273
PUBLIC RECORD OFFICE
Reference :-
C.O. 885
COPYRIGHT PHOTOGRAPH-NOT TO
RE
CED PHOTOGRAPHIC-
T PERMISSION OF THE
RD OFFICE, LONDON
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In view of the above conditions I do not think. any amendment in the existing system necessary. As I hope to return shortly to Jamaica as superintending medical officer, I shall use every effort to stimulate and strengthen the system now in operation with the assistance and approval of the Government.
20th January 1896.
SIR,
Enclosure 5 in No. 6.
CHARLES B. MOSSE, S.M.O.
Royal Colonial Institute, Northumberland Avenue, London, W.C.,
January 18, 1896.
In compliance with the request conveyed at a meeting held under your presidency at the Colonial Office on the 15th instant, for the purpose of considering and developing a scheme for the introduction of a system of trained nursing available in cases of sickness for the official as well as non-official residents of the various Colonies of Her Majesty's Government, we the undersigned beg to lay before you the following facts, suggestions, and recommendations as they occur to us in connection with such a proposal.
2. In the early days of the Straits Settlements, to which Colony our experience is mainly confined, hospital nursing was conducted solely by male attendants, a practice which, although at the time general throughout India, was open to many objections, and had with the expansion of the hospitals and their requirements, a few years ago to be abandoned as impracticable.
3. This system was then replaced by the employment of a staff of female nurses, supplied by the Roman Catholic convent in Singapore, and its branches in Penang and Malacca.
4. These nurses are not, however, properly qualified, but are trained in the hospital, and do no nursing work outside it. They have quarters provided for them by Govern- They are of mixed ment in the hospital precincts, and are therefore resident. nationalities, can all speak English and French, and some of them Spanish, and other languages as well, in addition to the Malay vernacular, an immense advantage in hospitals which receive patients from almost every part of the world.
They are comparatively inexpensive, cost nothing in passage, and when one falls sick, or is otherwise incapacitated, her place is immediately filled by a fresh one.
Any delicate operations on male subjects are performed by the apothecary and dresser staff, of which there is an adequate equipment. So that the difficulties said to have been experienced in Hong Kong, when a like experiment was made there, have not existed here. They are strictly forbidden in any way to proselytise, nor do we know of a single case in which the stipulation not to do so has been broken.
5. Such is, briefly, the method of nursing as it at present exists in the Straits hospitals, and, without deeming it perfect, we believe it to be, on the whole, very satisfactory, and to have answered its purpose well.
6. Outside the hospital, with the exception of one or two qualified midwives from Madras, who, when not otherwise engaged, undertake cases of general sickness, there is practically no nursing available for members of the general community, who, therefore, have either to be dependent on their friends in the emergency, or to be admitted to the private wards of the general hospital for treatment, which in the more serious cases is now generally what happens.
7. There can be no doubt, however, in our minds, as to the vast amount of good capable of being effected by a competent system of trained nursing for the residents in all Colonies, and we think that at least a trial should be made somewhat on the following lines.
8. That a lady superintendent and, say, one fully trained nurse, from some good home hospital, should be sent out to start and organise the scheme.
9. These, we propose, should be placed under the control of a committee of resident ladies of influence (of which the head should be, where possible, the wife of his Excellency the Governor) who would frame rules, and arrange details as to the general working of the establishment, charges for nursing, &c., &c.
10. That the Government should itself undertake the initial expense, but that the Committee should meantime appeal to the public, in whose interest and for whose welfare the scheme is projected, for subscriptions to aid them in its development and extension, and to which we think there would be a ready response.
13
Later on, and as the services of the nurses become more and more in demand, it is anticipated that the scheme will be in a great measure self-supporting.
11. We further suggest that these nurses should be attached to, say, the pauper hospital for the purpose of training on the spot women of different nationalities for nursing the sick of their own race, and we think that in the Eurasian community there will be found many members who will gladly lend themselves to a service of this nature, and who would probably be found, in the end, to make excellent nurses for general purposes.
12. Our reason for thus limiting the number of nurses from home to two, is that we believe there to be ample material available in the Colony itself, which it would only be fair in its interest to utilise.
13. We recommend that the salary to be paid to the European nurses should be as follows:-
Lady Superintendent Nurse.
For each. Diet when not employed
"
Light and service
ས
Salary.
$70 per month.
$50
"
$20 $12.50
19
14. We would particularly draw attention to the necessity of securing as lady super- intendent one who should be a woman of marked intelligence, energy, and tact, physically strong, not less than 35 years old, and with, if possible, few home ties. The need of this will be apparent when it is considered that on her will depend in a very large measure the success of the whole scheme.
15. In conclusion, we would remark that in framing this report we have of course had Singapore more particularly in our minds, but what applies to it may be made also to apply in varying ratio, according to the individual wants of each, to the sister settlements of Penang and Malacca, and might be also extended to the Native States.
6907.
We have, &c.
J. IRVINE ROWell, M.D., C.M.G.,
late P.C.M.O., Straits Settlements. WILLIAM HOAD, M.B., C.M.,
Colonial Surgeon, Resident, Singapore.
No. 7.
MRS. F. T. PIGGOTT to COLONIAL OFFICE. (Received March 31, 1896.)
the
87, Cadogan Gardens, S. W., March 30, 1896.
drawn
with
DEAR MR. Wingfield,
WITH this letter I am sending you papers
up great care, by the Committee of the Colonial Nursing Association. They include, with the general scheme for proposal to the Crown Colonies, the suggested rules for use of local committees, and a copy of the nurses' agreement. The list of vice-presidents is not yet completed but a full one shall be sent to the Colonial Office as soon as it is ready.
Lord Loch has kindly consented to act as president of the home association. The committee trust that the proposals will meet the approval of the Secretary of State for the Colonies, and that he will be able to give the scheme his practical support by agreeing to present it officially to the Crown Colonies. Any suggestions or alterations he may desire to make will immediately receive every attention from the committee. I should like to add that the scheme has started work in a most promising manner in Mauritius to which place a nurse was forwarded last week, the local fund raised by an influential committee covering not only the cost of maintenance and salary but going some way towards recouping the passage money now paid by the home association.
Trusting you will kindly lay the matter before the Secretary of State for the Colonies at a convenient opportunity.
Believe me, &c.
MABEL N. PIGGOTT.
I
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274
PUBLIC RECORD OFFICE
Reference :-
C.O. 885
CORD OFFICE, LONDON
COPYRIGHT PHOTOGRAPH—NOT TO
DUT PERMISSION OF THE
DUCED PHOTOGRAPHIC-
14
Enclosure in No. 7.
The COLONIAL NURSING ASSOCIATION for providing TRAINED_PRIVATE NURSES in the CROWN COLONIES and small ENGLISH COMMUNITIES 1 FOREIGN COUNTRIES,
President.
LORD LOCH.
Vice-Presidents.
The VISCOUNTESS KNUTSFORD.
GENERAL ROBINSON.
SIR HENRY NORMAN.
SIR HUBERT JERNINGHAM.
Committee of Management.
LADY MUSGRAVE.
MRS. CHARLES ROBINSON. MRS. CHARLES HOBHOUSE. MRS. F. T. PIGGOTT. MISS ROSALIND PAGET.
Bankers.
MESSES. GOSLING & SHARP.
Hon. Treasurer.
Hon. Secretary.
MRS. F. T. PIGGOTT.
THE COLONIAL NURSING ASSOCIATION.
The above Association has been formed with a view to meeting the great need for skilled private nursing experienced in many of the Crown Colonies, and in some British communities in foreign parts. This need has been strongly represented by medical officers abroad, who in many places attribute the high per-centage of deaths to the impossibility of obtaining trained nurses.
Individual and isolated efforts have been made to remedy this state of things, but in most cases without permanent success.
In many places such hospitals as exist are inadequate, unsuitable, or for various reasons not available, while skilled private nursing cannot be obtained, principally for the following reasons :—
1. The shifting character of some of the communities themselves, and their consequent inability to absolutely guarantee the cost of maintenance of the nurse whilst in the Colony, and her passage out and home, and also to meet the exceptional expenses which often arise, such as those entailed by necessary but unexpected It cannot be expected that change of nurses, owing to failure of health, &c. the best class of nurse will leave her own country to go abroad without some definite guarantee securing her position and salary.
2. The difficulty of a distant Colony or community securing from England, without any central organisation in England, qualified nurses, suited to its particular needs.
The object which the Colonial Nursing Association bas in view is to meet these difficulties:-
(a.) By raising a fund from subscriptions and donations at home.
(6.) By providing qualified nurses through the home organisation, which is in connexion
with nursing associations and interests in England.
15
(c.) By guaranteeing from its funds to those nurses sent abroad their salary and
passage money to and from the Colony.
(d.) By assisting financially those Colonies and communities which, though greatly in need of a nurse, can show that they are unable themselves to bear the full expenses of her maintenance and travelling expenses from and back to England.
(e.) By assisting to meet, as far as the funds of the association will permit, exceptional expenses, such as those entailed by the death or illness of a nurse before her full term of engagement has expired.
It should be understood that the Home Association is not intended to supersede the efforts of the Colonies and communities themselves to provide for all expenses incident to the supply of nurses, but to supplement them in case of real need.
Therefore any Colony or community abroad applying to the Colonial Nursing Asso- ciation for a trained private nurse will be expected to organise at once a representative local committee, who will endeavour to raise such a fund as may together with the nurse's fees provide for her maintenance during her term of engagement, and for her travelling expenses out from England and home.
"
By the word "maintenance is meant suitable board and lodging, and a yearly salary of 60l. (sixty pounds) sterling.
No nurse will be engaged for less than two, or more than three, years.
Each nurse engaged undertakes to refund to the Colonial Nursing Association her passage money out should she for reasons unapproved by the local committee break her engagement, or should the local committee find it necessary to terminate her engagement owing to serious misconduct on her part; and she will be required to find two persons who will guarantee such repayment.
The local committees in the Colonies or communities abroad will in all cases determine and receive the fees for nursing, and will also make the necessary arrangements connected with the nurse's reception and work, and undertake her entire charge during the term of her service abroad. They will send home an annual report to the Secretary of the Colonial Nursing Association, giving a statement of the receipts and expenditure and a general account of the nurse's work and efficiency.
Accounts will in the case of each nurse be balanced and settled as between the local committees and the Colonial Nursing Association on the termination of her engagement in the Colony.
Should there then remain a balance to the credit of the local committee, they will expend it as they may think best in advancing local nursing organisation and interests.
The Colonial Nursing Association will arrange for the nurse's travelling expenses out, taking her passage, &c., on as favourable terms as may be obtainable.
In the event of any dispute or disagreement arising between the Colonial Nursing Association and a local committee, such dispute or disagreement shall be referred to the President of the Colonial Nursing Association, whose decision shall be final.
Nurse's Agreement.
AGREEMENT made this day of
ASSOCIATION of the one part and part.
1. The undersigned
189, between the COLONIAL NURSING of the other
is engaged by the Colonial Nursing Association upon the terms and conditions mentioned on the second page of this paper.
years
2. The undersigned
agrees to work as private nurse in the Colony of wherever the local committee may require her services for from the date of her arrival in the Colony, and to abide by the said terms and conditions and to obey the rules of the local committee in the Colony to which she is sent.
C 3
Nurse.
Hon. Secretary,
C.N.A.