271
PUBLIC RECORD OFFICE
6
Reference :-
THELLC.O. 885
ست.
COPYRIGHT PHOTOGRAPH-NOT TO
REP
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DOFFICE, LONDON
PERMISSION OF THE
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W ecan also, if wished, enter into the means of forming amongst natives themselves a useful class for nursing their own people, and for performing intelligently, instead of ignorantly, the office of midwife.
SIR,
We are, &c.
CHAS. GAGE BROWN, CHAS. B. MOSSE, D.S.G.,
Senior Medical Officer.
PH. B. C. AYRES, C.M.G.,
Colonial Surgeon and Inspector of
Hospitals, Hong Kong.
G. SNELL, M.D.,
Medical
Superintendent Public Lunatic Asylum, British Guiana. ANDREW DAVIDSON, M.D.,
F.R.C.P.Edin.
T. IRVINE ROWELL, C.M.G., M.D., late P.C.M.O.,
Settlements.
WILLIAM HOAD, M.B., C.M.,
Colonial Surgeon, Singapore.
Enclosure 1 in No. 6.
Straits
60, Gordon Road, Ealing, W., January 16, 1896.
In compliance with your request to consider what steps should be taken by the Governments of some of the tropical countries to assist European residents, both official and unofficial, in obtaining efficient nurses in case of serious illness, I beg to state that about two or three years ago Canon José started a Nurses Home in Demerara, with three or four nurses obtained from England for the use of Europeans in the Colony, but owing, I believe, to want of sufficient support the undertaking had to be abandoned.
In the various Government institutions in British Guiana there are no trained European nurses, the nurses being, for the most part, natives of the place, and trained by
the niedical officers.
I am of opinion that if a permanent home could be established with an efficient lady superintendent, under the organization of a strong committee of the most prominent citizens in the Colony, who would undertake to find them employment at moderate cost, that such a scheme would be quite feasible. But unless something of this kind were done I fear that such an undertaking would hardly be practicable.
Dr. Gage Brown, C.M.G.,
SIR,
88, Sloane Street, Sloane Square, S.W.
Enclosure 2 in No. 6.
I have, &c.
G. SNELL.
15, Grosvenor Road, Westminster, S. W., January 18, 1896.
In compliance with your request I forward the following report concerning the nursing staff in Hong Kong.
When I was appointed in 1873 to my present post as Colonial Surgeon the nursing staff of Government Civil Hospital consisted of two European wardmasters and a nursing staff of coolies trained in the Hospital, and one female Nurse Ameh (Chinese) also trained in the Hospital.
The nurses used by private practitioners were then all nursing Amahs trained more or less by themselves...
About 1889, I am not quite certain of the exact date, the large increase in the size of the Government Civil Hospital, and the increasing demand for accommodation, also the troubles caused by the existing nursing staff, rendered the existing state of things impossible to continue longer.
On the score of economy, a staff of nurses, nine in number, under a lady superior, was obtained from the French Sisters of Marie in connexion with the French Convent.
9
The Sisters were found to be only supervisors. They objected to taking notes of any directions given by the medical staff, and these directions were passed verbally from one nurse to another on being relieved; this led to misunderstandings, directions got mutilated, and some forgotten, to the great detriment of patients. They also declined to take notes of temperatures; they would not administer enemas or vaginal injections. They would not be present when there was any exposure of the person, even accidentally when a patient was delirious and threw off the clothes, or when it was absolutely necessary either in male or female cases. I therefore had to represent to Government that we were put to much extra expense with very little gained, as we had to retain most of the Chinese staff, and that the nursing was a failure.
In 1890 a staff of trained ladies, Nursing Sisters, who had been educated in the London hospitals, were obtained, five in number, under a matron; this staff has now been increased to nine, and they have given the greatest satisfaction in every way, so that the Government in this Colony is as well served as it could possibly be. The terms of the engagements of these ladies are that they are not to be employed outside the hospital; indeed none can be spared, for they are overworked if more than one is on the sick-list at one time, and we are rather in difficulties now that their home-leave is becoming due.
The public generally and private practitioners have to depend on the nursing Amalis, as before mentioned, and some Europeans that have originally come out as nurses in charge of children of European families and have gradually received some sort of training, but not such as would be recognised by any nursing Institute at home.
One firm of private practitioners have established a private hospital for patients of a superior class, and they have had one or two nurses educated at home and brought out at their own expense to attend at their hospital.
I know that there has often been great trouble in getting nurses for the use of the public, and great complaints in consequence, and I think if Government could see its way to guaranteeing properly qualified nurses it would be a great gain to the Colony, and I think they could nearly always find employment, but I certainly would not recom- mend that they should be sent out without a Government guarantee.
In which case they might be under the present matrons, and should be obtained from the London Hospital; when not required for outside work they could be employed at the hospital for the relief of others on our own staff.
As I said at our meeting, from my own experience, I think each Colony should obtain all their nurses from one source, I mean, whatever school or institute is chosen from among the training schools at home for a particular Colony they should, in that Colony, continue to obtain them from the same source. Our experience is, that obtained from different schools, there are disagreements and unpleasantnesses among themselves, and the matron and medical staff have trouble, but obtained from the same source in all cases there is an esprit de corps among them that is wanting in the case mentioned. I give my experience as none present at the meeting of colonial surgeons seem to have had any experience in the Colonies they came from of a trained English nursing staff.
In what I have stated as regards my experience of French nursing sisters, the surgeons present who had the same experience agreed very much with me both in private conversations and at the meeting.
I think it would be best for the Government of Hong Kong to be communicated with, and that it should inquire from the private practitioners in the Colony as to their needs But it in this respect, and ascertain the number that employment could be found for. should be distinctly understood that these nurses guaranteed by Government are not for the use of private hospitals or chronic cases, but are only for temporary cases or until the requisite nurses could be obtained for such cases.
Under that arrangement, or something similar, I think it would be an advantage to Government as in event of any serious trouble, such as the late plague epidemic, they could retain the services of some or all of the nurses they guaranteed.
From my experience I cannot speak too highly of the services of the ladies of our nursing staff, and I think it would be the greatest gain and the cheapest in the end if all Government hospitals in the Colonies were similarly supplied, subject to the conditions Į have stated.
C. Gage Browne, Esq., C.M.G., M.D.
O 91826.
B
I am, &c.
PH. B. C. AYRES, C.M.G.,
Colonial Surgeon and Inspector of Hospitals, Hong Kong.