
The necessary resolution amending the Constitution and Bylaws will be
moved at the Saturday morning session of this Convention, and as several
Auxiliaries have expressed a desire to have their delegates' expenses pooled,
it will be drawn accordingly.
Respectfully submitted,
CHARLES E. WILSON,
Convenor.
Mr. Wilson also read the proposed wording of Article 13, as follows:
ARTICLE 13—POOLING OF DELEGATES' EXPENSES:
In the interpretation of this article the words "travelling expenses" are
defined as being moneys actually and necessarily expended in purchasing transportation, sleepers and berths from the place of residence of delegate to the
Convention and return, but shall not include moneys disbursed for meals, tips,
or other incidentals.
The travelling expenses of one delegate to the Annual Conventions from,
each hospital holding an institutional membership in the Association shall be
pooled in the following manner, namely:—
(a) All delegates shall register with the Secretary of the Association
before the opening of each Annual Convention and one delegate
from each hospital shall at the time of registration file with the
treasurer a statement of his or her travelling expenses (if any)
certified as correct by such delegate.
(b) On or before the closing of the Convention the Treasurer shall
ascertain the average cost of the travelling expenses of all pooling
delegates, and shall pay to each said delegate the amount that his
or her said travelling expenses exceed the said average cost, and
the pooling delegates whose travelling expenses are less than the
said average cost shall pay to the Treasurer the amount of such
deficiecy.
(c) The Executive Committee shall have power to add to, subtract from
or otherwise amend any statement filed under Sub-article (a) hereof.
—17— In a manner similar to that set out in Sub-articles (a„ (b) and (c) hereof
the travelling expenses of one delegate from each Auxiliary holding a membership in the Association shall be pooled.
On behalf of the Committee on Business Affairs, Mr. McGregor submitted
a paper prepared by Mr. Charles Morrison, Accountant of the Provincial Royal
Jubilee Hospital, as follows:
NOTES ON HOSPITAL ACCOUNTING PROBLEMS
To attempt to discuss fully the many difficulties met with in Hospital
Accounting would require more time than this convention can possibly devote
to any one subject, and a great deal more than has been allowed for the preparation of these hasty notes, but the mere mention of some of the knotty points
may give rise to profitable consideration and perhaps evoke helpful comment
and criticism.
To begin with, the business office staff must not be less, but more efficient
than is necessary in ordinary commercial work.The ordinary business man
and his assistant are dealing, as a rule, with normal people, and disagreement
or misunderstanding can be quickly cleared up by a statement of fact or
production of proof, or through the give and take of everyday business. The
Hospital staff, on the other hand, are dealing with sick people or their relatives, all more or less worried and therefore peculiarly sensitive and susceptible
to imaginary or, at least, unintentional slights. A single curt or sharply-
worded sentence which would pass unnoticed in a store or a shipping office,
may destroy the good feeling towards a hospital which it has, perhaps, taken
weeks of devoted service from the nursing staff to create. An overcharge
or error in an invoice is just a matter of adjustment by credit-note or refund,
"but a mistake in a hospital bill often seems to become a personal grievance to
be remembered and bitterly talked about when the service rendered has been
forgotten. Absolute accuracy in bookkeeping is, of course, a beautiful dream,
but slackness in the handling of patients' accounts is too expensive for any
institution to indulge in, and the difficulty that first confronts us is that of
ensuring reasonable accuracy in the original entries, or charges in the various
departments to be posted to the patient's account. Simplicity and a minimum
of clerical work on the part of the nurse or technician should be aimed at,
and .good results have been obtained by the use of an ordinary sales-slip for
the recording of special charges, such as visitors' meals, laboratory and X-Ray
fees, telephone calls, etc. Differently colored slips can be used in each department to facilitate segregation of earnings by departments. A nurse can
easily remember to scribble on a pad of sale slips that Mr. Jones in Room 424
had an extra tray sent up, when it would be liable to be forgotten if she had
to write up a report showing a list of all the extra meals served during her
hours on duty.
The collection of data for posting is taken care of by having all charge
slips sent down to the office with the morning and evening reports, from
which the room rent and daily ward charge slips are made out in the office.
Earnings are totalled by departments, then segregated into municipalities, the
patients' names on the slips being arranged alphabetically as in the ledger,
which is divided into sections, viz., City, surrounding municipalities, unorgan-
zed districts, etc.The use of a posting machine, while too recently installed to
permit more than cautiously worded recommendation, gives a daily balance and
a complete check on the agreement between total earnings credited to departments and the total charges posted to the Patients' Control Account in
«ach municipality and the grand total posted to the Ledger Control. The same
arrangement is used for the posting of Cash receipts and sundry credits.
Where there are no specially trained Admitting Officers, considerable. worlr_
is thrown on the office staff in the way of carefully checking the details shown
on the Admission Slip.  Mrs. Jones has perhaps lived all her life just outside
—IS— the city limits, and it is quite natural for her to give her residence as Victoria,
but the eagle eyes of municipal officials are on the outlook for such mistakes,
and they are quick to express their conviction that the Hospital is trying to
put something over should a name appear on their monthly statement of residents in hospital, the bearer of which has not the necessary three months of
residence within the limits.
Much unproductive work might be eliminated where it is possible to employ trained Admitting Officers, who could be trusted to classify patients as
Pay, Part-pay, Contract, Free, and so forth. It often happens that the
accountant, in following up delinquent accounts, after he has sent numerous
statements and requests for payment, some of which come back marked "Gone,
no address," and has sent a special collector to trace and report, finds that
Mrs. Mary Smith, North Turner Street, is the same person who was in as
an indigent patient the previous year and registered as Mrs. John Smith, South
Park Street.
There is also the vexed question of the registration of out-patients. How
many hours must a patient stay in hospital to be classed as an in-patient, be
registered, and have a day entered on the monthly Government return of
Hospital Days?
The collection of patients' accounts could be made much less haphazard,
and deadbeats and repeaters more quickly tagged, under- a system calling for
fuller information regarding the incoming patients' ability to pay than is now
generally obtained, although the cold-blooded credit agency methods are
obviously out of the question,, and such work would do more harm than good
unless very tactful and sympathetic in cases of real distress.
In connection with the collection of accounts, one of the factors to be
borne in mind when considering bookkeeping machines for Hospital work, is
that machines which turn out a statement with symbols or abbreviations are
likely to prove sources of trouble. The average patient is not in business and
so familiar with machine statements, and is liable to waste more of the bookkeeper's time in explanation of the mysterious items than has been saved in
posting. The machine previously referred to, types the various charges
clearly, and by the use of a perforated statement form the confusing extended
balances are eliminated, and a simple, easily understood bill produced.
On the other side of the ledger, Accounts Payable are taken care of by
a Voucher Register with columns corresponding to the headings of the Monthly
Government Return of expenditure. Each firm's bills for the month are
vouchered and posted in total after being checked by the department concerned as to quantities and by the Purchasing Agent as to prices and extensions. Disbursements are by Voucher Cheque, and both Voucher and Cheque
Registers are posted to the individual firm accounts in the Accounts Payable
Ledger, while the totals of the columns are posted to the corresponding accounts in the General Ledger.
As to costing, there are two opinions among the smaller institutions.
• Accountants cannot be satisfied with less than a complete and accurate system of cost accounting, while the executive of the small hospital points to
the fact that, unlike the factory which can stop the use of an unprofitable
machine, the hospital must continue to run its special departments even at a
loss and must keep its patients in badly located rooms or wards because there
is nowhere else to put them. As to the cost of operating the various departments, he depends upon keeping an eye on the figures shown on the monthly
return and promptly investigating any notable fluctuation. It is a matter for
discussion where the expense and labor of keeping cost accounts as they should
be kept to be of any value is offset by the possibility of effecting real economy
through the intelligent study of the figures obtained.
There are many other aspects of the work which deserve attention and,
indeed, must be studied by any Hospital Accountant, but time will not permit
—19— more than passing mention of a few. Such are the standardization of forms,
statements, etc., the improvement of the Government Return which would entail discussion of the Income and Expenditure basis as against the Receipts
and Disbursements plan, the question of standard fees, special charges and
so on, but perhaps enough has been said to bring forth more valuable opinions.
One last Word regarding statistics, those fascinating sets of figures which
can be either helpful or harmful according to their accuracy and the understanding of the true relation of the data on which they are based. Comparative figures may be most valuable, but it is easy to overlook the fact that the
results obtained from their compilation and study may not be worth the labor
involved, labor which might be much more profitably expended in other less
showy directions. A statement showing- that the average earnings charged
to patients' accounts in any one month were more or less than usual may be
very interesting, but is not nearly so valuable as the knowledge that every
collectable account running in that month has been followed up and given
proper attention. A curious by-product of a statement showing that only a
certain percentage of patients' accounts in a certain municipality were being
paid which was given publicity, was the declaration by several debtors that they
did not see why they were being dunned when their neighbors did not pay.
One man brought in a payment, saying that he did not see how the hospital
could carry on with so many people owing it money, but so far he is in a
minority of one.
Moved by Mr. McGregor, seconded by Mr. Burns:
That a committee be appointed to take up with the Provincial Authorities the compiling of reports on hospital statistics, as evidently there
is a great variance in the systems adopted by the various hospitals in
"Indoor" and "Outdoor" Patients' reports.      Carried.
Mr. McCullough drew attention to the widespread difference in the average
hospital days stay in the two Victoria hospitals as reported to the Provincial
Secretary and published by his department, and suggested that the»e must be
a difference in method of recording to account for such a discrepancy.
Dr. Lamb, Provincial Hospital Inspector, drew attention to the fact that
this discrepancy may be explained at least in part by the fact that the Jubilee
Hospital received financial assistance from the City of Victoria, which is not
the case with St. Joseph's and consequently chronic cases are sent to the
Jubilee Hospital, thereby swelling their average. Furthermore, the former
hospital is caring for a large number of tubercular patients, who, of course,
are in hospital for a protracted period.
On behalf of the Committee on Municipal Affairs. Mr. Burns reported as
follows:
To- the President and Members of the
British Columbia Hospitals Association.
Tour Committee, whilst not actively engaged during the past year, has
nevertheless carefully watched any steps leading to the opening of the Hospital Act, which might be detrimental to the Hospitals of the Province.
The Executive Committee has. at its various meetings, discussed reports
which suggested that steps would be taken by the Union of Municipalities of
the Province, to petition the Government to re-open the Hospital Act to provide
for increased representation on Hospital Boards. Thi§ question was raised
by the Municipalities of the Lower Mainland who felt that they were entitled to
representation on all Hospital Boards to whom they made payment for services
rendered. This, of course, was a most ridiculous stand to take, as it would
appear from their attitude that any organization or body who paid for any
person's hospital bill, might justly be entitled to representation upon the Board
of the Hospital.    Strong opposition was taken to this, and I feel sure that the
—20— Government will see and recognize the danger from accepting any recommendation from the Municipalities along this line.
The question of the Union of Municipalities pressing for a reduction in
the per diem rate, set under the hospital Act. from 70c to 50c must be
strongly opposed. Any effort of the Union in this direction must be met by
strong opposition from the Hospitals Association, and must be supported by
facts and figures such as are now being obtained from the hospitals of the
Province. It is most unfortunate that the Municipalities should even consider pressing for this reduction in the rate, as the total sums paid by certain
Municipalities, wherein hospitals are not established, are very much lower than
what these Municipalities would have to pay for hospital service if they had
the care and expense of their own Institution.
Respectfully submitted,
R. ROBERTS BURNS,
Convener.
On motion the report was adopted.
• The Secretary reported that, acting on instructions from the Executive,
he had sent a Questionaire to all the hospitals, asking for statistics .regarding
the hospitals', relations with the municipalities under existing legislation, and
asking for details as to the total amounts charged the patients from the various
districts and the proportion thereof that had been paid.
He reported that replies had been received in response to this Questionaire, and on motion it was resolved:
That all this data be referred to the Municipal Committee for compilation.
The President reported that the delegates would be welcomed by the
Lieutenant-Governor at Government House, at 5 p.m. on Friday, instead of on
Saturday, as originally arranged.
The Secretary asked that in anticipation of a decision in connection with
the pooling of delegates' expenses, that one delegate from each hospital represented file with him a statement of their travelling expenses, stating therein
whether the delegate was institutional or auxiliary.
Mr. Miller of Mission Hospital referred to the losses which are sometimes
sustained by the hospitals as a result of Workmen's Compensation Board
cases who, in the opinion of the Board, remain too long in hospital, and as a
result the account was reduced accordingly. Considerable discussio"h ensued
on this subject but no action was taken thereon.
The following resolution was submitted by Mr. McCullough and seconded
by Mrs. Wilkes and referred to the Resolutions Committee:
It having come to the observation of this Association of the kindness
and prompt attention afforded by the physicians and surgeons of this
Province in the hospitals and in the outlying districts in rendering aid
to the sick without consideration as to remuneration, that this Association goes on record as expressing their deep appreciation of the services rendered, and that a copy of this resolution be sent to the British
Columbia Medical Association.
Mr. A. P. Glen of Ladysmith stated that he had recently paid a visit to
the "British Isles, where he had visited many hospitals, and stated that he had
copies of reports from a number of these hospitals, which he would be glad
to submit for the benefit of the Committee which will be engaged in the matter of compilation of statistics.
The meeting adjourned at 4 p.m. when a visit was made by steamship
to the Dominion Quarantine Station at William Head, at the invitation of
the Quarantine Officer Dr. C. P. Brown, returning to Victoria at 7 p.m. Morning Session, Friday, September 9th, 1927.
The President opened the proceedings and announced the Committee which
he appointed in connection with the resolution submitted yesterday afternoon
by Mr. McGregor, following his report on behalf of the Committee on Business
Affairs, namely:    Mr. Carr Hilton, Dr. Pearse, Mr. C. E. Wilson.
The President also announced the appointment of the Rev. Cook in the
place of the Rev. Antle on the Resolutions Committee.
Dr. F. C. Bell then took the Chair, as Convener of the Committee on
Medical Affairs, and introduced Dr. H. E. Young, Provincial Health Officer.
Dr. Young addressed the Convention on the subject of a Health Insurance
Tax. He agreed with the opinion as expressed by the President, that the time
was not opportune to make a request to the Government to levy a tax for this
purpose but urged that the time was opportune to begin to educate public
opinion towards the time when a health tax could be imposed, entitling citizens
to free hospital treatment, and he urged the Hospitals Association, as custodians of public health, to take steps to inaugurate a campaign of education to
this end.
The Government had been generous in its grants to hospitals, said Dr.
Young. With the increase of the Government grants the pubUc had become
to think that they were entitled to hospital care as taxpayers. But how many
were taxpayers.
As a remedy Dr. Young suggested that a health tax should be levied, not
merely on property owners, but on every citizen. Under a similar system education had been made free to everyone, and he thought health care should be
available in the same way. This system would enable every man to secure the
benefit of the very latest aids to diagnosis and treatment, whereas under the
present system he could not afford it.
At 10 o'clock a.m., His Honor the Lieutenant-Governor Randolph Bruce
attended and expressed his appreciation of the invitation to attend. He
expressed his appreciation of the work' of those connected with hospitals and
on behalf of the Province expressed gratitude for their earnest activities in
th interests of the sick.
Father O'Boyle replied! to His Honor on behalf of the Association.
Dr. H. E. Ridewood President of the B. C. Medical Association, addressed
the Convention and brought the congratulations of his Association and assured
the Hospitals Association of the co-operation of the Association that he represented in any matters of mutual concern and interest, and especially in relation to the furthering of some scheme which might be worked out in the way
of health insurance.
Dr. C. H. Vrooman delivered an address on the institutional treatment of
the tuberculous patient.
Dr. Vrooman stressed the importance of general hospitals making provision to accommodate tuberculous patients. He said that the death rate in
tubercular cases had been cut in two, but that the essentials of treatment had
not changed in the last twenty years, the chief essential being rest in bed, and
he added that the pneumo-thorax treatment was an assistance to rest. He
advocated rest for a period of six to nine, or even twelve months, and with
hospital care during that time. If this is neglected, the patient turns the corner and becomes a permanent charge on society. He said that fifty per cent,
of cases that go to sanitaria have gone too far. Dr. Vrooman criticised the
lack of fresh air facilities in hospitals, which is so important in the care of
any ailment, whether it. be T.B. or any other disease or injury. He said that
climatic conditions were an unimportant factor, and that, granted there are no other complications, a T.B. patient will thrive on an ordinary diet, and deprecated the overfeeding by solicitous friends. He said that only positive
sputum cases should be sent to hospitals, which should serve as clearing houses
for the sanitarium, and should also care for cases that are round the corner,
so that such cases may be cared for at the hospital nearest their home, where
they can have the comfort of being near their friends and relations.
Dr. Vrooman stated that T.B. patients must be segregated on account
of the infectious condition which is contained in their cough sputum. He said
that they require nursing care, and stated that with seventy-six cases in the
Vancouver General Hospital, that forty were bed cases, eighteen with
toilet privileges, and eighteen up to meals. In advocating the training of
pupil nurses in the care of T.B., Dr. Vrooman stated that the degree of inV
fection amongst nurses is no higher with T. B. than with other diseases. He
urged that T.B. cases be not always placed under the care of graduate nurses,
stating that pupil nurses should be trained to be of value to their community in
this respect.
Miss E. Pipes, Dietitian, Vancouver General Hospital, read a paper on
"Food Service in the Small Hospital."
FOOD SERVICE IN THE SMALL HOSPITAL
Just what is meant by good food service? Is it to serve three meals a
day as .cheaply as possible and as one Superintendent said, "Wtih the least
annoyance to the other departments." Or is it to have meals well cooked and
nicely  served?
Very few patients can intelligently criticize nursing service; if the nurse is
kind they are content, neither can they criticize medical service for they do
not know enough about it.But when it comes to food, they do not hesitatte
to pass judgment and why? Simply because there isn't a human being from
a week-old infant to a centenarian who can't in his his own opinion tell you
of what a good meal consists. To many of the patients the arrival of the
tray three times a day is their chief diversion and often the main topic of
conversation with their visitors. The question which we must settle is how
best to satisfy them.
Owing to the fact that from 20 to 40 per cent, of the entire operating
expense of the hospital is needed for maintenance of the Dietary Department,
and that the reputation of the hospital in the community is influenced by the
quality and service of food to the patient, it is well for all those interested in
the building of hospitals to devote more time and consideration to the best
attainable location and equipment of the Department.
In a small hospital the kitchen should be centrally located either on the
ground floor or preferably for the sake of ventilation on the highest level.
I realize the top floor kitchen, although well lighted and ventilated, offers
many disadvantages such as extra labor required to deliver supplies remove
garbage and other refuse. Particularly if the elevator service is not of the
best.
The kitchen should never be placed in the basement, because natural lighting, is poor, working conditions are apt to become unsanitary, ventilation is
inadequate, as a result odors of cooking permeate the hospital. For the
large institution a separate "service building is often found advisable, where
kitchen, dining rooms, culinary stores and auxiliary rooms are located. When
the size of the kitchen is not proportional to the work required and necessary
equipment has to be placed elsewhere the additional labor and time involved
means increased operating cost without any compensating advantage. Labor-
saving devices are being increasingly used, for they not only conserve labor,
but they promote a marked saving of food supplies such as vegetable peelers, Food service in any institution can b
Food Quality,
Food preparation,
Food Variety,
Serving the Prepared Meal.
Special Feeding Methods.
Special Diets in certain diseases,
Food service to helpless or partly helple
meat choppers and slicers, bread slicers, butter cutters, fruit extractors and
electric toasters. Few mechanical labor-saving appliances serve the kitchen
better than the universally used electric mixing machine which beats eggs,
salad dressings, whips cream, mashes potatoes, mixes dough and pastry,
crushes fruits and vegetables, sieves soup and puree and has handy attachments
for grinding coffee and the making of ice cream.
With good equipment you  need less manual labor,  therefore be  ready to
pay good salaries and get employees who are thoroughly competent and inter-
tudied from the following aspects:
Patients
There is a saying that any mechanic can make a good product out of
good material, but it takes a good mechanic to make a good product out of
poor material. This does not hold true with "Kitchen Mechanics" of the
hospital. They cannot be expected to turn out good meals with poor quality
of supplies, ultimate results can be obtained only by using the best, and practicing econonvy in its use. For example, I know of a hospital where they
were buying a water pack or very light syrup pack fruit for table use. Granted
first cost was cheaper than a better grade, but to make it at all palatable,
sugar was added by the patients and personnel at the table, the result was,
wasted sugar in the individual fruit dishes, also a large per cent, of the fruit
found its way to the garbage can, to say nothing of the discontent oven
the desserts. A better grade syrup pack was obtained, the cost balanced on
the right side  against the former loss  outlined.
Food must be attractively prepared and in the small hospital I feel that
a house diet that will meet all the requirements' of a normal diet can be prepared for the patients on general diet and for the personnel alike. The essential
points to be considered in planning such a diet (a) The diet should contain sufficient calories to keep the weight at normal (b) The diet should contain sufficient protein to keep the body in equilibrate (c) The diet should contain an adequate supply of minerals and vitamines (d) The diet should contain bulk to
establish a normal evacuation daily (e) The diet should contain an adequate
amount of water. With these points in mind the menus are planned and
special diets may be planned in many cases to use the foods of the house
diet. Thus saving time and energy in preparation of separate dietai*ies for
various units. I do not wish to be misunderstood in making .this suggestion
of planning the menus, variations, which will "cover the personnel and keep
them contented and willing to give loyal and efficient service, may be made in
the same way as the special diets are worked out, but the main part of
the meals to be standard all over the hospital. For instance, everyone has
dinner at the same time of day, instead of the patients at noon and the personnel at night.
In the service of the prepared meal, we find some of our greatest difficulties. Food served cold, chipped dishes, soiled tray covers, etc.. are a few
of the problems and they are real problems, since their correction involves the
co-operation of nurses, maids, attendants and every employee connected in anyway with the food service. In central kitchen service, the dietitian (or nurse
in charge, in smaller hospitals) can give careful supervision of the individual
trays as they are set up. If the dietitian has discussed special diets with the
patient and with the attending physician as should! be done, this opportunity
to give particular attention to specific trays adds materially to the progress and satisfaction of the patient with food service. The dietitian also has a better
opportunity to instruct and supervise her students, either nurses or dietitians.
Remember this old adage:
If comfort you would give your whole household, serve hot things hot
and cold things cold.
T"he luke-warin habit to none is fair.
It soaks'into the system too much don't care. .
So Mothers, look well to the household ways
By heeding the injunction given of old,
Have hot things hot and cold things cold.
or nasal feed-
This respon-
Special feeding methods, patients who require rectal feeding
ing must not only receive proper food, but the proper attention,
sibility must rest largely on the nursing service and physicians.
Special diets demand proper co-operation between physicians, nurses and
special diet kitchens, with emphasis plaeed on individual service. Considering
not only the diet prescribed, but also the patient's preference in selection of
food allowed, and preparation. This affords good training for your student
nurses.
Food service to helpless or partly helpless patients is a special priblem,
additional help for such cases should be provided for at meal time.
Service in relation to Dietetics spells satisfaction, breeds contentment and
that is the corner-stone of good results, meaning the whole hospital satisfied,
friends gained, enemies lost. It has been said that: You can't please all the
folks all the time. But you can please part of the folks all the time, and all
of the folks part of the time.
EDUCATION  or  health-giving.
RESTORATION—Compensation through diet.
VERIFICATION—Substantiation of the claim as to the worth of a perfect dietary system.
INTER-RELATION—Dependence and the recognition that all things
as well as people have their connection and association.
CO-OPERATION—Achievement in the sunlight of victory.
EMULATION—To discover merits in other organizations than your own;
and the wisdom to make practical application of them.
The responsibilities of the dietitian in the small hospital are very similar
to a large hospital and are such that she should have:
1. A thorough knowledge of dietetics.
2. Good executive ability.
3. A sense of personal interest in spending hospital money for food,
for employees and for equipment.
4. An appreciation of the value of graciousness.
5    An understanding of the other side
6. A willingness to serve her group, and be able to translate physicians'
orders.
7. A deep sense of feeling for the human beings who are hospital guests.
8. Skill in rounding off the corners of her department so that it wffl
fit into other parts of the hospital composite. While on the other
hand the hospital has a responsibility to the dietitian.
Give her a real chance to do her work without any interference, then
if her work does not come up to standard, change dietitians. Do not curtail
your dietitian's power, let her have full sway in her department, require good
dietetics, see that she has what she needs to work. with. Give her loyal support,
remembering that often complaints about her work are from people who are too
sick to judge. Little can be accomplished without backing and co-operation of
the closely allied departments. Dr. A. S. Lamb, Provincial Hospital Inspector, delivered an address, in
which he advocated education of the public in the care of tuberculosis. He
referred to the instance of one hospital in the Province which had established
a special building for the care of tubercular patients, where such patients were
cared for by graduate nurses employed for the purpose. He expressed the
opinion that this should not be, and that an opportunity should be afforded
nurses in training to acquire knowledge in the nursing of tuberculosis.
Dr. Lamb advocated the establishment of flat rate charges by hospitals
and suggested that charges to patients might be established on a sliding scale,
according to the accommodation provided and the patient's ability to pay.
He said that the question of extra charges for special services rendered in hospital was always a source of dissatisfaction to the recipient of the bill.
He also stated that small hospitals who installed X-Ray equipment were
in the habit of establishing a rate of charges based on the scale in force in the
larger hospitals, but due to the amount of work required of them, they were not
able to employ the services of a competent medical radiologist, and consequently their scale of charges should be proportionately lower.
Dr. Lamb referred to the relationship of the Hospital Boards to their
Community and said that he thought that at times the attitude of the Boards
was somewhat too arbitrary, and that they should at all times be more prepared to disseminate information in their community which would prove enlightening and ensure the greater public sympathy.
He stated that in comparing the death rate in British Columbia in tuberculosis with that of other Provinces in the Dominion, that the comparison compared unfavorably; but on investigation it was found that this was due to
the Chinese, Japanese and Indian population, and that amongst these races
the disease was more prevalent and the death rate consequently higher. He
said that 25 per cent, of the Indian population of Canada was in British Columbia.
Dr. Lamb then continued
Middle Class Patient."
by reading a paper  on  the^ subject of  "The
THE MIDDLE CLASS PATIENT
At the session of the British Columbia Hospitals Association in 1925, Mr.
S. C. Burton of Kamloops read a paper entitled, "A Hospital Tax to cover
payment of public ward patients." In a short talk to the Hospital Association
last year I took the opportunity to refer to the same matter in a somewhat
different connection.
It was my great privilege last Fall to attend the sessions of the International Union against Tuberculosis in Washington, D. C. By going East
a few days early for those sessions I was enabled to take in part of the sessions of the American Hospital Association at Atlantic City. I want to say
to you that if this year or any other year you can make it convenient to take
in the meetings of this Association you will be well repaid for your trouble.
Among the many subjects di
best to provide for the middle clas
means." This was discussed from \
Administration, Standpoint of Muni
point of Finance, From the Nursing
Patient. I would advise any and all
as contained in the Report of the As
treat it in a general way and to poi
arrived at are not applicable to our
what way, in my humble opinion, we
ussed! there was a symposium on  "How
3 patient," or "The patient of moderate
arious angles, first, Planning of Hospital
cipality,  Standpoint  of Physician,  Stand-
Angle, and lastly from the Standpoint of
of you to obtain a copy of the discussion
sociation, for it is only possible for me to
nt  out   that  some     of    the    conclusions
conditions, and endeavor to point out in
must handle the same matter.
-26— Definition. The middle class patient includes all that large class ranging
from the low wage earner who, on account of his limited finances, is entitled
to ward service without fees, up to that class who on account of their financial
position can afford private room accommodation and all the extra laboratory
and other-tests which make up in many cases a considerable item of the entire
hospital account under the title of extras, probably 80 per cent, of the whole
hospita] population.
These patients, because of commendable pride, want a little more privacy
than is to be obtained in a public ward, both for themselves, their family and
friends that may visit them. Because also of that same pride, they refuse to
be classed as indigent cases, wish to select their own medical adviser and make
the best arrangements possible as to the payment of their hospital bill. As
a class, for that latter characteristic alone, they should be given all the encouragement possible as there seems to be an increasing tendency today to get
as much as possible without paying for it, and to accept any and all things as
their right. This is the class that if ill in the home, get along without consultation if possible even when consultation would be much to their advantage, because of the extra expense; in the hospital advise their doctor against X-Rays
and laboratory tests for the same reason.
What were the recommendations? Hospital building or parts of buildings
set apart for this class of patient with small semi-private wards ranging from
two to four or six beds with a larger number of the less expensive grades of
private rooms, the wards being further separated by cubicles or curtains. A
frank discussion with the patient on entering as to his ability to pay, and
graduated price for extra service tempered to the shorn lamb.
The actual cost of this hospital service may and probably in most instances will be greater than the fees charged would pay for. How then is
the difference to be made up ? Where are the finances to come from to provide
this extra service to this class of patient? The whole trend of the discussion
at this Hospital Association meeting was that the only solution wag extrta
endowments.
We have this same class of patients in B. C. and the same problem to
solve for the reason that here as elsewhere this class of patient is not getting
as good hospital treatment as the other two classes.
Does extra endowments solve our financial difficulties, I am sure you
are all agreed that it will not. Endowments on any large scale in this new
country is an impossibility.    Perhaps it is just as well that it is so."
In Eastern Canada large gifts to hospitals are still possible, as witness the
attempt in Montreal not long since when $4,000,000 was asked for. Close to
$5,000,000 was subscribed and the greater portion of it in amounts ranging
from $250,000 to $20,000.    The same condition exists in Toronto.
We are faced with the same problems in British Columbia. In Vancouver
with an extension costing close to $1,000,000 planned for this next year, that
will only bring present equipment up to date but add very few available beds to
present amount, the condition could almost be said to be acute. At least fifty
percent, of the hospitals of the Province have obtained or are asking for special
grants from the Government to assist in providing extra accommodation, either
in hospital proper or nurses' homes, and like the Vancouver General Hospital
these extensions are not providing for the future but in most cases only bringing plants up to present needs.
So what is the solution for us? I have got away a bit from the subject
I started out upon, "The Middle Class Patient," but we will get back to it
after a little.
I believe the only solution is a hospital tax, something on the same order
as our present school tax, the country being divided into hospital districts. The only solution thus far that Nanaimo can see for her present impasse is to
have a hospital district, including all the territory surrounding it, as the citi-
ens of Nanaimo feel that it is not up to them to provide accommodation for the
surrrounding country.lt is a very good illustration of an endeavor to build a
hospital by voluntary subscriptions.
Let it be understood that while I am a Government appointee, I am not
of necessity voicing the opinion of the Government.
You may ask, "Why not go to the Government with this proposition?"
Because public opinion must first be educated before a Government can safely
adopt any such policy.
Out of this tax, hospital accommodation would be provided, also all services which go to make up the extras on a hospital account today, the one
thing above all others that creates ill-feeling between the hospital and patient.
Graduated fees "would be charged for accommodation according to quality of
same and the patient's ability to pay, thus wc
patient.
get back to the middle class
This method would be compelling people to make provision for a rainy
day, largely according to their ability to pay. It would place at the disposal
of all, the same facilities of diagnosis and treatment which is the real purpose
of a hospital. It would only be extending that service that is already in operation through our Health Department, under Dr. Young, of making most laboratory services free.
Are there any examples of how this would work out. for our guidance?
Only this, that the hospitals that are being financed most easily today are
those where there is a considerable body of men working and making monthly
contributions to the hospital to provide for their accommodation when ill,
as some mining and logging camps are doing.
Is it all. one sided? Are all the advantages with this system? I would
say not.    Did time permit I might mention a few of the disadvantages.
What about the details? I believe we have ability enough in this Province
to attend to that if undertaken seriously.
Dr. W. A. Dobson of Vancouver made a resume of the report of the Royal
Commission on Mental Hygiene, copies of which were made available to the
delegates.
COMMENTS ON THE REPORT OF THE ROYAL
COMMISSION ON MENTAL HYGIENE
I presume I am correct in inferring that most of us here have received a
copy of the Report of the Royal Commission on Mental Hygiene, which was
issued a few months ago. I am also probably more or less correct in suggesting that many of us glanced hastily over the report and filed it away for future
reading. It is probably because of such well-known tendencies that I have
been asked to speak for a few minutes on the Report and incidently forced to
recover my own copy and read it over carefully.
Anyone reading this report will find in it a very comprehensive outline
of the problems in mental disease and mental deficiency in this Province. This
treatise on those problems presents in a very concentrated, but very readable
form one of the most important problems with which we have to deal in this
generation.
The members of the Commission, although they have very thoroughly gone
over the ground have, I think, very wisely recommended that the studies along these lines should be pursued for some time to come and I feel that I am voicing
the sentiments of all those interested in mental hygiene in this Province, when
I refer to the untimely death of the late Doctor Rothweli, who as chairman
of the Commission, lent his enthusiasm and great fund of knowledge to the
work which unfortunately for us he was unable to see through to the end.
The work which the Commission was to accomplish was more or less
definitely laid out for them and dealing with the findings I will take up in order
the phases with which they were to deal.
First:    The reasons for the increase in the number of patients maintained -
in the Provincial Mental Hospital and the branches thereof:—
The Commission points out very clearly that the increase is more apparent
than real. Comparisons have been made with other Provinces and with some
of the States to the South, and in some instances it appeared that our increase
was greater than in many other parts. On analysis it was found that in most
Provinces and States the mental hospitals received only mental cases, whereas
in British Columbia, where no provision is made for mental defectives and
epileptics, the latter of necessity had to be admitted to our Special Hospital.
It is probably a popular opinion that there is little difference between
a mental defective and a ease of mental disease. This Report points out that
a mental defective is one in whom the mind has failed to develop normally and
that a case of mental disease is one in which there is an aberration or change
in the mental state of the individual. To put in more simple terms: A mental
defective is one who is poor in intelligence and was always poor; whereas in"
mental disease there is poverty Avhere there was once richness of intelligence.
The increase in the number of admissions is also partly explained by the increasing demand for institutional care, because the public is more and more
realizing that better treatment can be carried on in mental hospitals. Furthermore, as result of better training of doctors, nurses and social workers,
hidden cases of mental disorder are brought to light. There is another factor
that operates in this Province, the advice of Horace Greely has been given
unstintedly to the mentally unwell and we find that many problem cases particularly of the Middle West have been advised to "go to the Coast," and thus
swell the number of our hospital admissions.
Therefore, we find there is not really an increase in the number of cases
in our Province, but rather an increase in the care of the cases already here
and of the cases coming from other parts.
The second phase of the Inquiry had to do with the causes and prevention
of lunacy in the Province generally:—
Heredity is put down as the most important cause, and on study,  the
Commission found that this factor was responsible for a widely varying percentage of cases.    Authorities are quoted in which the percentage from such
a cause varies from 15 to 90 per cent.
Acquired mental disease which usually occurs at middle age and is due
to syphilis, alcoholism, drugs, chronic infections, change of life and other disorders come next.
Then we have the mental disorders that occur with advancing years. These
in many cases can not be prevented although better attention to physical hygiene will often prevent or postpone the disorder.
In many of the heredity cases there is only a tendency to mental disease
and if early signs of breakdown are noted these can be relieved! of care and
responsibility, and they will often come through without any serious disorder.
The establishment of Behaviour Clinics and Child Guidance Clinics is
recommended by the Commission, so that children that show unfortunate tend-
—29— encies may be studied. The causes, which are often in their environment, may
be relieved and thus they may be saved from a breakdown that would have
necessitated institutional care. Prophylaxis or prevention of disease is now
recognized as applicable to mental disorders as it is to physical ones.
The Commission also points out the error in considering a case as hopeless just because it is sent to an institution.
A psychopathic hospital associated with a general hospital was urged,
where cases could be treated without being committed as insane, and treated
according to the most modern idleas.
In discussing prevention, the Commission was in favor of sterilization of
definite cases of mental deficiency and certain cases of mental disease
psychoses.) Dr. Dobson urged that the report of the Commission be read
especially by the nurses, and recommended that the various heads of hospitals
make provision for a short course in mental diseases. He said that a large
majority of cases cared for by any nurse shows mental symptoms at some
stage of their illness, even if the disorder be considered medical or surgical.
The nurse's interest and effectiveness would be increased with a fair knowledge of mental disorders, especially of the border line cases, the neuroses.
The President read a letter which he had received from the Vice-President,
Mr. J. H. McVety, who expressed his regrets at being unable to attend and
wishing the Convention every success.
Similar regrets were received from Mr. George R. Binger of Kelowna,
and on the motion of Mr. McGregor seconded by Mr. Cook and carried, the
Secretary was instructed to write these gentlemen expressing the regrets ol the
Convention for their absence.
The session then adjourned and the delegates assembled on the front steps
of the Empress Hotel for a photograph, following upon which transportation
was provided for the delegates to lunch at the Provincial Royal Jubilee Hospital, at the invitation of the Chairman and Directors of that Institution, where
they were splendidly entertained. An attractive feature was a quartette of pupil
nurses, who rendered two very pleasing selections.
The annual Question Box was opened, resulting in some interesting discussions, and later the delegates made a tour of inspection of the hospital.
Afternoon Session, Friday, September 9th.
Miss Mabel F. Gray, R.N., of the University of British Columbia, took the
chair as convener of the Committee of Nursing Affairs.
Miss A. Cavers, R.N.. read a paper entitled: "What Educational Pre-
Requisites should be Demanded of Applicants for Nurse Training."
In dealing with the subject, which is before us today I wish to make it
perfectly clear, that in the few rambling statements which follow, there is not
one atom of criticism directed against any Institution or Association. If I
make statements.which sound to you as so much ancient history, kindly remember, that being a stranger in your midst, I know not what ground has been
covered.
When I endeavored to convince Dr. Bell of my inability to deal with so
serious a question, he gave me to understand that it was not so much my
acquaintance with Hospitals and Training Schools, as association with educational conditions in other departments that might prove helpful.
There seems to be some difference of opinion as to what educational
pre-requisites should be demanded of applicants for Nurse Training, and this?
—30— no doubt is partly due to the fact that so little is known by the General Public
of the theoretical side of a nurse's -training.
If you mention High School or University, at once there is a mental picture
of a Lecture Room, Professors, Text Books, supervised study, and a parent will
discourse fluently on the benefits to be derived from Latin, French, Science,
or History. Is the term School for Nurses associated with any such picture?
Do a uniform and a Text Book go hand in hand? How many parents of our
pupil nurses are there who can name the subjects taught in our Training
Schools? They realize that a nurse is supposed to provide for her patients
the care and treatments prescribed by the most advanced doctors of the day,
but they believe that this knowledge is obtained very much as a daughter in the
home learns to cook—watching others. Yes, observation does play an important part, but it must be the intelligent observation of an educated mind.
And in a nurse's training, as in every other professional training, it is the
theory which she obtains from text books and lectures which changes her from
a purely mechanical agent to an intelligent worker. You cannot put the theory
one place and the practical another, they are inseparable.
The Training School provides a course of instruction which enables the
nurse to have a more or less thorough knowledge of the fundamental medical
subjects, so that she may intelligently co-operate with the medical profession
in all of the treatments now being prescribed for the prevention and cure of
disease.
The members of the Association of Graduate Nurses having themselves
been pupils, and knowing what the Training School expects of a pupil, compiled their Minimum Standard Curriculum where in Article 7 Clause B. we
find the following—"Applicants possessing matriculation standing are preferred. All applicants must present certificates showing them to have successfully completed two years of High School Work or its equivalent." Now
that sounds perfectly clear, but the world today is full of creeds because we
delight to interpret the Bible to suit ourselves.
Let us dissect the Clause:—
Applicants possessing Matriculation Standing are preferred: That means
ready to enter Normal School or University and requires no further explanation.
Let us proceed. "All applicants must present certificates showing them to
have  successfully completed two years  of High School."
What does two years of High School work mean as set down by the Department of Education of our Province.    Pupils must take 10 subjects:
English Literature and Composition.
Drawing.
History of the World.
Three Mathematical Subjects.
Arithmetic, Algebra, Geometry.
Physical Science
Two Languages, or
One Language and General Science
In the second year the pupils take more advanced work in the same subjects The only change is one concerning pupils who chose one language and
General Science. General Science becoming two specific sciences and they are
again allowed to choose Chemistry, Physics and Botany.
In British Columbia Departmental Examinations for these grades usually
are not held in High Schools, but the principal sets the examinations for his
school and the pupils are promoted providing they make 40 per cent on each
subject and 50 per cent, on the whole. Each pupil receives each year a statement similar to this which is the form used in the schools of Vancouver.  These
—31— marks are on file and can always be obtained from the Principal of the School.
It is not necessary for Directors of Training Schools to accept an indefinite
"1st year passed'' "2nd year passed." or even one of these forms, for towards
the end of June each year the Department of Education conducts examinations
for promotion from Grades IX. and X. to Grades X. and XL These examinations are for pupils attending Superior Schools, or Private School pupils who.
wish to enter High Sahool, but any pupil of any High School in British
Columbia may qualify as a candidate.
Now let us deal with the last phrase of the clause, "or its equivalent."—
This seems to be the stumbling block. Personally I would consider that it
referred to an applicant who received her education outside of British Columbia,
e.g., one of the Prairie Provinces, Eastern Canada, England or the United
States. With regard to evaluation of the educational qualifications of such
applicants, don't you consider it would be best to refer their credentials for
an opinion to an advisory board? When any such difficulty arises re entrance
to Normal School or the granting of certificates to teachers, the Superintendent
of Education or Principals of Schools invariably refer to Mr. J. Watson, Registrar here in Victoria, who never fails to supply the necessary information.
Applicants from the Prairie Provinces can always present certificates
issued by the Department of Education as Provincial Examinations are held
annually.
But there are many who believe equivalents are to be found in our own
Province so let us consider other interpretations:
1.    One year High School and one year Commercial High.
We have already discussed the subjects in 1st year High School. The
1st year Commercial includes:
English Literature. Grammar and Composition.
History, Arithmetic, Bookkeeping and Accounting.
Shorthand and Typewriting.
The number of different subjects making it quite impossible for a pupil of
average ability and with one year High School standing to begin with 2nd Year
Commercial. I questioned a member of the teaching staff of Vancouver Normal
as to recognized standing of such procedure and received this reply: "No
advancement whatsoever. Invariably the girl failed in 1st year High School
and rather than repeat has entered Commercial High where she would be
received as a 1st year pupil." In the 2nd Year Commercial, Civics take
the place of History, and Commercial Law is introduced. Now by comparing
the two programmes we will see which is the more beneficial to us. Both
stress English and Mathematics, w"hich we agree are essential. Of the sub--
jects which remain don't you believe that Latin, Chemistry, Physics or Botany
form a better foundation for the study of Materia Medica than Shorthand,
Typewriting and Civics?
The Normal School of British Columbia will not accept applicants who-
have completed three years of Commercial High as the Course does not include
sufficient academic subjects. Do you think we might raise the same objection?
One applicant understood the word Equivalent to mean One Year High School
(successful omitted) and a Commercial Course. She failed in four subjects in
1st year High. Took a six weeks' Commercial Course at the Sprott-Shaw
School and was quite indignant when her application was not accepted.
To provide the kind of care now prescribed for our patients, necessitates
continual revision and elaboration of the Nurses' Course of Instruction, and,
to cope with this advance, the State of Washington has raised the standard;
of educational pre-requisites  to  four years  of High  School.      Some  of  the
Training Schools of Seattle are affiliated with the University of Washington. Applicants are received twice a year and the first three months are devoted
to Theory with from 12 to 15 hours per week practical ward work. The pupils
take all their lectures at the University and at the end of three months they
must successfully pass tests in Chemistry, Anatomy, Physiology. Nutrition,
Cookery and Public Health Nursing. Usually the probation period is four
months but in the Swedish Hospital, six months. This extra time being considered necessary to enable the Director of the School to ascertain if the
probationer has other necessary qualifications—a general fitness for nursing.
For after all it is one thing to have the theory and another thing to be able to
apply it. It has been said that some of our most brilliant University students
make excellent waiters on a boat.
I hear you say that if we raised our standard and all applicants were
requested to present certificates showing them to have successfully completed
three years of high school work, that we would receive no applications. Why
not?
According to the report of the Superintendent of Education there were
11,779 pupils enrolled in the High Schools of this Province for the year
1925-26. A very conservative estimate would give us 5,600 girls. Surely
there should be enough for our 18 Training Schools with an approximate enrolment of 550.    1:10.
Do you realize that least year 324 young women obtained Teachers' Certificates from our Provincial Normal Schools and as there is a saturated market
about 25 per cent, were unable to practice their profession? Did any of the
overflow come to us?
It behooves us to discover why we are failing to attract these educated
young women. Do we make it understood that Nursing is a Profession
where there is continual educational advancement?
Now with so representative a gathering present, it should be possible
to discuss the question from every angle, and arrive at "a satisfactory understanding so that the regulations of the Graduate Nurses Association regarding
preliminary requirements may be revised and placed on a definite basis.
Have you had a new idea?
Pass it on!
Does it seem to you quite clear?
Pass it on!
It will maybe form another
In the mind of toiling brother;
So to aid each one the other.
Pass it on!
Good nursing service, Florence Nightingale tells us, is the work of the
skilful hand, directed by the cool head, inspired by the loving heart. The hospital is the arena wherein are exercised all the faculties of the hand, the head
and the heart, so that when the triple years of training are over, our nurses
may fully realize the nobility, the grandeur, and especially the responsibility
of their profession.
The vigorous editor of "Hospital Progress," the Reverend E. F. Garesche,
speaks of the service of eminence, which is the steady increase of personal
efficiency in one's calling: "Everything else being equal, one renders far
better service by becoming eminent in one's sphere of work, striving after
superior achievement."
Since repeated acts make the habit, trainers of nurses must so habituate
these young girls to acts of perfection in work as to make this perfection a
second nature.    Time is aH too short even in the thirty-six months devoted to the course in nursing; so every available means must be employed to give, in
this limited period, the best training possible.
To dream of ideal conditions, and to plan ideal courses, without applying
practical principles of action, is simply to grasp at shadows, losing valuable
time. The practical education of the nurse must parallel her theoretical work,
and both must be so blended as to make one intelligent whole.
The title of this paper is as unpretentious as the contents warrant; it is
intended to be just a homely talk, and its raison d'etre is the smaller hospitals.
A summary of a few solutions of our own problems may be helpful, and may
perhaps suggest other and better ideas.
To begin with, it is most essential that regular meetings of supervisors
be held, where difficulties are considered, problems wrestled with, and ameliorations effected. We had noticed for some time that there was in our Hospital
unnecessary overlapping, and at our monthly conference, we planned ways and
means of remedying matters. We first focussed our attention on the Meal
Trays, and there found that while each department made a specialty of serving hot, appetizing meals on attractively arranged trays, yet there were as
many ways of setting these as there were departments.
So, "Standardize the trays; make all service uniform," was the verdict, and
in doing this we found that we had gained both time and efficiency in the
training of our young nurses. Once they had been taught in the first days of
their probation period, they knew henceforth exactly how every meal tray was
to look when prepared.    Nothing in this matter had to be unlearned later.
keener
mornin_
securing of which
in their
Then with keener gaze and observation we noticed that doctor
rounds would often call for special instruments   or    ointments,    the
'   would necessitate many brisk steps.    Hot
steps   and  give  more  satisfaction  to   the  doctors,   prompter
patients, and incidentally,  keep tempers  sweet all round?    Lmj-,.............    ....
dressing trays!"    And immediately fully set trays were prepared for each one
of our seven departments, equipped with the following:
save all1 these
service   to   the
"Standardize  the
Gauze swabs and drains, alchol, polusterine, iodine, peroxide, glass
jar containing tubes of boracic ointment and vaseline, zinc oxide, silver
nitratepencil, six adhesive straps, roll of adhesive plaster, B. F. I.
powder; Instruments on each tray: probe, tissue forceps, artery forceps (3), one lifting forceps, surgical and stitch scissors (sterilized);
The Dressing Set proper contains: (all sterile) one large drape to
cover tray, two dressing towels, four gauze swabs, one dressing and
one iodine dish; as extras we have on the tray: one dish for eusol,
sterile pus basin, and narrow drains.
AH this occupies but little space, is neatly placed according to written
directions, and has proved its merits by giving perfect satisfacton to the
surgeons  using  it.
Other service trays which we have made standard throughout the hospital
are Preparation trays, blood test trays, examination, emergency and hypodermic trays; individual infant trays in maternity section, and especially the
eye-dressing tray which is set up in strict technique according to the directions
as  follows:
Argyrol    10% Cocaine      2 '
Argyrol    20 " Cocaine       4'
Atropine       1" Gauze Swabs
Atropine       2" Eye pads.
Ointments and epthalmic tablets.
—34— S u p p I i e s—Sterile towel, eye pads, cotton wool and gauze swabs, 4
applicators, dressing forceps, scissors, three eye droppers,
flask with boracic solution 5 per cent, sterile dish for solution, kidney basin, flash light, loop head mirror.
These trays are always in readiness, being prepared by a nurse each morning,
*nd copies of the regulations for standard methods in tray service are to be
found in the Service Room in each department, so that as the same nurse
rotates in her work, she meets with uniform system throughout. This makes
for saving of time and patience; it does away with the embarrassment experienced by the nurse when the doctor is delayed; it secures far better service
for patients, and promotes greater efficiency in training.
We found that there was a diversity in our charting wMch could be made
uniform (in so far as uniformity can be obtained in stating symptoms and
treatments) only by preparing and placing before student nurses a "model
chart" for various cases of illness. As is usual in most hospitals, the day's
clinical record is in black, that of the night in red, and each as initialled
by the nurse making the report.
The setting of fractures in the wards took much valuable time, and the
nurse, not knowing exactly what the surgeon would require, was obliged to
make many unnecessary steps, causing delay and sometimes annoyance to the
doctor and prolonged discomfort and pain to patient. After much thought
and consideration, a Splint Cabinet was designed and made by our hospital
carpenter. This, a complete unit, has given satisfaction to all concerned.
Running easily on four small tired wheels, it is conveniently rolled into private
room or ward, thus dispensing with all unnecessary going to and fro. The
cabinet is divided into four parts, the upper being a deep tray for the Thomas
Leg Splints. The lower forms a triple compartment, the central one having
five drawers, where are kept Buck's Extensions, tools, twine, cord, bandages,
adhesive and absorbent cotton. The side section contains weights, and assortments of splints in general use among our surgeons.
To facilitate matters in the wards and in the business office, and to secure
prompt response from the patient when possible, we have prepared printed
dismissal forms. As soon as the doctor has signed the discharge note, which
is always some hours before the patient leaves, the nurse under the direction
of the floor supervisor fills out the required form which carries the following
information: Name, room, doctor, date of entering and of leaving, a summary
of "extras," such as anaesthetic, medicine, dressings, X-ray, special nurses,
etc. Room transfers are also stated, and the slip signed and dated by the
nurse responsible. This is immediately forwarded to the accountant's office,
and an itemized bill is prepared. The nurse, as a matter of routine, conducts
the departing patient to the office where the account is presented, and if
payment is not made at once, at least satisfactory arrangements are decided
upon for future settlement.
These are some of the ideas which have taken practical form in out]
hospital; and much as we have been helped by suggestions offered at previous
conventions and meetings, so we hope in our little measure to contribute to
greater success and efficiency in the work of hospitals in general, and of
the smaller hospitals in particular.
At the conclusion of her paper, Miss Taylor extended an invitation to the
delegates to visit St. Joseph's Hospital, where the standard equipment referred
to would be'demonstrated.
Miss Mabel F. Gray R. N.. reported as delegate to the Conference on
Hospital and Nursing Affairs, held on the occasion of the Annual Meeting of the
Canadian Medical Association, June, 1927.
As it was my privilege to represent the British Columbia Hospitals Association as well as the B. C. Graduate Nurses' Association at the Conference
—35— on Nursing held in Toronto on June 14, 1927, it is now my duty and pleasure
to inform you of the proceedings of the Conference.
A report of the Conference seems naturally to- arrange itself under three
headings:
(1) Events leading up to the Conference.
(2) The Conference itself.
(3) The outcome of the Conference.
While a fuorth division may well be added as:
(4) The--concern of Hospital Associations in nursing problems.
The Conference was held in the Academy of Medicine, and was presided
over by Dr. A. T. Bazin, of Montreal. In his opening address, Dr. Bazin outlined the events which had indirectly led up to the Conference. First Dr.
Bazin indicated his own great interest in nursing and his sympathetic understanding of many nursing problems: the problems of the private duty nurse
arising from unemployment and seasonal employment; the problems of the
nurse in the rural district and many other such problems; and the one
greatest problem perhaps of all—that of finding a way to make skilled nursing care available for all sick people. Then he touched upon problems of
nursing education as they might be considered to affect the care of the
patient and also to become a concern of those interested in hospital administration. Dr. Bazin reported his own request to the Council of the Canadian
Medical Association at the Victoria meeting in June of 1926 for the appointment of a committee to make a study of the curricula of Training Schools for
Nurses in Canadian Hospitals, and to determine how the present curricula
had been evolved and also to determine the authority in matters of nursing
education. Dr. Bazin made it clear (and very rightly it would seem to me)
that nursing education is a concern of the physician, of the public, and of
hospital administrators as well as of the nurse. While Dr. Bazin had been
granted authority to convene a committee of the Medical Association to make
the suggested study; he reported that his resolution, or its object, had apparently been misunderstood and had aroused so much criticism that he had decided
to take no further action. The next step in bringing the subject of nursing
to the attention of those interested was through a Conference on Medical
Services.
In March last (1927), at the Conference on Medical Services held in the
Dominion House of Parliament, Ottawa, through the courtesy of the Minister
of Health, a paper on Nursing and Nursing Service was presented by Dr. G.
Stewart Cameron of Peterborough. This was a wonderful opportunity to
show the importance of nursing services and also their relation to the broader
field of medical services. The nurses were represented by the late Miss F. M.
Shaw, of McGill, as President of the Canadian Nurses' Association, amd by
Miss Jean I. Gunn, of Toronto, both of whom took part in the discussion
of Dr. Cameron's paper. The paper was not a criticism of nursing ideals or
methods; but a presentation of many problems as seen by the physician, which
were elaborated by the nursing representatives present. This Conference had
no executive powers, but as the outcome of the paper it was decided that some
action should be taken to obtain accurate and detailed information on Nursing
in Canada, the Conference therefore recommended to the Canadian Medical
Association the calling together of representatives of the three bodies especially
interested—Medical, Nursing and Hospital Associations—and the Conference
in Toronto in June Hast was the result.
There were present at the Conference the following nurses, representing
jbh"e Canadian Nurses' Association and the Nurses' Associations in the Provinces
named:
—36— Representing:
P. E. Island Miss Jean Browne (replaced by Miss Rayside
at the afternoon meeting).
Ontario   Miss J. I. Gunn
Manitoba Miss E. Russell
Quebec   Miss Hurley
Alberta  _  Miss Auger
New Brunswick   Miss Pringle
British Columbia  Miss M. F. Gray
Saskatchewan    Miss  Sinellie
Nova Scotia Miss E. K. Russell
General Representatives—Miss Hersey, Miss Bennett, Miss Buck.
These nurses represented evrey province in  Canada,  and  every branch
of nursing—Training School, large and small; the Universities, thus the broader
fcfield of purely educational work; and the public health nursing field, concerned
E with preventive educational work, and curative care, i.e., bedside nursing.
The following members of the Canadian Medical Association were in
attendance:
Dr. A. T. Bazin, of Montreal, Chairman of the Conference.
Dr. G. Stewart Cameron, of Peterborough.
Dr. S. E. Moore, Dr. D. Low, Dr. D. W. Johnstone, of Regina, Sask.
Dr. F. W. Marlow. Dr. D Graham, of Toronto.
Dr. Ramsay, of London.
Hospital Associations were represented by Doctors Waugh, Nenoit, St.
Pierre and Masson. These delegates unfortunately arrived too late to take
any active part in the Conference..
In the letter sent out by Dr. Cameron upon behalf of the Canadian Medical.
Association, inviting the attendance of representatives from the Associations
I named, it was indicated that while the meeting was for the "general discussion
of the various nursing problems as they are related to doctors and hospitals,"
yet, it was recognized that in the short time available it would be absolutely
impossible to gain any definite results by discussion; the primary object it was
hoped to gain was the appointment of a Committee to arrange for a study of
all the nursing problems materially relating to the three bodies.
That there might be a definite subject for discussion Dr. Cameron, who
was called upon first by the Chairman to address the meeting, presented the
following resolution:
"That it is the opinion of this conference that the study of the
nursing problem should be conducted by the formation of a joint committee composed of the Canadian Medical Association, Canadian
Nurses' Association and the Provincial Hospital Associations."
This was very freely discussed, the discussion hinging largely around the
term "the nursing problem," indicating that there was not one problem but
many problems—nursing education in its many phases; nursing service in the
cities and in rural communities; the question of unemployment of private duty
nurses in certain districts and at certain seasons hinging on the question of
{ "supply and demand;" and there was also the question of the "authority"
in nursing education—or, as expressed by some delegates—"the relation of
the nurse to the medical profession." It was very clear that little or nothing
could be gained by an attempted discussion of the problems at this meeting—
opinions could be freely expressed, but facts were necessary before any agreement could be expected. There seemed no doubt of the advisability of the
study.    Dr. Cameron's resolution passed. A sub-committee then retired to consider the size and personnel of the
Committee to be recommended, and alteo the scope of the study to be suggested.    The following resolutions were presented and passed:
(1) As to number and personnel of committee:
That the nucleus of this committee to outline and direct the study
should be composed of seven members—three representatives from
Canadian Nurses' Association, three representatives from the Canadian Medical Association, and one member from the Hospital Associations of the province in which the committee will meet, and that
the member from the Hispital Associations should be a layman.
(2) As to the suggested general outline of the stucfiy:
1. Nursing education in all its aspects;
2. Nursing service to the community;
3. Supply and demand of nurses;
4. Relationship  of the  nurse  to  the  medical  profession.
The delegates were unanimous in the opinions:
1. That the Chairman of the Committee should be appointed by the
Canadian Medical Association.
2. That the nucleus of the committee—as arranged for—must
necessarily be selected from a limited section of Canada and must
be within easy reach of the Chairman.
It was made very clear that the functions of the proposed committee were:
(a) To formulate plans for the study.
(b) To prepare a budget necessary for the carrying out of the plans.
The plans must then be submitted to the Canadian Medical and
Canadian Nurses' Association for approval, and should the study be undertaken, it would no doubt then rest with the Committee, probably enlarged
to meet the need.
(c) To direct the.study.
The question of how such a study should be financed was discussed, and
possible outside sources of assistance suggested; apart from any outside aid it
was decided that the expense should be equally borne by the Canadian Medical
and Canadian Nurses' Associations.
It was later learned that the Canadian Medical Association had appointed
Dr. G. Stewart Cameron of Peterborough, Ontario, as Convener of the Committee. The Council of the Canadian Nurses' Association appointed as the
three representatives of the Association: Miss Jean I. Gunn, Miss E. Kathleen Russell, and Miss Jean Browne, all of Ontario; the following resolution
was also passed by the C. N. A.:
"That the Canadian Nurses' Association express to the Canadian
Medical Association the appreciation of the members of the Canadian
Nurses' Association for arranging the conference held June 14th,
and that the Canadian Nurses' Association will very gladly take part
in the proposed study of nursing in conjunction with the- Canadian
Medical Association with the understanding that the study is made
along scientific lines and that the expense of the study apart from any
outside financial assistance is equally shared by the Canadian Nurses'
Association."
And now to present briefly the fourth division under which I stated the
report might be presented, i.e. :"The Concern of the Hospital Association in
Nursing Problems." While the representation from Hospital Associations upon the Committee to formulate plans for the study is small, yet medical, and nursing delegates
both recognized the great importance of such representation, as representing
the public as well as the,Hospital administrators. When one considers the first
two general topics suggested to be covered by the study—nursing education and
nursing service to the community—there is no need to elaborate the topics to
indicate the concern of Hospitals and Hospital Boards of Directors.
As to the time required and the expense entailed in making the suggested
study; no estimate could be made. We know it will take a considerable time
to make any adequate study and that the expense will) be great, and, as indicated, outside aid must be sought from some source. We are now awaiting a
definite report from the Committee. Should the study be decided upon, we
know that sub-committees will have to be appointed here and there all over
Canada; it will only be as we each assist in every way possible that results
will be obtained which will justify the expenditure. I know that we may count
upon the heartiest co-operation of the British Columbia Hospitals Association.
Moved by Dr. Bell, seconded by Mr. McDuffy and carried:
That the Report be received and adopted and that the Secretary keep
in touch with the Study Conference, so that the Executive of this
Association may be informed of its activities.
Moved by Mr. McGregor, seconded by Miss Gray and carried:
That this Convention appoint a Committee on ethical relationships
within the hospitals for report to the Association Executive; the
Executive to circularize this report amongst the Hospitals should
' they see fit; and further, that this resolution be referred to the
Resolutions Committee.
The meeting then adjourned to Government House, where they were received
and entertained by His Honour Lieutenant-Governor Randolph Bruce.
Morning Session, Saturday, September 10th
•A letter was read from Dr. H. C. Wrinch of Hazelton,  expressing his
regrets at being unable to attend the Convention   and   giving   assurances   of
. his support, not only as a member of the Hospitals Association, but in his
capacity as a member of the Legislature.
On behalf of the Resolutions Committee
as follows:
Dr. Gray submitted his report
RESOLVED that recognising that the uniform rate of payment for its
hospital eases at present obtained by the Workmen's Compensation
Board applies inequitably to the service and treatment given by the
hospitals of British Columbia, this Convention endorses any action tending towards securing payment commensurate with the treatment given.
RESOLVED that a Committee on ethical relationships among hospitals
be appointed. This Committee to report to the Association Executive.
The Executive to have the authority to circularise this report amongst
the hospitals at their descretion.
RESOLVED that the matter of State Health Insurance be referred
to the incoming Executive for attention and if necessary favorable
action during the coming year, especially in as far as hospitalisation is
concerned, so that in the event of the principle being adopted, the
public and the Government may have no doubt as to our endorsation.
RESOLVED that a hearty vote of thanks be extended to the following
and that the Secretary be instructed to convey the same:
—39— To His Honor the Lieutenant-Governor of British Columbia and
his niece. Miss Mackenzie, for their reception of the delegates at
Government House.
To the Directors and staff of the Provincial Royal Jubilee Hospital
for their activities contributing to the success of the Convention.
To the Sister Superior and staff of St. Joseph's Hospital for their
hospitality.
To all those who contributed papers and addresses to the programme.—To Dr. F. ('. Bell for his untiring efforts in the preparation   of  the  Programme.
To Dr. C. P. Brown, for his invitation and entertainment of the
delegates at the Quarantine Station at William Head.
To the public Press fo rtheir courtesy in reporting the proceedings
of the Convention.
To the Rotary Club of Victoria for their reception to the delegates
at luncheon.
To Mrs. R P. Butehart for her entertainment of the delegates at
her beautiful gardens.
To' Mrs. Rhodes and the Women's Auxiliary of the Royal Jubilee
Hospital for their assistance in entertaining and providing transportation.
To Messrs. Buttar & Chiene, for the gratuitous audit of the Treasurer's Accounts.
To His Worship Mayor J. C. Pendray, of the City of Victoria, for
his kindly welcome of the delegates to the City of Victoria.
To Mrs. J. H. Fletcher and the ladies of the Rotary Club for providing transportation.
On motion the report of the Resolutions Committee was received and
adopted.
Mr. C. E. Wilson, as Chairman of the Committee on Constitution and Bylaws, discussed the question of the pooling of delegates' travelling expenses.
On the motion of Mr. McCullough, seconded by Mr. Marshall and carried,
it was resolved: That this pooling be effective for one delegate from each
institutional member.
On the motion of Mr. Wilson, seconded by Mr. Marshall and carried, it
was resolved:
That the Constitution and Bylaws of the British  Columbia Hospitals
Association be amended by adding the following as Article 13; namely:
Article 13—Pooling of Delegates' Expenses:—
In the interpretation of this article the words "travelling expenses" are
defined as being moneys actually and necessarily expended in purchasing transportation, sleepers and berths from the place of residence of a delegate to the
Convention and return, but shall not include moneys disbursed for meals, tips,
or other incidentals.
The travelling expenses of one delegate to the Annual Conventions from
each hospital holding an institutional membership in the Association shall be
pooled in the following manner, namely:
—40— (a) All delegates shall register with the Secretary of the Association
before the opening of each Annual Convention, and one delegate from
each hospital shall at the time of registration file with the Treasurer
a statement of his or her travelling expenses (if any) certified as
correct by such delegate.
(b) On or before the closing of the Convention the Treasurer shall ascertain the average cost of the travelling expenses of all pooling delegates, and shall pay to each said delegate the amount that his or her
said travelling expenses exceed the said average cost, and the pooling
delegates whose travelling expenses are less than the said average
cost shall pay to the Treasurer the amount of such deficiency.
(c) The executive committee shall have power to add to, subtract from or
otherwise amend any  statement filed  under sub-article   (a)   hereof.
In a manner similar to that set out in Sub-article (a), (b) and (c) hereof
the travelling expenses of one delegate from each Auxiliary holding a membership in the Association shall be pooled.
An amendment was moved by Mrs. Rhodes, seconded by Mrs. La Pierre
and carried, to delete the clause in the above resolution concerning Women's
Auxiliaries.
The aforesaid resolution as amended was thereupon adopted.
Dr.  F.  C.  Bell gave  notice of motion  to  amend the  Constitution  and
bBy-laws to include a standing committee on Women's Auxiliaries affairs.
On the motion of Mrs. Rhodes, seconded by Dr. Gray and carried it was
^resolved   that   a   temporary   committee   on  Women's   Auxiliaries  Affairs   be
appointed to act for the ensuing year.
Mi'. Birch submitted his report on behalf of the Nominating Committee
and the election of officers resulted as follows:
Honorary  President—Hon.  William  Sloan,  Provincial  Secretary.
President—Mr. George Haddon, Vancouver.
First Vice-President—Mr. J. H.  McVety, Vancouver.
Second Vice-President—Mr. R. A. Bethune, Kamloops.
Treasurer—Miss G. M. Currie, R.N., North Vancouver.
Secretary-—Mr. E. S. Withers, New Westminster.
Executive Committee:
Vancouver Island—Dr. E. M. Pearse, Victoria.
Vancouver—Dr. E. J. Gray, Vancouver.
Coast Mainland—Mr. G. W. Marshall, North Vancouver.
Fraser Valley—Mr. K. L. MeCullough, Abbotsford.
Yale-Cariboo—Mr. M. L. Grimmett, Merritt.
Okanagan—Mrs. Wilmot, Kelowna.
Kootenay West—Miss A. McArthur, R.N., Nelson.
Kootenay East—Mother Nazareth, Cranbrook.
Grand Trunk—Mr. H. W. Birch, Prince Rupert.
Conveners  of Standing Committees and  therefore  members  of the Executive Committee:
Medical Affairs—Dr. F. C. Bell. Vancouver.
Business Affairs—Mr. George McGregor. Victoria.
Nursing Affairs—-Miss Mabel F. Gray, R.N., Vancouver.
Constitution and By-laws—Mr. C. E.  Wilson, Victoria.
Municipal Affairs—Mr. R. R. Burns, Vancouver.
—11— Mayor Busby and Mr. Nichol of Nanaimo spoke of the difficulties in connection with the Nanaimo Hospital.
The Mayor described the present condition of affairs as a disgrace to the-
district, and stated that everything possible had been done to find a way out
of the difficulty. After trying numerous methods to finance the new hospital
building they were about to launch a project which was now being planned
and which they hoped would meet with success.
Mr. Nichol reviewed the sequence of events leading up to the present
situation at some length. He pointed out that the old hospital building was
in such a condition that it should have been condemned although it had done
splendid service for many years. But the hospital work was crippled as far
as room and equipment was concerned, and the board of trustees felt themselves impelled to seek a better building and equipment. The new building--
was planned at a cost of $160,000, of which sum the board had about $50,000
in hand.
With the assurance of Government support in the shape of the customary
grants, and with the promise of help from the industrial section and the
industries of the city themselves, the board went ahead with the building.
Unfortunately in certain quarters the promised support was not forthcoming,
so that the board found itself with a hospital partly finished, with about $100,-
000 of the cost paid, but with $60,000 still required for its completion. This,.
he stated, was the present position of affairs in Nanaimo, a city which was
a centre of one of the most hazardous occupations, that of mining, and without
adequate hospital service to care for the injured in cases of accident or for the
sick.
Mr. McGregor expressed sympathy at the difficult situation which had
presented itself in Nanaimo and Dr. Bell referred to the difficult situation
as it affected the staff of the Nanaimo Hospital.
On the motion of Dr. Gray, seconded by Mr. Glen and carried!, it was
resolved:
That this Convention go on record as expressing their sympathy with,
the Nanaimo Hospital Board of Trustees and wish them success in
their efforts for re-opening the Hospital.
Mr. Wilson opened a discussion in connection with the day treatment
rendered in the hospitals and the method of reporting the same to the Government for the purpose of per capita grant. Some interesting sidelights were
thrown on this question, showing a lack of uniformity amongst the hospitals.
and the matter was referred to the Committee headed by Mr. Carr Hilton.,
previously appointed at the Session on Business Affairs.
RESOLVED: That the time and place of the next Convention be referred
to the incoming Executive.
On adjournment, the delegates were entertained at luncheon by the Sister
Superior and staff of St. Joseph's Hospital in the ball room at the Empress
Hotel, where an address on the subject of Hospitals and Social Service was delivered by the Rev. Father Evans of Victoria. After which the delegates were
transported to the home of Mr. and Mrs. Butchart, where they were shown
through the beautiful gardens and tea was served to the delegates, Mrs. Butchart receiving.
The 1927 Convention then concluded.
-42- Constitution and Bylaws
Article I—Name.
The name of this Association shall be "The British Columbia Hospitals'
Association."
Article 2—Purpose.
(a) To serve as a means of intercommunication and co-operation for
the hospitals of this Province.
(b) To increase the efficiency of all hospitals in the Province by establishing and maintaining the best possible standards of hospital
service.
(c) To stimulate and to guide intensive and extensive hospital development.
(d) To develop on the part of hospitals a sense of responsibility to
the community with respect to education in health matters with
special emphasis on the training of nurses.
(e) To keep the people of this province informed concerning hospital
problems and to serve as a means of communication between
hospitals and those in authority in provincial and municipal affairs.
(f) To frame from time to time suggestions for additions to, or changes
in legislation affecting hospitals.
Article 3—Membership.
Members shall be all persons connected directly or indirectly with hospitals
paying the membership fees hereinafter mentiond, and such members shall be
classified as follows:
(a) Honorary
(b) Individual
(c) Institutional
(d) Auxiliary
Honorary members shall be those persons who are held by the Association
to have rendered conspicuous service in the hospital field.
Institutional membership may be held by any hospital, public or private,
carrying on work within the province. Institutional membership shall include
all members of Trustee Boards or Boards of Directors and all persons holding
executive positions in hospitals having membership in the Association.
Individual membership shall be all persons connected directly or indirectly
with hospital work who are not members of Trustee Boards or Boards of
Directors, or who do not hold executive positions in hospitals.
Auxiliary Membership.—The senior Auxiliary or Women's Organization
duly recognized as such by the Board of Directors of the Institution it serves
may be admitted to corporate membership, provided the hospital with which
it is associated is a member of the B. C. Hospitals' Association.
—43— Article 4—Officers.
The officers of the Association shall be:
Honorary President
President
First Vice-President
Second Vice-President
Secretary.
Treasurer.
The executive Committee shall be composed of twenty members, as
follows:
(a)      The  Officers  of  the  Association
fb)      The representatives of the Districts hereinafter mentioned
(c)      The  Conveners  of  the  Standing  Committees.
The following districts must be represented on the Executive Committee,
viz.. Vancouver Island, Vancouver, Coast Mainland, Fraser Valley, Yale-
Cariboo, Okaifagan, Kootenay East, Kootenay West, Grand Trunk Pacific.
Article 5—Fees
Membership fees shall be due and payable on the first day of July in
each year, as follows:
Honorary Members (no fee).
Institutional Membership shall be payable according to the following scale:
(a) Hospitals of ten beds or under, per annum $ 5.00
(b) Hospitals of eleven to twenty beds, per annum  10.00
(c) Hospitals of twenty-one to fifty beds,, per annum  15.00-
(d) Hospitals of fifty-one to one hundred beds, per annum  20.00
(e) Hospitals of one hundred and one beds and over, per annum.. 25.00
Individual members shall pay  a fee of five dollars per annum.
Auxiliary membership fees shall be one-half of that paid by the Institution '
with which it is associated.
Article 6—Election of Officers
Election of Officers shall take place at the Annual Meeting each year,
and shall be by ballot. All officers shall be elected for a term of one year.
Institutional members only shall be eligible for office.
A Committee on Nominations consisting of three members shall be
appointed annually. Two of these members shall be designated by the Executive Committee, and the third, who shall act as convener, shall be appointed
by the President. No member of the Executive committee shall be eligible
to serve upon the Nominating Committee. It shall be the duty of the Nominating Committee to request and to receive from the members of the
Association the names of persons suitable to hold office in the Association.
Two weeks prior to the Annual Meeting the Committee shall prepare a list
of all persons so nominated for the information of the members attending the
Annual Meeting. Nominations shall be permitted from the floor at the Annual;;
Meeting.
Article 7—Committees, Executive and Standing
(a) The Executive Committee shall transact the business of the Association during the year and shall report to the Association   at  the   Annual;
—14— Meeting, or to Special Meetings when necessary. It shall act in the capacity
of a Membership Committee and shall pass upon all applications for membership in the Association. The Executive Committee shall also act as a Legislative Committee for the purpose of considering legislation affecting hospitals.
(b) Medical Affairs.    The Standing Commttee on Medical Affairs shall
consist of five members, the Convener of which shall be elected by the Asso-'
ciation at the Annual Meeting.    Its duties shall be to investigate and report
upon all matters relating to medical service in hospitals.
(c) Nursing Affairs. The Standing Committee on Nursing Affairs shall
consist of five members, the Convener of which shall be elected by the Association at -its Annual Meeting. Its duties shall be to investigate and report
upon all matters relating to nursing in hospitals.
(d) Business Affairs and Accounting. The Standing Committee on
Business Affairs and Accounting shall consist of five mefmbers, the Convener
of which shall be elected by the Association at the Annual Meeting. Its duties
shall be to investigate and report upon all matters relating to business administration and accounting in hospitals.
(e) Constitution and By-Laws. The Standing Committee on Constitution and Bylaws shall consist of five members, the Convener of which shall
be elected by the Association at its annual meeting. .Its duties shall be to
receive, consider and report upon all proposed amendments of, additions to,
and deletions from the Constitution and Bylaws of the Association.
(f) The remaining members of the Standing Committees shall be appointed
by the Executive Committee at the meeting immediately following the Annual
Meeting.
Article 8—Meetings: Time and Place
The time and place at which the Annual Meeting and Cofavention shall
be held may be decided at the regular meeting of the year preceding or may be
left in the hands of the Executive Committee with full power to act. Special
Meetings may be called from time to time by resolution of the Executive Committee. Fourteen days notice in advance of the holding of said meetings shall
be sent to each member of the Association.
The Executive Committee shall meet at least once a year. It shall meet
when called upon to do so by the president of the Association or at the
request of any five members of the Association.
Article 9—Quorum
Ten per cent, of the institutional membership shall constitute a quorum of
the Association at its Annual Meeting or at a special meeting. Five members
shall constitute a quorum of the Executive Committee.
Article 10—Amendments to Constitution and By-Laws.
The Constitution and Bylaws may be amended at any regular meeting of
the Association by a two-thirds vote of members present, providing that
notice of motion has been given prior to the meeting to the Committee on
Constitution and Bylaws.
Article 11—Resolutions
No resolution affecting the general policy of hospitals holding mem
bership in this Association shall be presented at any regular or special meeting of this Association unless the same shall have first been presented
to the Executive Committee in writing. No action affecting the general policy
of said hospitals shall be taken until the question has been referred to all
—45— institutional members, unless the question at issue shall have been unanimously
agreed upon by the delegates present at said meeting.
Article  12—Voting.
In any matter of business or policy requiring action by vote of the Association, voting of institutional.members shall be in proportion of one vote for
each five dollars ($5.00) of membership fee: thus an institution paying five
dollars in membership- fee shall be entitled to one vote, and so forth. One
delegate shall be entitled to record the entire vote of the hospital represented
by such delegate.
The combined delegation of any institution or auxiliary body shall agree
among themselves as to how that institution or auxiliary body shall vote. No
institutional or auxiliary vote shall be divided on any question. If time for
deliberation is required by a delegation of an institution or an auxiliary body
before casting a vote, the chair shall postpone the taking of a vote for a
reasonable time. After postponement for such a purpose there shall be no
further discussion of the question before taking a vote upon it.
Honorary members are not entitled to vote.
Individual members shall not be entitled to vote at the Annual Meeting or
at any subsequent meeting of the Association unless the membership fee shall
have been paid at least thirty (30) days prior to the holding of the Annual
Meeting.
Auxiliary bodies are entitled to half the number of votes cast by the institution with which it is associated.
Votes by proxy will not be allowed. .
Article 13—Pooling of Delegates' Expenses.
In the interpretation of this article the words "travelling expenses" are
defined as being moneys actually and necessarily expended in purchasing transportation, sleepers and berths from the place of residence of a delegate to the
Convention and return, but shall not include moneys disbursed for meals, tips,
or other incidentals.
The travelling expenses of one delegate to the Annual Conventions from
each hospital holding an institutional membership in the Association shall be
pooled in the following manner, namely:
(a) All delegates shall register with the Secretary of the Association before the opening of each Annual Convention, and one delegate from
each hospital shall at the time of registration file with the Treasurer
a statement of his or her travelling expenses (if any) certified as
correct by such delegate.
(b) On or before the closing of the Convention the Treasurer shall ascertain the average cost of the travelling expenses of all pooling delegates, and shall pay to each said delegate the amount that his or her
said travelling expenses exceed the said average cost, and the pooling
delegates whose travelling expenses are less than the said average
cost shall pay to the Treasurer the amount of such deficiency.
(c) The Executive Committee shall have power to add to, subtract from
or otherwise amend any statement filed under Sub-article (a) hereof.
—46-  <0
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P-( 02 Cfi       &}&*** l*~ '*-'**■ ^ *^ '** ?£»•**
23 r-
£
\   \   \   \y~j. ROYAL CITY BRAND
CANNED FRUITS and
VEGETABLES
JAMS
PURE AND WHOLESOM
Xatural Goodness Retained
Broder Canning Co., Ltd.
New Westminster, B. C.
Mackay Smith, Blair <S£ Co.
LIMITED
Wholesale Dry Goods
VANCOUVER, B. C.
SPECIALIZING IN HOSPITAL SUPPLIES
BEDDING—Blankets and Spreads, Sheets and Sheeting,
Pillows and Pillow Slips
Towels and Toweling, Linens
Patients' Gowns, Doctors' Gowns, O. R. Supplies
QUOTATIONS ON APPLICATION    University of British Columbia Library
DUE DATE
MAR8~ Ml
MAR 22 1971
MAR 2 4 REC'D
MAY 14 P.M.
N R      ycgasfX
rt-u 6' 1 4 1981
APR i 5 Wl 5
p.
MAR 1 6 1964
MAR 3 0198*
*Wt>$ifi'Wt
,&;i\ 11BM
FORM 310
-^  

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