c' \ Ò"( '(" \<. t 'I 0. 0 ì6 .... \ '/). tl ,e. V. -- O{) - --- MIS MT'1 MùRRIS 2 O NELSON Sf APT 812 JTTAwA 2 O f 00C05784 L ..-........ ,"- - - - """-- ,.- . . /II / 1 10 I. 'I 9 } 8 7 January 1970 ,; . 1; The Can ad ian Nurse JJ J 1 \ ,- / \ r , : I tl , \ i ' , 1.1-1"....... , \ , 1 '/- (J \ . .....---., - 'I t r-. I -, 'I ,I. , " / t , '- /t' ' -r \ ..'1. , '''' Happy New Year! " / new in psychiatry: Moditen injectable therapy i' '- " " -;1, , " '\ \ , , __ N/"" 7/0 .\ nurse to the performing arts , I l J " .... / M .--/ ( ------ . , ß. & _ We want a nurse who can handle two jobs: one who can nurse the men of the Canadian Armed Forces and who can accept the responsibilities of being a com missioned officer. It's interest.. ing work. You could travel to bases all across Canada and be employed in one of several different hospitals. It's challenging.You'll never find yourself in a dull routine. And, in addition, you have the extra pres tige of being made a commis e want sioncdofficcrwhenyoujoinus. If the idea intrigues you, you're probably the kind of special person we're looking for. We'd like to have you with us. Write:The Director of Recruiting, Canadian Forces Headquarters, Ottawa 4, Ontario. a special kind of nurse. .-1 .:j:". J i,'Î. i , )o'io -. '" ,..,. AIÕ.., o? t. . . ... THE CANADIAN ARMED FORCES if the thought of all those heavy IV bottles depresses you, , ,., , .. , " , ...... . ...' ... -- I t) \ 4- ....... , , ! . - \ \ .. j U ' , L . ,(\ l 'J --- V1AFLEX WILL GIVE YOU A BIG LIFT I.V. solutions in glass bottles are heavy enough to begin with-but the longer the procedure, and the more bottles you use, the heavier they seem to get. It's hard to make light of a heavy subject like this, but we did-with VIAFLEX' plastic solution packs. They're much lighter and easier to handle than glass bottles. And, since there are no metal closures or caps to fumble with, set-ups and changeovers are faster. The whole procedure is safer, too. Because VIAFLEX is a completely closed system. No vent; no room air enters the container; no airborne contaminants get inside the system. Empty bags go mto the wastebasket. VIAFLEX is the first and only plastic container for I.V. solutions. For safer, easier, faster procedures, it's the first and only one you should consider. fiV OL R 2 !c'TORJES OF CANADA 6405 Northam Drive. Malton. Ontario Viafle" -n w. Trade Merle . Ready for Second New Edition! Semester . . . NUl{SING O\1ill .. .\0 _ /" \ :\ '-<< "'\ .. - .. þ..-....... "'\ , .. 1'\ " " ... ,þ. .. - \ t iPPincott PHILADELPHIA T . ORONTO NURSING (form CARE OF CH By FI.'encee I ,E:sen!iaIS of Pedia! .ILOREN . a e, R.N. M A rlC Nursin ) and Euge ia.' F. Howell Wright 9 586 Pages 18 8 H. Waechter R N ' M.D., Illustrations 8 . ., Ph.D. J th Edition anuary, 1970 $10.00 The Canadian Nurse ð A monthly journal for the nurses of Canada published in English and French editions by the Canadian Nurses' Association Volume 66, Number 1 January 1970 21 New in Psychiatry: Moditen Injectable Therapy and Follow-Up Care A. Symington 25 Nurse to the Performing Arts C. Kotlarsk) 28 Public Health Nurses Work With Family Physicians D.A. Hutchison. D.M. Mumby 32 The Independent Study Tour E.M. Horn 34 Idea Exchange 36 One Little Boy With Two Big Problems D. Chapman 39 No Time For Fear E. Follett The views expressed in the various articles are the viev. of the authors and do not necessarily represent the policit:s or views of the Canadian Nurses' Association. 5 News 18 In a Capsule 12 Names 41 Research Abstracts 15 Dates 42 Books 16 New Products 44 Accession List Execulive Director: Helen ... \lu"allem . Editor: Virginia .\. Lindabun . Assistant Editor: Eleanor B. Mitchell - E'ditorial Assist- ant: Carol A. Kodarsk\ - Circulation Man- ager: Be')l Darling - Advenising Manager: Ruth H. Baumel - Subscription Rates: Can- ada: One Year, $4.50; two years, $8.00. Foreign: One Year, $5.00; two years, $9.00. Single copies: 50 cents each. Make cheques or money orders payable to the Canadian Nurses' Association. - Change of Address: Six weeks' notice; the old address a, well as the new are necessary, together with regis- tration number in a provincial nurses' asso- ciation, where applicable. Not responsible for journals lost in mail due to errors in address. e Canadian Nurses' Association 1970. \lanuscript Information: 'The Canadian Nurse" welcomes unsolicited anicles. All manuscripts should be typed, double-spaced. on one side of unruled paper leaving wide margins. Manuscripts are accepted for review for exclusive publication. The editor reserves the rieht to make the usual editorial chanees. Photògraphs (glossy prints) and graphs nd diagrams (drawn in india ink on white paper) are welcomed with such anicles. The editor is not committed to publish all anicles sent, nor to indicate definite dates of publication. Postage paid in cash at third class rate MONTREAL, P.Q. Permit No. 10,001. 50 The Driveway, Ottawa 4, Ontario. JANUARY 1970 In his 1938 best seller The Summin, Up, W. Somerset Maugham wrote: "There is a sort of man who pays no attention to his good actions, but is tormented by his bad ones. This is the type who most often writes about himself. He leaves out his redeeming qualities, and so appears only weak, unprincipled. . . ." When reading this passage we tried to think of a writer who would fit Maugham's description, but drew a blank. Last month, as we prepared to write this editorial. his words came back to us. We still couldn't remember any autobiographer who had emphasized his own bad qualities, bu we could identify a profession - our own - which practices self- degradation to the extreme. Well, let's look at nursing in the sixties. Was it as bad as some critics in our profession would have us believe? Did we really fail in the past decade to live up to our former standards of patient care? We think not. Here are a few reasons why we believe our colleagues deserve kudos for their work in the sixties: . Nurses have shown an amazing flexibility in adjusting to the ever- increasing use of complex machines an computers, which certainly came into their own in the sixties. At the same time these nurses have retained their interest in the patient as a person - a feat that few other members of the health team have managed. . The old master-slave relationship between doctor and nurse has almost disappeared, mainly because nurses have convinced physicians that patient are better served when a colleague rela tionship prevails. Mind you, the death rattles of this traditional relationship can still be heard and will require som attention in the seventies, but they are definitely becoming feebler. . Despite many obstacles. nurse educators have had considerable suc- cess in placing nursing education wher it should be - in educational institu- tions. There is still some kicking and screaming going on as the "schools" are torn away from their hospital womb. but this ruckus comes from a SOUrce other than RNs and students. . Finally, nurses in the sixties have made their demands known to emplo} ers and government as never before. Our hope for the seventies is that this "militancy," as some call it. will be directed toward demands for better patient care and for laws concerning social issues that affect the health of all citizens. - V..\.L. THE CANADIAN NURSE 3 . in Canada its Stille exclusively from De Puy There's no disputing the fine quality of Stille Surgical Instruments. As a matter of fact, other instrument manufacturers use Stille as a gauge. But there's no duplicating the strength, precision and perfect balance and the prime stainless steel of Stille instruments. A Stille instrument will not only outperform but it will also outlast any other surgical instrument and we have case histories that prove it. '" , " , " Available only from DePuy Manufacturing Company (Canada) Ltd. \( ( '\ ) For additional Quebec and information write: Maritime Provinces Guy Bernier 862 Charles-Guimowd Boucherville, Quebec 4 THE CANADIAN NURSE Ontario and Western Canada John Kennedy 2750 Slough Street Malton, Ontario DePuy, Inc. A Subsidiary of Bio-Dynamics Warsaw, Indiana 46580 U.S.A. JANUARY 1970 news Government Rejects CNA Project Ottawa. - The federal government has refused to fund a nursing education project submitted by the Canadian Nur- ses' Association in the Spring of 1969. At the same time the government has agreed to fund several projects submit- ted by the Canadian Hospital Associa- tion, apparently including a study on nursing education. According to CNA executive di- rector Helen K. Mussallem, CNA was one of several health associations invited by the department of national health and welfare to submit projects for possible .., funding under the new national health ' grants. Because of the limited time for submissions and the belief that one study rather than several might receive favor- able consideration, the CNA submitted only one project design, Dr. Mussallem said. The topic was "Factors Preventing Registered Nurses from Achieving Their Educational Goals." A letter was later received from the minister of health stating that CNA's project had not been aoproved. The min- Four nurses from Trinidad currently studying at the Clarke Institute of Psychiatry are ister gave no reason for his decision. from left: Maria Keith, Hollis Lashley, Josephine Parris and Barbara Harding. The Canadian Hospital Association sought federal grants for four major pro- jects, according to the September 1969 issue of Canadian Hospital News. One project listed was "the study of the perfonnance in the hospital situation of the graduates of the two and three-year courses in nursing." An article in the November 14 issue of the Saskatoon Star Phoenix quotes the CHA president. L.R. Adshead, as saying that tills study is being fully underwritten by the federal government. The CNA board of directors, at its meeting November 4-7, expressed concern about the CHA's proposal to conduct a study to evaluate the perfonnance of gra- duates of two- and three-year diploma programs. The board believed that such a study would be premature since the number of graduates of two-year pro- grams is still small and since most two- year programs have graduated only one class at the most. The board directed the CNA executive director to write to CHA, relaying CNA's interest in the research and indicating that studies on this sub- ject are already being carried out in seve- ral provinces. The federal government recently announced its approval of two other CHA projects: $9,050 will be granted 10 CHA by the government to help finance JANUARY 1970 - . 4 '\ , - ...... L' . . 17 . t .\: J! J,}f-4 . *'" " ....r.. _ '""...... ... ... ( ; ";). 'J. '.>." 1:-. ç ". ..}:>> 'c . ".... t 'j/ ,,;, "-ct î ..: >J?,.I;' 1. _:"0>,"" ... , ". ".' ..... .. f I '- a national symposium on computer appli- cations in the health field; and money will be funded to CHA for a study on the transfer of functions among medical, nur- sing, and paramedical personnel. Federal Grant for CMHA Ottawa. - A $15,400 grant has been approved for the Canadian Mental Health Association under tenns of the new National Health Grant. Approval of the grant was announced by national health and welfare minister John Monro. The money will assist a CMHA pro- ject to examine methods of developing effective preventative programs for mental health witilln the existing structure of public health services. The project's goal is 10 coordinate mental health services with the public health services that have been developed and are available in most parts of the country. Activities of the project include an examination of present public health programs across Canada, with particular attention being focused on their mental health implications. The program inclu- des visits to communities in British Co- lumbia, Saskatchewan, Ontario, Quebec, and Nova Scotia. Trinidad Nursing Instructors Train At Clarke Institute Toronto, Onto 4s part of the on- going psychiatric aid program operating in Trinidad and Tobago under the aus- pices of the Canadian External Aid. four nursing instructors from Trinidad are spending six months at the Clarke Insti- tute of Psychiatry to obtain further ex- perience in psychiatric nursing and nurs- ing education. The nurses were able to come to Canada because of scholarships awarded by the Canadian International Development Agency. The technical aid project for Trinidad and Tobago is administered by the Clarke Institute under the direction of Dr. W.J. Stauble. He has been responsible for recruiting the Canadian group working in Trinidad and has visited Trinidad once or twice a year since the program commenc- ed in 1966. On these visits Dr. Stauble reviews the work of the Canadian group and meets with psychiatrists, university and govern- ment personnel to maintain continuity and director for the program. The prima- ry aim of the training program is to raise the level of nursing education at the various hospital schools in Trinidad and Tobago. (Continued on page 6) THE CANADIAN NURSE 5 news (Continued from page 5) The four nurses are: Barbara Harding, Josephine Parris, and Hollis Lashley, nurse instructors at St. Ann's Hospital, Port of Spain; and Maria Keith, who IS on the nursing staff of the Caura Chest Hospital, Port of Spain, as head nurse and administrator of the inservice training program. Members Appointed To Ad Hoc Committee On CNA Testing Service Ottawa. - Nine members have been appointed to the ad hoc committee on CNA Testing Service by the executive committee of the Canadian Nurses' Association. The members of the ad hoc committee are: Dr. Dorothy Colquhoun, director of testing services, Registered Nurses' Association of Ontario; Dr. Mildred Katzell, director, Measurement & Evalua- tion, National League for Nursing, Inc., New York; Barbara Kuhn, nurse educa- tor, Association of Nurses of the Province of Quebec; Joan Macdonald, director of the College of Nurses of Ontario; Irene Leckie, professor, School of Nursing, University of New Brunswick; Alice Baumgart, associate professor, University of British Columbia School of Nursing; Sister Mary Felicitas, CNA president; Ernest Van Raalte, CNA General Manager; and George Hynna, CNA law- yer. The CNA Board of Directors decided to set up this committee to develop a recommended structure for the CNA Testing Service. At the same time, the board directed that the ad hoc commit- tee should be composed of two psycho- metricians, two representatives of regis- tering bodies, two representatives of clinical nursing, one representative from business, and one from law. The first meeting of the ad hoc com- mittee was held at CNA House December 11-13, 1969. CNF Scholarship Fund Gets Boost From CNA Ottawa. - This year the Canadian Nurses' Foundation can count on its scho- larship fund climbing to at least $30,000. This guarantee comes from the Canadian Nurses' Association. The CNA board of dIrectors agreed in November that CNA would make up the difference if the CNF scholarship fund did not reach a minimum of $30, 000. Helen K. Mussallem, executive direc- tor of CNA and secretary-treasurer of CNF, pointed out to the CNA board that 6 THE CANADIAN NURSE Playhow;e Is Hub Of CNA Biennial Jj/!j.. ..,,:'\\\ . '; . -- "- - ..... -- " \j l=t - 0'- ., o. J:m IIIII ..1111 I - - 11111 11 'jl till 11311 _ ..111 Lilt till 1131 ' < :::: IIIII. }.! II 111 1 . - ', 1 . ;,tf- 4t1, " , tit " . -' ---- .. " . I/ . // "'" / / -' ::::",-< "., "' --;>- 'If. , . .SI:; I' . c .. - --- .. .-. , , # , I' , .; "': j t' j .' "',' . I, 'r I ; 111\'9111__, .' 1111 - J;,". .- , ':':1 I .r :; .... - ""iiO;;: - -- III'" - - -,:- ..... Fredericton, N.R. - The Playhouse theatre will be the hub of events when up to 1,000 nurses gather here June 14 to 19, 1970 for the biennial convention of the Canadian Nurses' Association. All business sessions will take place in this modern structure with its Georgian architectural motif, centrally located and on the banks of the Saint John River. The theatre accommodates 1,000 persons; seats are spaced and graded for viewing effectiveness. The stage is 30 feet deep and has an elevator-controlled forestage that can adjust to three different levels. Complementing the theatre and adjacent to it is the Long Gallery, an ideal setting for art displays and collections. Used for professional and amateur drama, the Playhouse is the setting for a wide variety of other cultural events, including concerts and ballet. It is also in heavy demand for community and university purposes. The Playhouse was a gift to the province from the late Lord Beaverbrook; it is presently supported by the Beaverbrook Canadian Foundation. CNF's scholarship fund is made up entire- ly of contributions, whereas the general fund is made up of membership fees. The membership fees could be trans- ferred to help pay the operating and administrative expenses of CNF, if direc- ted by members at the CNF annual meeting. These operating expenses are now absorbed by C.N.A., Dr. Mussallem, explained. In 1969-70, over $41,000 was award- ed to CNF scholars. After the full amount of these awards is paid this month, only $16,000 will remain in the CNF scholar- ship fund. Any registered nurse can become a regular member of CNF by paying an annual fee of $2. Cheques or money orders should be sent to: CNF, 50 The Driveway, Ottawa 4, Ontario. Business finns, corporations, and associations can also be sustaining members or patrons of CNF by paying the required fee for these categories. Individuals or groups can contri- bute gifts or donations, which are also tax deductible. The Foundation has re- ceived donations from CNA, nurses' assoc- iations at provincial, district, and chapter levels, individual nurses, and business firms. Nurses At Yellowknife From Association Yellowknife, N.W.T. - The newest registered nurses' association in Canada was incorporated here last May, The Canadian Nurse learned at press time. Elected officers of the Yellowknife Registered Nurses' Association are: Mari- lyn Robertson, president; Ollie Sinclair, vice-president; Barbra Bromley, second vice-president; Jeanette Plaami, secreta- JANUARY 1970 ry; Eileen Wry, treasurer: and Elaine Richinger, past-president. The YRNA now wants to form a Northwest Territories Registered Nurses' Association, and has written to the Cana- dian Nurses' Association and several Com- munities asking for comments and suggest- ions. CCHA Moves To Accredit Extended Care Centers Toronto, Onto - Early in 1970 the Canadian Council on Hospital Accredita- tion will expand its program to include accreditation of extended care centers across Canada. The new program will be voluntary, the same as the established program in the acute general hospital field. It will be open to institutions and agencies offering health care to patients whose stay is over an extended period. According to CCHA's definition, an extended care center is one that provides the necessary nursing and medical care with other required services as well as personal assistance with the acts of daily living. These centers may operate under voluntary, proprietary, or government31 auspices. Hospitals for the chronically ill, convalescent hospitals, nursing homes, home care agencies, and a variety of service organizations that span or include these kinds of care may become eligible on application. "We are indebted to the W.K. Kellogg Foundation for their encouragement and their support in the form of a substantial grant to prepare a program and to imple- ment it," said Dr. R.S. Duggan, chairman of the CCHA Board. Work on the new program began in May 1968. Project Director was Dr. Michel Gingras, now medical director of Jean T310n Hospital, Montreal. He was assisted by Nicole Du Mouchel, CCHA nursing consultant. The accrediting process will follow essentially the same pattern as that of the acute general field. A survey date is assigned to the eligible applicant four to eight weeks before the visit. A survey report is also prepared before the visit to provide a background of basic and cur- rent information necessary for accredita- tion. An experienced nurse surveyor will take part in each survey and will be assisted in selected situations by a doctor or administrator. After appraisal of the completed report by CCHA's executive office and board, the center will be notified of the accreditation status award- ed. Accredited centers will be visited every three years unless some important issue requires earlier reassessment. Provision31- ly accredited centers are resurveyed in one year. Non-accredited may seek re- survey when ready for reassessment. JANUARY 1970 a show of hands... '- ... R roves its sn100thness NEW FORMULA ALCOJEL, with added lubricant and emollient, will not dry out the patient's skin - or yours! ALCOJEL is the economical, modern, jelly form of rubbing alcohol. When applied to the skin, its slow flow ensures that it will not run off, drip or evaporate. You have ample time to control and spread it. ALCOJEL cools by evaporation. . . cleans, disinfects and firms the skin. Your patients will enjoy the invigorating effect of a body rub with Alcojel . . . the topical tonic. r . coolin efresh\1"9'" 9. ALCOJEL Send for a free sample through your hospital pharmacist. .- :" ALCOJEL Jelfied RUBBING ALCOHOL WITH ADDED LUBRICANT- ENiOWENT H DIUI HO THE BRITISH DRUG HOUSES (CANADA) lTD Barclay Ave., Toronto 18. Ontario THE CANADIAN NURSE 7 . news Organization and beginning costs will come from the Kellogg grant and from the Council. The ongoing program will be self-supporting from fee-for-survey charges, which will range from $300.00 to $500.00, depending on the size of the extended care center. There are some 3,000 such centers in Canada. A target of at least 100 surveys has been set for 1970. Both the standards and an accredita- tion guide book for extended care centers to interpret the standards, are now availa- ble. New Nursing Consultant Joins DNHW Studies Team Ottawa Beverly M. Du Gas became the first nursing consultant in the Health Manpower Studies Section of the Health Resources Directorate, Department of National Health and Welfare, in August 1969. As nursing consultant, Dr. Du Gas collaborates with a medical consultant, an economist, and a statistician to gather data on the numbers and distribution of health manpower and to make projec- tions of future needs for health personnel throughout Canada. This team plans to carry out studies in attrition, mobility, wo"rk patterns, and regional disparity of health personnel, utilization of personnel already available, and preparation of health workers. It also hopes to stimulate research by individuals, university schools ot nursing, and other groups. ... " . I " -.. II New Look For VON ... . .... , C"t' ..... ..,. 11 l ........ I More than 700 members of the Victorian Order of Nurses are now wearing a new uniform. A navy blue shift with three-quarter sleeves and white notched collar (left) replaces the shirt-waist style worn for the past five years. The summer dress (not shown) is peacock blue with short sleeves. The new navy blue top coat (right) is cut on straight lines with raglan sleeves. VON nurses now wear a navy Breton sailor hat, which shows the Order's crest. An ear covering of navy wool jersey in a scarf style mI Cord-Clamp should be within reach. Its contoured finger-grips and wide jaw angle make one- hand application easy. Hollister's Cord-Clamp has other benefits too: a hinge guard to keep even a large cord within the sealing area; firm-holding Double-Grip jaws to prevent slipping; a constant, even pressure to eliminate the dangers of seep- age; and no need for belly bands or dressings. The clamp has a permanent, blind closure. When it's ready for re- moval-usually after 24 hours-the clamp is simply cut through at the hinge. Hollister provides the clipper. This disposable, lightweight Hollister Cord-Clamp may be autoclaved, or it can be purchased in individual pre- sterilized packets. Write for samples and literature, on hospital or professional letterhead, please. " HOLLISTER II IN CANADA: ItiO BAY ST, TORONTO I. ONT. . 211 E CHICAGO AVE. CHICAGO, ILL tiOtiIi 10 THE CANADIAN NURSE 1, 1968 and will remain in effect until June 20, 1971. The previous salary scale for RNs started at $390 a month; the present scale starts at $<'1.47. Agreements were 31so signed for 56,000 non-medic31 hos- pital employees, giving tot31 benefits that will cost the provincial government $164, 000,000. The agreements end 18 months of negotíation between the government and AHPQ, and the three independent bar- gaining groups representing the nurses: the United Nurses of Montreal, the Syn- dicat professional des infirmières de Qué- bec, and the Alliance des infirmières de Québec. In an interview with The Canadian Nurse, Gloria Blaker, president of the 3,OOO-member UNM, said that the govern- ment agreed to include s31ary for inser- vice education personnel in the new con- tract. Also, she explained, there are now 15 yearly increments instead of seven, giving recognition for eight more years of experience. Mrs. Blaker said that many other items had not yet been negotiated, but would be discussed in a year's time. Nurses Hold Education Day Chilliwack, B.C - The Fraser Valley district of the Registered Nurses' Associa- tion of British Columbia held its seventh education day here in October, 1969. More than 200 registered nurses and other members of the health team were present to hear Dr. Rae Chittick and Mary Southin, Q.C., discuss the legal and moral aspects of nursing responsibilities. Miss Southin defined legal requirements as the minimum standards of behavior and discussed the many situations that require the nurse to remember the legal responsibilities expected of her. Dr. Chittick defined the moral require- ments as involving the maximum standard of behavior, and reminded the audience that patients expect the nurse to be able to meet their needs at the bedside and in community health care. Following, a panel dealing with the problems of drug abuse and drug addic- tion was chaired by Monica D. Angus; president of the RNABe. Panel members included: Dr. W.P. Brown, psychiatrist and consultant chemotherapist for Riverview Ment31 Hospit31, B.C.; warden, Pat Spence; parole officer, John Phillips of the Matsqui Drug Addiction Institution; and the educational supervisor of the BC Narcotic Addiction Foundation, Bob Hickey. 0 BE A + BLOOD DONOR JANUARY 1970 NEW AND FOR NURSES Sutton: BEDSIDE NURSING TECHNIQUES IN MEDICINE AND SURGERY Second Edition By Audrey Latshaw Sutton, R.N., Case Reviewer, Blue Crass of Philadelphia. This valuable source book of advanced clinical nursing techniques is one of the most widely used books of its type ever published. Now it has been made even more valuable. The newest concepts of hospital care, the latest equipment, currently preferred medications and diets, and the most recent diagnostic and therapeufic methods in medicine and surgery - all are explained in the new Second Edition. In clear, precise language, supplemented by more than 850 explicit drawings, Mrs. Sutton tells precisely how to perform hundreds of nursing functions - from intramuscular injection to caring for the patient in hyperbaric oxygen therapy. Among the new sections Hymovich: NURSING OF CHILDREN A Guide for Study By Debra P. Hymavich, University of Florida. A workbook in pediatric nursing that teaches creative thinking about nursing care problems. 389 pages, illustrated. $5.9S. May 1969. Mercer & O'Connor: FUNDAMENTAL SKILLS IN THE NURSE-PATIENT RELATIONSHIP By Lianne S. Mercer, formerly of the University of Michigan, and Patricia O'Connor, University of Michigan. A self-teaching programmed text covering the impor- tant skills of interpersonal relations. 192 pages, illustrated. $4.30. May 1969. Marlow: TEXTBOOK OF PEDIATRIC NURSING 3rd Edition By Dorothy Marlow, Villanova University. The most widely used text in its field, "Marlow" has now been thoroughly revised and updated. 687 pages with S72 illustrations. $9.20. May 1969. are ones on reverse isolation, tubeless gastric analysis, IPPB respirators, fluid and electrolyte balance, hypo- dermoclysis, heart transplants, controlling hemorrhage from esophageal varices, and intra-arterial infusion of anticancer agents. Nurses by the tens of thousands have found "Sutton" an unparalleled source of current information. It is ideal for the recent graduate who seeks help on how to perform specific procedures, for the nurse returning to practice after an interruption, and for the nurse preparing to transfer from one area of practice to another. 398 pages with 871 illustrations, $8.95. Second edition. Published March, 1969. Secor: PATIENT CARE IN RESPIRATORY PROBLEMS By Jane Secor, Syracuse University. Discusses in depth the intensive care of patients with respir:Jtory problems. 229 pages, illustrated. $8.40. September 1969. Simmons: THE NURSE.PATIENT RELATIONSHIP IN PSYCHIATRIC NURSING By Janet A Simmons, University of Massachussets. A workbook to guide the student nurse during her institutional affiliation in psychiatric nursing. 189 pages. $4.0S. August 1969. King & Showers: HUMAN ANATOMY AND PHYSIOLOGY 6th Edition By Barry J. King, U.S. Public Health Service, and Mary Jane Showers, Hahnemann Medical College. A well known text combining structUre and function, now revised and redesigned for faster learning 432 pages with 212 illustrations plus 8 pages of calor plates an transparent overlays. $9.4S. September 1969. W. B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7 Please send on approval and bill me: Author: Nome: Address: City: 'ANUARY 1970 Book title' Zone: Province: CN 0 THE CAN DIAN NURSE 11 names Jane Y. Aitken (S.R.N., Central Middlesex School of Nursing, London; S.C.M., Western Dis- trict Hospital, Glas- gow; Health Visitor's Certificate, Broc- klands College, Wey- beridge, Surrey; Operating Room Postgraduate Course, Hammersmith Hospital, London; B.N., McGill U., Montreal) has been appointed maternal and child health consultant to the public health nursing division, Saskat- chewan Department of Health. For the past two years, Miss Aitken was regional nursing supervisor of the North Battleford health region, Saskat- chewan. Miss Aitken has also been a public health nurse and assistant to the regional nursing supervisor in the Yorkton, Sask., health region. She has worked as an operating room nurse at University Hospi- tal, Saskatoon, Sask., at the General Hospital in Montreal, and the General Hospital in Kingston, Ontario. Before she came to Canada, Miss Aitken was a health visitor in the County Health Department, Surrey, England. ;;a ..t Sister Thérère Cas- tonguay (R.N., St. Boniface General H., Man.; B.Sc.N., L'lns- tÏtut Marguerite d'Youville, U. of Montreal; M.Sc.N., Catholic U. of Ame- rica, Washington, D.C.; B.A., Marillac College, St. Louis, Missouri) has been appointed director of nursing service, St. Boniface General Hospital, St. Boniface, Manitoba. Sister Castonguay, a native of Quebec, was previously superintendent of nursing education for the Saskatchewan Depart- ment of Education. Before she was ap- pointed to this department, she was director of the school of nursing at Regina Grey Nuns' Hospital. Her varied experience also includes medical-surgical nursing supervision, Maisonneuve Hos- pital, Montreal; obstetric and operating room supervision, St. Theresa Hospital, Fort Vermilion, Alberta; and assistant director, school of nursing, St. Boniface General Hospital. 12 THE CANADIAN NURSE \ ...,. The pOSItion of associate director of nursing at Victoria Hospital in London, Ontario, has been fJIled by Bernice Lewis, (R.N., Public General Hosp., Chatham, Ont.; cert. in nursing education and B.Sc.N., U. of Western Ontario). Miss Lewis has held positions of direc- tor of nursing at the Public General Hospital in Chatham, and Norfolk Gener- al Hospital in Simcoe. She left the post of director of nursing service and education at the St. Thomas-Elgin General Hospital. Sheila Quinn, execu- tive director of the International Council of Nurses for the past two years, will soon be leaving ICN head- quarters in Geneva to return to England. She has accepted a new position as chief nursing officer at the Southampton Group of Hospitals. Miss Quinn (S.R.N. S.C.M. Sister Tutor Dipl. and B.Sc., economics, U. of London ) was appointed to the ICN executive staff in 1961 as director of the new division of social and economic welfare. In 1966 she became deputy executive director of the ICN. Miss Quinn has worked with na- tional nurses' associations in many parts of the world, studying conditions of work of nurses and giving advice and guidance to the associations in social and econo- mic welfare programs. Before her appointment to the ICN, Miss Quinn held the positions of night su- perintendent, administrative sister, and principal sister tutor at the Prince of Wales General Hospital in London. Ifio, .......;- - \ Ellen J. Pittuck (R.N., Ontario H., Cobourg, Ont.) has retired as director of nursing at the Onta- rio Hospital School in Orillia, Ontario, a p osition she held since 1961. Miss Pittuck, who was born in England, began her nursing career in Cobourg, Ontario, where she became assistant director of nursing and teacher at the Ontario Hospital. Later, she joined the staff of the Ontario Hospi- tal in Orillia, as assistant director of t nursing and teacher, before becoming director of nursing. Active in the Registered Nurses' Asso- ciation of Ontario, Miss Pittuck was a member of the RNAO finance commit- tee, and was president of the Huronia chapter and District 2 of the RNAO. Marlene Anger (B.S.N., U. of Sas- katchewan) has join- ed the staff of Mount Royal Junior College, Calgary, Al- berta, as a nursing instructor. Mrs. Anger has .... worked as a nursing instructor in psychiatry at Foothills Hos- pital in Calgary, a senior nurse with the Division of Alcoholism in Calgary, a mental health nurse at the Burnaby Men- tal Health Centre in Vancouver, and as a public health nurse in the Mount View Health Unit in Calgary. - .- .. Yolande Cyr (R.N., Edmunston Regional Hasp.; B.Sc.N., U. of Montreal) recently was appointed direc- tor of the school of nursing sciences, Ed- 4! m un s ton Regional H 0 spital, Edmuns- ton, N.B. Mrs. Cyr has served as an instructor for six years, and assistant director of the school for four years. She is regional superintendent of the St. John Ambulan- ce Brigade in the Edmunston area. I"- , ..,. .- ,. ... The University of British Columbia School of Nursing has announced a num- ber of new faculty appointments. Helen Elizabeth Eifert (Reg.N., The Hospital for Sick Children, Toronto; B.N., McGill U., Montreal; M.A., New York U.) has been appointed assistant professor. Mrs. Eifert has worked in various parts of the country. She was a staff nurse at the Kitchener-Waterloo Hospital in Kitchener, Ontario; staff nurse, assistant head nurse, head nurse, and teacher at the Calgary General Hospital, Calgary, Alber- ta; and lecturer and assistant professor at the School for Graduate Nurses, McGill University, Montreal. Mrs. EIfert was a 1965-66 Canadian JANUARY 1970 Nurses' Foundation Fellow. Kirsten Weber (R.N., Victoria Hos- pital School of Nurs- ing, Winnipeg; P.H.N. diploma, School of Nursing, V. of British Colum- b i a, Vancouver; B.N., McGill V. School for Graduate Nurses, Montreal; M.S., School of Nurs- ing, V. of California. San Francisco) has been appointed assistant professor at VBC. Miss Weber has worked as an operating room staff nurse at The Vancouver Gener- al Hospital, the Royal Jubilee Hospital in Victoria, B.C., Gentofte Amtsyhus in Copenhagen, Denmark, and as a theatre sister at Croydon General Hospital in Croydon, England. As a public health nurse, Miss Weber worked for the City of Toronto health department and the British Columbia health branch in Powell River and Port Alberni. She was a PHN supervisor in Prince Rupert, Kelowna, and Trail. Brit- ish Columbia. Miss Weber is a member of two com- mittees of the Registered Nurses' Associa- tion of British Columbia: nursing service and library policy. .... Maude Irene Dol- phin (R.N., Royal Victoria H.. Mon- treal; RM., McGill u.; M.N.. V. of Washing- ton, Seatle) has been appointed assistant IL professor at V.B.C. ......... Prior to this ap- .. pointment, Miss Dol- phin was assistant professor at the school of nursing, Vniversity of Toronto. Miss Dolphin has worked in Montreal as a supervisor at the Alexandra Hospital and a head nurse at the Royal Victoria Hospital. Her experience in British Co- lumbia includes being an instructor at The Vancouver General Hospital; a nurse in the public health unit in Nanaimo, and director of nursing at Nanaimo Regional General Hospital. For six years Miss Dolphin was a nurse educator with the World Health Organiza- tion in Pakistan. Syria. and Mauritius. Jeanne Marie Hurd (B.A., Ohio Wes- leyan V., Delaware, Ohio; M.A., Colum- bia V., N.Y.; M.N., Yale V. School of Nursing, New Haven, Connecticut) has been appointed clinical instructor in pedi- atrics at VBe. Mrs. Hurd has worked as a bedside teacher at Bonnie Burn Tuberculosis Sani- torium, Berkeley Heights, New Jersey; dean of women and nurse at Westminster College. Salt Lake City, Vtah; part-time staff nurse at Salt Lake County General Hospital; school nurse at the Vniversity of Wyoming in Laramie and Laramie JANUARY 1970 public schools; and nurse-social work- er with Operation Head Start in Laramie. Sister Therese Cari- gnan (R.N., S1. Paul H., Vancouver; B.S.N., Seattle V., Seattle, Wash.) has been appointed ins- tructor at the Vni- versity of British Co- lumbia School of Nursing, Vancouver. Prior to this appointment, Sister Cari- gnan was director of the Training Centre at Lake of the Woods District Hospital, Kenora, Ontario. Sister Carignan served as coordinator of inservice education at S1. Mary's Hos- pital, New Westminster, B.C. for one year. Before that she worked asa nursing supervisor at S1. Paul Hospital, Vancou- ver; St. Eugene Hospital, Cranbrook, B.C.; St. Joseph Hospital, Kenora, Ont.; Providence Creche Baby Home in Calga- ry, Alberta; and night supervisor at Sacr- ed Heart Hospital in McLennan, Alberta. Barb.n.l Mary Nitins (S.R.N., Middlesex Hospital, London, England; Cert. in industrial nursing, Birmingham V., Eng- land; Sister Tutor Diploma, Queen Eli- zabeth College, Lon- don V.) has been appointed instructor at VBC. A native of Wales, Mrs. Nitins was a nursing sister in Queen Alexander's Royal Army Nursing Corps, a staff nurse at Birmingham Accident Hospital, and a sister tutor at Middlesex Hospital in London, England. In Canada, Mrs. Nitins has worked as a staff nurse at Toronto East General Hos- pital, Shaughnessy Hospital in Vancouver. and The Vancouver General Hospital; a private duty nurse in Vancouver; and a part-time clinical instructor at VBC. r, ... f1 .... Sister Delia Clermont (R.N., St. Boni- face H., Mdnitoba; B.Sc.N .Ed., St. Louis V., St. Louis, Missouri) is the newly- appointed director of the School for Nursing Assistants, La Verendrye Hospi- tal, Fort Frances, Ontario. Sister Clermont has held a number of positions at S1. Boniface General Hospi- tal. as a head nurse, instructor, assistant director, and director of the school of nursing, director of nursing service, and educational director. She has been ad- ministrator at La Verendrye Hospital. Holy Cross Hospital in Calgary, and St. Boniface General Hospital. Sister Clermont has been vice presi- dent of the Manitoba Association of Registered Nurses; chairman of MARN's Committee on Nursing Education; and a former member uf the CNA executive. Elizabeth Anne Mowatt is the new director of nursing service at the Saint John General Hospital. Saint John. New Brunswick. Mrs. Mowatt (R.N., Saint John Gener- al H.; dipl., teaching and supervision. and B.N., McGill V.; M.Sc.N., Boston V.) has held the positions of instructor. assistant director of nursing education, assistant director of inservice education, and asso- ciate director of nursing at the Saint John General Hospital. An active member of the New Bruns- wick Association of Registered Nurses, Mrs. Mowatt has served on several NBARN committees and has been a vice-president. Lucy Cook (R.N., Moncton H.; Public Health Nursing Dipl., McGill V.) has been appointed as- sistant director of public health nurses for the Nova Scotia Department of Pub- lic Health. Miss Cuok, a native of Nova Scotia, has worked as a nurse at Colchester County Hospital in Truro. and Camp Hill Hospital in Halifax. As a public health nurse, she worked in the Truro office of the department of public health, and was supervisor of public health nursing in the Fundy and Atlantic health units. \' --' -....\ " -- \. Marianne Elizabeth LacaV,l (R.N.. B.S., V. of Connecticut; M.Ed.. V. of lIart- ford) has been ap- pointed advisor in nursing service for the Registered Nurses' Association of Nova Scotia. She will formulate and recommend nursing service projects and progrdms. Miss Lacava has held positions as instructor at the St. fr Jncis Hospital School of Nursing. Hartford. Conn.. and the Kaiser Foum]Jtion Hospital School of Nursing. Oakland. Calif.; as public health staff nurse with the Ne.... BritJin Visiting Nurse Association. ('onn.. and as di- rector of nursing services, Winsted Me- morial Hospital, Conn. For the past two years she has been involved in reseJrch for the state of Rhode Island under a U.S.A. public health service contract in the field of reentry of the health professional. Miss LJCdVd has served JS consultant to the New England board of higher education; to the state-wide planning depJrtment of Rhode Island: and to the blJdrd of direc- tors. state colleges Jnd universities. Rhode IslJnd. She WJS a member uf the Rhode IslJnd governor's advisory com- mission on vocJtional rehJbilitJtion. 0 THE CAN DlAN NURSE 13 or you aPJ your patIent Now in 3 disposable forms: . Adult (green proteclive cop) . Pediatric (blue protective cop) . Mineral Oil (orange protective cap) Fleet - the 40-second Enema. - is pre-lubricated, pre-mixed, pre-measured, individually-packed, ready-to-use, and disposable. Ordeal by enema-can is over! Quick, clean, modern, FLEET ENEMA will save you an average of 27 minutes per patient - and a world of trouble. DmJ mm [ENE 1 IDDI !! N .:ï MIHIERAlO,t. t.3.ooI &.J...d,C. WARNING: Not to be used when nausea, vomiting or abdominal pain is present. Frequent or prolonged use may result in dependence. CAUTION: DO NOT ADMINISTER TO CHilDREN UNDER TWO YEARS OF AGE EXCEPT ON THE ADVICE OF A PHYSICIAN. In dehydrated or debilitated patients. the volume must be carefullv determined since the solution is hypertonic and may lead to further dehydration. Care should also be taken to ensure that the contents of the bowel are expelled after administration. Repeated administration at short int"rvals should be avoided. Full information on request. "Kehlmann, W. H.: Mod. Hosp. 84:104,1955 FLEET ENEMA@ - single-dose disposable unit A QUALlTV Pt1...ftMACr:UTICALS "... * t;. .t !o.Co. 'CXlffDt.D IN CAItADA IN'''' 14 THE CANADIAN NURSE JANUARY 1970 dates February 18-22, 1970 Conference on The Nurse's Reactions and Patient Care, sponsored by the Re- gistered Nurses' Association of Ontario, Geneva Park, lake Couchiching. Registra- tion fee: RNAO members - $80; non- members - $95. This fee includes meals, double room accommodation, and gener- al-conference expenses. For further in- formation and application forms, write to: Professional Development Depart- ment, RNAO, 33 Price Street, Toronto 289, Ontario. February 24-25, 1970 Institute on Nursing Home Care, Inn-on- the-Park, Toronto. Sponsored by the Registered Nurses' Association of Onta- rio, Associated Nursing Homes Inc., the Ontario Dental Association, and the Ontario Medical Association. For further information, write to the RNAO Profes- sional Development Department, 33 Price Street, Toronto 289, Onto March 20, 1970 Seminar sponsored by The Operating Room Nurses of Greater Toronto, Royal York Hotel, Toronto. Direct inquiries to: Mrs. Jean Hooper, Chairman, Public Rela- tions Committee, The Operating Room Nurses of Greater Toronto, 43 Beaver- brook Avenue, Islington, Ontario. March 16-18, 1970 Combined doctor-nurse meeting sponsor- ed by the American College of Surgeons, Washington, D.C. No registration fee for nurses. Official housing forms are availa- ble from Mr. T. E. McGinnis, Manager of Exhibits and Meeting Arrangements, A- merican College of Surgeons, 55 East Erie Street, Chicago, Illinois 60611. Miss Doris Kirk, Operating Room Supervisor, The George Washington University Hospital, is dlairman of the nurses' program. March 19-20, 1970 Symposium on "Problems in Delivering Cardiac Care," sponsored by the sub-<:om- mittee on nurse education of the New York State Heart Assembly's Coronary Heart Disease Committee, Flagship Hotel, Rochester, N.Y. The symposium is direct- ed toward hospital administrators, nurs- ing instructors, nursing service directors, and nursing supervisors. For further infor- mation write to: New York State Heart Assembly, Inc., 3 West 29th Street, New York. N.Y. 10001. April 2-3, 1970 The Changing Role and Function of a Department of Nursing, hospital work- IANUARY 1970 shop in Washington, D.C. sponsored by the National league for Nursing. For more information, write to the N IN, 10 Columbus Circle, New York, N.Y. 10019. April 9-10, 1970 23rd National Conference on Rural Health. Pfister Hotel and Tower. Milwau- kee, Wisconsin. Sponsored by the Council on Rural Health, American Medical Association, in cooperation with other organizations. No registration fee. Write to: Council on Rural Health, AMA, 535 North Dearborn Street, Chicago, Illinois 60610, USA. May 4-7, 1970 First National Operating Room Nurses' Convention, Queen Elizabeth Hotel, Montreal. For further information write to: Mrs. I. Adams, 165 Riverview Drive, Arnprior, Ontario. May 12-15, 1970 Alberta Association of Registered Nur- ses Convention. Calgary Inn, Calgary. For further information write to: AARN 10256 - 112 Street, Edmonton. Alberta June 15-18, 1970 Canadian Conference on Social Welfare Skyline Hotel, Toronto. Tours and talk- ins at innovative agencies and services are planned. For information write to: The Canadian Welfare Council, 55 Park- dale Ave., Ottawa 3, Ontario. June 15-19, 1970 Canadian Nurses' Association General Meeting, The Playhouse, Fredericton, New Brunswick. August 9-14, 1970 Third International Congress of Food Science and Technology, sponsored by the United States Department of Agriculture, Washington, D.C. Further information may be obtained from: Dr. W.A. Gortner, Secretariat, SOS/70 - Third Internation- al Congress of Food Science and Techno- logy. U.S. Department of Agriculture. Beltsville, Maryland 20705 October 1970 Symposium in respiratory disease and tu- berculosis nursing for registered nurses, the University of Manitoba and The Win- nipeg General Hospital. Write to: C.W.L. Jeanes, Executive Secretary, Canadian Tu- berculosis and Respiratory Disease As- sociation, 343 O'Connor St., Ottawa 4. o bfu3(;tb -t nd Spec:i ' Seleclions tor Nurses MRS. R. F. JOHNSON SUPERVISOR .... - -.. TII..... AI ..III ".1. fõRJõHN WilLIAMS L RESIDENT DROO'" --MRS. \,\OL_p_ - OHN,LP.N. IIetaI , FrI"" _, ".1. AI WIIiÞ Pllstic ".511 largest-selling among nurses! Superb lifetime QU . . smoolh rounded edges fealherwelghl, lies ftal deeply engra.ed. and lacquered Snow while plaslic wIll nol yellow. Sallsfacllon guaranleed GROUP or--JUNTS SAVE, Order 2 ido.lic.al Pins as pro- c.a.lio. ...i.sl loss, loss cban!in! .IMPOIIIA,.T Please Md 2X þtf OI'dH IYIntll" c"'rlt on III ordrfs 0' J pins 01' Ins GROUP DISCOUNfS 2!).,g PlM, s't. 100 or lIIOI'1. 10% Send cnh, m.o., Dr check. No billinis or COD'.. Sel-Fix NURSE CAP BAND :-----. Blx. velvet band mlle,.,1. Self-ad- L \ hesive presses 01'1. pulls oft; no sewln' ........ or plnnln&. Reusable severll IlInes /.. :rh :': s,2 ;.' t ; . ':.,:g .:'%. Iq- (8 per bol), ...- (6 per boX), .- No. 6343 16 per bolJ. Specify wldttl desired In cap Band. ..1 bOJ 1..65 ITEM colwnn on coupon 3 or Inarl 1.40 II NURSES CAP-TACS _ __ ...--- - lIemowe.nd refaslen cap band inslantly for laundennJ and replxement l Tiny , = C::tcB :. ' O C :I ... --' wllh Gold CaduceLlS. Dr III bile. (plaint ,....__, ---. No.200Sltaf6Tlcs..I'OOpersel.... , SPECIAL! 12 or mGresels ....80 per set Nurses ENAMELED PINS Be.utlfully sculptured slatLlS IMIPIl, 2 olot bred, h.rd.fired enamel on told pI.te Dlme'Slzed. pln-back Sjlecrly RN. LPN. PN. LVII. NA. ...", on _ No. 205 Enlmeled Pin. . . . . , . . . 1.65 .a. ppd. . Waterproof NURSES WATCH O SWISS made. raised Silwer full "LlMIIIs IIIftlll 111.,.- . r I"IS Red tlPDtd sweep second hand ctlrome stllnless . use Stllnless e. nSlon bind plus FREE blx. leath" : p r. ......... . .16.5011. ppd_ @ Uniform POCKET PALS Protects .t'IMI slalnS and wear. Pilible ""lie ptasllc wllh told slamped caduceus Two com-- rtme"ts for pens. shears. elc Ideallo.en lifts or flWl's IE =W: ()'E f r eI1 1: PPd. Persoøalized BAN DAG E SHEARS ,- protnsKNIII precrslOn she.rs forled In sleel. G ranleed 10 Slay sh,rp 2 years No. 1000 Shein (no initials) . .. , . 2.75 '1. ppd. SPECIAL! I Doz. Sh..n ............ $26. tDtl1 Inilials (up to 3) .tch.d. .. . .dd 5Oc: plr pill Áf 1--../ '" "SENTRY" SPRAY PROTECTOR Protects J'OU 11.lnit Wlolent InIII or do, Instantly disables Wltnout penn.nenl I"JUI'J No. AP-ll Sintry . . 2.2S II. ppd I ' OROER "'JI :. I I COLOR QUANT. PRICE . I PIN LETT. COLOR. u Black BI r While (No. 169) METAL FINISH .J Gold 05,1.., INmALS _ __ . LETTERING . I enclose S I Sind 10 . 5..... ______ City S Jle ZIP .......... Pl..... .110. luttlclent time tor d.llv.f)'. . . . . . .. 2n(J l"1e THE CANADIAN NURSE 15 new products { Descriptions are based on information supplied by the manufacturer. No endorsement is intended. ........"., " '" " .. ....... .... ;.,- . ;;:-/, " . , , .r. ., ... ,.. V Teaching Nursescope The Littmann Teacillng Nursescope, developed by the 3M Company, has an ultra slim, diaphragm-type chest-piece to pennit placement close-to the cuff when obtaining blood pressure. It is designed to allow the nursing student and teacher to listen at the same time. Tills training stethoscope is equip- ped with two headsets. It provides a wide range of pertinent sound with excellent clarity for student and teacher. Delrin eartips and epoxy-fiberglass, resin diaphragm are virtually unbreakable. Further information is available from: Medical Products Group, 3M Com- pany, Box 5757, London, Ontario. Disposable Prep Tray The shape of this new, disposable prep tray follows the contour of the body in axillary and perineal areas, thus allowing placement of the tray close to the pa- tient. This conserves space at the bedside and gives maximum convenience. The tray contains all the necessary items for preoperative prepping: razor, sponge impregnated with hexachloro- phene, lanolin and castile soap, two cotton-tipped applicators, two soft ab- sorbent towels, one underpad, and one gauze pad. The special prep razor has a Gillette super stainless steel blade capable of complete prepping without blade replace- ment. The angle between the non- clogging razor head and double-edged blade is designed for body prep, and the 16 THE CANADIAN NURSE f' extra long striated handle provides a sure grip. The tray is divided into two extra deep compartments that provide ample space and fluid capacity for lathering and rins- ing. Overall fluid capacity has been in- creased by 25 percent. A finger grip makes the tray easy to carry even when filled. Each tray is packed in a tear string plastic film pack, willch ensures the clean- liness of all the items until ready for use. This product is manufactured by Sterilon Corporation, 1505 Washington St., Braintree, Massachusetts 12184. It may be purchased from Canadian distrib- utors in Montreal, Toronto, Quebec City, St. John's, Newfoundland, London, Win- nipeg, Calgary, and Vancouver. ) Electronic Monitoring System System 808 is a new medical electron- ic monitoring and emergency treatment system for use in cardiac care and inten- sive care units of hospitals. Tills system is designed to eliminate the problem of false alarms, and alerts hospital personnel when a potentially dangerous condition threatens the pa- tient. It includes electrical instruments for correcting certain of these conditions. System 808 is compact and features interchangeable components. It consists of five modular components designed to perform together as a system or as sepa- rate specialized units. These components include: Display Scope 808, the system's wave- form display instrument featuring a large screen that can display two traces simul- taneously. Display Writer 808, a waveform documentation unit of the system that provides a written trace of the patient's physiological parameter. Monitor/ Alarm 808, a component that provides an automatic monitoring of pa- tient heart rate by recognizing R-wave amplitude and R-wave frequency charac- teristics of the patient's electrocardio- gram. The dual-purpose sensitivity con- trol significantly reduces false alarms, willie assuring recognition of real emer- gency situations. Pacemaker 808, a self-contained, battery-powered component, provides immediate pacemaking in cases of cardiac emergency. When attached to other com- ponents, it can be automatically activated when the patient's heart-rate drops below a pre-set limit. Monopulse Defibrillator 808, a self- contained, battery-powered emergency resuscitation instrument, delivers an elec- trical shock to the fibrillating heart to allow restoration of regular heart action. These five component modules inter- connect neatly through a multipurpose common cable. As new developments occur, they can be plugged in to replace or complement the current System 808 \ \ / It'll. i l:S' BB Ct,........ *a( llJM1J I'IßIWy 1 ;:- .. ..... ...:: '&l __ 121 _ -..- L - - -- .......... ÑtQ> .. _............ ("";:;.";'toas -.-. .... .. , ::;:' "'v ...... - \----l .- Disposable Prep Tray JANUARY 1970 moving? married? wish an adjustment? v All correspondence to THE CA- NADIAN NURSE should be ac- companied by your most recent address label or imprint (Attach in space provided.) Are you =- Receiving duplicate copies? L Actively registered with more than one provincial nurses' association? Perm.nent re,. no. Provinc..1 association Permanent reg. no. Provincial association C Transferring registration from one provincial nurses' asso- ciation to another? From: ................................. Provincial association Permanent reg. no. To: ...................................... Provincial aSSOCiation Permanent reg. no. Other adjustment requested: ATTACH CURRENT LABEL or IMPRINT HERE to be assured of accurate, fast service Print New Name and or Address Below Miss Mrs. Sister/ Mr. Name (please print) Street address City Zone Province Please allow six weeks for processing your change The Canadian Nurse cannot guarantee back copies unless change or interruption in de- livery is reported within six weeks! Address all inquiries to: ThE-Canadian Nurse ð 'Ç7 ulat, "Dept. so The DruewilY Ott....4 CanaCi. JANUARY 1970 components. This "building block" principle also allows equipment to be speedily shifted as needs of patients vary. Built-in carrying handles and safety stack- ing devices facilitate the setting up and movement of the components. For further information, write to Baxter Laboratories of Canada Limited. 6405 Northam Drive, Malton, Ontario. ........ ( " " . _c .- ..... , '-.11 -............. Nylon Restraint Net This new restraint net for hospital use is designed to provide maximum patient restraint. The net is constructed of quick-drying nylon netting that has been reinforced at all stress points. Accessibil- ity is provided for the head, arms, and feet. The nylon restraint net is available in one size to fit all beds and patients. This Posey product can be obtained from Enns & Gilmore Ltd., 1033 Range- view Road, Port Credit, Onto New Fluff Underpad A new Princess Fluff Underpad by Texpack can save hospitals up to SO percent of their underpad cost. This underpad introduces numerous exclusive features: deodorant; fire resist- ancy; dispersion layers quickly spread liquid to use total absorbency of the pad, which saves money and keeps patients more comfortable; bactericide helps reduce cross infection and assists in patient care; dispenser carton results in dispensing ease; paper-tab indexing controls quantity dispensed; and blue top disposal safeguard prevents accidental discarding of underpad with laundry. which can damage laundry equipment. The underpad has sealed sides with poly overlap. This prevents liquid run-off, and fluff escape at sides reduces the need for pad changes and keeps linen clean and dry. It also has sealed ends that prevent fluff escape, removing the danger of aspiration of fluff. Samples and literature from Texpack Limited, Street, Brantford, Ontario. are available 3040 Craig o -----.. When your day starts at ß 6 a.m... you're on charge duty... you've skimped on meals... ß and on sleep... Y9 u haven't h 1f; tIme to hem - a dress... make an apple pie... wash your hair.: even powder ti:Jjj your nose ' 0 in comfort.. --- it's time for a change. Irregular hours and meals on-the. run won't last. But your personal Irregularity is another matter. It may settle down. Or it may need gentle help from DOXIDAN. use DOX I DAN@ most nurses do DOXIDAN is an effective laxative for the gentle relief of constipation without cramping. Because DOXIDAN con- tains a dependable fecal softener and a mild peristaltic stimulant. evacuation is easy and comlonable. For detaIled ,nformation consult Vademecum or CompendIum. !j9M !jêr 3"00 JEAN TALON W MONTREAL 30' DIVISION OF CANADIAN HOECHST LIMITED .-.-.. f "MAC) f'_ THE CA DlAN NURSE 17 in a capsule Hidden talent Helen K. Mussallem, executive director of the Canadian Nurses' Association, was back in her native British Columbia in October. Something quite unexpected happened to her in Vancouver while she was at the University of British Columbia to deliver the Marion Woodward Lecture. Dr. Mussallem got a "kick" out of the incident, which she enjoys recounting. She was taken to the UBC stadium to watch the annual homecoming "teacup playoff' football game between the home economics students and the nursing students. The winner of this event wins a golden teacup trophy. Much to Dr. Mussallem's surprise, she was asked to kick off! "When I say kick," a young uniformed student told her, "kick - but face the camera! " Considering that this was a "first" for CNA's executive director, her ten and one-half yard kick, which was accompani- ed by appreciative cheering, was indeed something to be proud of. Although she had to leave shortly after the kickoff, Dr. Mussallem found out that the nurses won the trophy for the second time in the game's history. Brighten our new year We're hoping that you, our readers, enjoy some light moments in the new .year. We're also hoping that when you do, you'll share them with us. As you may have noticed, "In a THATS THE liCKer! GET'6UI-;; >.:. I I I This decongestant tablet contends that a cold is not as simple as it seems on television Coricidin* "0" tablets shrink swollen mem- branes with the best of them (note the 10 mg. of phenylephrine). Unfortunately, the mis- ery of a cold doesn't end with unblocked passages. That's why Coricidin "0" also contains two anti- pyretic and analgesic agents. They cool down the steaming fever and suppress the aches and pains that go with the adult cold. That's why we also help perk up sagging spirits with 30 mg. Caffeine. And why we also include 2 mg. of Chlor- Tripolon* to combat rhinorrhea .. and strike out at the very root of congestion. Know of another cold reliever that gives your patient so many helpful also's? Conc/dm . D' comprehensive rpllel 01 cold symptoms C:i'øJr/Hfl Corporation Limited c )a",,"'d- Pointe Claire 730, P.O. .- "\ DESCRIPTION: Each CORICIDIN 'D' tablet contains 2 mg CHlOR- TRIPOlOW (chlorpheni- ramme maleate), 230 mg. acetyl- salicylic acid, 160 mg. phena- cetin. 30 mg. caffeine, 10 mg. phenylephrine. DOSAGE: Adults: one tablet every 4 hours. not to exceed 4 tablets in 24 hours. Children (10- 14 years): '/, the adult dose. Children under 10 years: as di- rected by the physician. ConclllO'D' SIDE EFFECTS: Adverse reac- tions ordinarily associated with antihistamines, such as drowsI- ness, nausea and dizziness occur infrequenlly with Coricidin '"0" when administration does not exceed recommended dosage PRECAUTIONS: May be injurious if taken in large doses or for a long tIme. Additional clinical data available On request . reg. Trade Mark. For colds of all ages: Coricidin tablets, Coricidin with Codeine, Coriforte for severe colds, Nasal Mist, Medilets and Coricidin "D" Medilets for children. Pediatric Drops. Cough Mixture and Lozenges. 24'_ .....,....... --ow --- -- - Give new depth to your students' understanding of their future responsibilities.. . ;., '-, .' "\. ........... ' " ,, ,') t' ' , . ' l \ .... 1\/' r:'" \ 7" \o C ,[\. I . t -- - -- i " , i ." , ( ;\ I /' / IV , ,I 1 1 I . t fa IVIOSBV TIMES MIRROR THE C. V MOSBY COMPANY LTO B6 NORTHLINE ROAO TORONTO 374. ONTARIO. CANAOA 20 THE CANADIAN NURSE New Volume III CURRENT CONCEPTS IN CLINICAL NURSING Use this clinically oriented sourcebook to stimulate your students to explore current nursing concepts and techniques in depth! A significant report written specifically for the professional nurse, it deals directly with the primary focus of nursing - giving medically sound and humanly understanding care to each patient according to his own particular needs. Sections consider medical-surgical. psychiatric, pediatric, and maternity nursing. Thirty-one articles by carefully selected authorities investigate such diverse topics as trauma nursing, patient teaching for home hemodialysis, nursing needs of adolescent patients who use psychedelic drugs, and supportive emotional care of the new mother. Each discussion explores its subject theoretically and develops sound, clinically based recommendations for intervention. It clearly explains new procedures and techniques which have been proven in clinical practice, and shows how to deal with specific nursing care problems encountered on the wards. Recommend this outstanding professional reference to your studems! Edited By Betty S. Bergersen, R.N., Ed.D.; Edith H. Anderson, R.N., Ph.D.; Margery Duffey, R.N., Ph.D.; Mary Lollr, R.N., Ed.D.; and Marion H. Rose, R.N., M.A. With 37 contributors. October, 1969.361 pages plus FM I-XII, 7" x 10", 19 illustrations. Price, $13.20. A New Book! Douglass-Bevis TEAM LEADERSHIP IN ACTION Principles and Applications to Staff Nursing Situations 1: '. -t '. Every nurse must practice leadership, by the very nature of nursing. Choose this paperback as a supplememary reference to your lectures and required text in various courses, particular(v "Fundamentals". This unique book presents the nurse's role in team leadership, in the form of predictive principles which can help her coordinate effort and organization to give the best possible nursing care. It shows her how to formulate these principles and use them in problem.solving. Specific leadership principles examined in depth include teaching-learning, group dynamics, delegation of authority, effective conferences, and evaluation of personnel. Numerous examples demonstrate these predictive principles in action-a practical method which can enable your students to become effective leaders on the nursing team! By Laura Mae Douglass, R.N., B.A., M.S.; and Em Olivia Bevis, R.N., B.S., M.A. February, 1970. Approx. 224 pages, 7" x 10",2 illustrations. About $5.50. A New Book! Hepner-Boyer-Westerhaus PERSONNEL ADMINISTRATION AND LABOR RELATIONS IN HEALTH CARE FACILITIES This stimulating new book contains a wealth of up-to-date information of value to the nursing service administrator and others responsible for health care personnel. It considers the context of personnel administration, the role of human relations in successful personnel administration, and the specific functions of the administrator and his staff. In concrete, pragmatic terms, it explains the unique personnel requirements of hospitals and other medical facilities. A comprehensive discussion of policies and procedures, a candid report on collective bargaining and relevant legislation. and suggestions for organizational innovations highlight this presentation, important background for your supervisory role in the clinical setting. By James O. Hepner, B.A., B.H.A., Ph.D.; John M. Boyer, B.A.. M.A.; and Carl L. Westerhaus, B.S., M.S. November, 1969. 391 pages plus FM I.XVI, 6%" J( 9%", 9 illustrations. Price, $16.50. JANUARY 1970 "II New in psychiatry: Moditen injectable therapy and follow-up care A clinic that uses a new drug therapy and brings tried and true public health concepts to community psychiatric care also precipitates a new role for today's nurses. Aileen Symington, B.Sc.N. - ........ -::;-0.. _UJ..Q" ... Moditen* therapy involves the use of a new drug that effectively reduces hostili- ty, anxiety, agitation, and hyperactivity. It helps get a psychiatric patient out of hospital and back into the community. Treatment with Moditen - and other new treatments - are having miraculous results, but discharge from hospital some- times creates new and different stresses that affect therapy. More is needed - a continuous relationship between care in hospital and care in the community. In London, Ontario, a special clinic has provided the answer. It has just completed a one-year pilot project that illustrates psychiatry's awakening to follow-up nursing care in the community. This special clinic. called the Moditen Clinic, is set up at the London Psychiatric Hospital to do two things: fust, to permit - Mrs. Symington graduated with her bachelor of science in nursing from the University of Western Ontario in 1943, after receiving her diploma from the Victoria Hospital School of Nursing in London, Ontario. She worked for a year with the Victorian Order of Nurses in London, then "retired" to raise four children. Eight years ago she began work as a public health nurse in London; she was seconded to her present position with the Moditen Oinic about one year ago. *Brand name of injectable fluphenazine enant- hate manufactured by Squibb Pharmaceuticals. Much of the information about the drug is taken from the booklet supplied by the manu- facturer. JANUARY 1970 I I the use of a new drug that still needs close medical supervision and, second, to provide a follow-up nursing program that helps the patient adjust to community life. This second purpose is especially necessary as the new drug is rapidly preparing two groups of patients to go back to life outside the hospital: . those who have developed a psychiatric disorder and are treated and discharged from hospital after a short stay of 28 to 40 days, and . those who have spent years in a mental hospital and present a mode of life altered by long-term institutional living and characterized by apathy, desocializa- tion, and deteriorated work skills and in terests. In a way, such a clinic is an inevitable outcome of current psychiatric practices. Diagnosis, treatment, and rehabilitation are seen as closely connected, perhaps even as indistinguishable from one an- other. In this new concept, follow-up care is part of the whole treatment scheme and is planned from the onset. Follow-up care is now seen to involve the use of supportive interviews, more intensive psychotherapy, group therapy, maintenance electroplexy, routine oral medication, or routine injections. Two or more of the above may be used simulta- neously. In London, our solution was to estab- lish a clinic, close I}:' attached to the THE CAN:toIAN NURSE 21 I ... . '\... - ., '\, - . , . . ' .,. ". ... . .. .. "" .. '\. -........ . r-- The author (right) with Dr. W. Andrews, director of the Moditen Clinic. hospital, but at the same time more like a community agency with close liaison with other agencies in the area. The clinic itself The clinic was set up in August 1968 through a cooperative arrangement be- tween the hospital and the board of health for London and Middlesex County. Its basic permanent staff was one public health nurse seconded from the public health unit - but the approach to patient care was a team one. The team consists of a psychiatrist. one or two unit physicians, a ward supervisor, an occupational therapist, one or more social workers, a registered nursing assistant, and the clinic nurse. Sometimes an intern, a psychologist, and a chaplain sit in with the team. The unit head acts as moderator. Together the group formulates a working diagnosis, establishes short- and long-term goals, and carries these goals out. Clinics are held Wednesdays from 9:00 a.m. to 5:00 p.m. and Thursdays from 5:30 to 7:30 p.m. The evening clinic was opened for convenience of patients who work during the day or find daytime transportation a major problem. We do make special appointments at other times if necessary. The number of patients at the clinic has grown from 42 in August 1968 to 22 THE CANADIAN NURSE slightly more than 100 in June 1969. This means that over 200 injections are given every four weeks. Last December it was necessary to ask for an additional nurse to help with the work load. The hospital was able to provide the services of a registered nurse who had served nine years with the Department of Indian and Northern Health Services. This past public health experience has been in- valuable. The actual work at the clinic mainly concerns the continuing of Moditen injec- tions that were started when the individu- al was an inpatient. To help us supervise this continuing drug therapy, we ask that an information slip about the patient be filled out by the ward clerk or charge nurse and sent to the clinic at the time a patient's discharge or leave of absence is planned. We try to get to know the patients before they come to us as outpatients. One way is to have the charge nurse arrange for the last injection of Moditen before discharge to be given at the clinic. We believe this makes the transition just a little bit easier. The usual maintenance dose of Modi- ten is 50 mgm. (2 cc) every two weeks. In maintenance therapy for patients with schizophrenia, however, there is consider- able variation in individual tolerance, response, and duration of action. Close . . fi ,. medical supervision is required, especially in the first few weeks. Appointments are made for the next visit while the patient is at the clinic. Attendance is watched, and if a patient is delinquent, the hospital unit he came from is notified and either the clinic nurse or a social worker gets in touch with him. We believe it is better therapy for a patient to remember his own clinic date, so we do not remind him. Charts are kept on each patient in manila folders, complete with a white dosage sheet for date and observations, a green treatment sheet. and a yellow home visit sheet. Filing cards containing perti- nent information and total medication records are also kept up-to-date; these are accessible only to professional staff. In a separate book, we keep records of laboratory work and x-rays, as well as records of special clinics. We also keep pertinent monthly statistics regarding the work of the clinic. Some might believe the clinic should be in a separate building from the hospi- tal; ours is not. One advantage is that it is convenient to the hospital pharmacy where patients can pick up their pills. We think it is good for them to have this responsibility for reordering their own; however. we do keep careful records of medications as well. Another advantage of a hospital loca- tion is that it enables clinic personnel to work closely with ward personnel. Before discharge of a patient, the clinic nurse and the ward social worker can work together to see that the patient has adequate living quarters. This means that the patient has somewhere to go and that those who will be living with him will understand his illness and the best ways of helping. At present, the clinic nurse visits pa- tients who have been sent to boarding homes under an "approved homes" plan - somewhat similar to foster care. These early home visits often seem to help the patient reestablish a balanced life pattern and become a useful citizen. Home visiting The clinic nurse, because she is a regular employee of the public health unit, is free to make home visits when necessary. It is an excellent theory to try to provide support and encouragement to the patient between his visits to the clinic but, because of the work load, we usually visit only when there is a problem. After we get to know the patient, we can give him much support over the telephone. JANUARY 1970 The home visits have proven to be of real value. The public-health-trained nurse brings special skills in interviewing, ob- serving, and establishing rapport in strange situations. With her medical knowledge and her great concern for the patient and family, she becomes an ideal liaison person between the doctor and the family. She is sometimes the only one who can help in special situations. This spring, because the clinic nurse could and did take the time to make repeated visits and gradually was able to overcome a language barrier, she was able to help a family that was seriously split over a question of a tubal ligation. The mother had become a clinic patient fol- lowing hospitalization for an unsuccessful attempt at infanticide. Another baby would likely have been a disaster to the family because of the mother's fragile emotional balance. The nurse needed to use all her knowl- edge of community resources to help this family and even became the one who helped the mother through the admission routine before the surgery. The drug itself Naturally, to work in a clinic that is mainly concerned with a specific drug therapy, the nurse must have a thorough knowledge of the drug. Treatment with fluphenazine enant- hate - Moditen Injectable - was intro- duced in Ontario at the London Psychiat- . " t 1f' I'. S. r. . '. ,.- " ,'. .'- . . I '. _ . .. ... ,. \ . " . " '." . " ",1 : : . , I': ).: :. : , . ; 'iJ.; . t : to '. ..... . , '" .. a ." . f . ,,1# 4 . .. ..... .,.....".... e..' '-1 . :--.. "=4. :--. . . . .' ....... ,' '. ,,-' . r : ...'l T . ;, ...,. '.;;>"" þ "" ".. ;J",. '...., ...........II'. ... ,,' ..-- .... ...: Ê .. ,," ...! ".. . '.. .. , ... ...".... "'II' .. ... ......... . .." , . . ?... . .. . I' ... I. ;;= ...t... ,. .. ", ..... .....". --; ." .. ... , . .. .. -t. .. _-. :.;. 1 . .. ... . ".' . : ,e . , , ric Hospital in October 1967 by Dr. W.N_ Andrews. He had previously used it with excellent results for two years in York- ton, Saskatchewan. The drug had also been used in England since 1965. It is now being used extensively in Southern Ontario. and two other Moditen clinics have been started in other health units. The drug is a member of the pheno- thiazine family, which first came into use about 15 years ago. It is manufactured in such a way that the effects of an intra- muscular injection are prolonged for one- to-three weeks, with an average duration of about two weeks. It is primarily effective in reducing hostility, anxiety, agitation. and hyper- activity. Confusion, hallucinations, and delusions are effected to a lesser degree. The onset of action generally appears in 24 to 72 hours and the effects of the drug on psychotic symptoms become signifi- cant within 48 hours. When the acutely-ill patient becomes more settled on Moditen therapy, he is shifted to maintenance therapy while still in hospital. The dosage is worked out for each individual and is sometimes altered during attendance at the clinic. A patient seldom requires a higher dosage. but occasionally the dosage is reduced. It is important to do full blood counts, liver function, blood urea analysis, and urinalysis before the drug is started, to provide a base line. These are repeated every four months at the clinic through a f,j. . / ..., , " - r , ...... '. -- , cooperative arrangement with the provin- ciallaboratory . Moditen is contraindicated for patients with suspected or established subcortical brain damage, patients receiving large doses of hypnotics, patients with blood dyscrasias, hepatitis, severe renal insuffi- ciency, cerebral thrombosis, circulatory collapse, or altered states of conscious- ness, and patients with severe depression. It is not recommended during the first trimester of pregnancy. although this is a matter for the individual physician's judg- ment. It is used with caution in patients with a history of convulsive disorders, and reduced amounts of anesthetic may be required if a patient on Moditen undergoes surgery. Adverse behavioral effects or over- sedation. characterized by drowsiness and lethargy, may occur; relief is obtained by adjusting dosage. Contrast hyperactivity and post-injection insomnia have been noted; conventional sedatives usually bring relief. Toxic effects on the central nervous system are sometimes noticed. Most frequently reported are reversible extra- pyramidal symptoms, such as parkin- sonism. Most often observed in our clinic are shaking of the hands, tapping or twitching of a foot. slight facial rigidity, rigidity of arm and leg muscles, and increased restlessness. These effects are related to the chemi- cal structure of the drug. They largely ..... . ';J ..i.: '.I" : . . , ..." A.""i r 1 . / .. -- The Moditen Clinic team in conference with a patient who has recently been able to retum to her work in the 'ommwlity. IANUARY 1970 THE CANADIAN NURSE 23 " II. , .. \ r , \/ t . ,-., '> } t, .'; u. 1.:' '., ::> '"' -"') Barbara DUllcall, head of the Arts Celltre's nursing team. on her way to the main foyer. The red carpetmg 011 the stairs is one of the mallY colorful features found throughout the Celltre. IANUARY 1970 The National Arts Centre is alive and well in Ottawa. So well that seven part-time nurses are on staff to take care of the throngs of theater lovers who come daily in pursuit of culture. Carol Kotlarsky, B.I. When seven Ottawa nurses talk about their work in the theater, they are not referring to the operating room. For them. theater means the glitter and glamour of the Capital's National Arts Centre, also known as "Fort Cul- ture," where the latest in fashion blends with futuristic architecture to capture a mood in tune with the performing arts. Operations here vary from modern poet- ry, folksong, dance. and drama to orches- tra, opera. and ballet. Even Shakespeare can be up-to-date (complete with elec- tronic music) or traditional. The Arts Centre houses a 2,300-seat opera house-concert hall. an BOO-seat theater, a 300-seat experimental studio. and a smaller salon for more intimate gatherings. Whether there is one perform- ance on or three, only one nurse is on duty. She arrives before curtain time and spends most of her time in the first-aid room on the main floor near the opera house, until the theatergoers have gone. In the words of one young visitor. the nurse is there for people who get over- whelmed by a performance. Although the nurses were hired mainly to look after the public, there is a second nursing room backstage where the performers can be looked after Another group that the nurses attend to consists of the more than 2 00 NAC staff members. Miss Kotlarsky. a graduate of Carleton Univer- sity's School of Journalism, is presently Editor- ial Assistant, The CanadIan Nurse_ The nurses agree that nursing at the Arts Centre is unpredictable. "It is some- thing like emergency and industrial nursing, with lots of common sense need- ed," explained Barbara Duncan, who is in charge of the nurses. "You are on your own and must play it by ear. You never know what is going to happen." The first-aid room is supplied to reme- dy the Centre's most common com- plaints: headaches, cuts, upset stomachs, dizziness, and even sunburns. Antihis- tamines are stocked for people with allergies. A doctor is on call for serious problems. Different audiences bring different problems for the nurses. One group, "The Mothers of Invention" - a modern jazz group - attracted crowds of enthusiastic young people. many who arrived bare- foot! That evening one man walked into a glass door and cut his brow, adding more excItement. Mildred Dempsey, who is a full-time nurse at the Ottawa General Hospital during the day, remembers particularly well a concert that drew many older people and many handicapped. A number of the handicapped persons came alone. The Arts Centre has three wheelchairs, but Mrs. Dempsey estimated that close to 15 were needed that evening. "It was like Grand Central Station," Mrs. Dempsey said. "I felt as though I were running a taxi service." She operat- ed a wheelchair service alone, as all the THE CA DIAN NURSE 25 ushers were busy. There is a special hal1way for people in wheelchairs, which leads into the opera house. The nurses have discovered that some visitors who need treatment do not seek it, chiefly because they do not want to miss the program. Some, however, visit the nursing room during intermission. Shirley Klymasz, who also does part- time nursing at the Riverside Hospital of Ottawa, was on duty the evening a woman had a heart attack. This woman insisted that she knew what to do, would not al10w the nurse to help her. and I ! : -I; , -- i Ip . . ':' ,.." J- ,- .",. refused to go to hospital. The woman phoned her doctor but could not reach him. Although she was alright the next day, she had a few miserable hours that could have been avoided. Mrs. Klymasz said. One unusual accident involved a young girl who had her pet rabbit with her in the foyer. The rabbit bit her, causing a good deal of bleeding. Gayle Argue, the nurse on duty, phoned the girl's mother and suggested that she take her daughter to a doctor for tetanus antitoxin. At least four or five people have fal1en .... lIMIt , I f ' ., . on the steps leading to the underground garage, and there have been several bad fal1s in the garage. Not all the fal1s have been inside the building. though. One girl broke her leg behind the building when she tried to jump from the grass onto the walk, about four feet below. Mrs. Duncan, who was on duty at the time, stayed with her until the ambulance arrived 20 minutes later. The grassy ter- races behind the Arts Centre, which lead to the canal. are a favorite gathering place during the summer, especially for teen- agers. .. I .... f. .'-. ... " . ..... .. ..,;; " - .-- Preparing for the nex t patient. Although small. the Centre's first-aid room is well-equipped to handle the most common comp/alllts: headaches, cuts, dizziness, allergies, and upset stomachs. A record of each person treated is kept by the nurses. ., oi1It . . " '" t. .. l '\ ... -.... \ ..... f - "Î" '" .. -.- " -... ...... \, . - -iI, '+, " 1.\ ." ... \\- Intermission in the theater foyer during the Ottawa premiere of "La Visite de la Vieille Dame, " perfonned by Le Théâtre du Capricorne. Opening nights are particularly good occasions for people-watching - but this one was better than most. 26 THE CANADIAN NURSE JANUARY 1970,. .4 '. .. ... ...: , One evening a young man who was inebriated appeared on the roof looking for his car. He also had a sprained ankle. The nurse helped him down. and a doonnan took him to the garage to look for his "lost" car. As for accidents occurring during per- formances, Mrs. Argue remembers one perfonnance of "Les Feux FolIets." In one part of the show in which fire was used. a performer burned one of his hands. Mrs. Argue brought him ice cubes, which he proceeded to pop into his mouth and return to dance on his hands. f I... l I ë .. .-- One member of the NAC security staff lives dangerously. The bicycle that he uses for getting around the garage is not large enough for him. He has received some nasty cuts and bruises from several falls on the cement floor. but is always good-natured about being bandaged. An important part of the nurses' equipment is a pocket pager, which is small and compact. It is convenient for receiving messages anywhere in the build- ing. When a message comes on. there is a whistling sound: once the message is repeated. the noise continues until the r . I- ." . - .".. right button is pressed Another button controls the volume. "There is something for everyone at the National Arts Centre:' says Mrs. Duncan. referring to the broad range of decoration as well as the variety of entertainment. And not least of the advantages in being a nurse here. Mrs. Duncan points out. is the fun of "people- watching. They come in anything: pyjamas (pantsuits). floor-length gowns, and barefoot." For the nurses, however, it is still white cap and unifonn 0 1 1 1 , I I , It \ .., .- - '1.: " ,; r '- '. , 1- .,.. . .Þ :--.,.f . '. . 'I f, . '.< ,. ;; I. - . Jr:.. .. r- ,":.:-:..' ,.::!ijÞ---:-r '. , I r 'I ì'ì II \ \ .'" , 'II' This front J'iew of the National Arts Centre gives some idea of its multi-faced character. The complex, developed as a series of hexagonal buildings on terraces of varying levels, is situated on six and one-half acres in the heart of downtown Ottawa - I, t Ii n ' . I ,.aUI.., . -"/ ' / ; :--tJ III /I II ... , , " - Backstage after the first night's performance of "La Visite de fa Vieille Dame. .. Mrs. Duncan removes a speck from eye of actress. JANUARY 1970 fJ "' - - ,. .... , ' . , ' . . \ \ J$' '1" " .\" " " , .\ III I II - 1. \\\,\, " \ \\' :111 " /I ; I It I I .. I I I I I \ , II '\ ! - . . --. . I - -. \...... ....j.- IIJ . .- The opera house is a horseshoe-shaped auditorium with three balconies and the latest in lighting and sound systems. The stage area, which is slightly larger than the auditorium, is the second largest in North America. THE CAN.\DIAN NURSE 27 Public health nurses work with family physicians Since May 1968, three public health nurses employed by the London (Onta- rio) Health Department have been assign- ed to work with three different groups of family physicians. One nurse works with a group of three general practitioners whose offices are at the Family Medical Centre at St. Joseph's Hospital. The second nurse works with two family physicians who are located in an office in the northeast section of London, and the third nurse works with a group of three physicians whose office is the southeast section of the city. The stimulus for this project dates back to Dennis Brannan's study done in 1965,1 which showed that there was little contact between private physicians and public health nurses. The impetus for assigning a nurse directly to the Family Medical Centre followed the preliminary report from the East York Leaside Health Unit project conducted by Phyllis Jones. 2 Responsibilities of nurses In setting guidelines for these nurses, the London Health Department stated that the nurses would do health counsel- ing for patients and families at home or in the physician's office. They would plan hospital admission and discharge for pa- tients, and would arrange referrals to other community agencies. It was believ- ed that their knowledge of community resources would be valuable to the physi- cians. Thus the major duties would be 28 THE CANADIAN NURSE An article in the September 1969 issue of The Canadian Nurse reported on the progress of a special project in East York, Ontario, where public health nurses had been assigned to work with private doctors to provide better care for patients. This article describe!> a similar project in London, Ontario. D.A. Hutchison, M.D., D.P.H., and Dorothy M. Mumby, B.Sc.N., M.A. those of any public health nurse in a traditional program. In addition, it was agreed that the public health nurse's role could be ex- panded to include other tasks for which she is prepared and which the physicians might wish to delegate to her. Such additional tasks might include prelimi- nary diagnoses, such as in communicable diseases. However, up to the present time this area has been tested infrequently. We believed that in some situations, where rapport had been established be- tween the district public health nurse and a family, this relationship should not be disturbed. In such cases the nurse has become the liaison person between the physician and the district nurse. The nurses' responsibilities do not include the traditional bedside nursing care in the homes. This responsibility continues to be assumed by the Victorian Order of Nurses. However, there are occasions when the public health nurse may be visiting homes in which the VON nurse is giving care, and in these situa- tions the PHN may become the liaison between the physician and the visiting nurse. Family Medical Centre The first nurse was assigned to the Family Medical Centre in May 1968. The Dr. Hutchison is Medical Officer of Health and Mrs. Mumby is Director, Public Health Nursing, City of London (Ontario) Health Department. physicians at this Centre are on the faculty of medicine at the University of Western Ontario in the department of community medicine. Their responsibili- ties include teaching in the university's family practice training centre. The Centre provides this nurse with office space and clerical assistance and the health department pays her salary and car allowance. She also has the benefit of the health department's personnel po- licies. She has adjusted her working hours to fit those of the Centre. This public health nurse was responsi- ble for setting up her own records and method of recording. At the beginning she dictated her notes for typing, but found that her notes were sometimes out of sequence with the physician's notes. She nOw records her home visits on the physician's progress sheets to make sure they are up-ta-date when the patient sees his physician. The essence of any successful multi- professional operation is good verbal communication among those involved. There is no substitute for this. Therefore, short discussions on each patient's prog- ress are essential. Questions must be asked and answered if there is to be effective understanding between physi- cian and nurse and if better health care is to result for the patient and his family. The public health nurse at this Centre has tried with limited success to establish regular meeting times with the physicians. JANUARY 1970 Busy physicians traditionally seem to be reluctant to set aside even a small block of time on a regular basis for routine reporting. But this is the only way that a good mutual relationship can be establish- ed between a physician and nurse, and important patient-related data communi- cated. After the first few months. these conference times need not be as frequent as at the beginning. The public health nurse is at the Centre most mornings. and tries to confer with the physicians about patients at this time. [n the afternoons she makes home visits as required. She visits families living anywhere within the city of London and the county of Middlesex. To date there have been no referrals outside these areas. Private practice The nurse working with the two physi- cians started her assignment in January 1969. at the request of the senior physi- cian in the practice. She. too, works from the physician's office and is supplied with clerical assistance from his office. She remains a member of the health depart- ment staff, enjoying the privileges of personnel policies with the regular staff. She has supervisory assistance available to her and is able to participate in the staff education program at the health depart- ment. She does not engage in any routine or clinic activities of the health depart- ), ... .. ment, but rather works full-time in the practice. This nurse has set up her own records and recording system She dictates her nursing notes. which are typed directly on the physician's progress record by his secretary. At the beginning this nurse met daily, at 8:30 a.m.. with the physician at one of the hospitals to bring him up-ta-date on her visits. have her questions answered. .and obtain any new referrals. As the confidence of the physician and nurse in each other increased. it was possible to reduce the frequency of contact from daily to two or three times a week. When necessary. the nurse can reach the physi- cian by telephone during his office hours. Once a week this nurse makes hospital rounds with the physician: at other times she visits patients in hospital to ensure continuity of care and to make plans to visit when the patient is discharged. This seems to be particularly helpful to those patients whom the nurse has known prenatally and whom she will be visiting postnatally. When a spot check was done of this nurse's case load in May, 1969. it was found that she was working with approxi- mately 100 families. the same as the nurse at the Family Medical Centre; but 59 of these families had been active with the district public health nurses, compar- --- ed with 35 in the first nurse's case load. One of the reasons for this is that the physicians in this practice have a relative- ly higher obstetrical case load than the physicians at the Family Medical Centre. In this particular practice. the area of maternal and child health seems to be satisfying to all concerned: mother. public health nurse, and physician. After the mother has been discharged from hospital. the nurse visits her as often as necessary. Previously the physician saw the baby at three weeks of age. again at five or six weeks. at eight or ten weeks. and at twelve weeks of age when immunization started This schedule has now been reduced to visits at one. two. and three months of age. The physician has found that his tIme in this area of his practice has been reduced by 30 to 50 percent; he has had to make fewer telephone calls and visits to lessen the anxiety of new mothers. Through guidance and health teaching. the public health nurse has helped to allay these fears. In addition, the susceptible baby does not need to be exposed to the public in the physician's office as frequently as before. This physician has also observed that he has been relieved of much of his prenatal counseling work load because of the prenatal teaching done by "his" public health nurse. This. in turn. allows WI- " . ... ..-.... Dr. M. Hickey, left, senior resident at the family medical center, and Dr. B. Hennen, center, lecture.r in family m dicine on the faculty of medicine at the University of Western Ontario, discuss a patient's progress with Mrs. MarCia Fuller, publlc health nurse assigned to the family medical center b\! the London Health Department. JANUARY 1970 THE CAN DIAN NURSE 29 :1 Mrs. Pauline Knierim, left, public health nurse assigned to the private practice by the London Health Departmellt, discllsses relaxation exercises with prenatal patient. Within two months of this assignment the referrals became backlogged. This resulted from the large number of refer- rals received and absence of the nurse because of illness. It was also learned that One of the physicians in the practice was moving to a teaching position and would be replaced by another in July. By mutual agreement, a second nurse was added to the practice to work with the first nurse. Presently. things seem to be going well. Although one public health << nurse has resigned. it is expected that she will be replaced. These nurses seem to enjoy having the variety of school respon- sibility along with the responsibilities related to the physician's group. The physical working arrangements are somewhat different in this setting. The public health nurses work from the health department office and do not have facil- ities in the physicians' offices. They also use health department record forms, al- though pertinent information and case summaries are prepared separately for the family folders in the physician's office. There is no difference, however. in the important area of communication. The public health nurses meet twice weekly at the physicians' offices to discuss their patients' progress and to receive new referrals. The senior physician in this group has expressed satisfaction in having the public health nurses working so closely with his patients. hIm to devote more time to problems specifically referred to him by the nurse. Because the public health nurse has her own office in this setting, she is able to do health counseling during the physi- cian's office hours and at other times. This saves her travel time, especially when several prenatal patients are scheduled for appointments the same afternoon. - "'-- Group practice In April 1969, a third public health nurse was assigned to a group practice of three physicians at their request. It was decided that this nurse would continue to carry her school responsibility and the responsibility for any families whose children attended the school. If she found she could not meet all her responsibilities of case load. we would then decide whether or not the school and associated responsibility would be removed, or whether additional assistance would be provided by another public health nurse for the "routine" program in the health agency. '- v> í \ - -- ....-- ... - .. . ." - .. .... , V -i '''''It,lal' -- ....,. J ,. _="..J - '1 ',--' - :., / . . =- f ./ J, "=1 ... \ .J . -,. ".... . p. - .. . ..,.,... , t-- .. " .. I" =:- ". "" I i ., ... It .. " Mrs. Knierim, the public health nurse assigned to the pripate practice. dictates nutes for the physician's record. Mrs. Joan McGinnis (top right), the private practice secretary, transcnbes the nurse's notes ontu the physician's recurd. 30 THE CANADIAN NURSE JANUARY 1970 Mrs. Jane Guthrie. (right) public health nurse assigned to the group practice by the London Health Department, consults with Mrs. Helen Stearns, supen'isor of public health nursing, London Health Department. Selecting the nurses In selecting nurses for these positions, we looked for qualities such as maturity. initiative. self-confidence. sense of humor and flexibility. We also considered the ability of the nurse to work independent- ly, her knowledge of the community, and whether she seemed interested in the project. We kept in mind. too. the following quotation: '"From the health depart- ments' point of view an unfavourable aspect of careful selection is that the health visitors are very marriageable.'"3 We thought that at least one difficulty had been overCOme by appointing three married nurses and only one single nurse. However. the inevitable has happened: the single nurse has already married and two of the married nurses are pregnant. The feeling of satisfaction among these nurses is reflected in a statement one of them wrote on her progress report. "I feel that the close liaison with the family physicians has enabled me to offer better public health nursing care to these fam- ilies than I was able to provide while assigned to a specific geographic district." Another nurse has stated that she would not want to return to a traditional geo- graphic district. Physicians' response - The requests for nurses to be assigned to work with physicians have come from the physicians themselves. In general. JANUARY 1970 1 '- -- ....' , .., , ... r - y . 1-::- , rI , , ... . , "- . .e J ,t' . .. ..e; .. " .. - - these doctors seem to be satisfied with the arrangement. Recently, when one nurse was on vacation. the physician made a minimum of referrals to her interim replacement. It would seem that this physician was pre- pared to wait until "his" public health nurse returned. rather than refer patients to someone whom he did not know well. Another physician is most anxious that the arrangement with his group of physicians continue and is prepared to discuss partial financial subsidization of "his" public health nurse if this is indicat- ed. In one of the assignments, communica- tion and interpretati n of the public health nurse's function and breadth of activity is a point of some concern and requires further attention. The future This article con tams only a brief de- scription of what has happened to date. It is recognized that further study and collection of data are essential. In future we hope to answer some of the following questions: I. What type of patient is referred by the physicians? What services are given'! How many visits per patient are necessary, compared with similar figures for the district public health nurse'! 2. How many referrals are made by the nurse to the doctor? 3. How many patient conferences are there between nurse and doctor. compar- . .,.r .. \ t -- .." ed to contacts between a district public health nurse and the physician? 4. How soon after delivery is the first postpartum visit made. compared with the first visit by the district public health nurse? How many visits are made? How many tele- phone calls are there from new mothers? Some readers may believe that the assignment of these PHNs to physicians' offices should have been delayed until research outlines were prepared to collect data from "Day One." Others may be- lieve that some of the kinks should be ironed out before data collection is start- ed. Only the future will be able to shed some light on which method would be better. There probably will be agreement, however. that the delivery of public health nursing services as part of total comprehensive heaith care needs to be looked at critically. References L Brannan. Dennis. The public health nurse and the family physician. J. Coli. Gen Pract. of Canada. 12:9:34-37. June 1966. 2. Jones. Phyllis. The public health nurse in the office of the private physician. Unpublished address delivered at the Canadian Public Health Association meeting in Vancouver. B.C., May 7. 1968. 3. Akestor, Joyce M. and MacPhail, Angus N. Health Visiting in the Sixties. A Nursing Times Publication, London. Macmillan and Co. Ltd., 1963. 0 THE CA ADIAN NURSE 31 The independent study tour When lack of time prevents a nurse from undertaking a lengthy period of formal study, an independent study tour may be an alternative, the author suggests. She offers some suggestions, based on her own experience, for those who might wish to set off on their own to study health programs in other countries. Ethel M. Horn, M.A. A little over a year ago, certain changes in health care organization in our community convinced me that I needed time to study a trend that was developing in certain areas in Ontario. This trend was the relatively new approach to the health care of families, whereby public health nurses are assigned to work directly with family physicians. I had several reasons for wanting to find out as much as I could about this new approach to health care. As a teacher of community nursing at the University of Western Ontario, I obviously had a responsibility to keep up-to-date on all aspects of health care. And, too, several public health nurses in our city had recently been assigned by the local health department to work with family physi- cians who are in private practice, group practice, and a family medical center. * In addition, the faculties of nursing and medicine at UWO had expressed interest in the possibility of developing a m u It i disciplinary learning experience from group practices for advanced stu- dents in nursing and medicine. We envi- sioned students from both disciplines working together with the same family. Miss Horn is Associate Professor, Community Nursing, Faculty of Nursing, the University of Western Ontario, London. *Dorothy Mumby, Public health nurses work with family physicians, Canad. Nurse 66: 1: 28 January 1970. 32 THE CANADIAN NURSE In such an ammgement each would have the opportunity to learn his own contri- bution and the contribution of others to the community health team. I decided that as well as studying the programs in our own community, I would explore the roles of the health visitor and the general practitioner in units in Scot- land and England. In the units I planned to visit, health visitors are assigned to group practices and the interdisciplinary programs in some instances are well established in the university medical schools. Planning the visits There are some steps that anyone planning a visit should take ahead to ensure a degree of success. Initially, it is wise to begin inquiries and readings in periodicals at least a year in advance to compile useful information on trends, innovations in programs, and research in progress in your chosen area of interest. Talking to and corresponding with people who may help you or have a similar interest may prove valuable. I did as much reading as time allowed in Canadian and British publications. I talked to people who were knowledgeable about group practice in Canada and Britain, and wrote to persons who I thought could assist me in becoming familiar with programs, problems, and research in this area. Through this corre- spondence I received the name and ad- JANUARY 1970 dress of a Millbank Fellow who had spent one year in England and Scotland. She had visIted ex tensively and shared her opinions and experiences with me. It takes considerable time to focus plans and to organize an area of inde- pendent study. Writing out a tentative proposal as a starting point helps to restrict the study area for review of the current literature. This is a disciplinary exercise that forces a person to come to grips with the study proposal early. Should you be seeking research or short study funds, you will, in all probability, need to submit an outline of your object- ives with your application. Also, an out- line is essential if you are going abroad and need to make arrangements through the Canadian Nurses' Association or other nursing groups. Your subject should not be too re- stricted. You should look for a broad base in which you can find several over- riding interests in education, service, and research. This way you can work with greater ease in these related areas during the tour. After considerable preparation, my study plan began to take form. I was able to outline four areas of interest that were interrelated. I purposely kept these fairly broad and flexible at this point. I wrote a succinct statement of the purpose of the tour and briefly re- considered my areas of interest. The reading, the collaborating and the inde- pendent thinking I had done helped me to reclarify my needs and purposes before undertaking the tour. At this point I talked to various individuals who were interested in the project; on my return, these persons helped me to meet with the groups who would share the results of my visi ts. The visits begin The overall plan of the modus operan- di for an independent study tour should include regular periods of relaxation. Emphasis and consideration need to be given to bi-weekly periods for additional JANUARY 1970 reading, thinking, listening to tapes made, and writing. This, of course, will vary with individuals and with studies. To rush from one experience that has been stimulating to another before you have had time for a critical thinking period and time to do further necessary reading, defeats the purpose of the study tour. Nor can you compile a report while experiencing new ideas and meeting and interviewing many new people. However, a large portion of the framework of ideas take shape during the thinking periods and can be put on paper in rough form. In such a study tour it is wise to confine yourself to the original plan as far as possible. There are always temptations to deviate from your original plan. As you begin to move about on the tour you hear from many sources about experi- mental structures, new research results, and persons who have similar concerns. Though this can be tempting, it is best to deal with these ideas through correspond- ence. Although this does not substitute for a person-to-person confrontation, correspondence can be very stimulating. I tucked away whatever information I re- ceived with the idea that I might be able to help someone else seeking information in the future. Eight months following my initial planning I began my carefully organized study tour. In retrospect, knowing the correspondence that follows requests and the planning that has to be done by agencies, I would recommend that re- quests to agencies be made a year in advance. Also, I found that by outlining areas of interest in my original letter of request, my specific needs were known from the outset. Not only was the request area define, but the agency knew the boundary of my interests before I arrived. My study followed the same pattern in each country. It began with interviews with professors in the social medicine units of the university who were involved in medical education and research in the general practice units. This proved to be a sound background from which to proceed to the next step, that of visiting the local health authority where the health visitor is attached to general practice groups. My first visits were made in Edinburgh and Aberdeen. Later, I visited Newcastle- Upon-Tyne, Winchester, Hythe, and London. The stimulation of meeting in the university settings, where research was being done; seeing and hearing about the new administrative relationships in the community brought about by health visitor attachments; and seeing new rela- tionships between what I had done in the past and what is being done there, pro- duced some new and exciting ideas. On two occasions during my month- long study tour, my requests had coincid- ed with two nurses from other countries. These nurses were on their way to the International Council of Nurses' Congress in Montreal. They had stopped in England and Scotland for a period of observation. We had a lively exchange of information about our joint observations and about nursing in our respective countries. Summary The study tour helps the participant to take a refreshing look at her own con- cerns, to broaden her point of view from the provincial to the international scene, to be actively involved in writing about an area of interest, and to be involved with researchers who are experimenting in their work setting. This form of independent study allows a person to gain a new base for ideas. research, and clinical practice, while view- ing and drawing contrasts with the profes- sional scene away from the home setting. A frequent comment heard about the preparation for a tour is that the reading can be done anytime. In my opinion. if it is not done before and during the tour, the opportunity is lost forever. Once you return to the professional setting. your first obligation is to share information with others. 0 THE CAN DlAN NURSE 33 idea exchange I \, " ... v " '!' ,,: " i 1& r '- ..... ''''f ..-......J. ,l ... .. "';.''/' . >t .. p . 1;'% .ì--& .. .. () J . p -, , :\ - ) .:. .. \\ . 10 \ \ '\ . ..... . . \ \ " j) 'fl . d m ---- .- -- ............ .. .. . , .. - Part of display at book Jàir. Mrs. Gladys Owen, PH.N., librarian for the Sudbury health Wilt, and Dr. B.l. Cook, medical office of/lealth, examine the books. 34 THE CANADIAN NURSE They Came To Our Fair A little grade seven friend knocked at the door of my office at the Sudbury & District Health Unit and asked, "Could you please help me with a health proj- ect? " A chain reaction began with that simple question. To help her, I checked the school library where the material should have been available, and found little on health. I began to wonder if all school libraries in the area were so short of literature pertaining to health. And, if so. what would be the best method of getting new material to them? Book fairs had often been used to expose the public to new books - why couldn't a health unit use this method, too? I discussed my idea with the director of nursing and the medical officer of health. We decided that a book fair could serve several purposes. First, it would show persons of various age groups what material was available on health and the health professions and where it could be obtained. Second, a book fair could be considered as part of in service education for our own nursing staff. Third, such a project would be good public relations, as the various activities and services of the health unit are not always understood by the public. As the idea gained momentum, we involved other departments in the health unit. Everyone had something new to add. Eventually we decided upon the broad outline of the project and our book fair was on its way. Everyone contributed. The Canadian Book Council got in touch with publish- ers whom they represented, collected books they thought would be helpful, and forwarded them to us in time for our fair; the public library loaned us some book supports, and the local book stores sent us paperbacks on the subjects we had chosen. In the end. we got the books we wan ted. To advertise the fair, letters were sent to all professional groups in Sudbury, inviting them to see the most recent books published on nursing, guidance, and nutrition. Attactively designed, JANUARY 1970 simple posters were displayed in libraries, shopping areas, schools, and hospitals in the area served by the health unit. Every- one read about the book fair in the "coming events" section in the local papers. Our public health nurses promoted the book fair and showed posters on their regular television series. Radio announc- ers urged people to visit the fair. We decided to hold the book fair in the health unit offices. They were old, crowded, but central, and gave the tax- payers an opportunity to see the build. ing - and how much we needed a new one! Traffic moved smootWy through a series of small adjoining offices on the main floor, where staff members served as hostesses. We provided a quiet area for browsing, so often lacking at book fairs. A guest book, strategically located near the dental hygienist's office, where our visitors entered the health unit, help- ed us to identify those who attended the fair. Later, this information was useful in evaluating the success of the fair. The dental hygienist spoke with many who were interested in her work. Descrip- tive material on this relatively new career ran out quickly. One room was set up to show audio- visual material on sex education for child- ren. The series ran continually, many visitors seeing part, if not all. of it. Parents were pleased to have the opportu- nity to see what their children might be learning about sex education in school, and librarians were interested in the material available. The room set aside for medicine and nursing contained many books and recent paperbacks - several available in the French language. Young people and guidance counselors were particularl) pleased with the display on "Nursing as a Career." They also had an opportunity to talk with public health nurses about their work. Another room contained material on psychology and guidance, grouped under broad classifications. Health inspectors demonstrated their methods of testing water and treating samples and explained the procedures for restaurant inspection. Their materials on poilu tion were particularly popular. The health unit nurses set up a manne- quin, appropriately dressed with safety helmet, goggles, shoes, and gloves to illustrate one aspect of occupational health. In their hunt for realism, they had been unable to find a male mannequin for our safety display. However, an offer JANUARY 1970 from Eaton's of a bald-headed female form saved the day. Once the helmet, goggles, suit, shoes, and gloves were on, "he" looked real. Two areas for nutrition and communi- cable diseases completed the project at the book fair. The nutritionist's display was both attractive and practical. The book fair was packed away for another time. We had been able to bring the latest professional books and materi- als to our staff, nurses, teacher-librarians, social workers, guidance counselors, and the general public in our area. We helped to provide my little friend and others like her with good health project materials in their school libraries. - Gladys Owen, Public Health Nurse, Sudbury & District Health Unit, Sudbury, Ontario. 0 I II I I I Bradford Frame Covers Canvas Opposing Velcro Strips Nurses on pediatnc units frequently collect 24-hour urine specimens on child- ren for investigation and diagnostic pur- poses. Children incapable of cooperating often have a urine collector applied, and to facilitate both collection and hygiene they usually spend the 24 hours lying on a Bradford frame. Covering the frame's upper and lower canvas segments by pinning or taping sheets is time-consuming and difficult. Also, soiling necessitates re-covering. that is, re-pinning or taping. often repeatedly in a day. We have sewn triple-thick flanelette squares, made to cover the upper and lower canvas segments exactly. Sewn around the borders of the frame's canvas and the flanelette squares are opposing strips of Velcro. As seen in the diagram, the covers can Flanelene Cover I I I I I Supporting Box (raises frame to allow bedpan beneatl be quickly stripped off or firmly attached to the Bradford Frame. This is comfortable for the child to lie on, extremely simple to handle. and easily laundered. - Maureen BrencWey, formerly employed by the Children's Psychiatric Research Institute, London, Ontario as head nurse of the metabolic investigation unit. 0 THE CANAtlAN NURSE 35 ,I 36 THE CANADIAN NURSE One little boy with two big problems How a 10-year-old with cystic fibrosis and serious behavioral problems learned to accept his illness and to trust those who cared for him in hospital. Dorothy Chapman Brian Brown, a healthy-appearing IO-year-old with sandy hair and big blue eyes, did not look as though he had a serious congenital disease when he be- came a patient at The Hospital for Sick Children in Toronto. On admission he had an upper respiratory infection with hoarseness, swollen neck glands, and shortness of breath, and was coughing up copious amounts of white sputum. Brian's diagnosis was cystic fibrosis, a disease transmitted as a mendelian re- cessive trait. It was evident from his x-rays, which showed extensive lung damage, that he had not received treat- ment for at least 10 months. Brian had another problem that could not be ignored: he behaved abnormally in several ways. He was aggressive when he really wanted to be friendly, and to attract attention he would hit someone or wave his arms in the air. He seemed unable to learn from experience, and had a low level of frustration tolerance. Family background Brian's home life seemed to be largely responsible for his behavior. His mother, who is separated from her husband, is the most important person in his life. Brian lives with her during the winter and with his father in the summer. A nervous woman, Mrs. Brown cries easily, smokes heavily, and is still depen- dent on her own mother. She does not believe in keeping to routine, sleeps late every morning, and often lets her three young children make their own meals. Mrs. Brown visited Brian in hospital as often as she was able, but her visits were irregular. Brian showed his disappoint- ment in her by hitting the person nearest him, hanging up the phone on her, refusing his food and treatments. When his mother was with him she appeared concerned about him and quietly tried to persuade him to behave. She was usually unsuccessful and admitted that she was unable to control him. Brian's father, a big, aggressive-looking man, is still a steady provider for the family, even though he hasn't lived with them for eight years. According to Mrs. Brown, he is not dependable in other ways: he acts on impulse, and once served a four-year prison term. In Brian's presence, Mr. Brown seemed awkward and tense, unable to talk to his son. When Brian accused him of treating his mother "mean," his father walked out and did not return to see his son in hospital for several days. Brian resents his father for having left his mother to live with another woman, whom Brian dis- likes. Brian has a 14-year-old sister, of whom he seems jealous, possibly because she does not have cystic fibrosis. He speaks highly of his little brother, aged four, and seems to miss his company. Miss Chapman is a third-year student at The Hospital for Sick Children in Toronto. JANUARY 1970 Brian had not attended school for several months before his admission to hospitaL because he had been suspended for running away and for swearing, screaming, and spitting at his classmates. Thus, the absence of a father, the presence of a disorganized mother, the lack of routine in the home, and a serious medical problem all contributed to Brian's behavior. We hoped that his habits would gradually improve if we consistent- ly ignored inappropriate behavior and rewarded that which was appropriate. Medical background For some reason. Mrs. Brown would not admit that Brian had cystic fibrosis. When the boy was four years old, she suspected that he had a serious illness and took him to several doctors, who told her she had nothing to worry about. Finally, when his disease was diagnosed, she was upset and clung to the belief that he was "normal." She never did tell Brian that he had cystic fibrosis. She avoided doctors and postponed asking them about her son's condition, not realizing that his lungs would deteriorate without treat- ment. Because he appeared well, she believed he was well. Cystic fibrosis is a disease that cannot be ignored by either the child or his parents. In this condition thick secretions block the ducts of the pancreas, prevent- ing important digestive juices from enter- ing the intestine. The stools contain undigested fat and are foul smelling. Gradually the infant becomes malnourish- ed. Small air ducts in the lungs are also blocked by thick mucous, predisposing the lungs to chronic infection and fibrotic change. There is no cure for cystic fibrosis. Treatment is life-long and is aimed at removing the excess mucous in the lungs and supplying the missing pancreatic enzymes. If these are not accomplished the child dies. usually of pulmonary disease. Problems with treatment On admission, Brian was treated with antibiotics, vitamins, and pancreatic enzymes. Inhalations by mask, lasting JANUARY 1970 from I 0 to I 5 minu tes, had to be given three times daily. The inhalations were unpleasant. since the solution used was foul-smelling. Postural drainage then removed from the lungs the excess secretions that had been loosened by the inhaled solution. There are several drainage positions that help to clear the five lobes of the lungs. These positions are uncomfortable and the treatments can be painfuL especially if the secretions are profuse. But each posi- tion must be assumed every day if the patient is to survive. The patient lies in each position for 10 minutes while the physiotherapist claps the chest over the particular lobe to loosen the secretions. Throughout the procedure he coughs up as much sputum as he can. At first. Brian refused the postural drainage treatment. although he took his inhalations and medication without fuss. He decided he did not like the physio- therapist. This may have been because she had to emphasize the importance of the clapping of his chest. The physiotherapIst was very patient with him and often let him choose his favorite position. After a week he still would not assume several of the positions and would hold none of them for the required 10 minutes. He ... "-_" .. .: . -... , . "', , ..- Z/ _a. -- ., , .. _,.t :: {......... "1 . -,:, '-! ::"'::.' ;. :./':. - """' \ . ':: '" .i {\.:. ... \.,\ ":1,, . .,. - .. - ...'"," ," ....I I -:. - . -rl f ., ., . llt 'e --. .. - /'." ' I ;'I' ':' /I, - -- . ..:.0:- _ .. l.l' .:." r / ,.!,. , , :! ",. '.i/ II,,!i." """"'," 11 ."" . :' ,/O-;ø'. ,' , . . : ,. . 1i ,ft,: ::.,.... il; II ". ,. ::-f: -:: . , h1. '1/' .' , I. l." ! I I I !II J: .'., ,t r ,!'l" , , II I \." , ./ ,1 I \' , I . .lJ I !' \" "-. ! ,' 'Ir' \ f C) II ð \, (\1 kicked, screamed, and swore when she tried to teach him a new position. At night Brian was to sleep in a tent, which provided moisture. This too was uncomfortable, as he became wet in a few hours from the condensation in the tent. He then refused to sleep in his tent, and even refused to stay in bed. Some nurses, ill an attempt to calm him. gave him a prescribed sedative, which he did not like. Other nurses would let him stay up until he fell asleep on the floor outside the nursing station. To get attention, Brian refused his meals. I would sit with him aDd we would list the foods he liked and disliked. When the cafeteria sent him a menu, he could no longer say he did not like the food offered since he had chosen it. He enjoy- ed this special privilege. At the weekly team conference. those of us caring for Brian discussed the limits we should place on his behavior and planned how we would deal with his problems. Somehow we had to convince him of the importance of the various treatments, which he will have to carry out daily for the rest of his life. The psychiatrist advised us to ap- proach Brian in a matter-of-fact manner and to tell him simply it was now time to THE CANADIAN NURSE 37 i' 1 do his postural drainage, or time for his inhalations. In this way Brian would know exactly what had to be done and when. The psychiatrist decided to see Brian regularly three times a week for half an hour, to give the child a chance to share his feelings with someone who was not directly involved in his medical treat- men t. Mrs. Brown was counseled by the same psychiatrist. He told her that it would be necessary for the boy to have regular treatments for the rest of his life, which might be 10 to 20 years or longer. He also told her that she would have to talk to her son about his illness, although he knew it would be difficult for her to do so. Brian had to learn to accept his disease if he were to survive. The new plan As part of the new plan, Brian was expected to get up and have his breakfast at 8 :00 a.m. When he refused, saying that at home he always slept in, I told him that while he was in hospital he would have to get up for his breakfast. When he still refused, or threw his food on the floor, I left the room. Usually he would then calm down and eat at least part of his meal. Brian behaved similarly at the time of his tub bath or inhalations. As long as I entertained him while he took his inhala- tions, he behaved well; but if I had to leave the room, he would pour the solution on the floor. Three times a day Brian was to have postural drainage. When the physio- therapist entered the room, he fought so violently that for several days it was necessary to restrain him during the treatments. Brian enjoyed the remainder of the day, which he spent at school, at play, or in occupational therapy; in the evenings he went to the play room or to Cubs. At these times he behaved as normally as any IO-year-old boy. When Brian had violent tantrums be- cause he had to go to bed at 9:00 p.m., his door was locked. Eventually he would fall asleep. After he was asleep we would turn on his tent. He knew we did this and accepted it since his objection to the 38 THE CANADIAN NURSE tent was that the noise kept him awake. Several weeks after admission Brian asked some revealing questions: "What is the worst disease you can have? " "WiU I have to have the clapping done when I'm grown up?" "Do they have tents big enough for a grown man?" Brian was beginning to accept his illness. It was important for him to be able to relate to us how he felt. Occasionally he would have a good day, when nothing upset him, and he would take his treatments without need- ing restrain t. Brian still became upset if his mother did not say definitely when she was coming to visit; if the doctor mentioned that he would have to stay in the hospital for a long time; or if his mother told him he was not going home after his hospi- talization, but instead was going to a children's rehabilitation center. At such times the physiotherapist needed extra help with his postural drainage. Enforcing his treatments was necessary at this time, as other approaches had failed. New problems now developed. He would lock himself in the bathroom or run off the ward when his inhalations were to begin. At another conference, which included the physiotherapist, the occupational therapist, the pediatricians, the psychiatrist and the nurses, the psychiatrist advised us not to run after Brian when he was merely seeking atten- tion, but to bring him back when he was running away from his treatments. When Brian said "Give me a knife, I'd rather kill myself than have to do my treatments for the rest of my life," the psychiatrist explained that the boy was going through a depression period and that we should let him talk freely, reassure, and comfort him. He urged us to observe Brian closely, since he was serious about harming himself. In addition, it was decided that since he was an active boy who needed exercise, we should allow him to go to the gym as frequently as possible. A male psychiatric nurse was assigned to the ward because the regular evening nursing staff had difficulty coping with Brian. The first evening Brian was hostile and rebellious. He ran away; when confin- ed to his room, he became destructive. The psychiatric nurse was strict, but kind, and disciplined him in a fatherly way. Brian's hostile feelings gradually disappeared. Though I was no longer his regular nurse, I continued to visit Brian. I was available when he wanted someone to talk to, to read him a story before he went to sleep, to kiss him goodnight, if he wished. As a reward for his good be- havior, I often took him to the cafeteria for a snack in the evenings. He looked forward to this and knew that he had to behave well to merit this privilege. In this privacy he would tell me what, if anything, had upset him during the day, for example, when his mother had called or failed to come when she said she would. He even admitted that he should not have misbehaved. Brian faces reality During my final week on the ward, it was important to tell Brian exactly when I was leaving. He asked where I was going, and what I would be doing. He had begun to face reality. When the psychiatrist decided that Brian's mother was still unable to care for him at home, we discussed what other temporary, institutional care he required and how we should prepare him for it. We showed him pictures of his new tempo- rary home, and we arranged for him to speak to other children who had stayed there. With help, Brian will be able to handle the inevitable problems and disappoint- ments that lie ahead of him, just as he has come to accept the fact that he is ill and that his treatments are necessary if he is to grow up. Because he accepts his illness, his behavior has improved. No longer the aggressive or destructive child he was when he first entered the hospital, he has begun to trust the adults around him. Since Brian must invest many hours of his life in treatments, he cannot live as rich a life as any other child. If he lives by the necessary regimen, however, he will continue to adjust to this disability and will, therefore, be better equipped to use his ability. 0 JANUARY 1970 No time for fear A nurse remembers how one teen-age boy reacted to a fatal illness, and how he affected the lives of those around him. Elvie Follett I rust saw Bob the morning after his admission to hospital. As I walked through the ward to the head nurse's station, I noticed a boy with reddish blond hair and skin so fair it looked almost transparent as it stretched taut over the fine bony structure of his face. He looked young to be in a ward for adults but, although slight, was a good height for I 5 years. A few evenings previously. Bob had noticed a large bruise on each thigh as he was getting ready for bed. Next morning he saw his doctor. At 2:00 p.m. the same day, the doctor told Bob's parents that the boy had leukemia. Steps were taken immediately for Bob to be seen by a specialist, and within a few days he was in hospital. In hospital. both staff and patients took a keen interest in this boy who, in the weeks to follow would do nothing of a dramatic nature, but who would show nobleness of spirit, quiet courage and other qualities of character - the stuff of which real heroes are made. Bob was to have an effect on a number of peo- ple - an effect that has been enhanced rather than diminished by time. As instructor in science and medical nursing at the time, I helped student nurses with nursing procedures, conduct- Miss FoUett, a graduate of Toronto General Hospital Schoot of Nursing, is nwse-in-charge, Employee Health Service, at Toronto Western Hospital. She is editor of The TGH QwIrterly. IANUARY 1970 ed patient-centered clinics, and held dis- cussions on all aspects of patient care. It was necessary for me to be familiar with the conditions of all patients and the doctors' orders for them. I remember my first conversation with Bob. I was impressed with his mature outlook as he discussed his plans for school in September. He had been reluc- tant to enter hospital for it meant missing the June examinations at school. He was jubilant later when he was granted his year on the basis of his past work. Making friends Bob made friends with everyone, and. when he could, went from bed to bed sharing his treats. He talked to a 70-year- old patient with the same ease as he talked to the younger patients and class- mates when they visited. He would often say to his father. "Dad. Mr. - doesn't have any visitors. Go over and talk to hi " m. Little incidents. such as his mother's birthday, stand out in retrospect. I saw no reason why Bob could not celebrate with his parents and sister. as he request- ed. I arranged a corner of the sunroom off the ward. A covered table, with a bouquet of fresh flowers contributed by a patient, was laid out with the necessities and a few chairs were drawn up. We wheeled in Bob's bed. along with the intravenous standard. A family friend had made a cake. At THE CANAQIAN NURSE 39 Bob's request it was a whopping big one, for he insisted that everyone on the ward should have a piece. His mother, hiding her feelings behind a gay smile, served cake to all who could have it. Dave and Pat, two straightforward Scotsmen, took a real interest in Bob, whose bed was next to theirs. Dave had a great sense of humor and an endless fund of stories. Their laughter was contagious. Never have I seen so much fun among a group of sick men. Both men tried to protect Bob and to keep from him any information that might disturb him. One evening they drew a screen around him and engaged in some quiet horseplay so he would not see Bert, another young lad with leukemia, being moved to a single room because of severe gastrointestinal pains and muscular spasms. There were many other parties with goodies supplied by Bob's neighbors and friends from home. No skimpy tid-bits were found at these parties; instead, the fare usually consisted of whole roasted chickens, Dagwood sandwiches, and extra large cakes. Bob's reputation for sharing was well known. Returning home Bob's treatment, palliative only, result- ed in considerable improvement. Drugs, blood transfusions, rest, and diet all contributed toward a feeling of well- being. There was every indication he would be returning home. As his home- town was small, we thought he should be told of his condition rather than learn it from one of his friends or by chance. The doctor told Bob there were several types of leukemia, which varied in sever- ity. Bob was not surprised at this diagno- sis, but believed he had a mild type. He had discussed his blood and sternal bone marrow tests, compared his treatment with that of Bert, and had drawn his own conclusions. He confided to Dave that he thought he had leukemia but cautioned him not to let his parents know, as he did not want them to be worried. The day the doctor told him his diagnosis, he said to his parents: "It's not anemia I've got, but leukemia." He thought it would be easier if they knew he was aware of it. He asked his father to get him a hot dog and, alone with his mother, told her he was not afraid to die. She said later that she had no words to answer. 40 THE CANADIAN NURSE He began to ask his doctor questions. He leamed why he was taking certain drugs and why he was on a low sodium diet. He knew that his nosebleeds and subscutaneous bruising were in part due to his low platelet count. He read an article on Strontium-90 and its possible effect on white blood cells. He was aware that the prognosis was not encouraging. "Well, I've had a good life," he told one patient. Bob went home to enjoy his summer. More mail than usual was delivered. One morning he received an envelope contain- ing a bank draft for $300. When his father called the bank manager for an explanation, he was told it was a gift for Bob from a friend who wished to remain anonymous, and was for him to spend in whatever way he wished. Bob, who loved music, chose a record player, records. and a small transistor radio, which he and his friends enjoyed that summer. He swam, played ball, and went on a few weekend trips with his parents. A highlight was having Dave and his family visit. The men went fishing, and Bob caught the only fish. The day was topped by a barbecue supper in the garden. There were a few snags. a few remind- ers, but Bob seemed capable of coping with them. A child asked, "Is it true you only have one year to live? " "And how did you hear that? " Bob countered, as he raced off on his bicycle. One day an acquaintance, visiting his home, asked: "What are you taking the tablets for?" "lust in the interest of research," was the quick reply as he swallowed the medica- tion and bolted through the door. Reentering hospital In September Bob returned to school - for two weeks. An attack of influenza hastened a relapse, which made readmission to hospital necessary. He did not want to go, but was reassured on seeing familiar faces a he entered the same ward. He kept a daily diary, and with a little returning strength wrote home that he intended studying French and mathemat- ics. He made arrangements with his mother to do his Christmas shopping. In 30 envelopes, each marked with the recipient's name, he placed money and instructions for his mother concerning the gifts. He asked her to buy presents for three doctors who saw him daily, and a student nurse who had become a good friend. He wanted to keep these gifts until the last moment on Christmas Eve so the staff would not feel they had to give him something in return. Three weeks before Christmas Bob was transferred to a private room where he could have his tree, gifts, television, and visitors. He was worried about the ex- pense of his hospitalization and was relieved only when his father showed him an insurance policy that included cover- age for leukemia. Bob's parents heard from others of his nosebleeds, discomfort, and abdominal cramps. If he had to tell them anything he tossed it off lightly, almost gaily. One day, as he glanced at his swollen, discolor- ed legs, which he could not bear to have covered, he said to his father: "Never mind, Dad, perhaps they'll be better tomorrow." A week before the end he said: "This has been a great day. So many of my good friends have been to see me." The following day he told his mother that as they had been rushing Christmas and cheating a bit, he thought he would give the doctors their gifts. Though his strength was waning, he smiled his pleas- ure when the cuff links, cigarette lighter, and tie reappeared in use the next day. Dave, still a patient, got up to visit Bob, "because I had to see that boy again. There were so many wonderful little things about him, and yet they were all big things. He was great in every way," he said. A staff worker told me, "Everything about Bob was outstanding. I will never forget his courage, or the way I felt strengthened after visiting him. For him death was nothing to fear. It was like walking through a door to another room. .. It is not easy to describe this boy and his affect on others. There was something about him that defies description. Some faces become blurred with time, but not his. I deem it a privilege to have known him. In him we saw a magnificent blend- ing of the finest in human qualities, a boy who could lift others to a higher level. 0 JANUARY 1970 research abstracts The f ollowrng are abstracts of studies select- ed from the Canadian Nurses' Association Repository Collection of Nursing Studies. Abstract manuscripts are prepared by the authors. Sellers, Betty Louise. A study to compare the nursing care given by professional- ly and technically prepared nurses on a medical unit. Seattle. Washington, 1968. Thesis (M.N.) University of Washington. Nursing literature was relatively devoid of support for the thesis that quality nursing care exists when there is maxi- mum utilization of generaJ staff nurses according to their knowledge, skills, and abilities. This descriptive study was de- signed to assess nursing roles of profes- sionally and technically prepared nurses, to redefine them as necessary to provide for maximum utilization, and to assess quality of nursing care given before and after role redefinition. An activity study was employed to assess how that nurse was spending her time, while a quaJity study was employed to assess to what extent the nursing care was satisfactory. Each study consisted of three phases which extended over one year. Data for the activity study was coUect- ed using a modified version of Arnstein's tool. Data for the quality study was collected using a modified version of the Pardee standards for nursing care, which employed patient interviews, nurse ob- servations, and examination of the pa- tient record. Findings revealed that the quaJity of nursing care as given by all registered nurses on the ward did improve by 11 percent over the three phases. However, the professionally prepared nurses did not appear to be perfonning specifically in the redefmed roles which provided for increased planning for directing and as- sessing of patients' nursing care needs. Griffith, ). Kirstine (Buckland). An insti- tute as an educational experience in the continuing education of a selected population of nurses. Vancouver, 1969. Thesis (M.A.) U. of British Columbia. This study was an effort to evaluate the effectiveness of a two-day institute on "EvaJuation of Personnel" as an educa- JANUARY 1970 tionaJ experience in the continuing educa- tion of nurses, to submit a method of evaluation to critical analysis, and to examine the relationship of educational and experiential backgrounds of the par- ticipants to the learning that took place subsequent to an observational analysis of the institute. An unstructured interview technique was used three months after completion of the institute to elicit sub- jectively what respondents thought they had learned at the institute. The informa- tion was later arranged in a structured format for compilation, tabulation, and anaJysis, both by punch card and comput- er. The socioeconomic background data were gathered through the use of a structured questionnaire at the time of the interview. A behavioraJ concept of learning was used throughout. The results reveaJed that 91 percent of the sample indicated that learning had occurred, as the nurses perceived a change in their behavior because they had attend- ed the institute. Furthermore, 76 percent perceived a change in knowledge, 62 percent in attitude, and 76 percent in practice; and more than haJf perceived a change in aU three areas. The greatest change was perceived by those who were younger, married, had less education (aca- demic and post basic nursing), less experi- ence in nursing, and were employed in the larger agencies. The perception of little or no change was indicated by those who had more education (academic and post basic nursing), more experience in nursing, and were employed in the smal- ler agencies. The comparisons of change to back- ground factors revealed that although none of the comparisons were consistent- ly significant, there was a positive rela- tionship of learning with age, basic aca- demic education, post basic nursing edu- cation, years of nursing experience, and size of employing agency. Marital status, husband's occupation, parental status, in- come, sociaJ participation, years of head nurse experience, size and type of nurs- ing unit, and size of staff showed some interesting comparisons by observation, but the sample proved too smaU for accurate inferences to be drawn. The conclusions of the study were that the institute was effective as an educa- tional experience for continuing educa- tion in the three aspects of behavioraJ learning examined, provided that the credibility of the respondents was accept- able. The instrument used was adequate for the purpose of indicating change of behavior with the above proviso, but not adequate for reveaJing whether change was relevant to certain socioeconomic data. No claim can therefore be made concerning the relationship between this data and learning in a situation such as this institute. Macleod, Catherine Shirley. An explora- torv study to determine if the stated objectives of a maternity nursing pro- gram provide senior diploma student nurses with a family-centered philo- sophy. Boston, 1969. Thesis (M.S.N.) The purpose of this study was to determine if the stated objectives of a maternity nursing program provided sen- ior diploma nursing students with a fami- Iy-centered philosophy. Ten students from a three-year diplo- ma school were interviewed foUowing the completion of their maternity nursing experience. With the use of an interview schedule, data were coUected and summa- rized under four major topics: students' attitudes and feelings prior to their nurs- ing education; the maternity nursing ex- periences that had an impact on the students' philosophy of maternity nurs- ing; what a family-centered philosophy means to students and how it can be achieved by nurses; and the relationship of students' former attitudes and feelings to their present philosophy of family- centered maternity nursing. The interviews from this study reveal- ed that students had a limited knowledge of human reproduction prior to their nursing education. The students maintain- ed that much of this information had been gained through reading and peer relationships. From their maternity nurs- ing experience, students became aware of parents' physical, psychological, emotion- al, and educational needs during the entire maternity cycle. The students re- cognized many areas in which nurses could assist parents to meet these needs effectively during the period of child- bearing. All students interviewed sub- scribed to a family-centered philosophy of maternity nursing. The students readi- ly verbalized this concept of family-cen- tered philosophy; however, they felt they were unable to practice this type of nursing within their present nursing situa- tion. 0 THE CANADIAN NURSE 41 books Diseases That Plague Modern Man by Richard Gallagher. 230 pages. New York, Oceana Publications, Inc., 1969. Reviewed by Justine De/motte, Super- visor, Ottawa-Carleton Regional Area Health Unit, Ottawa. The subtitle of the book, "A History of Ten Communicable Diseases," clearly describes its content. The author focuses particular attention on tracing historically 10 communicable diseases that are vital world forces. The book is timely, with today's swift travel, expansion of tourism, migrant labor, and nomad movements. The author emphasizes that the principle of surveil- lance is an important factor. A global effort is being made to cope with these diseases by replacing epidemic control by epidemic prevention. What happens to their growth depends largely on what will be done in the future to cure, control, and possibly eradicate these diseases. The author presents a brief overview of the history of these diseases in the introduction, and treats each disease in a separate chapter. Major difficulties, prin- ciples of control, and recommended measures to implement these principles are clearly presented. A profIle of the disease is presented at the end of each chapter. The annexes are particularly valuable in giving basic references for state and local agencies by listing members and associate members of the World Health Organization; important non-government- al organizations in official relations with WHO; and references relative to each of the 10 communicable diseases. The book contains a glossary of some important communicable disease terms. Readers searching for new direction in the problems of communicable disease control will fmd that the book systemat- Ically presents background material and practical assistance. The book may well serve as a companion to The Control of Communicable Diseases in Man - the basic primer of community management of disease. Orthopedic Nursing Procedures 2nd ed., by Avice Kerr. 414 pages. Springer Publishing Co. Inc., New York, 1969. Reviewed by Marjorie Beckwith, Clini- cal Supervisor, Sherbrooke Hospital, %erbrooke, Quebec. This is not an exhaustive textbook on orthopedic nursing, but it is much more 42 THE CANADIAN NURSE than a procedure book. It is a brief, clear, reference book presenting a wealth of material in a form that the busy nurse could use with much profit. The author covers in outline form the first aid, emergency room, and hospital nursing care of patients with injuries to the spine, chest, pelvis, and extremities, and with other conditions producing musculoskeletal defonnities. She deals with numerous types of mechanical devices used in treatment, such as frames, slings, casts, traction, crutches, splints, and bandages. Other procedures used in treatment of complications and special problems related to orthopedics are covered, including tidal drainage for b I adder complications, restraint for irrational patients, and heat treatments (old and new) used for relief of muscle spasm and pain. The mental and emotion- al needs of the patient are not forgotten. The book carries a good presentation of body alignment from the point of view of prevention as well as correction of deformities. The nurse is made aware of her own need to apply this knowledge to herself in prevention and correction of posture problems and back strain. The material on optimum positions, support, and exercise could be put to good use in every area of nursing practice. One addition that I would like to see is a good alphabetical index for quick refer- ence. This comprehensive orthopedic procedure manual could be recommended as a guide on any orthopedic urùt, general surgical, or medical ward. Popular Hospital Misconceptions by Anthea Cohen. 90 pages. London, IPC Business Press Ltd., 1969. This delightful book contains 31 hu- morous selections reprinted from Nursing Mirror and Midwives Journal Each story briefly outlines a popular hospital mis- conception, many illustrated by Philip Meigh who has the ability to bring out the best in each of the author's selections. The titles of the selections add to the humor. "I will let you know when the doctor can see you," will strike a familiar note with anyone who gets to see her doctor, after reporting for her appoint- ment on time and is reprimanded with "Why didn't you tell somebody you were waiting? " Any nurse married to a doctor will chuckle at Miss Cohen's "It's Wonderful being married to a doctor." When a child in a doctor's family becomes ill, the author suggests the doctor will probably say to his wife: "Well, you look after him, dear. I'm sure you can handle it. I'll have a look at him tomorrow." Nursing is almost universally thought of as an underpaid profession. "Nurses are not in it for the money," is a priceless example of Miss Cohen's ability to cap- ture the spirit of an issue. The accompa- nying illustration for this selection is delightful. Any nurse who can laugh at the "facts of life" in her profession will be delighted with Anthea Cohen's book. New Guinea Nurses by Elizabeth Burchill. 1 5 1 pages. Adelaide, Australia, Rigby Ltd., 1967. Canadian Agent: Ryerson Press, Toronto. Reviewed by Valerie Fournier, Public Relations Officer, Canadian Nurses' Association, Ottawa. Any nurse who has thought of using her skills "away from it all" will be fascinated by the experiences of Eliza- beth Burchill, who worked as an infant welfare nurse in a remote area of New Guinea. Sister Burchill's surroundings were strange and exotic. The natives she treat- ed had not forgotten witchdoctors. The author shows that the island medical service is devoted to bringing the best possible medical care to all inhabitants of New Guinea, including those in the deep jungles. The author describes the government's health plan for the island, including its scheme to train native girls in infant, child, and maternal care. She then treats in more detail the working of the outpost hospital where she was stationed and the mobile clinics that visited the jungle villages. Perhaps the most interesting chapters describe what happened when Sister Bur- chill was temporarily put in charge of one of the mobile clinics. This gave her "a priceless opportunity to study the intrica- cies of native life." During her periodic examinations of mothers and infants, she came in close contact with the primitive tribesmen, in an area where health has been bound up with superstition for centuries. She found that not only their way of life, but even some of their ailments were unique! This book is by no means confined to nursing topics. The author takes pleas- ure in describing the lush, tropical land- JANUARY 1970 scape and many of the individual flowers, trees, and animals she came across. She also talks of the natives she worked with and their customs. As an appealing extra, her book is laced with photographs of the scenes and people she describes. Sister Burchill is no stranger to nursing in remote areas. She trained as a nurse in Melbourne, Australia, and worked in the Australian Outback, New Zealand, Thurs- day Island, and Labrador. The author has a flowing style and a gift for making the scenes she describes come alive. This travel story with a difference - especially for nurses- may well give others in the profession the call of the wild! Introduction to Clinical Nursing by Myra Estrin Levine. 468 pages. Philadelphia, F .A. Davis Company, 1969. Canadian Agent: The Ryerson Press, Toronto. Reviewed by Arlene A ish, Assistant Professor, School of Nursing, Queen's Unh'ersity, Kingston, Ontario. Myra Levine interprets her book as a beginning course in nursing. She has analyzed the content usually found in introductory nursing courses and has or- ganized this content within a structure of scientific principles from which nursing processes are derived. The theoretical framework from which the author views nursing activities is the concept of nursing as a conservation activity. Each chapter develops a particu- lar patient problem utilizing her four principles of conservation of energy, con- servation of structural integrity, conserva- tion of personal integrity, and conserva- tion of social integrity. Conservation is interpreted as a "keeping together." The patient is seen as an individual whose response to environmental stimuli results from the integrated and unified nature of the human organism. Miss Levine's concept of nursjng offers an excellent framework on which to base nursing content. It is unfortunate that her concept of the patient appears to be limited to the person in hospital. Little or no emphasis is placed on the fact that nurses are also concerned with people in the community. Each chapter involves a model that provides a framework for a variety of related nursing processes; for example, "body movement and positioning" and "ministration of personal hygiene needs." Each model includes a statement of ob- jectives, a long list of essential science concepts, and a long list of principles related to the associated nursing activi- ties. The author believes it is important to use a generalized approach rather than one that adheres to the policies of a particular hospital. This aim is not always followed, however. For instance, the nursing process related to vital signs JANUARY 1970 includes several statements that appear to be dependent on particular hospital rou- tines rather than on the nurse'sjudgment. Although the text is referred to as a first level course, a student would need a fairly extensive background in physical and social science to use it. The develop- ment of particular patient problems in the text moves into the area of medical- surgical nursing and pathophysiology. It is doubtful that many instructors would want to organize their content in a beginning course in precisely the way suggested in the book. However, it is higWy recommended for examination by instructors and practitioners of nursing because many concepts are well develop- ed by the author and should not be missed. Of particular interest is the last chapter. which deals with the concepts of territoriality (personal space require- ments. the establishment of personal boundaries, and their defense) and of circadian rhythms. Perceptual-Motor Efficiency in Children by Bryant J. Cratty and Sister Marga- ret Mary Martin. 223 pages. Philadel- phia, Lea & Febiger, 1969. Canadian Agent: Macmillan Company of Cana- da. Reviewed by Dr. G. J. Jarvis, Ophth- amologist, Toronto. This well-organized monograph deals principally with techniques to improve perceptual-motor efficiency in children diagnosed as having a dysfunction in this area. Remedial therapy is controversial and the authors must be congratulated for tackling this subject in such an honest and open-minded manner. In doing this, the book accomplishes more than its specific title suggests. The foreword, preface, and first two chapters provide an objective, critical review and background of the most perti- nent aspects of perceptual dysfunction. This is supported by a well-selected and up-to-date bibliography. Although the authors are actively en- gaged in the training and remedial thera- py of perceptual-motor dysfunction and believe that such motor training is bene- ficial for children, they do not overem- phasize its value. In simple style they stress that correlation does not prove causality. Unlike some discipI.:s of unproven theories concerning the causation of per- ceptual dysfunction and its motor corre- lates, the authors question that efficient movement is the basis from which all cognitive perceptual attributes spring. The Doman-Delacato method of remedial therapeutic creeping, crawling, and lateral limb manipulation is criticized for un- proven theoretical tenets and lack of objective and valid supporting data and controls. Using a psychophysiological approach, perceptual-motor activities are analyzed and discussed as component parts of gross and rme motor activities. Movement attri- butes, performance capacities, and the principles of perceptual-motor education are presented in a concise and practical manner. Twenty-three performance charts for graded motor skills are given. These are particularly useful as they give normative values and thus serve as a guide to teachers and parents not to exceed certain levels of performance. With the help of excellent drawmgs, the remainder of the book serves as an easy-to-follow manual. Despite the manu- al-type categorical style. the book never becomes purely motor-oriented, but re- tains a psychosomatic integrated ap- proach when discussing self-confidence, body image, and the components of games with ideas. The book concludes with three appen- dices that contain normative tables, test procedures for gross and fine motor control, games-choice tests, self-opinion tests, and physical fitness tests. A controversial aspect of perceptual dysfunction is presented in a simple and practical form by two authors who seem qualified to discuss this specific subject. Although the book addresses itself to parents and educators, it can be recom- mended to everyone who has to deal with the diagnosis and treatment of perceptual dysfunction. I I II Personal and Vocational Relationships in Practical Nursing, 3rd ed. by Carmen F. Ross. 266 pages. Toronto, J.B. Uppincott Co., 1969. Reviewed by He/ell D. Taylor, Direc- tor of Nursing, Jewish General Hospi- tal, Montreal, P. Q. This book illustrates that relationships are an integral part of nursing, and that good relationships are fonned when there is an understanding and control of one's own attitude and behavior. It also offers guidance to the practical nurse in devel- oping nurse-patient relationships and vocational relationships with other people in the hospital. The roles of the individual hospital team members have been defined in this edition and nursing care patterns discussed in an attempt to give the practical nurse a better understanding of her place in the health team. This book is designed for use as a primary text for a course covering person- al and vocational relationships in practical nursing, or as a supplementary text when the subject is integrated with other basic nursing courses. Sections of the book, notably the chapters entitled "Ethical and Legal Responsibilities" and "Organi- zations," specifically describe the Ameri- can situation. Much of the material in other chapters, however. can be generally THE CANA'bIAN NURSE 43 Next Month in The Canadian Nurse . Ritualism and Tradition vs. Judgment . Night Safety - a Problem for Nurses . Tracheotomy Suctioning Technique o Photo credits for January 1970 Clarke Institute of Psychiatry, Toronto, p. 5 Harvey Studios, Fredericton, N.B., p. 6 N.B. Travel Bureau, Fredericton, N.B., p. 6 Paul Horsdal, Ottawa, p. 8 Dept. National Health & Welfare, Ottawa, p. 8 Victor Aziz, London. Ont., pp. 21-24,29-31 Photo Features, Ottawa, pp.25,26,27 The Sudbury Da.1ly Star, Sudbury, Ont., p. 34 44 THE CANADIAN NURSE books (Continued from page 43) applied; therefore the book should be a valuable addition to the library of a school for nursing assistants. It is more comprehensive and has greater depth than some other available texts with similar titles and content. Textbook of Pediatrics, 9th ed., edited by Waldo E. Nelson, Victor C. Vaughan, Ill, and R. James McKay. 1,589 pages. Toronto, W.B. Saunders Company, 1969. Reviewed by Dr. Helen Evans Reid, Director, Dept. of Medical Publica- tions, The Hospital for Sick Children, Toronto,Ont. This revised edition of one of the best standard textbooks in pediatrics should be in the library of every nursing school. The authors are distinguished scientists and pediatricians; the material they present is welt organized and indexed. The last 100 pages of the book are packed with valuable, specific informa- tion on poisoning, including its recogni- tion and the appropriate emergency and long-term treatment; diets for the treat- ment of particular disorders; normal blood values, with cerebrospinal fluid values clearly tabulated; conversion tables for measures, weights, and temperatures, and charts indicating normal develop- mental sequences. This up-to-date infor- mation would be of immense help to nurses serving in isolated areas. The section on maternal medications, which may adversely affect the fetus and newborn infant, and the sections on high-risk pregnancy and high-risk infants should be required reading for all those interested in reducing Canada's high neonatal mortality rate. 0 accession list Publications on this list have been received recently in the CNA library and are listed in language of source. Material on this list, except Reference items, including theses, and archive books which do not circulate, may be borrowed by CNA members, schools of nursing and other institutions. Requests for loans should be made on the "Request Form for Accession List" and should be addressed to: The Library. Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario. No more than three titles should be requested at anyone time. Stamps to cover payment of postage from library to borrower should be in- cluded when material is returned to CNA library. Books and Documents 1. The arithmetic of dosages and solutions by Laura K. Hart. St. Louis, Mo., Mosby, 1969. 77p. 2. Associate degree nursing; a guide to program and curriculum development, by Ann N. Zeitz et al. Saint Louis, Mo., Mosby, 1969. 207p. 3. Being a ward clerk. Chicago, Hospital Research and Educational Trust, 1967. Iv (various paging) 4. Canadian Universities and colleges, 1969. Ottawa, Association of Universities and Col- leges of Canada. 1968. 427p. 5. Canadian universities' guide to founda- tions and granting agencies. 2d ed. Ottawa, Association of Universities and Colleges of Canada, 1969. 1l0p. 6. Classification internationale type des pro. fessions. Rev. edition 1968. Geneva, Bureau intemational du Travail, 1969. 415p. 7. Content and dynamics of home visIts of public health nurses. Part 2 by Walter L. Johnson. New York, American Nurses' Founda- tion, 1969. 134p. 8. Cecil & Loeb's textbook of medicine edited by Paul B. Beeson and Walsh Mc- Dermott. Philadelphia, Saunders, 1967. 173p. 9. Christopher's textbook of surgery edited by Loyal Davis, Philadelphia, Saunders, 1968. 1493p. 10. Descriptive cataloguing: a students' in- troduction to the Anglo-American cataloguing rules i967 by James A. Tait and F. Douglas Anderson. London, Give Bingley, 1968. 95p. 11. Dictionnaire de la langue française par Emile Littlé, edition intégrale Paris, Gallimard Hachette, 1966-67. 7v.R 12. Doctors & doctrines: the ideology of medical care in Canada by Bernard R. Blishen. Toronto, University of Toronto Press 1969. 202p. 13. Educational leadership by Helga Dags- land. Oslo, Norwegian Nurses Association 1965. 288p. (English summary: p.285-288) 14. Eléments de bactériologie à /'usage des infirmières par Marie-Louise Loiseau-Maralleau. Paris, Flammarion, 1968. 229p. 15. How to manage a union. 1st ed. by Jules J. Justin. New York, Industrial Relations Work- shop Seminars 1969. 2v. 16. Human anatomy and physiology by Barry G. King and Mary Jane Showers. 6th ed. Philadelphia, Saunders, 1969. 432p. 17. influencing smoking behaviour; a report of the Norwegian Cancer Society. Committee for Research in Smoking Habits edited by J. Wakefield. Geneva, International Union Against Cancer, 1969. 90p. 18. intensive nursing care by Zeb L. Burrell and Linette Owens Burrell. Saint Louis, Mo., Mosby 1969. 298p. 19. introduction to clinical nursing by Myra Estrin Levine_ Philadelphia, Davis 1969. 468p. 20. Jensen's history and trends of pro- JANUARY 1970 fessional nursing by Gerald Joseph Griffm and Joanne King Griffin. 6th ed. Saint Louis, Mo., Mosby 1969. 339p. 21. Management by objectives; a system of managerial leadership by George S. Odiorne. New York, Pitman 1965. 204p. 22. Middle age and aging; a reader in social psychology by Bernice Levin Neugarten. Chica- go, University of Chicago Press 1968. 596p. 23. Modern bedside nursing. 7th ed. by Vivian M. Culver. Philadelphia. Saunders, 1969. 841p. 24. Mosby's comprehensive review of nursing. 7th ed. St. Louis, Mosby, 1969 590p. 25. Non-degree research in adult education in Canada, 1969. Toronto, Canadian Associa- tion for Adult Education. 1969. 103p. 26. Nurse's contribution to the health of the worker, 1966.1969. London, Permanent Commission and International Association on Occupational Health. Nursing Sub-committee. 1969. 30p. 27. Vursing, a challenge; that we may serve society better by Helga Dagsland. Oslo, Norwe- gian Nurses Association, 1955. 218p. (Brief in English pj-vi) 28. Nursing in Idaho; a study of nursing needs and resources sponsored by Idaho office. Mountain States Regional Medical Program of the Western Interstate Commission for Higher Education in cooperation with the Idaho State Nurses Association. Boise Idaho, 1969. 75p. 29. The operating room technician. 2d ed. by Sister Mary Louise. Saint Louis, Mosby, 1968. 282p. 30. Orthopedic nursing procedures 2d ed. by Avice Kerr. New York, Springer, 1969. 414p. 31. Papers presented at National Rehabilita- tion Conference on Comprehensive Services in Long Term Care, New York city Jan. 30 and 31, 1969. New York, National League for Nursing, 1969. 80p. 32. Patient care in respiratory problems by Jane Secor. Philadelphia. Saunders, 1969. 229p. (Saunders monographs in clinical nursing no.l) 33. Petit guide du bibliothécaire par Charles Henri Bach et Yvonne Oddon. 7e édition. Paris, Librairie Armand Colin, 1967. 182p. 34. The politics of the family by R.D. Laing. Toronto, Canadian Broadcasting Corpo- ration, 1969. 49p. (Massey Lecture, Eighth Series, 1968) 35. Psychiatric nursing by Marguerite Lucy Manfreda, 8th ed. Philadelphia, Davis, 1968. 474p. 36. Rapport des journées d'étude regionales organisées à ['intention des directrices de serv- ices infirmiers d'hõpitaux du 27 février au 1er mars, 1968, Montréal, Québec. Ottawa, 1969. Association des Infirmières canadiennes. 72p. 37. Rapport des journées d'étude reKionales organisées à ['intention des directrices de serv- ices infirmiers d'hõpitaux du 28 novembre au ler décembre 1967, Québec, P.Q. Ottawa. Association des Infumières canadiennes 1969. 70p. 38. La recherche en education des adultes au Canada 1968. Toronto, 1969. Canadian Association for Adult Education. 103p. 39. Répertoire des fondations et organismes JANUARY 1970 de subl'entions aux universités du Canada. 2.éd. Ottawa. Association des Universités et Collèges du Canada. 1969. HOp. 40. Resources of Canadian academic and research libraries by Robert Bingham Downs. Otta....a, Association of Universities and Col- leges of Canada, 1967. 301p. 41. Selected papers from Latin American Regional Conference on Cancer Control. Santia- go, Chile Nov. 25-28, 1967. Geneva, Interna- tional Union against Cancer, 1968. 91p. 42. Social theory and social structure. En- larged ed. by Robert K. Merton. New York, Free Press. 1968. 702p. 43. Socio.demographic characteristics of Is- raeli student nurses sponsored by Dept. of Nursing and Dept. of Research and Statistics Kupat Holim Centre General Federation of Labour in Israel. Tel Aviv, Tel Aviv Research Faculty of Contiuious Medical Education, 1969. 76p. 44. Sydneys' nurse crusaders by Isadore Brodsky. Neutral Bay, N.Z. Old Sydney Free Press, 1968. 13 2p. 45. Textbook of pediatrics. 9th ed. by Waldo E. Nelson. Philadelphia, Saunders, 1969. I 589p. 46. Training for service. Canadian Council for International Co-operation. Ottawa, 1969. 49p. 47. Training the ward clerk. Chicago, Hos- pital Research and Educational Trust, 1967. Iv. 48. The work of WHO 1967. annual report to the World Health Assembly and to the United Nations Geneva, 1968. World Health Organization. 197p. 49. Workbook for practical nurses. 3d ed. by Audrey Latshaw Sutton. Philadelphia. Saunders, 1969. 421p. Pamphlets 50. Alcoholics and alcoholism by Harry Milt. New York, 1967. 23p. (Public affairs pamphlet no. 426) 51. Alumnae Association of Women's Col- lege Hospital, School of Nursing, 1919.1969. Toronto, 1969. 22p. 52. Collective agreements and their senior- ity provisions; a talk to the Institute on Collective Bargaining of the Registered Nurses' Association of Ontario. by Félix Quinet. Toron- to. 1968. 16p. 53. Current issues and rheir implications for practical nursing programs. Papers presented at the first conference of the Council of Practical Nursing Programs. Washington, May 9-10, 1968. New York. National League for Nursing. Dept. Practical Nursing Programs, 1969. 19p. 54. Criteria for the evaluation of diploma programs in nursing. 3d ed. New York. National League for Nursing Dept. of Diploma Programs. 1969.14p. 55. Directions pour les écoles d"infirmières en hygiène maternelle et en pédiatrie reconnues par la Croix-Rouge suisse. Berne, Croix-Rouge suisse, 1966. 16p. 56.Directives pour les écoles d'infirmières et d'infirmiers en psvchiatrie reconnues par la Croix-Rouge suisse. Berne, Croix-Rouge suisse, 1968. 29p. 57. DirectÏl'es pour les ecoles d'infirmières et d'infirmiers en soins généraux reconnues par la Croix-Rouge sui se. Berne, Croix-Rouge suisse, 1966. 36p. 58. Final report and recommendations to be presented to the executive COUTicil of the association at its 60th annual meeting in Hali- fax. 20th May 1969. Toronto, Committee on Recruitment of Public Health Personnel, Cana- dIan Public Health Association, 1969. 42p. 59. How to prevent suicide by Edwin S. Shneidman and Philip Mandelkorn 1st ed. New York, Public Affairs Committee. 1967. 18p. (Public Affairs pamphlet no.406) 60. Immunization for all by Jules Saltman. New York, Public Affairs Committee, 1967. 28p. (Public Affairs pamphlet no.408) 61. Medical nursing procedures as approved by Association of Registered Nurses of New- foundland, Newfoundland Hospital Associa- tion, Newfoundland Medical Association. St Johns', 1969. 4p. 62. New hope for dystrophics by Elizabeth Ogg. 1st ed. New York, Public Affairs Com- mittee, 1968. 28p. (Public Affairs pamphlet no.2715) 63. Nursing unit design: survey of staff and patient opinions about radial and double corri- dor nursing units by John F. Leckwart and David K. Trites, Rochester, 1969. lip. 64. Paraplegia: a head, a heart, and two bIg wheels by Jules Saltman. New York, Public Affairs Pamphlet, 1960. 28p. (Public Affairs pamphlet no. 300) 65. Programs accredited for public health nursing preparation 1969-70. New York, National League for Nursing. Dept. of Baccalau- reate and Higher Degree Programs, 1969. 6p. 66.. The position, role and qualifications of the administrater of nursing services. American Nurses Association Commission on Nursing Services, 1969. 4p. 67. Photocopying in university libraries and the Canadian law of copvrlght by Mary Lou Parker. Ottawa, Canadian Library Association, 1969. I4p. (Canadian Library Association. Occasional paper no. 77) 68. Recent empirical studies of public health nursing: a selection of abstracts and extracts by Dennis O'Neill. Toronto, Oarke Institute of Psychiatry. 1969. 29p. 69. Règlement concernant La reconnais- sance d'écoles d'infirmières en hygiène mater- nelle et en pédwtrie par la Croix-Rouge suisse. Berne, Croix-Rouge suisse, 1966. 4p. 70. RègLement concernant la reconnaissan- ce par la Croix-Rouge suisse d'écoles d'infumiè- res et d'infirmiers en psychiatrie. Berne. Croix- Rouge suisse. 1968. lOp. 71. Règlement concernant la reconnaissan. ce par la Croix-Rouge sUisse d'écoles d'infirmiè- res et d'infirmiers en soins généraux. Berne, Croix-Rouge suisse, 1967. 9p. 72. Some statistics on baccalaureate and higher degree programs in nursing-1968. New York, National League for Nursing, Dept. of Baccalaureate & Higher Degree Programs, 1969. IIp. 13. Television: hov. to use it wisely with children by Josette Frank. Rev. ed. New York, Child Study Association of America. 1969. 24p. II THE CANAQIAN NURSE 45 accession list 74. Venereal disease. a renewed challenge by Abe A. Brown and Simon Podair. New York. Public Affairs Pamphlet, 1964. 20p. (Public Affairs pamphlet no. 292A) 75. When children ask about sex. Rev. by Ada Daniels and Mary Hoover. New York, Child Study Association of America, 1969. 40p_ 76. The why and how of discipline. Rev. edition by AJine B. Auerbach. New York, Child Study Association of America, 1969. 40p. Government Documents Canada 77. Atlantic Development Board. Profiles of education in the Atlantic provinces. Ottawa, 1969. Iv. (various paging) 78. -.Bureau of Statistics. Advance statistics of education. Ottawa, Queen's Printer, 1969-70. IIp. 79. -Annual salaries of hospital nursing personnel, 1968. Ottawa, 1969. 47p. 80. - .Census of Canada 1966. 1966.- vol.2 Households and families, characteristics by marital status, age and sex of head Ottawa, Queen's Printer, 1969. 2v. (Ioose-Ieaf) 81. -.The female worker in Canada by Sylvia Ostry. One of a series of Labour Force Studies in the 1961 Census Monograph Pro- gramme. Ottawa, Queen's Printer, 1968. 63p. 82. Dept. of Labour Legislation Branch. Changes in workmen's compensation in Canada, 1968. Ottawa, Queen's Printer, 1969. 8p. 83. -. Workmen's compensation in Ca- nada. Ottawa, Queen's Printer, 1969. lllp. 84. Dept. of Manpower and 1mmigration. Career outlook community colleges graduates, 1969-1970. Ottawa. Queen's Printer, 1969. 67p. 85. Dept. of National Health and Welfare_ Research and Statistics Directorate. Research projects and investigations into socio-economic aspects of health in Canada, 1969. Ottawa. 1969. l87p. 86. The Science Council of Canada. Li- braries Subgroup. Scientific and technical information in Canada. Pt. 2 ch. 6 Libraries. Ottawa, Queen's Printer 1969. 49p. (Science Council of Canada special study no.8) Great Britain 87. Standing Nursing Advisory Committee. Subcommittee to Consider Ways of Relieving Nurses of Non-Nursing Duties in General and Maternity hospitals. Report. London, Her Majesty's Stat. Off., 1968. 23p. Ontario 88. Ontario Hospital Services Commission. Report, 1968. Toronto, 1969 139p. pt.2 Statistical supplement. Saskatchewan 89. Board of Nursing Education. Evaluation of the state of nursing education in the pro- vince of Saskatchewan. Regina, 1969. 27p. United States of AmerIca. 90. Public Health Service. Oral care for oral cancer patients_ Report of a conference held in Chicago, Ill., June 1968. Washington, 1969. 67p_ (U.S. Public Health Service publication no.1958) 91. Public Health Service. Working with older people. Rev. ed. Washington, U.S. Gov't Print. Off., 1969. Iv. (U.S. Public Health Service publication no. 1459) Virginia 92. Governor's Committee on nursing. Final report. Richmond, 1969. 89p. Studies Deposited In CNA Repository Collection 93. The area superJiisor concept in nursing serJiice by Siste Mary Michael Demers. Toron- to, Ont., 1968. 158p. (Thesis (Dip!. Hosp. Admin.) - Toronto)R 94. The effects on the registered nurse of the increasing use of non-nursing personnel in the hospital by Frank Thomas Hughes. Toron- to, 1968. 126p. (Thesis (Dip!. Hosp. Admin.) - Toronto)R 95. Opinions of selected graduate nurses from diploma programs in British Columbia concerning their preparation to function as team leaders, by Sister Miriam Anne Deas. Washington, D.C., 1969. 82p. (Thesis (M.Sc.N') - Catholic University)R 96. A study of absenteeism patterns and related factors far registered nurses by George Brian Doyle. Ottawa, 1968. 83p. (Thesis (M.H.A.) - Ottawa)R 0 Request Form for "Accession List" CANADIAN NURSES' ASSOCIATION LIBRARY Send this coupon or facsimile to: LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario. Please lend me the following publications, listed in the .............................................................. issue of The Canadian Nurse, or add my name to the waiting list to receive them when available: Item No. Author Short title (for identification) .................................................................................................................... ..................................................................................................................... Requests for loans will be filled in order of receipt. Reference and restricted material must be used in the CNA library. Borrower ............................................................................................................ Registration No. ................................ Pos i ti on ..................................................................................................................................... ......................................... Add ress .............................................................................. ................................................................................................ Date of req uest ........ ... .... ........ ..... .......... ..... ....... ..... ........ .................... .......... ............. ................... ..... ... ...... ... .., ...... ...... .... 46 THE CANADIAN NURSE IANUARY 1970 r February 1970 ,,- - -oJ - " " , --' '- I I (" ISS MTM ,....nRIS --- - - - _9 NELSON ST APT 812 nTTAWA 7 nNT n 157B4 ," --- The 'Canadian Nurse ,i .... " \ , " ---- ... oJ, -ã slavery to routine = assembly-line care "' 4 \ ".... .. -4 \ \ ..... invitation to a checkup I .,,; E)( , ...J 4 , 'P . I II , / - /. D II ' \ ;, \ ' 1_- Î. .- I," , r ," \ I. night safety - a problem for nurses :( , ... .. . c: .- . -. 1.1'...2 ,S tì - - -: ... '" - !t Tilt = I 911'. UpeUtN' Su, tilt pIli, elc 12 9, 104 ,.".. !IJ \t1. ,. ",/111!!'''' !j ,\CWo ,,,,.,,, !.þ '''fl..en/Iff Íl'''''';;' .././, . I ,,1It'" ? oll/IC h...ouscolurnnlSi f nun.. trig probe Illto tells all! (tit C..rbo m,""Qur ;102 m A ( (I" ;- \\1 iu JIll l i __.- 2 Trul' ,tDf'J' D. (tit 111M Amrr.c;I" all ...". hkah"_C poling laW)''' TeMe 1'Mrwt.... "I" . tlfnonrPd BOlton btst-ulI.ng no.el *'f'I'Nh ".CI'M" boOle by .ut'" of ....rJOrt ,""- ,,\\ "-'- ./ ,_.... \)\C.\.\o;:.) ò.'\;" Choose any '2 L.tl'\ll'd'Io . 896 p", 80 000 I'''tn 10,000 ptlr.V1i 36 j... " !I.. ... NYS ,.;, -"" coli ,.0"'" .... . "filE . [,PfJ plol)'. pOfftI lI.s.'fti. ".I" .'1' W,.eM'iI" c:lhllH II ro.a.s... pl.III.Uon. M..1 foirro. ma".' 1'0 r. , I TN .1.-.,11."11 How to ..1.11,1, I'.e-r, Eu..,ng nt'. '* 'or "dI,ldrIPflPW" boole room a. home. IlIlIs. tlørne-stwetS IlIus, 95 ...1,111 ..,;;. t t. '-.; À IflSlr.cUDM 'or bftlllN(. If_Mrt. d -!J ,.-' i'J filllUIItU: ndpn from IrCLIIffI to .."" loollh Accept this remarkable oller from Doubleday Book Club. Take any 5 best.sellers hard-cover, full-length volumes costing up to $5.95 and more m publishers' editions-ail for 99c when you Jom ! . As a member, choose from many new book bargains each month. Selections are adult novels from all lead- ing publishers. Priced at $4.95 and up in publishers' editions, they come to you for only $1.98 each (some extra value books priced higher). You save up to 70%. . Alternate selections ofter a wide choice of hard-cover books including cook books, self.help, famous classics, inspirational and home-making books. All at special prices-many only $1.98. ANO-the Club's bonus plan saves you even more! . RUSH THE COUPON NOW! Cucle numbers of the 5 books you want. We'll ship them fast and bill you only 99c plus shlppmg and handling. Doubleday Book Club, 105 Bond Street, Toronto 2, Ontano. NOTE Book Club editions shown are sometimes reduced in size, but texts are full-length-not a word is cut! FEBRUARY 1970 OF THESE 54 BEST-SELLERS for only I '"""- 211 , .1 Bnt-Stllf'r' .,ÞttlØl'DI V.II.,01 tilt Dolh I c when you join Doubleday Book Club and agree to take only 8 book 8 month for only 8 year, out of a wide selection-at low Club prices. --lir ,.. 150 _A')!I' '!; [ I"" 'WI,1I << )."UP. 1iP \ (-1:1::,11 i .V 1 fllll.aCCOllIl10' No.. 21. 1963. Authorlt.a...r Mint! TI'I boOle tNt I.SIt"" Sift, uti tIt1t-M'IIPr of Dlluk 'Of I.mll, ne ttl, tilt moori. ."port .11 11I.lftlul 7 . '-v.-' .Þ' ;! " Of 'DUIII ...:I lilt l'I.tlll' 01' ,., "....rfuIIllO'l'..' 20 ^ "G,,'f.!!..t: - CtlIU:O'- , fc#. "IIY.JrIÍ>l' "W"' Br,lhant 1II,,,rt" by AQ.I nl' ..,.:1:.:.. ....,. ;:. 'I:':'" I"' '''' I .. 'ð "it" fII" u,",III.I. 911'. Sf'tIYtlCWIil' 11"".1 01 All about lIum..' to wc:..1 ,on....(. hi..., Mr, M D" Ma to "aU' W'nw' All PM" Itw'..... Coml) .1'1....".. It.I'. pr010e and pott., Ie .0t\'I.-n , prOb'"'" r-----------------------------, DOUBLEDAY BOOK CLUB Carcle numbers 01 DEPT. 2-CN.10, 105 BOND STREET. TORONTO 2, ONTARIO Please accept m} a pl1catlOn 'er membt>r..hl and send me a m} ne .mem- bt>r bonus. the 5 books I have cucled Bin mp onl} 991 plus shlppmg and handUng. If not delighted. I ma} return the Introductory package within 10 days and m} membt>I....hip u.ill be canceled. Send me fue t'ach month the Ciub Bulletin describmg the commg .selec- tions and alternate book bargains Wht"never I don't want a commg srlec- Uon I ma\ nohh" \ou on the convelllf'nt form al\\a}s ,provided I need buy only one bÒok a month out of at least 20 ollel ed earh month. and may resign any time after one }ear. I pa} only$1.9R for earh selection or alternate cplus shippme and handhngl unle s I rerer to recene an extra-\alue book at a hlKnt:"r price. Mr. Mrs. M... (111eL'W I)rlnl) 5 boots WOU choa.e: Addre.. Apt. No. '4 17 23 25 39 42 56 57 60 74 75 93 95 10' 102 104 124 149 150 154 155 158 178 186 196 202 210 222 226 230 235 262 270 284 289 291 296 331 336 345 35' 354 364 365 375 378 380 405 412 420 424 665 733 992 Clt)' ... Zone Pro". n ce Credit reference (\ nur I.hnlle. nUlllbrr. hank or de I.arlruen. Nlon- rllarJiU. all nunll It under l' p.rent must Sllin her. Mf!mÑrs accepted In Canada and continental U.S.A. onl.\" If you wi"h to charJ(e All hooks to your CH4.R(;F\. ,ccount. J(ive numher fì9-Ul'l L_____________________________ THE CANApIAN NURSE 1 , v'fÞ- / q' o ", UMB EIi r- - 0 (C' S o tn @D lJJ J.,.. $ - , -..011 .. -n o G WOME. Q I , I , Q I Q , , ", I THE LINIC ,....bf: ......... -ECo II... ....T. 0'.. . '.......0... ".OK' ... U . .. SHOE M.w WIVh,@ SOME STYLES ALSO AVAILABLE IN COLORS...SOME STYLES 3Vz-12 AAAA-E, $17.95 to $24.95 For a complimentary pair of white shoelaces. folder showing all the smart Clinic styles. and list of stores selling them. write: THE CLINIC SHOEMAKERS · Dept. CN-2 ,1221 Locust St. . St. Louis, Mo. 63103 2 THE CANADIAN NURSE FEBRUARY 1970 The Canadian Nurse ð A monthly journal for the nurses of Canada published in English and French editions by the Canadian Nurses' Association Volume 66, Number 2 February 1970 23 Special Report: Task Force on the Cost of Health Services in Canada 25 Nurse, Please Show Me That You Care ..............................................P.E. Poole 28 Night Safety - A Problem For Nurses............................................E. Mitchell 31 Examining Student Nurses' Problems By the Case Method ................ ........................................................................ V . Wood 34 An Invitation to a Checkup ....................................................................T. Dier 37 Sleep......... ...... .............. ........ ..... ..... .......... ............................ ....... ...... ... B. Long 41 A Day Hospital for Elderly Persons ................................................... S. Cooper 44 Tracheotomy Suctioning Technique ...................................................B. Kearns The views expressed in the various articles are the views of the authors and do not I'ecessarily represent the policies or views of the Canadian Nurses' Association. 4 Letters 21 In a Capsule 7 News 49 Books 16 Names 50 A V Aids 18 Dates 50 Accession List 19 New Products 72 Index to advertisers Executi\e Director: Helen ..... \lu"allem . Editor: V inia .\. I indabun . Assistant Editor: Eleanor B. Mitchell - Ëditorial Assist- ant; Carol A. Kotlarsk, - Circulation Man- ager: Be'}l Darling - Advertising Manager: Ruth H. Baumel - Subscription Rates: Can- ada: One Year, $4.50; two years, $8.00. Foreign: One Year, $5.00; two years, $9.00. Single copies: 50 cents each. Make cheques or money orders payable to the Canadian Nurses' Association. - Change of Address: Six weeks' notice; the old address as well as the new are necessary, together with regis- tration number in a provincial nurses' asso- iation, where applicable. Not responsible for Journals lost in mail due to errors in address. Canadian Nurses' Association 1970. \Ianuscript Infonnation: "The Canadian Nurse" welcomes unsolicited articles. All manuscripts should be typed, double-spaced. on one side of unruled paper leaving wide margins. Manuscripts are accepted for review for exclusive publication. The editor reser\es the ril!ht to make the usual editorial chanl!es. Photõgraphs (glossy prints) and graphs ãnd diagrams (drawn in india ink on white paper) are welcomed with such articles. The editor is not committed to publish all articles sent, nor to indicate definite dates of publication. Postage paid in cash at third class rate MONTREAL. P.Q. Penn it No. 10,001. 50 The Driveway, Ottawa 4, Ontario. tlSKUAKY l /U The recommendations of the seven task forces that recently investigated the cost of health services in Canada ("Special Report," page 23) warrant the nursing profession's scrutiny and comment. If implemented, these recommendations would radically change the present pattern of health care and might or might not improve the care our patients now receive. Moreover, the implementation of certain of these recommendations would undoubtedly affect the nurse's role and her relationships with patients and co-workers. The Canadian Nurses' Association will issue a short general statement on the task forces report in March. In the coming months the association will study in depth many of the 348 recommendations. Here are a few capsule comments on the report. As with all signed editorials, these comments represent the editor's views. There's a lot of meat in this massive report, although much of it is hidden by the verbiage that invariably follows a committee's deliberations. Certain basic recommendations, which we find easy to support, emerge: the regionalization of health services; the expansion of home care programs; the need for better prepared administrators at all levels; and the need for better utilization of health personnel. We also support the recommendations that accreditation be mandatory for all hospitals and that the scope of the accreditation survey be expanded. But why did the task force stop here? Why did it not state that a hospital should be accredited only if its nursing services are up to par? Could the reason for this omission be that this particular task force (and most others) was composed entirely of physicians and hospital administrators? We disagree with the idea of introducing another category of health worker, the "practitioner associate," to bridge the gap between nursing and medicine. <\dvocates of this medical assistant role use the felds"er system in Russia as a model when arguing that such a category should be created. Nowhere in the report. however, could we find .In adnltSsion that Russia is planning to phase out her Jelds"ers, because the system is no longer useful. - VAL. THE CAN\DIAN NURSE 3 letters { Letters to the editor are welcome. Only signed letters will be considered for publication, but name will be withheld at the writer's request. Likes November issue Your November issue is one of the best yet. I enjoyed the short editorial on the World War I nurses, and also the article "The Bluebirds Who Went Over" by Carlotta Hacker. This is a most inter- esting and well-written article. The story of "Two-Year-Old Mi- chael - III and In Hospital" was also well presented. It should be instructive to many mothers as well as to nurses. - Jean Bell. Newmarket, Ont. Nurses check their image I have been asked by our supervisory group to congratulate you and your staff on the publication in The Canadian Nurse of the article by Glennis Zilm on the appearance of nurses (Oct. 1969). It is an excellent adjunct to our campaign to have our staff spruce up their appearance. This humorous vein helps and the article helps people to see themselves. There was some concern expressed, however. that in the same issue of the journal there were ads for extremely short uniforms. This seemed a bit of a contradiction. May I take this opportunity to con- gratulate you and the staff on the general- ly high calibre of the articles in the journal. - Mary L. Richmond. Director of Nursing, The Vancouver General Hos- pital, Vancouver, B.C We are impressed with the article by G. Zilm, "Check Your Image - It's Slip- ping!" in the October issue of The Canadian Nurse. We would like to order 12 reprints of this article. - Mary A. Rothrock, Librarian, Albert Einstein Medical Center, School of Nursing Li- brary. Philadelphia. Pennsylvania. We want to order 100 reprints of the article "Check Your Image - It's Slip- ping! " by Glennis Zilm. Gertrude Haus- sler, Associate Director of Nursing Serv- ice, The University Hospital, Lorna Linda University, Lorna Linda, California. Our faculty has keenly appreciated the article by Glennis Zilm in your October issue. "Check Your Image - It's Slip- ping! " illustrates and emphasizes a prob- lem hospitals everywhere are facing to- day. The situation was discussed in detail at the September faculty meeting here. It is satisfying to find each item about which we felt serious concern dealt with so succinctly in your article. We congratulate the author and the 4 THE CANADIAN NURSE publisher for this timely piece of work, and are ordering reprints of the arti- cle. - Mrs. Eileen Nutting, Librarian, Holy Cross School of Nursing, South Bend, Indiana. I believe that the article "Check Your Image - It's Slipping! " would be of interest to the nursing units in our hospi- tal. I wish to obtain reprints of it. Please send me a price list for 100 reprints of this article. - Rita C. Ostwalt, Instruc- tor, St. Joseph Infirmary, Louisville, Ken- tucky. I agree with the letter from Rosalind Paris (Dec. 1969) regarding the article "Check Your Image - It's Slipping! " Tidiness or untidiness are not criteria for measuring professionalism. Also, many nurses do not wear a uniform, especially in public health units and psychiatric settings. Does their attire make them less professional? Neatness and uniformity too often MOVING? BEING MARRIED? Be sure to notify us six weeks in advance, otherwise you will likely miss copies. Attach the Label From Your Last Issue OR Copy Address and Code Numbers From It Here NEW (NAME) lAD DRESS: Street City Zone Prov.lState Zip Please complete appropriate category: o I hold active membership in provincial nurses' assoc. reg. no.lperm. cert./lic. no. o I am a Personal Subscriber. MAIL TO: The Canadian Nurse 50 The Driveway OTTAWA 4, Canada have symbolized submissiveness and conformity - qualities which. in my opinion. have retarded the growth of nursing. If a nurse is proud of her work, she will be proud of her appearance. It is not necessary to chastise her in her professional journal. - William Fulton, Reg.N., Toronto. I am on the side of Mrs. Rosalind Paris (Letters, Dec. 1969). It saddened me to find on my return to part-time nursing, after 10 years in the business world, that the customer is made to feel at least tacitly right. whereas the patient rarely is. Nurses are still not listening to the pa- tient, but are being pressured into believ- ing that their image can make the patient acquiesce to the structured way of caring for him. This obedience from staff and patients makes things easier for adminis- tration of any large organization. At the same time we pay only lip service to the need for indivIdual patient care. So much talk about non-essential things. such as hemlines and appearance, appalls me. If we encourage the nurse to keep in mind what her goal is. hemlines will take care of themselves! In a climate of increased self-respect, the nurse will emulate the colleagues she respects. Such a climate will achieve more rapidly what silent manipulation from petty tyrants will never achieve. The onus is on each individual nurse to pull up her own socks without complain- ing and not diminish herself or her colleagues by requiring external policing. Let us resolve to seek honesty and meaningful caring in all our relation- ships. - Pam Fairchild, RN. British Columbia. We wish to order 25 copies of the article "Check Your Image - It's Slip- ping! " - Mrs. A. Cox, Nursing Office, S1. Anges Hospital. Baltimore, Maryland. We are interested in ordering reprints of your splendid article in the October 1969 issue "Check Your Image - It's Slipping! " - Mrs. Sylvia Bookman, School of Nursing Library, East Orange General Hospital, East Orange, New Jer- sey. Reprints of the article "Check Your Image - It's Slipping! .. by Glennis Zilm (October 1969) are available from The Canadian Nurse. 50 The Driveway, Otta- wa 4. Ontario. Cost: 25 cents per copy or $:!O per 100. - Editor. 0 FEBRUARY 1970 :X-L iPPincot Fi I m Loops An economical, efficient method of teaching basic nursing skills and techniques. . . Save demonstration time. . . eliminate the problem of students not close enough to see uhow it was done." TWO NEW SERIES-NOW READY! Lifting and Moving Patients Six films demonstrate skills and techniques needed to lift and move patients safely, efficiently and comfortably. Workers learn how to protect themselves from strain and fatigue by applying basic principles of body mechanics and physics. Procedures become more complex as the series progresses. . Moving Weak Patient up in Bed (One and Two Worker Methods) . Moving Helpless Pat,ent up in Bed (One Worker Method) . Moving Helpless Patient up in Bed (Two Workers, Sheet Pull) . Weak Patient: Into Chair, Walk, Back to Bed (One Worker Method) . Wheelchair: Very Weak Patient-From Bed to Chair and Return (Two Worker Method) . Stretcher: Helpless Pat,ent- Transfer from Bed to Stretcher and Return Price fOl" each film: $23.75 Asepsis: Medical and Surgical Nine films demonstrate how to prepare and implement aseptic procedures used in patient care. Both re-usable and disposable equipment are shown. Differences between medical and surgical asepsis are made clear. Essential aseptic principles as they apply to each procedure are dem- onstrated in action. . Handwashing . Gloves: Re-usable, Open Technique . Gown, Gloves, Mask: Single Use, D,scard Technique . Gown: Re-use Technique . Blood Pressure in Isolation Unit . Sterile Field Preparation: Wound Care . Wound Care: Cleansing and Re-dressing of Clean Surgical Wound . Surgical Scrub . Surgical Gown and Gloves: Closed Techmque Price fOl" each film: $23.75 FEBRUARY 1970 Also Available: Bedmaking Making an Unoccupied Bed (Parts I, II) Making an Occupied Bed (Parts I, II). Manipulation of Linen (Parts I, II) $47.50 $47.50 $47.50 Hygiene Giving a Bed Bath (Parts I, II) Giving a Back Rub Care of Dentures $47.50 $23.75 $23.75 Positioning and Exercise Prevention of External Rotation (Trochanter Roll) Prevention of Drop Foot (Part I, II) $23.75 $47.50 Injection Technique Preparation of an Injection from a Vial Preparation of an Injection from an Ampule. Preparation of an Injection from a Tablet Subcutaneous Injection: Site Selection and Administration Selection of a Site for Intramuscular InJectIOn: Deltoid . Selection of a Site for Intramuscular Injection: Lateral Thigh Selection of a Site for Intramuscular Injection: Ventrogluteal Selection of a Site for Intramuscular Injection: Dorsogluteal Administration of an Intramuscular Injection. $23.75 $23.75 $23.75 $23.75 $23.75 $23.75 $23.75 $23.75 $23.75 .Write for descriptive material on new film loops. or for complete film loop catalog. J. B. lIPPINCOlT COMPANY OF CANADA lTD. 60 FRONT STREET WEST TORONTO I, ONTARIO THE CAN\DIAN NURSE 5 UUDLtR NEWBORN REuLlAR I NEWBORr. Sh 11 PREMAT t The "Saneen" disposable diaper concept. What are its advantages? In providing greater comfort and safety for the infant: More absorbent than cloth diapers. "Saneen" FLUSHABYES draw moisture away from baby's skin, thus reducing the possibility of skin irritation. Facial tissue softness and absence of harsh laundry additives help prevent diaper derived irritation. Five shes designed to meet all infants' needs from premature through toddler. A proper fit every time. Single use eliminates a major source of cross- nfection. Invaluable in isolation units. In providing greater hospital convenience: Polywrappecl units are designed for one-day use, and for convenient storage in the bassinet. Also, Saneen F1ushabyes do not require autoclaving-they contain fewer pathogenic organisms at time of application than autoclaved cloth diapers. * Prefolded Saneen disposables eliminate time spent folding cloth diapers in the laundry and before application to the infant. Easier to put on baby. Constant supply. Saneen F1ushabyes eliminate need for diaper laundering and are therefore unaffected by interruptions in laundry operations. Elimination of diaper misuse, which may occur with cloth diapers. *The leRiche Bactetiology Study-1963 More and more hospitals are changing to Saneen Flushabyes disposable diapers. Write us and we will be glad to supply you with further information on clinical studies, cost analysis, and disposal techniques. Use these and other fine Saneen products to complete your disposable program: MEOICAL TOWELS. "PERI.WIPES" TISSUE, CELLULOSE WIPES, BEO PAN ORAPES. EXAMINATION SHEETS ANO GOWNS. aneen + hctllt Compon, Lim,ltd. 1350 Jont Sireel, Toronlo 15, Onlorio. Subsidior, of Conod,on Inltrnolionol Poptr Compon, c6- .1-H4 "Saneen". "Flushabyes". "Pen-Wipes" Rea'd T.Ms. Facelle Company limited comfort. safety. convenience news Members Appointed To CNA Ad Hoc Committ(>e On legislation Ottawa. - Six members have been appointed to the Canadian Nurses' Association ad hoc committee on legisla- tion by the association's board of direc- tors. Members of the ad hoc committee to consider CNA bylaws are: chairman, Jeanie S. Tronningsdal, British Columbia; Eileen C. Flanagan, Quebec; E. Marie Sewell, Ontario: Marcelle Dumont, New Brunswick; Sister Mary Felicitas, CNA president: and CNA's legal advisor, Geor- ge Hynna. The decision to set up the ad hoc committee on legislation was made by the CNA general membership at the 34th general meeting in Saskatoon in July 1968. The committee wiII meet at CNA House February 26-28, 1970. CNA Committee To Prepare Brief On Poverty And Health Ottawa. - A special task committee has been appointed by the executive committee of the Canadian Nurses' Asso- ciation to prepare a brief on poverty and health for submission to the special senate committee on poverty later this year. Trenna Hunter, formerly director of public health nursing, Metropolitan Health Service, Vancouver, RC., and a past president of CNA, will write the brief. Other members of the special task committee are: Catherine Keith, Depart- ment of National Health and Welfare Ottawa; Doris Small. Victorian Order of Nurses, Montreal; Constance Grey, Toronto City Health Department; and Phyllis Kenny, Bruce County Health Unit. The committee will meet at CNA House February 12-14,1970. No Canadian Candidat.. For 3 M Award in 1970 Ottawa. - The Canadian Nurses' As- sociation will not nominate a candidate for this ye,u's International Council of Nurses 3M Nursing Fellowship. This deci- sion was made by the CNA board of directors at its meeting in November because there was too little time to prepare selection policies, make an- nouncements to CNA members, and FEBRUARY 1970 \:.ST TEl( / '" 0 , 11, --p 0 -- Z . rn - V) · "n . (ì \:::) /V rEN '\ N\j\ NWT. - This circular symbol has been chosen to commemorate the Northwest Te"itories "Centennial 70," which is being celebrated this year. It features three fiKUres in black with linked hands, which are intended to express the unity of all the people in the North and the spirit of celebratioll The figures represellt the I Franklin. Mackenzie. and Keewatin geographic areas that form the Northwest Te"itories. The parka hood of one of the fìgures has been rounded to represent the pattern worn by the people of the Macken=ie. The three figures are encircled by blue lettering on a white background. NWT pennission required to reproduce symbol choose a candidate before the deadline. However. a candidate wiII be chosen for the 1971 lCN 3M award. Criteria for the 3M fellowship were established at the board meeting and are the same as those required for a CNF scholarship. To be eligible an applicant must be a member of CNA. accepted into a graduate program. have intellectual and leadership ability. and experience in nurs- ing. One CNF candidate will be chosen as Canada's entry for the ICN 3M award. The $6.000 fellowship was recently established by the International Division of Medical Products Group of 3M Com- pany under the auspices of ICN. It was announced at the 14th quadrennÎJI con- gress of lCN last June. Nurses from more than 60 countries are eligible for the fellowship. CNA librari,m Visits libraries In Manitoba Schools of Nurlliin Ottawa. - Margaret L. P.ukin,librari- an at the Canadi.m Nurses' Association. visited libraries in six Manitoba schools of nursing in December at the request of the accreditation committee of the Manitoba Association of Registered NUrses. Includ- ed were libraries at Brandon General Hospital. St. Boniface General Hospital. The Grace Hospit,d. The Winnipeg Gener- al Hospital. Misericordia General Hospi- tal. ,md The Victoria General Hospital. Miss Parkin told The Canadian Nurse that staffing was a problem common to all libraries. "Each library should be administered by a qualified librarian." she s.tid. "However. there has been a shortage in the p.lst, and for economic reasons it has not been possible for any of these THE CAN DlAN NURSE 7 news librdries to hdve a full-time librarian." Miss Parkin believes that a health sciences library in each hospital would be more economical than employing a pro- fessional librarian for each school. The library would combine resources for all health professions. "This could apply to any province in Canada," she said. "As nursing education gradually moves out of the hospital schools into the general education system, library facilities to support the educational programs will cease to exist as autonomous nursing libraries, and will become a collection of nursing literature within the library of the educational institution. If the institution is primarily for education in the health sciences, this library will be a health sciences library," she added. Some libraries lack basic reference tools, such as the International Nursing Index, hospital and medical directories, and professional journals. However, the majority of schools were interested in developing their library resources, Miss Parkin said. Processing audiovisual materials was one of the topics discussed at length during the workshop. "Many possibilities exist here," Miss Parkin said, "but audio- visual materials can be handled with slight modification by standard library methods. " Other topics included in the workshop were the general philosophy of library science, the content of technical services and reader services, the membership and function of the library committee, teach- ing functions of the library, and process- ing of periodicals and documents. Ontario RNs To Cé\rry Out Some Medicé\1 Procedures Toronto, Onto - Registered nurses in hospitals in Ontario will soon be authoriz- ed to carry out some procedures previous- ly done only by medical practitioners. The decision was made last December by the Registered Nurses' Association of Ontario, the Ontario Hospital Associa- tion, and the College of Physicians and Surgeons of Ontario. The Policy on Special Procedures by Registered Nurses and Technical Person- nel outlines the procedures that authoriz- ed registered nurses and technicians may perform. According to the policy, under circumstances where medical personnel are not available, registered nurses may be taught to start intravenous infusions of saline, glucose, blood, plasma, or other electrolytic solutions. 'The list of solu- tions which may be given by the designat- ed registered nurse shall be prepared by 8 THE CANADIAN NURSE the medical advisory committee or its delegate and who from time to time may make additions to the list," the policy states. Other activities an authorized register- ed nurse may carry out include: adminis- tration of intravenous medications, ex- ternal cardiac massage, chronic hemo- dialysis, epidural analgesia, gastric tubes, immunization procedures, intracutaneous tuberculin tests, uterine stimulating drugs, and rectal and vaginal examina- tions on antepartum patients during labor. During surgery, assistance may be provided by a suitably instructed register- ed nurse or technician, if only technical assistance is required. A new procedure for registered nurses involves electrical defibrillation. The poli- cy states that competent and instructed registered nurses may be authorized by a hospital's medical advisory committee to perform electrical defibrillation. The cir- cumstances are to be specified by the committee and prepared in writing by the chief of the department concerned. Although the College of Physicians and Surgeons of Ontario has agreed to permit registered nurses and technicians to carry out the procedures described above, a hospital must make provision for this in its rules and regulations. The policy states: "Where this provision is made the College of Physicians and Sur- geons of Ontario expects the responsible medical authority in the hospital to take proper steps to assure that the registered nurses and technicians have been ade- quately instructed and designated for the procedures they are to be permitted to perform." Doris Gibney, assistant executive di- rector of the RNAO, said the new policy will have implications for nursing educa- tion because nurses are doing more today than they did 20 or 30 years ago. The policy will protect both the patient and the nurse, Miss Gibney said. NBARN Project To A'isist CNF Fredericton, N.B. - The New Bruns- wick Association of Registered Nurses launched a concentrated CNF project called "Campaign 70" in January. It will continue through March. Canadian Nurses' Foundation representative Shirley MacLeod reported that the aim of the campaign is to boost the membership of New Brunswick nurses in the CNF. Miss MacLeod said that membership application forms were issued to each member with her receipt of 1970 NBARN membership. "This personal contact will be for the convenience of association members and will serve as a reminder to join or rejoin CNF," she said. "Chapters will assist with mini-campaigns at the chapter leveL" CNF has adopted the calendar year, but nurses may join at any time. CNF Membership Still Low Ottawa. - The year-end membership of the Canadian Nurses' Foundation indi- cates a total of 1.311. Provincial member- ship is shown below. Canadian Nurses' Foundation Membership as of 3/ December /969 Propince Membership British Columbia 170 Alberta 126 Saskatchewan 153 Manitoba 128 Ontario 319 Q bK M New Brunswick 211 Nova Scotia 70 Prince Edward Island 6 Newfoundland 9 Outside Canada 28 Total 1.294 Sustaining 16 1,310 Patron I Grand Total I ,311 Any registered nurse can become a regular member of CNF by paying an annual fee of $ 2. Cheques or money orders should be sent to: CNF, SO The Driveway, Ottawa 4. Ontario. Business firms, corpordtions, and associations can also be sustaining members or patrons of CNF by paying the required fee for these categories. Individuals or groups can contribute. All donations are tax deducti- ble. The form for membership or dona- tions is on page 5 I . Students Need C(.unselor'i To Interpret Information Toronto, Dill. - Infonnation on adult education courses must be distribut- ed adequately and interpreted to the potential student. according to a panel discussing the topic "Exchanging Informa- tion" at the Canadian Education Show- place held in Toronto December 4 to 6, 1969. Diana J. Ironside. of the Ontario Institute for Studies in Education in Toronto, described the project she has been directing in which courses available for adults have been compiled into a directory for sale or reference in Toronto area libraries. "But this information is basically a tool for counselors," she said. "There should be some guidance available to the potential student to interpret it to him." She also pointed out that the 5,300 courses listed may not constitute the total number available. However, they were all that they were able to locate during the four months in which the book was produced. Bertrand Schwartz, director of L'lnstitut National pour la Formation des Adultes in Nancy, France, suggested that students must also be informed of the FEBRUARY 1970 .,,,-:1 .' ...,'t_- .n . : ; Maybe you feellike this after your tour of duty. After giving hours of service - 57825 - U above and beyond the call. . . 16845 Then it's tinle to call in White Uni- WHITE fonn Oxfords. Here's a beautiful way to UNIFORM win the battle of foot fatigue. They're bvSa ge s ientifìcally designed to gIve your feet cOlnfort. Day in. Day out. No I '-" . .... Inatter what your orders. So if you're looking for a pair of Oxfords that will stand up for you, buy White Uniform by Savage. F atigV I Q,Ç! . ' \ , , .11 L. . - , , ..- -, , J , , .,0 ... \ .... \ ," ''- ,..\ , .- \ 'I '\\\ news (Continued from page 8) economic possibilities of further educa- tion. "And they must be given a choice," he added. "They should not merely be pushed into an area. they must be shown all the possibilities and then make their own selection." Another panelist, Bob Russell of Orba- films of Montreal. said that in future it was possible that industry may take over part of what is now government responsi- bility in education. He said that industry in some northern American cities has successfully experimented with hiring ghetto unemployed to train on the job. The seminar was one of a series of six that formed the internatiunal cunference on continuous learning held during the Education Showplace. First Male Nur e Licen"t>d To Practice In Quebec Montreal, P. Q. - The first man to become a fully licensed nurse in Quebec was accepted into membership in the Association of Nurses of the Province of Quebec in December. Jean Robitaille. a graduate of Hôtel Dieu de Montréal with a baccalaureate degree from Université de Montréal. was formally presented with a license by Helen D. Taylor, ANPQ Presi- dent. Mr. Robitaille becomes the first male nurse in the province's history to carry the initials "R.N." after his name. Bill 89 - Legislation to permit men to enter the nursing profession - was passed December 12 by the National Assembly of Quebec. Previously, the profession was restricted to female nurses by the Quebec Nurses' Act. Although the prior legislation had precluded licensing of male nurses, some nursing schools have been admitting men for several years. Six hundred male graduates of nursing schouls are eligible for licensing immedi- ately by ANPQ. In presenting the license to Mr. Robi- taille, Miss Taylor said that ANPQ has been striving for many years for the admission of men to the profession. "It is particularly fitting that the legal machine- ry to permit male nurses to be licensed by ANPQ should occur at this time," she said, "because we are at the eve of our 50th anniversary as an association. We are, therefore, at this time celebrating two important milestones in nursing history in Quebec." With membership in ANPQ, male nurses also become members of the Canadian Nurses' Association. Another provision of Bill 89 amends the French version of the association's title to reflect the admission of male nurses. The new name of ANPQ in French is "l'Association des infirmières et 10 THE CANADIAN NURSE H "" , , f, .7' , - \, \ I, l ., " , . "- ... I t , I ,"- ... .. .. .. J' ' J; \ \ f The first male nurse in Quebec history to receive his license to practice nursing. From left, Eileen Flanagan, co-chairman, ANPQ Committee on Legislation; Jean Robitaille, the first fully licensed male nurse in Quebec, and president of the Male Nurses Committee of Quebec; Jacques Maynard, treasurer of the Male Nurses' Committee; and Helen D. Taylor, ANPQ president, who made the presentation. Miss Flanagan. who was president of ANPQ in 1946 when the Nurses Act was passed. said that ANPQ endeavored in 11)46 to have men legally admitted to the profession. The move was blocked in the Quebec Upper House. and one senator commented that it was "immoral" to have men working under female nurses in hospitals. In 1962, ANPQ resumed efforts to have men legally admitted into the profession. infirmiers de la province de Québec." Bill 89 also lowers from 21 to I 8 the minimum age required by law for the practice of nursing. This enables all qualifying graduates from nursing schools to be admitted to practice without wait- ing until they are 21 years of age. NBARN Members Approve Fee Increase Fredericton, N.B. - At a special general meeting, members of the New Brunswick Association of Registered Nurses approved a fee increase from $30 annually to $40 annually, effective Janu- ary 1, 1970. The increase was made to overcome a deficit budget and to improve NBARN services presently offered to the members and the community. NBARN president. Irene Leckie. chair- ed the meeting. Labour Relations Act Proclaimed in NB Fredericton, N.B. - After two years of planning, the New Brunswick Public Service Labour Relations Act was pro- claimed law on December I, 1969. The new legislation gives 30,000 public servants, including at least 2,000 nurses, collective bargaining rights. Nurses' staff associations have been organized in local hospitals and agencies throughout the province in preparation for the new Act. Nurses have chosen the New Brunswick Association of Registered Nurses as their bargaining agent. The Treasury Board, designated as the employer for public servants. will specify and define the groups within each occupational category. This will be done on the basis of job descriptions. After groups are named and within 90 days after proclamation, NBARN can apply for certification as bargaining agent. The collective bargaining structured to be used by NBARN under the new Act underwent a trial run during the 1969 voluntary bargaining sessions with the New Brunswick Hospital Association. Quot.l Remains The Samp For Male Nurses In Canada's Forces Ottawa. - No change has been made in the quota of four positions allotted for the enrolment of male nurses into the Canadian Forces since the first male nursing officer was commissioned as a lieutenant in November 1967. According to Brigadier General L.A. Bourgeois, director of general informa- tion, Department of National Defence, neither male nor female nurses are being recruited for the fiscal year 1969-70 as all available positions are presently filled. FEBRUARY 1970 Most Canadian Forces Recruiting Centers have waiting lists of applicants. General Bourgeois said. Normally all applications from registered nurses who meet the requirements for enrolment as officers in the Canadian Forces are considered in competition when vacant positions exist. Male nurses may be selected for any type of nursing duties for which they have been professionally trained. Current- Iy, two of the four male nurses are serving at the Canadian Forces Hospital, Halifax, and one is at the Canadian Forces Hospi- tal. Esquimalt, British Columbia. The other nurse serves with I Air Division Medical Center at Lahr, Germany where, as a trained flight nurse, he takes his turn with other flight nurses on medical evacu- ation flights. The commissIOning of male nurses in the Armed Services came after 26 years of attempts by the Canadian Nurses' Association and the Registered Nurses' Association of Ontario to persuade the government to change its policy of commissioning only female nurses. RNAO Publishes Statement About TGH Senior Nurses Toronto, Onto - The Registered Nurses' Association of Ontario has pub- lished a detailed account of its knowledge of the suspensions of the three senior members of the nursing staff of the Toronto General Hospital in October. The statement, which appears in the current issue of RNAO News, is printed below in its entirety. On Thursday, October 23. the two associate directors of nursing were asked to resign by the executive director of the Toronto General Hospital - the resigna- tions to be effective immediately. In their view this request was not justified. They asked for a period of time for considera- tion prior to making a decision. The next word they had was that the director of nursing and the 2 associates were on "suspension" pending a report from con- sultants. The hospital had previously ask- ed for a study of the nursing department to be conducted by the Ontario Hospital Services Commission, but the report had not yet been released by the OHSC. During this time, RNAO staff met not only with the 3 nurses involved, but with a delegation representing the head nurses as well. The incident was picked up in the press Wednesday, October 28. By Thurs- day it became evident that the situation was rapidly deteriorating, basically be- cause no useful infonnation supporting the action taken was forthcoming from the hospital. On Friday, a letter was sent from the RNAO to the chairman of the board of trustees of the hospitaL The following release was made to the press by RNAO: FEBRUARY 1970 "The Registered Nurses' Association of Ontario announces today its full sup- port of the three senior members of the nursing staff of the Toronto General Hospital who have been suspended from their positions while still remaining on full salary. The RNAO has asked the board of trustees of the hospital to disclose the basis of the unusual action taken by the executive director so that the three nurses involved may know what complaints have been made and will have the opportunity of answering them_ "The association made it quite em- phatic that it has no knowledge whatever which could justify the suspension of these nurses. "In response to numerous inquiries from nurses of all position levels through- out the province. the association an- nounces that the three nurses involved are already receiving active assistance from their association. They have seen RNAO's lawyer and are in close contact with executive director. Laura W. Barr, and the employment relations staff." On Monday, November 3rd. the asso- ciation received a reply to its letter stating that the board of trustees of the Toronto General Hospital had rescinded the suspension of the 3 senior nurses in the department of nursing. The nurses had been reinstated in their positions. RNAO made the following release to the press: "In reply to the Registered Nurses' Association of Ontario's request of Octo- ber 31 st to the board of trustees of the Toronto General Hospital that they dis- close the reasons for action taken by the executive director in suspending the 3 senior nurses, the RNAO received a letter today from Mr. T.J. Bell, the chairman of the board of trustees of the Toronto General Hospital. stating: "The Board of Trustees of the Toron- to General Hospital has rescinded the suspension of the three senior nurses in the department of nursing. "The nurses have been asked to con- sider appointment to the Task Force on Nursing which is investigating the problems related to budget, staffing, and organization of the nursing depart- ment. The nurses are considering this proposal, namely. that they be second- ed to the Task Force as special assis- tants. This force will be studying the report just concluded by a consulting team from the Ontario Hospital Ser- vices Commission and should be re- porting to the board of trustees of the hospital as quickly as possible." Subsequently, a final release was made to press: "The RNAO has been notified by the chairman of the board of trustees. Toronto General Hospital. that the direct- or of nursing and the two associate directors of nursing service have agreed to the proposal of the board of trustees that they be on loan from their present responsibilIties to the Task Force on Nursing. "As special assistants to the Task Force, they will be devoting full time to it. During this full-time involvement. we have been advised that Miss Viola Aboud will continue to function as acting direct- or of nursing service." Red Cros", Booklet Available On Right.. And Duties Of Nurse!'t Under The Geneva Conventions Geneva, Switzerland. - The Inter- national Committee of the Red Cross published in May 1969 a 4S-page booklet entitled Rights and duties of nurses, military and civilian medical personnel under The Geneva Conventions of August 12, 1949. Also included are the seven Red Cross principles of humanity. im- partiality, neutrality, independence, voluntary service. unity, and universality. The section on The Geneva Conven- tions includes a definition, infonnation on diplomatic conferences, signature, ratification and accession by govern- ments. and detailed information on the Four Geneva Conventions. The Red Cross on a white background is the universally respected international symbol adopted in October 1863. Under the section on Humane Treatment, the booklet states: "Persons taking no part in the hostilities. . . shall in all circumstances be treated humanely, without any adverse distinction founded on race, colour. religion or faith, sex, birth or wealth, or any other similar criteria." The protective Red Cross sign is worn on the left arm and the person carries an identity card. Under the direction of military authority the emblem is display- ed on flags and all equipment in the medical service. Under terms of the Second Geneva Convention. hospital ships and lifeboats are painted white with one or more dark red crosses displayed on each side. The hospital ship hoists its national flag as well as the Red Cross flag. These mark- ings can be used to protect only the ships mentioned. The Fourth Geneva Convention stipu- lates that designated civilian hospitals have the right to display the protective emblem. Civilian casualties are transport- ed in convoys of two or more ambulances whose drivers are under the orders of a responsible commander. The distinctive emblem does not confer protection. The remainder of the booklet contains information on the International Red Cross and the International Committee of the Red Cross. Copies of the booklet can be obtained for 40 cents from: The International Committee of the Red Cross. 7, avenue de la Paix. CH-1211 Geneva I. Switzer- land. THE CANA.IAN NURSE 11 When your rJay starts at L 6 a.m... you're on charge duty... you've skimped on meals... , and on sleep... I you haven't had timetohem _ adress... make an apple pie... wash your hair.: even powder o/ JI your nose ,'0 In comfort...- it's time for a change. Irregular hours and meals on.the- run won't last. But your personal irregularity is another matter. It may settle down. Or it may need gentle help from OOXIOAN. use DOX I DAN@ most nurses do DOXIDAN is an effective laxative lor the gentle reliel 01 constipation without cramping. Because OOXIOAN con- tains a dependable fecal softener and a mild peristaltic stimulant. evacuation is easy and comfortable. For detailed information consult Vade mecum or CompendIum Ii R g DIVISION OF CANADIAN HOECHST LIMITED """'E1'VI3t"" ( PMAC ) 12 THE CANADIAN NURSE news (.... New Pattern Developing In Collective Bargaining For Ontario Nurses Toronto, Onto - Five arbitration awards settling contract disputes between Ontario hospitals and nurses' associations organized for collective bargaining under the wing of the Registered Nurses' As- sociation of Ontario show that a new pattern seems to be developing. In each case negotiations, conciliation, and arbi- tration took so long that the awards gave the nurses increases retroactive to January I, 1969, in four cases, and to April I I. 1969, in one. Nurses' salaries have consistently been set by hospitals on the basis of the amounts the Ontario Hospital Services Commission has indicated would be ap- proved in hospital budgets. For 1968 the basic starting figure for a registered nurse was $445 per month; for 1969, $470. In negotiations, hospitals have tended to offer only the OHSC salary rate. Four recent arbitration awards set the 1969 basic figure at $490. Three hospitals received incr ases retroactive to January I, 1969: Clarke Institute of Psychiatry in Toronto, Hamilton Health Association (a group of hospitals), and Queensway Ge- neral Hospital in Etobicoke. At Peel Memorial Hospital in Brampton the in- crease was retroactive to April 11th. For nurses who left the hospitals in the interim, the period for which they receiv- ed a bonus varied. These dates were determined by the end of the last con- tract, or in the case of the Clarke Institu- te, the long period of negotiation for a first contract. All four contracts are for two years and therefore include an increase for 1970: nurses at Hamilton Health Associa- tion now start at $525 per month, and 1970 rates for the other four start at $535. St. Joseph's General Hospital in Guelph, could be a pacesetter. The arbi- tration board award gave the nurses $525 per month, retroactive to January I, for 1969, and a one-year contract. A 1970 contract is now under negotiation. The OHSC has indicated no definite approved figure for starting salaries for nurses for 1970. The Commission has stated that hospital costs may rise eight and one-half percent. Insulin Storage Important Food & Drug Directorate Warm Ottawa. According to a release from the Food & Drug Directorate, Department of Nationalllealth and Wel- fare, unsatisfactory patient response to treatment with NI'J-I Insulin, reported by certain practitioners, may have resulted in part from the drug being subjected to improper storage conditions. The Directorate warns that all insulin preparations must be stored under the conditions indicated in the Food and Drug Regulations. It is imperative that the provisions of this regulation be strict- ly observed. "No person shall sell or dispense an Insulin preparation that has not been stored by him continuously at a temperature between 35 and 50 degrees F (2 and 10 degrees n." Because critical reactions might be suffered by diabetics if an unsatisfactory insulin preparation were used. suitable precautions should be taken by distribu- tors and dispensers both when they re- ceive the preparations and when they deliver them to the patient. Examine the label for identification and expiration date. the Directorate advises. If the con- tents of the vial are frozen or if any discol- oration, deposit. foreign matter, lumping, granulation, or any change from the nor- mal appearance is observed, the insulin must not be sold or dispensed. The abnor- mality should be reported immediately to the manufacturer. Only Insulin Injection (Regular) and Globin Insulin with Zinc are clear solu- tions; all other insulin preparations sold in Canada are cloudy. UWO To Offer New Nursing Program London, Ont. - Beginning Septem- ber 1970, the University of Western Ontario faculty of nursing will offer a revised master's degree program to prepare teachers of nursing. The course arrangement for this new master's program is designed to introduce basic concepts and theories of learning and educatiun and to demonstrate their application in nursing education. Student participation in course work with labora- tories and practice will be stressed throughout the year. Courses with concurrent laboratory sessions will include: measurement and evaluation in nursing education; human learning and planning for teaching; student personnel services in nursing education; research and methodology with clinical investigation in nursing; education and the cole of the teacher; and current issues in nursing. Five of these courses are offered throughout the full academic year. The last is for one term only. Written into the program are opportunities for students to do case research under supervision, to experiment with various teaching methods and media, and to investigate a clinical nursing problem as a group proj- ect. Students entering this program must have a baccalaureate degree in nursing with a minimum B average. Studenh with a B average from either of Westcrn's two (Collfilllll'd Oil plI l' I-I) FEBRUARY 1970 Self- .' ------------ .1 - -- ... -:--.:::- ..=.:::.-- --...- teaching .. -- - .---- -..... -..-. ..., , , -'::=.._.--- _...,.- ...-..-..-- -- -- texts " \ -- .. -=.:::. -::: - - -_.....- ---.. -- and workbooks for independent study Mercer & O'Connor: FUNDAMENTAL SKILLS IN THE NURSE-PATIENT RELATIONSHIP By Lianne S. Mercer, R.N., M.S., formerly of University of Michigan School of Nursing. and Patricia O'Connor. Ph.D., University of Michigan. A nurse educator and a psychologist collaborated to develop this teaching program for the vitally impor- tant but often neglected skills of interpersonal relations. It requires about seven hours of independent study and answers such questions as: What should you say if a patient refuses a treatment? How should you respond when a patient asks about his diagnosis or prognosis? How can you get more information from records or from the patienf himself when you need it? The principles of effective nurse-patient interaction become clear as you work through the program. 192 pages, illustrated. $4.05. May 1969. Anderson: A PROGRAMMED INTRODUCTION TO NURSING FUNDAMENTALS By Mojo C. Anderson, B.A., M.N., SUNY Upstate Medical Center Part I: Basic Patient Care Part II: Basic Nursing Techniques These volumes cover the first and second halves of the basi:: nursing course, from bed making and bathing to administration of medications and care of patients with communicable diseases. They teach, reinforce, and evaluate learning while the student works independently at her own pace. Part I: 234 pages, illustrated, soft cover. $4.05. February 1965. Part II: 305 pages, illustrated, soft cover. $5.15. March 1068. Gillies & Alyn: SAUNDERS TESTS FOR SELF- EVALUATION OF NURSING COMPETENCE By Dee Ann Gillies, R.N., M.A., Cook County School of Nursing, and Irene Barre" Alyn, R.N.. M.S.N., University of Illinois. This self-teaching and self-evaluating review of clinical nursing describes typical case histories and presenting situations in each specialty area and asks perceptive questions about them. As the case develops, more information is introduced and more questions asked. Perforated answer sheets (and correct answers) are provided. 426 pages. $7.30. April 1968. Hymovich: NURSING OF CHILDREN A Guide for Study By Debra Hymovich, R.N., M.A., University of Florida. This workbook presents realistic cases and asks questions that review your knowledge of anatomy, physiology, pharmacology, and all the natural and social sciences. You are asked to formulate objectives, interpret tests, and make plans for nursing care - in short, to think creatively as in actual nursing practice. ------------ 389 pages, illustrated, soft cover. $5.95. May 1969. Please send on approval and bill me: w. B. SAUNDERS COMPANY CANADA Ltd., 1835 Yonge Street, Toronto 7 Author: Name: Address: FEBRUARY 1970 Book title: Zone: Province: CN 2-70 THE CANAblAN NURSE 13 POSEY SAFETY VESTS The Posey Patient Restrainer is one of the many products which com- pose the complete Posey Line. Since the introduction of the original Posey Safety Belt in 1937, the Posey Company has specialized in hospital and nursing products which provide maximum patient protection and ease of care. To in- sure the original quality product, always specify the Posey brand name when ordering. The Posey Patient Restrainer with shou Ider loops and extra straps keeps the patient from falling out of bed and provides needed security. There are eight different safety vests in the complete Posey Line. #5163-3131 (with ties), $7.80. ., "::'- The Posey Disposable Limb Holder provides desired restraint at low cost This is one of fifteen limb holders in the complete Posey Line. #5163-2526 (wrist), $19.50 doz. pro "' L The Posey Keylock Safety Belt is de- signed with a revolutionary new key- lock buckle which can be adjusted to an exact fit and snap locked in place. This belt is one of seventeen Posey safety belts designed for patient com- fort and security. #5163-1333 (with snap ends), $18.00. / , ., \ The Posey Retractable Stretcher Belt can be adjusted to fit eyery stretcher, guerney or operating table. This is one of seventeen safety belts in the complete Posey line. #5163-5605 (non-conductive), $24.00 set. 'r\, " The Posey Footboard fIts any stan- dard size hospital bed and is fully ad- ju table to any comfortable angle. Helps prevent foot drop and foot ro- tation. Complete Posey line includes twenty-three rehabilitation products. #5163-6420 (footboard only), $39.00. Send for the free all new 1970 POSEY catalog - supersedes all previous editions. Please insist on Posey Quality - specify the Posey Brand name. Send your order today! POSEY PRODUCTS Stocked in Canada ENNS & GILMORE LIMITED 1033 Rangeview Road Port Credit, Ontario, Canada 14 THE CANADIAN NURSE news (Continued from page J 2) new baccalaureate programs may enter directly into the new program. Graduates from earlier programs or from other universities must have their credentials assessed and a qualifying year, or part thereof, may be required. As well as depth of knowledge in nursing practice, advanced work in psychology or sociology and in health science will be required. Selected students may complete the program in one academic year. Upon successful comple- tion of the program, the degree of master of science in nursing will be granted. For further information write to the Dean, Faculty of Nursing, The University of Western Ontario, London, Ontario. University Of Montreal Receives Health Resources Contribution Ottawa. - An $874,052 contribution from the federal government's health resources fund has been approved for the School of Nursing Sciences and School of Hygiene of the University of Montreal, Quebec. The federal contribution will be used to purchase a building on Côte St. Cathe- rine Road that previously housed the school of nursing of the Marguerite d'Youville Institute. Three floors of the building formerly used as the students' residence will have offices for the school of hygiene and the institute of hospital administration. New laboratories will be set up on the ground floor. Other rooms will be converted into lecture and seminar rooms. The new location for the school of hygiene and the hospital administration institute provides additional space in university buildings for the faculty of medicine. The new quarters have facilities for 540 students. First live Mumps Vaccine Now Available Montreal, P.Q. - Merck Sharp & Dohme Canada Limited has developed the first live mumps vaccine, known as Lyovac or Mumpsvax. The vaccine is prepared from the Jeryl Lynn (B Level) strain, named after the patient from whom the virus was first obtained. Mumpsvax, a live attenuated strain, is grown in cell cultures of chick embryos free of Avian leukosis. Studies in susceptible children and adults have assessed the safety and effec- tiveness of the vaccine. A single subcutan- eous injection induced an antibody response in approximately 97 percent of susceptible children and 93 percent of susceptible adults. FEBRUARY 1970 There were no significant differences in the incidence of fever in clinical trials when children vaccinated with mumps vaccine were compared with unvaccinated subjects studied concurrently. Adequate antibody levels with continuing protec- tion of vaccinated children exposed to mumps have persisted for three years without substantial decline. Usually mumps is a mild disease, al- though it may occasionally be severe and produce serious complications. Now mumps can be prevented in most cases. Among contraindications for use of the vaccine are pregnancy, and allergic reactions to eggs, chicken. or chicken feathers. It should not be administered with other vaccines. Additional information is available from the manufacturer at: Box 899, Pointe-Claire-Dorval 700. Quebec. CARE/MEDICO Sponsors Project In Surakarta, Indonesia Toronto. Onto - CARE/MEDICO of Canada is sponsoring an all Canadian project in Surakarta. Indonesia over the next six years. A team of three Canadian doctors. three nurses, and a lab technician will work in an Indonesian hospital to upgrade the level of training of physicians and nurses in that country. Contracts for two years. including a salary. cost-{)f-living allowance. and trans- portation both ways are available. Anyone interested in this project is asked to write CM. Godfrey. B.A., M.D.. Chair- man, {:ARI:., MEDICO of Canada. 484 Church Street. Suite 109, Toronto 5, Ontario. Female Graduates Spurned Ottawa. - Women graduates are denied the opportunity of competing, even on their own university campuses. for two-thirds of the jobs for which graduates are recruited. In a paper entitled Highly Qualified Manpower Policies and the Canadian Woman Graduate: What Price Discrimina- tion? , Sylva M. Gelber, director of the Women's Bureau. Canada Department of Labour. referred to recruiting material that showed that many of the biggest firms in Canada refused even to interview women graduates for 2.024 out of 3,268 vacancies offered. Speaking at a luncheon meeting of the Beth Tzedec Sisterhood in Toronto, Miss Gelber suggested that industry should reexamine the grounds on which it bases its policy of limiting to male graduates recruitment for executive positions. She challenged the grounds on which industry justifies this discrimination, mentioning particularly allegations of high turnover rates of women executives as compared to those of men. She discussed the implications for national and inter- national manpower policies of such dis- FEBRUARY 1970 criminatory practices in recruitment. Survey Shows More Schools Employ Full-Time Nurses Toronto, Onto A survey conducted by the Ontario Teachers' Federation reveals a sharp upsurge in the number of schools employing full-time staff nurses. More than 4.000 Ontario elementary schools were included in the study. which compared the number of schools employ- ing full-time nurses between 1967 and 1969. Only 235 schools had full-time nurses in ] 967, compared to 383 schools in 1968. and 629 schools in ]969. W.A. Jones. OTF deputy secretary treasurer. said the figures indicate a change from the old "mass innoculation role of school health services" to a more modern preventive medicine approach geared to the individual student. The survey also showed that 2.695 schools had part-time nurses in 1969. However. 850 schools are still without any nurses on staff, even on a part-time basis, Me. Jones said. "Even the smallest school in the province should have the services of a nurse for at least a half-day a week," he said. "That is the basic mini- mum." 0 - *T.M. ASSISTOSCOPE %-we, '/?- ð/- -! - /f ...,a4/ -r: - ;thr :;r 77.' J C . aZI/9g " 1;:/. f.J . . , . " ...... ASSISTOSCOPE OESIGhED WITH THE NURSE IN MIND Acoustical Perfection A SUM AND DAINrt A RUGGED AND DEPENDABLE A UGHT AND flEXIBLE A WHITE DR BLACK TUBING A PERSONAL STETHOSCOI'E TO RT TOUR POCKET AND POCKETBOOK r Ey ----l l I 2795 BATES RD. MONTREAL, P.O. I Please send. on time lor Christmas, I I I 'Asslstoscope(s)' at $985 I Black tubin g White tubong I - - I I NAME I I ADDRESS I I .1 L : J Reslden.s of Quebec add 8" PrOVlnc,al Sales Tax III'" Q ..MaoI. nada THE CANADIAN NURSE 15 names A number of new staff members have joined the faculty of The University of Alberta School of Nursing in Edmonton. Devamma Purusho- tham (R.N.. Mid- wife, dipl. teaching and superv., Vellore, India: B.N.Sc., Queen's U.. King- ston: M.Sc.N., Mc- Gill U.) is assistant professor at The University of Alber- ta School of Nursing. Miss Purushotham was formerly in- structor and clinical nurse specialist at the Kingston General HospItal, Kingston, On- tario. Her experience in Canada also includes general duty at the Toronto General Hospital. Miss Purushotham has worked as a staff nurse and head nurse in Vellore, India. - Stella L. Hazlett (R.N., S1. Paul's H., Saskatoon; B.Sc.N.. U. of Alberta, Ed- monton) is a lecturer in the community .. health and home visiting areas of the basic degree program at U of A. Mrs. Hazlett worked as a general duty nurse at Union Hospital, Lucky Lake, Saskatchewan, and at Inuvik General Hos- pital, Inuvik, Northwest Territories. She also did general duty nursing at District Hospital, Bombola, New South Wales, Australia. As a public health nurse, Mrs. Hazlett worked in Outlook, Saskatche- wan, and at Watson Lake, Yukon. Frances M. McAdoo (R.N., Royal Colum- bian H., New West- minster, B.C.; B.Sc.N., Dip!. 1">. þ P.H.N., U. of Saskat- chewan, Saskatoon; M.Ed., Colorado State U.) is assistant professor at The University of Alberta School of Nursing. Miss McAdoo is working in the post basic degree program's public health and family health areas. Miss McAdoo was previously nursing supervisor of public health in northern Saskatchewan. She also worked as a public health nurse in northern British 16 THE CANADIAN NURSE Columbia. as well as an operating room nurse at the Royal Columbian Hospital in New Westminster and the Vernon Jubilee Hospitdl. Patricia Hayes (S.R.N., Royal Free H., London, Eng- land; S.C.M., Eng- land; B.N., McGill U.) is lecturer in the advanced practical obstetrics program at U of A. Miss Hayes was a clinical instructor in obstetrics at Plum- mer Memorial Public Hospital in Sault Ste Marie, Ontario, and at the Royal Victoria Hospital, Montreal, as well as a nurse midwife in England. -- .,. Karen R. Stevens (R.N., The Montreal General H.; B.Sc.N., U. of Western Onta- rio) is a lecturer in the junior medical- surgical and pediat- ric nursing areas of the basic degree pro- /... ."un " Th' Unw,,- sity of Alberta School of Nursing. Mrs. Stevens was previously a staff nurse and assistant head nurse at the Victoria Hospital in London. Ontario. Jeanette T. Funke (R.N., Regina Grey Nuns' H., Regina; postgraduate clinical course in psychiatric nursing, Allan Me- moriallnstitute, Montreal; B.N. and Dipl. P.H.N., McGill U.) is a lecturer in the junior medical-surgical nursing and mater- nal and child health courses of the basic degree program at U of A. Eileen Patricia Walla- ce (R.N., The Mon- treal General H.: B.N., Dipl. Nursing Se rvice Admin., Dip!. P.B.N., Dal- housie U., Halifax) '-. has been appointed ,., lecturer at U of A. .... \- . Mrs. Wallace was previously with the emergency depart- ment of the Victoria General Iluspital in Halifax, Nova Scotia. Her experience includes medical nursing at The Montreal ';;'" Ç. ...... "' General Hospital; nursing in the intensive care unit of The Hospital for Sick Child- ren, Toronto; private duty nursing in Vancouver; and public health nursing with the New Brunswick department of health. Donna E. Cooley (R.N., Calgary Gen- eral H.; postbasic course in psychiatric nursing, Alberta H., Ponoka; B.N., Mc- Gill U.) is a lecturer in mental health in the basic degree pro- gram at U of A. Prior to her appointment, Miss Cooley worked at the Royal Alexandra Hospital in Edmonton as a general duty nurse, an instructor in medical and psychiatric nursing, and for one year worked in the nursing inservice department. Joanne M. Boyd tR.N., U. of Alberta H. Edmonton; B.Sc.N., U. of Alber- ta) has been appoint- ed a lecturer at the University of Alberta. Mrs. Boyd has had general duty and nursing office super- visory experience at the University of Alberta Hospital. As a public health staff nurse, she worked in the South Okanagan health unit in Kelowna, British Columbia; the Sturgeon health unit, S1. Albert, Alberta; and the department of national health and welfare in Cambridge Bay, Northwest Territories. i/IiO. ..;:. ... t . -'^ ,. The University of Alberta, School of Nursing has also ap- pointed Joan S. Ford (R.N., Epsom District H.. Surrey, England; Midwifery. '\... Simpson's Memorial Maternity J>;JVilion, Edinburgh. and Royal Maternity 1-1., Glasgow. Scotland; B.N., McG ill U.) lecturer in the junior medical-surgical area of the basic degree program. Miss ford was a nursing instructor at Foothills Provincial General Hospital in Calgary before her appointment. She has had general duty experience at the I3ristol Royal Ilospitai. England. and The Mon- treal Generaillospita!. - -- '" ""Ç;7 FEBRUARY 1970 Lucy D. WiUis (Reg.N., Atkinson School of Nursing. Toronto Western H.; Cert. in teaching and supervision, U. of British Columbia; B.S. and M.A., Teachers College, Columbia U., New York; Ed.D., U. of California. Berkeley) has been appointed director of the School of Nursing at the University of Saskatche- wan in Saskatoon. Dr. Willis first joined the faculty of the University of Saskatchewan in 1954 where she has since been an assistant professor of nursing and director of clini- cal education. She had previously been director of the Centralized Teaching Program in Regina; head nurse. instruc- tor, and educational director at the Saska- toon City Hospital School of Nursing; and an instructor at the Moose Jaw Union Hospital School of Nursing. Dr. Willis is a fonner president of the Saskatchewan Registered Nurses' Associa- tion. She was a Kellogg Foundation Inter- national Fellow in 1950-52, and a Cana- dian Nurses' Foundation Fellow in 1966-67. .. f. ,. · --;' f> Marion W. Sheahan, retired deputy gener- al director of the National League for Nursing. was the 1969 recipient of the Sedgwick Memorial Medal, awarded annually by the American Public Health Association to the nation's outstanding public health leaders. From ]949 to ]952, Miss Sheahan was director of programs for the national committee for improvement of nursing services. In 1952 this committee joined with several other committees and organi- zations to become the NLN. From 1963, when she retired from her NLN position. to 1967, she was secretary to the task force on organiLational structure ofNLN. Miss Sheahan. a former APHA presi- dent, is presently chairman of the com- mittee on equal health opportunity of the APHA. She has served on the President's Commission on the Health Needs of the Nation. the Surgeon General's Consultant Group on Nursing, the National Commis- sion on Community Health Services. In 1967 Miss Sheahan was one of the first two persons to receive the NLN distinguished service award. given bien- nially to two persons who have contribut- ed. through nursing. to the improvement of patient care. She has also received the APHA Lasker award. the Herman M. Biggs Award of the New York State Public Health Association, and the Horence Nightingale Medal of the Inter- na t ional Conference of Red Cross Societies. In addition. Miss Sheahan has hcen awarded honorary doctor of human- ities and doctor of laws degrees. 0 FEBRUARY 1970 .... ,.... 40 'rUok.i --::--=- For nursing . convenIence. . . patient ease TUCKS offer an aid to healing, an aid to comfort Soothing, cooling TUCKS provide greater patient comfort, greater nursing convenience. TUCKS mean no fuss, no mess, no preparation, no trundling the surgical cart. Ready- prepared TUCKS can be kept by the patient's bedside for immediate appli- cation whenever their soothing, healing properties are indicated. TUCKS allay the itch and pain of post-operative lesions, post-partum hemorrhoids, episiotomies, and many dermatological conditions. TUCKS save time. Promote healing. Offer soothing, cooling relief in both pre-and post-operative conditions. TUCKS are soft flannel pads soaked in witch hazel (50%) and glycerine (10%). TUCKS - the valuable nur- sing aid, the valuable patient comforter. " Specify the FULLER SHIELD as a protective postsurgical dressing. Holds anal, perianal or pilonidal dressings comfortably in place with- out tape, prevents soiling of linen or cloth- ing. Ideal for hospital or ambulatory patients. W ""VINLEY-l\10RRIS I !:;' M MONTREAL CANADA TUCKS is a trademark of the Fuller Laboratories Inc. THE CANA IAN NURSE 17 *IMPORTANT PlelSe add 25c pet order hlndl,.. C"'tlf on .11 orders of ] pins or less CROUP DISCOUNTS 2 99 plns. " 100 or mar.. IO Send cIsh, m.o.. or check. No billinlS or COD"I. Sel-Fix NURSE CAP BAND .__ Blaek .e'.et band mitenll. Self.3d- heslve: presses on. pulls off: no sevun, or plnnlnl. Reusable several times ::,h s:2 :w I rl r: e:I':st : ::r. W 18 per 1>011. . 16 per I>od, I' No 634J (6 per boxl. Specify width desired in CIP Ø.nd . ..1 bOI J.e ITEM column on couþOn. 3 or more lAO II. NURSES CAP-TACS_,. _ Remcwe aM ,ef tfft tap bini' Instantl)' for Ilundering and replacement! Tin)' _ ë' :: &:: : c B : : o ldërc :i .:.. _.: with Gold Clduceus. Dr III bl.ck (prim). ..___ NO.200Setof6Tacs..l.00perslt.... \ ?'I SPECIAL! 12 or more sets....80 plr Sit @) Nurses ENAMELED PINS Beaulifull)' sculptured st.tus instltli.; 2..co&or keyed. e:N i. lp f: I:r ':' : ' No. 205 Enlm.lld Pin. . .n.... .J.e II. ppd. . Waterproof NURSES WATCH ?9 - SWISS mlðe. "ised silver full numerals. lumln. mark. . . Inls Red.llpped sweep second hind. chrome st. In less . . clse. Stainless explnSlon band plus FREE black Itllher strap. 1 'T. IUI"ntee. No. 06-925 . .. .. . .. .... . .. . . 16.50 '". ppd. UnifDrm POCKET PALS Protects qamst stlms Ind wear. Pliable white plashc with laid stamped caduceus. Two com- parlments 'or pens, ShelfS. etc.ldtll token lifts Dr 'avors. Il Na.210-E 1 6 for 1.75.10 for 2.70 Savers 25 or mar. .25 ....111 ppd. Personalized BANDAGE .- SHEARS -=-- 6 w profeSSional precIsion shears. for,ed r-:;---- - In steel. Guaflnteed to stay sharp 2 ,ears No. 1000 Shears (no inlblll) . . . . . . . 2.75 ea. ppd. SPECIAL! 1 Doz. Sh..n ............ $26. total Initials (up to ]) Itched. . . . . . . . Idd 50c plr pair "SENTRY" SPRAY PROTECTOR Protects ,ou Igamst vlolenl mln or dO,. . mstantly disables ffithout permanent In,uf)'. No. AP-16 S.ntry 225.1. ppd. ,I I I COLOR GUANT. PRICE I ' OROER NO. . . . . I enclose $ . Send 10 . St,eet . . \iC;... atÍi.iII :-iiilïiïrl PleasI .now suttlclent lime tor d.li"ery. PIN Lm. COLOR' 0 Black 0 Blue 0 Wh'te INo. 169) METAL FINISH, 0 Gold 0 S,lve, INI_LS _ _ _ LETTERING 21'\d line . .. ... .. . . .. . 18 THE CANADIAN NURSE dates March 2-6, 1970 Conference for directors of schools of nursing, Westbury Hotel, Toronto. Sponsored by the Registered Nurses' Association of Ontario, 33 Price Street, Toronto 289, Ontario. March 16-18, 1970 Conference for staff nurses on their leadership role, Geneva Park, Lake Couchiching. Sponsored by the Register- ed Nurses' Association of Ontario, 33 Price Street, Toronto 289, Ontario. March 20, 1970 Operating Room Nurses of Greater Toronto, seminar, Royal York Hotel, Toronto. For more information, write to: Mrs. Jean Hooper, Chairman, Public Relations, Operating Room Nurses of Greater Toronto, 43 Beaverbrook Ave., Islington, Ontario. April 22-24, 1970 Conference for faculty of university schools of nursing, Twin Seasons Motor Hotel, Jackson's Point, Ontario. Sponsor- ed by the Registered Nurses' Association of Ontario, 33 Price Street, Toronto 289, Ontario. April 10-11,1970 Conference for public health nurses, Geneva Park, Lake Couchiching. Follow- up from conference last March at Geneva Park, sponsored by the Registered Nurses' Association of Ontario, 33 Price Street, Toronto 289, Ontario. April 30-May 2, 1970 Registered Nurses' Association of Onta- rio, Annual Meeting, Royal York Hotel, Toronto. Write to the RNAO, 33 Price Street, Toronto 289, Ontario. May 4-7, 1970 First National Operating Room Nurses' Convention, Queen Elizabeth Hotel, Montreal. For further information write to: Mrs. I. Adams, 165 Riverview Drive, Arnprior, Ontario. May 4-28, 1970 Developing leadership in supervision of nursing services, a continuing education course, University of Toronto. Designed for nursing staff of hospitals and commu- nity health agencies who take responsibi- lity for the work of others. Write to: Continuing Education Program for Nurses, University of Toronto, Division of Ex- tension, Room 104, 84 Queen's Park, Toronto 5, Ontario. May 12-15, 1970 Alberta Association of Registered Nur ses Convention, Calgary I nn, Calgary For further information write to: AARII 10256 - 112 Street, Edmonton. Alberta May 19-22, 19ïO Canadian Public Health Association annual meeting, Marlborough Hotel, Win- nipeg. For further information write to the CPHA, 1255 Y onge Street, Toronto 7, Ontario. May 31-June 12, 1970 Ninth annual residential summer course on Alcohol and Problems of Addiction, Brock University, St_ Catharines, Ontario. Co-sponsored by Brock University and the Addiction Research Foundation of Ontario. Enrollment is limited to 80. Basic information and findings of current research relating to the misuse of alcohol and other drugs will be presented. Provi- sion will be made for discussion of prevention and treatment aspects of addiction problems. Address enquiries to: Summer Course Director, Education Division, Addiction Research Founda- tion, 344 Bloor Street West, Toronto 181, Ontario. June 1-3, 1970 70th annual meeting ot the Canadian Tuberculosis and Respiratory Disease Association and the 12th annual meeting of The Canadian Thoracic Society, will be held at the Fort Garry Hotel, Winnipeg. Further details are available from Dr. C.W.L. Jeanes, Executive Secretary, CTRDA. 343 O'Connor Street, Ottawa 4, Ontario. June 9-12, 1970 Catholic Hospital Association Annual Convention, Cincinnati, Ohio. For more information, write to: CHA, 1438 South Grand Boulevard, Saint Louis, Missouri, 63104. June 15-18, 1970 Canadian Conference on Social Welfare Skyline Hotel, Toronto. Tours and talk- ins at innovative agencies and services are planned. For information write to: The Canadian Welfare Council, 55 Park- dale Ave., Ottawa 3, Ontario. June 15-19, 1970 Canadian Nurses' Association General Meeting, The Playhouse, Fredericton, New Brunswick. 0 FEBRUARY 1970 new products { Descriptions are based on information supplied by the manufacturer. No endorsement is intended. Patient Security Suit A new type of security garment for use in hospitals and nursing homes. called the Posey Houdini. provides patient safe- ty and security with comfort. The suit is designed to prevent removal by the pa- tient. The vest and lower portion of the garment are interlocked by the waist belt. which is tied under the bed. out of the patient's reach. If desired. the vest can be worn separately. This suit. manufactured by the J.T. Posey Company. can be purchased from Enns & Gilmore Limited. 1033 Range- view Rd.. Port Credit. Ontario. ,) \ 4 . Memory tape ,'_tern A new memory tape system capable of monitoring. recording. and storing cardiac events on a closed loop magnetic tape is available from The Birtcher Corporation. Designated the Mode] 410 Memory Tape System. the unit provides an electro- cardiogram by monitoring one to six patients simultaneously. recording their cardiac history prior to abnormal events or distress. The system consists of six plug-in tape modules plus a strip chart recorder. It is also available in singular configurations. adding tape modules as needed to serve up to six patients. Each tape-loop is connected to the patient at the bedside through the Birtcher Sentinel Alert. Model 40 . When cardiac events become hazardous, the alert signal immediately stops the recording. The tape cartridge provides a patient's full ECG history: when played back. the stored data is automatically transferred to ECG chart paper for permanent record reference. Each standard tape cartridge stores up to 70 seconds of data. Data storage capabili- ty for 3, 5. 10. and ]5 minutes is available on special order. The Model 410 Memory Tape System is an addition to the Birtcher 400 Series of Central Nursing Station patient FEBRUARY 1970 monitoring instruments. This product is available in Canada from the Stevens Company in Vancouver. Calgary. Winni- peg, and Toronto. and from Millet. Roux & Cie in Laval (Chomedy). Quebec. Packaging ,,'tern The new Bard Steril-Peel Packaging System is designed to meet all steriliza- tion packaging needs. Small and large instrurnents and even odd-shaped items can be neatly, easily. and securely heat- sealed for either steam or gas sterilization. The packaging rnaterial is available in IOO-foot rolls in three. six. and nine-inch widths. A convenient dispenser carton makes removal of the desired length easy and at the same time protects the remain- ing supply. The material is transparent on one side for ready identification of the contents: an autoclave indicator stripe indicates that the contents have been sterilized. Complete details are available from C.R. Bard (Canada) Ltd.. Torlake Crescent. Toronto 530. Ontario. Walking aiel This aid is especially recommended for patients suffering from polio. rheuma- tism, arthritis. cerebral palsy. etc. It is also indicated as a means of obtaining early postoperative. supported ambula- tion. The walking aid is strongly construct- ed of steel tubing. triple chrome-plated for lasting appearance. 1 he large front caster permits easy steering. with stabIlity achieved by the direct-action brakes. Brake pressure is adjusted by loosening or tightening the brake adjustment knobs. The handle grip height is adjusted to suit the user. assuring correct posture. Other features include an overall width of 26 inches. adjustable height 29 to 36 inches. and folding for easy storage. For complete information. write to Everest & Jennings Canadian Limited. P.O. Box 9200. Downsview, Ontario. Surgical tapt' Drenison Tape. a new concept in topical corticosteroid therapy. has been introduced by Eli Lilly and Company (Canada) Limited. This is a transparent plastic surgical tape impervious to mois- ture. The tape is made of a thin. matte- finish polyethylene film which is slightly elastic and highly flexible. The pressure-sensitive. Jdhesive surface is covered with a protective paper liner to permit handling and trimming before application. Because of the even distribu- tion of steroid throughout the tape. it is particularly effective in controlling those types of dermatoses where occlusive dressing corticosteroid therapy is pre- ferred. Control of dosage by the physician. ease of application. and virtual invisibility when applied to the skin are some advan- tages offered. The area treated is protect- ed from scratching and e>..ternal irritants. It cannot be washed off and will not rub off on clothing. This product is available from: Eli Lilly and Company (Canada) Limited, P.O. Box 4037. lerminal A. Toronto l. Ontario. Ore ing Cuttt'r This new dressing cutter quickly cuts through all cast padding materials. includ- ing felt. A curved handle. which conforms to the user's hand. provides a firm. comfort- able grip. Lightweight and easy to use. the dressing cutter features disposable blades to assure a sharp cutting edge every time the instrument is used. This cutter is narrow and thin so that it slips under the padding easily. The smooth lower edge of the instrument protects the patient from the blade's cutting surface. For additional information. write to Depuy Manufacturing Company (Canada) Lt d. . Quebec and Maritime prov- inces Guy Bernier, 862 Charles- Guimowd. Boucherville, Quebec: Ontario and Western Canada - John Kennedy. 2750 Slough Street. Malton, Ontario. -- ( . Literature availdhle A new catalog describing the complete line of more than 200 products m.mufdc- tured by the Posey Company is available free of cÏ1arge. (Colltillued 011 page O) THE CANAQ,lAN NURSE 19 Next Month in The Canadian Nurse . Fredericton, New Brunswick - Something for Everyone . Something to Say - and How! . CNA Ad Hoc Committee Repol on Functions, Relationships, and Fee Structure ð Photo credits for February 1970 Graetz Bros., Ltd., Montreal, p.8 Julien LeBourdais, Toronto, pp. 34,35,36 Drummond Photos, Montreal, pp. 41,42 The Hospital for Sick Children, Toronto, pp. 45,46,47 20 THE CANADIAN NURSE new products The products are divided into sections, which include safety belts, limb holders, safety vests, wheelchair safety products, pediatric control products, rehabilitation, and orthopedic products. Write to: Enns & Gilmore Limited. 1033 Rangeview Road, Port Credit, Ont. A new brochure on the Medi-Scan 660 Hospital Staff Register System is available from Motorola Communications and Electronics, Inc. The brochure explains how this unique electronic system provides rapid, low-cost distribution of registration data to erner- gency and surgical areas, nursing floors. administration areas. information centers. or anywhere in a hospital. It also points out the flexibility of the system which makes it possible to expand economically readout points to key areas throughout a hospital simply by adding low-cost status display units. Also designed to facilitate staff expansion or changes, the system requires no costly rewiring, complex re- arranging of names, or reassignement of code numbers. For a copy of the brochure, No. 92-112, write to: Motorola Communica- tions and Electronics, Inc., 4501 West Augusta Boulevard, Chicago, II1inois 60651, U.S.A. A filtration method for analyzing amniotic fluid as a means of estimating fetal maturity is described in "Amniotic Fluid Filtration and Cytology" by Wil- liam S. Floyd, Paul A. Goodman, and Arlene Wilson. The article was originally published in the Journal of Obstetrics and Gynecology. In the study, cellular contents of amniotic fluid samples were collected on a Metricel membrane filter using a Cytosieve, product of the Gelman Instru- ment Company. This filtration method of concentrating cells eliminates need to centrifuge sample. Cells are easily and accurately observed, and specimen can be preserved. For free copies of this reprint, write to the Information Department, Gelman Instrument Company, P.O. Box 1448, Ann Arbor, Michigan 48106. The Angostura-Wuppermann Corpora- tion has produced a set of recipe, color cards that illustrate how Angostura bitters can be used to improve the taste of low-sodium dishes. The bitters are particularly useful in restricted diets as they contain virtually no sodium and are a totally natural food product. They can be used in chicken, fish. and rneat dishes, and in sauces and vegetables. Recipes for 12 low-sodium dishes include beef liver stroganoff. meat loaf, chicken fricassee. rice stuffed fish rolls. and duchesse potatoes. The blend of Angostura is not identifiable in the finish- ed dish. The dieter knows only that the food has more tang and flavor. Low-sodium angostura recipe cards are available free to institutional users by writing to the Angostura-Wuppermann Corporation. P.O. Box 123. Elmhurst. N.Y. 11373. A colorful. illustrated leaflet on prevention and treatment of decubitis ulcers is available from Everest & Jen- nings Canadian Limited. Preventative nursing care covers the use of alternating pressure pads and high power purnp units. Major subjects are under the headings of etiology. incidence. location, prevention. and summary. For a copy of this leaflet. write to: Everest & Jennings Canadian Lirnited. P.O. Box 9200, Downsview. Ontario. "- ".. p- JêJ Light-Weight Walker The Everest & Jennings Rollator fea- tures simplicity of design, stability. and ease of movement. Because it eliminates side motion. it gives patients the confi- dence of full control of their locomotion. The Rollator. though light in weight. safely bears the weight of the heaviest patient, and the smallest size can be used successfully by children. It providcs a new approach to retraining bed-riddcn legs to walk. and is especially valuablc in solving gait-training problems of polio. cerebral palsy. multiple sclerosis. and similar disabilities. The unit. available in three si/cs. is made of tubular steel and chrome-platcd for lasting beauty. For complctc infonna- tion write to: Everest & Jcnnings Cmadi- an Limited. P.O. Box 9200. Downsvicw. O u . 0 FEBRUARY 1970 in a capsule Watch those writing rult's Editors may not have invented the golden rules of grammar, but they strive to live by them. Anyone who writes for publication should chuckle at the follow- ing do's and don'ts, taken from the November 8 issue of Editor & Publisher. Tom Watts of Chicago Today uncovered these rules of newspaper writing. l. Don't use no double negatives. 2. Make each pronoun agree with their antecedants. 3. Join clauses good. like a conjunction should. 4. About them sentence fragments. 5. When dangling, watch your participles. 6. Verbs has got to agree with their subjects. 7. Just between you and I, case is impor- tant to. 8. Don't write run-on sentences they are hard to read. 9. Don't use commas, which aren't neces- sary. 10. Try to not ever split infinitives. Unt'lTlploymt'nt imurance for nursesf Hunters, trappers, and nurses take note. The federal government has promis- ed to present a white paper outlining changes in the Unemployment Insurance Commission Act. The Minister of Labour. Bryce Macka- sey, said in the House of Commons in December that the proposed white paper, which was mentioned in the Speech from the Throne in October, might be intro- duced in early Spring. The Act now excludes several groups from unemployment insurance coverage, including private duty nurses, nurses who work in non-profit hospitals, teachers, members of police forces and the Cana- dian Forces, and persons employed in agriculture. forestry, fishing, hunting, and trapping. The idea is that such persons can always hunt successfully for employ- ment. According to a news item by Murray Goldblatt in The Globe and Mail October 24, the government is planning to expand unemployment insurance into a more broadly based income-maintenance pro- gram. This program would drop the above categories and would treat all employees, except those considered as self-employed, on an equal basis. Officials in the Unemployment Insur- ance Commission told The Canadian Nurse that predictions about changes in the Unemployment Insurance Commis- sion Act, which might affect nurses, are FEBRUARY 1970 only speculation. Also referred to as "speculation" was the rumor that the present $7,800 ceiling might be raised to $10,000, that is, employees earning up to $10,000 would pay unemployment insur- ance to the ever-growing fund. Nurses who don't want to get caught in an unemployment insurance trap should let their members of parliament know how they feel! Remember that well-worn expression: An ounce of prevention is worth a pound of cure. 0 I4ERE5 A BRI T ( ! WIN NoT COW\B\NE A HOLlDAÝ IN NEW 8RlJN Wt:K W'TI-I A TRIP TO CNA'S BI N'AL CONVENTlcN IN R \ \ \\\ I J FEBRUARY 1970 who has little rnemory loss seems to sleep about the same as the young adult. The patient who shows senile changes awak- ens often. especially during Stage I REM, sleeps 20 percent less than the young adult. and tends to wander around at night.7 Medical crises are thought to occur during Stage I REM sleep. Nocturnal angina pectoris has occurred in the labo- ratory mostly during REM periods, rais- ing the question of whether there is a relationship between the occurrence of myocardial infarction and the latter part of the sleep cycle when the REM periods are most prolonged. Persons who have duodenal ulcers typically have more pain at night. related to the increase of gastric acidity during Stage I REM sleep. Asthmatic episodes have shown no pat- tern of occurrence. s Thus. one rnight expect patients with angina or peptic ulcers to have an increase in pain during the latter part of the night. Since a person usually perceives any pain as being worse at night, due to the fewer distracting external stirnuli, the nurse's reassuring explanation, along with the ordered p.r.n. medication. may help de- crease his perception of the pain. Cuntrol of sleep Although we know better what to expect in a sleep pattern. we still know relatively little about how to control sleep. The irnportant variable in control- ling sensory input to promote sleep appears to be quality rather than quanti- ty. Volunteer subjects placed in a com- pletely silent room had rnore difficulty going to sleep than those subjected to monotonous light or sound. 9 Early research in factors promoting the induction of sleep indicated that immobility with rnuscle relaxation were effective mechanisms. Little research has been done in this area in recent years. Most sedatives significantly decrease REM sleep. However. if the person con- tinues to take the sedative. there is a gradual return to the baseline amount of REM sleep. But then when the drug is FEBRUARY 1970 withdrawn there is a marked increase in REM sleep. associated with frequent nightrnares. insomnia, and a feeling of having slept poorly. These uncomfortable changes have persisted for up to five weeks. 1o Behavioral changes can occur, depend- ing on the dose of the drug and on the individual characteristics of the patient. The same drug that causes sleep in one person may cause wakefulness in another. Obviously. good judgment is necessary in carrying out the order for sedatives to be given h.s., p.r.n.. for not giving any sedatives at all could be as detrimental as giving them to every patient. If the patient has been taking a sedative routine- ly at horne, ornitting it in the hospital might lead to withdrawal symptoms. On the other hand, if the patient has not been taking sedatives at home, the nurse will want to consider the patient's need each night and give sedatives as necessary, but only along with other nursing meas- ures. Increased irritability. fatigue. and sensitivity to pain may be exhibited by newly adrnitted patients suffering from REM sleep deprivation due to the unac- customed use of sedatives. If a sedative is given. its effectiveness should be noted to assist the physician in his prescription. Amphetamines. tranquilizers. and alcohol also reduce the amount of REM sleep when taken in the usual dosage range. Behavioral changes in a person on these drugs may be due to REM sleep deprivatIOn. Lo of Ieep With total deprivation of sleep. normal volunteer subjects have shown changes in both personality and performance. With- drawal. depression. and apathy occur as well as periods of irritability and aggres- siveness. As total deprivation continues. confusion and hallucinations appear. In performance. the person's reaction time is not necessarily slowed down. but periods of inattention occur. Thus. when a subject could work at his own pace. performance was good, although he work- ed fewer problems. However. more errors occurred when subjects had to maintain a steady pace. 1 1 After 4g hours of sleep loss, the body produces a stress chemical belonging to the indole group and related in structure to lysergic acid diethylamide - LSD-25. This may account for the behavioral changes. 1 2 Also. the body does not produce adenosine triphosphate, the catdlyst for energy release. after four days of sleep deprivation. This may be a factor causing fatigue. Of more pertinence to nursing is the effect on a person whose total normal sleeping time is reduced. Reduced sleep is not a miniature of a full night's sleep: the person's EEG pattern shows thdt he is mostly in Stage IV sleep. and has little Stage I REM sleep. In persons whose REM sleep only is deprived. irritability, fatigue, increased sensitivity to pain, a feeling of pressure around the head. and momentary illusions have been noted. On recovery nights. a person who has been deprived of REM sleep spends.a greater than normal amount of time in Stage I REM sleep. The need to dream (during REM sleep) thus seems app.trent; the redson for this need has not yet heen established. Vogel suggests that REM sleep and antidepressant activity may be controlled by closely related biochemical mechanisms.1 3 In a situation where the patient is awakened frequently throughout the night. as in the intensive care unit. the nurse should be alert to the above signs of sleep restriction. Perhaps especially important is her awareness that the pa- tient will have an incredsed sensitivity to pain if he has not had enough sleep. When at all possible, care should be planned so that the patient has blocs of uninterrupt- ed sleep. In omnid InsomniJ is essentially a subjective feeling, meaning different things to differ- ent people. According to Kleitman. whether '"insomnia" occurs depends. in THE CANADIAN NURSE 39 . some persons, on the value the person attaches to getting enough sleep, and to deviations from his normal pattern. 14 Kleitman divides insomnia into three types: initial, intermittent, and terminal, depending on whether the person has difficulty getting to sleep initially, awak- ens frequently during the night, or awak- ens early in the morning and cannot return to sleep. Initial insomnia is the rnost common. Terminal insomnia is more likely to occur in elderly persons. There are many causes of insomnia. Wheatley lists the following five general causes: Physicial - pain, cough, pruritus, bronchospasm, diarrhea, enuresis, fre- quency. Physiologic - changes due to inter- ference with circadian rhythms; coffee and tea. PsycllOlogic - strong emotion, an- xiety, depression. Iatrogenic - amphetamines, anti- depressants, bronchodilators, and oral diuretics (if the diuretics cause nocturnal diuresis ). Idiopathic - no cause; some persons seem to require only small amounts of sleep.l 5 If the patient cornplains of insomnia, the nurse can try to determine the possi- ble cause. Are there any apparent physi- cal causes? If so, measures to relieve these symptoms may be all that are needed. Is the patient anxious or upset abou t something? Psychogenic factors are the most cornmon cause of insomnia. An interested listener or, if necessary, a tranquilizer, may be more effective than a sedative. Has the patient been receiving central nervous system stimulants? If he has repeated difficulty with sleeping, his problem should be discussed with the physician. The nurse will, of course, vary her approach depending on the type of insomnia that is occurring. Measures to relieve initial insomnia may include elimination of sudden or diverse stimuli and promotion of physical and mental relaxation. A good backrub is still one of the best tools for promoting 40 THE CANADIAN NURSE sleep. Not only does it effect muscle relaxation but also, through its rhythm, it provides a monotonous stimulus condu- cive to sleep. A fresh smooth bed helps decrease irritating stimuli. The patient who has intermittent insomnia awakens easily from Stage I or II sleep. Are there sudden noises (such as clanging bedpans, slamming doors. or loud vOices) that cause the patient to awaken easily? Are there physical symptoms that are awakening him? The patient with terminal insomnia may be wide awake at 4:00 A.M., but at what time did he go to sleep? If he was asleep by 9:00 P.M., he has already had a good night's sleep. Pointing this out to him and encouraging him to read or listen to the radio may settle the problern. If he has not had sufficient sleep, there may be psychologic reasons for his insomnia. Patients tend to sleep lightly when first admitted to the hospital. During Stages I and II sleep, as mentioned earlier. if the patient awakens he rnay not be aware that he has been sleeping. The nurSe can explore with the patient his concern about his apparent inability to sleep. If the concern is about the insomni- a itself and its effect on his illness. he can be reassured that he is "resting," and that transient insomnia will not create any permanent problems. However, a patient who is having severe problerns with in- somnia should be watched for signs of behavioral changes indicating depression, and his behavior brought to the attention of his physician. Recent research has given us a begin- ning insight into the complexities of sleep. As more is learned about factors affecting sleep, there rnay emerge more specific answers about how to help a patient who is having trouble sleeping. There may come a time when people can be taught how to enter Stage I of sleep at will. The role of the nurse then may include being a teacher and promoter of this ability. References 1. U.S. National Institute of Mental Heallh. Cu"ent Research on Sleep and Dreams (U.S. Public Health Service Publication No. 1389) Washington, D.C., U.S. Government Printing Office, 1965, p. 1. 2. Ibid., p.l1. 3. Webb, W.B. Sleep: an Experimental Ap- proach, New York, Macmillan Co., 1968, p. 17. 4. Luce, Gay G., and Segal. Julius. Sleep. New York, Coward-McCann, 1966, p. 290. 5. Kleitman, Nathaniel. Sleep and Wakefulness. rev. ed. Chicago, m., University of Chicago Press, 1963, p. 39. 6. Kales, Anthony, and Others. Sleep and dreams; recent research on clinical aspects. Ann. Intern. Med. 68: 1078-1104, May 1968. 7. Luce and Segal, op, cit., p. 139.. 8. Kales and Others, op. cit., p. /094. 9. Oswald, lart. Sleep. Baltimore, Md, Penguin Books, 1966, p. 46. (Paperback) 10. Kales and Others, op. cit., p. 1086. 11. Webb,op. cit., p. 19. 12. U.S. National Institute of Mental Health, op. cit., p. 23. 13. Vogel, G.W. REM deprivation. Part 3. Dreaming and psychosis. Arch. Gen. Psychiat. (Chicago) 18:237, Mar. 1968. 14. Kleitman,op. cit., p. 274. 15. Wheatley, David. Causes and management of insomnia. Practitioner 200:853-854, June 1968. 0 Reprinted, with permission, from the American Journal of Nursing, September 1969. FEBRUARY 1970 Various clinics and clubs in an urban community provide the older citizen with the medical, social, and recreational resources he requires. What happens to the individual who is not motivated or who is physically unable to take advan- tage of these facilities? Must he spend his remaining years in forced isolation from society? The day hospital at Maimonides Hospi- tal and Home for the Aged in Montreal was set up to help these lonely individu- als. Its facilities are available to the aged person who is facing a crisis and who feels isolated and depressed. The person's crisis may follow the loss of a friend or family member, retirement from a job, physical deterioration, or a change in living accommodation. The day hospital began as a pilot project in March 1966 with 10 patients. At that time the program was unique; a survey in 1964 had shown that there were no day facilities anywhere in North America that provided medical and psychiatric care specifically for the aged.* A growing project The day hospital, situated on the ground floor of Maimonides Hospital and Home for the Aged, has five main areas: a large activity room with a lounge and music section; a sitting room where some *R.L. Epp , and L.D. Hanes, eds., Day care of psychiatric patients from the National Day Hospital Workshop, Kansas City. Mo.. /963, Springfield, III., C. Thomas, Publisher. 1964. FEBRUARY 1970 A day hospital for elderly persons Description of a day program that is specially geared to help the aged person who is lonely and perhaps Isolated from society. Shirley Cooper of the group meetings are held: a two-bed room used for treatments and emergen- cies; a fully equipped kitchen, used for retraining and remotivating some pa- tients; and a cafeteria for noon meals. The staff offices are near the patient areas. The day hospital accommodates 60 patients. This nurnber is increasing gradually as the program expands. Since most of the patients attend two or three days per week, the average daily census is 35. A fee for attending the program is determined on a sliding scale, ranging from fifty cents to five dollars per day. The individual is referred to the day hospital by a professional health worker or by his farnily. Sometimes he cornes on his own. An assessrnent of each applicant is presented to the tearn by the nurse and the social worker. To be eligible for admissIOn. an applicant must be ambula- tory. Sorne persons attending the day hospi- tal use canes or walkers to give them additional support. A bus service provides transportation between home and hospi- tal for those whose physical or mental condition prevents them frorn using public vehicles. Mrs. Cooper, a graduate of The Jewish General Hospital School of Nuning in Montreal. Quebec, i a clinic.l1 imtructor at the Catherine Booth Ho pital School for Nur,ing As,istants. Previou,ly. she W.l' head nur,e at the Day Hospital at Maimonide, Ho,pit.ll .Ind Home tor the Aged in Montreal. Quebec. Promoting independence The goals for each patient vary with his capacity for independence in all as- pects of daily living. Prevention of regres- sion on all levels is a common goal for patients. To determine and evaluate an indi1lidu- aI's potential, the staff use examindtion . interviews, and observation. The goals for each patient are reviewed by the day hospital tearn throughout the patient's participation in the program and are discussed with the individual. His own feelings about them are explored. Basical- ly, the goals are achieved by remotivating the patient - first through his relation- ship with staff members, then through recreational and occupational activities. and ultimately through relationships with his peers. Sorne pdtients are encouraged to participate in community activities. such as "Golden -\ge" clubs, while maintaining some association with the day hospital. To prevent a patient from becoming dependent on the day hospital. the num- ber of days per week that he may attend the program is gradually decreased. Other patients are discharged from the program when they can function adequately in the community. They are encouraged to work as volunteers or visitors or to join local organizations. Thl' team dpprodch The taff members include a psyd1ia- trist who is team leader. a re ident psv- chiatrist from a nearby general hospital. a THE CANADIAN NURSE 41 . " 1 . f1 ..... . ",.. ....- . , , - \ C! O O ." r" , ' 1;\ . i t , , \ .. A ,J, . \ . f . , - ...... " , '" 1 , 1 . . --"'\ \ . .. \ .1 . .... - -/ , .... '\ r \ h ...... - The physiotherapist leads the patiellts ill the biweekly exercise group held at Maimonides Hospital. rnedical doctor available for clinics and ernergencies. two registered nurses. a certified nursing assistant. an occupation- al therapist. an arts and crafts worker, and a dietitian. Team meetings are held twice a week to discuss the patients' progress and their short and long-range plans. The nurse is involved with all aspects of patient care and coordinates the activi- ties of the rnembers of the tearn. For exarnple. she rnay channel communica- tion from the physiotherapist to the bus driver who transports the patients daily. about a plan for a certain patient who is being taught to climb stairs. Structure of the program The day hospital operates on week- days frorn 9:00 a.m. to 5:00 p.rn. Group therapy sessions, occu pational therapy. and medical services are provided. Group therapy sessions help the elder- ly to relate better to one another. Through sessions led by staff rnembers, the patients are encouraged to express their feelings and to interact. Five group sessions, Iirnited to 10 patients each. are held weekly. One large group session is conducted weekly so that all patients can attend at least one therapy group. Through crafts, patients are encourag- ed to express their feelings and to develop their creative talents. When their articles are sold they receive a srnall fee. This helps to promote a sense of worth as a productive person. One group of patients publishes a newspaper every two months: another group has forrned a choir. which is directed by a volunteer. Medical services are provided by a physician and a group of specialists who see patients on referral. All rnedications are distributed by the hospital pharrnacy; specifIc instructions for any rnedication or treatrnent are explained to the patient by the nurse. If the patient suffers from mernory loss, the nurse gives the instruc- tions to his family. To help maintain body functioning at an optimurn level, exercise groups are conducted for all patients twice weekly by the physiotherapist. Only a few pa- tients require individual physiotherapy. A changing program The program at the day hospital is frequently reevaluated and changed to rneet the needs of the people it serves. For example, the discharge program was \.. t 1/1 ,. \ -ð .ilíi 1 · {. '. 1;, .. .. , / '. .:. .: " ... a .\. ;. . 'O " , . . ' . '\ 1 , þ...... f I --, .... , ... \ " ø (, \" ... Ao , - A group ofpatiellts gathers for a weekly therapy sessiollied by the author (back, right}o Patients attend at least vne session 42 THE CANADIAN NURSE FEBRUARY 1970 revamped to rnake it rnore effective. Previously. patients were reluctant to be discharged; many of those who were discharged had to be readmitted after a short time. However. by preparing the patients for discharge soon after their admission and by discussing long-range plans with them over a longer period, their eventual discharge was less trauma- tic. This approach was used with a 75-year-old woman, who becarne with- drawn soon after moving to Canada from her native England. She was admitted to the day hospital knowing that after a specific time she would be discharged. Soon after her admission she started to work as a hospital volunteer, a job she continued after her discharge. to help her cope with her marital situa- tion. Mrs. S. began attending the day hospi- tal three days a week. At first she found it difficult to relate tJ her peers and felt guilty about expressing any anger toward her husband. Most of the other wornen in the group were widowed and resented Mrs. S. because she had a husband. Despite these difficulties, Mrs. S. soon was able to express her problems and feelings in a small therap} group. She became interested in group projects in the occupational therapy program and enjoy- ed teaching her skills to new members in the group. Both she and her husband had regular interviews with the staff social worker. In addition, Mrs. S. received an antidepressant medication. -.J.j- '- -I . ( " " " , . "- -........ --- - ... '\ ) .":;:: :::.' "-,--- '. r- "e' \ -- '- 't "'":1" , - ., ,......, I .."", . '" ;: :. "--" T__&" _ r Mr. R. soon became dependent on his son and daughter. He moved to his daughter's home where there was contin- ual conflict between hirn and the rest of the family. His periodic visits to his son's home resulted in man} disagreernents .1:- well. The resulting tension led Mr. R.'s daughter to seek help frorn her family physician, who referred her to the day hospital. After he was accepted for the day hospital program, Mr. R. continued to receive speech and physiotherapy. He soon became the editor of the group newspaper (his former occupation was in journalism). As well. he discovered that he had a talent for painting. Meetings were held with Mr. R., his children, and the staff SOCidl worker. ,-, r :: 'iF T; "e;;; . t1 -. -þ, ( .. . .. -- ... , . . ... ...,..... m' ..... . >.'1-., .. .., _.:;..... .. .. "'"--.,..... ... :;..\ .... . . .... '. :.: .... . ....... .......... . ::. -- .........---- ,:.-....- / The occupational therapist's assistant gives instruction to a group of patients hooking rugs. Later these articles will be sold at the Open House, held annually at the Maimonides Hospital and Home for the Aged Patit'nf histories Throughout most of their IO-year marriage. Mr. and Mrs. S. experienced conflict, mainly about the division of responsibilities in the home and financial matters. This conflict increased after Mr. S. retired frorn his small business. Mrs. S., who is 70 years old. becarne depressed and was no longer able to function in the home. She became totally dependent on her husband and her behavior continued to regress. Although he had always inter- fered with his wife's household tasks. Mr. S. resented having to cope with thern on his own. He brought his wife to the geriatric clinic at a general hospital where a psychiatrist referred her to the day hospital. The tearn established treatment goals for Mrs. S.: to remotivate her to care for herself. her husband. and their home; and FEBRUARY 1970 After eight months Mrs. S. was dis- charged from the day hospital. By this tirne she was attending the program only one day per week and had returned to the monthly rneeting of an organization she belonged to prior to her adrnission. She was referred back to the geriatric clinic at the general hospital. and our day hospital team continued to follow her progress. Although Mrs. S. did not gain much insight into her relationship with her husband. the day hospital provided a milieu where she could express her feel- ings and find new diversions. Mr. R., a 72-year-old widower. lived alone in his own home and had plans of remarrying. Then he had a cerebrovasular accident. which left him with aphasia and one-sided weakness. He started receiving speech and physiotherapy immediately. Both Mr. R. and his children expre sed a need to live independently. Mr. R. was helped to find accommodation in a senior citizen's apartrnent. Here he was able to be independent and to develop new relationships among his peers. His relationship with his farnily improved considerably. Mr. R. began dttending the day hospital less frequently and a dis- charge plan was discussed. The day hospital program dt Maimon- ides Hmpital and Horne for the Aged has proved to be of value in rernotivating dnd reintegrating into the community elderly persons who might otherwise have remained isolated and depressed. PerhdPs this day hmpital will serve as a model dnd as a stimulus for the credtion of similar facilities for the elderly in other towns and cities in Canada. 0 THE CAN.\OIAN NURSE 3 Tracheotomy suctioning technique The day-to-day care that a nurse gives to a child with a tracheotomy is no small responsibility. In fact, the child's life depends on the skilful, safe, and effective nursing care that he receives. For in airway maintenance there are no half-way measures. The purpose of this paper is to explain the method used at The Hospital for Sick Children to ensure safe tracheal-bronchial aspiration of a tracheotomy tube. A tracheotomy may be performed either as an elective procedure when the cough reflex is inadequate, as in the unconscious patient with pneumonia, or as an ernergency procedure to relieve increasing respiratory distress and hypoxia. The emergency procedure is generally required for the following common conditions. Inflammatory disea t's Acute laryngotracheobronchitis (tra- cheitis, croup): This is a specific viral inflammatory swelling with a superimpos- ed bacterial infection that causes swelling in the larynx and accumulation of tena- cious secretions in the tracheo-bronchial tree. These result in stridorous, difficult respirations. The patient assurnes a prone position and is usually restless and irrita- ble. Prolonged dyspnea and tachycardia of 160 or over produce extreme fatigue, and the child succumbs unless tracheoto- my is performed. The age group most commonly affected is from one to three years. Supraglottitis (epiglottitis): Inflamma- tion and swelling of the epiglottis and soft tissue of the supraglottic space (above the vocal cords and below the epiglottis) not only Impede respirations but make swallowing difficult as well. The patient assumes a "bolt upright" sitting position, his lower jaw hangs open and pooled saliva drools from it. Death from obstruction can occur within two 44 THE CANADIAN NURSE A description of some of the childhood conditions that may require tracheotomy and of the methods used at The Hospital for Sick Children to suction a tracheotomy. Barbara Kearns hours after onset of symptoms. This is therefore more of a potential surgical emergency than any other inflammatory condition of the respiratory tract. The age group cornmonly affected is from four to nine years. Congenital anomalie Subglottic Stenosis: This is a condition that results in airway obstruction from a congenital narrowing of the space just below the vocal cords at the level of the cricoid cartilage. The severity of air flow impediment depends upon the degree of obstruction. Some children, however, may not display respiratory distress despite the abnormality until a super- imposed infection adds more swelling to the already narrow airway. Vascular Compression: The most common form of vascular anomaly is the compression of the trachea by the in- nominate artery. As the vessel branches off the aorta it "leans on" the trachea externally, pushing the tracheal wall in- ward, thus narrowing the internallurnen. To relieve the distress, the innominate artery is suspended by suture to the sternum. Soon after the tracheotomy tube can be removed. Laryngomalacia (laryngeal stridor): In this condition the epiglottis, laryngeal, and tracheal cartilages are immature and lack the strength to support the airway. As the child breathes in, the floppy epiglottis is sucked down into the supra- glottic space, occluding the air passage. On expiration the passage is forced open again. Ordinarily a tracheotomy is requir- ed only in severe cases. Congential Hemangioma: This vascular growth, which can be as small as a pea or as large as a fist, invades the laryngeal or Mrs. Kearns is Clinical Instruclor on the Eye, Ear, Nose, and Throat Unit at The Hospital for Sick Children in Toronto. tracheal lumen and irnpedes air flow in and out of the lungs. Radiation therapy has been successful in reducing the size of the mass and improving the airway. Pie"e-Robin Syndrome: This includes a congenitally srnall lower jaw and asso- ciated cleft palate. When hypoplasia is marked, the tongue may be displaced backward and partially obstruct respira- tion. In extreme cases tracheotomy is usually necessary. Around age two, enough deveIcpment of the jaw has taken place to support the epiglottis adequately and relieve the distress. New growth Juvenile Papillomas: Mostly male toddlers are affected. Wart-like growths of viral origin begin to sprout on the vocal cords and, as the child grows, spread down into the trachea and bronchi. Its rapid growth occludes the airway and necessitates frequent removal if the patient is to survive. Since this growth extends into the bronchi, the patient's airway may still become ob- structed below the tracheotorny tube. This condition norrnally resolves itself at puberty. Other cause Presence of a foreign body may ob- struct respiration. Usually a foreign body can be removed without too much difficulty. The child may not require a tracheotomy, if the object that impedes respiration is not large. Trauma, too, can obstruct the airway. Occasionally, after a diagnostic procedure such as laryngoscopy or bronchoscopy, the swelling caused by the friction of the scope in the airway is enough to occlude the airway. Also, recent research has indicated that the friction of an endo- tracheal tube left in the airway for a prolonged period causes tissue breakdown, scarring, and stenosis of the lumen. This does not occur in all cases, FEBRUARY 1970 but in a large enough number to be a significant finding. Some of these children require short- term care only until the immediate crisis is over and the tracheotomy tube is removed. Others spend as long as one to five or more years in hospital. undergoing repeated surgical correction. The suctioning procedure outlined here will be based on six basic facts that must be recognized as relevant guides to safe and effective tracheotomy care. Six b.l ic fact ill To live. the human organism must have an airway free of obstruction to allow for adequate exchange of O 2 and CO? with its environment. Partial or total occlusion may Ie d to hypoxia. coma and death. The artificial opening into the trachea allows for easier access of infective agents into the lungs, as the better part of the body's natural defense mechanism - na- sal mucosa, cilia. and lymph glands - has been bypassed. [}] Air entering the lungs via the trache- otomy does so without being adequately moistened by the mucous membrane of the upper respiratory tract. Unmoistened air irritates the U:acheal mucosa and dries secretions, making them difficult to raise. @] Any foreigh body in the airway (e.g., tracheotomy tube, suction catheter, en- dotracheal tube) irritates the tracheal lining. Repeated contact irritation of a prolonged or rough nature can cause tissue breakdown and eventually the formation of granulation tissue that will obstruct the airway. Suctioning produces a cough that helps clear the airway of secretions and initiates deep breathing. lID Because of its anatomical structure. the shape of the trachea and right and left bronchi can be altered slightly by the extension or flexion of the head and neck. Using these facts as the core of the suctioning technique. the nurse should be able to maintain a patent airway and. at the same time, minimize tissue trauma. reduce the possibility of infection. assess and provide adequate humidification of aIr to prevent mucus plugging. and promote good lung function by stimulat- ing the patient to cough and deep breathe. The actual steps in the suctioning procedure are outlined in detail on the following pages. Beside each step is mark- ed [] [}] [!] or lID to indicate which basic fact (as previously listed) is being considered as the maneuver is carri- ed out. THE SUCTIONING PROCEDURE ANTICIPATED PROBLEMS AND COMMENTS Step See Fact IT] 1. Establish the need for suctioning. I. The signs of increasing respiratory distress are: increased pulse and respiration; stridor; in drawing (subcostal. supracostal. etc.); restlessness, anxiety; pallor with circumoral cyanosis, generalized cyanosis. Usually if a patient needs suctioning, a rattling. bubbling. or whistling sound can be heard coming from the airway. Whistling usually means there are drying secretions in the cannula that require liquefication and suctioning. Frothy, loose secretions might be coughed up with no suctioning at all required. [!] Children normally fidget or wiggle more than an adult. However. if the child is fully cooperative, he can sit up to be suctioned. Secretions may be harder to raise however. because of the effect of gravity on secretions in the upright position. If the need is urgent, skip hand-washing. OJ Step 2. If the child requires suctioning. place him flat in bed IT] or on some firm surface. Step 3. Wash hands thoroughly. m Step 4. Unlock and remove the inner cannula, keeping a m steadying finger on the outer cannula. If the inner cannula should stick to the outer because of dried secretions, squirt about one-half cc. of normal saline between the two for lubrication. then try again. Hold the outer cannula firmly in position and pull hard on the inner one using a steady, controlled force. \ \ FEBRUARY 1970 \ \ Step 4: RemOl'al of inner camllllo.. THE CANADIAN NURSE 45 THE SUCTIONING PROCEDURE Step 5. Place dirty inner cannula on a Kleenex on the bedside table. Step 6. Open tray covers. Step 7. Put on clean plastic glove. m Step 8. Pick up one catheter from dish of aqueous Zephiran r;l I: 1000, using gloved hand. Always use a rubber catheter L.::..J for a long-term patient as it is less traumatic to the o tissue. Step 9. Connect catheter to "Y" connector (or straight connector if no "Y" available). You may touch the catheter at the connector end with ungloved hand to pull it securely on to ensure good suction. '" If- '\. ". , Step 10. Immerse the catheter completely in dish of sterile o H20 and flush it through. Step [i] o I I. With ungloved hand, position the child's head. Turn head acutely to the opposite side of the bronchus that requires clearing. 'I, ---- ,.,. r-- .........,. " / , ... Step o IT] 46 THE CANADIAN NURSE 12. With the gloved hand, introduce the catheter into the outer cannula. Suction is not applied on insertion. Feed it through your fingers quickly but gently. ANTICIPATED PROBLEMS AND COMMENTS Once this glove is on. it should touch nothing else but the catheter during the procedure. When not in use, the catheters are left soaking continuously in this solution and are boiled at the end of 24 hours (i.e., rubber catheters are boiled and returned to the dish; plastic catheters are discarded). If the catheter collapses where it connects to the "Y", try pulling it on further by folding it up on itself (much like shoving up a sweater sleeve). Step 9: Catheter is attached to Y connector. All aqueous Zephiran must be rinsed from the catheter, otherwise it may caUSe tissue irritation. Because of the structural difference between the right and left bronchi, the left is harder to enter with the catheter. Tilting the chin up slightly more toward the right might help. If the child will not keep his head turned, maintain the position for him with the ungloved hand. If the child has a fat chin, which hides his airway. try putting a small rolled diaper or towel under his shoulders to help in neck extension. Step J J: Head is held to left before catheter is imroduced to clear right bone/IUs. Does the catheter fill the entire hole of the outer cannula? It should not exceed 2/3 the diameter of the airway. Is it a straight catheter (one-holed) or French catheter (3-holed, whistle-tipped)? The more secretions you suction out with FEBRUARY 1970 THE SUCTIONING PROCEDURE ') " \. , , \) '- """'- .. ... Step 8] 13. Insert the catheter so that it extends beyond the end of the outer cannula and down into the mouth of the right or left bronchus. Because children vary in size, no specific number of inches can be stated as exact depth of insertion. Using the length of the inner cannula plus one- and one-half to two inches extra, should ensure that the catheter passes deeply enough. Step 14. As the patient begins to cough, create suction by m placing thumb over the open end of the "Y". .... I , "\ '", v Step IS. Withdraw the catheter slowly, creating on-off rAl suctJoning by thumbing the open "V". This helps LiJ prevent grabbing of the tracheal wall by the catheter tip. The catheter must be rotated on withdrawdl, giving the three lumens a better chance to cover a larger surface area. To do this, roll catheter between your fingers. N.B. If a catheter becomes stuck in the outer cannula and resists withdrawal, do not yank forcefully. The probable result will be accidental extubation. If you have to tug, do so gently, holding the outer cannula firmly in place with your other hand. I f the catheter is stuck firmly. cut it with scissors well above the tracheotomy opening or disconnect the catheter from the suction tubing. Air can be blown into this, i.e., mouth to tube, or 02 administer- ed through it if necessary until a doctor is summoned. FEBRUARY 1970 ANTICIPATED PROBLEMS AND COMMENTS each insertion, the fewer times you have to reinsert. Therefore use only a French catheter. Its bevelled tip prevents the tracheal wall from being sucked into the catheter. Step 12: Catheter being inserted without suction Note that thumb is removed from Y connector. It is important to get only a good cough started - not a strangling, red-faced purple-lips cough. If a child starts to cough like this. remove the catheter immediately. Do not use deep bronchial suctioning technique unless the patient is unconscious or unable to cough adequately, or in the immediate postoperative sta g e'8] As the patient coughs reflexly, encourage him by saying "cough, good boy, cough" - even to an infant. A child can learn to cough on command, thereby clearing his own airway. The more secretions that are coughed up. the less amount of suctioning required. [!] Step 14: After catheter is fully inserted, sucIiun is pruduced by closing end of Y connector with thumb. Insertion and withdrawal should take a maximum of 10 seconds. Any more time leads to hypoxia and cardiac irregularities. Remember, suctioning removes air as well a secretions from the lungs. [D On some wall suction outlets, there are no pressure gauges. An open tap can create as much as 260 mm. Hg. pressure which is too strong for a child. The most effective way to regulate suction pressure is by using the "V" connector in the manner described and by keeping within the IO-second time limit. Appropriate suction pressure for a child is gO-I 20 mm. Hg. THE CAN DIAN NURSE 47 THE SUCTlONING PROCEDURE Step [IJ m 16. After the first suctioning is completed, insert sterile normal saline into the outer cannula using a plastic pipette in the ungloved hand: infants one-half cc.; toddlers - one cc.; older aged - two cc. '"' l "".. t \- c\ .. ... t Step 17. Allow 10 seconds or so for the saline to loosen the OJ secretions before repeating the suctioning procedure Step 18. Repeat suctionings until patency is reestablished, IT] clearing both right and left bronchi. Step 19. Flush the suction catheter through with a small amount of aqueous Zephiran I: 1000. Step 20. Disconnect the catheter from the connector and replace it in the aqueous solution. Step Step IT] [I] 21. Remove dirty plastic glove. 22. With a Kleenex, wipe the outer cannula clean. Include the skin around the tracheotomy tube. Pay special attention to the area under the chin. Secretions left in the chin crease can cause tissue breakdown and infection. Step 23. Pick up alternate clean inner cannula, insert and lock r:ïl in pldce, keeping a finger on the outer cannula as you do l2J so. ANTICIPATED PROBLEMS AND COMMENTS The air in hospital is dry, particularly in winter. and because the tracheotomy removes the normal humidifying action of the nasal mucosa, tracheal secretions tend to be tenacious. By using saline with each suctioning, the chances of consolidation and plugging of secretions are reduced. Also, the thinner the secretions, the more easily they are coughed out and the less suctioning is required. With some older children, and with those who. for specific reasons, cannot be suctioned, inner cannula removal and saline instillation that produces a cough. are the only steps necessary to maintain a patent airway. Step 15: Repetitive thumbing. Note that thumb opens and occludes Y connector over and over again to produce intermittent suction. Good exchange of air in and out of the tube, little or no dyspnea, good color, and good air entry to both lungs indicate patent airway. The catheter must be totally immersed if disinfection is to be effective. If accumulated secretions are left, the inner cannula can adhere to the outer, making removal difficult, time-consuming, and dangerous, particularly if the child's need for suctioning is urgent. General consideratiom In the overall consideration of the procedure, two areas in particular may cause concern. The first is the frequency of suctioning. As a rule, suctioning is done at the nurse's discretion, or p.r.n., based on her assessment of the adequacy of the patient's airway. Learning the significance of the different sounds that the patient makes as air passes in and out of the tube takes practice. If in doubt about the quality of air entry, look closely at the characteristics of the respi- rations and check with a stethoscope the air entry to both lungs. It is a wise practice to listen to a child's chest at the beginning and end of 48 THE CANADIAN NURSE each tour of duty as a matter of routine. It not only helps the nurse to assess her effectiveness in suctioning, but also gives an idea of the general status of the child's lung function. In the immediate postoperative stage, the newly tracheotomized patient must be suctioned at regular, specified inter- vals. The other area of concern involves the use of restraints during the procedure. Repeated practice makes the nurse quite adept at coping with little fists and grasping fingers, but "why put up with it? " The reason is that binding the child with a tight restraint impedes active coughing. It is preferable to have a second person restrain the child's hands. "Bunny- ing" is used only as a last resort. Above all, consider that the child's airway is markedly reduced during suc- tioning and the fear of asphyxia in the patient is a real one. Try to be quick, gentle, and calm, even if anxious yourself. This approach helps to make the proce- dure less traumatic for your young pa- tient. Bibliography Fearon, B. et al. Airway problems in children following prolonged endotracheal intuba- tion.Ann. Otol. 75:4:975, Dec. 1966. Fearon, B. Acute obstructive laryngitis in infants and children. Hospital Medicine, 4:12:51, Dec. 1968. 0 FEBRUARY 1970 books Pralfic,,1 P"ediatrics: A Guide Fur Nur t' . 3rd ed. by James Michael Watt. 2 \3 pages. Christchurch, New Zealand, N.M. Peryer Ltd.. 1969. Rel'iewed bv Mrs. E Fitzgerald, Ins- tn/ctor, Sydney City Hospital, Sydney, Napa Scotia. The author mentions many of the important needs of infants and children, as well as the most common diseases of childhood. To read this textbook with understanding, a solid background in medical sciences is a prerequisite. The content is well organized under age groups, although most emphasis seems to be placed on the infant. Photo- graphs and diagrams are, for the most part, excellent and are arranged close to the related subject matter. The short chapter at the end of the book on the Maori child is not of much significance to those of us on this continent. This book would be useful as a refer- ence text in any pediatric unit. This reviewer would not, however, recommend the book as a text for student nurses, mainly because there is only bare mention of many of the most important diseases and problems of childhood. P vchology A Applied To Nur ing, 5th ed., by Andrew McGhie. 340 pages. Edinburgh and London, E. & S. Livingstone Ltd.. 1969. Canadian Agent: The Macmillan Company of Canada. Ltd., Toronto. Rev iewed by Margaret Lounds, Instn/ctur in Psvchiatric Nursing. Cal- gary General Huspital, Calgary, Alta This book is primarily for nursing students It would also be an excellent review for graduates, as the newer theo- ries are explained in a straightforward manner. The book is divided into five parts. which are subdivided into chapters. At the end of each chapter questions help the reader evaluate how much has been retained. Part I deals with the development of the personality. The section on childhood warns that we cannot be sure that specific traumatic experiences will effect a partic- ular form of personality disturbance in later life. Unfortunately. the chapter on adolescence contains detail on psycholo- gical disorders that are common in adult- hood. Part II deals with intelIigence dml pe r so n a lit Y t e ting. The purposes, FEBRUARY 1970 strengths. and weaknesses of these various types of tests are clearly outlined. Part III is concerned with human motivation. More detail on unconscious morivation would be helpful. The chapter dealing with environmental stimulation is particu- larly interesting Part IV presents human interaction with the environment. Learning theories are simply and effectively explained. Part V briefly describes the ways in which social groups function. Group processes. leadership, amI morale are the primary focus. The major strengths of this book are many references made to the direct application of pscyhology to nursing, theories presented in understandable language, many references for further reading. and a sincere and usually success- ful attempt to avoid being dogmatic. This book would be a valuable edition for a school of nursing library. Pharmacology in Nursing, II th ed., by l3etty S. Bergersen and Elsie E. Krug. 695 pages. Saint Louis, C.V. Mosby Company, 1969. Canadian Agent: C.V. Mosby Compdny, Toronto. Rel'iewed by J. Louise Gillman, Lec- turer, The UnÏ1'ersity of Manitoba School of Nursing, Winnipeg. In this new edition of their well- known text. the authors state that their purpose is to provide information "to enable the nurse to make intelligent decisions about the administration of drugs and their effects." The usual introductory chapters on history, legal aspects, measurements. administration of medicines, drug action. and toxicology are included, as well as an interesting chapter on symbolic meanings of drugs and self-medication. Also includ- ed is a useful section on Canadian drug legislation. In looking to the future, the authors indicate the advantages of changes now taking place in hospital drug administra- tion: unit dose packaging; prefilled disposable syringes (although they omit mention of safe disposal methods); and clinical pharmacists. The increasing role of computers in ordering. distributing, and monitoring the administration of drugs is omitted. The remaining chapters provide an overview of specific categories of drugs, illustrated by a good selection of drugs in each category. A new chapter on psycho- tropic drugs is included. There are helpful reference readings and study questions at the end of each chapter. The questions would have been more useful, however. if answers were supplied. giving the student the opportu- nity to evaluate her own knowledge in her independent study. The value of this book could have been enhanced by expanding several areas: teaching patients to take prescrip- tion medicines at home safely: identifying the increasingly frequent adverse inter- actions of drugs; and the chapter on vitamins and minerals. In some instances, the amount of detail offered might lead the reader to assume that all important points have been covered when. in reality. they have not. For example, in describing the intra- muscular route of administration, the book describes the exact sites, positions of the patient, types of needles and solutions. but omits discussion of asepsi . This book would be a useful intro- ductory text for nursing students. provid- ed they have some background in bio- logy, chemistry, and physiology. as it sometimes assumes knowledge beyond the introductory level. The book contains general information and demonstrates a pattern for the study of drugs. The professional nurse will require other sour- ces of information to broaden her cJpaci- ty for assessing the nursing implications of the drugs she gives. This book could serve as a competent, up-to-date guide and introduction to pharmacology for beginning nursing students. Fundamental of Nur ing, 4th ed.. by Elinor V. Fuerst and LuVerne Wolff. 446 pages. Toronto, J.8. Lippincott Company. 1969. The fourth edition of Fundamentals uf Nursing continues to reflect the duthors' attempts to meet nursing's changing needs. Teachers of introductory courses in nursing and their students will find the arrangement of the material more flexi- ble, easier to locate, and easier to read in this new format. The focus on principles is the same as in the previous edition. Principles that guide nursing action are explained effec- tively with good illustrations and photo- graphs, up-to-date examples, and tables valid to 1965 and many to 1967. Details of procedures are not given because. in the authors' words, "It is possible thdt details of certain activity can be stres ed to such a degree that they cloud the principles. " THE CANADIAN NURSE .J9 . Of the book's seven units, unit four, Nursing Implementation - Man as an Organism, makes up the largest section. It considers man's basic needs. Two chap- ters in this unit are of special interest. The chapter on maintaining fluid and electrolyte balance is one of the best examples of the effective use of figures, tables, cross references, and implications for nursing. In this chapter, the table shows at a glance some of the more characteristic symptoms of fluid and electrolyte imbalance. Implications for nursing include specific signs for which the nurse should be alert, the importance of the patient's history, and ways to preven t fluid and electrolyte imbalance. References to ear- lier chapters in the text help the reader integrate knowledge. The chapter ends with a study situation and reference to books and journal articles published in the 1960s. The other chapter of special interest in this unit, care of the body after death, includes a brief reference to tissue and organ transplantation. Also new in this edition is the last unit - a patient study dealing with nurs- ing in a home situation. The team ap- proach of home care is well illustrated both pictorially and in writing. Teachers and students should find this text a valuable asset to the learning experience. 0 A V aids EVR communications system The latest addition to audiovisual materials, Electronic Video Recording, will be available in July, 1970. . ... f )I' ..... .\.J \. . '" " . EVR, a new communications system for storing audiovisual material, has been developed by the Columbia Broadcasting System's Electronic Video Recording Division. The system operates with a regular television set, the EVR cartridge, film, and player. The cartridge holds the dual-tracked film. Each track can carry a different series of frames, with a maximum program running time of 25 minutes. One track may carry questions and the other, answers. The seven-inch cartridge, sealed when in position, auto- matically takes up, plays, and rewinds the film. One external connection clamps the EVR player to the external antenna terminals of a television set. The operator can switch from one track to the other without disturbing the cartridge or dis- connecting the player. Each numbered frame can be frozen for detailed study if desired. From the 180,000 frames, one can be selected by turning the counter. EVR will be available only from the United States at a cost of approximately $795 plus duty and handling charges. Cartridges will be made from 16 mm., 35 mm., and one- or two-track video tapes sen t by a school to the CBS processing plant in RockJeigh, New Jersey. The EVR system offers a unique new approach to teaching. Schools of nursing would find it a valuable asset. However, the initial cost of EVR, and the minimum 50-print requirement for a 5- or 50-min: ute program will make EVR too costly unless several schools are willing to use the same programs. Cost ranges from six dollars for a five-minute print to $47 for a 50-minute print. Additional information on EVR can be obtained from CBS Electronic Video Recording, 51 West 52 Street, New York, N.Y. 10019. ....-,.. " i, ' o .' The EVR cartridge (right) and the 16 mm. film reel (left) each stores 50 minutes of audiovisual information The cartridge drops on a spindle on the EVR player (background). The EVR film has no sprocket holes. 50 THE CANADIAN NURSE The troke patient comes home A series of six 28-minute, 16 mm. black and white films probe the world of the stroke patient. Available from Educa- tional Film Distributors Ltd., 191 Eglinton Ave. East, Toronto 315, Onta- rio. The films describe the nature of stroke and early hospital rehabilitation; the training of the family to assist the pa- tient; changes in treatment as the patient progresses: speech therapy; the use of graded exercises and devices for arm and leg motion; reemployment training; the activities outside the home for recreation and social living; and home care services. The series includes: Understanding His Illness; Understanding His Problems; His Physical Well Being; Getting Around; He Learns Self-reliance; and His Return to the Community. These films would be of special inter- est to nurses working with stroke pa- tients. 0 accession list Publications on this list have been received recently in the CNA library and are listed in language of source. Material on this list, except Reference items, including theses, and archive books which do not circulate. may be borrowed by CNA members, schools of nursing and other institutions.- Requests for loans should be made on the "Request Form for Accession List" and should be addressed to: The Library, Canadian Nurses' Association, 50, The Driveway. Ottawa 4, Ontario. . No more than three titles should be requested at anyone time. Stamps to cover payment of postage from library to borrower should be in- cluded when material is returned to CNA library. Book<. and Document 1. Aggressive nursing management of acute myocardial infarction; a symposium, presented by Cedars-Sinai Medical Center, Dept. of Nurs- ing. Philadelphia, Charles Press, c 1968. 87p. 2. Bilan et avenir de l'éducation permanente des infirmières françaises. Paris, Association Nationale Française des Infirmières et Intïr- miers Diplomés d'Etat, Commission de I'En ei- gnement et de Ia Promotion Sociale, 1968. 125p. 3. Classification internationale type des professions. Ed. rev. 1968, Genève, Bureau international du travail, 1969. 4 I5p. 4. Community health by Carl Leonard Anderson, St. Louis, Mosby, cl969. 343p. 5. Community health test manual by Carl Leonard Anderson. St. Louis, Mosby, 1969. 47p. (Contl1lued on page 52) FEBRUARY 1970 DO YOU W ANT TO HELP YOUR PROFESSION? Then fill out and send in the form below REMITTANCE FORM CANADIAN NURSES' FOUNDATION 50, The Driveway, Ottawa 4, Ontario A contribution of $ payable to the Canadian Nurses' Foundation is enclosed and is to be applied as indicated below: MEMBERSHIP (payable annually) $ 2.00 $ 50.00 $500.00 Nurse Member - Regular Sustaining Patron Public Member - Sustaining Patron $ 50.00 $500.00 BURSARIES $ MEMORIAL $ RESEARCH $ in memory of Name and address of person to be notified of this gift REMITTER (Print name in full) Address Position Employer N.B. CONTRIBUTIONS TO CNF ARE DEDUCTIBLE FOR INCOME TAX PURPOSES FEBRUARY 1970 ..... .. "rm leasing this Renault 1 D for less than SBD a month... 0' J . .. . :;; . , . " .:.. :' - . --.. :.':- - :a:' . . . t t '. <( :" ..... ,. , ... -. ::-"\. J.. ... -r;: , -- "': ì . - '" . ... so can you with the RINAUlT PRD=PlAN" The RENAULT PRO-PLAN is a special 12-month leasing plan offered only to certain professional people like us. I don't know much about cars, and even less about leasing, but the people at RENAULT have kept the whole thing beautifully simple. (1) There's nO down payment. (2) There are no service or maintenance charges (you pay for gas only!. (3) You build up equity with every payment. Number one was very important to me because I didn't want to tie up a lot of money right now in a car. Number two makes my monthly cudgeting a snap, and number three means I have the option of buying at the end of the leasing period, for a very special price. And I will too. The Renault 10 is a great car. Easy to drive (you can get it with automatic!, easy to park, tremendously comfortable, and very economical (up to 40 miles to the gallon!. Considering I don't know anything about cars or leasing, I think I've been pretty smart, don't you? -------------- I To RENAULT OF CANADA I I 50 Progress Avenue, Scarborough. Ontario I I want to know more about the Renault PRO-PLAN. I NAME I I I I ADDRESS I I I I CITY.. . . .. .. .. .... ... .... .. PROV I ...- ----------- THE CANADIAN NURSE 51 accession list (Colltinued from page 50) 6. Concepts and practices of intensive care for nurse specialists. fdited by Lawrence 1:'. Mcltzer, Faye G. Abdellah. J. Roderick Kit- chell. Philadelphia. Charles Press, c 1969. 469p. 7. Current concepts in clinical nursing, Edit- ed by Betty S. Bergersen et al. Saint Louis, Mosby, 1967-1969. 2v. 8. Dictionnaire de la psychologie par Nor- bert Sillamy, Paris, Larousse, 1967. 319p. (Dictionnaires de l'homme du XXe siècle.)R 9. Diseases that plague modern man: a history of ten communicable diseases by Ri- chard Gallagher. New York, Occana Publica- tions, cl969. nop. 10. Excerpts from papers read at Royal Society of Health, Health Congress, Eastbourne 28 April to 2 May 1969. London, 1969.6 pts. m 1. Contents The future of occupational health service by A. Lloyd Potter. - Tommor- row's occupational health nurses by Dorothy M. Rawanski. - The nursing staff by Irene M. James. - The administrative, clerical and other hospital staff by Frank Reeves. - The changing pdttern of midwifery training; cause or effect'! by Miss M. L Farrer. - Practical aspects of nursing the acutely ill patient at home. II. Fundamental statistics in psycholoKY and education, 4th ed. by J. P. Guilford, New York, McGraw-Hili, cl965. 605p. 12. Glossaire de psychiatrie de psychologie patholoKique et de neuro-psychiatrie infantile par Lisette Moor, Paris, Masson. c 1966. 195p. 13. Health career fact sheets. Madison, Wis- consin, Health Careers Program, 1969. Iv. (loose-Ie at) 14. I presume you can type; the "mature" women's guide to second careers by Sonja Sinclair. Toronto, Canadian Broadcasting Cor- poration, cl969. 161p. 15. Intensive coronary care; a manual for nurses, by Lawrence Edward Meltzer et .II. Philadelphia, CCU Fund, Presbyterian Hospital, cl965. 201 p. 16. Medical reference works 1679-19ö6; a selected bibliography edited by John Bellard Blolke, and Charles Roos. Chicago, Medical Lihrary Association,cl967. 343p. 17. Mental health and the community: prohlems, prOKrams, and strateKies. Fdited by Milton F. Shore and Fortune V. Mannino. New York, Behavioral Publications, cl969. 209 p. (Community Mental Health series) 18. Motivation and personality, by A. H. MolSlow, New York, Harper & Row, cl954. 411p. 19. Net comme ça, par Denise Legrix. Paris, Kcnt-Segep, c 1960. 2v. 20. Proposal jor a comparative study oj the positions, roles and norms oj medical practi. tioners; by Anne Crichton. Vancouver, Dept. of Health care and Fpidcmiology, Univ. of British Columhia, 1 ,Columbia. GRADUATE NURSES for active 21-bed hos- pital, preferably wIth obstetrical experience. Friendly atmosphère, beautiful beaches, local curling club. Single room and board $40 a month. Salary $508 for Gen. Duty Registered Nurses; Salary $483 for non-registered nurses plus recognition for postgraduate experience. Shift differential. Apply to: Matron, Tofino General Hospital, Tofino, Vancouver Island, B.C. NURSES' COME TO THE PACIFIC NORTH- WEST - Gateway to Alaska. Friendly com- munity, enjoyable Nurses' Residence accommo. dation at minimal cost. 1969 salaries in effect. Salaries - Registered $508 to $633. Non registered $483. Northern Differential $15 a month. 1970 RNABC contract being negotiat- ed. Travel allowlnce up to $60 refundable after 12 months service. Apply to: Director of Nursing, Prince Rupert General Hospital, 551 5th Avenue East, Prince Rupert, British Colum- bia NEW aRUNSWICK "Registered Nurses (2) & Registered Nur ing Assistant required for 17-bed actIve hospItal, modernly equipped. For further information contact:.The Administrator, Albert County Hospital, Albert, N.B." NOVA SCOTIA GENERAL DUTY NURSES: Positions availa- ble for Registered Qualified General Duty Nurses for 138-bed active treatment hospital. Residence accommodation available. Applica- tions and enquiries will be received by: Director of Nursing, Blanchard-Fraser Memorial Hos- pital, Kentville, Nova Scotia. ONTARIO "PUBLIC HEALTH NURSING SUPERVISOR with preparation on advanced Public Health FEBRUARY 1970 ,"arch 1970 ,..ISS "'T'" f'lCRRIS - - - - - - - -- - -- - 290 ElSC ST ÞPT 812 OTTA A 2 C T CCCC5184 he anadian urse . .the face of Biafra: what one nurse remembers and the world can't forget 'something to say - and how! Ire we getting to you? . . . " . , , , '\ \ .,., I .. 1- f t:. '" j --- , .... ..... - , -- Alberta minister of health, James D. Henderson (center, arms folded), meets with the provincial council of the Alberta Association of Registered Nurses to discuss proposed legislation to establish a council on nursing. Helen Sabin, AARN executive secretary, is at the extreme right, and next to her is M. Geneva Purcell, AARN president. MARCH 1970 f.... , c::. .c. "- - .- a c o This decongestant tablet contends that a cold is not as simple as it seems on television Coricidin* "0" tablets shrink swollen mem- branes with the best of them (note the 10 mg. of phenylephrine). Unfortunately, the mis- ery of a cold doesn't end with unblocked passages. That's why Coricidin "0" also contains two anti- pyretic and analgesic agents. They cool down the steaming fever and suppress the aches and pains that go with the adult cold. That's why we also help perk up sagging spirits with 30 mg. Caffeine. And why we also include 2 mg. of Chlor- Tripolon* to combat rhinorrhea... and strike out at the very root of congestion. Know of another cold reliever that gives your patient so many helpful also's? Coric/din D' comprehensive reltef of cold symDtom- C- J' . Corporation Limited c::.;J,d{ø Pointe Claire 730, P Q. DESCRIPTION: Each CORICIOIN 0" tablet contaons 2 mg. CHLOR-TRIPOLON' (chlorpheni- ramine maleate). 230 mg. acetyl- salicylic acid. 160 mg. phena- cetin. 30 mg. caffeine. 10 mg phenylephrine. DOSAGE: Adults one tablet every 4 hours. not 10 exceed 4 tablets in 24 hours. Children (10- 14 years): '/, the adult dose. Children under 10 years' as di- rected by the physicIan COrlCIIIn'D' SIDE EFFECTS: Adverse reac- tions ordinarily associated with antihistamines. such as drowsI- ness. nausea and dizziness occur infrequenlly with Coricidon "0" when administration does not exceed recommended dosage PRECAUTIONS: May be onjurious if taken in large doses or for a long time. Add,honal clinical data available on request . reg. Trade Mark For colds of all ages. Coricidin tablets, Coricidin with Codeine, Coriforte' for severe colds Nasal Mist, Medilets and Coricidin "D" Medilets for children. Pediatric Drops, Cough Mixture and Lozenges. 24.__ -........ --.,. --- -- -@ . , 14 THE CANADIAN NURSE .. ..... r-' ...; " leads the \Nay... in styling and workmanship. Each and every garment is painstakingly manufactured to assure the finest value, style and wearability. ....J J Front step in "Skimmer" with three-quarter roll-up sleeves. Action sleeve gussets. J 80% DACRON - 20% COTTON Style 5044 Retails about $15.98 Sizes 8 . 20 This and other styles available at uniform shops and department stores across Canada. PRoFESSIONAL UNIFORMS For a copy of our latest catalogue and for the store nearest you, write: La Cross Uniform Corp. 4530 Clark St., Montreal, Quebec Tel: 845-5273 MARCH 1970 news (Continued from page I:!J ANPQ Donates $15,000 To CNF Ottawa. - The Canadian Nurses' Foundation received a welcome boost from a provincial nurses' association in January. The $15,000 cheque from the Association of Nurses of the Province of Quebec will help the Foundation to make awards to all applicants whom the selec- tions committee recommends. The dona- tion resulted from a resolution passed by the ANPQ membership. In 1969-70. more than $41,000 was awarded to CNF scholars. The ANPQ donation brings to approximately $35.000 the amount of funds available on February I. for CNF scholars in 1970-71. Symbol For Disabled Ottawa. - An international symbol to indicate building services available for the handicapped was selected by the Inter- national Society for the Rehabilitation of the Disabled in December. The winning entry in the world-wide competition, representing a figure seated in a wheelchair, was submitted by Susanne Kofoed. a Danish student. It was selected because it is easily identifia- ble from a reasonable distance, can be understood with or without text is simple and aesthetic, and can be produc- ed in metal, glass, and other materials. The winning design is copyright free and available for use by anyone. It has been adopted by the standing committee on building standards for the handicap- ped of the associate committee on the national building code of Canada Public Threatened, RNABC Warns Vancouver, B. C - The Registered Nurses' Association of British Columbia MARCH 1970 has expressed concern about a decrease in services of the provincial hospital insur- ance and health departments. In a January news release the RNABC said that the published statement attri- buted to B.C. Health Minister Ralph loffmark was a warning to the public that it will be unsafe to become ill. "The nursing profession cannot guarantee the safety of patients under these circum- stances," said the RNABe. According to the news release. the RNABC board of directors believes that provincial government cutbacks in ex- tended care already are compounding problems in these facilities. Space and staffing ratios allowed for extended care facilities in B.C. do not provide for adequate nursing care or room for pa- tients to do more than lie in bed and wait. Such a policy. the release added, tells the public not to bother with its old people. The public must decide whether to shortchange itself or prepare to pay for adequate services, the association said. It explained that the public is threatened by the health minister's statement that de- creases in health services will follow further demands on wages or staff enrol- ment. (Continued on page 17) TO PLAN LIFETIME FOR A " " \ ,'- I. r )..: A \ ...., ..... f . .:/..... t 'i \' Marriage is a ...ponsibility that often re' quires both spiritual and medical assistance from professional people. In many instance. a nune may be called upon for medical counsel for the newly married young wo- man, mother, or a mature woman. "To Plan For A Lifetime, plan With. Your Doc. tor" is a pamphlet that was written to assist in preparing a woman for patient.physician discussion of family planning methods. The booklet stresses the importance ta the indi- vidual of selecting the method that most suih her religious, medical, and psychological needs. I , '- .. l \- , I Nunes are invited to use the coupon below to order copies for use as an aid in coun. selling. They will be suppfied by Mead John. son Laboratories, a division of Mead John. son Canada Ltd., as a free service. Moa!LtÐ iTiæ LAB 0 R A TO R I E S ORDER FORM To: Mead Johnson Laboratories, 95 St. Clair Avenue West, Toronto 7, Ontario. I I Plea.. ..nd copie. of "To Plan For A Lifetime, Plan With Your I Doctor" to: Name I Add.... I L --------- 15 THE CANADIAN NURSE 1 ELASTOPLAST elastic adhesive bandages give strong support, allow air to reach the skin and moisture to evaporate to promote rapid healing. 2 bS are available in 4 types for casts of great strength, minimum weight, and fine porcelain-like finish. 3 a G 1reSSingS are non-adherent and open-meshed. Now available in individual sterile unit 'peel-apart' envelopes 4 ELASTOPLAST dressing strips are continuous elastic adhesive porous dressings. Strips are cut to fit the wound. 5 ELASTOCREPE Cotton Crepe Bandage is a smooth surface non-adhesive bandage with unique properties of stretch and regain. 6 i bl e 1 w v iety of skin conditions after deep x-ray therapy, plastic surgery, chafing, and as a lubricant. 7 SUPER-CRINX Softstretch Bandages conform to difficult body contours. It's unique weave of cotton and nylon assures sustained tension. S r 1 inting Material is light yet strong enough to form a variety of splints, supports, and prostheses. 9 ELASTOPLAST 4 a irstrip' ward dressings for the care of post-operative wounds-air-permeable yet water- proof to permit healing under ideally dry conditions. 10 ! , s eets, bed pan and urinal covers are for low- cost sanitary use in the hospital. 11 I t r Blankets give maximum warmth and comfort with minimum weight and withstand the strain of repeated laundering. 12 ELASTOPLAST skin traction kits are ready-to-use and provide the most efficient method of skin traction. 13 ELASTOPLAST anchor dressings feature a porous elastic adhesive fabric- H-shaped to give firm anchorage on hard-to-dress areas. 4 10 SMITH & NEPHEW LTD, 2100-52nd Avenue, Lachine, Quebec 3 7 s 9 12 2 .' the best dressed patient 6 11 1 \ \ \ news (Continued from page 15) The news release also criticized the provincial government policy, as stated by the health minister, for forcing nurses to spread themselves thinner in delivery of service in all areas, including intensive care, extended care, and public health. This policy does not explain how a depleted nursing staff can provide safe care at the present population level, let alone cope with a rapidly increasing population in the province, the RNABC said. BC Nurses To Study Night Travel Problems Vancouver, He. - A joint study of the "journey-home" travel problems of hospi- tal employees who work night shifts has been undertaken by the Registered Nurses' Association of British Columbia, the Psychiatric Nurses' Association of British Columbia, and Local 180 of the Hospital Employees' Union. The study, announced by the RNABC, began in January. Dr. Nirmala d. Cherukupalle, assistant professor at the school of community and regional planning, University of British Columbia, is conducting the study. Twenty hospitals in the Greater Vancou- ver and New Westminster areas are involv- ed in the project, which aims to explore the feasibility and costs of alternative solutions to the problems of returning home from work after dark. Travel problems in B.C. became a particular concern to nurses and their employers after the fatal stabbing last fall of a nurse on her way home from work after midnight. "Million Letter Write-in" Helps Nurses' Campaign London, England. - Nurses in Britain can thank the public for the support they received during their November campaign to "Raise the Roof' for better pay. One million printed letters were dis- tributed throughout the country by mem- bers of the 67,OOO-member Royal College of Nursing. Each letter contained a simple message: "I, a member of the general public, recognizing the importance to the community of the service given by nurses, support wholeheartedly their fight for a substantial increase in pay. I call upon the government to see that nurses get justice now so that we, the people of this country, can rely on their services for the future." During the first few weeks of the campaign, Richard Crossman, secretary of state for health and social services, receiv- MARCH 1970 ed 126,000 signed letters. Other individu- als signed petitions with thousands of sIgnatures and sent them to either the prime minister or the secretary of state. The British Medical Association pledged official support to the nurses' cause. The aim of the campaign was to keep pressure on the government and the Whitty Coun- cil, which looks after nurses' pay, while the latest wage claims were being discuss- ed. In January, the nurses received a pay offer from the government. Effective April I, 1970, nurses in certain grades in general and psychiatric hospitals and in "Salmon" posts (supervisory positions), will receive a 15 percent pay increase. An additional 7 percent increase will take effect April I, 1971. The present salary for a staff nurse is 785 pounds per year ($2,009.60) The Royal College of Nurs- ing requested 1,000 pounds ($2,560). According to an Rcn release, the coun- cil met in special session on January 14 to consider the offer. The council agreed that the offer "formed a reasonable beginning for further negotiations." How- ever, the council prefers an immediate large pay increase rather than one spread over two years. Negotiations resumed on January 27. No further details were available at press time. - ASSISTOSCOPE*T . DESIGNED WITH THE NURSE IN MIND Acoustical Perfection .. SLIM AND DAINTY .. RUGGED AND DEPENDABLE .. LIGHT AND FLEXIBLE .. WHITE OR BLACK TUBING .. PERSONAL STETHOSCOPE TO FIT YOUR POCKET AND POCKETBOOK Order from vJ M WINLEY-MORRIS CO. LTD. Surgical Products Division MONTREAL 26 QUEBEC \ ASSISTOSCOPE DESIGNED WITt-! 'HE. huRSE IN MIND Acoustical Perfection . SLIM AND DAINTY . RUGGfD AND DfPfNDAILf . LIGHT AND fLfXIILf . WHIT( DR lUCK TUIING . PERSONAL STETHOSC1IPE TO FIT rOIJ/l POCKET ANO POCKETBOOK Made in Canada r ; ;' ----l I 2795 BATES RD. MONTREAL, P.Q. I I Please accept my order lor I I - - 'AssIStoscOpe(S)' at $1295 each o White tubing 0 Black tub" I I I I NAME I I AOOAES I I y I L_______________J Re.idenh Df Quebec add 8% PrDvincial Sa'.. Tax. THE CANADIAN NURSE 17 . news Centennial Stamp Ottawa. - The formation of the Northwest Territories will be commemor- ated this year on a Canada Post Office Stamp, Postmaster General Eric Kierans has announced. The Northwest Terri- tories is celebrating its official Centennial year. The inhabitants of this region - more than one-third of Canada's total area - are emphasizing unity, not only with respect to all Canada, but among the Eskimoes, Indians, and other Canadians . .... .... '" . . .. b,- -' j - .. I I I / , a. I I, \' h n time IS mor Important than anything else i p . "ng pI ,i1iv afe aspirahon to a patient, thi pI _n Gomco Portable Aspirator is a friend i, I' J to patient and nurse. Be sure you have it when you need it. Keep at least one on hand at every nursing station. Then you can get a replacement from Central Supply who work together in developing the Territories' component areas of Franklin, Mackenzie, and Keewatin. The Postmaster General's announ- cement also said that Louis Riel, one of the most prominent figures in the events of Western Canada 100 years ago, will be commemorated on another Canada Post Office stamp in 1970. It was in 1870 that the Manitoba Act brought the Red River area into confederation as Canada's fifth province. Red Cross Bursary Available Toronto, Ont. - A bursary of $1,000 is being offered by the Volunteer Nursing Committee of The Canadian Red Cross SUGGESTION TO NURSING SUPERVISORS: Why not a GUMtt7@ portable aspirator at every nursing station! I I I " : - .4 \' for the next emergency. The Gomco No. 789 "Portable Aspirator" weighs only 16 pounds, is easily carried, requires less than 1 sq. ft. of space, provides up to 20" of vaCUum. Ask your nearby Surgical Supply dealer for com- plete information and demonstration or write: 828 E. Ferry Street. Buffalo, New York 14211 Dept. C-2 GOMCO SURGICAL MANUFACTURING CORP. , b--..... "E"... [}{l o[}{lÆo 18 THE CANADIAN NURSE Society to graduate nurses registered in Ontario. The announcement was made in January by Mrs. M. Mathieson. chairman of the committee. The award will enable a nurse in Ontario to undertake further studies in nursing at the degree level. The successful candidate will be selected on the basis of training, nursing experience, and leader- ship qualities, with consideration being given to the applicant's anticipated contribution to nursing in Ontario. Interested nurses can write to Miss C.M. Sarginson, The Canadian Red Cross Society, 460 Jarvis Street, Toronto 5, Ontario. for application forms and further information. Applications must be submitted before April 1. 1970. The 1969 Bursary Award was made to Frances M. Howard, formerly consultant in nursing service with the Canadian Nurses' Association, who is presently studying for a master's degree in nursing service administration at the University of Western Ontario, London. Ontario. ICN Seeks New Executive Director Geneva, Switzerland. - The Inter- national Council of Nurses is seeking applicants for the position of executive director. The post will fall vacant this summer when present director Sheila Quinn takes up a new position. The successful candidate will work at ICN Headquarters. Geneva. starting in Septem- ber 1970. Applicants must be members of their own national association. must be fluent in English and have a good working knowledge of French. They should also have up-to-date knowledge of develop- ments in nursing and nursing education on a wide basis; give evidence of proven managerial ability in their present posi- tion; and be capable of working as a leader of a small professional team. Further details may be obtained by writing to lCN Headquarters, P.O. Box 42, CH-1211 Geneva 20. Switzerland. Study Shows HO!tpitals Retain Involvement In Education New York. - Hospitals that have closed their diploma nursing schools continue to be involved in nursing educa- tion. according to a report issue in Octo- ber 1969 by the National League for Nursing. The League recently surveyed 221 diploma nursing programs that closed between 1959 and 1968. It found that 63 percent now offer clinical facilities for practical nursing programs, 49 percent for associate degree programs (usually in junior and community colleges). 31 percent for baccalaureate degree pro- grams in senior colleges and universities, (Contmued on page 21) MARCH 1970 . I 1 go ah- - '. I ... ... o P. ith the right way. . I Dermassage cools and soothes. Softens and smooths. Refreshes and deodorizes without leaving a scent. Protects with antibacterial and antifungal action. Dermassage forms a greaseless film to cushion your patients against linens, helping to prevent sheet burns and irritation Just think of the welcome comfort a Dermassage rub can be to a patient's tender, sheet-scratched skin. And when you give back or body rubs with Dermassage, you never have to worry about rough, scratchy hands. So go ahead... soften them up. ..... - - - ëirnassa e" .---...- :;,ø lakesIde laboratorlas (Canadailld. 64 Colgate Avenue' Toronto 8, Ontaroo 'Trade mark in Canada its Stille exclusively from De Puy There's no disputing the f quality of Stille Surgical 'ine """, , Instruments. As a matter of fact, "",- other instrument manufacturers use "\.. Stille as a gauge. But there's no " duplicating the strength, precision and perfect balance and the prime stainless steel of Stille instruments. A Stille " instrument will not only outperform but it will also outlast any other surgical instrument and we have case histories that prove it. , '\ r '" JI , \, ( '\ ) Available only from DePuy Manufacturing Company (Canada) Ltd For additional Quebec and information write: Maritime Provinces Guy Bernier 862 Charles-Guimowd Boucherville, Quebec 20 THE CANADIAN NURSE Ontario and Western Canada John Kennedy 2750 Slough Street Malton, Ontario DePuy, Inc. A Subsidiary of Bio-Dynamics Warsaw, Indiana 46580 U.S.A. MARCH 1970 news (Continued from page 18) and II percent for other diploma pro- grams. The study points out that in 1959 there were 918 diploma programs gradu- ating 59 percent of the basic nursing students. By 1968 the number of pro- grams had dropped to 728 with a commensurate decline in graduations to 39 percent. The study reflects the fact that. al- though hospitals continue to supply the essential ingredient of nursing educa- tion - that is, clinical contact with pa- tients - the control of nursing educa- tion is gradually shifting away from them to institutions of higher education. Hospitals also reported that they engaged in educational activities for paramedical and ancillary personnel and for students in other disciplines, such as nursing aides, ward clerks, inhalation therapists, and technicians for operating room and obstetric departments. The report. entitled Present Inmlve- ment in Nursing Education of Institutions Whose Diploma Programs Closed, 1959-1968, is available from the National League for Nursing, 10 Columbus Circle, New York, N.Y. 10019 for 75 cents a copy. U.S. Funds. (Publication No. 19-I374). lJBC Family Practice Unit Involves Nurses Vancouver, B.C - Two Vancouver nurses are involved in a major experiment to educate members of the health profes- sions. The experiment is being conducted at the family practice unit (FPU) recently established by the University of British Columbia's faculty of medicine. Employed as public health nurses by the new unit are Pat Ohashi and Elinor Joensen, both graduates of UHe's school of nursing. They are participating in an experimental service, teaching, and learn- ing situation that may broaden the scope of nursing at the primary health care level. "At the family practice unit, we hope to demonstrate the potential for assuming a greater share of responsibility for the provision of improved health care for families that we know exists in nursing," said Elizabeth McCann, acting director of UBe's school of nursing. "In this situa- tion nurses can be challenged to practice nursing to the maximum level of their knowledge," she said. One of the major objectives of the FPU is to train student doctors, nurses, social workers, and other members of the health professions to cope with the many problems encountered in a family prac- tice by actually training within a func- tioning family practice. Dr. J.F. McCreary, dean of UBe's faculty of medicine, explained that the . " .." þ If 1. ' "- , f , . '- " , .", ..r .... . Discussing the events of another busy day at the University of British Columbia's new Family Practice Unit are its two public health nurses, Pat Ohashi, left, and Elinm Joensen, right, and social worker, Lucille Cregheur, center. MARCH 1970 blliullD of " and Special S. liars ,,,, Hu..... MRS. R. F. JOHNSON SUPERVISOR ... - -_. ,...... ., ebl ....IIt --:- [DR. JOHN WILLIAMS I _ R SIDEHT aROO" \ '- RS \-\OL{) . ANN COHN. L.P.N. Mebl Fr...... ".IIt AlIßIII PlastIc 110 510 Largest.seillngamolll nurses' Superb hlet,me quahty. smooth rounded edges . . . featherweight, hes ftat . . . deeply engra.ed, and lacquered Snow wh,te plast'c w,lI not yellow. Sat,slacllon guaranteed GROUP OISCOUNTS SAVE. O'-or 2 ,de.tical Pi.. .. ,re. caution aKlI..tle.., Iiss cblllini. I N.me Pi. .." 1.75* 2.05* 2 Pi.. (ume ..lIe) 2.60* 3.10* I No.e PI. .IIy .85* 1.15* 2 Plu (ulle ...e) 1.35 * 1.90* . JRTMT Pltne Idd 2Sc pet' ødrt' ...... cNflt 011 .11 orden of J pillS Of Ins GROUP DISCOUNTS 2 99 pHIl., s,., 1m Of ..... 10% Send cash. moO.. or check. No billings or COD"L Sel-Fix NURSE CAP BAND - BlICk velvet band mllenll StH... L \ heslve. presses on. pulls oft: no sewln, ........ or plnnma:. Reusable sever.1 lilnes : w-: _2 :_ f : ':sl:: =: ""- 18 per boa). - (6 per bol.!, 1- No. 6343 & n :.;:dth desired III c.p B.nd . . . 1 bal 1.65 3 Dr morl 1.40 n. -" NURSES CAP-TACS Remove.nd reflSlen CIP bind Insllftll)' -r for Ialndenn, and repllCtmenl l Tift)' . - molded pJasllc IK. dllnty uceus .. Choose BlICk Blue Wtllie or Crystll - wI11'1 Gold Caduceus or III bl.k Ipilln) ...__ -..... No 2OOSetofCSTacs..1 OOplrsel ' SPECIAL' 12 or more Slls... .80 plr SIt , I @ Nurses ENAMELED PINS BeÞtdull, sculptured sillus Insll"lI. 2.coØ ktytcI, =I e:N I'; f: g:1 :z:.: . ND. 205 [n.meled Pin. . . . . . . . . 1.65 el. ppd. Waterproof NURSES WATCH 9 SwtSS made, rllsed Sllvlr full møeflls lurnln rnMk. . ''''' Red tlØøed sweep second hind dlrome slliniess . _ Clse Stllnleu elparl'SlOII bind ølus FREE bl.k Inlh. : : r. . ,. ........ 16.50 el. ppll. Uniform POCKET PALS Protecls IIllnsl silins and ..... Pilible wtlll, pllStlC with pld stlmDtd caduceus Two com- partmen1s for pens, wan, Ilc Idul loileft lifts or flvors. f to ? ::v: o-E t to;r 1 :-:, g ppd. Personalize' BANDAGE L . SHEARS .I- s- professtONl preclSlOII shein. forpd -- 10 sleel GUirOflleed to IllY sharp 2 JlIn ....-:ø. No. 1000 Shlln (nD Inllills) . . . . 2.75 el. ppd. SPECIAL! 1 DOL Shein............ $26.IDhl Inlll.ls (up h 3) etch" . , ... .dd 50C per pllr "SENTRY" SPRAY PROTECTOR ProtlCts you 1"lnsl .,101_ ...... 01"" .. Insl,.,lI, dlubl" WlthoIII ,'"""'Im Iftl" No. A'.16 SontrJ . . 2.2!1 u. ppll. I I I ' ORDER NO I E' COLOR QUANT. 'RICE 2nd Line . . . . . .. . 'IN LETT. COLOR, j Black uBI... 0 Wh,tl (No. 1691 METAL FINISH. ] Gold J S"ver INIJlALS _ - - . LETTERING . I enclose S . Send to . Street ____ City Statt ZID .......... PIIIM IIIDW lufflC.lnt limo tor d......." THE CANADIAN NURSE 21 . news tion where the student can become in- volved in a functioning family practice and learn something of the rewards of this type of activity. To increase efficien- cy and decrease costs, the FPU will train doctors through the team approach to health care to delegate some health care duties to appropriate members of other health professions whose training and whose services are less costly than are the doctor's, he added. The role of the nurse within the team approach to health care will be one of the areas where the most innovation will take place. By working side by side with nurses at the FPU, doctors will be en- need for a reorientation in the training of health care professionals to provide primary health care stems from the trend away from general practice in Canada. In 1945, he said, 22 percent of Canada's physicians were specialist-qualified. By 1960, more than 50 percent were special- ists. Dr. McCreary said the FPU will at- tempt to attract more medical graduates into family practice by creating a situa- NOWI HOllister's comPlete U-BAG system regular and 24-hour collectors in newborn and pediatric sizes I gel anJ inlanl urine soeCimen when JOU wanlll The sure way to collect pediatric urine specimens easily. . . every time. Hollister's popular U.Bag now has become a complete system. Now, for the first time, a U.Bag style IS available for 24-hour as well as regular specimen collection, and both styles now come in two sizes . the familiar pediatric size and a new smaller size designed for the tiny contours of the newborn baby. Each U-Bag offers these unique benefits: - double- chamber and no-flowback valves - a perfect fit on boy or girl, newborn or pediatric - protection of the specimen against fecal contamination _ hypo-aller. genic adhesive to hold the U.Bag firmly and comfort- ably in place without tapes - complete disposability. Now the U.Bag system can help you to get any infant urine specimen when you want it. Write on hospital or professional letterhead for samples and informa- tion about the new U-Bag system. HOLLISTER LIMITED, 160 BAY STREET, TORONTO 116, ONTARIO 22 THE CANADIAN NURSE couraged to delegate duties that nurses are able to perform. Nurses in turn will be encouraged to think and act more inde- pendently, negating to some extent the nurse's traditional role as the doctor's alter ego. Miss McCann explained that the nurse will be defining, developing, and inter- preting her professional role within a new setting and will communicate it to her fellow professionals at the FPU and to the student doctors, nurses, social work- ers, and other members of the health professions who will train there. The nurse at the FPU will move freely between patients' homes and the unit, said Miss McCann. In some cases she may be able to make house calls, report on the patient's condition, and inform the doctor if it is necessary for him to make a visit. The nurse will make her special con- tribution to the analysis of individual and family health problems through a nursing diagnosis and will share in the planning and provision of services for care and rehabilitation. "ICN Calling" Gets New Format Geneva, Switzerland. - fCN Calling, the news bulletin of the International Council of Nurses, now has a new format. The bulletin. produced six times a year in Geneva, is now 16 pages per issue. Each issue contains 10 pages of Eng- lish text and photographs. and selected news items in French, Spanish, and Ger- man. This format has been adapted from that of the daily multilingual bulletin distributed during the 14th quadrennial congress of ICN in Montreal in June 1969. Persons wishing to subscribe to fCN Calling should write to: S. Karger AG, Arnold-Böcklin-Strasse 25, 400 Basel II, Switzerland. Subscription price for one year is $2.15. 0 NWT Centennial . . MARCH 1970 . --- .. ,'" ..... - , /'" , '- _. . \- J , r , ... '!- , ..,....."" ':"'-- .... -of .;y ..-.,.. - oF -, ;.... " " . - "- \.. . J ,. , , ,J . ) . " - "'-If' , ..\\... ). , -"",,\ . \ ., .,tIt"- ,..,." - . <<- ........ ..... .... .. ..... .. .. --. .}...... -"" -..... -- ,. \ \ .. ..... (' -'" 'è-- ,. ". -'"' . -- I, DON'T DROP THE SU ECT Until you switch to UROMATIC plastic con- are, though, that they won't fall-because tainers for safer, easier, faster irrigation they're lighter and easier to handle. No procedures. Bottles have a habit of falling. metal closures or caps to fumble with. Set- And breaking. Which increases costs-not ups are faster, changeovers are faster. And just for the solutions, but also for clean-up the whole procedure is safer. Because labor. And sometimes people get cut by UROMATIC is a completely closed system. the broken glass. UROMATIC plastic contain- No vent; no room air enters the container; ers can fall, but they can't break. Chances no airborne contaminants get inside the V OL R fc\TORIES OF CANADA 6405 Northam Drove Malton, Ontaroo MARCH 1970 system. The spike completely occludes the port opening before it punctures the inter- nal safety seal. UROMATIC is the first and only plastic container for TUR. cysto and irrigation solu- tions. For safer, faster pro- cedures, It'S the first and only one you should consider. urêmatlC THE CANA IAN NURSE 23 names Hildegard Peplau (R.N., Pottstown H., Pottstown, Pa.; B.A., Bennington College, Vermont; M.A. and Ed.D., Teachers College, Columbia U., New York) has been appointed interim executive director of the American Nurses' Association. She succeeds Judith Whitaker, ANA executive director from 1958 to 1969. Dr. Peplau is on leave of absence from Rutgers, the state university of New Jersey, where she is professor and direc- tor of the graduate program in psychiatric nursing. Dr. Peplau has served on many com- mittees and advisory groups of the ANA and the National League for Nursing. She is currently chairman of the ANA's divi- sion of psychiatric-mental health practice, is a member of the congress on nursing practice, and is ANA consultant to the advisory council of the National Institute of Mental Health. She is a member of the board of directors of the New Jersey State Nurses' Association and a member of the nursing education advisory com- mittee to the New Jersey board of higher education. From 1950 to 1960, Dr. Peplau was a member of the expert advisory panel on nursing of the World Health Organization. She also served as consultant to the U.S. Public Health Service, the Veterans Administration, and the surgeon general of the U.S. Air Force. Dr. Peplau has lectured widely and has had many articles published in health and education journals. She is author of two books: Interpersonal Relations in Nursing and Professional Experience Record. Margaret Neylan (B.Sc.N., McGill U.; Dipl. Superv. Psych. Nursing, McGill U.; ,... M.A., U. of British Columbia) has been appointed associate professor and direc- tor of continuing nursing education in the school of nursing, University of British Columbia, Vancouver. Mrs. Neylan was previously assistant professor in the school of nursing at UBC. Her experience includes teaching and supervision in psychiatric nursing at The Montreal General Hospital. A member on various committees of the Registered Nurses' Association of British Columbia, Mrs. Neyland has also been a member of the Canadian Confer- ence of University Schools of Nursing. 24 THE CANADIAN NURSE , ..... '"' '" . . I ... Å i Iii. ...- ... .......-. . Hagen Picard Houle Dr. Edna L. Moore Scholarships were recently awarded for the second time. The recipients were from the Laurentian University School of Nursing in Sudbury, Ontario. Mary Hagen received the Dr. E.L. Moore award for general proficiency and excellence in the practice of nursing in first-year nursing. Louise Picard receiv- ed her award for general proficiency and excellence in the practice of nursing in second-year nursing. Margaret Houle was awarded the entrance scholarship. Donations to the Dr. Edna L. Moore Scholarship Fund of Laurentian Universi- ty School of Nursing may be sent by cheque or money order to Miss F .M. Tomlinson, c/o Sudbury and District Health Unit, Cedar St., Sudbury, Ontario. Evelyn Pepper retir- ed in January after a distinguished nursing career that brought her recognition throughout Canada, the United States, and overseas. For the past 19 years Miss Pepper has been nursing consultant in the emergency health services division of the department of national health and welfare. Born and educated in Ottawa, Miss Pepper is a graduate of the Ottawa Civic Hospital. After becoming a registered nurse, she registered in a course in radio- graphy and x-ray therapy given at The Montreal General Hospital. Later she received a certificate in hospital adminis- tration from McGill University School for Graduate Nurses. Early in her career Miss Pepper worked - / as senior technician and nurse supervisor of the department of radiography and x-ray therapy at the Ottawa Civic Hospi- tal. During this period she was awarded a fellowship in the Ontario Society of Radiographers. As a nursing sister, captain (matron), and major (principal matron) in the Cana- dian Anny during World War II, Miss Pepper served in Canada and overseas. Her war decorations include the Royal Red Cross, first class; 1939-45 Star; France-Germany Star; Italy Star; and CVSM war medal. After the war, Miss Pepper worked in Ottawa as hospital matron with the department of veterans' affairs, where she became assistant to the director of nurs- ing services. In 1961 the United States civil defense council presented this internationally known nurse with the Pfizer A ward of Merit for her contributions to medical- health and disaster preparedness. She has also been honored by the Order of St. John of Jerusalem, being named a commander sister in 1968. An active member of numerous nurs- ing associations in Canada, including the CNA, Miss Pepper is a past president of the Ottawa unit of the Nursing Sisters Associa- tion of Canada and has served on national committees of the St. John Ambulance, the Canadian Red Cross, and the Victorian Order of Nurses for Canada. She is a member of the board of the Ottawa Civic Hospital. Sarah A. Wallace, (Reg.N., Hamilton General H.; Cert. P.H.N., U. of Western Ontario) has retired as senior nursing consultant in occupational health service with the environmental health services branch of the Ontario Department of Health, following 26 years of service with the branch. Miss Wallace was the fIrst full-time occupational health (industrial) nursing consultant appointed at a provincial level in Canada. She is known throughout the country for her counsel, guidance, and leadership in the field of occupational health nursing, for her contribution to nursing education, and her participation in nursing organizations at the provincial and national levels. For the past nine years Miss Wallace was one of the few nurses on the Penna- nent Commission and International Asso. ciation on Occupational Health. She was a member of its new subcommittee on nursing during the last triennium. MARCH 1970 Four public health nurses from Saskat- chewan, Manitoba, Ontario, and New Brunswick have been awarded $500 scholarships by G .0. Searle Co. of Canada Limited. The scholarships cover two weeks' training at the Vnited States Plan- ned Parenthood Association's Chicago clinic, plus living and travel expenses. The nurses are Sheila M. Paul, B.S.N., Meadow Lake, Saskatchewan; Betty Louise Flecknor, R.N., Neepawa, Manito- ba; Ruth Linton, R.N., P.H.N., Kirkland Lake, Ontario; and Bella LeBlanc, P.RN., Shediac, New Brunswick. The scholarship will enable the nurses to qualify for senior positions in clinics and instruct public health nurses taking up duties related to family planning. Joanne Dolores Oss of Edmonton (R.N., City H., Saskatoon; B.Sc., V. of Saskat- --' chewan; M.Sc., V. of Washington, Seattle) has been awarded the Abe Miller Me- morial Scholarship A by the Alberta Asso- ciation of Registered Nurses. The $1,500 scholarship is awarded annually to a registered nurse who is enrolled in a master's or doctoral program. Miss Oss is on leave of absence from the University of Alberta, where she is coordinator of the bachelor of nursing science program, to receive her doctorate in education from the Vniversity of Wash- ington. Margaret Jean Bayer (R.N., Nova Scotia H., Dartmouth, N.S.; Dipl. Teaching in Schools of Nursing, Dalhousie U., Hali- fax, N.S.; B.N., Dal- housie V.) is the , i...,..., recently appointed 1,.. director of nursing education at Nova Scotia Hospital in Dartmouth. Mrs. Bayer has worked as a head nurse and instructor at Nova Scotia Hospital. She has been an active member in the Halifax branch of the Registered Nurses' Association of Nova Scotia. Patricia Stanojevic (Reg.N., The Hospi- tal for Sick Children, Toronto; B.Sc.N., V. of British Columbia; M.Sc. (App.), McGill V.) has been named assistant research and planning officer (nursing) with the research and planning branch of the Ontano Department of Health. MARCH 1970 - ""':::t L Mrs. Stanojevic began her nursmg career as a staff nurse at The Hospital for Sick Children, where she later joined the school of nursing teaching staff. She was the first full-time nurse appointed at the hospital to organize an inservice educa- tion program for graduate nurses. Mrs. Stanojevic's experience also includes working as an inspector of schools of nursing with the nursing branch of the Ontario Department of Health, and assistant director, profession- al standards, with the College of Nurses of Ontario. J. Maurice LeClair has been appointed deputy minister of the department of national health. He succeeds Dr. John Crawford who retir- ed in August 1969. Dr. LeClair comes to the department from the Vniversity of Sherbrooke in Quebec, where he has been dean of the faculty of medicine since 1968. As dean, he continued to work on the staff of the Vniversity Hospital in Sherbrooke. He joined the medical faculty at the Vniversi- ty of Sherbrooke in 1965, after serving as associate professor of medicine at the Vniversity of Montreal. A native of Quebec, Dr. LeClair attended Collège Notre-Dame in Montreal and McGill Vniversity. A Fellow of the American College of Physicians and the Royal College of Physicians of Canada, he studied at the Mayo Clinic in Rochester, Minnesota, and practiced internal medi- cine in Montreal. The new deputy minis- ter has specialist qualifications in internal medicine and hematology. Dr. LeClair is vice-president of the Medical Research Council of Canada and the Association of Canadian Medical Colleges. He has also been active in the National Cancer Institute. III Mary E. Barrett (Reg.N., Victoria H., London, Ont.; B.N., McGill V.; B.A., Sir George Williams V., Montreal; M.S.N., Case Western Re- serve V., Cleveland, Ohio) has been appointed chainnan of the nursing education division of Daw- son College in Montreal. In her new position, Miss Barrett is responsible for setting up the College's nursing program. Dawson College is Mon- treal's only English-language CEGEP. CEGEP colleges have replaced all English hospital schools of nursing in Quebec. All English-language student nurses in the province enter CEGEPs for their nursing and pre-university schooling. .... -. Miss Barrett has had broad nursing experience at Montreal's Jewish General Hospital, where she has worked as an operating room staff nurse and head nurse, clinical instructor, assistant direc- tor, and director of nursing education. A fonner member of the curriculum committee and member of the Board of Examiners of the Association of Nurses of the Province of Quebec, Miss Barrett is now co-chainnan of the ANPQ school of nursing committee. She was a 1967-68 Canadian Nurses' Foundation Fellow. Marvelle McPherson (R.N., St. Boniface School of Nursing; B.N., V. of Manito- ba) has been ap- pointed assistant director of nursing service, planning and development, at St. Boniface General Hospital, St. Boniface, Manitoba. Mrs. McPherson, a native of Manitoba, worked as a general duty nurse and head nurse in pediatrics at St. Boniface General Hospital prior to her new appointment. , Irene E. Biddington (R.N., Hôpital Hôtel-Dieu de l'As- somption, Moncton, N .B.; Dipl. Nurs. Servo Admin., Dal- housie V., Halifax, N.S.) is the new director of nursing services at Hôpital Dr. Georges L. Dumont in Moncton, N.B. Miss Biddington was assistant director of nursing service at this hospital from 1964 to 1969. She has also worked as a general duty nurse, operating room nurse, and head nurse in the outpatient depart- ment at the hospital. Her experience includes work as an office nurse in Moncton. An active member of the New Bruns- wick Association of Registered Nurses, Miss Biddington is currently a vice- president of the Moncton chapter. Edna L. Oudot has been appointed coordinator, and Nora R. Steams teacher, of the Team Nursing Project, Registered Nurses' Association of On- IIiIII..... tario. t: OudOl Mis sOu dot (B.Sc.N., School of Nursing, V. ofToron- to; M.A., Nursing Education and P.H. Superv., Teachers College, Columbia V.) has worked as a staff nurse, assistant supervisor and supervisor. and assistant director with the Metropolitan Toronto THE CANADIAN NURSE 25 . ....... .", ..... .. - "" ...... ...,.. . It. 1.0 , U."k. I -.::::; ---- For nursing . convenIence. . . patient ease TUCKS offer an aid to healing, an aid to comfort Soothing, cooling TUCKS provide greater patient comfort, greater nursing convenience. TUCKS mean no fuss, no mess, no preparation, no trundling the surgical cart. Ready- prepared TUCKS can be kept by the patient's bedside for immediate appli- cation whenever their soothing, healing properties are indicated. TUCKS allay the itch and pain of post-operative lesions, post-partum hemorrhoids, episiotomies, and many dermatological conditions. TUCKS save time. Promote healing. Offer soothing, cooling relief in both pre-and post-operative conditions. TUCKS are soft flannel pads soaked in witch hazel (50%) and glycerine (10%). TUCKS - the valuable nur- sing aid, the valuable patient comforter. , Specify the FULLER SHIELD@ as a protective postsurgical dressing. Holds anal, perianal or pilonidal dressings comfortably in place with- out tape, prevents soiling of linen or cloth- ing. Ideal for hospital or ambulatory patients. 'VI WINLEY-MORRIS L,/rJI{\IU(t\ t> S . n,\\""ot\\\ \0.e\,,,,\ 3 \é "Ose '-1\1 ' ;\\\ 3 s\\\ 0"'0. oa O b,,09 ,be " ",,,b pa'" o \ baIt. . OÓ "ea,,,,eo\ ,,,,5 \0 aO ab'. f'I\O'O'" , óe,eo\\OO' a .se 0 1 ,o"'o \",e O \ "",b \Oa' ,.,.",,0' 000 óose "e a , oe O " osoa' oo ",0' \b a \ ,;,09\0' e ,a\e 0 1 96 e ,op-,^O\l'!<) b eeo sb o "e,a ll 0 0 ' ",oa,e,' \\ bas aob,e"" aO o. f'I'O'o'" a ó"""OO{\ . '\ oee\<..j....... 9 ... sa{\òe tS , ." as. . 9 '\ 915 .... v.a,efe(\C t.r.eÒ.ß..';)A '1\'\';) ,\9 60 . þ,(t\. j .1 tO t>.. t>/Ie ò ' 156 '. . \.. h t!I- C\I{\' j. au. request. . rT'IatiOn on Fullinfor c; \J ,c;..\.5 ",,.P-"'''' Q\J"\.\ " :""......l f>. Co- & c...... .0.'.....--....- f O"c...-- . I. dates March 13-14, 1970 The British Columbia Operating Room Nurses' Group Biennial Institute, Hotel Vancouver, Vancouver. Information is available from Mrs. E. McLean, 135 Isle- view Place, Lion's Bay, West Vancouver, B.C. The University of British Columbia School of Nursing is sponsoring a number of non-credit courses: March 19-20 1970 - maternal health nursing; Aprií 2-3, 1970 - psychiatric nursing "be_ havior therapy"; April 22-24, 1970 - implementation of change in nursing services, for nurses with adminis- trative responsibilities in nursing services. Registrations from other health profes- sions are welcomed; May 7-8, 1970 - nursing care of adult with acute illness, for nurses providing care for surgi- cal patients. Information about these courses is available from: Division of Continuing Education in the Health Sciences UBC Task Force Building, Vancouver S, B.C: April 1-2, 1970 Conference on the team approach to the emergency department, sponsored by the Registered Nurses' Association of Ontar- io, the Ontario Medical Association, and Ontario Hospital Association, Geneva Park, Lake Couchiching, Ontario. Confer- ence fee: $55. Write to: Professional Development Department, RNAO, 33 Price Street, Toronto 289, Ontario. April 17-18, 1970 First assembly of the Canadian Rehabili- tation Council for the Disabled, Winni- peg. Write to CRCD, Suite 303, 165 Bloor St. E., Toronto 285, Onto April 30-May 2, 1970 Registered Nurses' Association of Onta- rio, Annual Meeting, Royal York Hotel, Toronto. Write to the RNAO, 33 Price Street, Toronto 289, Ontario. May 4-7, 1970 First National Operating Room Nurses' Convention, Queen Elizabeth Hotel, Montreal. For further information write to: Mrs. I. Adams, 165 Riverview Drive, Arnprior, Ontario. May 4-28, 1970 Developing Leadership in Supervision of Nursing Services, a continuing education course designed for nursing staff of hospi- tals and community health agencies who 28 THE CANADIAN NURSE take responsibility for the work of others. For information write to: Continuing Education Program for Nurses, Division of Ex ension, University of Toronto, 84 Queen s Park, Toronto 5. May 11-June 5, 1970 Rehabilitation Nursing Workshop, an intensive four-week course offered annually to registered nurses working in acute general and chronic illness hospi- tals, nursing homes, public health agencies, and schools of nursing. For information write to: Continuing Educa- tion Program for Nurses, Division of Extension, University of Toronto, 84 Queen's Park, Toronto 5, Onto May 12-15, 1970 Alberta Association of Registered Nur- ses Convention, Calgary Inn, Calgary, For further information write to: AARN 10256 - 112 Street, Edmonton, Alberta. May 18-22, 1970 Workshop on tests and measurements for teachers in schools of nursing, sponsored by the Registered Nurses' Association of Nova Scotia. Jean Church, assistant direc- tor, Dalhousie University School of Nurs- ing, will be leader of the workshop. For further details write to the RNANS 6035 Coburg Rd., Halifax, N.S. ' May 19-22, 1970 Canadian Public Health Association annual meeting, Marlborough Hotel, Win- nipeg. For further information write to the CPHA, 1255 Y onge Street, Toronto 7, Ontario. May 25-June 12, 1970 Annual training workshop for rehabilita- tion workers, sponsored by The Canadian Rehabilitation Council for the Disabled in cooperation with The University of Mani- toba Extension Division. Emphasis in this course is on the interdisciplinary nature of rehabilitation. Brochures and applica- tion forms are available from the Ex- tension Division, The University of Manitoba, Winnipeg 19, Manitoba. M y 26-28, 1970 Annual meeting of the Registered Nurses' Association of Nova Scotia, Acadia Uni- versity, Wolfville, N.S. For more informa- tion, write to: RNANS, 6035 Coburg Rd., Halifax, N.S. May 27-29, 1970 Jeffery Hale's Hospital nurses' reunion, Quebec City. Nurses are requested to send their addresses, and write for more information to: Mrs. D. Firth, 1304 Allard Ave., Ste Foy 10, Quebec. May 27-29, 1970 Registered Nurses' Association of British Columbia Annual Meeting, Bayshore Inn, Vancouver. Write to the RNABC, 2130 West 12th Ave., Vancouver 9, B.C. May 31-lune 12, 1970 Ninth annual residential summer course on Alcohol and Problems of Addiction Brock University, St. Catharines, Ontario: Co-sponsored by Brock University and the Addiction Research Foundation of Ontario. Enrollment is limited to 80. Basic information and findings of current research relating to the misuse of alcohol and other drugs will be presented. Provi- sion will be made for discussion of prevention and treatment aspects of addiction problems. Address enquiries to: Summer Course Director, Education Division, Addiction Research Founda- tion, 344 Bloor Street West, Toronto 181, Ontario. 'une 1-3, 1970 70th annual meeting of the Canadian Tuberculosis and Respiratory Disease Association and the 12th annual meeting of The Canadian Thoracic Society, will be held at the Fort Garry Hotel, Winnipeg. Further details are available from Dr. C. W.L. Jeanes: Executive Secretary, CTRDA, 3430 Connor Street, Ottawa 4, Ontario. June 1-3, 1970 Annual meeting of the Canadian Confer- ence of University Schools of Nursing with the Learned Society at the Universi- ty of Manitoba, Winnipeg. For further information, write to Margaret G. McPhed- ran, President, CCUSN, The University of New Brunswick, Faculty of Nursing, Fredericton, N.B. 'une 15-19, 1970 Canadian Nurses' Association General Meeting, The Playhouse, Fredericton, New Brunswick. June 22-July 3, 1970 Two-week conference for hospital person- nel, Memorial University of Newfound- land, St. John's. Theme: Administration. Further information is available from the Association of Registered Nurses' of New- foundland, 67 LeMarchant Rd., St. John's, Nfld. 0 MARCH 1970 r.:---, " " I ., l' I' .. .r , ,;0 I , -- VI' --- I ----- ......."\! ;,., J .IJ . . - .'.,4 f " .' .... J' --. .... Use Abbott's Butterfly Infusion Set in an adult arm? Certainly. The fact is. today more Abbott "Butterfly Infusion Sets" are used In adult arms and hands. etc.. than in infant scalps. Good reason. Abbott's Butterfly Infusion Set simplifies venipuncture in difficult patients. It has proved fine m squirming infants. But it has proved equally helpful in restless adults. and in oldsters with fragile. rolling veins. And. once in place. the small needle. ultraflexible tubing. and stabilizing wings tend to prevent needle movement. and to avoid vascular damage. Folding Butterfly Wings The Butterfly wings are flexible. Like a butterfly. They fold upward for easy grasp- ing. They let you manoeuver the needle with great accuracy. even when the needle shaft is held flat against the skin. Then. once the needle is inserted. the wings spread flat. They conform to the skin. They provide a stable anchorage for taping. The needle can be immobilized so securely and so flat to the skin that there is little hazard of a fretful patient dis- lodging or moving it. .. a BUTTERFLY -23 __5(1 F.....c-.-...-..1It Infusion Set Abbott's Butterfly MARCH 1970 23& c- __ __ - :...=-......-- ..---..--- =-.'="' .::::- - -- - Five Peel- Pack Sets To accommodate patients of vanous ages. Abbott supplies Butterfly Infusion Sets in 5 sizes. Four provide thinwall (extra- capacity) needles. The Butterfly-25. -23. -21 and -19 come with a small-lumen vinyl tubing. The 16-gauge size. however. provides tubing of proportionately en- larged capacity. and thus is particularly suited to mass blood or solution infusions in surgery. The sets are supplied in stenle "peel- pack" envelopes. Just peel the envelope apart. Drop the set onto a stenle tray- it's ready for use in any stenle area. Your AbbottManwlllgladlygiveyou eJ material for evaluation. Or write to Abbott Laboratories. A..OTT Box 61 50. Montreal. Quebec. 435Y THE CANADIAN NURSE 29 I I, new products { Descriptions are based on information supplied by the manufacturer. No endorsement is intended. Stelabid Forte Stelabid Forte, an addition to the Stela bid line, is now available from Smith Kline & French Canada Ltd. Stelabid Forte contains 50 percent more of the anticholinergic Darbid than its companion products (Stela bid No. I, Stelabid No.2, and Stelabid Elixir). It is indicated for use in patients who require additional therapy to control hypersecretion or spasm. Stelabid Forte also contains 2 mg. of Stelazine in combination with its 7.5 mg. of Darbid. Since both components of Stelabid Forte are long-acting, the product can be administered b.i.d. for convenience and economy. Like the other Stelabid pro- ducts, it is indicated in a wide variety of gastrointestinal disorders. Stelabid Forte is available on prescrip- tion only, in bottles of 100 maize- colored, monogrammed tablets. . \ \ t ..,. Enema Kit The unique foil closure on this dispos- able enema bag can be shaped into a rigid funnel for fIlling, then folded over to form a secure closure. The one-piece bag is dielectrically sealed for strength and eliminates the nuisance of assembly or leakage. The positive action shut-off clamp can be operated with one hand. The kit is compactly boxed and com- plete with all items needed for procedure: 1,500 ml; 60 inches of 24 Fr. tubing with clamp; castile soap packet; lubricant; and waterproof underpad. This MacBick product is available from the Stevens Companies in Toronto, Calga- ry, Winnipeg, and Vancouver, and from Compagnie Medicate & Scientifique Ltée. and Quebec Surgical Company in Montreal. 30 THE CANADIAN NURSE Leather Cuff This new padded leather cuff, intro- duced by the Posey Company, is for the most active patients. The Kodel polyester padding is held in place by Velcro and can be removed for easy laundering. This cuff can be worn without padding if desired. Each cuff comes with a 36-inch strap with a new friction type keylock buckle that allows desired arm movement. The leather cuff, lined, is Cat. No. 5163-2205, and the unlined leather cuff is Cat. No. 5163-2204. For further information, write to Enns & Gilmore Ltd., 1033 Rangeview Road, Port Credit, Ontario. '" ", \ {, ,,- j ..... I p Ear Drops Burroughs Well come & Co. (Canada) Ltd. has announced a new product. Lidosporin ear drops 7.5 cc. come in a new plastic dropper packing and are being promoted for over-the-counter sales. In- dication: earache. For more information, write to: Burroughs Wellcome & Co. (Canada) Ltd., P.O. Box 500, Lachine, Quebec. Literature Available Extracorporeal Medical Specialties, Inc., has published a four-page illustrated brochure describing the use of SAF-T- Shunt Series S-300 silicone cannulas and Series T-400 Teflon tips for customizing arteriovenous shunts at the operating table. The cannulas and tips find wide application in terminal renal disease, where patients must be connected to external dialyzers for chronic hemo- dialysis. Brochures are available free of charge from: Extracorporeal Medical Specialties, Inc., Church Road, Mount Laurel Town- ship, New Jersey 08057, U.S.A. .... ,r .... ...... -... . \. \i;, , "'t ' '- j . .. '" Ultrasound Diagnostic Instrument A new ultrasound diagnostic instru- ment called the Vidoson, developed in Germany, is proving popular among gyne- cologists and doctors of internal medi- cine, according to a report from German Features. The instrument sends out low frequen- cies that reflect off organs, tissue, and bone with varied impulses, depending on the intensity and composition of the reflector. Tumors reflect a different im- pulse than adjacent healthy tissue. The impulses are recorded on a screen and can be evaluated there by diagnosticians. Menotrol Tablets E.R. Squibb & Sons Ltd. has introduc- ed Menotrol for control of the meno- pausal syndrome. Menotrol tablets are available as small, sugar-coated tablets in potencies of 0.3 mg, 0.625 mg, 1.25 mg, and 2.5 mg. The potency is expressed in terms of sodium estrone sulfate content. Advantages of Menotrol are: standar. dized potency for uniform activity; tablets that are easy to take; attractive, compact 21-day regimen package; and flexibility of dosage. Further information can be obtained from E.R. Squibb & Sons Ltd., 2365 Côte de Liesse Road, Ville St. Laurent. Montreal 9. P.Q. 0 MARCH 1970 or you a your patIent Now in 3 disposable forms: . Adult (green protective cap) . Pediatric (blue protective cap) . Mineral Oil (orange protective cap) Fleet - the 40-second Enema* - is pre-lubricated, pre-mixed, pre-measured, individually-packed, ready-to-use, and disposable. Ordeal by enema-can is over! Quick. clean, modern. FLEET ENEMA will save you an average of 27 minutes per patient - and a world of trouble. DIm IENEMA" WARNING: Not to be used when nausea. vomiting or abdominal pain is present. Frequent or prolonged use may result in dependence. CAUTION: DO NOT ADMINISTER TO CHilDREN UNDER TWO YEARS OF AGE EXCEPT ON THE ADVICE DF A PHYSICIAN. In dehydrated or debilitated patienls. the volume must be carefully determined since the solution is hypertonic and may lead to further dehydration. Care should also be taken to ensure that the conlents of the bowel are expelled after admimstration. Repeated administration at short intervals should be avoided. rmD -E EM ...;:;;T.", DIm N-ÊM l MINERAL OK. l..",- '==..t. "JwooI Full information on raquest. .Kehlmann, W. H.: Mod. Hosp. 84:104.1955 FLEET ENEMA@ - single-dose disposable unit MARCH 1970 A QUALITY ........I111......CIr.YTIC...L. ""'.. C .... ÚI. I'OUNDEDIIIC_ADA"".... I I, THE CANADIAN NURSE 31 ELI LILLY AND COMPANY (CANADA) LIMITED, TORONTO. ONTARIO , For four generations -we've_ been making medicines as if people's lives depended on them. * ....... *IDENTI.CODE™ (formula identification code, Lilly) provides QUick, positive product identification. '<-... ' I I in a capsule Quote of the month Our monthly award of a wreath of poison ivy goes to a senior medical student at the University of Western Ontario. When asked by a reporter from The Medical Post if he thought the doctor has to be master and the other members of the health team the sevants, he came up with this erudite answer: "I do not think the master-servant relationship exists in most of the support- ive staff, the psychologists and sociolo- gists with which we work. These people are really the doers and we are the onlookers. But when you get into the field of internal medicine you run into staff conflicts with nurses and they are sometimes hard to overcome unless you are the boss. " (Italic ours.) This boy will go far. We hope. Cure for wandering nurse How do you keep enough nurses work- ing in intensive care units? The problem of a nursing shortage in ICUs was discussed in a news item that appeared in the October 4 edition of the Kitchener Waterloo Record. According to Dr. Frank Walker, coor- dinator of the intensive care unit at St. Joseph's Hospital in London, Ontario, the biggest single stabilizing factor in the supply of ICU nurses is marriage. "Marri- ed nurses seem to stay with us longer than single types." he said. Many nurses might prefer the lCU prescription of Dr. Gordon Sellery, coor- dinator of the ICU at London's Victoria Hospital: "If there's any way to keep them, it's to keep them happy. This means that their environment should be pleasant and stimulating." Last, but not least, Dr. Sellery thinks that a younger doctor should be in charge of the unit. Convention key It's not too soon to be planning your strategy for CNA's biennial meeting in Fredericton in June. Planning how you can get the most out of attending a convention is an important step toward effective participation. Here are some helpful suggestions from the September-October issue of HospitAlta, published by the Alberta Hospital Association. . Evaluate the program: Study all sessions, speakers. social functions, etc., well in advance. to get them fixed in your mind. Underscore those that interest you the most. Then some last-minute distrac- MARCH 1970 tion is less likely to divert you. . Summarize your needs: One of the main reasons for holding a convention is to bring members together so that they can exchange ideas and solve each other's problems. Jot down your concerns and dilemmas and bring your notes to the meeting. Use it as your shopping list for first-hand advice and suggestions. . Command attention: Speak up at the convention. Don't wait to be called upon. Take advantage of discussion periods and answer as many questions as you can. There is a way to do this without dominating. First. hold back to see if others have an answer; second, accumul- ate three or four unanswered points and tie them together when you speak. . Keep on the go: Circulate - don't hide. Breakfasts, luncheons, and impromptu "bull sessions" sometimes yield better returns than formal sessions. You can absorb a good deal by mingling with people and talking shop. Eat with someone different at every meal. "Float" at parties and receptions. The person you have not spoken to yet may help you most. . Get directions: If you don't know who can help you with a problem. speak to an officer or staff member. They will steer you to the experts. LoBSTER LOJE.RS! COME ,AND SA\JOR ìl-\E. DELICIOU WaLaAE AWA\TING YOU AT FREDERI Wf;2ING- CNA BIENNIAL Ga\J\lEtJDOt-J ItJJU THE CANADIAN NURSE 33 I, t' '" " , , ... "- " ,,:... "- ,", .. . .. , \" . "-. '"' · 1 v f "" I/IÞ Does Jane Cowell know the facts about dandruff? Probably not! The facts are dandruff is a medical prob- lem and requires medical treatment. Ordinary shampoos cannot control dandruff. New formula Selsun can! The doctors you know are undoubtedly familiar with Selsun. And they prescribe it because it's medically recommended. And proven effective in 9 out of 10 severe dan- druff cases. Our new formula Selsun is as effective as the old. We use the same efficient anti- seborrheic - selenium sulfide. We've simply improved the carrier. A more active deter- a selsun gent produces foamier lather - a finer suspension gives smoother consistency. To top off new formula Selsun we added a fresh clean fragrance and put it in an at- tractive unbreakable white plastic bottle. If you know someone with a dandruff prob- lem tell them to ask their doctor about Selsun. And if dandruff worries you - ask your own doctor. selsun* eJ (Selenium Sulfide Detergent Suspension U.S.P.) A PRODUCT OF ABBOTT LABORATORIES, LIMITED -AD. T M. 457Z_g SPECIAL REPORT Ad Hoc Committee of the Canadian Nurses' Association on Functions, Relationships, and Fee Structure Completed December 1969 CHAPTER 1 The Committee and its Assignment At the 34th General Meeting of the Canadian Nurses' Association held in Saskatoon, Saskatchewan, July 1968, the following resolutions were passed: I. "That an ad hoc committee be appointed by the board of directors of the Canadian Nurses' Association with the addition of consultants as required and that this committee be empowered to study: a) The national and provincial associations' functions and relationships; b) The question of membership and fee structure and that the report of this study, with recommendations, be available to the provincial associations six months prior to the 1970 General Meeting." 2 "Whereas ditlìculties have been encountered with respect to the amendments to the Act of Incorporation and this has resulted in uncertainty with respect to the bylaws of the Canadian Nurses' Association; Now be it resolved that the board of directors of the Canadian Nurses' Association immediately establish an ad hoc committee on legislation to study over the coming months the incorporation documents and bylaws of CNA to determine what, if any, amendments appear to be required, and that this committee report on these matters to the next general meeting of the association and that the Canadian Nurses' Association operate under its present bylaws until this report is accepted." These resolutions formed the terms of reference for the ad hoc committee on functions, relationships, and fee structure appointed by the board of directors in meeting on July 12, 1968. The members of the committee are as follows: Miss K. Marion Smith, representing British Columbia; Miss Madge McKillop, representing the Prairie Provinces; Miss E. Marie Sewell, Ontario; MUe Madeleine Jalbert, Quebec; Mrs. Marilyn Brewer, New Brunswick; Miss Dorothy Wiswall, Nova Scotia; Miss Elizabeth Summers, later replaced by Miss Janet Story, MARCH 1970 representing Newfoundland; Reverend Sister Mary Irene, Prince Edward Island; Reverend Sister Mary Felicitas, president, CNA. ex-officio; Mrs. Jeanie S. Tronningsdal, chairman. In setting up the committee, the board of directors received the recommendation of each of the provincial associations regarding its representation. The three Prairie Provinces, because of distances, agreed to have one representative. CHAPTER 2 An Outline of Committee Activities The chairman of the committee met with the president in Ottawa October 10, 1968, to obtain background infonnation regarding the committee's assignment. The committee held three meetings at CNA House. At the first meeting, January 9 and 10, 1969, it was agreed that a member of the committee would serve as secretary, on a rotating basis. Accordingly, Madge McKillop, E. Marie Sewell, and K. Marion Smith have served in this capacity. At this meeting the committee identified the functions and activities of the CNA and related these to its objectives as stated in the Act of Incorporation. It was decided that these functions and activities should serve as the basis of a questionnaire along with items on national-provincial relationships and fee structure. The questionnaires were distributed to provincial associations and to the board of directors and the professional staff of the CNA. with the request that they be completed and returned by March 3 I, 1969. At the second meeting, held May 8 and 9. 1969, the completed questionnaires were reviewed in detail. A summary of the replies is included in Chapter 4. The committee scheduled interviews during this meeting with CNA editors, consultants, general manager, associate executive director. and executive director. This gave the committee the opportunity to clarify items in the questionnaire. and allowed the staff to express personal views. THE CANADIAN NURSE 35 I, At this meeting the president informed the committee that the board of directors, at its meeting February 11-14, had met with the legal counsel of the CNA and his associate to consider the changes in the bylaws and any new bylaws that are necessary in order that the CNA bylaws conform with Part II of the Canada Corporations Act. Since it appeared that the board of directors was considering the necessary changes to bring the CNA under the Canada Corporations Act, Part II, this committee agreed that at this time it was not feasible to take action regarding bylaws. A draft report was prepared by the chairman, using material from the minutes, completed questionnaires, and comments from committee members. At the third meeting, held September 25, 26, and 27, 1969, the draft report that had been circulated to the committee members was reviewed in detail and revised to formulate a report for presentation to the board of directors at its meeting in November, 1969. In the light of discussion at the meeting of the board of directors, three members of the committee revised sections of the report immediately following this meeting. The report was again circulated to the committee members for approval prior to its final release. CHAPTER 3 Pertinent Information Regarding CNA The Canadian Nurses' Association, founded in 1908, was incorporated in 1947 and the Act of Incorporation was revised in 1954. In keeping with a federal government trend that it is preferable for professional associations to operate under the Canada Corporations Act Part 11, rather than private bills, the CN A currently is considering steps to accomplish this. The objects of the association are stated in the present Act of Incorporation as follows: I. to dignify the profession of nursing by maintaining and improving the ethical and professional standards of nursing education and service; 2. to encourage its members to participate in affairs promoting the public welfare; 3. to promote the best interests of the nurses of Canada and to maintain national unity among them; 4. to encourage an attitude of mutual understanding with the nurses of other countries; and 5. such other lawful acts and things as are incidental or conducive to the attainment of the above subjects. In the present Act of Incorporation, the membership of the association is divided into the following classes: I. honorary member; 2. association members; 3. ordinary members; and 4. any other class or classes of members which the association may establish by bylaw from time to time. The affairs of the association are managed by a board of directors. The board is composed of the elected officers, the appointed chairmen of the three standing committees, the president of each of the 10 provincial associations, and elected representatives from the nursing sisterhoods. The board reports at each general meeting upon the business transacted since the last general meeting and is expected to make decisions and take all such appropriate action as is necessary to further the objects of the association. It carries out the legislative functions of the association. The number of voting delegates for general meetings is determined by the number of members in each provincial association. The executive committee of the board of directors has the power to administer the affairs of the association between meetings of the board of directors. It is composed of the 36 THE CANADIAN NURSE elected officers and the appointed chairmen of the three standing committees. It carries out the cabinet functions of the association. The board of directors has the responsibility and authority to appoint the executive director and to delegate the implemen- tation of association policies to this position. The executive director is the senior administrative officer of the association and acts as secretary to the board of directors and to the executive committee. All members of staff of the CNA are ultimately responsible to the executive director and through her to the board of directors. The income of the CNA is provided through an annual membership fee paid on behalf of each ordinary member. The amount of the fee is fixed by resolution of the general meeting of the association, is collected by the provincial association to which each member belongs, and is remitted to the CNA semi-annually. A number of the functions and activities of the CNA are mandatory to meet the requirements of the Act of Incorpora- tion. The programs that are carried out by the association are established in accordance with the wishes of the membership and in light of the available financial support. Relationships with other organizations are determined in accordance with criteria established by the board of directors. Every relationship reflects one or more of the objects of the association. At present, the CNA has relationships with 22 national and international organizations. CHAPTER 4 Responses to the Questionnaire The completed questionnaires from the executive committee of the CNA, on behalf of the board of directors, from the 10 provincial associations and from the staff of the CNA proved extremely helpful to the committee in its deliberations. Information that emerged from the questionnaires and from interviews with the staff is dealt with here under the main groupings as identified in the questionnaire. Part I - Objectives, Functions, And Activities The functions identified by the committee consist of the secretariat services, the representative services, and the reo search and advisory services. These functions and resulting activities are based on the needs of the membership who develop objectives, formulate policies, and provide the finances for the services. Administrative, public relations, and communication roles are woven through all activities and form an integral part of each function. It is recognized that some of the functions and activities of the CN A are mandatory and others are voluntary. The responses to the questionnaire indicated that the functions identified by the committee were acceptable. The comments helped the committee to identify the following common factors. I. There is a strong support in all the provinces for the CNA, although there is some difference of opinion on its functions. 2. The administrative structure of the CNA is questioned It is recognized that there are certain basic business functions required, regardless of the programs under. taken. There appears to be a lack of understanding, however, of the administrative function and concern that this function is given more emphasis than the professional functions. 3. There is a need for more complete services in all aspects MARCH 1970 of the association's activities for the French-speaking members of the CNA. 4. There is support for The Canadian Nurse and L'infinni- ère canadielllle journals. with suggestions that more emphasis be placed on reporting research. 5. It is suggested that special services, such as the Canadian Nurses' Foundation and the National Testing Services, should be set up to be self-supporting. 6. The membership expects the CNA to act as its official spokesman to government, to allied organizations, to the public, and to its own members and suggests that this function should increase. 7. It is suggested that the role of the consultant requires examination. When this service is requested, the res- ponses are emphatic that a charge should be made. I t is recognized that this might work a hardship on some provinces. 8. It is recognized that the library provides a valuable national service which is not available from other sources. It is suggested that the library could be called upon to provide advisory services in the audiovisual field in view of the rapid changes and developments that are taking place. 9. The consensus is that the CNA should not be engaged in the running of workshops and conferences. Part II - National-Provincial Relationships It was stated in the questionnaire that functions and activities of the national and provincial associations may complement, overlap, or be in conflict. There are some areas of difficulty in the relationships between the CNA and the provincial associations. The following common factors were elicited from the responses. I. There would appear to be a lack of understanding of the unique role of each association. 2. There would appear to be duplication of services in some of the consultant and educational activities. 3. The rnterpretation of activities to members has present- ed problems, but indication was given that communica- tions are improving. 4. The role of the standing committee member is not understood. She is appointed to represent her provincial association in a particular field, but at national commit- tee meetings she is not considered as a representative from her association but rather a "national" nurse. It is suggested that the number of national committee meet- ings should be reviewed and the possibility of including provincial counterparts at these meetings should be considered. Part III - Fee Structure The types of fee structures used in financing organizations, i.e., a fixed per capita fee and a variable fee, were explained in the questionnaire. Each association was asked to react to the possible adoption of a sliding scale for the payment of fees to the CNA. The majority of replies favored the retention of a fixed per capita fee structure. Six were not in favor of adopting a sliding scale, three would accept it with reservations in time of crisis, two were in favor, and one association withheld comment until receiving more information. It was pointed out that any kind of a sliding scale would be more expensive to administer. Any fee scale would need to be designed to produce the funds required to cover the cost of approved programs. MARCH 1970 CHAPTER 5 Recommendations .md Summary Recommendatiolls In the light of replies to questionnaires, discussions with staff, and committee deliberations, the following recommendations are presented for consideration. Objects The functions and activities of the CNA are carried out to fulfill its objectives. Recommendation 1 It is recommended that the objects of the association be restated as follows: 1.1 To promote high standards of nursing practice in order to provide quality nursing care for the people of Canada. 1.2 To promote educational programs required to achieve high standards of practice. 1.3 To encourage an attitude of mutual understanding and to promote unity among nurses. 1.4 To speak for Canadian nursing and to represent Canadian nursing to other organizations on national and international levels. 1.5 To foster and participate in affairs contributing to community services. 1.6 To promote the social and economic welfare of the nurse in the practice of her profession. Membership The CNA is a federation of provincial nurses' associations. The nurses of Canada participate in the national association only by virtue of membership in a provincial association. Recommendation 2 It is recommended that the membership of the CNA consist of the nurses' associations of the provinces as listed in the Act of Incorporation, or territory or any division of any territory in Canada or the respective successors and assigns of such associations, and such other classes of members as the association may establish by bylaw from time to time. Fee Structure Careful consideration was given to the types of fee structures commonly used for financing organizations. A sliding scale was considered, but presented several adverse implications. Recommendation 3 It is recommended that the Association be frnanced on a per capita fee basis with the amount to be determined according to the bylaws. Role of the National Association There appears to be a necessity to clarify the role of the national association in relation to the provincial associations. Recommendation 4 It is recommended that the role of the CNA be: 4.1 To lead. to coordinate, and to advise. 4.2 To be the voice for nursing on national and inter- national levels. 4.3 To act as a catalyst for change by identifying trends and helping to implement new programs in the health. social, and welfare fields. 4.4 To develop statements of policy on matters of national jurisdiction or of national interest and to prepare position papers on other matters. THE CANADIAN NURSE 37 4.5 To initiate workshops and conferences in relation to the biennial meetings or in areas of particular national in terest. 4.6 To explore with the provincial associations methods to improve the exchange of infonnation. 4.7 To provide assistance and advice to provincial associa- tions on request. Role of the Provincial Association Certain functions are the prerogative of the provincial associa- tions. Recommendation 5 It is recommended that the role of the provincial associa- tions be: 5.1 To fulfill the legal requirements relating to member- ship in the association. 5.2 To recommend standards for schools of nursing. 5.3 To implement programs for the continuing education of its members. 5.4 To fonnulate policies for the social and economic welfare of its members. 5.5 Where applicable, to act as the bargaining agent for the membership. 5.6 To be the voice for nursing in provincial matters. 5.7 To explore with the national association methods to improve the exchange of infonnation. Board of Directors The board of directors is a policy-making body acting as the representative of the total membership of the national association. It is responsible for setting priorities and establish- ing programs to meet the objectives of the association. At present, the board is made up of the elected officers, the appointed chairmen, the elected representatives from the nursing sisterhoods, and the presidents of the provincial associations. The executive director acts as secretary at aU meetings. It would seem that national needs could be met more satisfactorily if a different method were used in providing for membership on the board, and if all members served for a two-year term. Recommendation 6 It is recommended that the following changes be instituted in determining the membership of the board of directors: 6. I The chairmen of the standing committees be elected rather than appointed. 6.2 There be no specific representatives elected from the nursing sisterhoods. 6.3 A member, not necessarily the president, be elected by and from each provincial association. National Committees The importance of the three national standing committees is recognized. Since the chairman of the provincial committee is also the provincial representative on the national committee, with consequent dual responsibility, her two roles may be frequently in conflict. Therefore, the national needs might be more satisfactorily met by a representative from the province other than the chairman. Recommendation 7 It is recommended that the provincial representative on the national standing committees be selected by and from each provincial association for a two-year term. Research and Advisory Services The board of directors approves projects and ascertains the 38 THE CANADIAN NURSE direction the CN A is to take in the future, in the light of the financial capabilities of the association. Activities related to professional advancement objectives need to be examined on two planes: i. a general examination, such as gathering statistics, acquiring library holdings, conducting library research, and attending meetings; ii. specific examination in each of the three fields of nursing education, nursing service, and social and economic welfare. The program emphasis at anyone time will depend upon current needs. Thus, the role of the nursing consultants will change also in relation to the implementation of new programs. Recommendation 8 It is recommended that there be well-qualified nursing personnel in the research and advisory services to undertake approved programs. French Services There is need for the services provided by the CNA to be available in the two official languages. Recommendation 9 It is recommended that the CNA appoint a senior member of staff, whose mother tongue is French, to provide French-speaking members with services comparable to those presently available to English-speaking members. Special Services The committee received comments about the Canadian Nurses'. Foundation and the National Testing Service. The majority supported both these activities, providing they did not necessitate a financial outlay by the CNA. Recommendation 10 It is recommended that as soon as feasible the Canadian Nurses' Foundation and the National Testing Service be self-supporting financially. Administrative Review It has been a number of years since a comprehensive review of the administrative structure of the CNA was undertaken. It is realized that ongoing review of the organization and functions of the association is part of the role of both the board of directors and the staff of the association. Recommendation 11 It is recommended that the board of directors, in consulta- tion with the staff, undertake a review of the administrative structure. Summary The ad hoc committee recognizes that the acceptance of its recommendations would necessitate changes in the bylaws of the CNA. The committee has tried to fonnulate recommendations to provide for a viable association in a changing society. It is recognized that any such guidelines must be sufficiently flexible to permit easy adaptation to new situations. It is also recognized that because of the difficulty of carrying out an in-depth review of the work of the association by those most intimately involved in its activities, it may be well to consider periodic establishment of an ad hoc committee to carry out an assignment similar to this committee's. This type of review should help to set the direction for the association and to make planned adjustments as required. 0 MARCH 1970 I I I I From Canada to Biafra I I ... - . . .' of . ... ... ... - \ = ... The lIurse is Calladian, but the settillg is Africall. Dialllle North is showlI here all the groullds of the Queell Eli-:::abeth Hos- pital in Umuahia. Eastern Nigeria. She was the OIl(V Canadian nurse working in this region throughout its Jl-momh fight for independence as Biafra. MARCH 1970 In October 1969, Dianne North, a Canadian RN on her way back to war-torn Biafra after a five-month absence, was interviewed at CNA House. Shortly after this article was prepared for publication, the war between Nigeria and Biafra ended, and Dianne was evacuated to Saô Tomé. Even so, the editorial staff believe this article will be of interest to nurses. The war is over, but the suffering continues. Carol Kotlarsky Dianne North is the only Canadian nurse working in Biafra, the Eastern region of Nigeria. * A graduate of the Toronto Western Hospital and Queen's University in King- ston, Ontario, Dianne began working at the Queen Elizabeth Hospital in Umua- hia, Eastern Nigeria, as a nurse with Canadian University Service Overseas. She enjoyed her work at this hospital so much that in 1966, when her contract with CUSO was completed, she signed a two- year contract with the hospital. When Dianne first arrived at the Queen Elizabeth Hospital, she found a modern, well-equipped complex that could accom- modate some 180 patients, had 150 student nurses from Eastern Nigeria, and a busy outpatient department. There were two medical and two surgical wards, one pediatric ward, two large buildings for maternity, and two operating rooms. The hospital was run by Anglican, Presby- terian, and Methodist churches from Scotland, Ireland, and Canada and was subsidized by the Nigerian government. A sister tutor from England was in *At the end of May 1967, the Eastern region of Nigeria declared itself an independent state - Biafra. Federal Nigerian forces moved quickly to end the secession, and the fighting ceased January 1970. Miss Kotlarsky, a graduate of Carleton Univer- sity's School of Journalism, is presently Editori- al Assistant, The Canadilln Nurse. charge of the school of nursing, which was based on the British system. After four years, students became Nigerian registered nurses (NRN). Dianne explain- ed to us that the NRN is not equivalent to the state registered nurse in Britain or to the registered nurse in Canada. Instruction begins on wards Dianne, who had been a clinical in- structor on the surgical ward at the University of Alberta before she left Canada, was the only clinical teacher at Nigeria's Queen Elizabeth Hospital. Soon after she began teaching surgery in the classroom, she decided to introduce clinical instruction on the wards. The custom in African study, Dianne explain- ed, is for the students to read a book, memorize it, know the material perfectly, yet have no idea how to relate the theory to the practice of the subject. Clinical instruction was an ideal way to break this down, she added. It was exciting and challengmg, Dianne said, to do her surgical teaching in the classroom and then relate tills to patients with special ward assignments. For example, a student nurse would be assign- The Canadian UNICEF Committee is launching a national appeal for funds to support l'NI- CEF's specialized work \\ith mothers and child- ren in Nigeria. Donations would be gratefuUy accepted at l NICEF, 737 Church Street. Toronto 5, Ontario. THE CANADIAN NURSE 39 I I, -, > ' .!t. ,'\ "x..e \ ::... :}'i . .. .'.t · . 1.-. " T : "' .' , ------ .......... --"""""' -" .'1 i.t':.,... . i:...:'-!'. . f.\ - ;. --' r--... ...... ."",.,. - '"- , ........ .." A nurse tube-feeds a Biafran child in a refugee camp in the Eastenz Region of Nigeria. in class," Dianne said. She explained that it was better for the students to work in the hospital than to go to class and wait tensely for the inevitable air raid. About a year ago, March 1969, classes stopped completely. Before the war there were 150 nurses on staff at the Queen Elizabeth and six doctors, mainly European. The majority of Biafran doctors, Dianne said, preferred to go to larger cities such as Port Har- court, Enugu, or Lagos, the Nigerian capital. With more and more of the larger hospitals occupied during the war, the Queen Elizabeth became the biggest and busiest hospital in Biafra. Its staff increas- ed to 35 doctors - mostly Biafran - and over 250 nurses. Dianne spoke enthusiastically of the skill of the Biafran doctors. Many had come to the Queen Elizabeth from the best hospitals in West Africa and had received much of their training in Britain and America. So much accomplished The doctors organized themselves into two teams. Each night one team did all the admitting, whether there were four casualties or sixty. This team, Dianne recalled, would perform up to 10 laparot- omies, apply 15 to 20 plaster of paris casts, and suture countless numbers of wounds. The nurses, too, were well organized and continued to work eight-hour shifts. overlapping an hour at the most, six days a week. "But we were working at a much greater pace and with the stress we got more done," Dianne said. At the same time the nurses finished a day's work more exhausted mentally and physically because of the strain. Dianne vividly described the over- crowded conditions at the hospital: "On the busiest day I can remember, there were 135 men on a ward that normally held 35. They were on the beds, under the beds, and were forced out of the ward onto the verandas outside. When we came on duty in the morning we had to cope with these 135 patients, of whom more than 30 had undergone surgery during the night. "Miraculously enough," Dianne continued, "we would go on that ward the next morning and find that all the patients had been accommodated, had had their surgery, and had been bathed and cared for. She credited the student nurses with the extraordinary amount of work done. "First-year students did things that third-year students wouldn't MARCH 1970 have known how to do in normal times," she said. Hospital relocates In April 1969 the Queen Elizabeth Hospital had to be evacuated. The Nigerians entered two nearby towns and, as Dianne described it, "for the fust time we began to hear shooting and the sound of tanks." At that time the hospital had 900 patients. With the help of the Inter- national Red Cross and the World Council of Churches, hospital personnel transfer- red all the patients to other mission and military hospitals during a three- to four- day period. Queen Elizabeth staff later started up small clinic work in a bush medical station about 10 miles from Owerri, which was the acting capital of Biafra. Dying all around Dianne quickly learned that in war- time death was an everyday occurrence. For example, she described what she saw on her way to the market. "I would walk by adults and some- I -r-í'" times even children just lying in the ditches. I didn't know if they were dead or half dead and I didn't bother to stop. I could tell by their appearance that they were so far gone that even if I brought them into the hospital. no resuscitation would help. Also, we had no more room." She added that patients often died in wheelchairs waiting in the out- patient department. Protein deficiency was initially the worst problem created by the food short- age, but starvation itself has become worse, Dianne said. And it is now reach- ing the adults, not just the children. She pointed out that two million Biafrans are estimated to have died since the war began, about one and one-half million from starvation. "From what I saw in the hospital, in the town of Umuahia, and in the refugee camps I went to see," she added, "these catastrophic numbers have not been overestimated." Conditions at the Queen Elizabeth have deteriorated since last May, Dianne said. Until that time relief flights had operated effectively, bringing in dried milk. dried fish. powdered eggs, and drugs .- that were sufficient to keep all the hospital, sick bay, and refugee popula- tions healthy. However, since the Nigeri- ans destroyed an International Red Cross airplane bringing relief supplies into Biafra in June 1969. the Red Cross has stopped its relief flights into Biafran territory, which is only accessible by air. At least two hospitals have suffered from the bombing, Diane said. The Mary Slessor Hospital in Itu, 30 miles south of Umuahia, was almost completely destroy- ed by a systematic bombing raid that struck four times, and the Itigidi Hospital was completely flattened. I I Returning to Biafra When Dianne left Biafra last May, she was not sure if she would return. "There was no special job for me and there is no use going to that country unless there is something specific to do - it's a soul- destroying business," she explained. During the summer, however. Dianne was invited to work at a neurological clinic at Ekwereazu. She explained that she would still be an employee of the Queen Elizabeth Hospital, on loan to the I I -_e._. r - l 1 .. . --- --.. ----- - ..... -..... ) "-...- -- -- --.,.., ........-.- .. '. f\ I. There was not room for these wounded soldiers at the Quccn Eli:abeth Hospital in Umuahiu. Eastern Nigeria 900 patients in the IS5-bed hospital had to be e!'acuated because of nearb\' fighting. MARCH 1970 THE CANADIAN NURSE: 1 - \ In April 19(,1} the I ....... 42 THE CANADIAN NURSE "" .--" r " ... .. " ..' , clinic. Patients with gunshot wounds to the head and the spine are brought to this clinic from different parts of Biafra. The clinic also cares for patients with hemiple- gia, paraplegia, and speech defects, and has a separate building for many of the amputees. Dianne said there is an excel- lent physiotherapist in charge. There is a great need for morale-boost- ing at the clinic, Dianne told us. As well as helping the patients, she hopes to make things easier for the understaffed and war-weary clinic personnel. Postscript Dianne was able to spend a short time with her parents in Aurora. Ontario, before returning to Biafra at the end of October. In November she sent a letter to her friends in Canada telling of her return to Biafra and the conditions she found there. Here are some excerpts from her letter: "Essentially, things haven't changed since I left 5 months ago: food and drugs are still scarce, people continue to die (but at an increased rate) and the military situation has remained relatively stagnant so that hospitals are full of the chronical- ly ill or those needing rehabilitation. One cup of salt costs $21.00; a battery, $21.00; a pen, $3.00; an egg, 75 cents. etc. "Driving to Mbaiteli, Owerri, on Sun- day, I saw the matchstick legs and bony ribs of the children rather than the puffy faces and tummies characteristic of the protein deficiency disease, kwashiorkor, wruch was rampant here about a year ago. I don't know wruch is worse." 0 . "'" Progressive stages of kwashior"-or, ccJuseu by severe protein deficiency. The suffering of the children in the region "-flOwn as Biafra was the most tragic outcome oJ the Nigerian war. MARCH 1970 Adapting instruction to individual differences In September 1968 our biology team at St. Joseph's School of Nursing in Hamilton, Ontario, adopted a relatively new method of class division: we grouped students according to their ability, rather than by random. Called "ability group- ing" or "homogeneous grouping," this method places students in work groups that are alike, so that ranges in differences within a class are reduced to some extent. Nursing biology was considered the ideal course for such an approach as our students all had a varied background in science. As simple as the ability grouping approach appears, much confusion often exists because different educators use different bases for deciding how students are alike. Our reference source is James B. Conant, an educator in the United States.' ,2 Although Conant admits that ability grouping is highly controversial, he endorses ability grouping in one subject- matter area, but not across-the-board grouping in all subjects, as this tends to segregate students. This type of grouping is necessary only if the teacher is dealing with large numbers of students. If the class consists of no more than 32 students, such group- ing is unnecessary and impractical as the teacher can organize the work within the classroom to meet each student's needs and abilities. We found that grouping for instruction in nursing biology has sub- stantial value since groups proceed at different rates and cover different amounts of material, according to their past experience with biology. MARCH 1970 Grouping students by ability gives the teacher a better opportunity to meet their individual needs. Belly Mcinnes, B.Sc.N., M.Sc. (Ed.) Teacher responsibilitv Once we had chosen ability grouping as our method of approach, we then had to consider teacher selection. We looked for the following qualities: particular skills and preferences for working with pupils of one ability level; ability to make adjustments to suit the particular needs of the group; and wide experience in the classroom and clinical teaching areas, as appropriate correlation must be made between theory and practice. How the students' interest, talents, and past experiences are used by the teacher will vary with the particular problem presented by each group. Common teaching elements must be differentiated in tenns of particular students and particular situations or much of the instructional material is wasted. We have found no educational magic in grouping itself. Little is gained by grouping if each group is taught the usual material in the usual way. With a select group, the teacher takes full responsibili- ty for adapting content, method, and pace. She interprets the data comprising a particular course according to its meaning to the students. The teacher's recognition of differ- ences is seen in the way the group sessions are conducted, in the types of Miss Mcinnes, a graduate of St. Joseph's School of Nursing, Hamilton, The University of Toron- to. and Niagara University, New York, is Biology Team Leader at St. Joseph's School of Nursing in Hamilton. OnUrio. assignments given, in the materials select- ed for discussions, and in the degree to which the students participate in the course. Initial student grouping Heterogeneous grouping in past years led the biology teacher to direct her teaching to the "average" student, ignor- ing the other students. Most of these groups consisted of students of various levels of preparation in biology: high school students with a grade 12 diploma who had never studied biology; students from provinces other than Ontario who had studied different subjects; grade 13 students who had not selected biology as an elective; grade 13 students who chose biology as an elective, but obtained vary- ing degrees of success; mature students who mayor may not have studied biol- ogy at some point in their education, but who had been away from school for several years; and, finally, students with varying levels of interest in biology. This diversification was further magnified by the size of the group, which ranged from 110 to 135. All factors considered, we felt justified in im- plementing ability grouping as an approach to our problem. As the personal qualities of the new students were unknown at the time of the original grouping, our initial decision was based on the one common, familiar element - high school grades. Our reason for making this decision was based on an extensive analysis of the high school biology and science grades for the THE CANADIAN NURSE 43 students admitted to our school during the past three years. This analysis provid- ed the criteria for the four initial ability groupings in the biology course. Group One was composed of all stu- dents who had taken grade 13 biology as an elective and had received a final average of 50 to 59 percent. Group Two was composed of students who had studied biology in high school and had obtained an average of 60 to 70 percent. Group Three remained the most heteroge- neous in nature, consisting of six catego- ries of students: grade 12 students with no biology instruction; grade 13 students who had taken biology as an elective but had obtained a final average of less than 50 percent; students who had been away from school for a number of years and who mayor may not have studied biolo- gy; grade 13 students who did not choose biology as a high school elective; students from other provinces or countries who had not studied biology; and students from other provinces or countries who had studied biology, but the course content could not be evaluated in relation to the nursing biology course. Group Four was composed of grade 13 students who had obtained an average of 71 percent or more in lUgh school biology. Variables to consider when regrouping Since most educators suggest that re- location and shifting of students among groups throughout the school year is necessary to avoid segregation, we decided that regrouping should take place at three set intervals in our I60-hour course. The first regrouping was carried out at the end of October following a biology examination; the second, follow- ing the Christmas examination; and the third, at the beginning of February, again following an examination. The course was completed in April. The time of regrouping was decided by the team of teachers and was based primarily on examination schedules. The fust relocation was considered the most important for two reasons: 1. When stu- dents are grouped according to test scores only - the basis of our original group- ing - they still vary significantly in many other areas; 2. The decisions made at this stage might affect the student's adjustment and outlook on the entire course. Other factors considered were the student's motivation level, work habits, interest in subject matter, emotional background, and the number of extra- curricular activities that competed with her studies. The criteria evolved for regrouping students were: I. interest in biology as demonstrated by class participation; 2. special ability f9r learning the sci- ences; 3. maturity to accept group place- ment and handle course content with its particular approach and stress level; 4. grades obtained on biology examina- 44 THE CANADIAN NURSE tions; 5. initiative for self-learning versus directed learning; 6. judgment concern- ing degree of study necessary for success; 7. past experience with biological concepts in high school, or college; 8. personal problems creating stress that might inhibit learning. To avoid segregation, the biology team also used the heterogeneous or large group approach at specific intervals in the course. At these times the entire group of 120 or more students met as a unit to participate in certain aspects of the course content. In this way all students were allowed equal participation and were able to see for themselves that they were all receiving the same basic content, although the approach was different. Approach to each group The basic assumption of the teacher assigned to Group One was that although these students had previously studied biology, their level of knowledge was minimal. All teaching methods chosen encouraged these students to become actively involved in their own learning; few lectures were given. For Group Two the basic assumption was that this group already possessed an average knowledge of biology. These stu- dents were encouraged to find out for themselves more about the subject. The teacher and students agreed that most of the basic knowledge would be the respon- sibility of the students, and that group discussions would be used to clarify and enlarge on the subject matter. In Group Three. the most hetero- geneous of the groups, the teacher work- ed on the assumption that these students had little biological knowledge. The emphasis was placed on the presentation of basic, factual material. To enhance the factual knowledge and to make the ideas more concrete, as much correlation as possible was carried out between the theory and the actual nursing care. The lecture method was used, as well as discussion groups to clarify material. This group required guidelines, as the time element of the course caused too much stress if self-directed learning was requir- ed for too long. In Group Four the basic assumption was that these students had an above average grasp of biological concepts. The emphasis was placed on a presentation to maintain the students' high degree of interest in self-directed study and re- search. Knowledge of basic principles was considered to be almost entirely the students' responsibility, and was reviewed only through short daily question and answer periods of approximately 10 to 15 minutes. The teacher's role was one of guidance and reference. In each of the four groups students were required to evaluate their own progress as well as the teaching approach. In turn the teacher evaluated the stu- dents, either in a group process or in a private interview, as the situation war- ranted. All students were required to write the same basic examinations, but tests were used in the groups as the teachers deemed necessary. In this way students could be shifted between groups and not fear the examinations. Summary Our biology team has noticed that the students seem less inhibited, have greater self-esteem, and fewer feelings of insignif- icance than they had when placed in the traditional group setting. They are no longer afraid to comment, and they are able to determine for themselves what the biology course means to them. Ability grouping does not entirely solve the problem of meeting individual differences. However, the possibility of adapting instruction to meet each stu- dent's needs is improved by reducing the range of differences. After using the method for one year most teachers and students at St. Joseph's School of Nursing have found this method effective and satisfying - so much so that we are continuing this year. References l. Conant, James B. The American High School To-Day. New York, McGraw-Hill, 1959. 2. Conant. James B. Some Problems of the American High School. Ph, Delta Kappan, 40, Nov. 1958. Bibliography Anderson, Robert H. Organizing Groups For Instruction - Individualizing Instruction Sixty-first Yearbook of The National Socie- ty For The Study of Education - Part 1. Chicago, Univ. of Chicago Press, 1962. Bernard, Harold W. Psychology of Learning and Teaching. Toronto, McGraw-HiU, 1965. Cantor, Nathaniel. Dynamics of Learning. Buf- falo, Henry Stewart, 1961. Cronbach, Lee J. Educational Psychology, New York, Harcourt, Brace and World, 1963. Lambert, William W., and Lambert, Wallace E. Social Psychology. Englewood Cliffs, N.J., Prentice-Hall, 1964. Olson, Willard C. Child Development. Boston, D.C. Heath, 1959. Shane, Harold G. The School and Individual Differences - Individualizing Instruction. Sixty-first Yearbook of the National Society For the Study of Education - Part 1. Chicago, Univ. of Chicago Press, 1962. Thomas, R. Murray, and Thomas, Shirley M. individual Differences in The Classroom. New York, David McKay, 1965. Wellington, C. Burleigh, and Wellington, Jean. Teaching for Critical Thinking. Toronto, McGraw-HiU, 1960. Wisconsin Improvement Program, 1959-1961. Making Teaching and Learning Better. Madison, Wisconsin, Univ. of Wisconsin, 1962_ 0 MARCH 1970 Fredericton - something for everyone ",' i .'" ? .. .j .f. . , ' . ., , , ," \ ... " " I, ' tf\ 'I , ' "',.. -.ø-- ,... - ! : ..' .... _. :..... '. 1"',' ; ': . ".. ,. . ....- ' . ' r. . . . ''-:-' t'" , , " .' \... :<&"... .. ...... . .. ,," ;.... ",.1- ,Þ. ".... .. .....,. ...' -'. - .;' ,, '""J;!..' "11 " ..... .'''' . ' ..... .. · ......' 't Ìf- -4"": :=;:, :ë,_; "'! >I.ot}\..;.' .' ."s. {. '/1 " f tJk\.V' '. I t .- ..... .. I ' ..... . . 'Þ- """"'" .,. ... -.. ...{ - ........... A. - ..""'"\ .. ..,.... . . .... . ,.. . .J .... .... ' .-f: . ... . . '.' -; ... '. ..... ". ' 0::. it . .,.. .. . W'. ,,- .....:... . . iP.... ......,- ,. , .... -..... '" ''-'& ..., -...... \ . 'f' .... - ..- . .- ..J.. ,It <4" '. . .' ., I' '":' . ., ." .. . ': "'-4 S, .... .. t. (... _ : .. A i ... J I .... " ,J . ' 'J, ., ,.. .. ''':: -- - , . ... .) . . , :;; ... J-. '1! - 't.... .. . .. '..- . . .tãf'. i.. " '-; . '. ." t..', " . ç: -. "., ... . ".; .:. W .:, :1 -#,;". 't Ij l "", . t l , 11f '...J, .4._ ",', :I . of ì, t 1.." 1-. "'; ... " .. oj 1 oz, I, I :. 7 J . . .;."4. .. '.".. \: . ...- , , L 'II ..;." -I ... - 1..- . '" r - . A statue of Robbie Bums faces the impressÙ'e Legislative A ssemb(v building. by is the famous observatory built in 1851, the first structure in Canada to be used for that purpose. The new Memorial Student Centre and the Bonar Law-Bennett Library, given to UNB by Lord Beaverbrook, show a fme contrast with the old buildings. The library contains many priceless historical and literary treasures from his personal collection. The position of chancellor of lINB was specially created for Lord Beaverbrook, who was a former student of the law faculty. He was succeeded as chancellor by his son, Sir Max Aitken. Distinctive programs in addition to the traditional arts and sciences include the faculties of law, forestry. and engineering. Nursing education was begun in 1959, and the faculty is now one of the best in Canada. Poets' corner of Canada A monument on the campus of UNB. erected by the Historic Sites and Monu- ments Board of Canada in 1947, gives the stamp of officialdom to Fredericton's title as the poets' corner of Canada. The earliest English speaking poet in Canada, the Loyalist Jonathan Odell, came from Fredericton. Other famous poets include Joseph Sherman, Bliss Cannan, and Sir Charles G.D. Roberts; these three are commemorated by the UNB memorial. Bliss Carman's house is still standing and is on view. Fredericton also contains. several homes that once sheltered histori- MARCH 1970 ... . r =-- cal heroes and villains from the United States. Perhaps the most famous is Benedict Arnold, one of history's most controversial figures, who lived for two years in Fredericton's Rose Hall. History books record that Arnold was unpopular because of his bad manners and bad reputation; once the enraged citizens made an effigy of him, which they burned in his front yard. calling him a traitor. No visit to Fredericton would be complete without a visit to Christ Church Cathedral. Numerous massive buttresses and the pinnacles surmounting the gables make its exterior striking. The stone for the walls was quarried in the immediate neighborhood, and the weatherings of the buttresses, string courses, and cornices are from the shores of the Bay of Fundy. All the dressings of the doorways and windows are of Caen stone and done in England. The nave is an exact copy of an English church in Snettisham, Norfolk. Some items of interest on view in the cathedral are: the cloth of gold altar frontal used at the coronation of William IV in Westminster Abbey; the Royal Bible presented by the Prince of Wales. afterward King Edward VII. in memory of his visit to the cathedral in 1860; the letters patent given to the cathedral by Queen Victoria; and a pulpit antependi- um made from part of her coronation robe. Nurses visiting Fredericton might wish to view Victoria Public Hospital. which has enjoyed a long history of service to the needs of a growing community. Build- ing began in 1888, and the hospital first accommodated 14 patients. Eight opera- tions were performed during the hospi- tal's first year, when surgery was still in its infancy. The first operation was per- fonned only after two board meetings and the written consent of all the physicians then on the medical staff! A training school for nurses was estab- lished at the Victoria Public Hospital in 1896; students had to complete a two- year course. Two years after x-rays were discovered in 1895. a unit was brought to the hospital. the first such equipment to be installed in the Maritimes. Provincial capital In Fredericton, seat of the New Bruns- wick government. the increased activities and responsibilities at the provincial level are most noticeable. Proof of this growth is the new Centennial Building - the province's centennial year project - which brings most government depart- ments under one roof, thus promoting efficiency of operation. The $5 million building is practically designed. with clean. modern lines. Another source of pride to the capital is the province's legislative building erect- ed in 1880. The library, housed in an annex at the rear, has a copy of the original Domesday Book (1087) printed THE CANADIAN NURSE 47 in 1783; one of the two sets of the Audubon bird paintings in existence; and a set of Hogarth prints made from the original steel engravings. Built in 1828, Fredericton's old gov- ernment house displays a dignified Geor- gian facade. After Confederation in 1867, New Brunswick's lieutenant-governors occupied the residence until 1893. In recent years it has served as a barracks for the Royal Canadian Mounted Police. It has lately been designated as a historical monument. The city can boast of several special attractions for the convention visitor; indeed, Fredericton is becoming a major convention center of the Atlantic provin- ces. Accommodations range from the Lord Beaverbrook Hotel - the focal point of community life - to the univer- sity residences. Avid shoppers will be specially inter- ested in the top quality products of area handicraft studios. Potters, jewelry makers, weavers, and wood turners design their own work and hand-finish their products. Visits to their studios can be arranged through the tourist bureau. The city's industrial progress has been rapid. Printing and publishing are impor- tant industries in the area; others include shoes, bricks and concrete articles, mobile homes, paper bags and containers, and steel fabrication. Canoes made in Frede- ricton are used in the Arctic and in many other regions. District sights The surrounding countryside is ideally suited for mixed farming. The federal government has taken advantage of this by establishing a research station of the Canada Department of Agriculture at the east end of the city. Visitors are welcome to come and enjoy the spaciGus lawns, shrubs, and trees, the colorful flowers with names clearly indicated, all located around inviting picnic grounds. Another major tourist attraction in the Fredericton area is the new Mactaquac hydro dam, the largest single construction project ever undertaken in New Bruns- wick. The dam, a massive rock-fIUed structure, towers 180 feet above its base and stretches 700 feet across the channel of the river in a slight curve. It has created a large headpond or lake stretch- ing 59 miles up river. The Fredericton district provides many recreational facilities. Fishing in the area is a sportsman's delight, and local guides and boats are easily obtained. There is a large public swimming pool and admission is free; trailer and tenting facilities are available; and you will fmd 48 THE CANADIAN NURSE - .. - ... ,... - "- ,-" " ., Ii/" -. - " :. ..- t .. t-' :: 1 . A. .... 'Ïr " ;" . .. . ...... .. ,"" . . 1.':" ... ." . '_. ..-. ... t .... #' .. ;....-:.' .., '>0;. ., ,\.J; : .'t:' ;" . "'" _ "If' .... ( ..0 't J - A J f many areas set aside for picnics. A golf course is fIve minutes drive from the center of town. One of the big sport attractions in Fredericton during the summer months is the twice-weekly night harness racing, The great development of boating has made the Saint John River at Fredericton a scene of vast activity. The river itself is a famous and historic international water- way, starting in Maine and traveling the iJ, ,1..1.: - -. ...' "'0 .; .." <14" ... I I ", :;. !"" ,Ii <, " . .' t :' ....._. . . 'lilt.. :' .. ,. Christ Church Cathedral. a good example of Gothic architecture il1 North America. .. : ..... . . ,: %;. r . *"'. - .. 2: . .... '''........." ...... ;.,' '" -... ( . .. '!< "" - . . -(i.. t\ ..., ., .. ... .... ',. ..."... . .'...... .. ...y. .. . .-.. .::"ix; , f. ..... r;:t... . . .. ".. :'.. \. ...-. "fÞ . r' ...... .,., &- - , \.. . "\ - .:. '. - .... ' .. J , . ... . '\' ., '. ": r '\,.. . "'''1.-.'' .. iJl ... ; ---' .. l. -.. .. . . .--#"., ... "'- :.. *..., . 1 .... '. ",'" f/#f :' .... I " , ".. .; ;. " .. 'i-'.:: : "J,. · )t ...}, tv"" t. f -;,. I': . ,I ..,.\ . " . ., .., f . - - ""'.... .. -= '!t.,l.:. ,r, " "'.t .""" . ; ,' J' pf'" :r. . t J'-'" - '" - . ",. 4 .. . ''to ,,' .. - I' , ... . , . .. ," - . . , . ., . . ., - . . . ., . , ., ' ., . . .... . . . . . '. ........ . ... . . . . - . .. . \ " '. The author, left. discusses the details of a subscriber's enquiry with Pie"ette Hotte, a 11U!mber of the circulation staff, Canadian Nurses' Association. MARCH 1970 Are we getting to you? If you are an active member of a provincial nurses' association, a personal subscriber to The Canadian Nurse or L'infirmière canadienne, or a nursing stu- dent who subscribes, you are probably nodding your head in the affirmative and thinking this question is a silly one! Perhaps, but as one of more than 90,000 persons in 104 countries to whom the Canadian Nurses' Association's maga- zine is mailed each month, we thought you might like to have a glimpse behind the scenes in our circulation department and see how you can make sure your copy arrives regularly. Members in Canada Registered nurses form the greatest percentage of readers, as The Canadian Nurse is automatically provided with active membership in a provincial nurses' association. Within six weeks after the provincial nurses' association has sent a list of its members to the CNA, the new member receives her journal and contin- ues to receive it until six weeks after CNA is notified that her membership has termi- nated. The journal is available in either the English or the French language and is directed to the member on the basis of information provided to CNA by the Mrs. Darling is Circulation Manager, Canadian Nurses' Association, 50 The Driveway, Ottawa. THE CANADIAN NURSE 55 .. Processing Journal labels for members in Canada are produced by computer at a local data center, which keeps member listings on magnetic tape. A matching master card me is maintained at CNA, med numeri- cally by registration number. An addition of a new member, change of name or address of a current member, or deletion of a non-member can be made only when CNA submits the appropriate member card to the data center, indicat- ing the action requested for transfer to the magnetic tape. This is done on ap- proximately the twelfth of each month and is referred to as the monthly "up- date." Four girls are engaged in processing this "up-date:' During the first 10 months of 1969, a total of 111,903 cards were processed - an average of 11 ,190 per month. During peak periods at the beginning of a calendar year, when regis- tration renewal takes place, as many as 19,000 cards have been processed in one month. Obviously additional help is required at these times and work contin- .. ues at night and on weekends. Gloria Wilcox checks CNA 's copy of This "up-date" provides the final Febrnary labels to confirm that an issue information that will be printed on the was sent to a member. 56 THE CANADIAN NURSE - - - - - - - - - - - - - - -- - -- - ".11 - - - - - - .. - - - III!. - - - / ... j .. . \ ', 4 i.. .. t "'-' . . -. ^' ... . . ... +J. . - .-..... -.. .. .- : . .- - " K""... '" FrançOlse Charbonneau prepares an addressograplz plate for a personal sub- scriber in Africa. provincial nurses' association, unless an individual request is received from the member. - labels for the next month's issue. The labels are then sorted by town and postal zone, arranged in numerical order by registration number, and forwarded to the printer where they are cut, glued, and affIXed by machine to each member's copy of The Canadian Nurse before being mailed from Montreal. Any change in a listing that arrives at CNA after the tenth of any month is already too late for inclusion in the "up-date" for the next month's issue. For example, February 10 is the last date on which a change or adjustment can be made to labels for the March issue. This is why six weeks are required for process- ing. Any change received after February 10 will be effective for the April issue. You might ask: What happened to the eleventh and twelfth of the month if the "up-date" is delivered to the data center on the twelfth? These two days are necessary to put the 7,000 to 19,000 cards (average 11,190) in numerical sequence by registration number, sort them by language code and province of registration, and complete a transmittal record count to accompany the delivery to the data center. Other subscribers Another section of the circulation )0 , ..\. ... .. ...... .. " ,t- \ . " .... '1' ... -. .. ..:ill , .' r;, "iii '. ( 1 . - . , , I /' . .,....... ...... \ \, '- , " Brenda Moore refers to the master direc- tory to identify a member who omitted her registration number when requesting a change of address. department deals with a total of 15,048 listings for other subscribers. These in- elude members living outside Canada to whom the same benefits and privileges apply regardless of their address; personal subscribers; and exchange arrangements with affiliated professional journals. These are processed on an addressograph system by one staff member. Among our subscribers are 9,239 nursing students in Canada who receive the journal each month (7.416 English-speaking students and 1,823 French-speaking students) through a bulk arrangement with their schools of nursing. Hospitals, school of nursing libraries, public libraries and health agencies, and individuals allover the world are listed among our personal subscribers. Postal regulations New postal regulations brought other changes in addition to the overwhelming increases in postage costs. Pri:-r to April 1, 1969, hundreds of undelivered copies of The Canadian Nurse were returned to CNA. As the journal is now classified as third-class mail, undelivered copies are no longer returned to us. Assuming the same rate of mobility still exists within tþe profession, we suspect that hundreds of copies are currently being sent to the dead-letter office for disposal each month. MARCH 1970 ..... r" p - .- - 1 .. - - .... ... . . .. , , . ..... , Joann Knight checks the CNA's master IBM card file with 1970 renewals from a provincial association. In addition, members tell us that their journals are not reaching them. In some cases an incorrect city zone has been given, in other cases no zone has been given. The post office routinely provides directory assistance for first- and second- class mail. However, third-class mail does not receive the same service as first-class or even second-class mail. Frequently members have mentioned that their Life magazine and Reader's Digest have reach- ed them without difficulty and without the new mail zone number included. This is probably true as these publications are still classified as second-class mail. In effect, the priority rating of The Canadian Nurse has been lowered, even though the postage rates have been in- creased by approximately $135,000 annually. The proper city zone must be included in all addresses where zones exist to ensure proper and regular delivery. Your label To the five girls in the circulation department, you are known by your label. Miss B.A. Nurse 10 Skyway Drive Montreal 352, P.Q. B066-3295 MARCH 1970 For a CNA member living in Canada, the number at the lower right of the label is most important. This is your practicing license or registration certificate number, prefixed by the provincial code. We need this number to check an enquiry or make an adjustment in your listing. Please quote it on all correspondence if you are unable to attach a recent label. If you are actively registered in more than one provincial association, quote both num- bers and provincial associations. Librarian School of Nursing University of the Watusi Watusiland, AFRICA 12-70 BHH 10-69 A personal subscriber or a member outside Canada, such as the subscriber listed on the label above, is identified primarily by location, since postal regula- tions require us to maintain listings by a geographical sort. For this reason the previous address is most important when requesting a change. The code letters at the bottom indicate the registration num- ber for members, and, for personal subscribers, the expiration date, the agency through which the subscription was placed, and whether the subscription was a gift. Moving? We invite our readers to use the "Moving? " form that appears m each issue. If you are a member in Canada and are unable to provide a recent label. please send us your registration or permanent certificate number and the name of your provincial nurses' associa- tion. If you are a personal subscriber or member outside Canada, please give us your former name or address, registration number if a member, and the name of the agency or donor where applicable. Please notify us personally of any change in name or address, since change of address cards provided by post offices have proven unreliable. We will change your listing only on notification from individual members, subscribers. or provincial nurses' associations. Are we getting to you - and to your colleagues? We hope so. But if not, be sure to let us know! 0 THE CANADIAN NURSE 57 research abstracts The following are abstracts of studies select- ed from the Canadian Nurses' Association Repository Collection of Nursing Studies. Abstract manuscripts are prepared by the authors. Kerr, Janet c. The fonnulation of an instrnment to evaluate performance of nursing students in clinical nursing based on correlated behavioral object- ives. Madison, 1967. Thesis (M.S.) U. of Wisconsin. The evaluation of student performance in clinical nursing is of concern to nursing educators because of the necessity to determine the quality and effectiveness of teaching and learning and to ensure pa- tient safety through the rendering of competent nursing services. It is im- portant that this evaluation be as object- ive as possible. Traditionally there has been a tenden- cy to appraise personality characteristics rather than progress. It is the contention of the writer that the classification of objectives and the close relation of objectives and evaluation advocated by Benjamin S. Bloom are both applicable and helpful in making the process ot evalua- tion in the school of nursing as objective as possible. An evaluative instrument, accordingly developed to measure clinical performance in medical-surgical nursing at two selected levels, is based on course objectives expressed in behavioral terms. These objectives and tools for clinical evaluation were developed specifically for two clinical nursing courses at a particular diploma nursing school in the midwestem United States, and are presented to provide an example of how clinical evalu- ation may be carried out in terms of behavioral objectives. Stinson, Shirley M. Deprofessionalization in nursing? New York, 1969. Thesis (Ed.D.) Teachers College, Columbia U. Most major works in the nursing litera- ture seem to be based on the assumption that the occupation of nursing is gradual- ly becoming more and more professional- ized. The reverse of that assumption, that nursing is "deprofessionalizing," is the thesis that is tested in this study. The research approach employed was that of a comparative social analysis of nursing in 1920 and in 1960. The study was restrict- ed to nursing in the United States. Because the concept of "deprofession. alization" is a poorly developed one, the 58 THE CANADIAN NURSE author constructed a paradigm and a typology of "deprofessionalization." The concept of professionalization was exam- ined in detail, and the impact of bureau- cratization on professionalization was as- sessed. It was concluded that within the social contexts of the times, nursing in the 1920s exemplified the characteristics of professionalization to a greater degree than it does today. Some of the major reasons for this were: I. the relative integrity of the substantive knowledge- skill component (e.g., nurses may have more factual knowledge?); 2. the exist- ence of a well-knit occupational culture; 3. the substantial harmony of nursing roles in the 1920s with roles of other health personnel; 4. the high degree of autonomy of the nursing practitioner in the 1920s; and 5. advancement in nurs- ing was largely coterminal with increased clinical nursing expertise, a characteristic not typical of nursing in the 60s. Two primary recommendations arising from the study were: First, that the American Nurses' Association reconsider its position with respect to the category of technical nurse. It was submitted that however "underprofessionalized" the status of the registered nurse is at present, her role is professional in its character. There was no criticism of the intent of the ANA position, but considering the relatively slow rate of professionalization of female occupations, it was considered that the ANA position was premature, and is a disintegrating factor rather than a professionalizing mechanism. Second, that the techniques of this study be applied to nursing in other countries, e.g., Canada, to establish similarities and dis- similarities in trends in nursing. Middleton, George. A study of the rela- tionship between patient involvement and patient attitude in transfers occur- ring in a selected unit of a general hospital. Montreal, 1969. Thesis (M.Sc. (App.)) McGill University. This study inquires into the reasons for in-unit transfers of patients in a public medical unit of a general hospital, the degree of involvement of patients in these transfers, and their subsequent attitudes toward them. The data were obtained by head nurses completing an information sheet covering the reasons for the trans- fers, and by unstructured intelViews with patients 48 hours after they were moved. It was found that there were two categories of transfer: nursing, those transfers made in the interest of the patient being moved, and accommoda- tive, those made to accommodate other patients. A greater degree of patient involvement in the nursing category was demonstrated than in the accommodative category. Patients' attitudes were more favorable to nursing than to accommoda- tive transfers. The fmdings suggest a functional relationship between the degree of pa- tient involvement in transfers and the patient's subsequent attitude toward them. It would thus seem that regardless of the reasons for in-unit transfers, as the degree of patient involvement increases, the patients' subsequent attitude is more favorable toward these transfers. Deas, Sister Miriam Anne. Opinions of graduate nurses from diploma pro- grams in British Columbia concerning their preparation to function as team leaders. Washington, D.C., 1969. Thesis (M.Sc.N.) The Catholic Univer- sity of America. This study was undertaken to deter- mine the opinions of selected graduate nurses from diploma programs in nursing concerning their preparation to function as team leaders. The criteria for the selection of the participants in the study were: I. gradu- ation from a diploma school of nursing in British Columbia; 2. graduation within the past year; 3. employment in a general hospital in British Columbia that has approximately 100 beds or more; and 4. a minimum of six months' experience as a team leader. The sample consisted of 26 graduate nurses who were employed in 10 hospi- tals; five conducted a school of nursing and five did not. The intelView guide was used as the data-collecting instrument. The findings showed that "as student nurses, the majority of the participants had received five or more hours of fonnal instruction in team nursing and all had functioned as a team leader. The time spent as a team leader ranged from two weeks to eighteen months. Eighteen participants believed that they had receiv- ed sufficient preparation, theory, and practice to function as a team member and as a team leader during the time they were nursing students in the basic nursing program. As graduate nurses, 17 of the partici- MARCH 1970 pants stated that they had not been oriented to team nursing during their orientation period. Only four of the nine participants, who were oriented to team nursing, recalled having the philosophy and objectives of team nursing discussed during the orientation period. Problems that the participants believed the team leader encountered in her functioning were lack of personnel, lack of communications among nursing per- sonnel, and a lack of self-confidence. They believed that more experience as a team leader in the basic nursing program during the early period of employment, as well as orientation and inservice educa- tion, would prevent some of these problems. It was concluded that nursing students in British Columbia have sufficient preparation, both in theory and practice, to prepare them for team nursing, and that graduate nurses in British Columbia do not receive sufficient orientation in their first positions to enable them to function as team leaders. Ritchie, Judith Anne. Fantasy in the communication of concerns of one five-year-old hospitalized girl. Pitts- burgh. 1969. Thesis (M.N.) University of Pittsburgh. The purpose of this study was to describe the concerns of one five-year-old hospitalized girl and her predominant means of communication of those con- cerns. The method used was the descrip- tive case study. The nurse-writer func- tioned as participant-observer, giving nursing care to the subject throughout her hospitalization. The data were obtain- ed from process recordings, daily des- criptive narratives of the subject's be- havior, and interaction with those in her environment; from descriptions of the subject's spontaneous drawings; and from recordings of two types of play interviews conducted: I. with a toy kit containing family dolls, a doctor and a nurse doll, and household equipment, and 2. with puppets. Three major areas of concern related to hospitalization and illness were reveal- ed. Of these, separation comprised 52 percent, followed by body integrity, 31 percent, and intrusion, 17 percent. The subject communicated her concerns by verbal communication, non-verbal communication, and fantasy. Verbal communication constituted 17 percent of the total, and consisted of verbalization, ability to listen, and refusal to verbalize. Non-verbal communication also constitut- ed 17 percent of the total, and consisted of body language and regressive behavior. Fantasy made up 66 percent of all communication. The concerns revealed through fantasy were more specific and more varied in each of the three areas. MARCH 1970 Fantasy also indicated the subject's needs more effectively. The major agents (46 percent) through which the subject communicated in fantasy were the stuff- ed toys she brought from home. These toys served as transitional objects and as imaginary companions. The other agents of communication were puppets (24 per- cent), drawings (18 percent), and play interviews with the toy kit (II percent). The study revealed how the child interprets and feels about illness and hospitalization; that fantasy may open the avenue to communication in areas which, when approached in reality terms. the child finds frightening and must deny or avoid; and that fantasy helps in the gradual mastery of the child's feelings surrounding hospitalization. Shepherd, Audrey Elizabeth. A study of the attitudes of public health nurses in a selected agency toward direct patient care. Seattle, 1%9. Thesis (M.A.). U. of Washington. The purpose of this study was to measure the attitudes of full-time public health nurses in a selected agency toward direct nursing care. More specifically. it was to determine if there were differences in the attitudes toward direct patient care in relation to the age of the public health nurse, to the length of time employed in public health nursing. and to the original professional educational preparation of the public health nurse. A modification of Vaughan's Attitude Scale on Direct Patient Care was the instrument used to collect the data. A personal questionnaire accompanied the modified attitude scale. The t-test was used for computation of the data. The findings of the study for the 83 full-time public health nurses were that these nurses had an extremely favorable attitude toward direct patient care. Those in the 37-plus year group were more favorable in their attitude toward others than the 21-24 year group. but were less positive in their attitude toward self and aspects of nursing than the other age groups. Nurses with 0-2 years of experi- ence in the field of public health nursing had a more favorable attitude toward the patient than nurses with more experience, but nurses with five-plus years experience were more positive in their attitude to- ward others than the 0-2 year experience group. Graduates of diploma programs had a more favorable attitude toward others than those graduated from collegiate pro- grams; however, the latter were more favorable in their attitude toward self and aspects of nursing. Finally, nurses em- ployed at the public health nurse I level evidenced a more positive attitude toward the patient than nurses employed at the public health nurse II level. 0 Next Month In The Canadian Nurse . Cancer Detection Clinic . Counseling Nursing Students . '\Turse on James Bay ð Photo credits for March 1970 Canadian Hospital Association, Toronto, p. 8 Joe Stont> & Son Ltd.. Fredericton. N.R. p. 10 AARN Newsletter. p. 12 University of British Columbia. Vancouver. p. 21 Canadian Press. pp. 39.41 Church World Service. New York. RG. Shaffer. p. 40 Church World SelVlce, New York, p. 42, cover N.R Travel Bureau, Fredericton. N.B., pp. 45,46, 47 The Harvey Studios. Fredericton, N.B.. p. 48 Photo Features. OttJwa. pp. 55, 56.57 THE CANADIAN NURSE 59 books Concepts and Practices of Intensive Care for Nurse Specialists by Lawrence E. Meltzer, Faye G. Abdellah, and J. Roderick Kitchell. 469 pages. Philadel- phia, The Charles Press Publishers Inc., 1969. Reviewed by Mrs. Eileen Clarke, Head Nurse, I.C u., Sherbrooke Hospital, Sherbrooke, Quebec. The introduction to this book defines the clinical nurse specialist and the nurse specialist, and outlines their respective duties within a well-organized intensive care unit. Teamwork with the physician is stressed for efficient patient care. Meth- ods of training physician-nurse teams are suggested. The book has 15 chapters, each deal- ing with a condition that requires con- stant nursing care. It is a comprehensive and informative book for nurses working in such a unit. Usually many reference books are needed in an intensive care unit, each dealing with a different condi- tion. This book covers the many and varied conditions of critically ill patients. All conditions (e.g., respiratory failure, shock, chest surgery, renal dialysis) are well described and illustrated by charts and diagrams for quick reference. Ther:e is also an excellent bibliography at the end of each chapter. The book covers modern treatments and describes up-to- date equipment. A short chapter is in- cluded on organ transplantation. Al- though the care of patients with myo- cardial infarctions has become a specialty now handled in many hospitals by coro- nary care units, there is a good descrip- tion of this care, and the complications and treatment. This book is clear and concise and would be an asset in any library. It could also provide valuable reading for class- room use. It leaves no stones unturned in the most challanging area of nursing today. Current Concepts in Clinical Nursing, vol. 2, edited by Betty S. Bergersen, Edith H. Anderson, Margery Duffey, Mary Lohr, and Marion H. Rose. 361 pages. Saint Louis, C.V. Mosby Co. Reviewed by Marie T. Mellon, Clinical Coordinator, School of Nursing, Uni- versity of Ottawa, Ottawa, Ont. This is a collection of papers by 42 nurses. The book is divided into four sections: medical-surgical nursing, psychi- atric nursing, pediatric nursing, and 60 THE CANADIAN NURSE maternity nursing. It is encouraging that the chapters in each section dealing with widely varying aspects of current nursing also deal with nursing actions, nursing interventions, nursing skills, and nursing decisions. Medical-surgical nursing includes clinical decision-making; a new role for the nurse who is primarily responsible for care of the ambulatory, chronically ill person; trauma nursing; problems and life-style of severely burned patients; pa- tient perceptions of nurses; and patient teaching for home hemodialysis. Psychiatric nursing includes papers on therapeutic intervention with adolescents, use of psychodelics in adolescence, and community health care. Pediatric nursing covers nursing assess- ment of sick children, brief episodes of pain in children, restraint and the hospi- talized child, nursing assessment and intervention through play, and uniforms for pediatric nurses. Maternity nursing discusses rooming- in, eating non-food substances during pregnancy, adapting postpartum teaching to mothers' low-income life-styles, indices of fetal welfare, and nursing care of the premature newborn. There are references at the end of each chapter and there is a good index at the back of the book. Basic Nutrition and Diet Therapy for Nurses, 4th ed., by Lillian Mowry and Sue Rodwell Williams. 226 pages. Sain t Louis, Mosby, 1969. Reviewed by M McCloy, Assistant Dietitian, South Peel Hospital, Missis- sauga, Cooksville, Onto This book is divided into two parts. The first, on nutrition, discusses the requirements of normal nutrition, includ- ing situations with specialized needs. The second, on diet therapy, discusses how food becomes a tool of therapy. Section one begins with a discussion of the importance of a balanced diet, based on the recommended daily dietary allow- ances set by the Food and Nutrition Board of the United States government. Of particular interest is the generous nature of these allowances in comparison with the dietary standard for Canadians. The Canadian standards are floor levels, whereas the American are optimum. Clinical signs of nutritional status, clearly charted in table fonn, compare good and poor signs. The succeeding chapters in this section review the basic food groups, energy requirements, and digestion. One chapter outlines the changes that occur in food as it passes through the digestive system. The satiety value of different foods mentioned here is worthy of note. Chapter 10 deals with the importance of tailoring eating habits to age groups and special stress situations. The needs of the geriatric patient are considered at length. The last chapter deserves special attention as it reviews American laws that directly affect the food industry. The discussion of food-borne diseases is worthy of ex- panding. Section two on diet therapy begins with a discussion of routine hospital diets. These vary from institution to institution but are basically alike. The special nature of each individual patient is included here, as well as the importance of meals that appeal to the eye. The chapter on diabetes is handled well. It must be noted, however, that this text is American and the exchange system for American use is given. As the Canadi- an dietary system differs in some major respects, the introduction of the Ameri- can system would be confusing. In general, I found the book concise and well written, although the format of presenting therapeutic diets could be improved. Questions at the end of each chapter provide a vehicle for further study and review. My chief objection to this book as a text for nursing students in Canada is that it was prepared for the United States and uses American exam- ples. Since food patterns and require- ments differ in the two countries, I believe it is best to use Canadian nutrition and diet therapy texts whenever possible. Man Modified: An Exploration of the Man Machine Relationship by David Fishlock. 215 pages. London, Jona- than Cape, 1969. Canadian Agent: Clarke, Irwin and Company Ltd., Toronto. Reviewed by E.J. MacDonald, Science Instructor, The Moncton Hospital, Moncton, New Brunswick. This is a fascinating, interesting book of how man's parts are being modified with the help of machines. Man is now being measured with more precision than ever before and physiolo- gists and surgeons need the help of engineers to make the measurements and to help with the replacement of body MARCH 1970 parts. The author compares man to a machine with several flow systems and subsystems that are dutomatic. self- regulating. and self-repairing. With the central nervous system as the computer. man-mdde organs would have to be microminiaturized and made of sub- stances that would not be affected by the elements of man"s internal environment. Machines can be run by computer and remote control. but as yet they have not been made as versatile as man. Surgeons will soon be able to do microsurgery by remote control from outside the sterile capsule where the patient is placed. Space travel has helped to perfect this procedure. There has been great improvement in prostheses. By moving remote muscles not affected by an amputation, the pros- thesis moves smoothly and the person knows the position of the part involved without looking. Engineers have several new ideas of making hearts work without removing them by adding auxiliary ventricles or using electro-hydraulic artificial hearts - separate or over existing hearts. Small artificial kidneys that can be worn around the waist and work continuously are being improved. In the future, glands that release daily doses of drugs into the general system over a period of one or two years will be implanted under the skin. This could take the place of "the Pill." When tissue typing is as improved as blood typing is now, it may be possible to replace more organs. However. will the demand for hearts and kidneys ever be met. considering that the demand for the cornea is still not met? This book gives us an idea of what will happen in the years to come. When engineers and surgeons finally solve the problem of the body's rejection of for- eign substances, the possibilities of replac- ing body parts will be unlimited. This book would be interesting reading for any instructor or student. IIImtrated Dictionary of Eponymic Syndromes and Diseases and Their Synonyms by Stanley Jablonski. 335 pages. Toronto, W.B. Saunders Compa- ny, 1969. The author's purpose in compiling this dictionary is "to gather together in one volume the profusion of eponyms and descriptive synonyms used to designate syndromes and diseases." An eponym is a name or phrase formed from or including the name of a person, such as Hunting- ton's chorea. Included in this illustrated dictionary are eponymic names of pathological con- ditions named after the discoverers, liter- ary and mythological characters, and pa- tients. Eponyms used in naming clinical entities, animal diseases, experimental dis- MARCH 1970 eases, important diagnostic signs, and pathological conditions are entered, along with their non-eponymic synonyms. This dictionary would be of consider- able value in a school of nursing library and for quick reference on a hospital medical unit. Its use to the individuaJ nurse practitioner would be limited. 0 accession list Publications on this list have been received recently in the CNA library and are listed in language of source. Material on this list, except Reference items, including theses and archive books which do not circulate, may be borrowed by CNA members, schools of nursing and other institutions. Requests for loans should be made on the "Request Form for Accession List" and should be addressed to: The Library, Canadian Nurses' Association, 50. The Driveway, Ottawa 4, Ontario. No more than three titles should be requested at anyone time. Stamps to cover payment of postage from library to borrower should be in- cluded when material is returned to CNA library . Books and Documents I. Les complications en chirurgie et leur traitements. par Curtis P. Artz et James D. Hardy. Paris, Maloine, 1968. 1005p. (Traduit de la 2. édition Americain par Ch. Alamowitch et J. BezierJ 2. Coordinate index reference guide to com- munity mental health, by Stuart E. Golann, New York, Behavioral Publicatons. 1969. 237p. 3. Correspondence education and the hospi- tal: a summary report of a study conducted at Pennsylvania State University. Chicago Hospital Research and Educational Trust, c1969. 5Op. 4. Facts about nursing, 1969. New York, American Nurses Association, 1969. 250p. 5. International standard classification of occupations. rev. ed. 1968. Geneva, Inter- national Labour Office, 1969. 355p. 6. Introduction to work study, 2d ed. Geneva, International Labour Office, 1969. 436p. 7. Manuel de géronto-psychiatrie, par Christian Müller. Paris, Masson, cl969. 275p. 8. Les médicaments. Paris, Editions du Seuil, 1969, par Jean-Marie Peltz. 19Op. (Col- lections microcosme. Le rayone de la science, 29) 9. Nursing en obstetrique, par Françoise Piquette. 3.éd. Montreal, Renouveau Pédagogi- que, cl969. 254p. 10. Nutrition and diet therapy; 1500 multi- ple choice questions and referenced answers, edited by Mirenda Rose et al. Flushing, N.Y., Medical Fxamination Publishing, 1969. 211p. This hand was þa.ndaged In Just 34 seconds with Tube9,.Quz SEAMLESS TUBULAR GAUZE It would normally take over 2 minutes. But the Tubegauz method is 5 times faster-l0 times faster on some bandaging jobs. And it's much more economical. Many hospitals. schools and clinics are saving up to 50% on bandaging costs by using Tubegauz instead of ordinary techniques. Special easy- to-use applicators simplify every type of bandaging. and give greater patient comfort. And Tubegauz can be auto- claved. It is made of double-bleached. highest quality cotton. Investigate for yourself. Send today for our free 32-page illustrated booklet. SurgIcal Supply D,VIs,on The Scholl Mfg. Co. L,mited 174 Bartley Drive. Toronto 16. Ontano Please send me "New Techniques of Bandaging with T ubegauz" NAME ADDRESS THE SCHOLL MFG. CO. LIMITED .9 THE CANADIAN NURSE 61 (Nursing examination review book no.8) II. Pédwtrie par Marie-Claude Turcotte- Daoust. Montréal, Renouveau Pedagogique, 1969. 424p. 12. Popular hospital misconceptions by Anthea Cohen. Reprinted from Nursing Mirror and Midwives Journal. London, IPC Business Press, 1969. 90p. 13. RN's 1966: an inventory of registered nurses. Prepared by Eleanor D. Marshall and Evelyn B. Moses. New York, American Nurses Association, 1969. 50p. 14. Research contributions from psycholo- gy to community mental health, edited by Jerry W. Carter. New York. Behavioral Publica- tions, cl %8. I lOp. 15. Scientific writing, by Lester Snow King and Charles G. Roland. Chicago, 1968. 133p. (Based on a series of articles previously publish- ed in the Journal of the American Medical Association. ) 16. Standards for psychwtric facilities: a revision of the standards for hospitals and clinics. Washington, American Psychiatric Association, d 969. ll5p. 17. Threshold to nursing: a review of the literature on recruitment to and withdrawal from nurse trainin1( pro1(rammes in the United Kingdom, by Jillian MacGuire, London, G. Bell & Sons, cl969. 271 p. (Occa ional papers on social administration no.30) 18. Writing for professional and technical journals, by John H. Mitchell. New York, Wiley, 1968. 405p. (Wiley series on human communication) Pamphlets 19. Declaration of principles and code of professionol standards for the practice of public relations with interpretations. New York, Public Relations Society of America, 1963? lOp. 20. Improving delivery of comprehensive nursing services. New York, National League for Nursing, 1969. 36p. 21. Present involvement in nursing educa- tion of institutions whose diploma programs, closed 1959-1968, by Sylvia Lande. New York, National League for Nursing, 1969. 8p. 22. Report, 1968. Toronto, Canadwn Mental Health Assocwtion, 1969. 16p. 23. Special procedures by registered nurses and technical personnel Toronto, Registered Nurses' Association of Ontario, 1969. 4p. 24. Tell me where to turn: the growth of information and referral services, by Elizabeth Ogg. Public Affairs Committee, 1969. 38p. (Public affairs pamphlet no. 428) 25. What happens when you go to the hospital, by Arthur Shay. Chicago. Reilly & Lee, 1969. 30p. 26. The world health organization in Africa, 1970. Brazzaville, Congo. World Health Orga- nization, Regional Office for Africa, 1969. 44p. Government Documents Canada 27. Dept. of National Health and Welfare. Occupational Health Division. Guide for the development of a provincial occupational health nurse consultant program. Ottawa, 1969. 28. Dept. of Regional Economic Expansion. Inventory of research on adult human resource development in Canada. 1963-68, by Garnet Page and George Catdwefl. Ottawa, Queen's Printer, 1969. 215p. 29. The Science Council of Canada. Inter- national Subgroup. Scientific and technical information in Canada. pt. 2 ch. 4 International organizations and foreign countries. Ottawa, Queen's Printer, 1 %9. 63p. (Science Councit of Canada special study no.8) United States 30. Post Office Department. National zip code directory. Washington, U.S. Gov't. Print. Off., 1969, 1695p. 31. Dept. Health, Education and Welfare. Public Health Service. National Institutes of Health. Source book for community planning for nursing in South Dakota. Prepared by the Division of Nursing. Washington. U.S. Govt. Print. Off., 1969. 232p. Studies deposited in CNA repository collection 32. Effets thérapeutiques de la fonction "expressive" de l'infirmière dans l'accomplisse- ment d'une de ses activités autonomes. Mon- tréal, 1969. 76p. (Thesis (M.Nurse)-MontréaI)R 33. Jeanne Mance: infirmière missionnaire laique, 16U6-1673, par Soeur Allard, Montréal, Centre Jeanne-Mance Hôtel-Dieu, 1960. R 34. One hospitalized preschool girl's way of dealing with separation anxiety, by June F. Kikuchi. Pittsburgh, 1969. 72p. (Thesis (M.N.)-Pittsburgh)R 0 Request Form for "Accession List" CANADIAN NURSES' ASSOCIATION LIBRARY SCARBOROUGH CENTENARY HOSPITAL (Located Within Metropolitan Toronto) :t . ;..: - ...::::. ---==- - . ..-... .. Send this coupon or facsimi to: LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario. Please lend me the following publications, listed in the issue of The Canadian Nurse, or add my name to the waiting list to receive them when available. Item Author Short title (for identification) No. .. Invites Applications for all services and positions within the Nursing Department This modern 525-bed hospitol is fully equipped with the lotest focilities to ossist personnel in patient core ond embroces the most modern concepls of teom nursing. Excellent personnel policies ore ovoilable. Progressive staff and management development progroms offer the moximum opportunities for those who are interested. Salary is commensurate with experience and ability. Some Single Room Residence Accommodotion Available. Request for loans will be filled in order of receipt. Reference and restricted material must be used in the CNA library. Borrower Registration No. Position For further information, please direct your enquiries to: Personnel Department SCARBOROUGH CfNTENARY HOSPITAL 2867 Ellesmere Rd., West Hill, Ontario Address Date of request MARCH 1970 62 THE CANADIAN NURSE ,- " - April 1970 .... .. ... . \ '--. "t . MISS M1M MORRIS . 2QO ElSO S1 APT 812 OTTAwA 2 cr-a OCOO57B4 .,. . ...... (. , . , .. I , The ,) , -:. , Canadian .. .. Nurse ." , .- t--' \ " '" t ,. university schools of nursing in Canada "' a split in the family cancer can be beaten . ,.-. . . " ( 1 I '. ,. .. , . THE LUXURY PROFESSIONAL FABRIC L - OOOO O OOOOVOOæ[@ OO[Wæ VæOO æ OOOO[æ ill V NOW, in me exciting Poor Boy Rib! Luxura - a luxurious, soft and supple uniform fabric that's also extremely durable and possesses the finest wash and wear properties. Wash tested. _ . wear tested. #0277 - A beautifully shaped princess of a skimmer featuring a hidden front zipper closing, twin pockets and a separate belt, in Luxura 100% Fortrel'l!) double knit. Short sleeves only, a regular length skirt. Sizes: 8-18 to retail at $23.98. #0278 - An ingenue collar tops this back zipping skimmer in Luxura Fortrel'l!) double knit. Short sleeves only, I"ew short r length skirt. Sizes: 6-16 to retail at $21.98. I I WHITE c) SISTER White Sister Uniforms are available at fine retail and department stores. For the name of the store nearest you, please WHITE SISTER UNIFORM INC., 70 Mt. Roval West, Montre:-' '1uebec THE PERFECT PROFESSIONAL FABRIC p PD - æ TI æTIæ OO[æ OO OO OOOOTIOOæ[ OOTITIOO ect for both home and commercial laundering. Premier Poplin was developed for White Sister by one of Canad 1ding textile firms. Wear tested and wash tested by the Kitchener Waterloo Hospital. Premier Poplin proved superio to all cotton uniforms in every category - for Wearability... Washability. . . and Durability! #0676 - A back zipper skimmer with tiny buttons running down the placket front, in-seam pockets and a set-in belt waistline. In Premier Poplin, short sleeves only, regular skirt length. Sizes: 8-18 to retail at $11.98 #0624 - A snappy front buttoning step-in featuring a low-body torso, a swing skirt with inverted pleats and action sleeve gussets. In Premier Poplin, short sleeves only, new shorter length skirt. Sizes: 6-16 to retail at $11.98 White Sister Uniforms are available at fine retail and department stores. For the name of the store nearest you, please write: WHITE SISTER UNIFORM INC., 70 Mt. Royal We.t, Montreal, Quebec WHITE SISTER .. I \ , \ :;, . v l4.I q' o '1\ o )..0 (,,/11 G I , - ) . " ' ,: \: JJ , " - 1 A ' Ð ' C \ \a U Ñ UMB E { - O d\ S o '" @D lU J-.. $ , - ---., ,. " \. 'v / \ WOME.Ñ THE CLINIC "".DI ......." _. ..."'.... . SHOE kW Lf\tW ' SOME STYLES ALSO AVAILABLE IN COLORS. .SOME STYLES 3Y2-12 AAAA-E,$17.95to$24.95 For a complimentary pair of white shoelaces. folder showing all the smart Clinic styles. and list of stores selling them. write: THE CLINIC SHOEMAKERS · Dept. CN.4 1221 Locust St. . St. Louis, Mo. 63103 2 THE CANADIAN NURSE APRIL 1970 Editorial I The Canadian Nurse ð A monthly journal for the nurses of Canada published in English and French editions by the Canadian Nurses' Association Volume 66, Number 4 April 1970 31 A Split in the Family ........................................................................... S. Rose 33 Welcome to the Picture Province .................................................. V. Fournier 37 Cancer Detection Clinic............................................................ F.H. Cracknell 39 Cancer Can Be Beaten ..................................................................... K. Antoft 41 University Schools of Nursing in Canada 52 Counseling Students in a Hospital School of Nursing ........................................................D.G. Ogston and K.M. Ogston The views expressed in the various articles are the vie\\s of the authors and do not J"ecessarily represent the policies or views of the Canadian Nur e ' Association. 4 Letters 9 News 22 Names 24 Dates 26 New Products 28 In a Capsule 54 Research Abstracts 55 Books 56 AV Aids 56 Accession List Executive Director: Heten K. \Iussallem - Ed. itor: "ÜJ:inia A. Lindabun - Editorial Assist. ant: Carol A. I\.otlarsk, . Production Assist. ant: IlÏLabeth .\. Stantòn - Circulation Man. ager: Beryl Darling - Advertising Manager: Ruth H. Baumel - Subscription Rates: Can- ada: One Year, $4.50; two years, $8.00. Foreign: One Year, $5.00; two years, $9.00. Single copies: 50 cents each. Make cheques or money orders payable to the Canadian !\urses' Association. - Change of Address: Six weeks' notice; the old address as well as the ne.... are necessary, together with regis. tration number in a provincial nurses' asso- ciation, where applicable. Not responsible for journals lost in mail due to errors in address. Canadian Nurses' Association 1970. \Ianuscript Information: '"The Canadian Nurse" welcomes unsolicited articles. All manuscripts should be typed. double-spaced. on one side of unruled paper leaving ....ide margins. Manuscripts are accepted for re\ie.... for exclusive publication. The editor resef\es the ri!!ht to make the usual editorial chan!!es. Photographs (glossy prints) and graphs and diagrams (dra....n in india ink on white papert are welcomed with such articles. The editor is not committed to publish all articles sent, nor to indicate definite dates of publication. Postage paid in cash at third clas rate MO'ITREAL. P.Q. Permit No. 10.001. 50 The Driveway, Ottawa 4. Ontario. For Smokers Only Having read that the Great Man Himself - Dr. Sigmund Freud - tried all his life without success to give up smoking (he apparently averaged 20 cigars a day, clenching them with some difficulty as his jaw had become cancerous and had been replaced by an artificial one), we wondered what chance we would have to kick the habit. After all, we lacked his obvious motivation for wanting to quit, to say nothing of his rare gift of introspectiOi And our past efforts to abstain from cigarette smoking didn't offer much encouragement. As Mark Twail said many years ago, "It is easy to give up smoking. I have done it thousands of times." Nevertheless we decided to give it another try. Admittedly, much of the impetus for our decision to stop smoking came from the non-smokers in the building - a disgustingly healthy, cough-free group who cleared their throats and rubbed their eyes complainingly whenever they were forced to enter our polluted comer. Not the least of these was a reformed smoker - the 1ibrarian - who continually brought to our attention magazine an< newspaper items that did little for the morale. Sample headlines: Smoking Beagles Get Cancer; Female Mouth Cancer Rate Up; Smokers Responsible For More Fires; Smoker' Bad Breath Knocks Over Non-Smoke At Twenty Paces, etcetera. If there's anything worse than a reformed smoker, particularly if she happens to be a librarian. . . . But on with the story. It's now over 15 weeks since we hac a puff. That's 15 LONG weeks. But we're living proof that it can be done. Furthermore, we've given heart I a ph) sician friend \\ ho had doubts that a heavy smoker really could quit. "If YOll can do it, anyone can do it," this physician exclaimed. (After an icy silence, we decided to accept the remark as a compliment.) Has it been worth the effort? Absolutely. And we'd be delighted to pass on our method to anyone interested in trying to stop. It's now April- "cancer month"- a good time for any smoker to quit. With pleasant weather and more outdoor activities ahead, a mok.er's chance of staying off the weed is better. Now we don't want to sound like a reformed smoker, but let us draw certain facts to your attention. V.A. THE Cf4NADIAN NURSE 3 APRIL 1970 letters { Letters to the editor are welcome. Only signed letters will be considered for publication, but name will be withheld at the writer's request. Show me that you care The article, "Nurse. Please Show Me That You ('are " (Feb. 1970) by Pamela Poole seems ideal in theory, but could be practicable only in a dream hospital with one nurse to three patients. To my knowledge. no such place exists. Until nursing conditions and salaries improve, the profession will not be attrac- tive to young high school graduates. With a chronic nursing shortage, putting indivi- dualized care back in nursing - as ex- plained by Miss Poole - is a far-off goaL - J Comeau, RN, Halifax, Nova Scotia. I must admit that the article, "Nurse, Please Show Me That You Care! " (Feb. 1970) made me angry. However, this does not mean I am unconcerned about nurs- ing care. I certainly hope to see it improved, but ( don't think this can be accomplished by attacking staff nurses and telling them to spend less time with routine chores and more time with patients. How many nurses have greeted a supervisor with a comment such as: "I had a long talk with Mr. Smith tonight about his finding a place to live," and received a reply such as: "That's fine - are your wheelchairs washed? " Staff nurses have always cared for their patients. I presume this is why most of us entered nursing. If that care has been smothered or extinguished by rou- tine business. I suggest looking at higher levels for the cause and the cure. - M Hepburn, RN. Halifa"t, Nova Scotia. After reading Pamela Poole's article, "Nurse, Please Show Me That You Care! " (February 1(70), I was in no way angered. but I was somewhat confused. As the new trend in nursing is toward specialization and automation one not more than the other - Miss Poole is either putting the cart before the horse or does not believe that absence makes the heart grow fonder. I agree with Miss Poole that a nurse is not a nurse if she does not care. I would even say that a person who does not care for others is not a whole person. Al- though I sympathize with the author's anxietie , this article contains no solu- tion. Maybe, a yet, there is none. Under the heading "ritualism vs. judg- ment." Miss Poole states that 20 years ago the patient was weakened by remain- ing in bed postoperatively. On discharge. 4 THE CANADIAN NURSE to prevent him for failing or perhaps to prevent the hospital from a lawsuit, the nurse took the patient to the front door and accompanied him to the waiting vehicle. So, for 20 years I have been tricked into thinking that this was tender, loving care! When progress was needed, we should have asked: progress of what, and for whose betterment? - Dorothy M. Dent, Ottawa. Hurrah for Pamela Poole on her article about slavery to routine! If nürses would stop taking the time to say, "I haven't enough time," and would take the time to give the kind of nursing care they say they want to give, they might be surprised at what they get done. It is up to each nurse to try to get rid of routine. Unfortunately, the staff nurse can get very discouraged using her initia- tive and talents to help her patients, when she must continually answer to head nurses and supervisors who are hung up on routine. All supervisory staff are not like this, but a good many still are and do a great deal to interfere with individualiz- ed care. - Rhoda L. Brooke, RN, Vancouver, B. C The pregnant student nurse I have spent seven years nursing in obstetrics - six in the case room and one as head nurse of a postpartum unit, before retiring to the new role of mother- hood. During these years, I gained insight into the trauma resulting from pregnancy out of wedlock. One patient, in particular, made me wonder about the policies of our nursing institutions. She was a student nurse with three months of training to complete when she was forced to give it up because of pregnancy. Without job training and an adequate income, she eventually had to give up her baby for adoption. As the age ot permIssIveness IS here to stay, all we can do is contribute a positive example to young women. My plea is to eliminate the nursing drain that results from undesired preg- nancy in the student nurse. In many cases, pregnancy forces the student nurse to leave the educational institution and go into society as just another dropout, untrained to fill any role. Few places of higher learning, apart from schools of nursing, force a student to give up her education completely because of preg- nancy. Schools of nursing should examine their policies and decide whether their rules need updating. This may be hard to accept, but undesired pregnancy is here to stay. Would we sooner have the student obtain an abortion. legal or otherwise, so that on the surface everything is rosy? Will the presence of a pregnant student taint the moral outlook of her fellow students? We would be naive, indeed, to believe so. Most young women have concluded for themselves the course of action they wish to follow in most situations, and there is not much that parents and educators can do to alter this. We can, however, alter the outcome by making available information on how to prevent pregnancy. Not all schools of nursing apply an outdated moral, ethical code to its students. But for every pro- gressive school, there are probably five that need a change in policy. We need to accept the fact that a number of students will be lost to the profession if forced to leave because of pregnancy. The profession needs every trained and skilled individual. We must not be guilty of old-fashioned concepts in an ever-changing world. - Francene (McCarthy) Cosman, RN, Dartmouth, Nova Scotia. Change "midwife" to "matrician" About a month ago, an article written by Sidney Katz in the Toronto Star was drawn to my attention. In this article, Dr. Helen K. Mussallem, executive director of the Canadian Nurses' Association, des- cribed the term "midwife" as follows: "It has a stigma attached to it. It conjures up a picture of an old, unhygienic, un- scientific granny delivering babies in the backwoods, relying heavily on supersti- tion and magic elixirs. We need a new term to reflect the scientific training of the modern nurse-midwife." This is precisely the way in which I have thought of this word, and this has worried me as it is an obstacle to modern obstetrical developments. I would like to suggest a solution to this problem. The word I suggest is "matrician." The first part of the word refers to maternity, motherhood. etc., and the Letter!"> Welcome Letters to the editor are welcome. Be- cause of space limitation, writers are asked to restrict their letters to a maximum of 350 words. APRIL 1970 second part refers to the scientific train- ing necessary for the management of the mother. It compares with technician, obstetrician, etc., and has a direct rela- tionship to maternity work. I think parents would be proud to be able to say: "Our RN daughter is now studying to be a matrician," whereas they probably would not even mention that their daugh- ter was a midwife. Similarly, the appeal to the youngster would be far greater with this term than with anything else I have been able to come up with. The term "maternity nurse" is bulky, awk- ward, and difficult to apply. I hope that publication in your journal will at least bring this matter to the attention of a large number of people who are interested and concerned about this matter. - Michael Broser, MD, ,Mall Medical Group, Winnipeg, Manitoba. Ht'alth Services I would like to comment on the recom- mendation of the task force on health services regarding time spent by public health nurses in school service. (Task Force on the Cost of Health Services in Canada, February 1970, page 23.) The recommendation was that this time should be reduced. Since I have read only this condensed report, I do not know how the task force reached its decision. I know, however, that I do not agree with this recommendation. I speak from experience in a general- ized public health program and in a specialized full-time school health service program. It is necessary to spend enough time in the school to be part of the staff so that teachers and students feel free to seek counseling. It is possible to do a routine, superficial job in less time, but this does not fulfill a school nurse's function of preventing and detecting problems that arise. Our society is producing more dis- turbed children who must be accommo- dated as far as possible in the ordinary school program. Due to her unique train- ing, the public health nurse is able to help both pupil and teacher in this problem area - but this takes time. If public health agencies find it neces- sary to reduce service to schools, perhaps more school boards will be forced to hire full-time nurses. On page 15 of the February issue, The Canadian Nurse re- ports that this appears to be happening, according to a survey of Ontario schools. Dorothy Fulford, Ottawa, Ontario. Up-to-date publication After reading the rebruary issue of The Canadian Nurse, I would like to say what a marvelous magazine it is and how much I appreciate the articles. Thank you for an instructive and up-to-date publication. Mrs. Betty Kwiatkowski, RN, Ontario. 0 APRIL 1970 40 Tuok_i - "':::-.:0- " For nursing . convenience. . . patient ease TUCKS offer an aid to healing, an aid to comfort Soothing, cooling TUCKS provide greater patient comfort, greater nursing convenience. TUCKS mean no fuss, no mess, no preparation, no trundling the surgical cart. Ready- prepared TUCKS can be kept by the patient's bedside for immediate appli- cation whenever their soothing, healing properties are indicated. TUCKS allay the itch and pain of post-operative lesions, post-partum hemorrhoids, episiotomies, and many dermatological conditions. TUCKS save time. Promote healing. Offer soothing, cooling relief in both pre-and post-operative conditions. TUCKS are soft flannel pads soaked in witch hazel (50%) and glycerine (10%). TUCKS - the valuable nur- sing aid, the valuable patient comforter. '- Specify the FULLER SHIEL as a protective postsurgical dressing. Holds anal, perianal or pilonidal dressings comfortably in place with- out tape, prevents soiling of linen or cloth- ing. Ideal for hospital or ambulatory patients. vI'VINLEY-l\IORRISL<;gj. M MONTREAL CANADA TUCKS is a trademark of the Fuller Laboratories Inc. THE C4NADIAN NURSE 5 l' l I{"'I ( l . " ' A.\{l'OI-UHU>R '\ 1.r.xTI!(J()1i (Jt I)I \1; '1\ - '\ .' ( " . 'q' .. '" . .. _ , tJl , { T ... '- - Order Nt>W .....' , 11'1" - Ilnl 1::1... =-::11: t:::a.. Q)=-a a: ",a.. _CO) \ -. -"c cn ."'C -.. c:::= - 'fit ... "" '" ' - .r . .. I ., Ii ! I -- -- :::: ....... \; ::! :. t Q l fJIsS' . . for Fall Classes. . . New (2nd) Edition! TEXTBOOK OF MEDICAL-SURGICAL NURSING By Lillian S. Brunner, R.N., M.S., Charles P. Emerson, Jr., M.D., L. Kraeer Ferguson, M.D., Doris S. Suddarth, R.N., M.S.N. Specifically designed to develop clinical expertise. Out- standing in its depth of pathophysiologic as well as psychosociologic factors involved in patient care. In- cludes entirely new or expanded material on vascularJ 1130 Pages . 325 Illustrations . cardiacJ respiratory intensive care nursing J neurologic and neurosurgical problemsJ burnsJ genitourinary and gynecologic disordersJ rehabilitative measures. 2nd Edition, April 1970 About $14.95 . PHARMACOLOGY AND DRUG THERAPY IN NURSING By Morton J. Rodman, M.S., Ph.D., and Dorothy W. Smith, R.N., M.S., Ed.D. This text's pharmacodynamic approach provides the untoward effects, cOntra indications, and implications student with a true understanding of the nature of for nursing action. nA textbook of superb quality. . .n drug action and a sound rationale for nursing inter- _ American Journal of Nursing. vention. Covers sources, dosage, physiologic action, (Includes "NURSES GUIDE TO CANADIAN DRUG LEGISLATION") 738 Pages . Illustrated . 1968 . $10.75 Cooper's NUTRITION IN HEALTH AND DISEASE By Helen S. Mitchell, Ph.D., Sc.D., Henderika J. Rynbergen, M.S., Linnea Anderson, M.P.H., and Marjorie V. Dibble, M.S. A comprehensive survey of the principles of nutrition and their application to normal and therapeutic needs is presented in the 15th Edition of this classic text. Additional emphasis is given to the underlying bio- 685 Pages . 6 THE CANADIAN NURSE chemical and physiological components of nutrition as they affect the maintenance or restoration of optimum health. 121 Illustrations . 15th Edition, 1968 . $10.00 APRIL 1970 FUNDAMENTALS OF NURSING: The Humanities and Sciences in Nursing By Elinor V. Fuerst, R.N., M.A., and LuVerne Wolff, R.N., M.A. This extensively revised and expanded edition reflects greatly increased emphasis upon the independent func- tions implicit in the nursing role. Highlighted are nurs- ing responsibilities that include care of man as a human being as well as a biological organism. Nursing 446 Pages measures, fundamental to the care of all patients, have been added and others updated. Stressed are the phy- siologic, pathologic and psychosocial bases for nursing intervention. . 166 Illustrations . 4th Edition, 1969 . $8.25 CARE OF THE ADULT PATIENT: Medical-Surgical Nursing By Dorothy W. Smith, R.N., Ed.D., and Claudia D. Gips, R.N., Ed.D. A patient-centered text that emphasizes the needs of cepts from the life sciences. Nursing principles and medical/ surgical patients and the nurse's role in caring practices created by advances in nursing and medical for them. Incorporated throughout are relevant con- knowledge are included. 1206 Pages . 406 Illustrations . 2nd Ed.ition, 1966 . $13.00 BASIC PHYSIOLOGY AND ANATOMY By Ellen E. Chaffee, R.N., M.N., M. Litt. and Esther M. Greisheimer, Ph.D., M.D. This skillful blending of the two sciences provides the student with a vivid picture of living man. Revised and updated to reflect recent research findings in bio- science, this edition has enhanced value as a basic text 634 Pages . 412 Illustrations, 45 for students of nursing and allied health fields. Chapter-end summaries and review questions combine to stimulate and guide the student. in Color, plus Videograf@ . 2nd Edition, 1969 . $10.25 SCIENTIFIC FOUNDATIONS OF NURSING By Madelyn T. Nordmark, R.N., M.S. (N.E.), and Anne W. Rohweder, R.N., M.N. This text applies the principles and facts from the bio- developing understanding of the relevance of science physical, social and behavioral sciences to clinical content to effective nursing care. An indispensable nursing. It is designed to clarify and give added mean- instrument for problem-solving, nursing observation, ing to basic science courses and to aid the student in assessment and intervention. 388 Pages . 2nd Edition, 1967 . Paperbound $5.25 . Clothbound $7.50 New (8th) Edition! NURSING CARE OF CHILDREN By Florence G. Blake, R.N., M.A., F. Howell Wright, M.D., and Eugenia H. Waechter, R.N., Ph.D. This completely revised and expanded edition of a very associated nursing therapies. Special attention is given popular text offers increased emphasis on growth and to recent trends in minority group problems, adolescent development at each age period from infancy to ado- development, and cultural differences as they relate to lescence. Recent findings in all areas of care are re- nursing care. flected - growth and development; medical entities; 588 Pages . 254 Illustrations . 8th Edition, 1970 . $10.00 New (8th) Edition! PROFESSIONAL NURSING: Foundations, Perspectives and Relationships By Eugenia K. Spalding, R.N., D.H.L., and Lucille E. Notter, R.N., Ed.D. Extensively revised, this authoritative text reflects the added to include such topics as Responsibility for present range of opportunity and status of professional Nursing Practice, the American Nurses Foundation, and nursing. All chapters have been updated and new ones legal issues in nursing practice. 700 Pages . Illustrated . Ready, Spring 1970 . About $10.25 BASIC PSYCHIATRIC CONCEPTS IN NURSING By Charles K. Hofling, M.D., Madeleine M. Leininger, R.N., Ph.D., and Elizabeth A. Bregg, R.N., B.S. By presenting basic concepts useful in all areas of non-psychiatric as well as the psychiatric setting. Em- nursing, the authors provide content and method phasis is on nursing care and the nurse's significant essential to the practice of professional nursing in the position. 583 Pages . 2nd Edition, J 967 . $7.50 iPPincot PHILADELPHIA. TORONTO APRIL 1970 THE C.4NADIAN NURSE 7 or you a your patIent Now in 3 disposable forms: · Adult (green protective cap) · Pediatric (blue protective cap) · Mineral Oillorange protective cap) Fleet - the 40-second Enema * - is pre-lubricated. pre-mixed. pre-measured. individually-packed. ready-to-use. and disposable. Ordeal by enema-can is over! Quick. clean. modern. FLEET ENEMA will save you an average of 27 minutes per patient - and a world of trouble. mm - EM.i ' JIIDI ENEMA' mm -ENEM '---AN Dil WARNING: Not to be used when nausea, vomiting or abdominal pain is present. Frequent or prolonged use may result in dependence. CAUTION: DO NOT ADMINISTER TO CHILDREN UNDER TWO YEARS OF AGE EXCEPT ON THE ADVICE OF A PHYSICIAN. In dehydrated or debilitated patients, the volume must be carefully determined since the solution is hypertonic and may lead to further dehydration. Care should also be taken to ensure that the contents of the bowel are expelled after adminislration. Repeated administration at short intervals should be avoided. L""' &.... f.:Jooooi Full information on request. *Kehlmann, W. H.: Mod. Hosp. 84:104,1955 FLEET ENEMA@- single-dose disposable unit A QUALITY PHA"....ACIEUTICALS * L LCo. 'fJIM< qualified applicants for Put Damper On Bargaining these 6 posItIons. . Amherst, N.S. - Negotiations between ApplIcants for the school of nursmg the board of commissioners of Highland will n? longer. be required. t.o pass the View Hospital and the registered nurses' AtlantIc Provmces Exammmg Board staff association of the hospital broke examinations as a prerequisite for admis- down in late February when the board sion. This is because the University of said it could not offer any wage increase Prin e .Edwar.d I la d h.as establish d new or additional fringe benefits for 1970. admission cntena In heu of passmg the The board said this was a direct result examinations, and the school is following of budget restriction placed on the hos- suit. pitaJ for 1970 by the Nova Scotia Hos- pital Insurance Commission. Provincial hospitaJs' operating budgets will not in- crease this year over 1969 despite requests for an overall 10 percent in- crease. The Registered Nurses' Association of Nova Scotia beJieves this situation will hamper all collective bargaining by nurses in 1970. To date 12 nurses' staff associa- tions have been formed in the province. ;/ f \ , 1". TV's Marcus Welby, MD, Honored .>Þ , , t , I I r - ..... .. .. \ - . \ .--- " \. ð Ina L. Williams, president of the Association of Operating Room Nurses, presents a plaque of appreciation to Robert Young, star of Marcus Welby, M.D., at the I opening session of the 17th Annual AORN Congress held in California in February. Mr. Young welcomed the 6,000 operating room nurses and other health industry I leaders to the Los Angeles area. Other participants in the opening ceremonies shown here are Betty Thomas of Denver, who was installed as ihe new president; and Dr. Denton Cooley, of Houston, Texas, famous heart transplant surgeon. 10 THE CANADIAN NURSE " ' ..." ). Þ' ':iY ........., t ," :. .. ... .", ...' ?f"':' t.'" . "'t t'" New Two-Year Contract For RNABC Vancouver. B. C - The terms of a new two-year contract for some 5,000 regis- tered nurses in 69 British Columbia hospi- tals have been announced by the Register- ed Nurses' Association of British Colum- bia. The agreement worked out between the RNABC and the British Columbia Hospitals' Association is effective from January 1, 1970 to December 31,1971. It provides for an eight percent salary increase during the first year and a seven and one-half percent increase the second year. The 1970 base rate for a registered general staff nurse will be $549 to a APRIL 1970 maximum of 5684. The base rate for that level in 1971 will be S590 to a maximum of 5740. The base rate in 1969 was $508 to 5633. The contract also provides for a short- er work week of thirty-eight and three- quarter hours in the first year and thirty- seven and one-half hours in the second year. The portability clause provides for transferable salary increments, sick leave benefits, and service credits toward extended vacations if not more than 60 calendar days elapse after a nurse's last employment in another British Columbia hospital. Benefits also include a shift differential of S 1.20 for each afternoon and night shift worked. 3-M Nursing Fellowship Awarded Geneva, Switzerland. - Berenice King of New Zealand is the first nurse to receive the 3-M Nursing Fellowship. The $6,000 award, sponsored by the Minnesota Min- ing and Manufacturing Company and administered by the International Council of Nurses, IS for postbasic nursing studies in the institution of her choice. Miss King, who was one of 28 appli- cants, is a member of the national econo- mic welfare committee in New Zealand. As nurse adviser (nursing education) to the division of nursing of the Ministry of Health in Wellington, New Zealand, she is involved in reviewing schools of nursing. She previously held posts as ward sister, tutor sister, public health nurse in a rural area, and temporary nurse instructor in public health. B renice King took her basic nursing training at the Christchurch School of Nursin\ New Zealand. A registered Ished pr 't;' u dergo today;s mos tl1 regimen as well as microbiological tests an,l patient safety and comfort. I Professional quality of needles and syringes Super sharp 304 stainless steel lancet poinj short and intradermal bevels. Burrs and cC by world famous Gillette grinding technique ally cleaned. microscopically inspected an are protected by color coded patented. I which prevents tampering and rolling, act! or remove needle, isolates contaminated n able in 26 to 18 gauge with lengths from %' Velvet smooth aspiration and Injecllon. plungers, extra wide comfortable wings, c: thumb pieces combine to create a com1 balance and flawless action which makes po. Other features include easy-to-read vertic will not rub off or fade, airtight leak-resistan needle hub and syringe luer tip, and ex1 popular syringe sizes. Wide choice of syrin syringe combinations are standardized for and economy. Dual purpose packaging promotes organize' and aids disposal. Compact corrugated c ship all components. Attractive, durable intE protect contents until use and double as I 8'-rllon Corporallon 1505 Wuhlngton Street . Bralnt" Subaldlarl.. of The Gillette Company maternity nurse and registered midwife, she is also the holder of the Plunket Nursing Certificate and a certificate in psychiatric nursing. She holds a diploma of nursing from the New Zealand Post- Graduate School for Nurses and has BA and MA degrees in education from the University of Canterbury in Christchurch. Miss King plans to use the fellowship for studies in nursing research at the Ohio State University School of Nursing in the United States. On completion of the program she hopes to return to the nursing division in New Zealand. She believes that New Zealand has a commit- ment to aid developing countries in the South Pacific and Southeast Asian region, and "would consider it a privilege to contribute to this aid in the field of nursing. " All 74 national nurses' associations in membership with ICN will agin be invited to submit applications for the second 3-M Nursing Fellowship, which will be award- ed in January 1971. Editor Needed For ICN Nursing Review Geneva, Switzerland. - The Internation- al Council of Nurses is seeking applica- tions for the post of editor of the International Nursing Review. The successful candidate must take up the position by October 1970 and will reside in Geneva. Applicants must have previous experience in the editorial aspects of magazine production and must speak English, with a good working knowledge of French. It would be an advantage to be a nurse. Further details may be obtained from: ICN Headquarters, P.O. Box 42, CH-1211 Geneva 20, Switzerland. NBARN Sets Up Management Nurses' Association Fredericton. N.B. - A new organization formed within the New Brunswick Association of Registered Nurses, the Management Nurses' Association, will assume an active role in nursing affairs that relate to the management nurse group. Its first meeting was held here March 16. The association was developed in response to an expressed need for oppor- tunity to discuss mutual goals and prob- lems. Membership is open to all registered nurses employed full-or part-time in a management position. The constitution defines a management nurse as an RN who is responsible for administering the nursing program in a hospital or agency. The MNA lists five objectives: to promote highest possible health standards for the people of New Brunswick; to establish lines of communication with employers and with other appropriate groups; to promote and sponsor educa- (Cul/tillucd on pOKe 14) When your day starts at ß 6 a.m... you're on charge duty... you've skimped on meals... and on sleep... (t; you haven't had time to hem 1?- adress... make an apple pie... wash your hair. Ø#i. even powder 4f . (L your nose Iin comfort..." I it's time for a change. Irregular hours and meals on'lhe. run won't lasl. BUI your personal irregularity is another mailer. It may seltle down. Or il may need gentle help from DOXIDAN. use DOX I DAN@ most nurses do DOXIDAN is an effecrive laxallve for the gentle relief of conslipation wilhoul cramping. Because DOXIDAN con. tains a dependable fecal solrener and a mild perislalric slimulant. evacualion is easy and comlonable. For detaIled informat" - " Vademec 1m or CompendIum. tH R 3 Ê DIVISION OF CANADIAN HOfCHST liMITED ..........1 (PMAC) ..... THE CAIltADIAN NURSE 11 \ \:\\ \ . . 1 I - .,. r- 110I1 - \ \ "\ \ j . , \\\\ ; ). -"-,( .. - s1'"erllcnl STERIMED C™ SYSTEM . .... "', ". , ' ' -- ' " 'Ii . , \\ ! I " ... ',' \' '- -' -- 1"e rt1on J -- ..... ... -;q; .', I ì \\ ... IIJ ....... "........ - I psplt ls operating budgets wIll no m- ease this year over 1969 despite quests for an overall 10 percent in- ease. The Registered Nurses' Association of 40va Scotia believes this situation will 'mper all collective bargaining by nurses 1 1970. To date 12 nurses' staff associa- ons have been formed in the province. ... ew Two-Year :ontract For RNABC Vancouver, B.C - The terms of a new 'wo-year contract for some 5,000 regis- .ered nurses in 69 British Columbia hospi- tals have been announced by the Register- d Nurses' Association of British Colum- bia. The agreement worked out between the RNABC and the British Columbia Hospitals' Association is effective from January I, 1970 to December 31, 1971. It provides for an eight percent salary increase during the first year and a seven and one-half percent increase the second year. The 1970 base rate for a registered general staff nurse will be $549 to a APRIL 1970 New Disposable Needles and Syringes Professional quality to earn your confidence An answer to your quest for quality. Sterilon achievement in sterile disposables combines with the facilities and experience of Gillette to produce superiority and integrity in a totally new disposable hypodermic system. Working with Gillette Research Institute near Washington, D. C. and Gillette Surgical of England, Sterilon has developed Sterimedic needles and syringes. These "Depend- able Expendables" offer maximum flexibility and convenience for the hospital staff. , . utmost security for your patients. Each Sterimedic component incorporates the best features of existing products. The system adapts to familiar hospital proce- dures, speeding your work flow and avoiding confusion. Advanced clean room creates Sterimedlc needles and syringes. To achieve a controlled manufacturing environment, Sterilon designed and built a sophisticated clean room. This room, with its personnel, precision equipment and procedures, assures pre- eminent hospital quality in every STERIMEDIC component. Fin- Ished products undergo today's most up-to-date sterilization regimen as well as microbiological tests and evaluations to assure patient safety and comfort. Professional quality of needles and syringes earns your confidence. Super sharp 304 stainless steel lancet point needles offer regular, short and intradermal bevels. Burrs and coring edges minimized by world famous Gillette grinding techniques. Needles ultrasonic- ally cleaned, microscopically inspected and siliconized. Needles are protected by color coded patented. snap cap rigid sheath which prevents tampering and rolling, acts as wrench to tighten or remove needle, isolates contaminated needle after use. Avail- able in 26 to 18 gauge with lengths from %" to 1 Y2 ", Velvet smooth aspiration and injection. Stable, multi-vaned plungers, extra wide comfortable wings, contoured and grooved thumb pieces combine to create a comfortable grip, perfect balance and flawless action which makes positive control a reality. Other features include easy-to-read vertical calibrations which will not rub off or fade, airtight leak-resistant connection between needle hub and syringe luer tip, and extra mixing ranges in popular syringe sizes. Wide choice of syringe sizes and needle/ syringe combinations are standardized for hospital convenience and economy. Dual purpose packaging promotes organized use of CSR storage and aids disposal. Compact corrugated cartons are boxed to ship all components. Attractive, durable intermediate boxes fully protect contents until use and double as disposal receptacles. Color coding for quick, positive Identification of needle gauges. Boxes and individual packages are plainly marked with color coding, contents. directions. Needle box features perforated cover, reclosable for storage. Internationally accepted color code needle sheaths, hubs and snap caps. Handy Peel Paks assure sterility.. of needles and syringes. Separate easily to fully expose contents. Permit sterile aseptic introduction onto sterile field. Serve as patient charge records. "CAUTION: Federal (U.S.A.) law restricts this device to use by or at the dlfection of a physician. As with a/l sterile dlsposab'e Items, the packaging should always be checked. " the packaging Is damaged or seal broken, product should not be considered sterile. Steristation provides convenient storage at nursing stations. Plastic trays may be kept in existing storage space or in heavy duty, lockable, brushed stainless steel Steristation. Holds ample stock of needles and syringes in sizes and quantities to suit most needs. Ideal means of organizing, storing, dispensing and re- filling ward supplies through either one-for-one exchange or restocked replacement of entire unit. Steritray Is your key to convenience, adaptability and safety dur- ing delivery of medications. Lightweight, durable, only 13V2" x 15", Filled syringes are placed needle sheath down in Steritray, carned to bedside, injected, resheathed and temporarily disposed of in paper bag. Patient and nurse are protected since only minimal handling is necessary. Spaces for 12 syringes, 24 medication cups, dosage cards and alcohol swabs. Sale, secure method of disposal. After injection, needle sheath is used to snap needle at its mid-point, then replaced on the luer tip and snapped downward to destroy the syringe. Red "contaminated" labels convert packing box into disposal re- ceptacle. Needles and syringes are pushed through sunburst one-way opening. Filled box is taped shut for final disposal. Invaluable In-service training provided by Sterllon. A thorough evaluation program will be designed and implemented by your Sterilon representative. Comprehensive in-service training is con- ducted through a series of orientation lectures on all three shifts. Assured service and supply. Components and continuing tech- nical assistance are always available to meet your emergency or routine needs. For complete Information. Call your Sterilon representative, hospital supplier or write: - s"t"er'IC"1 8'-rllon Corporation 1505 Washington Street. Bralntree, Mass. 0218-4 Subsidiaries 01 The Gillette Company 8terllon 01 Canada, Ud. 3269 American Drive. Malton, Ontario .U. S. Patent 3,114,455 Steromedic 1M Is a trademark 01 Stenion Corporation news (Continued from page 11) tional programs and/or workshops; to regulate relations between management nurses and their employer and to negoti- ate a written contract; to establish and promote salaries and conditions of employment for management nurses that reflect the value of their services to society and their worth in relation to other occupations and professions. The provincial committee of the MN A has representatives from each of five regions as determined by the provincial health district boundaries. Membership in the committee consists of regional com- mittee chairmen and secretaries. Officers of the MNA provincial com- mittee are: president. Constance Morri- son; vice-president, Anne Thorne; secre- tary, Virginia Levesque; treasurer, Ruth Dennison. Education, finance, and nego- tiating committees have been set up to help achieve the MNA's objectives. "Miss Hope 1970" Toronto, Onto - Judy Sharpe, nurse in- tern at St. Joseph's School of Nursing in Peterborough, Ontario, has been chosen "Miss Hope 1970" in the competition ----------------------- MOVING? BEING MARRIED? Be sure to notify us six weeks in advance, otherwise you will likely miss copies. Attach the Label From Your last Issue OR Copy Address and Code Numbers From It Here NEW (NAME) IADDRESS: Street City Zone Prov.lState Zip Please co mplete appropriate category: o I hold active membership in provincial nurses' assoc. I I I I I I I I I The Canadian Nurse : 50 The Driveway I OTTAWA 4, Canada I -------------------- 14 THE CANADIAN NURSE o reg. no.lperm. cert.llic. no. I am a Personal Subscriber. MAIL TO: J !r.ø - \ .n; r ,;!"; .\\ {J ' "tb- -J;D . ' v 0.0 . ...... .... ' t ýl' ' _,r" '9.: : <:- Ii i { " ' , ) ..ð; .\ ,t.N v . D '" yV- 'OL OtO .... . . ,, ""I'>' t:."t... . "V" . .I''f" .' .,. " / :;" f ., . - { " 1" i ./ ...Á... TV personality Fred Davis congratulates Judy Sharpe of Peterborough. Ontario, who was chosen "Miss Hope 1970" by the Ontario Division, Canadian Cancer Society. !f {,' . . r , '"' '" ..I + sponsored by the Ontario Division of the Canadian Cancer Society. Miss Sharpe competed with 12 other contestants in Toronto on January 25th, each of whom gave a three-minute talk on some phase of cancer nursing, the cancer problem, and the Canadian Cancer Society. In addition to receiving a cash prize of $200, Miss Sharpe will represent the Cancer Society on special occasions at public meetings, on radio, and on televi- sion appearances. Her travels will be underwritten by the Cancer Society. Judy Sharpe is a native of Picton, Ontario. She has her gold cord in Girl Guides and has been a Red Cross swimm- ing instructor. When she graduates this year she plans to specialize in pediatric and intensive care nursing. St. Lawrence College Teams With Regional School of Nursing Brochil/e, Onto - St. Lawrence College, Brockville Campus, has entered a coop- erative program with the Brockville Gen- eral Hospital Regional School of Nursing for the teaching of non-nursing science subjects to first- and second-year students. A sociology course is now given to 60 first-year nursing students at the school by a St. Lawrence College teacher. In September the program will expand to eight non-nursing science courses for first- and second-year students, to be given by college staff rather than nurse-teachers, as is currently the practice. Courses will include such subjects as ... 1'Jj,'t""\" ::: ...)t .... \.,. .. .. " developmental psychology, philosophy, and English and will result in St. Law- rence College credits on successful com- pletion. Elaine McClintock, director of the regional school of nursing, said the use of St. Lawrence College teaching staff to instruct non-clinical subjects will enrich the overall nursing program. She said the broader academic background of college teachers will benefit nursing students by providing a more rounded education in purely academic subjects. Mrs. McClin- tock pointed out that nurse-teachers will be relieved of non-clinical teaching loads. permitting them to devote full-time to nursing science instruction. The cooperative program is patterned after similar ones developed between community colleges and their local schools of nursing throughout Ontario. RNABC Asks Government To Adjust PH Budget VanCOlwer. - The Registered Nurses' Association of British Columbia has asked the B.C. government to adjust the budget for public health services. The recommen- dation was made in a brief submitted in February to the provincial cabinet. The association is concerned that in recent years the numbers of public health personnel employed in B.C. have failed to keep pace with the increase in population or with the increased utilization of ser- vices, such as home nursing and follow-up of patients being treated for psychiatric disorders. (Continued on page 1 7) APRIL 1970 1 r TOUULtR DlU NEWBORN REGULAR NEWBORN SHORT PREMATURE The "Saneen" disposable diaper concept. What are its advantages? In providing greater comfort and safety for the infant: More absorbent than cloth diapers, "Saneen" FlUSHABYES draw moisture away from baby's skin. thus reducing the possibility of skin irritation. Facial tissue softness and absence of harsh laundry additives help prevent diaper derived irritation. Five si::es designed to meet all infants' needs from premature through toddler. A proper fit every time. Single use eliminates a major source of cross-;nfection. Invaluable in isolation units. In providing greater hospital convenience: Polywrapped units are designed for one-day use, and for convenient storage in the bassinet. Also, Saneen Flushabyes do not require autoclaving-they contain fewer pathogenic organisms at time of application than autoclaved cloth diapers.. Prefolded Saneen disposables eliminate time spent folding cloth diapers in the laundry and before application to the infant. Easier to put on baby. Constant supply. Saneen Flushabyes eliminate need for diaper laundering and are therefore unaffected by interruptions- in laundry operations. Elimination of diaper misuse, which may occur with cloth diapers. .The leRiche Bacteriology Study-I963 More and more hospitals are changing to Saneen Flushabyes disposable diapers. Write us and we will be glad to supply you with further information on clinical studies, cost analysis, and disposal techniques. Use these and olher fine Saneen products 10 complete your disposable program: MEOICAL TOWELS. "PERI-WIPES" TISSUE. CELLULOSE WIPES, BEO PAN DRAPES, EXAMINATION SHEETS AND GOWNS aneen + Factll. Company llmiled, 1350 Jano SI.eel. Toronto 15.0nl."o, Subsidiary 01 Canadian Internallonal Paper Company. 68-H. '.Saneen.., .'Flushabyes'., .'Pen-Wlpes.' RegOd T.Ms. Facelle Company limited comfort. safety. convenience IA ! Gome to New Brunswick " , , the picture rovince of Canada, for your oli y , I ' . / II:': ) this year and attend the 35th Biennial ': , ': r Convention of the Canadian Nurses' Association I' . III \ -. \,\\ ,_'X B8 11 88 11 J 1 _.. \ I ....e" I :' \."""" . .I I "'II , --I ' \1 ",::',. ,',,"" :, B I BJ8'I I HB I Iì" \, :"", . - \ - fi'(þ: 11 æ:;!:..>,,;;;,,:: I , 1;--f-- I\W''''.\ If. _ I I II I 'L..ÀlllVIilIIlJtl:iþll U 'j lit' ',AI' I \ IT" r-,,;::::;.-- '..,.- - p:::;:'\ "4"- -;--- ,.I'\",,,..\\,,.I!,, f I >I- , 1/11 ',,'1il ;;: ",'. ' '11 '\'\\\"î-' I' . "" - ' I, ..,. " t ' ..J '''II ----- t, .., ill II " ,"',' " '- .,' . \ """ A 1 '1 1 ";';" \ I -, -( 1 4d · -I .\"I :'''',,'I'J r ':' 1 ", ) .,"1. , . I ''I. , . \ I ....;./ 11 " -.J /I." 'ttJII \ II >T "I" 't ....1,:/" . \ , "'I' / ' "s". ...rv""' ' " "" " ;L . ",1,1' \ -- ,/ .:- - - . 't r . jj,. '. - = --=---r '- ---- .;, '-' " !",: ....,_ /,------- I r. ilÄ . , ' - -. i i , , ."' , Fredericton and New Brunswick... so much to enjoy! The capital of New Brunswick, Fredericton is one of the most picturesque cities in Canada. You will be delighted with its elm-shaded streets, its parks and the scenic river winding through the city. Visit the art gallery, where paintings by Turner and Gainsborough, Krieghoff and Dali are displayed; or the York- Sunbury Museum with its outstanding collection of military equipment and rooms furnished in period style. Fredericton's cathedral is one of the best examples of Gothic architecture in North America. Tour the campus of the University of New Brunswick, where new and old buildings combine. While you are here, don't miss the picture provinæ itself. Enjoy the miles of inland waterways, the boating, the many picnic and camp sites. Or head for the sunny, sandy beaches of the coast. Whether in bustling cities, quiet towns or charming fishing villages, you will find friendly hospitality in this province of two cultures - 40 per cent of New Brunswickers are French-speaking. There is much here for 16 THE CANADIAN NURSE the historically minded, including the oldest museum in Canada, at Saint John; the French-built Fort Beauséjour; and the Auld Kirk at St. Andrews. Not to be missed is Fundy National Park, 80 square miles of spectacular vacationland stretching from beaches and towering cliffs to deep forests and quiet lakes. Visit the Fundy Isles, including Campobello, long the summer home of the Roosevelts. Unique natural phenomena in the province include Magnetic Hill, the Reversing Falls, the tidal bore of the Petitcodiac River and the magnificent rock formations at Hopewell Cape. New Brunswick has 180 covered bridges, including the longest one in the world. Skilled craftsmen make shopping for silver, pottery, woven, wooden and leather goods a delight. There is comfortable accommoclation everywhere, and you can savor the famous Atlantic cuisine, including lobsters, salmon, oysters, fiddleheads, and dulse! APRIL 1970 - .- ..-. _-....A"'.. '-'. ....,.. .11 Gebhardt's text, students learn basic microbiology labora tory principles and procedures. and explore soil and sanitaqC. microbiology, microbial genetics, and pathogenic micro\ \. organisms. The 26 relatively simple experiments inciudSISTOSCOPE sub-units which may be assigned for added depth. ThetNED, ... HE NURSE realistic design makes use of naturally occurring micro-' ical Perfection . d . I h . bl S h . U'DDAINT't organIsms an matena s w enever pOSSl e. earc 109 ques- ED AND DEPENDABLE tions which follow each unit guide effective review. March. AND fLEXIBLE 1970. Approx. 112 pages. 5 illustrations. About $5.25. : ;C N D nr 'DCKET AND f'OCKETBDDK news (Continued from page 14) The situation has become even more critical this year because the government has allowed no increase in nursing person- nel, says RNABC. CMHA Council Discusses Mental Health Problems Toronto, Onto - Drug abuse and proper use of sensitivity training were among the problems discussed by some 45 menbers of the national scientific planning council of the Canadian Mental Health Associa- tion during its 22nd annual meeting in February 1970. Among the decisions of the council were the following: . A study group is being set up to gather information on all public health programs across Canada that have a mental health aspect. The Canadian Nurses' Association will suggest a public health nurse to be a member. . CMHA will set up consumer guidelines for potential participants in the new sensitivity training groups run by com- mercial enterprises. It is hoped these guidelines will enable people to measure the value to them of such a group before taking part. . CMHA will approve a demonstration and training project for mental health personnel concerned with the care and management of patients in a drug crisis. . CMHA will prepare a brief to the LeDain committee on the non-medical use of drugs, concentrating on the prob- lems of drug abuse in society. . CMHA has established a draft of guide- lines for volunteers who work in schools with a focus on emotionally disturbed children. The association believes such volunteers can be most useful. CNA representative at the annual meeting was A. Isobel MacLeod, director of nursing at The Montreal General Hos- pital. and are most abundant along the rivers and their valleys. The fiddlehead can be found in mamy areas of North America. But only in a few areas - including New Brunswick - have they become a delica- cy and the basis of a business. WHO Bans Smoking At Its Meeting Geneva. Switzerland. - The executive board of the World Health Organization has requested that those attending its meetmgs refrain from smoking. The board welcomed similar action taken on cigarette smoking by WHO's regional committees for the Americas and Europe. The board's resolution recognizes "that the individual must decide for himself whether he will risk endangering his health by smokmg cigarettes, but should also have regard to the influence on others of his example." The board also stated its belief that no organization devoted to the promotion of health can be neutral in this matter. In discussion, board members called smoking "the principal avoidable cause of premature death." As pointed out in the resolution previously adopted by the WHO regional committee for Europe, this decision was (Continued on page 20) *T.M. =---:]; ASSISTOSCOPE, DESIGNED WITH THE NURSE IN MIND Acoustical Perfection . SLIM AND DAINTV . RUGGED AND DEPENDABLE . LIGHT AND FLEXIBLE . WHITE OR BLACK TUBING . PERSONAL STETHOSCOPE TO FIT YOUR POCKET AND POCKETBOOK Order from vi M WINLEY-MORRIS CO. LTD. Surgical Products Division MONTREAL 26 QUEBEC \) ,\\)\\ ()\H \>t tO t MD r ----l I 2795 BATES RD. MONTREAL, P.Q. I I Please accept my order lor I I - - 'Assistoscope(s)' at Sl2.95 each I o White tubing 0 Black tubong I I NAME I I ADOIIESS I I CHY I L_______________J R..idenh of Quebec add 8% Provincial Sale. Tax. TIMES I - Made In Canada APRIL 1970 THE C. V. MOSBY COMPANY, LTO . 86 NORTt THE CMIADIAN NURSE 17 .,- '5> \ -_ . ,r, -. -6t la " , '. .r W -t '" /' ' . ':.t.:' . . .;/' / ' '1.' \ . '. ..../ / ":.1" \''1: 9- I J t;. . . ' . - :-\\.,l t - ; - -; t. .2, << . "t / 1.. .. " , '0..) \ {, '\(.. r_ '\ll ;..' r ' / New 5th Edition! NEUROLOGICAL AND NEURO- SURGICAL NURSING By Esta Carini, R.N, Ph.D.; and Guy Owens, MD. The unquestioned leader in its subject area, this newly revised 5th edition stresses the need to understand each patient's social and emotional needs as well as hilì physical problems. The authors accurately describe diagnostic procedures and evaluation, medical and surgical treatment, and nursing care of patients with neurological diseases. Clearly written sections outline cur- rent nursing care in cerebrovascular disease, injuries to the nervous system, convulsive disorders, and other "road categories. Recent material clarifies blood-brain barrier, brain scan, and other vital topics. January, 1970.398 pages, 122 illustrations. $10.85. New 7th Edition! ORTHOPEDIC NURSING By Ca"oll B. Larson, M.D., F.A.C.S.; and Marjorie Gould, R.N, B.S., M.S. A major revision in format and content makes this new 7th edition of the most popular text on this subject an even more valuable delineation of current medical and surgical nursing care. A new introductory chapter explains body mechanics, and one compact section on spinal cord injuries replaces the scattered discussions in previous editions. More detail has been added to emphasize preven- tion and rehabilitation of chronic crippling. New illustra- tions and an enlarged bibliography \ expand this text's teaching value. February, 1970. 500 pages, 377 iIIus- (J" > trations. $10.45. ' \ \10 J \ New 5th Edition! PSYCHIATRIC NURSING By Ruth V. Matheney, R.N, Ed.D.; and Mary Topalis, R.N., Ed.D. This widely adopted text can help your students develop the under- "'- standing of interpersonal relationships they need to give successful nursing care, and the specific knowledge and skills to care for psychiatric patients. Carefully revised and updated, this edition uses a behavioral approach to de- lineate personality development and mental health, prin- ciples of psychiatric nursing, and their application to care of patients with specific disorders. A new section describes the concept of crisis intervention. Current official classifi- cation of disorders updates this edition. February, 1970. Approx. 368 pages, 33 illustrations. $6.90. 18 THE CANADIAN NURSE Pertinent, sensitive new texts and workbooks make nursing A New Book! TEAM LEADERSHIP IN ACTION - Principles and Applications to Staff Nursing Situations By Laura Mae Douglass, R.N, B.A., M.S., and Em Olivia Bevis, R.N, B.S., M.A. An outstanding new supplementary reference for your "Fundamentals" course, this unique book can give your students vital insight into their role in team leadership, in the form of predictive principles which can help them coordinate effort and organization to give the best possible nursing care. Specific leadership principles examined in depth include teaching-learning, group dy- namics, delegation of authority, and evaluation of per- sonnel. Numerous examples demonstrate these predictive principles in action. February, 1970. 151 pages, 2 illustra- tions. $5.45. A New Book! WORKBOOK FOR PEDIATRIC NURSES By Norma J. Anderson, R.N This stimulating new work- book employs a thoughtful case-study approach, which helps your students transfer theory into practice by comparing their own experience with the nursing care given to these prototype cases. This logical study begins with a survey of normal growth and development. A lucid prob- lem-solving format then presents basic principles of pedi- atric nursing technique and problems in specific disease conditions, accompanied by searching questions. Explana- tory drawings clarify difficult areas. Pages are punched and perforated for convenient use. March, 1970. 169 pages, 21 illustrations. About $4.40. ..!,)! the historically minded, including tne OloeSl II'U""UIII III Canada, at Saint John; the French-built Fort Beauséjour; \ land the Auld Kirk at St. Andrews. ,\ I- 'V Not to be missed is Fundy National Park, 80 square miles of spectacular vacationland stretching from beaches and owering cliffs to deep forests and quiet lakes. Visit the Fundy Isles, including Campobello, long the summer home of the Roosevelts. Unique natural phenomena in the province include Magnetic Hill, the Reversing Falls, the tidal bore of the Petitcodiac River and the magnificent rock formations at Hopewell Cape. New Brunswick has 180 covered bridges, including the longest one in the world. Skilled craftsmen make shopping for silver, pottery, woven, wooden and leather goods a delight. There is comfortable accommoclation everywhere, and you can savor the famous Atlantic cuisine, including lobsters, salmon, oysters, fiddleheads, and dulse! APRIL 1970 New 2nd Edition! PROGRAMMED INSTRUCnON IN ARITHMETIC, DOSAGES, AND SOLUTIONS By Dolores F Saxton, R.N., B.S.. M.A.: and John F Walter. Sc.B., MA., Ph.D. This carefully structured presentation, proven effective in four years of actual use, allows students to proceed in short, logical steps, at their own speed, from basic to more complex material. This new edition has been revised to include a review of basic concepts of arithmetic, presented in terms of both "old" and "new" math. It introduces the metric and apothecaries' systems, and the problems encountered in moving from one system to the other. Students then move on to mathematical problems encountered in actual nursing situations. July, 1970. Approx. 64 pages, 2 illustrations. easier to teach, easier to learn! New 4th Edition! MICROBIOLOGY By Louis P. Gebhardt, MD., Ph.D. An ideal text for nursing students without an extensive scientific background, this well-balanced survey of fundamental microbiology carefully examines general principles, industrial and sanitary applications, and patho- genic microorganisms. This carefully revised new edition incorporates updated terminology and revised classification of microorganisms, as well as an outstanding new discussion of molecular biology and microbial genetics. A short section on rejection immunity indicates problems en- countered in organ transplantation. New illustrations and an expanded glossary higWight this edition. March, 1970. Approx. 364 pages, 133 illustra- tions. About $10.75. A New Book! MICROBIOLOGY LAB- ORATORY MANUAL - A Sequence of Experiments By Louis P. Gebhardt, M.D., Ph.D. In this flexible manual, correlated with the new edition of Dr. Gebhardt's text, students learn basic microbiology labora- tory principles and procedures, and explore soil and sanitary microbiology, microbial genetics, and pathogenic micro- organisms. The 26 relatively simple experiments include sub-units which may be assigned for added depth. Their realistic design makes use of naturally occurring micro- organisms and materials whenever possible. Searching ques- tions which follow each unit guide effective review. March. 1970. Approx. 112 pages, 5 illustrations. About $5.25. New 6th Edition! SCIENTIFIC PRINCIPLES IN NURSING By Shirley H. Gragg, R.N., B.S.N., B.A., M.A.; and Olive M. Rees, R.N., M.A. This extensively revised new edition uses a modern multidisciplinary approach to emphasize problem- solving by use of known principles. In effect a new book in both content and appearance, it offers a fresh new view of this basic material. Relevant material on concepts of homeostasis is correlated throughout, as is much more information from the physical, biological, social, and behavioral sciences. A meaningful section uses sample plans to demonstrate the importance of effective nursing plans, and an entirely rewritten section on rehabilitation reflects current emphasis on this area. April, 1970. Approx. 424 pages, 165 illustrations. About $8.55. New 2nd Edition! BASIC CONCEPTS IN ANATOMY AND PHYSIOLOGY - A Programmed Presentation By Catherine Parker Anthony, R.N., MA., M.S. This self-teaching manual can help your students develop a clear, functional under- standing of the human body. In a format proven by the success of the first edition, it presents important, up-to-date material on each body system, and requires the student to respond to the information. Two new chapters in this timely revision depict the circulatory system and kidney function. Many new frames in other sections add recent developments and enhance learning. New illustrations clarify important points. July, 1970. Approx. 180 pages, 52 illustrations. About $5.25. New 3rd Edition! INTEGRA TED BASIC SCIENCE By Stewart M. Brooks, M.S. This compact fusion of basic physics, chemistry, micro- biology, anatomy and physiology can help you elimmate time-consuming duplication of material in your curriculum. Proven effective through two previous editions, this timely revision is a logical, sequential presen- tation of essential laws and theories, and the application of these principles to the appropriate body system. It incor- porates carefully selected new material, including a new chapter on genetics. A Teacher's Guide is furnished without charge to instructors adopting this text. April, 1970. 522 pages, 316 illustrations. $11.00. MOSBV TIMES MIRROR THE C. V. MOSBY COMPANY. LTD. . B6 NORTHLINE ROAD · TORONTO 374, ONTARIO, CANADA .. APRIL 1970 THE CANADIAN NURSE 19 news (Continued from page 1 7) motivated by the fact "that cigarette smoking is an important cause of, or a substantial factor contributing to, premature death from bronchopulmonary cancer, coronary disease, chronic bronchi- tis, and other chronic lung diseases." Nurses Discuss Communication And Evaluation Ottawa. - Some 270 registered nurses and nursing students attended a nursing service symposium on communication and evaluation presented by the Universi- ty of Ottawa School of Nursing in Janu- ary 1970. The symposium brought together scholars, specialists, and practitioners from nursing, medicine, psychology, and education to share knowledge and discuss issues. It was open to graduate nurses employed in hospitals and public health agencies in the Ottawa Valley. First day of the symposium was devot- ed to communications, and included discussion on: the need for communica- tion in health care facilities; how communications affect nursing service and the distribution of care; the nature of leadership and the need for leadership behavior. During the second day topics included: the need for evaluation in nursing service; interviewing and rating scales; developing an evaluation program for nursing care. ICN Committee Members Outline Basic Issues For 1969-73 Quadrennium Geneva, Switzerland. - The professional services committee of the International Countil of Nurses will recommend that a special ICN committee be set up "to study development and utilization of library resources, facilities and services for nursing." The committee, meeting in January at ICN Headquarters, feU the need to devel- op the use of library resources in nursing was urgent at this time. The committee also discussed the need for a definition of one or more groups of auxiliary nursing personnel in existence. A questionnaire will be sent to all nation- al nurses' associations in 1970. asking if they wish to suggest new names for a second and third category of nursing personnel and to state to what extent these two categories are organized in their countries. The committee believes the difference between the registered nurse and the categories of auxiliary nurse should be identified in terms of practice of nursing. preparation for nursing, and formal recognition awarded. 20 THE CANADIAN NURSE , j I . .... "" o /If Panel members during the first day of the Ottawa University School of Nursing's symposium on communication and evaluation are, from left: Roy Laberge, editor of Canadian Labour; Geneva Lewis, director of public health nursing at the Otta- wa-Carleton Public Health Unit; Roberta Rivett. of Ottawa Civic Hospital; and J. Brown, director of nursing service at Ottawa General Hospital. {CN headquarters has prepared a "historical background to the preparation of a special international instrument on the status of nurses." The committee will in future decide on the points that nurses would wish to see included in this doc- ument when it is published. The docu- ment will deal with all nursing personnel. The committee reviewed the (CN code of ethics and will recommend that a sub-committee be set up to consider its revision. Chairman of the committee is Ingrid Hamelin, Finland. Members include: Laura Barr, Canada; Rebecca Bergman, Israel; Adele Herwitz. USA; Renée de Roulet, Switzerland; Gertrude Swaby. Jamaica; and Margery Westbrook, United Kingdom. This was the first meeting of the committee for the 1969-73 quadren- nium. Canadian Nurses Give Volunteer Service In West Indies Montreal, Quebec. - Three young nurses from The Hospital for Sick Child- ren in Toronto are working in St. Lucia. West Indies. as volunteers with Canadian Executive Service OverseJs The CESO undertaking began m 1968. Kerry Pincombe, Susan Webb, and Anita Miller have been working at St. Judes Hospital in Fort Vieux, St. Lucia, since October 1969. They are expected to remain on the island, where they are working mainly with children, until May 1970. Under a combined plan of CESO and the Canadian Medical Association, physicians, surgeons, nurses, and techni- cians take time out from their practices and positions in Canada to relieve over- worked medical personnel in the Carib- bean and to direct improvements in medical services in the developing islands. The work is hard, often complicated by shortages of essential drugs and equip- ment, the unaccustomed heat is trying, and the queues of patients long. Yet in a recent report, the three Toronto nurses said: "So far our work at St. Judes has been very challenging and rewarding. . . the opportunities we've had really make our three years of training worth while." The CMA selects the Canadian person- nel who serve without remuneration. The host government or institution furnishes living accommodation and incidental expenses, and CESO provides travel costs. Enquiries can be directed to Dr. John Bennett. CMA House, 1867 Aha Vista Drive, Ottawa 8, Ontario. 0 APRIL 1970 "l, ..'. 'n.. . . . n - " 'n "'" ! -" 7 16845 \ WHITE UNIFORM bv sa ge F atig hJ Q"Q! Maybe you feellike this after your tour of duty. After giving hours of service above and beyond the call. . . Then it's tÎ1lle to call in Whi te U ni... fonn Oxfords. Here's a bCL1l1tijid way to win the battle of foot [ltigue. They're scientifically designed to give your feet cOlnfort. DdY in. Day out. No l11atter what your orders. So if you're looking for a pair of Oxfords that will stand up for you, buy Whi te U nifonll by Savage. ..... ... " j....... \ \ , . j .. ,. . .. , " --1 , \ \ . , , * .... ..- '\\\ names James H. Wiebe is the new director general of the medi- cal services branch of the Department of National Health and Welfare. Dr. Wiebe will direct the branch's activities, - which include health and treatment programs for Indians and Eskimos, administration of quarantine regulations. and immigration medical work overseas. Dr. Wiebe, a native of Saskatchewan, received a bachelor of arts degree from the University of Saskatchewan in 1939. While he was a medical student at the University of Manitoba during World War II, he joined the Royal Canadian Army Medical Corps. In 1946, he was seconded by the army to conduct a health program on the Caradoc Indian reserve in Ontario. After discharge with the rank of captain, he joined the newly-formed Indian Health Service of the Department of National Health and Welfare. Dr. Wiebe has worked as medical superintendent for the Lady Willingdon Hospital on the Six Nations Reserve near Brantford. Ontario. and as director of the eastern region of the Indian and Northern Health Service. an area that included most of Ontario. Quebec, the Maritimes. and the eastern Arctic. ... Margaret Phillips (Reg.N., The Hospi- tal for Sick Children, Toronto; Cert. in Teaching, McGill U.; B.S. in Nurs., and M. Litt.. U. of Pitts- burgh Nursing School; Ph.D., U. of Pittsburgh School of Education) has become associate profes- sor at the University of Toronto School of Nursing. Dr. Phillips has worked in Toronto as a staff nurse at Sunnybrook Hospital and as an instructor in psychiatric nursing at Wellesley Hospital; in London, England, as a staff nurse at Maudsley Hospital; and in Pittsburgh, Pennsylvania, as a head nurse and supervisor at Western Psychia- tric Institute, and as assistant professor at the University of Pittsburgh School of Nursing. The School of Nursing, Memorial Univer- sity of Newfoundland. St. John's. has announced four faculty appointments. 22 THE CANADIAN NURSE --- ;,.- -- ) . B. Coady Shirley A. Campbell Barbara Coady (R.N., Salvation Army Grace Hospital, Halifax, N.S.) has been appointed dinical instructor in psychia- tric nursing at Memorial University of Newfoundland. Mrs. Coady previously worked as a staff nurse at the Salvation Army Grace Hospital in Halifax. an instructor at the Hospital for Mental and Nervous Diseases in St. John's. New- foundland, and an instructor at the Salva- tion Army General Hospital in St. John's. Active in the Association of Registered Nurses of Newfoundland, Mrs. Coady was public relations chairman for four years and was a member of ARNN's education committee. Shirley A. Campbell (R.N., Akron City H., Akron, Ohio; B.Sc.N., U. of Akron) is a lecturer at Memorial School of Nursing. Mrs. Campbell held the positions of staff nurse, head nurse, supervisor, and assis- tant director of nursing at Children's Hospital in Akron. Ohio. " ....", . , 111 --!> &- loytl Mukerjee Marilyn Marsh Joyti Mukerjee (B.Sc.N., M.N., College of Nursing, Delhi U., India; B.Ed., Calcutta U., India) is a lecturer at Memorial School of Nursing. Miss MukeIjee held a number of nurs- ing positions in India. She was a staff nurse, instructor, nurse educator, and administrator with the West Bengal Government Service at Medical College Hospital in Calcutta and Presidency General Hospital. She also worked as an instructor with the Lien Service in Rangoon, Burma. Marilyn Marsh (R.N., St. John's General H.. Nfld.; Dipl. Nursing Education. U. of Western Ontario; Dip!. Rehabilitation Nursing New York U.; B.N.. Memorial U. of Newfoundland) is a lecturer at Memo- rial School of Nursing. Mrs. Marsh work- ed as a clinical instructor at St. John's General Hospital and director of nursing at the Children's Rehabilitation Center in St. John's, Newfoundland. She has served on various committees of the Association of Registered Nurses of Newfoundland. Philip E.T. Gower (R.N.. Nova Scotia H., Dartmouth, N.S.; B.Sc.N.. U. of West- ern Ontario, Lon- don) has been ap- pointed assistant director of nursing service at Queen Street Mental Health , Centre in Toronto. Mr. Gower has been supervisor of eastern service at Queen Street Mental Health Centre. He previously worked at London Psychiatric Hospital and was a staff nurse in the operating room of the Toronto Western Hospital. As a member of the Registered Nurses' Association of Ontario, he was active in the creation of the Middlesex North chapter, and was chairman of the socio-economic commit- tee while attending university. The Winnipeg General Hospital in Winni- peg, Manitoba, has announced two appointments to the department of nurs- ing service. ...# I ""'::\--' --- "SENTRY" SPRAY PROTECTOR ProtlCts you 1IIInst vt01.nl man 01' do, . _ . ,"stlntl, d,ubles Without pennlnenl Inlll')' No. AP-16 S..try . . 2.25 ... ppd I . ORDER NO. ITEM I I COLOR QUANT. PRICE I I PIN LETT. COLOR, 0 Bl;lCk (J Blue 0 While (No. 1691 . METAL FINISH, 0 Gold 0511_ INIJ.W.S _ _ _ I LETTERING. . I . . . ..1 2nd Line I ..clOM S . Send 10 Ilsl_t. \rCi:í.. iï I.... : 'le.M .lIaw sunlc.lenl: tlmo tar d.hvery. THE CANADIAN NURSE 23 dates April 16-17, 1970 First Assembly of the Canadian Re- habilitation Council for the Disabled, Fort Garry Hotel, Winnipeg. Theme: The voluntary agency in crisis. For further details, write to: The Canadian Re- habilitation Council for the Disabled, Suite 303, 165 Bloor St., E., Toronto 285, Ontario. April 17-18, 1970 First assembly of the Canadian Rehabili- tation Council for the Disabled, Winni- peg. Write to CRCD, Suite 303, 165 Bloor St. E., Toronto 285, Onto April 30-May 2, 1970 Registered Nurses' Association of Onta- rio, Annual Meeting, Royal York Hotel, Toronto. Write to the RNAO, 33 Price Street, Toronto 289, Ontario. May 1970 Workshop on pediatric nursing, The Hos- pital for Sick Children, Toronto. For further information, write to The Hos- pital for Sick Children, 555 University Avenue, Toronto 2, Ontario. May 4-7, 1970 First National Operating Room Nurses' Convention, Queen Elizabeth Hotel, Montreal. For further information write to: Mrs. I. Adams, 165 Riverview Drive, Arnprior, Ontario. May 4-28, 1970 Developing Leadership in Supervision of Nursing Services, a continuing education course designed for nursing staff of hospi- tals and community health agencies who take responsibility for the work of others. For information write to: Continuing Education Program for Nurses, Division of Extension, University of Toronto, 84 Queen's Park, Toronto 5. May 11-June 5, 1970 Rehabilitation Nursing Workshop, an intensive four-week course offered annually to registered nurses working in acute general and chronic illness hospi- tals, nursing homes, public health agencies, and schools of nursing. For information write to: Continuing Educa- tion Program for Nurses, Division of Extension, University of Toronto, 84 Queen's Park, Toronto 5, Onto May 12-15, 1970 Alberta Association of Registered Nur- ses Convention, Calgary Inn, Calgary. For further information write to: AARN 10256 - 112 Street, Edmonton, Alberta. 24 THE CANADIAN NURSE May 14-15, 1970 National workshop on increased educa- tional opportunities for the deaf of Cana- da, Don Valley Holiday Inn, Toronto. Information is available from Mr. E. Marshall Wick, President, Canadian Asso- ciation for the Deaf, 210-200 Gateway Blvd., Don Mills 402, Ontario. May 19-22, 1970 61st annual meeting of the Canadian Public Health Association, Marlborough Hotel, Winnipeg, Manitoba. Write to: CPHA annual meeting, Norquay Building, Room 316, 401 York Avenue, Winnipeg, Manitoba. May 18-22, 1970 Workshop on tests and measurements for teachers in schools of nursing, sponsored by the Registered Nurses' Association of Nova Scotia. Jean Church, assistant direc- tor, Dalhousie University School of Nurs- ing, will be leader of the workshop. For further details write to the RNANS, 6035 Coburg Rd., Halifax, N.S. M y 26-28, 1970 Annual meeting of the Registered Nurses' Association of Nova Scotia, Acadia Uni- versity, Wolfville, N .S. F or more informa- tion, write to: RNANS, 6035 Coburg Rd., Halifax, N.S. May 27-29, 1970 Registered Nurses' Association of British Columbia Annual Meeting, Bayshore Inn, Vancouver. Write to the RNABC, 2130 West 12th Ave., Vancouver 9, B.C. May 28-29, 1970 Workshop for community nurses, spon- sored by the faculty of nursing, The University of Western Ontario. Profes- sionals from family practice education, medical sociology, and nursing research will address the group. A one-day follow- up session will be held in late fall. Address inquiries to: Ethel Horn, Asso- ciate Professor and Director, workshop for expanding role of the community nurse, faculty of nursing, The University of Western Ontario, London 72, Onto May 28-29, 1970 Annual meeting of the Manitoba Associa- tion of Registered Nurses, International Inn, Winnipeg. For further information, write to MARN, 647 Broadway Avenue, Winnipeg, Manitoba. June 1-3, 1970 Annual meeting of the Canadian Confer- ence of University Schools of Nursing with the Learned Society at the Universi- ty of Manitoba, Winnipeg. For further information, write to Margaret G. McPhed- ran, President, CCUSN, The University of New Brunswick, Faculty of Nursing, Fredericton, N.B. June 1-3, 1970 70th annual meeting of the Canadian Tuberculosis and Respiratory Disease Association and the 12th annual meeting of The Canadian Thoracic Society will be held at the Fort Garry Hotel, Winnipeg. Further details are available from Dr. C. W.L. Jeanes, Executive Secretary, CTRDA, 343 O'Connor Street, Ottawa 4, Ontario. June 3-5, 1970 Canadian Hospital Association national convention and assembly meeting, Jubilee Auditorium, Edmonton, Alberta. Focus will be on the hospital and community health. Tours of the Rocky Mountains will be available at the end of the convention but must be paid for by April 30. Reservation deadline for the conven- tion is May 1. Write to the CHA, 25 Imperial Street, Toronto 7, Ontario. June 10-13, 1970 First annual meeting of the Canadian Association of Neurological and Neuro- surgical Nurses in conjunction with the Canadian Congress of Neurological Sciences, Royal York Hotel, Toronto. For further information write to: Miss M. Maki, Apt. 306, 161 Wilson Avenue, Toronto 380, Ontario. June 15-19, 1970 Canadian Nurses' Association General Meeting, The Playhouse, Fredericton. New Brunswick. June 17-20, 1970 20th annual meeting of the Canadian Psychiatric Association, Winnipeg. For information, write to: The secretary, Canadian Psychiatric Association, 225 Lisgar St., Suite 103, Ottawa 4, Ontario. July 18-22, 1970 Annual meeting of the Canadian Pediatric Society, Fort Garry Hotel, Winnipeg. Write to: Dr. V. Marchessault, executive secretary, Canadian Pediatric Society, Department of Pediatrics, University Hos- pital Centre, University of Sherbrooke, Sherbrooke, Quebec. 0 APRIL 1970 I ......... ... .. ". C5:RV" rH Of' TC..., ... ... A ^I S STAfJ[) FEMALE PE , '_I I r' ".., , '1_. when teen-agers want to know about menstruation one picture may be worth a thousand words Never are youngsters more aware of their own anatomy than when they begin to notice the changes of adolescence. And never are they more susceptible to misinformation from their friends and schoolmates. To negate half-truths, give teen-agers the facts- using illustrations from charts like the one pictured above. They'll help answer teen-agers' questions about anatomy and physiology. These BW' x II" colored charts of the female reproductive system were pre- pared by R. L. Dickinson, M.D. and are supplied free by Canadian Tampax Corporation Ltd. laminated in plastic for permanence, they are suitable for grease pencil marking. And to answer their social questions on menstruation, we also offer two booklets - one for beginning menstruants and one for older girls- that you may order in quantities for distribution. Tampax tampons are a convenient - and hygienic - answer to the problem of menstrual protection. They're convenient to carry, to insert, to wear, and to dispose of. By preventing menstrual discharge from exposure to air, Tampax tampons prevent the embar- rassment due to menstrual odor. Worn internally, they APRIL 1970 cause none of the irritation and chafing associated with perineal pads. Tampax tampons are available in Junior, Regular and Super absorbencies, with explicit directions for insertion enclosed in each package. TAM PAX SANITARY PROTECTION WORN INTERNAllY MADE ONLY BY CANADIAN TAMPAX CORPORATION LTD.. BARRIE, DNT. FREE CHARTS IN COLOR Canadian Tampax Corporation Ltd.. P.O. Box 627, Barrie, Onto Please send free a set of the DIckinson charts, copies of the two booklets, a postcard for easy reordering and samples of Tampax tampons. Name Address CN-. _________________________J THE CANADIAN NURSE 25 new products { Descriptions are based on information supplied by the manufacturer. No endorsement is intended. "tll t.nll Wnn. ; a ......... '" . - '", l "- " \\ \. j . i , I " J , :-/ ;.;w,. 'c Transistorized Monitoring Instrument A new monitoring instrument permits a doctor or nurse to keep track of fetal hearbeats of 10 patients at a time from one central listening post location. Designated the MM-IOOO, this transis- torized instrument was developed by the medical division of Magnaflux Corpora- tion. Chicago, for use with its MD-501 ultrasonic Doppler shift instrument that provides an easily interpreted audible signal of fetal heart rate. The ct.r1tral station unit extends moni- toring to patients in separate, preselected rooms. Instant selection of any patient is available by adjustment of a station selec- tor dial. A trained operator can listen for abnormalities in as many as 10 patients. even while performing other duties. The ultrasonic monitoring is valuable in evaluating fetal conditions during preg- nancy and labor, and in positively iden- tifying certain conditions associated with grave prognosis in time for corrective action. The transducer probe of the central station unit is quickly and easily affixed to the exterior of the patient's abdomen. 11 C . .4 ! / / . , . --' \ 4. I\. ....... J. - It sends signals that are monitored through a high-fidelity, built-in speaker. or through headphones. Slight adjustment of the transducer position and of volume and tone controls on the MM-lOOO panel provides fine tuning of signals. Since the Doppler output represents motion of the fetal heart rather than sound. there is little or no interference from background noise associated with maternal motion. This system requires no invasion of the birth canal or rupturing of membranes. which may be necessary in fetal electro- cardiology. The MM-1000 unit features solid state circuitry with instant warm-up. It is finished in gray vinyl and weighs about 20 pounds. This Doppler instrument is available from Electronic Instruments La- boratory, 1565 Louvain Street West. Montreal 355, Quebec. Safety Lap Robe This lap robe keeps the patient covered. his legs and feet warm, and protects his clothing. The waist belt holds the patient against the back of the chair and keeps Barium Enema Units This system offers a wide choice of Barium enema units, pre-charged with barium enema administration units. Ad- Barimex, Baraloid. or Baracoat, or empty, vantages of the system are a rigid. wide- are individually packaged with the widest mouthed spout for filling; screw-Jew Brunswick deserves its description as the picture province of Canada. It is a giant rectangle. some .:! .OOO square miles in area. bound- ed by the Bay of Fundy and the Gulf of St. Lawrence on the seaward sides and by Quebec. Nova Scotia. and Maine on the land frontiers. Inviting roads lead you through vast forests. rivers. and hills and along 600 miles of seacoast. New Brunswick offers the summer visitor clean. uncrowded beaches, warm sunny days and cool nights, the quiet charm of the rural countryside. New Brunswick is a busy. progressive province. It has vast pulp and paper mills: commercial fisheries on a large scale; large mineral resources now being developed; and a thriving agriculture of potatoes. poultry. livestock. and apples. But New Brunswick is also steeped in history. Nearly 45 percent of its people are French speaking and the influence of their Acadian background has' blended with that of the modern-day descendents of the United Empire Loyalists who emigrated north during the American Revolution. The population of 626,000 lives in fishing villages or bustling cities. in quiet towns and snug rural communi- ties. You would naturally think of a holi- day by the ocean in New Brunswick. Along the coast are dozens of sweeping APRIL 1970 Welcome to the picture province New Brunswick, with ih picturesque countryside ,md 600 miles of sea shore, its quiet villages and bustling cities, will be the extra attraction for nurses who attend the 35th gener.,t "* ". . . .-... .. .. . .. ,# . : . .....JI '_. ",!' .... -. ..j ...i! t, '1:- - . '\'" f" ... ;.. ../ , . '. Þ , .. .' A.",. . engine, and it coasts uphill backwards without help! Some say it is an optical illusion, but most visitors to the hill simply say they don't know how it happens. While at the hill you can also visit the nearby provincial game farm and observe at close range deer, moose. bear, and beaver in their natural habitat. The curious rock formations at Hope- well Cape on the upper reaches of the Bay of Fundy are well worth a visit. Known as the Sentinels and the Caves, these giant columns of rock that guard 36 THE CANADIAN NURSE .i. .. .... - ;, .- '"" *4 ..,' ,_. r - ' - ,. the entrances to huge caves have been quarried from the soft red sandstone by the erosive action of the Fundy tides. Atop one of the columns grows a good- sized tree, billed as "the largest flower pot on earth." Perhaps the greatest oddity of them all has been seen by only a few: the mysteri- ous fire-ship that sometimes haunts the Northumberland Strait. It is a large full- rigged four-masted ship, with her masts and sails ablaze, and she only appears when a rainstorm is lashing the area. 1' , ) - 4 . t .... - j' 91 t "';' "" . '..... Þ.. :. "'" · ..r.. ,: f! '"" .:7 , ,;':' " / ',...\ , :.. ., :. t . . .;Æ' .... ( . .... - . Nobody knows her origin, and to date she is simply known as "the phantom ship of Northumberland Strait." I . Bridges & bargains A delightful feature of New Brunswick is the abundance of covered wooden bridges - about 180 in all. They include the longest covered bridge in the world, 1 ,28 feet long, at Hartland. Most of these old bridges are off the beaten paths; on many you can still find ornate hand- lettered signs promoting horse blankets, Iinaments. and buggy whips. There are even reminders to "walk your horse and save the fine." The provincial governmeht has instituted a long-range plan to save some of these covered bridges and restore them to their original condition. Another way to get across New Bruns- wick's many waterways is by ferry; the province has a fleet of car ferries that ply the main rivers. All are free. Shopping, or just browsing, can be a treasure hunt in New Brunswick; the contemporary crafts have a sophistication of design that makes them valued souve- nirs. . Meticulous craftmanship distin- guishes the hand-wrought silver, the graceful pottery and the famous woven, wooden, and leather goods. You can buy beautiful handwoven tweeds at St. Andrews, silver jewelry set with native stones at a studio in Sussex; or visit the Loomcrofters at Gagetown and the Madawaska Weavers in St. Leonard. All over the province craftsmen produce attractive leather goods, wood carvings, basketry, needlework. metal- craft, and allied arts. You should also visit the Indian and Eskimo craft center at Nashwaak, which offers the largest selec- tion of native crafts in the Maritimes. Leading Canadian artists have studios in New Brunswick, where tourists are welcome and advice is dispensed to all who ask. Collectors who wish to buy paintings to take home will find them in abundance and variety and at reasonable prices. One other treat the visitor to New Brunswick will not want to miss is the Atlantic cuisine. You can enjoy fresh lobster, salmon, oysters, delicious berries of every kind with thick country cream, and fresh vegetables. You can make up your own mind about dulse, and savor the delicious fiddlehead greens. Wherever you go New Brunswickers will give you a warm and friendly welcome. And you can be sure of a unique stay in the picture province - after all, where else can you fmd. a reversing falls, the world's longest cove.!ed bridge, and a phantom ship? 0 _. APRIL 1970 Cancer detection clinic More than 20 years ago, a few women took advantage of the facilities offered in this clinic at Women's College Hospital in Toronto. Since then, many more have attended the clinic and found the hope of cure through early detection. Fanny H. Cracknell More than 20 years ago, a group of doctors at the Women's College Hospital in Toronto. Ontario, decided to establish a cancer detection clinic for women. Recognizing the importance of detecting cancer in its symptomless early stage, these doctors organized a physical screen- ing program whereby women could be examined at regular intervals. The first clinic opened in 1948 in a comer of the outpatient's department at this hospital. The screening included ex- amination of the breasts. cervix, rectum, skin. chest. and blood. Obviously, these examinations could have been done by the patient's family doctor; and in many cases they were. However, a large group of women did not have an annual examination and many had never had a Papanicolaou smear of the cervix taken. To avoid duplication by the family doctor and the clinic, a poten- tial patient was asked to get her doctor's cooperation. This meant he would exam- ine the patient annually and include a Pap smear, or encourage her to attend the WCH clinic, and accept responsibility where treatment or referral was indicated. The first clinics The clinic opened in 1948 with a staff Fanny (Posno) Cracknell, a graduate of Brant- ford General Hospital, is nurse-in-charge at the Women's College Hospital Cancer Detection Oinic, 901 Bay Street, Toronto, Ontario. APRIL 1970 of seven: five doctors, including the director, Dr. Florence McConney, one nurse, and two volunteers. We were fortunate to have the fman- cial support of The Ontario Cancer Treat- ment and Research Foundation, whose subsidy has supported us through the years. The Soroptimist Club furnished the clinic and has helped to maintain the equipment. The original charge of five dollars soon became unrealistic. Today, for holders of the Ontario Hospital Services Insurance Plan. the charge is eight dollars. Others pay twelve dollars. Fees are reduced accordingly if a patient is unable to pay the usual charge. Publicity was no problem since it was almost as if women had been waiting for a clinic such as this. Before long there was a waiting list one year in advance. During the first two years 1,502 patients had been to the clinic. It required two morn- ings to examine ] 2 patients. To examine more patients we needed larger facilities. Eventually we acquired an old house at 61 Grosvenor Street, added another nurse to our staff, and opened a larger clinic in 1950, where we could examine ]2 patients a day. five days a week. To our surprise the number of persons on the waiting list continued to increase. For one month we suspended new applica- tions. When calls were resumed. 52 appli- cations were made in one day. Attend- ance in ] 950 rose to ] ,878. THE CAINADIAN NURSE 37 Common cancer sites From an analysis of the data compiled over 20 years at the clinic. cancer of the uterus was most common. followed by skin, breast, rectum, gastrointestinal tract. ovary, and lungs. To examine the cervix, we use the Papanicolaou smear, recognized during the 1940s as a safe, reliable, surface biopsy. If the Pap smear reveals cell changes, the patient is seen every two to six months, depending on the severity of dyskaryosis. These findings may remain static for months or years; not infre- quently the Pap may eventually show a negative reading. If the Pap smear indicates increasing dyskaryosis. Class IV or V, a cone biopsy is indicated and this is brought to the attention of the patient's family doctor. If he wishes to have further diagnostic procedures carried out at the Women's College Hospital. the patient is admitted. In early stage cancer, the cone biopsy may be sufficient treatment. This patient is reexamined after six months and then annually, Several of our patients are in this category. When the disease reaches the invasive stage, the cone biopsy is only a diagnostic measure and must be followed by further surgery or sometimes radiation. If this does not constitute a cure, further surgery, with or sometimes without radiation, does. Today, uterine cancer is almost 100 percent curable if diagnosed and treated in the pre-invasive stage. During examination for breast malig- nancy, the patient is taught how to examine her own breasts. In several in- stances patients who have attended our clinic have discovered lumps during their monthly breast self-examination. Some of these lumps proved malignant on biopsy. The possibility of cure was much greater because of early detection. In some cases. however, breast self-examination makes a woman more anxious. Then she is encouraged to see her doctor or come to the clinic for an examination. The use of soft tissue x-ray technique, known as mammography, provides an additional method of detecting small le- sions in the breast. When a suspicious mass is found by palpation, the diagnosis can be confirmed by x-ray. In addition to the digital examination, which is part of the routine screening, a proto sigmoidoscopy is carried out for patients who require it or wish it. When the clinic opened. a chest x-ray was included in the examination. Today, patients are referred to their local chest 38 THE CANADIAN NURSE clinic. Although a detailed history is taken, examinations at the clinic are limited to accessible organs. If further examination is indicated, we recommend this to the patient's doctor. The nurse's role How does the nurse fit into this program? Basic clinical experience in assisting physicians and guiding patients is a necessity; as well, the nurse must be able to perform certain procedures. such as obtaining blood specimens. TABLE 1 Total patients seen 31,814 Total examinations conducted 58,732 Malignancies detected 346 Sites Uterus 131 Skin 102 Breast 75 Rectum 12 Ovary 6 Gastrointestinal tract 6 Blood (leukemia) 6 Mouth, neck, and thyroid 4 lung 3 Fibrous sarcoma 1 However, the main challenge is psychological. We face a constant barrage of questions by telephone and letter. Some express a great fear of cancer, others are not even related to the cancer problem. The nurse must be well- informed and able to communicate easily with those who ask for help. Often she directs patients to other sources of me- dical help. As nurses, we have a responsibility to avoid creating a false sense of security. We stress the value of regular examina- tions, listen to the "quiet worrier" ex- press her concerns. answer her questions, and direct many to family doctors and medical centers for problems unrelated to cancer. How well-informed is the average wom- an about cancer and its treatment? Literature from the Canadian Cancer So- ciety has helped her to be much better informed than women were in the past. However. the rather sensational and. at times, premature news stories in the press often cause confusion and fear. After the appearance of such an article or news item, we invariably receive an increase in telephone calls and letters. The clinic grows Attendance at the clinic continues to grow. In 1958, when Dr. Henrietta Banting succeeded Dr. McConney as di- rector, the staff consisted of three doctors, two nurses, a full-time typist with bookkeeping experience, and a part- time filing clerk. Approximately 2.M6 visited the clinic that year. By 1964, attendance reached 3,703 and the waiting list was long. Since 1965, when 4.836 women were examined, the number has remained relatively stable. We see an average of 24 women daily. Many arrange an annual appointment. The physical screening at the clinic does not take the place of the annual physical examination by the family doctor. When Women's College Hospital ex- panded its facilities in 1966, we moved to our present location at 901 Bay Street. The move did not create any great change, although more people are attract- ed and wander in for information. Men are directed to outpatient departments at nearby hospitals. Women frequently are referred to the clinic by their family doctor. Those refer- red by doctors in the smaller cities and towns often attend in groups of five or more. The atmosphere in the waiting- room almost resembles a social gathering, which helps lessen tension for the appre- hensive individual. During the Easter or Christmas recess, the clinic becomes a gathering place for teachers. Statistics As attendance at the cancer detection clinic grew, our statistics took on more meaning. From a large group of apparent- ly well women. we compiled statistics between 1948 and 1968. shown in Table 1. Statistics are incomplete - not so much in what they express, but in what they leave unexpressed. For the one patient in 92 who had cancer during this period. there were 91 who did not. Conclusion Our work never becomes monotonous. Every day brings surprises and challenges. We never know who our next patient will be. It could be a doctors wife, a young student, a famous author or artist, a charwoman. a teacher, a nurse, or a housewife. They all come. 0 APRIL 1970 Cancer can be beaten Although in terms of mortality statistics cancer is the second cause of death in Canada, only about 40,000 new cases are discovered each year. If each Canadian doctor were to see an equal proportion of these cases, the average would be less than two cases per doctor per year. Since cancer therefore is not an every- day experience for the doctor, he needs the support of all health and educational resources to detect the disease early. Furthermore, since many cases of cancer can be prevented, an all-out effort is needed to teach the public about signs and symptoms of cancer and early detec- tion. How to keep informed In what way can the nurse keep herself mformed so that she can speak intelli- gently about cancer? To help her, the Canadian Cancer Society and its sister organization. the National Cancer Insti- tute of Canada, carry on extensive profes- sional education through literature, films, and lectures. Because these efforts are carried out largely by volunteers, nurses can help by making their interest known to the local unit of the Society. Frequently nurses are bewildered by the different organizations involved in cancer treatment, research, and educa- tion. In many provinces, for example, there are provincial cancer control foundations operating under government sponsorship. The primary concern of APRIL 1970 The nurse's fight against cancer is not limited to care of patients who have the disease. Equally important is her responsibility to help reduce the number of persons who fall victim to the disease and to overcome the attitudes of defeat and fear that surround the word cancer. Knowledge of the agencies involved in cancer research, education, and treatment will help her fulfill her role. Kell Antoft these foundations is to provide diagnostic and treatment services. Then there is the National Cancer Institute of Canada. which is primarily responsible for the support of research on the causes and nature of cancer. The Institute is a professional body with membership drawn from Canadian medi- cal schools, professional societies of doctors and government agencies, as well as from the Canadian Cancer Society. The Society considers the Institute to be its research arm and provides most of the funds required to finance its program. The Institute provides the major financial support for cancer research units at a number of Canadian universities. These units consist of small groups of scientists working on a particular aspect of the cancer process. The Institute also has responsibility for professional educa- tion about cancer, and provides profes- sional groups with films and literature for teaching purposes. To doctors already in practice, the Institute makes available Ca, a quarterly journal devoted to discussions of diagnostic and treatment problems and to reports of new developments resulting from research. The Institute serves a somewhat similar function for the dental Mr. Antoft, now with the Institute of Public Affairs, Dalhousie University, was formerly assistant executive director of the Canadian Cancer Society and the National Cancer Insti- tute of Canada. profession, since dentists are in a position to detect early or precancerous changes in the oral cavity. The Canadian Cancer Society, a volun- teer organization of both laymen and professionals, operates through a system of units and branches with activities coordinated by provincial divisions. Since its founding in 1938, the Society has put its main emphasis on education about cancer. New demands have been made as knowledge of cancer has increased. The cervical cytology technique, for example, raised the prospect that cancer of the cervix could be eliminated if the female population became convinced of the need to seek this test every year or so. Re- search that eventually led to the under- standing of cigarette smoking as the primary cause of lung cancer created the need to present factual material and involved the Cancer Society in a study of all the complex problems of seemingly irrational human behavior. The Canadian Cancer Society also has an important role in providing services to patients. The need varies from province to province, since in some areas provincial health insurance schemes do not cover the specialized needs of patients with cancer. The Society's services include such things as transportation of patients to treatment centers; provision of dress- ings, drugs, and colostomy appliances; operation of lodges and hostels for out- THE <;ANADIAN NURSE 39 " . ... -:c:::' f II .1 .... . ... ,. J .. . . t , , . <:/. ... - , MC\.\\ 1 CAN f3[ I JcI '!' . . .. .....A - - . I' t I .. OtUftu. . 1101 -- :=;........ .. I '\ , . ;-l ... ... =- -'- . . j - . .. , \. '" Student nurse finalists in the "Miss Hope" contest, staged by the Ontario division of the Canadian Cancer Society, participate in the 1968 Grey Cup Parade in Toronto. A photo of this year's "Miss Hope" is on page 14. of-town patients; and, above all, the warmth and understanding of thousands of volunteers who do all they can to alleviate patients' fears and suffering. Cancer can be beaten The nursing profession has taken a prominent part in the development and the carrying out of the Society's educa- tional program. In addition, nurses have provided outstanding leadership at all levels. For example, they were the fIrst to sound a note of caution about the Socie- ty's former educational program, which emphasized the importance of the danger signals of cancer. Nurses were concerned about this negative approach because they recogniz- ed that fear was already an alarming feature of the public's awareness of can- cer. When polls of public attitudes con- firmed this fear, the Canadian Cancer Society realized that warnings about danger signals were largely self-defeating. This led to the new "Cancer Can Be Beaten" approach, with "Hope" as the 40 THE CANADIAN NURSE . , key word in the campaign to instill in the minds of Canadians a rational attitude toward cancer. The change in emphasis led to replace- ment of the danger signals with these seven safeguards: For everybody - have a regular medical checkup; don't smoke cigarettes; have your dentist check for unusual conditions; arrange with your doctor for a bowel examination; avoid excessive exposure to sunlight. For wo- men - practice regular breast self- examination; have a regular Pap test. The nursing profession can play a leading part in the success of this cam- paign. The public looks to the nurse not only as a member of a hospital staff, but as a member of the community to whom the individual can turn for advice and for interpretation of medical news. This places a heavy responsibility on the nurse to keep herself informed, to avoid dealing in speculative conversation about health matters, and to use the techniques of persuasion and reassurance in combatting fear of cancer. In the Canadian Cancer Society, there- fore, the nurse has an organization to which she can turn for support, assist- ance, and information when her profes- sional life brings her into contact with some aspect of the cancer problem. More than that, the Society presents the nurse with the opportunity to take a positive role in the fight against cancer. As a professional she is in a unique position to bring reason where there is ignorance. As a human being she is in a unique position to bring hope where there is despair. 0 APRIL 1970 University of Alberta The school of nursing of the University of Alberta, located in Edmonton within the university's health !iciences complex, is on a 154-acre site on the bank of the North Saskatchewan River. The school offers a four-year, integrat- ed baccalaureate program for high school graduates, leading to the bachelor of science in nursing degree. A new integrat- ed degree program for registered nurses is planned for September 1970. Details of this program will be in the new calendar of the school of nursing. Admission requirements for the degree programs include Alberta senior matricu- lation or equivalent, with a 60 percent average in five required subjects. RNs APRIL 1970 University schools of nursing in Canada A brief, up-to-date account of the programs offered by university schools of nursing. must be graduates of approved diploma schools of nursing and eligible for regis- tration in Alberta. Because of the need to limit enrollment in the degree programs, preference will be given to Alberta high school graduates and RNs working in the province. Applications for admission should be made early in the year. The certificate program in advanced practical obstetrics, equivalent to Part 1 Midwifery, is designed to give advanced preparation to RNs who work in obstetri- cal units of hospitals or in outlying areas where medical services are limited. A two-year program leading to the degree of master of health sciences ad- ministration, with a major in nursing service administration, is offered by the division of health services administration in conjunction with the school of nursing. This program is designed to prepare nurses for senior administrative positions. Academic admission requirements are a baccalaureate degree in nursing with at least a 65 percent average in the academic work of the last two years. Details of this program can be obtained from the direc- tor, division of health services administra- tion, department of community medi- cine. For complete mformation about nurs- ing programs. individuals should write to Miss Ruth McClure, Director, School of Nursing, University of Alberta. Edmon- ton, Alberta. University of British Columbia The school of nursing of the University of 3ritish Columbia is situated on beautiful Point Grey Peninsula, a part of Greater Vancouver. It offers an integrated, basic degree program for qualified high school graduates, a postbasic program for regis- tered nurses qualified for admission to the university, and a master's program for qualified baccalaureate nurses. The programs leading to a bachelor's degree prepare students for professional practice in all areas of nursing and include study of the fundamentals of teaching and administration. The master's program is designed to help the student develop greater knowledge and understanding in a clinical nursing area, as well as an THE C.NADIAN NURSE 41 opportunity to explore a functional role, such as administration in nursing services or teaching. The school also offers two diploma programs of approximately nine months, designed to help individuals function more effectively in a particular and more circumscribed area of nursing: public health nursing and administration of hos- pital nursing units. The latter program will be discontinued within two years. Admission to the university requires a minimum of British Columbia secondary school graduation - academic technical program or equivalent, with a 65 percent average. Admission to the basic baccalau- reate program requires completion of first-year university, and for the master's program, completion of a generic nursing program baccalaureate with good acade- mic standing. Registered nurses require registration in their own province. The school of nursing is involved in the plans of the evolving health sciences center. The faculty anticipates an increas- ing emphasis on the interprofessional approach to the delivery of health serv- ices. For information, write to Miss Eliza- beth K. McCann, Acting Director, School of Nursing, University of British Colum- bia. A S 1 0 assessment fee is required for evaluation of educational transcripts from outside British Columbia. 42 THE CANADIAN NURSE University of Calgary The University of Calgary had its origins in 1945 and since then has grown rapidly to accommodate a current student popu- lation of about 8,000. Situated in the northwest section of the city, it is sur- rounded by a Rocky Mountain panorama. The university gained full autonomy in 1966. The school of nursing was established on an independent basis within the univ- ersity administrative framework in 1969, and will offer a four-year basic baccalau- reate course, commencing September 1970. After completing this program, the student will be awarded a bachelor of nursing degree (BN), and will be eligible to write licensure examinations to prac- tice nursing in Canada. The student will be enrolled in the university in each of the four years and will pursue simultaneous study in the humanities, sciences, and nursing in each of these years. Clinical experience is obtained in conjunction with several hos- pitals and community health agencies and is associated with courses in nursing content throughout each academic year. Significant features of the program include emphasis on the Canadian cultur- al milieu and on flexibility to allow for individual differences. Each term allows for at least one elective area of study, and in the final year there will be an opportu- nity for independent study in nursing. Intersessional periods of continuous clinical practice will be held in the spring; however, a minimum of two summer months will be free of classes and clinical experience. Admission of postbasic stu- dents to the baccalaureate program is under consideration for 1972. The purpose of the school is to pre- pare nurses who are qualified to assume first-level positions in professional nurs- ing. The curriculum is designed to prepare a generalist in professional nursing, rather Ð than one who has received specialized preparation in functional areas, a philoso- phy compatible with national profession- al standards. Students from high schools in Alberta are admitted on presentation of Alberta Grade XII senior matriculation with an overall average of at least 65 percent and with 50 percent or equivalent letter grade standing in the required courses. Students from outside the province will be evaluat- ed on an individual basis. In the first years of operation, enrollment in the school of nursing is limited to 60. Further information may be obtained from the registrar's office. The Director of the School is Dr. Shirley R. Good. Dalhousie University Dalhousie University in Halifax, Nova Scotia, was founded in 1818. The Forrest campus, where the faculty of health professions - nursing, pharmacy, and physiotherapy - and the faculties of medicine and dentistry are situated. is in the southwestern section of Halifax. Nearby are many of the city's health agencies and hospitals. The school of nursing was organized in 1949 and has developed according to the needs of the province. Candidates for the basic baccalaureate program enter with senior matriculation - Nova Scotia Grade 12 - for a four-year program, which combines academic and profession- al nursing subjects. Clinical experience is obtained in the local hospitals and health agencies. Students receive a bachelor of nursing (BN) degree. Graduate nurses may obtain the bachelor's degree by completing three years of university work. This program provides depth and continuity in the professional nursing courses, and offers a wide choice of general academic subjects. In addition to the degree programs, the APRIL 1970 school offers diplomas in public health nursing, teaching in schools of nursing, and nursing service administration. A unique feature offered by the school of nursing is a two-year program for registered nurses leading to a diploma in outpost nursing. Variations in the pro- gram have been developed for nurses with diplomas in midwifery or public health nursing. E.A. Electa MacLennan, Director of the School, says, "This course was designed to prepare Canadian nurses for responsible nursing positions in remote areas. The first year is spent on the Dalhousie campus and the second year is spent in field situations, such as Labrador or Northwest Territories' hospitals. Persons interested in more information should write to the Director, School of Nursing, Dalhousie University, Halifax, Nova Scotia. Men and married women may apply. Applicants for some courses are limited; for example, 50 are accepted in the basic baccalaureate program and only 10 in the outpost nursing course. APRIL 1970 .+ ,.:II. .;.. Lakehead University Lakehead University in Thunder Bay, Ontario, has evolved from a technical institute to college to university. The first degrees in arts and science were granted in 1965. The university admitted the first students to its school of nursing in September 1966. The campus comprises 300 acres and is situated centrally in the city. An active building program, including student residences, is in progress; the modern buildings will conform to a long-range plan to ensure welllaid-out and beautiful surroundings. Two programs that lead to a bachelor of science degree in nursing are offered: one for registered nurses who wish to further their education and improve their clinical competence, and one for students who have senior matriculation standing, including Grade 13 chemistry. This four- year integrated program includes general and professional education within the university, hospitals, and other related health agencies. For information about these programs, write to Miss Christena Winning White, Director, School of Nursing, Lakehead University, Thunder Bay, Ontario. Laurentian University Laurentian University is situated on a beautiful campus in Sudbury, northern Ontario. The school of nursing, one of six professional schools of the university, admitted its first students September 1967. Entrance requirements for French- and English-speaking students are given in detail in the university calendar. An English-speaking student from Ontario is normally expected to present a minimum of four subjects, seven credits of Ontario Grade 13 arts and science, with a mini- mum overall average of 60 percent. The seven credits must be as follows: English or French (2); chemistry (1); biology (I); and three additional credits. Students study for the BScN degree; after passing the Ontario nurse registra- tion examination, they are qualified to practice nursing in hospitals or public health agencies and are prepared to advance professionally. without further formal preparation in all nursing positions for which a bachelor's degree is preferred. Graduates of the program who wish to study at the master's or doctoral level have a sound basis for advanced study. Approximately 50 percent of the curriculum consists of liberal arts and sciences, which are open to all students in the university. All nursing courses are under the control of the faculty of the school of nursing and are taught on campus and in local hospitals and health agencies. Expanding hospital, medical, and public health facilities ensure that a good variety of clinical experience is available. Faculty and students are completely accepted as members of the university community and participate fully in the life of the university and its varied activi- ties. The university senate has given approv- al in principle for a postbasic BScN degree, but this will probably not be THE CANADIAN NURSE 43 implemented for about another two years. Entrance requirements for it will include Ontario Grade 13 English or French and Grade 13 biology and chemistry, with a minimum overall average of 60 percent. Equivalent academic standing will be required for students from other provinces or coun- tries. The Acting Director of the School of Nursing is Dr. Margaret N. Lee. laval University The Laval University school of nursing, established in Quebec City in 1967, is affiliated with the faculty of medicine. Its French-language program leads to a degree in nursing science. The school is closely associated with the health sciences complex of the university, and two of its staff have seats on the permanent com- mittee of the health sciences. Since September 1968, nursing stu- dents have been enrolled in the same courses offered to all other students in the health sciences. As a result, all stu- dents should have a greater appreciation of the scientific and professional interests of their colleagues in other health disci- plines. They are also learning to work as a team from the beginning of their universi- tyexperience. The program of studies in nursing science is organized to permit the student to attain first-level objectives in university learning. Specifically, students learn to work independently and to adjust to scientific progress as well as to develop- ments in professional practice. Basic information is given in the bio- logical sciences and in the sciences of human behavior and professional learning related to clinical nursing care. The course requires three academic years or six trimesters, plus six weeks of clinical experience at the end of the second year. At the end of three years the student is 44 THE CANADIAN NURSE . granted a degree in health sciences. nurs- ing science division. All candidates must be high school graduates or have equivalent qualifica- tion. They should also have completed the biological sciences option offered at the CEGEP level. Those holding a nursing diploma should direct their enquiries about admission to the Service d'admis- sion or to the Secretariat of the school of nursing. At present, there is a total student body of 68, but in future 60 students will be admitted annually to the school. The Director of the School of Nursing is MIle Claire Gagnon. Applicants to the school should apply to: Service d'admission, Sécretariat général, Université Laval, Québec, 10, Québec. University of Manitoba The University of Manitoba, established in 1877, is situated on the banks of the Red River about seven miles from down- town Winnipeg. In 1929 the 663-acre site in Fort Garry, occupied by the Manitoba Agricultural College since 1913, was chosen as the permanent site of the university. Courses in nursing were first offered in 1943. The present nursing program offers a four-year, integrated program leading to a bachelor of nursing (BN) degree. In the first three years of the program, the academic year in nursing is from Septem- ber through June. In the final year, it is from September to early May. The bachelor's program for registered nurses approximates the four-year curric- ulum, requiring about three years to complete. At least two full years at the University of Manitoba are required, al- though exception may be made for candi- dates with credits from another universi- ty. As well, programs leading to a certifi- cate in either public health nursing or \tt Ø.IJ W teaching and superVISIon are offered to RNs. These programs are designed so that the student who later chooses to proceed into the baccalaureate program may apply the courses already completed in the certificate program. Several institutes are also offered each year to meet special needs of nursing groups, such as supervisors and instruc- tors. Minimum requirements include Manitoba Grade matriculation - and the high school subjects. Those interested in applying should write for complete information on admission requirements and courses offer- ed to Dr. Margaret Hart, Director, School of Nursing, University of Manitoba, Winnipeg, Manitoba. for entrance 12 - senior prerequisite McGill University The School for Graduate Nurses at McGill University is in downtown Montreal. Next October the school celebrates its 50th anniversary. Programs at the baccalaureate and master's level are offered; the most recent leads to a master's degree with emphasis on the teaching of nursing. The basic baccalaureate degree pro- gram prepares high school graduates for a nursing career and takes five years after Quebec Grade II. In 1971, students will enter the three-year university portion from the biological stream of Quebec CEGEP or university equivalent. Appli- cants with senior matriculation from other provinces are considered for entrance to the second year of the CEGEP pro- gram, with four years to the BSc(N) degree. The total course consists of academic and professional subjects with field ex- perience in teaching hospitals and health agencies. Graduates are prepared to accept responsibility to practice nursing APRIL 1970 within the new patterns of health service. For graduate nurses with senior matriculation. nursing is a two-year pro- gram leading to a BN degree. Academic and professional courses are integrated with a focus on the study of nursing, how it is organized and taught. The two-year program leading to the degree of master of science (applied) prepares the specialist in nursing who is equipped to promote the development of nursing through research, education, or service. The core of the program focuses on the study of nursing: examination and analysis of experience. and intensive investigation of more specific phenomena and problems. Students may also explore the process of learning to nurse and the implications for teaching and curriculum, or may be concerned more directly with change and development in nursing serv- ice and the health field. A one-year program leading to a master of nursing prepares teachers of nursing for the new educational programs in Canada. Throughout the course and in the two-month internship, beginning specialists in nursing. i.e., highly qualified graduates of four-or five-year basic nurs- ing university programs, participate in teaching nursing in many clinical settings. Courses in psychology, anthropology, sociology, and education assist in explor- ing how students learn to nurse and in testing related teaching practices. The Director of the School for Gradu- ate Nurses is Miss Elizabeth Logan. APRIL 1970 McMaster University The school of nursing is an integral part of McMaster University in Hamilton, Ontario. Nursing students share the academic and educational resources, as well as the social and recreational facili- ties, with other students. Since the first course for nurses was offered at McMaster, yearly enrollment of students has increased. In 1964, due to restricted resources. it became necessary to limit enrollment to a maximum of 30. In 1969, however. enrollment was doubled because of the near completion of the new health sciences center. Ulti- mately, first-year enrollment is expected to reach 75. The health sciences center will house a university hospital, biomedical library, medical learning resource center, and will provide facilities for research. The school of nursing will share these resources with the faculty of medicine and eventually with other schools that educate health workers. The present four-year basic course leads to the bachelor of science in nursing degree and qualifies students for first- level positions in hospital and public health fields. It prepares students for nurse registration under the College of Nurses of Ontario and grants approved public health nursing qualifications. The broad background of professional educa- tion offered in the course provides the necessary foundation for graduate study in nursing. The study of nursing spans the four years of the program. From an introduc- tion to health needs of individuals and families, the student is helped to evaluate the basic nursing needs of patients, and in the first year has the opportunity to plan and give nursing care in the hospital. In subsequent years, nursing study prepares the student to provide increasmgly complex nursing care to patients and their families. EEE - Admission requirements are Ontario Grade 13 or its equivalent, with certain prerequisite subjects. Applications from students from all provinces and from other countries are welcomed. As the number of applicants for ad- mission is always greater than the number of vacancies, prospective students should apply before May for admission the following September. Further infonna- tion may be obtained from Miss Alma E. Reid, Director. School of Nursing, McMaster University, Hamilton, Ontario. Memorial University of Newfoundland Memorial University is situated in the lovely old city of St. John's. It is sur- rounded by hills and valleys overlooking famous Signal Hill, with Cabot Tower standing high on a rock at the entrance to the harbor. The university school of nursing admitted its first students to a basic, in tegrated baccalaureate program in September 1966. These students will graduate in May 1970. Registered nurses who are residents of Newfoundland and entered hospital schools of nursing before 1966 can enrol as mature students in the degree program. The program extends over four years. Students are admitted after successful completion of the first year at Memorial. Students from other provinces are admit- ted from Grades 12 and 13. Biology and chemistry are required and physics is advantageous. Each year the students gain nursing experience in hospitals and agencies. The academic year of the university has been organized on a semester basis, and all curricula have been redesigned. In future, there should be more time for nursing laboratory practice during the academic year, enabling the faculty to eliminate or reduce the extended clinical practice period in May and June. Over one-half of the faculty members THE G\NADIAN NURSE 45 are prepared at the master's level in their area of specialization. With their assist- ants, they are responsible for the content and supervision of clinical practice. Enrollment is limited to 20 students in the first year to permit a workable student-teacher ratio and to keep within the limits of available clinical practice facilities. Male students are welcomed. Students from the school are elected as representatives to various administra- tive, faculty, and student committees and organizations of the university. Applications should be made to the registrar of the university. Further information about the school can be obtained from Miss Joyce Nevitt, Direc- tor, School of Nursing, Memorial Univer- sity of Newfoundland, St. John's, New- foundland. 46 THE CANADIAN NURSE ..v ' ,:- 'If'"n it "' k '\t o::::li q U þ University of Moncton When the University of Moncton in New Brunswick received its charter of in- corporation, other French-language ins- titutions for higher leaming in the province became affiliates of the universi- ty. These included Collège Saint-Joseph, Collège Saint-Louis, and the Collège Sacre-CoeuL Degrees are granted by the university. As early as 1964, the University of Moncton recognized the needs of New Brunswick's French-speaking nurses in nursing education. With the encourage- ment of the New Brunswick Association of Registered Nurses, Sister Jacqueline Bouchard was appointed to organize and direct the university's Ecole des sciences hospitalières. This school has the same academic status as other faculties and schools within the institution. The direc- tor is a member of the academic senate. In 1965, a four-year program of stu- dies leading to a degree in nursing science was inaugurated. Applicants must have completed Grade 12 or equivalent from another province, and must have a 60 percent average in examinations set by the New Brunswick department of educa- tion. Students receive intensive clinical experience during the summer months of the first three years. The school maintains complete control over the program. Agreements have been reached between the university and certain institutions and hospitals in the area to provide facilities for clinical practice. In 1966, a three-year program that provides for completion of studies at the baccalaureate level was begun. Applicants must be registered nurses. Courses in psychiatry and public health are requi- sites for the degree. However, they must be completed outside the regular acade- mic program, which combines general and professional learning. There will be no further admissions to this program after 1975. University of Montreal The University of Montreal is the only French-language institution in the world that offers a master's degree in nursing. The facuIty of nursing offers three majors in its master's program: hospital nursing administration, nursing education, and psychiatric and mental health nursing. In 1967, Institut Marguerite d'Youville became part of the faculty of nursing at the University of Montreal. Founded if, 1934, this institution was an affiliate of the university and offered advanced preparation in nursing education. As well as the master's program, the university has offered graduate nurses baccalaureate studies in nursing science and basic preparation for those wishing to study nursing under university direction. Clinical specialization in psychiatric and mental health nursing was added to the master's program in September 1968. Admission to the baccalaureate pro- gram requires a high school diploma and an option in biological sciences. This will be enforced for graduate nurses as of September 1972. Until then, diplomas from secondary schools and from C.P.E.S. (courses that prepare students for higher education) will be accepted. the baccalaureate program is three years in length. Graduate nurses are allowed credits for past preparation and can complete their studies in about two years. Each year 40 are admitted to the basic course and 100 to the nursing division. Applicants to the master's program must hold a degree in nursing science or its equivalent. The program covers two aca- demic years and requires a thesis. Six students are admitted to each section of the program. The faculty of nursing, in cooperation with the Canadian Nurses' Association and the Canadian Hospital Association, administers the French-language section of the course in nursing unit administra- tion. A certificate from the two spon- APRIL 1970 soring bodies is awarded when studies are completed. The faculty also assists in preparing nursing personnel for service in countries that adhere to the Columbo Plan, a program sponsored by the Cana- dian International Development Agency. Dr. Alice Girard is Dean of the Faculty of Nursing. Mount SaintVincent University Mount Saint Vincent University in Nova Scotia is the only independent women's university in Canada. It is a Catholic institution for higher education, con- ducted by the Sisters of Charity. Located in Rockingham, about a 20-minute drive from downtown Halifax, the campus overlooks Bedford Basin. The university is growing rapidly. with a new tower resi- dence on campus and a student union building completed recently. A new aca- demic building and adjacent professional buildings are under construction. Marguerite Hornby, director of the school of nursing, is responsible to the academic dean who reports directly to the university president. The basic nursing program is a four- year, integrated program leading to a bachelor of science in nursing degree. Under a new agreement with Dalhousie University, nursing courses are centralized at Dalhousie, with students taking arts and science courses at Mount Saint Vincent. The course includes three sum- mer sessions. Hospital practice is given in Halifax hospitals and health agencies under direct supervision of the university nursing faculty. A degree program is also open to. registered nurses who have completed one-year university certificate courses in a nursing specialty. Nurses in this program must complete 10 courses in science and liberal arts subjects. This program, insti- tuted to meet a pressing need for nurses with degrees in administrative and teach- ing positions in Nova Scotia, will be APRIL 1970 offered for a limited time. No certificate courses are available. Admission to the basic four-year, inte- grated program requires a Nova Scotia Grade 12 high school pass certificate in the university preparatory program, or its equivalent. Married women may apply, and although the university is primarily for women, men may apply. About 20 students are admitted to each new class. Interested candidates should write to the Director, School of Nursing, Mount Saint Vincent University, Halifax, N.S. University of New Brunswick The University of New Brunswick, one of Canada's oldest universities, is situated on a hillside overlooking the Saint John River. The school of nursing was estab- lished in 1958 and the first students enrolled a year later. In 1969 the school became the faculty of nursing and now occupies a new building - Katherine MacLaggan Hall. Two programs are offered: a four-year basic degree program and a three-year program for registered nurses. Both pro- grams, which lead to a bachelor of nurs- ing degree, are generic, without specializa- tirn, both include public health nursing integ{ated within the professional con- tent and courses in general education in the faculties of arts and science. The basic degree program extends from mid-September until approximately the end of June. Concurrent nursing theory and practice are arranged sequen- tially throughout the four years. During the academic year, clinical experience is provided in hospitals and community agencies in the Fredericton area, and during May and June a period of concen- trated practice is arranged in several centers in the province. The program for RNs is given during the academic year. Summer school and extension courses may be taken, but at least the final year must be spent in full-time study. Public health nursing practice is arranged during the academic year, supplemented by additional expe- rience at the end of the third year. Psychiatric nursing experience is arranged for students who have not previously had it. Entrance requirements for applicants to the basic degree program include a 70 percent average on New Brunswick de- partmental examinations in seven subjects, and for RNs, a 60 percent average. SACU tests will be required after 1970. Male and female, married, and single applicants are given equal consider- ation. Further information may be obtained by writing to Miss Margaret G. McPhedran, Dean, Faculty of Nursing. University of New Brunswick, Frede- ricton, N.B. THE CANADIAN NURSE 47 University of Ottawa The University of Ottawa school of nurs- ing, founded in 1933, originally offered a three-year diploma ,ourse. Since 1943, the school has offered programs leading to a certificate and to a baccalaureate in nursing education or public health nurs- ing for registered nurses. Originally a privately-owned, sectarian institution, the university became a public educational enterprise in 1965. In 1961 the school established a basic four-year program leading to a degree of bachelor of science in nursing. Entrance requirements for high school graduates are Ontario Grade 13 or equiva- lent standing in English or French, chem- istry, biology, and three other credits, with an average of at least 60 percent. There are 125 full-time students enrolled in this program. Students in the school of nursing may take general arts and science subjects in French or English, although not all sections offer identical courses in both languages. Nursing classes are given in English, with options for written work in French. One-year, post basic certificate courses in public health nursing and nursing education and supervision will be offered for the last time in the fall of 1970. Students in the 1970-71 academic year who wish to proceed to a baccalaureate degree must complete requirements for the degree by the fall of 1973. The new program, now under revision, will lead to a BScN degree and will start in the fall of 1971. The BScN program will provide generalized preparation for professional nursing practice, including public health nursing. Information about entrance requirements, length of pro- gram, and curriculum will be available at a later date. Future plans for the school include office and classroom space in the science building, now under construction, until 48 THE CANADIAN NURSE the health science complex is built. There are also plans to develop a master's program in nursing. Sister Yolande Proulx is Director of the School of Nursing. Queen's University Queen's University school of nursing in Kingston, Ontario, has replaced its five- year program with a new integrated curri- culum for basic and graduate nurse stu- dents studying for a bachelor of nursing science degree. Graduate nurses probably will complete the requirements in three years, rather than the four years needed by basic students. The purposes of Queen's nursing pro- gram are: the education of competent professional nurse practitioners for the future, advancement of nursing know- ledge, and improvement of current practice. The school of nursing, utilizing the resources of the university and communi- ty, offers learning experiences and guidance to enable students to design, implement, and evaluate nursing action based on a scientific rationale; to become active participants in the health team; and to become involved citizens in a demo- cratic society. The nursing courses focus on nursing needs of people in the community, as well as in an agency setting; provide a flexible approach to learning that enables students to observe and participate in the health care of an individual or family. Graduates should be capable of design- ing, implementing, and evaluating nursing action based on knowledge of the dyna- mics of human behavior, biological, physical, and medical science; establishing collaborative relationships with other members of the health team; developing relationships with patients and families to enable them to achieve their maximum health potential and retain their right to self-determination and independence; and developing skill in assessing the capacity of technical and vocational nursing col- leagues and in providing appropriate guidance to aid them in achieving their maximum potential for nursing care. Admission requirements are a minimum of 60 percent in seven units of Grade 13 or equivalent, including chemis- try, mathematics A, and physics, Begin- ning courses in mathematics and physics, if studied during the first year at Queen's, may lengthen the program. Graduate nurses must submit a diploma from an approved school of nursing and be eligible for registration in Ontario. Personal inter- views are highly desirable. The current enrollment of 90 includes 27 in the new program. Dr. Jean Hill is Dean of the School of Nursing. APRIL 1970 University of Saskatchewan The University of Saskatchewan has two campuses, one in Saskatoon and one in Regina. The school of nursing is on the Saskatoon campus, a 3,200-acre site on the bank of the South Saskatchewan River. The baccalaureate program (BSN) for high school graduates is a four-year, integrated course. Clinical experience is provided in University Hospital and in various branches of public health agencies in the province. Graduates are prepared for first-level positions in hospitals and public health agencies. The baccalaureate program for grad- uate nurses requires the equivalent of three academic years. At least one year must be spent in full-time study on campus, but part-time study, summer sessions, night classes, and correspond- ence courses permit graduates to plan according to their own work and personal requirements. To date, the programs avail- able provide for specialization in teach- ing, public health, nursing service admi- nistration, and advanced psychiatric nurs- ing. Changes that might affect specializa- tion are anticipated in this program within two years. One-year diploma courses are available for experienced graduate nurses in public health nursing, nursing service administra- tion, and advanced psychiatric nursing. Entrance requirements are based on Saskatchewan Grade 12 - senior matric- ulation - or its equivalent. Specific high school subjects are also required. The school admits about 100 students to the degree courses and about 10 to 15 to each diploma course. Men and married women are admitted. Mature students are also considered under adult admission standards, if requested. Students in the school of nursing participate actively in campus life and may live in university residences. APRIL 1970 Students should enquire about admis- sion as early as possible in the year. Completed applications for admission to baccalaureate programs must be received by mid-August. Because of quotas and field experience planning, applications for diploma courses should be completed by early summer. Complete information concerning these programs can be obtained by writ- ing to Dr. Lucy Willis, Director, School of Nursing, University of Saskatchewan, Sas- katoon, Saskatchewan. St. Francis Xavier University Founded in 1853, St. Francis Xavier University m Nova Scotia received its charter in 1866. The 27 university build- ings are situated on a 200-acre campus near the town of Antigonish. Through an agreement with St. Mar- tha's Hospital, the university has awarded degrees to nurses since 1926. However, the department of nursing at the universi- ty was officially established in 1966 and is part of the faculty of sciences. Sister Marie Simone Roach, presently complet- ing doctoral studies at Catholic Universi- ty, will become chairman of the nursing department in the spring of 1970. The school offers two courses leading to a bachelor of science in nursing degree. High school students are admitted direc- tly to a four-year, basic, integrated pro- gram. Clinical experience in medical, surgical, obstetrical, and pediatric nursing is taken at St. Martha's Hospital in Antigonish, psychiatric nursmg at the Nova Scotia Hospital at Dartmouth. Community health nursing is available through agreements with the public health department of Nova Scotia. Other health agencies in surrounding communi- ties are also used extensively. Part of the summer months in the first two years are utilized for clinical experience. The degree program for graduate nurses has been two years, with some additional summer school classes. Beginning in September 1970, the course will be in- creased to three years, with expanded nursing content. For admission, a Nova Scotia Grade 12 certificate is required. Candidates must have at least a 50 percent average in the required subjects and an overall average of 60 percent. Graduate nurses must have a license to practice. On the successful completion of either course. the bachelor of science in nursing degree is granted. The school admits 10 to 15 high THE C NADIAN NURSE 49 school students to each class. Registered nurse enrollment is usually about IS. For more information concerning the courses, write to: The Registrar, St. Francis Xavier University, Antigonish, Nova Scotia. University of Toronto Founded in 1920, the University of To- ronto School of nursing was first to offer a basic integrated course in which human- ities and sciences were related to nursing throughout the course. [n 1946 the university first granted its degree to nurses. In the basic degree course, content in the humanities, social, and biological sci- ences is given throughout the course, concurrently with the nursing subjects. Nursing is taught around a central core with concurrent clinical applications in hospitals and health agencies. The pro- gram is four years, or 34 months in length, and leads to a bachelor of science in nursing degree. Graduate nurses can also enroll for a degree course. The same academic princi- ples are applied in a program that consists of three academic years for graduates of the diploma schools of nursing. In this course, content in the humanities, social, and biological sciences is integrated with nursing subjects. Nursing is taught by the faculty of the school in the classroom and clinical areas. Graduate nurses can take the first year of the degree course either full-time in the school or part-time in evening and/or summer sessions through the division of university extension. The third year is taken on a full-time basis. There is opportunity in the summer for the stu- dent to secure employment. All degree candidates are prepared for public health nursing, teaching, and supervision. Ontario Grade 13, with certain pre- requisite subjects, is required for admis- SO THE CANADIAN NURSE sion. However, the admission standards are continually under revision and applicants should write directly to the university for information. Special consideration is given to mature appli- cants - over 25 years - who may not have had Grade 13 or who have not taken the required high school subjects. The school offers a one-year certificate course in public health nursing. The program covers one academic year and includes five weeks of field work. Dr. Helen M. Carpenter is the Director of the School. e RlTAS ET UTll>ITA University of Western Ontario The University of Western Ontario is in London, a city of just over 200,000, situated midway between Toronto and Windsor. The Health Sciences Center at the north end of the SOO-acre campus includes nursing, medical, and dental faculties, a cancer research center, and a university hospital under construction. A well-qualified and expanding faculty of nursing is an integral part of the COor- dinated health sciences division. Both undergraduate and graduate education in nursing is offered at West- ern. A four-year basic degree program is given for high school graduates, and a three-year degree program is offered to registered nurses who have graduated from diploma programs. Each leads to a BScN degree, with the common purpose of preparing professional nurse practition- ers who can assume beginning profession- al responsibilities in hospitals and other health agencies; are capable of using further experience to enable them to take responsibility in nursing practice; and have a sound educational foundation for graduate studies. Both BScN programs require Grade 13 standing for entrance, with specific prerequisite courses. There are special provisions for mature applicants - those who are at least 23 years of age - whose academic qualifications do not fully meet the admission requirements. Graduate education leading to the MScN degree offers preparation in administration or teaching. The two-year program in administration may be in hospital nursing service, public health nursing service, or administration of schools of nursing. The two-year program in education is intended for beginning and experienced teachers of nursing. Entrance requirements for graduate education are a bachelor's degree In nurs- ing or in arts or science, in addition to APRIL 1970 graduation from an approved diploma program in nursing; an academic year of post-basic study with a diploma in a nursing specialty from a university school of nursing; and an overall B average in undergraduate courses. Graduate education is designed to prepare personnel for leadership positions in nursing. New graduate programs now under consideration for the future are those with a major in a clinical nursing specialty and a major in nursing research. Total enrollment in all programs is currently 195. Inquiries for further information about programs and requests for application should be directed to Dean R. Catherine Aikin, Faculty of Nursing, The University of Western Ontario, London, Ontario. APRIL 1970 , \1 ,,,...... . , tP -\, . ( ....... \... li''t:* In" ,f,) j { k 1.--" . ø. -.. -..11 . !Io.">oi M.... "I.\.'I"'II.Vi1 Jot L!J University of Windsor The University of Windsor is situated in Windsor on a large campus bordering the Detroit River. Residences are available for students who want to Itve on campus. In 1955 the department of nursing was created within the faculty of arts and science and in 1962 it became a separate school. From 1957 to 1967, the school offered a non-integrated program leading to a baccalaureate degree in which the first and final years were taken at the university. This has now been replaced with a four-year, integrated, basic baccal- aureate program that began in September 1968. The school of nursing presently has three different types of programs. First, it offers a four-year basic program for high school graduates, leading to the bachelor of science in nursing degree. This program includes science and arts, as well as nursing courses. Concurrent clinical teaching and experience are provided. This program prepares the graduate for the practice of individualized, scientific nursing in the hospital or home; public health nursing team leadership positions; and graduate level studies. On successful conclusion of the program, the student qualifies to write the provincial nurse registration examinations. Second, the school offers a baccalau- reate degree program for registered nurses who meet university admission require- ments of two academic years and a summer session. This includes preparation for the general practice of public health nursing and introduces the student to the basic principles of teaching or administra- tion. Students may take the non-profes- sional courses through the division of extension. The school also offers a diploma pro- gram of one academic year in public health nursing for RNs. Admission requirements for all pro- grams are Ontariô Grade 13 or the Uni- versity of Windsor preliminary year or equivalent, and must include among other credits English. biology, and chemistry. Registered nurses must be currently reg- istered in a province of Canada. RNs seeking admission under the maturity clause must have completed at least biol- ogy, chemistry, and English of Ontario Grade 13 level. Complete information on each pro- gram is contained in the school brochure and the university calendar. As the aca- demic year begins in mid-September. can- didates are advised to submit their appli- C4tions several months in advance and to seek a personal interview. The Director of the School of Nursing is Miss Florence M. Roach. 0 THE CANADIAN NURSE S1 Counseling students in a hospital school of nursing The authors, both registered psychologists, describe the functions, success, and future of the coumeling service for student nurses at the Calgary General Hospital in Alberta. Donald G. Ogston, H.Ed., M.Ed., and Karen M. Ogston, B.A., M.A. Interest in the psychological development and counseling of nursing students is shown in nursing education literature to be directed largely toward university- affiliated nursing schools. 1 . 2 These schools have access to the university or junior college counseling service. Hospital-affiliated schools do not usual- ly provide or have access to a formalized counseling service, although their stu- dents have the same needs and concerns as university students. Most nurse educa- tors in these settings realize that counsel- ing should be an integral part of a total nursing education program, but do not always know how to provide it. Counseling service started Recognizing to need for a counseling service, the Calgary General Hospital school of nursing set up one in the fall of 1967. Since then this service has been available to the student body of about 300 students a year. This counseling service consists of three function s: co un seling the students, consulting with the faculty, and conduct- ing research. The counselor is a member of the hos- pital's psychology department. This Mr. and Mrs. Ogston have both held the position of counselor at the Calgary General Hospital. Both authors are working toward a Ph.D. in psychology at the University of Cal- gary, Calgary, Alberta. 52 THE CANADIAN NURSE affiliation has three advantages: the counselor is a professional psychologist registered under the provincial psycholo- gists' act, ensuring competence in coun- seling, consulting, and research; he is independent of the administration of the school of nursing, assuring the student freedom of access and strict confidentiali- ty; and he can give priority to the needs of the school of nursing. Counselor's time divided Table 1 shows the development and growth of the counseling service. The number of formal hours the counselor spent per month on each of the three functions is given for each year. During the 1967-68 session, the counselor spent 115 hours on the three functions. In 1968-69 this time was increased to 197 hours, even though there were two changes in personnel. It is generally as- sumed that an amount of time almost equal to the time spent counseling is de- voted to preparation and administration. 3 On the basis of this assumption, the actu- al amount of time the counselor spent would be roughly twice the above totals. The majority of counseling time was spent in one-to-one relationships, working through study, educational-vocational, and social-personal problems. Study prob- lems were primarily in reading or study strategy. Educational-vocational difficul- ties concerned decisions about continuing studies in nursing, adjustment to the nurs- APRIL 1970 OCTOBER NOVEMBER DECEMBER JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER TOTAL 3 5 5 8 6 5 3 2 10 5 3 4 59 o 1 2 3 3 3 4 2 6 3 2 4 33 * new counsellor 1 2 2 1 2 2 1 3 4 3 o 2 23 11 10 10 15 7 15 2 5 13 13 2 2 105 8 6 8 9 3 2 6 4 4 8 2 3 63 3 1 4 3 2 4 3* 1 2 4 2* o 29 Table 1. Time spent by counselor in each of the three functions. ing program, and the choice of nursing area in which to practice. Social-personal problems involved self-adjustment, inter- personal relationships, family, and hetero- sexual orientation. Group counseling constituted the re- mainder of the time spent. Communica- tion skills and special problems were dealt with most effectively in a group setting. Problems unique to nursing Nursing students present additional problems that are unique to their situa- tion. One common complaint is that residence living inhibits the pursuit and development of extracurricular activities; in short, many students feel cloistered. Another problem is that nursing educa- tion is unusual because it requires profes- sional responsibility of its students before their program is completed. Many stud- ents find such responsibility stressful. This stress may be intensified by the sometimes rapid adjustment required as the student changes from one study area to another. Currently a more preventative approach is being established to provide students with ways to handle concerns as they arise, rather than trying to remedy existing problems. For example, a "study skills" program can introduce rapid read- APRIL 1970 ing and study strategies, thus minimizing the number of problems that occur at crucial times, such as during examination periods. Groups directed toward develop- ing nursing skills can provide a setting in which stress-preventing techniques are discussed and practiced. Study groups and other group situations have the additional value of familiarizing the stu- dent with the existence and function of the counselor. Klemer found that high school coun- selors have a somewhat inadequate stereo- type of nursing students. 4 If high school counselors are counseling girls toward nursing on the basis of a faulty stereo- type, problems can be expected. A form of preventative service could be a yearly workshop for high school counselors held by the school of nursing and coordinated by the counselor. Consultation and re!>earch The professional counselor has been particularly useful as a consultant for the faculty of the school of nursing. Because of their positions, faculty members are often the first to be aware of a student's problem. The counselor can frequently offer the faculty guidance to assist them in their work with students. Moreover, the counselor's independence from the administration permits him to approach problems differently than the faculty. Presenting faculty with alternative ap- proaches has been useful in rethinking policy that governs student evaluation and assessment. Two areas in which a counselor has much to contribute are student evalua- tion methods and the routine and special psychometric assessment of students. A registered psychologist has competence in developing and using achievement meas- ures. On occasion, a promising applicant does not have all the requirements neces- sary for admittance to the school. In such a case the counselor might be able to provide auxiliary data, through testing, on which a decision, fair both to the applicant and the school, can be made. The counselor's research role has important potential. Early studies, direct- ed toward securing student noons on personality and achievement tests, might eventually be used in admission proce- dures. To this end, preliminary analyses of personality scales have been conducted to differentiate successful students from unsuccessful ones. The development of computerized accumulative student rec- ords and instruction methods is an ex- tremely exciting area of study. These projects, although still in the discussion stage, are possible in the near future. Conclusion The school of nursing's counseling program has experienced an increased demand for its services. Although much has been achieved in two years, there is much more to be done. Preventative activities, such as group work, should eventually benefit all students, not just those headed for problems. Basic re- search, complementary to preventative programs, should be undertaken. Student satisfaction with nursing, the role of the residence in group development and harmony, and the effects of teaching methods are examples of research areas that merit attention and perhaps conse- quent change. References 1. Bridgman, Margaret. CollegiJJte Education for Nursing. New York, Russell Sage Foun- dation, 1953. 2. Mussallem, Helen K. Nursing Education in Canilda. Ottawa, Queen's Printer, 1964. 3. Wrenn, e.G. The Counselor in a Changing World. Washington, American Personnel and Guidance Association, 1962. 4. Klemer, Margaret G. Counselors' images of the basic nursing student. Nursing Outlook, 12:54-55,1964. 0 THE û'NADIAN NURSE 53 research abstracts Kikuchi, June F. One hospitalized pre- school girl's way of dealing with separa- tion anxiety. Pittsburgh, Pa., 1969. Thesis (M.N.) University of Pittsburgh. A study of one preschool girl who experienced separation anxiety during her long hospitalization was carried out using the descriptive method, case study tech- nique. The child of this study was admit- ted to hospital, comatose and moribund, with the diagnoses of multiple staphylo- coccal abscesses and generalized sepsis. Initial contact with this child was made on the 67th day of her 91-day hospitalization. While giving care to this child for 19 days during the third month of hospitalization, the nurse-writer made direct observations. Process recordings, records of projective play interviews, the child's clinical records. and discussions with the child's parents and health work- ers were the sources of data. The data were validated by a clinical nurse special- ist. An analysis of the data to determine the behavioral patterns of this child revealed a theme of separation anxiety. Her behavior related to this theme was further analyzed to determine how she dealt with her feelings about separation from her parents through the medium of play, through the interaction with the nurse. and through the use of the defense mechanism of regression. This child appeared to be particularly vulnerable to separation anxiety for many reasons: her sudden separation, her traumatic illness, the length of hospital stay, her parents' infrequent visits, lack of one nurse giving consistent care, and her developmental stage. By the time the nurse observer started to care for her, this child was defending herself by using defense mechanisms of denial and repres- sion. As she began to form a close relationship with the nurse, her use of denial and regression started to lift. Much of the pent-up anger that she felt toward her family for having left her was then released. Unstructured play seemed to give her the opportunity to work on her anger by taking on the active role and doing to her family in play what she had to experience passively. Such play also enabled her to satisfy her desire to reunite her family, to use oral aggression, and to be the real baby. During her contdct with the nurse, she gradually transferred her positive feel- ings for her mother to the nurse. As this S4 THE CANADIAN NURSE transference increased, the anger this child felt toward her mother for the separation was directed increasingly to- ward the nurse. In conclusion. it was found that as this hospitalized. preschool girl was permitted to express and deal with her fear of abandonment and her anger about her separation in her own way and at her own pace, she was able to deal more effectively with her feelings about separa- tion from her family. A positive, consis- tent relationship with a need-fulfilling person appeared to be essential for such development to take place. Gauthier, Sister Cecile Marie. Organiza- tion of the elements of a selected nursing curriculum as revealed in course outlines. Washington, D.C., 1966. Thesis (M.S.N.) The Catholic University of America. The purpose of this study was to identify and describe the organization of elements of a pre service nursing curricu- lum as revealed in course outlines. A literature survey was conducted to identi- fy types of curriculum elements and patterns of curriculum organization in relation to the purpose of the study. Analysis of documentary materials, a form of descriptive research, was the method used for the study. The data consisted of curriculum elements, ex- pressed as words or phrases, or in short sentences that could be identified as a knowledge or a skill item, extracted from the course outlines. Elements were classified according to the three broad divisions of general education, nursing-related areas, and nurs- ing, in terms of subject matter, structure of subject matter, and educational focus within units of courses. Vertical and horizontal organization of elements, according to these broad areas, was stud- ied by courses, semesters, and years. Some of the findings were that the curriculum was constructed from 24 subject matter areas. Subject matter com- ponents were distributed approximately as follows: 5 percent of the total curricu- lum components were general education components, 64 percent were nursing- related, and 31 percent, nursing com- ponents. The construction of course units from subject matter components seemed to vary in the three types of COUrses identifi- ed. Organization of components appeared to vary from year to year and by semes- ters. General education components appeared in the general education courses only. Nursing-related components were identified in the nursing-related courses and in 14 of the 16 nursing courses. Nursing components were present in all nursing courses and in four nursing-relat- ed courses. Brkich, Rita M. A study to determine how patients view their digoxin ther- apy. Montreal, 1969. Thesis (M.Sc.App.) McGill U. This descriptive study was conducted to determine how patients view their digoxin therapy. A sample of 40 patients was interviewed to collect the patients' thoughts, feelings, and practices of digoxin therapy. Categories were derived from each of the questions. Content analysis was carried out to determine the nature and frequency of responses. It was found that patients could gener- ally explain the purpose and effects of digoxin; that they had positive feelings toward the therapy; and that they gener- ally carried on reasonably safe practices in self-administration. With more, Mary Anne, A study of com- municative behayior in young hospita- lized children. Montreal, 1969. Thesis (M.Sc.App.) McGill U. A descriptive, exploratory research study was carried out to investigate com- municative behavior among young hospi- talized children. The researcher sought to discover any patterns or regularities in communicative behavior. The sample under study consisted of 29 children from eight months to thirty- four months of age. The research setting was a medical-surgical unit in a large pediatric hospital. Data were collected in a running narrative form by the methods of observation and participant-obser- vation. The data were subjected to a content analysis. Three patterns or groups of communi- cative behavior clearly emerged from the observations. These groups showed certain regularities and consistencies, which were described. A possible inter- pretation of the patterns of communica- tive behavior was discussed, and recom- mendations for additional research were suggested. 0 APRIL 1970 books A History of the General Nursing Council for England and Wales 1919-1969 by Eve R.D. Bendall and Elizabeth Ray- bould. 312 pages. London. H.K. Lewis & Co. Ltd., 1969. Canadian Distribu- tor: McAinsh Ltd.. Toronto. Reviewed by Glenna Rowsell, Employ- ment Relations Officer, New Bruns- wick Association of Registered Nurses, Fredericton, N.B. The authors have succeeded in capturing the important and exciting events that led to the inception of the General Nursing Council for England and Wales and the governing legislation. It is a timely publi- cation. released during the 50th anniver- sary of the General Nursing Council. The chapters are in chronological order; recurring events are only described in detail the first time they happen. Readers who are unfamiliar with the United Kingdom governmental process and the societies and committees referred to in the book might miss the historical implications for the General Nursing Council. Although the book is well documented and includes an index of names and subjects, the reader is inclined to get lost in the masses of names, dates, titles, and figures. For example, is it important for the reader to know how many votes each member of the council received? This book may have a limited reading audience in Canada. but would provide an excellent reference text for students and graduates interested in the history of nurse registration and the struggle for legislation. Human Anatomy and Physiology, 6th ed., by Barry G. King and Mary Jane Showers. 432 pages. Toronto, W.B. Saunders Company, 1969. Reviewed by HJ. Alderson, Associate Professor, School of Nursing, Mc- Master University, Hamilton, Ontario. This book is concerned with the introduc- tion of much new material in keeping with the advances in cellular biology. More emphasis in this edition is placed on biology at both the cellular and molecular level; many microscope photographs should help the student grasp these concepts. Selected aspects of genetics are included in the section on reproduction. Much of the material throughout this book has been rearranged in a more meaningful sequence. The infonnation on endocrine mechanisms follows the APRIL 1970 nervous system and is included under "integration and control of the body." The sections on bones. muscles, and articulations are well illustrated. with the written material printed in smaller type close to the diagrams. The vascular system deserves special mention; the information is correlated so that arterial supply and venous return are now considered together. The cranial nerves and special senses have been combined in a functional manner and the infonnation concerning each condensed in table form close to the descriptive diagrams. Many new illustrations have been included and others made clearer by pastel shading. The major sections of the book are organized under five main headings on the basis of functional activi- ty and have been set apart by colored title plates. The authors should be commended for their effort in producing the sixth edition of this excellent text. Community Health by Carl Leonard An- derson. 343 pages. Toronto. c.v. Mosby Company, 1969. Reviewed by Ethel Horn, Associate Professor, Community Nursing, Facul- ty of Nursing, The UnÙ'ersity of West- ern On tario. Within the many broad areas of commu- nity health. this book is concerned with the polluted environment, the aged in the population. drug abuse. and the mental health of the population - a concern in an already over-crowded. technological society. This text brings readers of differing backgrounds and disciplines to a broad awareness of community health. The overview of the book gives a background of the rise of concern for health over the ages. The other four areas are: promoting community health. preventing disorders and disabilities, environmental health. and health services. Community health has taken on many new aspects. and new approaches and programs are explored in this text. Consideration of the worker's role and the citizen's participation is discussed when feasible. The format of the text is attractively set in each section. Interesting to the instructor and the student will be the questions about the community and health and the up-to-date additional refer- ences that conclude each chapter. Both student and teacher can find many uses for this material in the student-centered classes of today. The author combines areas that were previously seen in parts, but not as the whole community and its health. This holistic approach enhances and lends emphasis to the ecological approach. Thus, the author brings the reader a new framework as a basis for viewing health problems of man in his environ- ment. This text will be useful to a wide range of health workers in today's health team. The Elderly Patient by Bernard A. Stot- sky. 160 pages. New York, Grune & Stratton Inc., 1968. Canadian Agent: The Ryerson Press, Toronto. Reviewed by Viola Allan, Administra- tor. Island Lodge and Carleton Lodge, Homes for the Aged, Regional Munici- pality of Ottawa-Carleton, Ontario. This book deals comprehensively with a broad range of conditions associated with aging and programs of service to the aged. Several critical areas are discussed: economic security, housing, recreation, self-care and physical hygiene, family relations, community resources, institutional care, home care, medical and nursing care, psychiatric problems, mental health, and death and bereave- ment. From this wealth of material the author could have been more selective and treated fewer topics in depth. The author criticizes current institu- tional and community services. offers suggestions for improvements, and dispels some past misconceptions. He concludes that the degree of social organization of the community is crucial in determining whether aged persons interact socially and relate to younger persons. The chapter on general hygiene of aging focuses on self-care practices that are advocated for good health. The suggested measures could be incorporated into teaching programs for personnel engaged in caring for the aged. The suggested activity schedule for a nursing home seems skimpy and lacks imagina- tion; however, it may be directed toward nursing home directors who consider any activity program too complicated or ex- pensive to undertake. In the chapter on nursing homes, the author is critical of custodial attitudes th.lt stilI exist. He describes the fears and anxieties of elder- ly people entering institutions, and suggests six rules for "successful trans- plantation" that could be used as primary objectives by nursing homes. The author recommends that institu- THE C NADIAN NURSE 55 Next Month in The Canadian Nurse . Male Patients: One Standard - or Two? . Interview with CNA executive . CNA Ticket of Nominations ð Photo credits for April 1970 Miller Services, Ltd., Toronto, cover Crombie McNeill Photography, Ottawa, p. 9 Studio C. Marcil, Ottawa. p. 20 N.B. Travel Bureau, Fredericton, pp. 34,35,36 Canada Pictures Limited, Toronto, p. 40 56 THE CANADIAN NURSE tional physicians give more attention to the social, psychological, and fmancial factors in their patients' lives. A fuller use of caseworkers is also advocated to obtain complete histories and to utilize all community services for the patients' benefit. As well, administrative ingenuity must be exercised to break down bureau- cratic hurdles of many community agencies in limiting their spheres of responsibilities. Community services should be organized around the patient rather than around the needs and skills of independent agencies. This is a valuable book that should interest all those concerned in the care or social planning of the aged. A V aids Nursing as a career A new Canadian filmstrip and record unit gives a good insight into the choice of nursing as a career. The unit costs $14.75. This unit is designed for use under the direction of a teacher in class-room situa- tions or by individual students. Although maximum results are achieved by using the recording in conjunction with the filmstrip, each can be used independent- ly. One side of the recording contains a 20-minute panel discussion in which two teachers of nursing answer questions ask- ed by a group of girls interested in a nursing career. The other side of the recording contains commentary for the filmstrip. It is easy to synchronize sound with pictures when a manually-operated projector is used with a separate record player. A detailed brochure outlining the contents of the unit can be obtained by writing to McGraw-HiU Company of Canada Limited, 330 Progress Avenue, Scarborough, Ontario. accession list Publications on this list have been received recently in the CNA library and are listed in language of source. Material on this list, except Reference items, including theses, and archive books which do not circulate, may be borrowed by CNA members, schools of nursing and other institutions. Requests for loans should be made on the "Request Fonn for Accession List" and should be addressed to: The Library, Canadian Nurses' Association, 50, The Driveway, Ottawa 4, Ontario. No more than three titles should be requested at anyone time. Stamps to cover payment of postage f rom library to borrower should be included when material is returned to CNA library. Books and Documents 1. Album-annuaire 1970. Grenoble, Maisons d'enfants et d'adolescents de France, 1970, 308p. 2. Alcoholiques par Roger Gentis Paris, Edi- tions du Scarabée, 1968. 75p (Bibliothèque de l'infirmier psychiatrique) 3. Basic nutrition and diet therapy for nurses by Lillian Mowry and Sue Rodwell Wil- liams. 4th ed. Saint Louis, Mosby, 1969. 226p. 4. Bibliography and book production by Ray Astbury. Oxford, Pergamon, 1967. 260p. 5. A book of London with 54 photographs from The Times edited by Ivor Brown. London, Collins, 1961. 352p. 6. The Canadians at war 1939-45. Montreal, Reader's Digest Association of Canada, 1969. 2v. (Canada's 4172 nursing sisters... p.279-282) 7. Creative film-making by Kirk Smallman London, Collier-Macmillan, 1969. 245p. 8. Diet manual by Vanderbilt University Hospital 2d ed. Nashville, Vanderbilt University Press, 1969. 158p. 9. Education for nursing practice; report of 1966 Arden House Conference. Albany, N.Y., New York State Nurses Association, 1966? 52p. 10. The fat and sodium control cookbook; how to prepare tasteful meals for the sodium- restricted or low sodium diet and for the fat- controlled diet including recipes and sugges- tions for low saturated fat regimens by Alma Smith Payne and Dorothy Callahan. 3d ed. Bos- ton, Little, Brown, 1965. 473p. II. Guide to patient care: a procedural manual by Cedars-Sinai Medical Center, Cedars of Lebanon Division. New York, National League for Nursing, 1969. 1I3p. (League ex- change no. 90) 12. How to conduct a selection interview by John W. Blyth and Millicent Alter. New York, Argyle, 1965. 378p. (Management skills series no.8) 13. Illustrated dictionary of eponymic syndromes and diseases and their synonyms by Stan Ie y Ja b lonski. Philadelphia, Saunders, 1969. 335p. 14. The journalistic interview by Hugh C. Sherwood. New York, Harper & Row, 1969. 115p. 15. Lectures on the history of nursing with descriptive list of lantern slides. Part I, lectures 1-9 with addenda by Maude E. Abbott. Mon- treal, McGill University, 1923? 51p. 16. Leeboek voor zvebenverpleging by J. G. W. Van der Moolen and H. J. Quanjer. Lochem, Netherlands, N.V. Urtrverschappij de Tijst- room, 1967-68. 2v. v.5 Verpleegkunde, Basis- verpleging and v.6 Verpleegkunde, speciele verpleging. 17. Medical and surgical motion pictures: a APRIL 1970 catalogue of selected films., 2d. rev. ed. Chica- go, American Medical Association, 1969. 572p. 18. Natio11J11 Library of Medicine classifica- tion. 3d ed. with 1969 supplementary pages added. Washington, U_S. Gov't Print. Off., 1969. 286p. (U.S. Public Health Service publi- cation 1108 rev.) 19. Nurses technical manual. 1968/69 by N. E. Broome. London, Butterworth's, 1969. lOOp. 20_ Nursing aspects in rehabilitation and care of the chronically ill by Elisabeth C. Phil- lips. New York, National Letlgue for Nursing, 1956. 44p. (League exchange no. 12) 21. Planning and producing audiovisual materials. 2d. ed. by Jerrold E. Kemp. San Francisco, Chandler, 1968. 251p. 22. Planning for nursing education in a community college. Report of workshop on Associote Degree Programs in Nursing, Stern Hall, Univ. of Californio, Berkeley, Calif June 23-July 11, 1958. New York, National League for Nursing, 1958. 37p. (League exchange no. 32) 23. Poverty/pauvreté supplement 3 and 4. Ottawa, Canadian Welfare Council, 1968-69. 2v. 24. Proceedings of Conference on Nursing Schools Connected with Colleges and Universi- ties, Teachers College Columbia University, New York City, Jan. 21 & 25, 1928 held under the auspices of the Department of Nursing Education of Teachers College and the Commit- tee on University Relations of the National League of Nursing Education. New York, National League of Nursing Education, 1928. lOOp. R 25. Regardez et écouter; essais sur quelQues aspects de 10 documentation audio-visuelle dans la bibliothèque par Paule Rolland-Thomas. Montréal, Association canadienne des bibliothé- caires de langue française, 1969. 105p. 26. Report 1968. Toronto, Alcoholism and Drug Addiction Research Foundation, 1969. 152p. 27. Report of conference on field instruc- tion in public health nursing at Gull Lake, Michigan, October 9-13, 1956, prepared by Kathryn A. Robeson and Ella E. McNeil. New York, National League for Nursing, 1957. SIp. (League exchange no. 25) 28. Report of Fourth Nursing Research Conference, March 4-6, 1968. New York, New York, American Nurses' Association, 1968. 295p. 29. Report of Workshop on Public Health in the Nursing Cu"iculum, Center for Continua- tion Study, Univ. of Minnesota, June 13-/7, 1965. Sponsored by the School of Public Health, University of Minnesota National League for Nursing New York, 1955. 49p. (League exchange no. 8) 30. Sairaahoedon vuosikiya. Helsinki, Finnish Federation of Nurses, 1958 9. 6v. (Year book of nursing, English language titles and abstracts) 3l. Symposium on care of the cardiac patient edited by Adeline C. Jenkins (In Nurs- ing Oinics of North America. Philadelphia, Saunders, 1968. v.4 nO.4 p. 561 49) 32. Symposium on compassion and communication in nursing edited by Grace APRIL 1970 Theresa Gould. (In Nursing Clinics of North America. Philadelphia, Saunders, 1968. v.4, no.4 p. 651-729) 33. Tuberculose; visages d'hier et d'aujour- d'hui; aux enseignants et à leurs élèves. l.ed. Ottawa, Association canadienne contre la tuber- culose et les maladies respiratoires, 1968. 174p. 34. White-collor bargaining units under the Ontario Labour Relotions Act by G. W. Reed, Kingston, Ont., Industrial Relations Centre, 1969. 56p. (Research series no. 8) Pamphlets 35. Annual report of continuing nursing education, 1968-69. Vancouver, University of British Columbia, School of Nursing, 1970. Iv. 36. Bibliography nursing literature on cancer, 1958-64. Houston, Texas. M.D. Ander- son Hospital and Tumor Institute, Texas. 1965? 16 p. 37. Code de prêts entre bibliothèque Mon- tréal, Association canadienne des Bibliothécai. res de langue française, 1969. 5p. 38. The commemoration of Florence Night- ingale: an oration delivered by George Newman before the general meeting of the Ninth Qua- drennial Congress of the International Council of Nurses. London, 1937_ 16p. 39. Directory 1970. Toronto, Professional Photographers of Canada Inc., 1969. 41p. 40. Directory of nurses with earned docto- ral degrees. New York, American Nurses' Foun- dation, 1969. 18p. (Reprinted from Nursing Research, vol. 18, no. 5, Sept-Oct. 1969.) 41. L 'enseignement et les sciences de 10 san- té par Jacques Brunet. Ottawa, 1969. sanitaire, octobre, 1969. 18p. 42. From head to toe, Washington, U.S_ Pu- blic Health Services, National Centre for Chro- nic Disease Control, 1968. 14p. (U.S. Public Health Service publication no. 1808) 43. Guide for leadership in team nursing by Helen G. Beltran et al. New York, National League for Nursing, 1961. 26p. (League ex- change no. 54) 44. Hospital dollors are round by David K. Trites _ . . et al. Rochester, Rochester Methodist Hospital, 1969? 9p. 45. Interim brief submitted to the Commis- sion of Inquiry into the Non-medical use of drugs. Montreal, Canadian Medical Association, 1969. IIp. 46. Interlibrary loan code. Ottawa, Canadi- an Library Association, 1969. 5p. 47. Manual for the administration of the State Board Test Pool Examination for practic- al nurse licensure. New York, National League for Nursing, 1969. 12p. 48. Maslow and teachers in training by David N. Aspy (In National Commission on Teacher Education and Professional Standards. Journal of Teacher Education Washington, v. 20 (1969) p.303-310) 49. The nongovernmental organization at bay. New York, Carnegie Corporation of New York, 1967? 15p. 50. Non-medical use of drugs with particu- lor reference to youth. Toronto, Canadian Medical Association, 1969. 17p. (Reprinted from the Canadian Medical Association Journal 101:804-820, Dec. 27, 1969.) 51. Opportunities in the field of nursing. New York, Columbia University, Alumni Asso- ciation of Teachers College, Nursing and Health Branch, 1915? 44p. 52. The pediatric nurse practitioner and the child health associote; new types of health professionals by Henry K. Silver and James A. Hecker. 3p. 53. Personal medicine: health examinations and the automated Ioboratory. Washington, U.S. Public Health Service, National Center for Chronic Disease Control, 1968. 9p. (U.S. Public Health Service publication no.1832) 54. The photography of H. Armstrong Roberts, volume C. Philadelphia, n.d. 16p. 55. Potential for newer closses of personnel; experiences with the Duke physician's assistant program by Harvey E. Estes and D. Robert Howard. Durham N.C.. 1969. 13p. 56. rrogramme for extended care facilities as proposed by the Project Division, July 7. 1969. Toronto, Canadian Council on Hospital Accreditation, Project Division, 1969. 39p. 57. Psychology and psychiatric nursing re- search. Proceedings of a symposium at the sixty-fourth annual com'ention of the American Psychological Association August 31, 1956, Chicago, Ill. New York, National League for Nursing, Division of Nursing Education. 1956. 22p. (League exchange no. 18) 58. Report 1967. Geneva, League of Red Cross Societies, 1969. 56p. 59. Saskatchewan's developments leading to the establishment of diploma nursing education in the provincial government's Department of Education, by Linda Long, Regina, Sask., 1969. lOp. (Paper presented at School of Nursing Conference, University of Toronto, June 16-18, 1969) 60. The sick poor, Reprinted from Ameri- can Journal of Nursing Nov. 1969, vol. 69, no. II. New York, American Journal of Nursing Co., 1969. p. 2423-2454. 61. Statement to the Joint Legislotive Com- mittee on the problems of public health and medicare at its public hearings Monday, Sept. 26, 1966 in New York City On the topic The critical shortage of nurses in New York State and the problems reloting to the licensing and training of registered nurses and practical nurses. New York. New York State Nurses Association, 1966. lOp. 62. Three pathways to a head start in nurs- ing. Papers presented at the program meeting of the Council of Diploma Programs held on May 20 at the 1969 NLN Convention in Detroit, Michigan. New York, National League for Nurs- ing, Dept. of Diploma Programs, 1969. 19p. 63. Undergraduate and graduate diploma and degree courses at Canodion universities and colleges, 1969. Ottawa, Association of Universi- ties and Colleges of Canada. 1969. 39p. 64. Videotape and the vitalization of teach- ing by Judith M. Bloom. (In National Commi - sion on Teacher Education and Professional Standards_ Journal of Teacher Education. Wash- ington. v.20 (1969) p.31I-316). 65. Wine and health as food. . . in therapy. Marlo Park, Calif., Wine Institute, San Francis- co, Calif., 1969. 13p. 66. The writings of Florence Nightingale, an THE NADIAN NURSE 57 accession list oration delivered by Lucy Seymer before the Ninth Congress of the International Council of Nurses. Atlantic City, U.S.A., 1947. London, England, Nursing Mirror and Midwives Journal as gift & Florence Nightingale International Foundation, 1947. 16p. Government Documents Canada 67. Bureau of Statistics. Benefit periods es- tablished and terminated under the unemploy- ment insurance act. Report, 1968. Ottawa, Queen's Printer, 1970. 60p. 68. Commission d'assurance chomage. Rap- port, 1968. Ottawa, Imprimeur de la Reine, 1969. 76p. 69. Dept. of Labour. Accident Prevention and Compensation Branch. If you have an acci- dent; what to do and how to do it. Ottawa. Queen's Printer, 1969. 18p. 70.-.Economics and Research Branch. Labour organization in Canada, 1969. Ottawa, Queen's Printer, 1969. 114p. 71. Dept. of Manpower and Immigrdtion. Operation retrieval. List of Canadians studying abroad and available for employment in Cana- da, 1969/70. Ottawa, Queen's Printer, 1970. 4pts. 72. Dept. of National Health and Welfare. Earnings of physicillns in Canada, 1967. Ot- tawa, 1969. 37p. (Health care series no. 21, supp.) 73_-. Health Resources Directorate. Can- ada health manpower inventory 1969. Prepared by Study Group. Ottawa, 1969. 48p. 74. The Science Council of Canada. Govern- ments Subgroup. Scientific and technical infor- mation in Canada. Pt. 2, ch. 1. Government departments and agencies. Ottawa, Queen's Printer, 1969. 168p. (Science Council of Canada Special Study no. 8) 75. Central Office of Infonnation. Refe- rence Division. Care of the elderly in Britain prepared for British Information Services. London, 1969. 25p. Northwest Territories 76. Commissioner. Report, 1966-67. 97p. Ontario 77. Departmen t of Labour. Research Branch. Ontario Collective agreement expira- tions, Toronto, 1970. 206p. 78. Hospital Services Commission. Report 1968. Toronto, 1969. 22p. Studies Deposited in CNA Repository Collection 79. Etude des effets du "feed-back" sur la communication malade infirmière par Lo"aine Beaudin. Montréal, 1968. 68p. Thesis (M. N urs.) - Montreal R 80. Etude au rôle educatif de l'infirmière auprès de la femme enceinte en afrique noire; tendances actuelles, Montréal, Université, Insti- tute Marguerite d'Y ouville, 1966. 20p. (Travail de recherche présenté . . . par un groupe d'étu- diantes. candidates au Baccalaureates Sciences Infinnieres)R 81. L 'hôpital de Jeanne-Mance à Ville- Marie; son évolution à travers les siècles par Jeanne Bernier (Soeur) Montréal, Therien Frè- res, 1957. 119p. (Thèse présentée à I'école d'ad- ministration Hospitalière pour I'obtention du Diplôme en administration Hospitalière, 1955)R 82. Influences of sociological factors on the health needs of high school boarder students and their impact on nursing actions to be taken by Georgette Desjean. Detroit, Mich., Wayne State, 1968. 148p.R 83. Nursing service project. Toronto, The Wellesley Hospital, Hospital Systems Design Dept. 1969. Iv. various paging. R 84. One hospitalized preschool girl's way of dealing with separation anxiety by June F. Kikuchi. Pittsburgh, 1969. 72p. Thesis (M.N.) - Pittsburgh.R 85. A study of the attitudes of public health nurses in a selected agency toward direct pa- tient care by Audrey Elizabeth Shepherd. Seat- tle, Wash., 1968. 91p. Thesis (MA) - Washing- ton.R 86. Utilization of graduate nurses of basic baccalaureate and two year non-hospital diploma programmes as viewed by directors of nursing service prospectus for field study by Eileen D. Strike, Anne Mowat and Ivy H. Dunn. Boston, 1969. 19p. Completed at Boston University School of Nursing toward MSc degree.R 0 Request Form for "Accession list" CANADIAN NURSES' ASSOCIATION LIBRARY TEACHERS OF NURSING We invite YOU to join us! Send this coupon or facsimi to: LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario. Please lend me the following publications, listed in the .....' ...... .... issue of The Canadian Nurse, or add my name to the waiting list to receive them when available. Item Author Short title (for identification) No. You will enjoy working with our dynamic group of teachers and students. Our educational facilities in the new School building and in the practice areas are excellent. Come and help us with the development of an exciting educational program in Nursing. Request for loans will be filled in order of receipt. Reference and restricted material must be used in the CNA library. Borrower Registration No. Position /I you wish to know more about us, please, write to: The Director CORNWALL REGIONAL SCHOOL OF NURSING 801 Fourth Street East Cornwall, Ontario Address 58 THE CANADIAN NURSE Date of request APRIL 1970 May 1970 -. MISS MTM ORRIS 290 NELSON ST APT 812 OTTAWA 2 ONT 00005184 I , . \ I , j r-I' 1 The Canadian Nurse buoy up your spirits in the Maritimes! I . I It r ,,"I 'f/; ' I :: 1 II" ., male patients deserve better nursing care than they're getting nominees for CNA executive . \ 1 , ' \ .\ 1 · \ .\\ " , , . I , i , \ I., c; \. Today, choose tltese new Mosby books to New 8th Edition! SOCIOLOGY: Nurses and Their Patients in a Changing World By Jessie Bernard, Ph.D., and Lida F. Thompson, R.N., M.S. Today's emphasis on nursing care of the "whole man" makes this newly revised text a significant addition to your curriculum! It explores the sociological effects of the dramatic changes of recent years, both in the world situation and in educational pat- terns. Well-written new discussions present the many roles a nurse must play, and examine health implications of community life. June, 1970. Approx. 328 pages, 82 illustra- tions. About $9.35. New 8th Edition! ESSENTIALS OF PSYCHIATRIC A New Book! MATERNITY NURSING By Constance NURSING By Dorothy Mereness, R.N., Ed.D. This Lerch, R.N., B.S.(Ed.) This sensitive new text is planned popular text clearly describes the basic knowledge and for concurrent classroom and clinical learning. It presents nursing skills your students need to care for the mentally the entire maternity cycle as a normal physiologic process, ill. This up-to-the-moment revision includes four new with sections on the preparatory (pre-pregnancy) phase, chapters which make the 8th edition a complete overview pregnancy, labor and parturition, the post-partum period, of psychiatric nursing: they discuss emotionally ill chil- and the neonate. This richly illustrated book also includes dren and adolescents, mental retardation, community a chapter on high-risk pregnancy, as well as detailed psychiatry, and the nurse's role in group therapy. A more material on nursing measures to prevent postpartum logical sequence of chapters, new illustrations of psychi- complications. Practical teaching features include study atric nurses in action, and a current (,' " questions, blank pages for student bibliographyalsoenhancethisedition! q! J notes, a comprehensive glossary, and August, 1970. Approx. 336 pages, 20 full bibliography. May, 1970. Approx. illustrations. About $8.00. " , 480 pages, 190 illustrations. About $9.75. New 5th Edition! PSYCHOLOGY: ' , '."'- , ' 'Ie -" 2nd Edition WORKBOOK FOR PrincipJesandApplicationsByMarian ,l \ I" "'-', MATERNITY NURSING By East Madigan, Ph.D. This popular in- l ' \ \ 1"= I _ '? \ Constance Lerch, R.N., B.S.(Ed.) This terdisciplinary approach correlates ú ' " workbook, the most widely adopted topics in psychology with applications '" . -, t in its area, gains added significance to clinical nursing. This extensively --t ,.- I , , --, t as an adjunct to the new correlated revised new edition was carefully reviewed by a prominent text described above. Case studies, situation questions nursing educator with a master's degree in psychology-a for discussion, self-examinations, and carefully selected guarantee of its relevance to your needs. Meaningful dis- references help students learn theory and applications. cussions present psychology as a science, concepts of This recently revised edition describes the influence of heredity and development, basic psychological processes, heredity and environment on the developing fetus, and the development of personality, and problems of adjust- places greater emphasis on nutrition, minor discomforts ment and mental health. A helpful Teacher's Guide is of pregnancy, and high-risk pregnancy. This workbook provided without charge to instructors adopting this text. and its new companion text can give you an unmatched July, 1970. Approx. 442 pages, 129 illustrations. About $10.45. teaching package! 1969. 311 pages, 33 illustrations. $5.40. New 6th Edition! DISSECTION OF THE CAT (AND COMPARISONS WITH MAN) A Laboratory Manual on Felis domestica By Bruce M. Harrison, Ph.D., Sc.D., LL.D. This well-established manual, written for courses in human anatomy where cadavers are not available for dissection, carefully demonstrates the similarities and differences between the cat and man. This timely new edition gives many more such comparisons; in addition, it offers more embryological and physiological interpre- tations, and points out anomalies and their interpretation. The logical system of dissection is demonstrated in clear, thoroughly revised illustrations. This manual is punched and perforated for convenient use. August. 1970. Approx. 232 pages, 73 illustrations. About $5.35. instruct, involve, inspire tOJnorrow's nurses! :'-. """""'i , . , ',. f;;1:t - ,. ... J r , \ . t:t /....l !I í \ \\iJ (' ll' \ \;\ A New Book! CRISIS INTERVENTION: Theory and Methodology By Donna C. Aguilera, R.N., B.S., M.S.; Janice M. Messick, R.N., B.S., M.S.; and Marlene S. Farrell, R.N., B.S., M.S. This pragmatic new book can help your students understand the concepts involved in short-term therapy of psychiatric disturbances precipi- tated by specific stress situations. It describes biologic, sociologic and psychologic factors which may contribute to these situations, offers effective techniques for success- ful intervention, and carefully examines the nurse's role. Clearly written in non-technical lan- guage, it points out this versatile approach's broad implications for mental health care. June, 1970. Approx. 168 pages, 13 illustrations. About $5.45. A New Book! VOCATIONAL AND PERSONAL ADJUSTMENTS IN PRACTICAL NURSING By Betty Glore Becker, R.N., and Sister Ruth Ann Hassler, S.S.M., R.N., B.S. (Nursing). For your course in "Pro- fessional Adjustments", choose this well-organized new text. Building from basic to complex, concise discussions help your student better understand herself, her place on the health care team, current religious, ethical, and legal aspects of practical nursing. Non-technical language, study questions, a unique chapter on care of patients with special problems, and a timesaving Teacher's Guide and Test Manual (free to instructors adopting this text) add to its value. February. 1970. 168 pages. 13 illustrations. $7.55. New 2nd Edition! PROGRAMMED INSTRUCTION IN ARITHMETIC, DOSAGES, AND SOLUTIONS By Dolores F. Saxton, R.N., B.S., M.A.; and John F. Walter, Sc.B., M.A., Ph.D. Proven effective in 4 years of actual use, this programmed manual allows students to proceed in short, logical steps, at their own speed, from basic to more complex material. This new edition has been revised to include a review of basic concepts of arithmetic, presented in terms of both "old" and "new" math. It introduces the metric and apothecaries' systems, and the problems encountered in mov- ing from one system to the other. Students then proceed to mathemati- cal problems encountered in actual nursing situations. June, 1970. Approx. 68 pages. 2 illustrations. About $3.85. New 4th Edition! PRACTICAL l'IJURSING: A Textbook for Students and Graduates By Dorothy Kelley Rapier, R.N., B.S., M.S., Editor; Marianna Jones Koch, R.N., B.S.; Lois Pearson Moran, A.B.; J. R. Geronsin, R.N., B.S., and Geraldine Edwards Phelps, A.A., R.N., B.S., M.S. A widely adopted text on nursing funda- mentals, this new edition reflects the many recent develop- ments in health care which expand the practical nurse's role, and incorporates suggestions from users of the previous edition. The unit on nursing the adult patient has been completely revised. September, 1970. Approx. 640 pages, 197 illustrations and a Trans-Visionll!insert of human anatomy. About $8.50. MOSBY TIMES MIRROR MAY 1970 THE C. V. MOSBY COMPANY. 3207 WASHINGTON BLVO.. ST. LOUIS, MISSOURI 83103 THE CA ADIAN NURSE 1 , .. " " .. " " " : " " " . " ' ' " \l '\ j \ .", ., Ii Does Jane Cowell know the facts about dandruff? Probably not' The facts are dandruff is a medical prob- lem and requires medical treatment. Ordinary shampoos cannot control dandruff. New formula Selsun can! The doctors you know are undoubtedly familiar with Selsun. And they prescribe it because it's medically recommended. And proven effective in 9 out of 10 severe dan- d ruff cases. Our new formula Selsun is as effective as the old. We use the same efficient anti- seborrheic - selenium sulfide. We've simply improved the carrier. A more active deter- sets:' gent produces foamier lather - a finer suspension gives smoother consistency. To top off new formula Selsun we added a fresh clean fragrance and put it in an at- tractive unbreakable white plastic bottle. If you know someone with a dandruff prob- lem tell them to ask their doctor about Selsun. And if dandruff worries you - ask your own doctor. loA' - -. I I selsun. eJ -RD. T.M. (Selenium Sulfide Detergent Suspension U.S.P.) A PRODUCT OF ABBOTT LABORATORIES, LIMITED 4!51Z.1 The Canadian Nurse ð A monthly journal for the nurses of Canada published in English and French editions by the Canadian Nurses' Association Volume 66, Number 5 May 1970 27 One Standard - Or Two? 29 Idea Exchange 32 Program for 35th General Meeting A.W. Wedgery 33 Issues CNA Members Face at 35th General Meeting 39 Ticket of Nominations 45 Fredericton - Here We Come! C. Kotlarsky The views expressed in the various articles are the views of the authors and do not necessarily represent the policies or views of the Canadian Nurses' Association. 4 Letters 7 News 22 Names 23 In a Capsule 24 Dates 47 Books 48 Accession List 72 Index to Advertisers Executive Director; Helen K. Mussallem - Ed- itor: VÎrj(inia -\. Lindabur\ - Assistant Ed- itor: \Iona C. Ricks - - Editorial Assist- ant: Carol A. KotIarsky - Production Assist- ant; Elizabeth A. Stanton - Circulation Man- ager; Bel')\ Darling - Advertising Manager; Ruth H. Baumel - Subscription Rates: Can- ada: One Year, $4.50; two years, $8.00. Foreign; One Year, $5.00; two years, $9.00. Single copies; 50 cents each. Make cheques or money orders payable to the Canadian Nurses' Association. - Change of Address: Six weeks' notice; the old address as well as the new are necessary, together with regis- tration number in a provincial nurses' assJ . " '(f ." .. lfJ........ '""- -..; , ',i' f í'? --..............:-. , 1 I I ,-' ........ ....... .. ...:::..::::- ... , " " . New Disposable Needles and Syringes Professional quality to earn your confidence An answer to your quest for quality. Sterilon achievement in sterile disposables combines with the facilities and experience of Gillette to produce superiority and integrity in a totally new disposable hypodermic system. Working with Gillette Research Institute near Washington, D. C. and Gillette Surgical of England, Sterilon has developed Sterimedic needles and syringes. These "Depend- able Expendables" offer maximum flexibility and convenience for the hospital staff. . . utmost security for your patients. Each Sterimedic component incorporates the best features of eXisting products. The system adapts to familiar hospital proce- dures, speeding your work flow and avoiding confusion. Advanced clean room creates Sterimedic needles and syringes. To achieve a controlled manufacturing environment, Sterilon designed and built a sophisticated clean room. This room, with its personnel, precision equipment and procedures, assures pre- eminent hospital quality in every STERIMEDIC component. Fin- ished products undergo today's most up-to-date sterilization regimen as well as microbiological tests and evaluations to assure patient safety and comfort. Professional quality of needles and syringes earns your confidence. Super sharp 304 stainless steel lancet point needles offer regular, short and intradermal bevels. Burrs and coring edges minimized by world famous Gillette grinding techniques. Needles ultrasonic- ally cleaned, microscopically inspected and siliconized. Needles are protected by color coded patented' snap cap rigid sheath which prevents tampering and rolling, acts as wrench to tighten or remove needle, isolates contaminated needle after use. Avail- able in 26 to 18 gauge with lengths from %" to 1V2". Velvet smooth aspiration and injection. Stable, multi-vaned plungers, extra wide comfortable wings, contoured and grooved thumb pieces combine to create a comfortable grip, perfect balance and flawless action which makes positive control a reality. Other features include easy-to-read vertical calibrations which will not rub off or fade, airtight leak-resistant connection between needle hub and syringe luer tip, and extra mixing ranges in popular syringe sizes. Wide choice of syringe sizes and needle! syringe combinations are standardized for hospital convenience and economy. Dual purpose packaging promotes organized use of CSR storage and aids disposal. Compact corrugated cartons are boxed to ship all components. Attractive, durable intermediate boxes fully protect contents until use and double as disposal receptacles. Color coding for quick, positive identification of needle gauges. Boxes and individual packages are plainly marked with color coding, contents, directions. Needle box features perforated cover, reclosable for storage. Internationally accepted color code needle sheaths, hubs and snap caps. Handy Peel Paks assure sterility" of needles and syringes. Separate easily to fully expose contents. Permit sterile aseptic introduction onto sterile field. Serve as patient charge records. "CAUrfON: Federal (U.S.A.) law restricts this device to use by or at the dlfection ot a physIcian As with al/ sterile disposable items, the packaging shou'd always be checked. If the packaging Is damaged or seaf broken, product should not be considered sterl/e. Steristation provides convenient storage at nursing stations. Plastic trays may be kept in existing storage space or in heavy duty, lockable, brushed stainless steel Steristation. Holds ample stock of needles and syringes in sizes and quantities to suit most needs. Ideal means of organizing, storing, dispensing and re- filling ward supplies through either one-for-one xchange or restocked replacement of entire unit. Steritray is your key to convenience, adaptability and safety dur- ing delivery of medications. lightweight, durable, only 13V2" x 15". Filled syringes are placed needle sheath down in Steritray, carried to bedside, injected, resheathed and temporarily disposed of in paper bag. Patient and nurse are protected since only minimal handling is necessary. Spaces for 12 syringes, 24 medication cups, dosage cards and alcohol swabs. Safe, secure method of disposal. After injection, needle sheath is used to snap needle at its mid-point, then replaced on the luer tip and snapped downward to destroy the syringe. Red "contaminated" labels convert packing box into disposal re- ceptacle. Needles and syringes are pushed through sunburst one-way opening. Filled box is taped shut for final disposal. Invaluable in-service training provided by Sterilon. A thorough evaluation program will be designed and implemented by your Sterilon representative. Comprehensive in-service training is con- ducted through a series of orientation lectures on all three shifts. Assured service and supply. Components and continuing tech- nical assistance are always available to meet your emergency or routine needs. For complete Information. Call your Sterilon representative, hospital supplier or write: - s"t"erIID"1 81.rllon Corpor.llon 1505 Washlnglon Street . Bralntree. Mass. 02184 Subsldlarlas of The Gillette Company Sterl/on 01 Cenada, Ltd. 3269 AmerIcan Drive. Mallon. Ontario 'u. S. P.tant 3.114,455 Sterimed,c TM Is a trademark 01 Sterilon Corporation. news (Continued from page 9) support of the former director of nursing, Lucille Verrall, who was fired on January 27. Assistant director, Phyllis Walker, was demoted on the same day and then resigned. Mrs. Verrall and Mrs. Walker were both removed from the hospital by security guards. On March 12 the Ontario Hospital Services Commission recommended that a new director of nursing be appointed, after the Commission had obtained the views of the hospital administrator involv- ed but not those of Mrs. Verrall. RNAO informed the Milton hospital on March 16 that the resignations entrust- ed to it by 61 nurses of the hospital would be submitted unless Mrs. Verrall was reinstated as director of nursing, or a justifiable reason as to why she should not continue was given Mrs. Verrall and the RNAO. A second condition was the reinstatement of Mrs. Walker. When no action had been taken by the hospital board of directors by March 24, the nurses' resignations were forwarded to the Milton District Hospital Administra- tor. The hospital board's decision to rein- state the two senior nurses followed a series of meetings of hospital directors, nurses, doctors. citizens, and RNAO staff. Anne Gribben, director of RNAO's employment relations department, told The Canadian Nurse that the final out- come was very satisfactory to both the nurses at Milton District Hospital and the RNAO. "Any differences of opinion that existed between the nurses and the hospi- tal board are now a matter of the past," she said. Nurse Should Develop A "Colleagueship of Equals," Sociologist Tells Conference Toronto, Onto - To give good patient care, nurses must have the dignity of knowing that their colleagues and "the system" care for them, according to sociologist Hans O. Mauksch, director of health care studies at the University of Missouri. Dr. Mauksch was speaking at a conference on nursing education for the beginning practitioner, sponsored by the Registered Nurses' Association of Ontario in March. "Many nurses don't want to work with nurses," he said. "They want to work with patients or doctors. Nursing must develop a 'colleagueship of equals' if it is to provide its best service." Dr. Mauksch warned that the "aura of patient care" was so strong in nursing education that it threatens to interfere with education it- self. "The patient and the doctor are often put on a pedestal, and perhaps they are sometimes put there to be forgotten." he added. "Most nurses are deeply com- mitted, but they are inhibited by this system." Students Debate Nursing IS!iues "\ ....... r '""",,,' . \\.- $ \, ,. } \-'. \ - - .' , -"". /'. t "'''- .;,. \ :to Students in the certificate program in nursing education at the University of Ottawa held a lively debate March 13. Two questions were debated: first, that primary consideration should be given to individualizing clinical experience to meet each student's learning needs, and second, that medical-surgical nursing should be given at two levels of expertise. Participating in the two-hour program were, left to right, Maureen Hunka, affirmative speaker in the first debate; Nancy Powell, chairman; Helen K. Mussallem, executive director of the Canadian Nurses' Association and one of the debate's three judges; and Camille Wolfe, negative speaker in the second debate. The negative sides won both debates in the afternoon program. 12 THE CANADIAN NURSE . Dr. Mauksch also had criticism for nursing service. "It is bureaucratic and serves only the institution, not the pa- tient," he claimed. It is part of the institution's tendency to serve units rather than patients, he added. He also questioned the role the student is prepar- ed for and the one she eventually accepts as a practicing nurse, suggesting that much of the student's time is wasted learning something she will never use. "But we cannot change this over- night," he admitted, "since social behavi- or does not change simply with a change in the environment." He cited as an example a study he had conducted at a hospital that had tried to change the role of its nurses. New nurses coming into the hospital had continued in their old patterns rather than adapting to the new ones Dr. Mauksch said. "We must inculcate the obligation to question and learn," he said, "so that the idealism of the student does not simply change to competence, but modifies it to include both." Dr. Mauksch said that nursing, like other professions, has absorbed all the inadequacies of the system, and that it must identify them for what they are, rather than accepting them as part of the system. Other speakers at the conference included The Honorable Thomas Wells, minister of health for Ontario; Margaret D. McLean, nursing consultant for the hospital insurance branch of the depart- ment of national health and welfare; Dr. Norman H. High, professor of adult education at the Ontario Institute for Studies in Education; and Geneva Lewis, director of public health nursing, Ottawa- Carleton Regional area health unit, Ottawa, Ontario. Ryerson Offers Three Advanced Nursing Programs Toronto, Onto - In September 1970 the nursing department of the Ryerson Poly- technical Institute will be offering all three of its advanced nursing programs in psychiatric, pediatric, and adult intensive care nursing. The advanced pediatric and the adult intensive care nursing programs have been offered once and have received favorable reactions from students and employers. They are each one semester (15 weeks) in length. The advanced psychiatric nursing pro- gram has been offered three times as a one-semester program, and in September will become a two-semester (full academ- ic year) program. The first semester of this new program will be similar to the original programs, and the second semes- ter will go into more depth in psychiatric nursing. Nurses who have satisfactorily completed the original program will be eligible to enter directly into the new second semester in January 1971. (Continued on page J 5) MAY 1970 -:: .. '" ""V A - .. .\ . ... ,-+.... -, -. . ,. .. - " - ..... ..... ..... . - . \!If '- ..... --- - - ;-;;;;;.. -- \.. \, \ \ \ MARN celebrates t Manitoba ... Centennial -- 1 3 . , - , . '.,. II;"" . ..... c . /1>, "'" .. ).. . "-r.r' r 1 f .' II .1- .. .. , . , - .. , .4 _, I 5 1. Five Manitoba registered nurses were made charter members of the Manitoba Association of Registered Nurses' new honors list at a meeting saluting the province's centennial on February 13, 1970. With Bente Cun- nings, executive director of MARN, (third from left in back row), are, left to right: Myra Pearson, Fay McNaught, Lois Abbott, Marjorie Jackson, and Vi Miller. 2. Bringing greetings from the Can- adian Nurses' Association to the "Salute to Manitoba" is Marguerite ill I.' I .' t , Schumacher, CNA first vice-presi- dent. 3. Admirers of the display of arts and crafts, the work of Manitoba nurses, featured during the evening. 4. Intermission time during the "Salute to Manitoba" night staged by MARN, and Manitoba nursing students. Some 2,000 nurses and students celebrated Manitoba's cen- tennial year at the gala event. 5. The Winnipeg General Hospital Glee Club performs as part of a special program of entertainment. .. , t" ,. 2 .. .. ... ^ . -y _...... . \, . .. ,.- r 1"- ., . ;.t;\ - I' , .. ... I, ., . " ,. 'I.. , \ \. I 1 J 4 " t ... ... " , , "'- " .. 1 6 6. MARN President Dorothy Dick (right) and Bente Cunnings, MARN executive director(second from right) chat with Rene Toupin, min- ister of health and social services in the Manitoba government, and Kathleen DeMarsh, assistant execu- tive director of the Winnipeg General Hospital. 1 ELASTOPLAST elastic adhesive bandages give strong support, allow air to reach the skin and moisture to evaporate to promote rapid healing. 2 bS are available in 4 types for casts of great strength, minimum weight, and fine porcelain-like finish. 3 a G 1reSSingS are non-adherent and open-meshed. Now available in individual sterile unit 'peel-apart' envelopes. 4 ELASTOPLAST dressing strips are continuous elastic adhesive porous dressings. Strips are cut to fit the wound. 5 ELASTOCREPE Cotton Crepe Bandage is a smooth su rface non-adhesive bandage with unique properties of stretch and regain. 6 i b'eYe 1 w d iety of skin conditions after deep x-ray therapy, plastic surgery, chafing, and as a lubricant. 7 SUPER-CRINX Softstretch Bandages conform to difficult body contours. It's unique weave of cotton and nylon assures sustained tension. S fo r 1 nting Material is light yet strong enough to form a variety of splints, supports, and prostheses. 9 ELASTOPLAST 'airstrip' ward dressings for the care of post-operative wounds-air-permeable yet water- proof to permit healing under ideally dry conditions. 10 ! , eets, bed pan and urinal covers are for low- cost sanitary use in the hospital. 11 CELLO LITE All-Cotton Thermal Blankets give maximum warmth and comfort with minimum weight and withstand the strain of repeated laundering. 12 ELASTOPLAST skin traction kits are ready-to-use and provide the most efficient method of skin traction. 13 ELASTOPLAST anchor dressings featu re a porous elastic adhesive fabric - H-shaped to give firm anchorage on hard-to-dress areas. SMITH & NEPHEW LTD. 2100-52nd Avenue, lachine, Quebec 1 4 10 3 2 7 8 12 5 ,,' the best dressed patient 6 11 1 \' \ Next Month in The Canadian Nurse . Decentralized Nursing Service . A Positive Approach to the Mentally Retarded . Let's Have Permanent Shifts Photo Credits for May 1970 T. Dier, Ottawa, p. 8 Studio C. Marcil, Ottawa. p. 12 Manitoba Association of Registered Nurses, no. 1,2,3,4,6, p. 13 David Portigal, Winnipeg, no. 5, p. 13 National Publicity Studios, Wellington, New Zealand, p. 22 Vancouver General Hospital. Vancouver, p. 29 Prince George Regional Hospital, Prince George, B.C., p. 30 Photo Features. Ottawa, pp. 34-38 MAY 1970 news {Continued from page 12} A certificate is awarded to successful graduates of each of the three advanced nursing programs. They are available for part-time as well as full-time students. Each program offers a course in nurs- ing in the specific area, including classes and selected, supervised clinical experi- ence; a course in the corresponding medi- cal theory and practice; and a range of courses in the related social sciences and humanities. The entrance requirements for the advanced nursing programs is registration or pending registration in Ontario. For further information contact the Registrar, Rye rson Poly technical Institute, 50 Gould Street. Toronto 2, Ontario. Task Force Reports Published Ottawa. - The Department of National Health and Welfare announced in March that the task force reports on the cost of health services in Canada were ready for publication in final form. The English edition of the reports is now available, with the French edition to follow as soon as possible. Price for the three-volume reports is $8.75 per set. Orders for the reports may be placed through the Queen's Printer, Mail Order Division, Ottawa. Ontario, or at the Queen's Printer Bookstores in Vancouver, Winnipeg, Toronto, Ottawa, Montreal, and Halifax. Three nurses were among the 40 mem- bers of the seven task forces appointed by Health Minister Munro in February 1969 to prepare reports on three major areas of health care costs: hospital services, medi- cal care, and public health services. CHA Holds Symposium On Computer Applications In The Health Field Ottawa. - "Computers In Health" was the theme of the national symposium on computer applications in the health field, presented by the Canadian Hospital Asso- ciation with the cooperation of the De- partment of National Health and Welfare. The symposium was held in Ottawa March 18 to 20. Experts in this field from Sweden, France, Puerto Rico, the United States, and Canada discussed current applica- tions, past performance, and future plans, including successes and problems encoun- tered. Emphasis was on current working applications and reasonable expectations for future developments. In his keynote speech, Health Minister John Munro explained how computing systems can provide better quality of services to Canadians, and better hospital 1 Naml PII IIIIJ 2 PI.S (uml .aml) .IMPORTANT PI,,,,, Idd 2Sc per order bind!!". ebar.. Of! .11 ordtfs of ) þm or leu CROUP DISCOUNTS 2S 99 pI"'. S'í.. 100 or mGfl. 10'\ Send c..h l m..a.. Dr check. No blllinlS Dr COD"s. Sel-Fix NURSE CAP BAND . BlICk velvet IIlnd m.fenlt. SeIf.1d- L \ hes.ve-presses on. pulis off; no '.....in. ........ or plnninl. Reus.ble slYeral times ....... Each bind 20" Ion&. prl-(LI1 to pop- ... ular widths; V... (12 per plastiC box!. 11.1'" 18 per boxl. '" 16 rr Þod, I'" No. 6343 '& ':n ; d1 desired In Cap B;n:, 'm . b: .::' NURSES CAP-TACS .....-::::::;;; - Remove.nd re'asten tIP band rnst",", 'or ',undenn. .nd repl ement' Tin, . - == I:: C B :'. a 0 'i; :1 - - __' wdh Gold Clduceus or.1( blac (pl.ln) --__ No. 200 S.t of 6Taci ..I.oopeuet - - ,, SPECIAL! 12 or mort Sltl....ao per 'It @ Nurses ENAMELED PINS Btlu!"ull, sculptured stltu" Insllnll. 2.(:010r keyed, =:;e:N Ir: r t:r :' U . NI. 205 Enam.led Pin. . . . . .. . . 1.65 .a. ppd. e Waterproof NURSES WATCH r; SWISS Inlde. rllsed sdver 'u11 nume"ls lumln ",ar\. . r I n l5 litH-tiPped s.eep second hancf dlrome slllnless \ 'Clse Slllnless e.panSIOft bind plus fREE bl,c le.lher slrlP 1 " luarintee .....06-1125.................1&.50.. ppll. Uniform POCKET PALS Protects 'I'lnst stllns and ..". Pillbl, .tllt' pllstlr: with rold st,mped cÑuCeus Two com- partments 'or pens, shelrs. etc Idell token lifts or ',wn. No.21G-E 1 6 lor 1.75. 10 lor 2.70 S.vln 25 or marl .25 I'., an ppd. IE Personalized BANDAGE k . SHEARS 6- profnsMlnal pt'KISIGft shelrs. torred r:;- in steel. Guar.nteed 10 stay sh.rp 2 'firs --=- No. 1000 Sh'ln (no initiall) . .... .. 2.75 .a. ppd. SPECIAL! 1 Doz. Shill'S..... a a a.... $26. total Initi.11 (up to 3) .tch.d . . . . . . . . .dd 50c per pin ... . :t '" "SENTRY" SPRAY PROTECTOR ProtKt, you '1llnst YMlltnt mlft or dO, ._ Insl.ntl, dlsablas without permlnellt Inlury No. AP-l11 So.try . .2.25 I'. pptI. ;. I I COLOR QUANT. PRICE I . ORDER NO . . PIN LETT. COLOR, 0 Block 0 Blu. 0 Wh.teINo. 169) . METAL FINISH, 0 Gold DS.lve, INIHALS _ _ _ . LETTERIN& . . 2n<1L.... . I enclose S . 5.n> ASSISTOSCOPE DESIGNED WITH THE NURSE IN MIND Acoustical Perfection Å SLIM AND DAINTY Å RUGGED AND DEPENDABLE Å LIGHT AND FLEXIBLE Å WHITE OR BLACK TUBING Å PERSONAL STETHOSCOPE TO FIT YOUR POCKET AND POCKETBOOK The course is designed to enable students to develop depth in nursing knowledge in a selected area; ability to make discriminating use of research find- ings and investigate nursing problems; understanding and appreciation of leader- ship responsibilities. Candidates will be required to com- plete successfully a minimum of four full courses and a thesis to qualify for the degree. The program may be completed in a minimum of 16 months. As well as the nursing and research subjects, which will be given in the school of nursing, supporting graduate courses will be offer- ed in other university departments. Com- munity health agencies and teaching hos- pitals will provide the field for clinical study and the investigation of nursing problems. Applicants who have obtained a B.Sc.N. degree in the University of To- ronto, or an equivalent degree, with second class standing in the final two years, will be considered for admission. All students must satisfy the university's general regulations for admission as out- lined in the calendar of the School of Graduate Studies. For further infonna- tion or application forms, write to: The Secretary, School of Graduate Studies, University of Toronto, Toronto 5. "'T.M. Order from vi M WINlEY-MORRIS CO. lTD. Surgical Products Division MONTREAL 26 QUEBEC r ----l I 2795 BATES RD. MONTREAL, P.Q. I I Please acceDl my order for I " _ _. 'AsslsloscOpe(s)' al $]2 95 each I I o While lublng 0 Black lublng I I I N.... I I 'OORESS I I CN" I L_______________J Re.idents of Quebec add BOlo Provincial Sale. Tax. ,\\t \'t ttt' ASSISTOSCOPE DESIGNED WITH THE NURSE IN MIND Acoustical Perfection ... SUM AND DAINTY ... RUGGED AND DEPENDAlLE ... LIGHT AND FLEXIBLE ... WHIT! DR lLACK TUIING ... PERSONAL STETHOSCOPE TO FIT YOUR POCKET AND POCKETBOOK till'" Made in Canada \n \\.) C1W' \)\J . THE CANADIAN NURSE 17 news Speaker Relates Inservice Education, Job Satisfaction Toronto. Onto - There is a definite rela- tionship between job satisfaction and inservice education, according to an Amer- ican nurse who addressed the Operat- ing Room Nurses of Greater Toronto March 20. Myra K. Slavens, educational director of the Association of Operating Room Nurses. Inc., of Englewood, Colo- rado, spoke at the morning session of the one-day seminar. Miss Slavens said one of the main causes of poor relations between employ- er and employee is confusion caused by poor communication. This could be help- ed by an inservice education program that would provide an adequate orientation program to new staff, she said. By en- couraging better rapport between em- ployer and employee, providing enough information for the new employee to function effectively, and giving her an introduction to her co-workers, better patient care and job satisfaction is en- couraged, she added. New OVEX. TABSnCK. the discreet dispenser The Tab Stick provides a sImple method for her to keep an accurate dosage schedule. It identifies each tablet not only by number, but by the day of the week The Tab Stick has an inconspicuous cosmetic appearance. Consumer surveys revealed that it discreetly satisfied women's wish for packaging not recognizable by family and friends as medication MBa iTiU 18 THE CANADIAN NURSE LA BORA TOR I ES "T. M Reg'd A well-planned program in continuing education is also essential to improve communication and to ensure that the nurse has up-to-date knowledge, Miss Slavens said. She emphasized that both orientation and continuing education pro- grams would involve change and resent- ment, and suggested that by involving staff in planning and ensuring adequate communication of plans, this could be reduced. "Feedback from staff is especial- ly important," she said, "because the program should be based on their needs. It must also be flexible enough to cover the varying needs of the different partici- pants." Nursing must lose its rigidity, Miss Slavens continued, and learn to effect and accept change if it is to survive. Rituals, such as taking temperatures at customary rather than logical times, will have to give way to more use of the nurse's judgment, she said. Conference Focuses On Youth Menial Health Problems Ottawa - The mental health problems of childhood and youth were the focus of a national conference on medical action for mental health held March 11-13, 1970. Some 185 persons attended the con- ference, organized by the Canadian Medical Association. Recommendations from the conference include: . Models of community organization are needed to provide examples of the total use of all interested groups. . A means of reaching those authorities providing funds should be found so that more funds can be allocated to prevent mental health problems. . More regional programs to help children and youth are needed. . Every program should be evaluated. . Information on the experiments being conducted in Canada on these problems should be made available. Those attending the conference agreed that real and effective implementation of the recommendations by all involved dis- ciplines is necessary. The Canadian Nurses' Association was represented by Constance Gray, Public Health Nursing Division, Toronto Department of Public Health, who was a member of the initial planning team for the conference. Red Cross Booklet Available In Canada Single copies of the Red Cross booklet on "Rights and Duties of Nurses Under the Geneva Conventions" (News, Feb., page II) can be obtained from provin- cial headquarters of the Canadian Red Cross Society. Larger quantities can be obtained from the National Headquar- ters, 95 Wellesley Street East, Toronto 5, Ontario. MAY 1970 ICN Publishes New Nursing Statement Geneva, Switzerland - The Interna- tional Council of Nurses has published a statement on nursing education, nursing practice and service, and the social and economic welfare of nurses; its under- lying principle is the interrelationship of these areas as inseparable parts of nursing as a whole. The document was prepared so that national nurses' associations would know ICN's stand on these matters. ICN hopes the statement will help the associations in formulating their own policies. The statement calls for educational requirements for entrance into nursing schools to be on a level with those of comparable professions in the country, and special preparation for nursing school faculty. It points out the need for health and nursing services in the promotion of health and elimination of disease, and calls for the participation of nursing at all levels of health service planning and administration. It states the need and right of nurses to take part in determining conditions of employment. The English version of the statement is available now and the French, German, and Spanish translations will be ready shortly. Orders may be placed now with: International Council of Nurses, P.O. Box 42, CH-1211 Geneva 20, Switzerland. Copies of the statement cost 25 cents each. WHO Reports Decrease In Smallpox Geneva, Switzerland. - Smallpox incidence declined by almost 60 percent in the fIrst three years of a world-wide eradication campaign launched by the World Health Organization in 1967. Smallpox dropped from 128,300 cases in 1967 to an estimated 56,000 in 1969. The number of countries reporting small- pox decreased from 43 to 29. The most marked reduction occurred in the coun- tries of West and Central Africa, which recorded only 10 percent as many cases in 1969 as in 1968. The WHO report stresses that the improvement is even more impressive than shown in these figures because the reporting of smallpox has steadily improved since the beginning of the campaign. Since September 1968, no smallpox has been introduced into Europe, Austral- ia, and North America - another sign of the overall decline of the infection. As recently as 1962, 60 countries recorded cases of smallpox, indigenous or import- ed, compared with 29 countries last year. There are 17 countries in Africa, South America, and Asia where smallpox transmission continues in endemic fash- ion, compared with 27 in the beginning of 1969. In all but two endemic coun- MAY 1970 tries. intensive programs of eradication are now in progress. With three excep- tions, freeze-dried vaccine of satisfactory potency, stability, and purity is now used in all endemic countries. WHO still needs donations of vaccine. The organization distributed 21,640,000 doses of vaccine in 1969 and will need 33 million doses in 1970. Nine countries made donations to WHO in 1969. According to the report. the next logical step is for every country to set up the machinery for immediate investiga- tion of each smallpox case by trained investigators to trace the source of infec- tion and to apply prompt and effective containment measures. Nurse Instructor Needed For MEDICO In Indonesia New York, N. Y. - A nurse instructor with a degree in nursing education is needed by MEDICO, a service of CARE, for an all-Canadian medical team station- ed in Indonesia. The post is offered on a two-year contract basis. Team headquarters is at Mangkuben Hospital in the city of Surakarta, Central Java Province. Three Canadians - a physician, an operating room nurse, and a laboratory technologist - launched this program in January 1970. The team will be expanded at a later date. Although patient care will be part of the nurse instructor's daily responsibility, her main goal will be to help train counterparts to staff the six major regions of the province. She will be involved in a nurses' training program currently under- way with 350 candidates. In addition to the CARE-MEDICO Canadian team, two nurses who speak French fluently are needed for a joint American-Canadian team stationed at a hospital in Tunisia. These positions, also offered on a two-year contract. require an operating room nurse for immediate assignment and a general duty nurse to begin work in May 1970. Qualified Canadian nurses interested in the Indonesian or Tunisian positions are asked to write to world headquarters for details. Address queries to: Mr. Leonard Coppold, Director of Professional Person- nel, MEDICO, a service of CARE, 660 First Ave., New York, N.Y. 10016, U.S.A. Psychiatrists Say Abortion Should Be Removed From Law New York, N Y. - Abortion performed by a licensed physician should be entirely removed from the domain of criminal law. This is one of the conclusions pres- ented by the Group for the Advancement of Psychiatry, an organization consisting of nearly 300 distinguished psychiatrists, in a report it has just released entitled The Right to Abortion: A Psychiatric View. In this document. formulated by the organization's committee on psychiatry and law, the authors have analyzed the question of legalized abortion from so- cial, ethical. and legal viewpoints and j --. "!" , _ II ',,- \, ...... --t: "" , " '= - - r The Renault 10. EUl'ope and a new Renault, too? QueUe finesse! If you want to tour Europe in style - at a rea! saving - just plan now to lease or buy a Renault. Leasing prices start as low as $23.00. a week. You go where you like, see what you want-and there's no mileage charge. Or you can take delivery on the Continent of a brand new Renault (equipped to Canadian specifications and under factory guarantee) for as little as $1,203 Renault is responsible for shipping it home. So you save while you're there, keep on saving after you get back with the economical Renault. Send the coupon now. r----------------------- ' 1 a1 " .1 IJ - , OVERSEAS CN-, I t DEPARTMENT P.o. Box 6400, Montreal (Quebec) FREE pl..S. send compl.t. Inform.ttan on ...s. plans .nd purch... prICes. NAME ADORES '" TEL: CITY PROylNCE ----------------------- 1'6 month. I.... R.n.ult 4. THE C:NADlAN NURSE 19 through personal religious beliefs and should not, therefore, be directed by the state. "There can be no doubt," they assert. "that strong religious ideals contri- bute to sustaining the system of legal sanctions that makes abortion a source of guilt and labels it a crime." The authors emphasize that present laws do not eliminate illegal abortion, citing studies suggesting that most abor- tions in the United States are illegal. The affluent do not find it difficult to obtain a therapeutic abortion, whereas others, the report says "are driven by their needs into the hands of practitioners and charla- tans who may employ dangerous tech- news (Continued from page 19) have concluded "that a woman should have the right to abort or not, just as she has a right to marry or not." Anything short of this "stands four square against the right of the woman to control her own reproductive life." The authors believe that the moral questions of when .life begins and what constitutes the taking of a life in this particular situation are answerable only New Simpla Tablets Sterilise baby's bottles and nipples safel quickly and conveniently: :\ Simpla i\ tablet . , , \ It :.1 T " for s'tTilisin pOllnlt'riliscr . fn'cling hOllles ks hihc:rons ! and nipples l.,lt's tt'tincs . . -......... ..........#A.... M Just follow this routine I.Washthe bonlethoroughlywith warm water and washing-up liquid. Use a bottle brush. z. Clean the nipple thoroughly]. PUl one tablet in 4 pims of with a small brush and a little salt slightly warmed water Use a non- mClalliccontainer wilha fitting lid. -;i' JJi\ ?;; .. .11. ...J $ . i:.1' , if'1I. :l_ <.' -oM, <, { W . ; '\.. ..... [ \ 4 PINTS / of. Tablet dissolves in waterto give a sterilising solUlion of the right strength. 50 Completely immerse boule, 6. Make a fresh sterilising solution nipple, cap and disc in the sterilis- every 24 hours. ing solUlion. Manufactured in England by . and distributed throughout Canada by: Maltby Brothers Limited, 22 EIrose Avenue, Weston, Ontario. 20 THE CANADIAN NURSE niques . . . Thus decisions are made indi- vidually and personally, responsive to social, economic, moral, religious, and psychological factors, regardless of the status of the law." Seeing the moral issue of abortion as a "seemingly insoluble" legislative problem, the authors turn to other considerations. They express repeated concern for the mental health of both the mother and the unwanted child. "There can be nothing more destructive to a child's spirit than being unwanted," the authors maintain, "and there are few things more disruptive to a woman's s irit than being forced without love or need into motherhood." In other arguments, they criticize the American Law Institute's "liberalized" abortion law. This law provides for a legal abortion when great risk to the mother's physical or mental health is apparent, or when conditions indicate that the child would be born with grave physical or mental handicap. Such beliefs must be certified by two physicians in writing. The authors argue that this law, in effect in some states now, does not provide any answer to the moral ques- tion. Neither does it provide specific "psychiatric criteria" for standardizing interpretation of the law in all states. Thus, decisions fall upon the psychiatrists instead of upon the individual or society. In their conclusion, the authors sug- gest that many of the social, sexual, and pragmatic goals served by legal sanction against abortion have diminished in the past decades and that their continued application no longer can be sustained by a justifiable state interest. They recom- mend further study leading to future policy changes. Copies of The Right to Abortion: A Psychiatric View, can be obtained at $1.00 each (US funds) from the Publica- tions Office, Group for the Advancement of Psychiatry, 419 Park Avenue South, New York, N.Y. 10016. Quantity prices are available on request. NLN Favors Open Curriculum New York. - The National League for Nursing board of directors has adopted a statement favoring an open curriculum in nursing that would permit students to move from one type of nursing program to another or into nursing from another health discipline. The board recognized that although each type of nursing education program gives preparation for a specific kind of nursing career, many nursing schools, colleges, and universities are experiment- ing with curriculum plans that permit students who change career goals to move rapidly to another type of program. The board also approved a nationwide research study to determine and evaluate activities underway to achieve the open curriculum in nursing education. subject to funding. 0 MAY 1970 or you ap your patIent Now in 3 disposable forms: . Adult (green protective cap) . Pediatric (blue protective cap) . Mineral Oillorange protective cap) Fleet - the 40-second Enema * - is pre-lubricated. pre-mixed, pre-measured. individually-packed. ready-to-use. and disposable. Ordeal by enema-can is over! Quick. clean. modern. FLEET ENEMA will save you an average of 27 minutes per patient - and a world of trouble. mm 1mB ENEMfil . . (fNE ) IIPD ENEMA'; "INERAL 01- -..,;.. - u- -.....,. f"""' " WARNING: Not to be used when nausea. vomiting or abdominal pain is present. Frequent or prolonged use may result in dependence. CAUTION: DO NOT ADMINISTER TO CHILDREN UNDER TWO YEARS OF AGE EXCEPT ON THE ADVICE OF A PHYSICIAN. In dehydrated or debilitated patienls, the volume must be carefully determined since the solution is hypertonic and may lead to further dehydration. Care should also be taken to ensure that the contents of the bowel are expelled after admInistration. Repealed administration at short intervals should be avoided. Full information on request. o Kehlmann. W. H.: Mod. Hosp. 84:104,1955 FLEET ENEMA@ - single-dose disposable unit A QIJALlT'V Pt'lAfilUACIt.UTICAL. >".., CAa'lPuf. 6.Co. KAl.LAr.L1 '<<)N1R(AUl. rouøtXD W C_AOA.,.... MAY 1970 THE CANADIAN NURSE 21 names Mona C. Ricks, of Ottawa, has joined The Canadian Nurse as assistant editor. Prior to this ai'Point- ment, Mrs. Ricks had been an infor- mation officer in the federal civil service. In her last assign- ment, editor of a magazine for the De- partment of Indian Affairs and Northern Development, she covered stories that demonstrated the diversified programs of the Department in Ottawa and field offices across Canada. Her stories told of a young Eskimo sculptor, who, during a course at the University of Alaska, became aware of the importance of education in southern society and wrote a plaintive I letter beseeching students to remain in k school; the varied duties required of .. wardens in Canada's national I parks - why they use trail horses in summer and skis in winter; and of Eskimo patients in southern hospitals and their need to communicate with friends and relatives in the North. As an editor of school textbooks with McGraw-Hill Company of Canada Ltd., Mrs. Ricks became acquainted with guid- ance and counseling programs in the public schools, and the ongoing approach to educational challenges in today's changing world. In public relations her duties involved marketing books of varied subjects, meeting authors, and writing book reviews. While working as an editor- ial assistant on the Canadian Medical Association Journal, she gained insight into the vast area of medical research. When asked why she chose to work in the news field, Mrs. Ricks replied, "I didn't really choose the work, it chose me. Soon after my arrival in Canada as a newcomer from England, I was on the spot when a nest of homed owls was found in a broken tree limb." The young owls made news for Mrs. Ricks. It was her published story of the owls' rescue that created her interest in journalism. A few months later she enrolled in a journalism course and graduated with a diploma. Since then her work in the news media has led to many interesting adventures. The must notable, she says, was a Toron- to kidnapping case. Her editorial duties with the journal include covering items of general interest to the nursing profession. "I've seen some of the many roles a nurse fulfills," says 22 THE CANADIAN NURSE 1"';; . Visitor To New Zealand " , 't.' ,r-t .) . I.. . . ,.. ....:t " . ...'.. .'.+.. ..#. .e ,; ... I '1"#-........ . ' '- .., . t -0.{ \ . Verna M. Huffman (left), principal nursing officer \yith the Department of National Health and Welfare in Ottawa, visited New Zealand February 15-26 after attending the International Con- ference on Domiciliary Nursing in Mel- bourne, Australia, where she was a guest speaker. S.M. Bohm (right), direc- tor of the division of nursing, New Zealand Department of Health, arrang- ed Miss Huffman's proj!;ram of studies and comparisons. Mrs. Ricks. "As a Red Cross volunteer I visited veterans in hospital and played cards with the old-timers. I always re- membered to look the other way when they forgot to play the right card." The Canadian Nurses' Association's first executive secre- tary, Jean Scant- lion Wilson, died April 8 at Almonte, Ontario. Miss Wilson, who was known and re- s pe cted nationally and internationally, was CNA executive secretary from 1923 to 1943, and served as editor and business manager of The Canadian Nurse from 1924 to 1932. Brought up in Ontario and Quebec, -" - 6. ....... Miss Wilson received her nursing educa- tion at the Lady Stanley Institute in Ottawa. She was graduated in 1906, and spent several years in positions at the Vernon Jubilee Hospital, B.C., and the Moose Jaw General Hospital, Saskatche- wan. From 1917 to 1920 she was secretary-treasurer and registrar of the Saskatchewan Registered Nurses' Associa- tion. In 1921 Miss Wilson entered the McGill University School for Graduate Nurses, where she obtained a certificate in administration in schools of nursing. Also in 1921 Miss Wilson became honor- ary secretary-treasurer of the Canadian National Association of Trained Nurses. In 1922 the CNA TN general meeting decided to open a national office and employ an executive secretary. The following year Miss Wilson was appointed to the post and set up a national office in Winnipeg, Manitoba. In 1924 the Canadian National Asso- ciation of Trained Nurses changed its name to the Canadian Nurses' Associa- tion. That year, The Canadian Nurse was transferred to the Winnipeg office, and Miss Wilson became its editor and busi- ness manager until 1933. The national office then was moved to Montreal, Que- bec. and Ethel I. Johns was appointed full-time editor and business manager of the journal. A shrewd businesswoman, Miss Wilson was to a great extent responsible for the solid tinanClal sItuation of CNA at the time of her retirement in 1943 to her farm in Almonte. In 1938 CNA awarded her the Mary Agnes Snively Memorial Medal and award for "nurses whose work exemplifies Miss Snively's ideals of nurs- ing and service." Miss Wilson was an honorary member of the Saskatchewan Registered Nurses' Association and the Canadian Nurses' Association. Anne Elizabeth Blatz (R.N., Misericordia H., Edmonton; Dip!. Nursing Servo Admin., B.Sc.N., U. of Saskatchewan, Saskatoon) has been appointed instructor in nursing education at Mount Royal Junior College in Calgary. Miss Blatz has worked as a general duty nurse at Misericordia Hospital in Edmonton, Alberta; as a clinic nurse at Baker Clinic in Edmonton; as head nurse at the University of Denver Hospital, Colorado; and as assistant head nurse at Calgary General Hospital. 0 MAY 1970 in a capsule What a s! Our New Brunswick colleagues have been telling us about the pleasures awaiting registrants to the 35th biennial conven- tion of the Canadian Nurses' Association to be held June 14 to 19 in Fredericton. One scheduled treat particularly caught our eye. A tour of Saint John has been laid on for the hospitality day June 17, and "one of the city's breweries will receive the touring delegates for what promises to be an interesting afternoon." We wonder what exactly t-hey mean by that! TV medical hour Since 1959, the Swiss Medical Associa- tion, in cooperation with the Swiss TV network, has provided the general public with some 129 medical programs. The Swiss medical TV hour is a pro- gram of public medical education that deals with disease prevention and hygiene and public health. The program is intend- ed to improve rapport between patient and physician. These programs have included reports on progress in medicine, general aspects of practical medicine and procedures, the work of the general practitioner, sugges- tions for improvement of health and prevention of disease, and lectures with popular presentation of new break- through-type developments, such as heart transplantation. immunological problems, and cancer research developments. The Swiss public has accepted the TV programs with enthusiasm and approval, reports the Journal of the American Medical Association of February 2, 1970. We wonder how many Canadians would prefer this type of TV education to the drama that surrounds the word "doctor" on our screens. Walking good for eyes Jogging is acknowledged to be good for whatever ails you, but who would have guessed that plain walking was good for the eyes? This question was asked in the January St. John News. published by the St. John Ambulance in Canada. Proof for this recently-found connec- tion between walking and eyes came in the form of $40,000 - the sum raised by two Canadian "Miles for Millions" walks for the Ophthalmic Hospital in Jerusalem. The Miles for Millions organi- zations in Ottawa and Calgary each pre- sented St. John Ambulance with $20,000 MAY 1970 for the Ophthalmic Hospital. Those of us who have been impulsive enough to volunteer for these worthwhile walks know how healthy it feels after walking 25 miles on pavement and pebbles. But you really do feel good in retrospect, when you re-walk your feat for the benefit of less health-minded friends. New development? The first sentence of a press release we received recently read: "A seminar on conception control for physicians will be held on April 2-3 at New York University Medical Center, 550 First Avenue, New York City." That's one seminar we won't want to miss. 0 / THE FLAG5 WILL BE. FLYING TO WELCOME VOU 1õ FREDERICToN WHEN YOU AlTEND GNA'S 35lli Ble:NNIAL. CONVENTiON IN JuNE THE CANADIAN NURSE 23 This hand was bandaged In Just 34 seconds with Tubeø..DUZ SEAMLESS TUBULAR GAUZE It would normallytakeover2 minutes. But the Tubegauz method is 5 times faster-10 times faster on some bandaging jobs. And it's much more economical. Many hospitals. schools and clinics are saving up to 50% on bandaging costs by using Tubegauz instead of ordinary techniques. Special easy- to- use applicators simplify every type of bandaging. and give greater patient comfort. And Tubegauz can be auto- claved. It is made of double-bleached. highest quality cotton. Investigate for yourself. Send today for our free 32 - page illustrated booklet. SurgIcal Supply DIVISIon The Scholl Mfg. Co. LImIted 174 Bartley Drive. Toronto 16. Ontario Please send me "New Techniques of Bandagmg wIth Tubegauz" NAME ADDRESS THE SCHOLL MFG. CO LIMITED 24 THE CANADIAN NURSE dates May 12-15, 1970 Alberta Association of Registered Nur- ses Convention, Calgary Inn, Calgary. For further information write to: AARN 10256 - 112 Street, Edmonton, Alberta. May 19-22, 1970 61st annual meeting of the Canadian Public Health Association, Marlborough Hotel, Winnipeg, Manitoba. Write to: CPHA annual meeting, Norquay Building, Room 316, 401 York Avenue, Winnipeg, Manitoba. May 25-June 12, 1970 Training course in rehabilitation, Winni- peg. Write to: Extension Division, The University of Manitoba, Winnipeg 19, Manitoba. May 26-28, 1970 Annual meeting of the Registered Nurses' Association of Nova Scotia, Acadia Uni- versity, Wolfville, N.S. For more informa- tion, write to: RNANS, 6035 Coburg Rd., Halifax, N.S. May 27-29, 1970 Registered Nurses' Association of British Columbia Annual Meeting, Bayshore Inn, Vancouver. Write to the RNABC, 2130 West 12th Ave., Vancouver 9, B.C. May 27-29, 1970 Saskatchewan Registered Nurses' Associa- tion annual meeting, Hotel Saskatchewn, Regina. More details are available from SRNA, 2066 Retallack Street, Regina, Saskatch ewan. May 28-29, 1970 Annual meeting of the Manitoba Associa- tion of Registered Nurses, International Inn, Winnipeg. For further information, write to MARN, 647 Broadway Avenue. Winnipeg, Manitoba. June 1-3, 1970 70th annual meeting of the Canadian Tuberculosis and Respiratory Disease Association and the 12th annual meeting of The Canadian Thoracic Society will be held at the Fort Garry Hotel, Winnipeg. Further details are available from Dr. C. W.L. Jeanes, Executive Secretary, CTRDA, 343 O'Connor Street, Ottawa 4, Ontario. 69H9 June 3-4, 1970 Workshop on alcoholism and drug addic- tion: the feelings and attitudes of nurses to the problems of dependency and how it affects nursing care in acute and long- term cases. Sponsored by the Kent Coun- ty Chapter of the Registered Nurses' Association of Ontario and the Alcohol- ism and Drug Addiction Research Foun- dation. For further information, write to: Mrs. R. Hundertmark, Alcoholism and Drug Addiction Research Foundation, 153 King St. West, Chatham, Ontario. June 3-5, 1970 Cardiovascular Nursing in the New Dec- ade and the Computer Age, sponsored by the American Heart Association, Council on Cardiovascular Nursing. Kansas Heart Association, Department of Postgraduate Medicine, University of Kansas Medical Center. Address inquiries to the Canadian Heart Foundation, 270 Laurier Ave. West, Ottawa, Ont., or Mr. Bill Stanley, Program Director, Kansas Heart Associa- tion, 5229 West 7th Street, Topeka. Kansas 66606, U.S.A. June 3-5, 1970 Canadian Hospital Association national convention and assembly meeting, Jubilee Auditorium, Edmonton, Alberta. Focus will be on the hospital and community health. Tours of the Rocky Mountains will be available at the end of the convention but must be paid for by April 30. Reservation deadline for the conven- tion is May 1. Write to the CHA, 25 Imperial Street, Toronto 7, Ontario. June 10-13, 1970 Glace Bay General Hospital graduates' reunion, sponsored by the hospital's alumnae association, Glace Bay, Nova Scotia. Graduation of the nursing school's last class is June 11 and dance June 12. Address inquiries to: President, Alumnae Association, Glace Bay General Hospital, Glace Bay, Nova Scotia. June 10-13,1970 First annual meeting of the Canadian Association of Neurological and Neuro- surgical Nurses in conjunction with the Canadian Congress of Neurological Sciences, Royal York Hotel. Toronto. For further information write to: Miss M. Maki, Apt. 306, 161 Wilson Avenue, Toronto 380. Ontario. June 15-19, 1970 Canadian Nurses' Association General Meeting, The Playhouse, Fredericton, New Brunswick. June 17-20, 1970 20th annual meeting of the Canadian Psychiatric Association, Winnipeg. For information, write to: The secretary, Canadian Psychiatric Association. 225 Lisgar St., Suite 103, Ottawa 4. 0 MAY 1970 Among the "most helpful" books of 1969 In a recent review, expert nurses in six specialties singled out, from all the books published in 1969, the ones they found most helpful to students, teachers, and nursing practitioners. We are proud that these Saunders books were selected: Hymovich: NURSING OF CHILDREN: A Guide for Study "Contains the core content of pediatric nursing arranged in logical sequence and enriched by exceedingly useful bibliographic entries, Here is a workbook for students of nursing that excites a teacher's imagination. . I would expect this book to appeal to a staff nurse in search of a way to organize her thoughts about a patient as much as it does to a teacher seeking help for a student." By Debra P. Hymavich, R.N., M.A., University of Florida. 389 pages, illustrated. Soft cover. $5.95. Published May, 1969. Secor: PATIENT CARE IN RESPIRATORY PROBLEMS "The major aim . is to present a nursing specialization as an inseparable bleeding of technical expertise and personalized patient-centered care. Technical innovation in the patient setting requires that the nurse have flexible manipulative skills and reliable interpretive skills." How to develop those skills is discussed in depth in this new monograph, the first in a new series. By Jane Secor, R.N., M.A., Syracuse University. 299 pages, illustrated. $8.40. published September, 1969. SuNon: BEDSIDE NURSING TECHNIQUES IN MEDICINE AND SURGERY Second Edition "A reference for all those occasions when a nurse knows what to do but can't quite remember how to go about doing it. The newest concepts of hospital care, recent designs in equipment, current techniques and procedures, and latest diagnostic and therapeutic methods in medicine and surgery are included and explained in the light of a nurse's role in patient care. Numerous illustrations and diagrams enhance the explanations." By Audrey Latshaw Sutton, R.N. 398 pages with 871 illustrations. $8.95. published March, 1969. ---------------------- W.B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7 Please send on opprovol ond bill me: o Hymovich: Nuning of Children ($5.95) o Secor: Patient Care in Respiratory Problems ($8.40) o Sutton: Bedside Nuning Techniques ($8.25) Nome: Address: City: Zone: Province: CN 5-70 MAY 1970 THE CANADIAN NURSE 25 . I j I I I ! go ah" - , . I the P. ith · - rmassage, · u'll rub - ery tiént the right way. - I Dermassage cools and soothes. Softens and smooths. Refreshes and deodorizes without leaving a scent. Protects with antibacterial and antifungal action. Dermassage forms a greaseless film to cushion your patients against linens, helping to prevent sheet burns and irritation. Just think of the welcome comfort a Dermassage rub can be :-:.:- to a patient's tender, sheet-scratched skin. And when you give back or body rubs with Dermassage, you never have to worry about rough, scratchy hands. So go ahead. . . soften them up. )r ......w - -- -.- ëimCAàssa e- ......... -.... - M lakeside laboratories (Canada) ltd. 64 Colgate Avenue' Toronto 8, Ontario "Trade mark One standard OPINION - or two? In most Canadian hospitals two standards of nursing care are offered - one for the female patient and one for the male patient. This double standard of care can be removed by upgrading the education of the orderly. Albert W. Wedgery, Reg.N., M.A. Is the nursing profession in Canada still too complacent about the lot of the male patient in our hospitals? Perhaps this is an unfair question considering the attempts being made by many institutions to upgrade the prepara- tion of auxiliary workers and to intro- duce the team nursing concept, which makes the best use of the skills of all nursing personnel. However, if routine bedside nursing is becoming more and more the realm of the auxiliary worker, we must make an even greater effort to see that these workers are well prepared. I have a strong personal conviction that the male patient in most hospitals is entitled to a better grade of service from non-professional nursing personnel than he is now receiving. For example, in 1968 there were 698 registered male nursing assistants for the whole of Canada. 1 Compare this paltry total with 10,821 - the number of orderlies employed full-time or part-time in general and allied special hospitals for the same period 2 - and you begin to appreciate the realities of the situation for the male patient. Mr. Wedgery, a graduate of the School of Nursing. Ontario Hospital. Whitby; the Univer- sity of Western Ontario, London; and Teachers College, Columbia University, New York. is formerly Associate Director of the College of Nurses of Ont.uio. MAY 1970 Poor quality care The generally poor quality of orderly care, which often results from lack of professional instruction, supervision, and guidance, demands the development of a more respected, more responsible, and more secure male auxiliary worker to meet the needs of the male patient. There is need particularly to make the orderly a more stable employee instead of regard- ing him as another piece of flotsam in the constant ebb and flow of personnel. For example, it has just been reported by a joint federal-provincial committee studying ways to improve Canada's health services, that in 1967 the turnover rate of orderlies in public hospitals across Canada was 47 percent. What does this high turnover rate mean in increased costs through the time consumed in training, inefficient discharge of duties, poor use of equipment and supplies, and, even more important, the lowered standard of care that is an unavoidable concomitant? If the seemingly indispensable orderly were given a greater opportunity to learn and advance through continued guidance and encouragement, there would be not only a conspicuous improvement in the calibre of the orderly group itself, but also a refreshing uplift in the standard of care provided by these workers. When human life and suffering are at the mercy of hospital personnel, all workers must be prepared properly for their tasks. The orderly is flot entirely at fault for THE CANADIAN NURSE 27 the often unhappy position in which he finds himself in most of our institutions: "That he has often been inefficient and has performed duties for which he was unprepared without adequate su- pervision is no denial of the essential place he has filled. Within a well- coordinated team, with better in- service training, his efficiency could be increased."3 Is there any doubt that the nursing profession should look into its corporate conscience and help the orderly climb from his usual place on the lowest rung of the nursing service ladder? Examples of progress A notable example of real progress in this direction was a new deal for orderlies (to say nothing of a new deal for male patients! ) undertaken 1 0 years ago by the Winnipeg General Hospital. Taking stock of its situation, this institution discovered that only a reappraisal of the orderly's function and the organization of a course of instruction, designed to make full use of his potential, could bring about a long-needed element of efficiency and stability to this area of patient care. Consequently, a certified orderly training program paved the way for a wholesale improvement in morale and resulted in a more dependable, more satisfied, and, therefore, more valuable member of the nursing team. Out of this move toward better nurs- ing care through better qualifications and better preparation has developed the Manitoba Association of Certified Order- lies, incorporated in 1960. The code of ethics of this organization reflects a genuine desire on the part of its members to fit as closely as possible into the concept of quality care for all patients and to establish the orderly as a good citizen, a conscientious worker within the limit of his preparation, and a respected representative of nursing in the eyes of the public. In effect, the evolution of the certified orderly in Manitoba has given real meaning to an often despised job. Nor have other provinces been idle. The Central Nursing Orderly School in Edmonton, operated under the Alberta 28 THE CANADIAN NURSE Department of Education since 1967, offers training to men who want to be part of the health team. The recruitment brochure about this vocational opportuni- ty contains the following description: "The Nursing Orderly must be a re- sponsible man. He must be dedicated in his work of helping patients; in addition, he must be competent to give safe nursIng care. By being all of these, the Nursing Orderly keeps the interests of the patient uppeonost at all times and ensures that he is per- forming his part for the team." This appraisal of the role ot the orderly within nursing service and the important nature of the task he can perfoon clearly points to an outlet for certain abilities in a new and worthwhile career. In the summer of 1968, the Toronto Board of Education, at the request of the Ontario Hospital Association, offered two programs of instruction for hospital orderlies: a full-time course designed to prepare new orderlies, and a part-time, upgrading course for orderlies already working in hospitals. Following these ventures, there was a major increase in the number of regionalized orderly programs around the province. The up- grading courses have been particularly successful because they have led to order- lies being better integrated into organized patient care upon their return to the hospitals. A manual developed by the Ontario Hospital Association, Guidelines for the Preparation of Hospital Orderlies, has been used widely and to good purpose as a step toward the development of a uniform program of instruction in this. province. Thus, it is reasonable to expect that as other attempts are made to prepare order- lies at the level of a nursing assistant, many more men could find real satisfac- tion in this humanitarian work. And is it not logical to expect that some of these orderlies will become interested in professional nursing? Fresh approach needed As guest speaker at the International Council of Nurses' Quadrennial Congress in Montreal in June 1969, the Minister of National Health and Welfare, the Honora- ble John Munro, had this to say to Canadian nurses particularly: .. . . .for all the money the Canadian taxpayer is spending for hospital insur- ance, shouldn't we be able to expect that all our citizens are more or less equal in teons of access to necessary health care? - an access that we have come to accept as a fundamental human right, after all."4 The minister was asking for a commit- ment on the part of the nurses in this country to live up to the purpose of nursing: namely, the best possible care of the patient. Therefore, anything less than this in the pursuit of patient welfare vitiates our contribution to the better- ment of mankind. Isn't it time, then, to take a fresh approach to the care of the male patient in our hospitals? The sooner we get rid of a double standard of nursing care and achieve a proper synthesis of all nursing personnel, the sooner we can say that the best interests of every patient are in the forefront of our efforts. If we fail to do this, we shall miss the opportunity to serve all members of the public with the proper degree of efficiency and concern. References 1. Countdown 1969. Ottawa, Canadian Nurses' Association, Table 2, p.133. 2. Ibid., Table I, p.I14. 3. Pearce, Evelyn C. Nurse and Patient. Toron- to. J.B. Lippincott Company. 1954, p.78. 4. Munro, John. A challenge that confronts us. Canad. Nurse Aug. 1969, pp.4D-43. 0 MAY 1970 idea exchange I ..... ,..;. . ... l...&' ' '- 1 I. '- ...""" ,,-!'W ... .'-t' '!t.JI . , . "4 . \. ... II' . - -" 'III """" -If \, =- ... '( '" \ .. "- ....... - .. ----- -- f -.-..- Of Five members of the head nurses' association at The Vancouver General Hospital examine the results of the questionnaire they asked graduate nurses to complete. Left to right: Sheila Petrie, D. Babcock, E. Jakubovskis, M. Shepherd, and B. Burgess. A Head Nurses' Association Takes Action Head nurses are directly responsible for developing a staff that can operate on a high level of effectiveness and for providing good patient care. Both responsibilities become more difficult when there is a high turnover of nursing staff. What makes nurses leave their jobs? Why do they change jobs at frequent intervals? What are they looking for in their new jobs? The head nurses at The Vancouver General Hospital, who are organized as an autonomous association, decided to try to find some answers to these questions. MA Y 1970 As head nurses, one of our main objectives is to improve professional and administrative knowledge. With this in mind, our association decided to conduct a study to find out how general duty nurses felt about The Vancouver General Hospital and what made them dissatisfied enough to leave it. The first step in the investigation was the formation of a committee of eight head nurses. This committee developed a questionnaire based on some of the ideas the head nurses had regarding graduate nurse dissatisfaction. From an analysis of these ideas, a tentative questionnaire was prepared and given a trial run using the head nurse group. The subsequent criti- cisms and suggestions were considered when developing the final questionnaire. A total of 660 questionnaires was distributed. Each head nurse gave one to each graduate nurse on her unit. This method of distribution allowed the head nurse to explain the purpose of the questionnaire and to emphasize that participation in the enquiry was on a voluntary and anonymous basis. To facili- tate the return of the questionnaires an envelope was attached, addressed to the inservice education center. At the end of the three-week limit 303 questionnaires, or 45.5 percent, were returned. The response to the questionnaires was enlightening. The respondents expressed their feelings freely, helping the head nurses to undersftmd their satisfactions THE CANADIAN NURSE 29 idea exchange and frustrations. Most comments could be grouped into three main areas: staff development, personnel policies, and interpersonal relations. In the area of staff development, gradu- ates indicated a need for more inservice education and a better system for attend- ing ongoing progr ms; they suggested specific topics for inservice education. This information was forwarded to the inservice education department and the graduate inservice program was revised to include the nurses' suggestions. The head nurses reviewed the weekly time of the program and agreed to encourage gradu- ate nurses to attend. The questionnaires revealed many dis- satisfactions with personnel policies. Many criticisms dealt specifically with hours of work and rotations. In response to this, the head nurses and the director of nursing took part in an intensive workshop to plan time schedules. Many graduates commented on inter- personal relations. The analysis revealed that communication, or lack of it, was the basis for much frustration and dis- satisfaction. The need for better commu- nication between a head nurse and her graduate staff prompted the organization of a head nurse inservice program on interviewing techniques. This program helped the head nurses feel more sure of themselves when they evaluated and counseled their staff. As a result of this inservice program the head nurses discarded the traditional system of evaluating staff. The new system gives each staff member an oppor- tunity to evaluate herself and to explore goals and objectives with her head nurse. The head nurses now plan to interview their graduates every three months and to use this opportunity to encourage gradu- ates to evaluate their own progress and to discuss their current problems and ideas. This method has proved effective as a means of evaluation and as a method of improving communication. The head nurses hope that some of the frustrations and dissatisfactions expressed by the graduates will be eliminated. In answer to requests for information on the outcome of the questionnaire, the graduates each received an outline of the actions initiated as a result of their ideas and suggestions. It is still too early to measure the influence of the study on the turnover rate of graduate nurses at this hospital, but the head nurses are considering re- submitting the same questionnaire to evaluate changes in graduate staff atti- tudes. Whatever the final outcome, the head nurses believe they have grown both professionally and personally by under- taking this study. The project has given them a direction and a sense of purpose for continued explorations into their relationships with their graduate staff. - The Head Nurses' Association, The Vancouver General Hospital, Van- couver, B.C. 0 Move Equipment With Ease An adaptation of the type of dolly used for moving cartons in a store has been a boon to nursing personnel at Prince George Regional Hospital in British Columbia. The new metal cart has two wheels, which make it easier to move awkward items such as bedside lockers from one area to another, thus reducing noise and possible damage to floors. The upright part of the cart is approxi- mately four feet in length with the handles at a convenient height for push- ing when the Cart is loaded. The flange at the bottom is made of a thin strip of metal that is eased under the edge of the locker. The locker can then be tilted slightly, with the weight supported by the long frame of the carrier, and pushed with little effort. When not in use, the cart stands on the wheels and the flange, and takes up very little space. - Jane Layhew, Head Nurse, Medical Ward, Prince George Regional Hospital, Prince George, British Columbia. 0 30 THE CANADIAN NURSE . .. " ... .. "-. , .. (J -- ,/ I" ,,- MAY 1970 FREDERICTON, NEW BRUNSWICK JUNE 14-19, 1970 CANADIAN NURSES' ASSOCIATION . . . . ... , TENTATIVE PROGRAM ISSUES CNA MEMBERS FACE AT 35TH GENERAL MEETING TICKET OF NOMINATIONS FREDERICTON - HERE WE COME! . CNA BIENNIAL MEETING Program Highlights Theme: Continuing to Care in the '70s Sunday 14 June 19.00 Interfaith service 20.30 Official opening Address: "Health and welfare services for the '70s" Miss Verna Huffman, Principal Nursing Officer, Department of National Health and Welfare Monday 15 June 09.00 President's address Report of Arrangements committee Report of nominating committee 11.00 Address: "Professional associations in the '70s" 14.00 Report of executive director Auditor's report Budget 1970-1972 15.30 Recess Evening picnic - City of Fredericton, host 19.00 Symposium on the publication of nursing textbooks in French Tuesday 16 June 09.00 Reports of standing committees on - nursing service - nursing education - social and economic welfare 14.00 Report of the ad hoc committee on func- tions, relationships, and fee structure 16.30 Poll - election of officers 16.30 Interest sessions - concurrent I . Legal implications of nursing (simultaneous translation) Mr. L.E. Rozo, vsky Departmental Sol- icitor, Nova Scotia Hospital Insurance Commission 2 . Psychodrama (English only) Mrs. Dorothy M. Burwell, Director of Nursing, Clarke Institute of Psychiatry, Toronto, and Associate Professor, Facul- ty of Nursing, University of Toronto 19.30 Banquet - Government of New Brunswick Wednesday 17 June Hospitality and sightseeing day Thursday 18 June 09.00 Report of ad hoc committee on legislation Revision of bylaws 14.00 - Interest sessions - concurrent 17.30 I. Planning of patient care English - Miss Myrna Sherrard, Nurse Clinician, The Moncton Hospital, N.B. French - Mme. Huguette LaBelle, Director, Van- ier School of Nursing, Ottawa 2 . Delivery of nursing care English and French - Miss Pamela Poole, Nursing Consultant, Hospital Services Study Unit, Hospital Insurance and Diagnostic Services, De. partment of National Health and Welfare 3 . Expanded role of the nurse (simultaneous translation) Mrs. Rosemary Coombs, Clinical Nurse Specialist, Ottawa Civic Hospital Mrs. Monica M. Green, Director of Public Health Nursing, Health Branch, British Columbia Department of Health Services and Hospital Insurance 4 . Research Studies (sunultaneous translation) Friday 19 June 09.00 Unfinished business Budget 1970-1972 Report of Resolutions Committee 14.00 Report of election Installation of officers 16.00 President's reception Participants confirmed at press time are included Issues CNA members face at 35th general meeting Nursing care; CNA fees; personal or corporate memberships in CNA; salaries and working conditions; education; CNA consulting services; what the CNA can do for members; what members can do for the CNA - these are among the subjects that will be under scrutiny at the coming CNA general meeting in Fredericton. Recently the editor of The Canadian Nurse talked to the CNA executive * about some of the questions under review at the coming meeting. Here, in question and answer form, is the result. Q. What are the major issues facing nurses at the Canadian Nurses' Association's general meeting in Fredericton in June? SISTER M. FE LICIT AS: Probably the most vital issue concerns the individual member and her relationship with the national association. I believe the average nurse lacks involve- ment with CNA, sees it as something remote, and is unaware of its goals and functions. In June we'll have an opportunity to improve this relationship as we consider the recommendations of the ad hoc committee on functions, relationships, and fee structure. [The complete report of this ad hoc committee is in the March 1970 issue of The Canadian Nurse. ] LOUISE TOD: In other words we hope members will be willing to restructure CNA in such a way that the individual nurse will have a better chance to contribute, to help the national association attain its goals. KATHLEEN E. ARPIN: I see another dimension in the ad hoc committee report. As well as providing a framework within which individual members can participate, the restructuring of the CNA should also provide an environment in which the association's board of directors and staff can best function to serve both nurses and nursing. There's a lot happening in nursing today, and for me, the second major issue - an overlapping one as it, too, involves structure change - con- cerns the delivery of nursing care. In 1970 this is more than a diché: everything around us points out that we must provide health services and therefore nursing care in a very different way than we have in the past. Our association has to move with the times, "be with it," and try to foresee what the demands of the future will be. MARGARET D. MCLEAN: I agree with this. And one of the reasons a nurse becomes actively involved in her professional MAY 1970 association is because of her concern for the quality and quantity of care people receive. E. LOUISE MINER: It seems to me that we have to do more than give nurses the opportunity to become involved. We have to help them understand that this involvement is a professional responsibility. And if the Canadian Nurses' Association is not attempting to upgrade patient care, if it isn't keeping up with the times, then it shouldn't exist. MARGUERITE SCHUMACHER: As a profession we've matur- ed considerably in the past few years and have channelled our energies in a more productive way. For example, the Canadian Nurses' Foundation scholarships have allowed more nurses to further their education. These scholars are coming back with considerable preparation and we're now capitalizing on their knowledge. Much more research in nursing is being carried out, particularly in clinical nursing. KATHLEEN E. ARPIN: This emphasis on the delivery of health care will be focused in two ways at the forthcoming general meeting: first, through the ad hoc committe's recom- mendations on the role of the association and, second. through the theme of the meeting. "Continuing to care in the '70s," and the special interest sessions that highlight patient care. MARGARET D. MCLEAN: Another major issue to be resolved at the general meeting concerns CNA's bylaws. Presently there *The six members of the Canadian Nurses' Association executive are: Sister Mary Felicitas, president: E. Louise Miner, president-elect; Marguerite Schumacher, 1st vice- president; Margaret D. McLean, 2nd vice-president and chair- man of committee on nursing service; Louise Tod, chairman of committee on social and economic welfare; and Kathleen E. Arpin, chairman of committee on nursinl education. THE CANADIAN NURSE 33 .JI .... J ---- ;." .. \;.......t " . ( -::> '" "-- .... , ..... ........i<. '" ;j;. ... .... . , '.... ..... ..... . i "' ", . '4. -.:.. :;. . - ..if',, :å '" '.:r -.: , . ?: .. , , .... ::::"" ... . _ ,í-- .. .41. , .... .* -' ... ., - -olvemellt with her national associ- ation, sees it as somethlllg remote, and is unaware of its goals and fUllctions. .. MAY 1970 SISTER M. FELlClTAS: I see this interpretation and implementation role as the job of the research and advisory staff. I'm not sure what these employees will be called - it may be "consultant" or some other name. LOUISE TOD: We can't leave all this interpretation to staff, though. Somehow we have to convince our members, who are knowledgeable about their particular area of nursing, to promote the association's goals and to encourage implementa- tion of research findings. Q. The traditional role of the CNA consultant was questioned at the 34th general meeting in Saskatoon in 1968. Do you believe that the association should continue to employ consultants in nursing service, nursing education. and social and economic welfare? E. LOUISE MINER: We seem to get hung up on this word consultant. I believe each senior employee at national office must have a basic, generalized competency. Then he or she could be assigned at certain times to a specific area, for example, to act as a liaison officer between CNA and the federal government. This general competency is terribly important, as the needs of our association vary from time to time. We have to get away from the idea that these employees are 100 percent nursing service, or education, or social and economic welfare. ... ...... " I , J. ,f 11' tJ I ..I \00 .."... ) r , ..... "- ", I' (I ".; ' , , " 411. . - - ... ", ,A, " . E. Louise Ml1ler: "/n the future the Calladian Nurses' A socia- tioll should probab(v look at the problem ofpollutioll. This is even more important than the smoking issue. It's in areas like this where we can attempt to affect legislatioll at the federal gOl>enlment lel'eL " · THE CANADIAN NURSE 35 . it \ ....... \. -- - \\ !(t ., l - .. Margaret D. McLean: "Members have to decide what services they want from CNA and what should have priority. The fees are secondary.. we must look at the priorities first. " SISTER M. I.:ELlCITAS: We have to recognize, too. that the provincial nurses' associations have grown tremendously in the past few years. They have many more persons on staff now and the competencies of these persons vary according to the needs of the province. The CNA tries to avoid duplicating what the provinces have already done or can do, and attempts to provide leadership on a national level and supply the provinces with what they need at a particular time. The CNA can put itself out of business in certain areas and this is quite alright. I don't think we want to be in something forever. KATHLEEN E. ARPIN: I see this as the key: CNA's role is to start things, and when things have reached a point there they are moving, we should move on to a new area. I didn't feel any negativism at the Saskatoon meeting concerning the role of consultant. Instead, I felt that members were pointing out that the time had come to move on to other projects. LOUISE TOO: Social and economic welfare is a good example of this need for change in the consultant role. When welfare was a relatively new idea for nurses, the responsibility of CNA's consultant in this area was pretty basic: to help the provincial nurses associations develop programs of their own. These programs are now developed at the provincial level, so CNA's role has changed and needs to be reassessed. KATHLEEN ARPIN: The consultant CNA needs today has to be someone who can initiate a project, but give it up before every detail has been completed and move on to something new. She has to be comfortable on new and thin ground. When 36 THE CANADIAN NURSE the ground starts to get deeper, then it's time for her to move forward. MARGUERITE SCHUMACHER: We have to consider, too, just how much we can afford. We have to ask ourselves how we can put the money we have to its best use. When we look at the facts, such as CNA's need to be involved in research, to have bilingual staff, and so on, we will then be able to decide what consultants we need and can afford. Q. The ad hoc committee on functions, relationships, and fee structure has recommended that CNA appoint a senior member of staff, whose mother tongue is French, to provide French-speaking members with services comparable to those presently available to English-speaking members. Would you comment on this recommendation. SISTER M. FELlClTAS: I believe all provincial nurses' associations are in favor of having a French-language depart- ment at CNA House. Personally, I am all for having a welI-qualified person at the head of that department. MARGARET D. MCLEAN: Further to that, it is one of the hopes of the present board of directors that we would be able to offer our services in French or English. SISTER M. FELlClTAS: Our biggest problem is money, as this type of service is expensive. Also, CNA has had difficulty in attracting bilingual staff. MARGARET D. MCLEAN: This is going to be a challenge that faces the incoming board of directors. The board will have to set priorities within the financial limitations as set by membership. Q. The ad hoc committee also recommended a fixed per capita fee structure. Do you believe that aU the provincial nurses' associations will agree with this recommendation? E. LOUISE MINER: I believe the member associations will accept a majority decision. After all, the ad hoc committee asked the provincial nurses' associations for their opinions before making this recommendation. Q. Are there any social issues to be presented to the general membership by the board of directors? For example. will CNA be taking a stand against cigarette smoking? LOUISE TOO: The committee on social and economic welfare will recommend to membership that nurses should become more involved in their communities. And as a professional group we should make more suggestions about issues that fall within our competency. Probably we should be taking a stand against smoking. We have the background professionaHy and should be setting an example. SISTER M. FELlClTAS: We have taken a stand on certain social issues and submitted briefs in the past biennium. For example, CNA is presently preparing a brief ,for the Special Senate Committee on Poverty. Also, we submitted a brief to the Commission on the Status of Women in the fall of 1968. E. LOUISE MINER: In the future, we should probably be looking at the problem of pollution. This is even more important than the smoking issue. It's in areas like this where MAY 1970 ( For the asthma patient... Intal , . Isa I · revo utlon . In preventive therapy Intal prevents asthma SPECIFIC ANTIGEN 4 .... .:::.'.l;- ... ,':::::;., :;:: Ý- .a: ............... t:'::-::}:." .. .":;', .; :}:. REAGINIC ANTIBODY ;': i .:.:: t ... ..... Histamine SRS-A Bradykinin and others .. ....... , , \ Bronchospasm , "" Edema A I .... 't , Vascular congestion ft. I. " ....'V Secretion . . . -I · of mucus , If , . .. 'J: I ., . ., ABNORMALLY SENSITIVE LUNG TISSUE CELL INTAL ACTS HERE RELEASE OF SPASMOGENS AND INFLAMMATORY SUBSTANCES ' \: ; t..>. .....:.. .:.... *.:....:-.:. ...... . -:. ..... , . '\ I , II ACUTE PULMONARY RESPONSE , ., \ \ \ ,t":1l w.. \\ '-1' I.". , fì . . \ .. . I , ,. l INTAL ACTS HERE before the attack begins INTAL is new and unique. It is not a bronchodilator. not an anti-histamine. not a steroid. and acts in a different way from any previous anti-asthmatic drug. On the left is a diagram of the probable mode of action of disodium cromoglycate at the cellular level. One of the very first stages of the allergic reaction is blocked, thus preventing the release of the mediators of the asthmatic attack. i- On the right are the results of one of many experiments on rat mast cells which confirm the effectiveness of INTAL. Unprotected cells rupture and release spasmogens. Protected cells do not. The confidence which such a defence brings. especially to children. is invaluable to the doctor in subsequent management and encouragement of the patient. In thousands of patients, INTAL has already led to reduction in: Incidence and severity of attacks. Wheeze and chest tightness. Breathlessness. Cough. Concomitant therapies, e.g. bronchodilators and steroids. In thousands of patients. INTAL has already led to improvement in: Attendance at work or school. Exercise tolerance. Lung function tests. INTAL is a preventive therapy, which at last offers the asthmatic the prospect of a full. active life. . þ . ,,\ . . . . .. Sensitised mast cells. before antigen challenge .... . ( .. ! "-\ ... ) \ ....-.- Sensltlsed mast cells, disrupted after antigen challenge - Mast cells sensitised and challenged but protected with INTAL. They are substantially intact. . Intal defends against asthma attack INDICATIONS Bronchial asthma. ADMINISTRA TION INT AL shows significant clinical effect only when administered by inhalation. The drug is supplied in a single dose cartridge, which is administered by a specially developed insufflator, the Spin haler. Each cartridge contains 20 mg. disodium cromoglycate (INTAL) in ultra-fine powder form, with lactose B.P. as a carrier. DOSAGE-ADULTS AND CHILDREN Initial treatment-one cartridge four times per day. In more severe cases, and during periods of high challenge. the dose may be increased to eight per day (one every three hours). It is important that the patient should appreciate that INTAL is not intended to provide symptomatic relief in acute attacks. Maintenance therapy-when adequate response has been obtained, the frequency of inhalations may be reduced to three or even two cartridges per day. Patients should be warned against suddenly discontinuing therapy when symptoms have been partially or completely controlled by INTAL. CONCOMITANT THERAPY Other asthma medication should be continued until clinical improvement with INTAL permits a pro- gressive reduction in their dosage. INTAL therapy alone will often control symptoms of moderately severe asthma, especially in children and young adults. In severe asthma, particularly in older patients, INTAL therapy alone may be insufficient to control symptoms. In a proportion of such cases, significant improvement can be obtained by combining INTAL with corticosteroid therapy. In steroid-dependent patients, the addition of INTAL therapy to the regimen often permits a slow, progressive and significant reduction in the maintenance dose of steroids. The dangers of sudden withdrawal or reduction of corticosteroids are well recognised, particularly in patients on long-term administration. For full detai's of steroid dosage during INT AL therapy, please see the 'NTAL product literature or packing leaflet. WITHDRAWAL OF INTAL Continuity of therapy is important in patients whose asthma is controlled by INTAL. If for any reason I NT AL is withdrawn, a suggested regimen is the progressive reduction of dosage over at least one week. It should be borne in mind that symptoms of asthma may recur when INTAL is discontinued. SIDE EFFECTS No serious adverse effects attributable to INTAL therapy have been reported. Transient irritation of the throat and trachea has been the most frequently reported reaction, particularly following local infective episodes. There has been a small number of cases of an erythema or urticaria of the face. In each case the rash disappeared within a few days of withdrawal of the drug. At the beginning of INTAL therapy, in a small proportion of cases, transient bronchospasm follows the inhalation of the dry powder into hyper-irritable airways. It has been found that this effect, should it occur, may be minimised by the prior inhalation of a bronchodilator aerosol. CAUTION Teratogenicity experiments in animals have indicated that the use of INTAL in humans is unlikely to carry teratogenic risks. Nevertheless, as with any new drug, it is advisable where possible, to avoid its use during the first trimester of pregnancy. PRESENTATION INTAL cartridges are supplied in bottles of 30. Spinhaler turbo-inhalers are supplied in individual containers. STORAGE Important: INTAL cartridges should be stored in a cool dry place. Further information on INTAL is available from Fisons (Canada) Ltd. 26 Prince Andrew Place. Don Mills. Ontario. Canada. Telephone: 445-5700 FISDNS INTAL is a trade mark of Fisons Ltd.-Pharmaceutical Division, ::::::: ;':: : m '""CAN/" I nta I å [ = I we could attempt to affect legislation at the federal govern- ment level. LOUISE TOO: We say CNA should be anticipating legislation that concerns us, but perhaps we should also be spending more time in suggesting alternatives for what we don't like. COMMITTEE ON NURSING SERVICE Q. What are this committee's most important recommenda- tions to the general membership? MARGARET D. MCLEAN: One of the most important is that there should be sufficient registered nurses on staff in extended care facilities to assess the nursing needs of patients, to plan their nursing care, and to give or supervise nursing care. By extended care facilities I mean rehabilitation units, geriatric centers, nursing homes, long-term care hospitals, home care programs, and foster home care for psychiatric patients. What is even more important than this recommendation, and what may have greater impact in the provinces, is the survey of extended care facilities conducted by each comnllttee member in her home province. We all became much more knowledge- able about extended care facilities that exist in the provinces and about the nursing care needed by patients in these facilities. I think that in future we can expect greater involvement of the professional nursing associations in extend- ed care facilities. MARGUERITE SCHUMACHER: Doesn't this highlight again the many changes that are taking place? A few years ago we didn't have these facilities and weren't confronted with the problem of having to look at their staffing needs. Now the situation has changed; these facilities are springing up all over the country and it's timely for us to speak about them. MARGARET D. MCLEAN: As chairman of the committee on nursing service, I consider the recommendation on nursing research to be of considerable importance. If approved by membership, CNA will make a direct fmandal contribution for research purposes to the Canadian Nurses' Foundation for the next five years. Our committee saw an urgent need for research in many areas of nursing practice. COMMITTEE ON NURSING EDUCATION Q. What do you consider as this committee's most important recommendations during this past biennium? KATHLEEN E. ARPIN: There are two major recommenda- tions. One is that nursillg students in university programs should receive priority in the use of hospital and health agency facilities. The implication here is that we should be focusing on the baccalaureate and higher education programs at this time if we want to achieve the association's goals and make its statement of policy operational. We need to sell the baccalau- reate program to students who plan to enter nursing and we need also to expand the programs presently offered. One of the limitations in the expansion of baccalaureate programs in Canada is the lack of clinical resources. The committee's second major recommendation is that research should be carried out to determine how students learn to nurse. This is actually something we know little about. We feel we know a great deal about it, but when we get right down to it we find we have no real evidence. It gets back to the topic we were discussing a moment ago: the use of clinical resources. For example, are there other ways we can use the MAY 1970 clinical resources? Is the student really - . . - t/. " . ... .... . "'II1II... "',.,.,.....- - \\ .. , , ""'--- "". Marguerite Schumacher: "There is a need for CNA to collaborate more with other groups, such as the Canadian Hospital Association and the Canadian Medical Association. We need to interpret to these groups and others what is happening and what needs to be done so that valid research findings can be implemented. means of promoting programs to upgrade nursing personnel. If we can provide an environment in which nurses can carry out nursing care as they feel they should, this is going to be reflected in improved patient care. Along with this we have recommended that bargaining agents for nurses attempt to establish professional practice committees within collective agreements to interpret patient care needs to administration. We believe that nurses should be making more decisions about nursing care. We can't negotiate these items into a contract, but through professional practice committees in hospitals nurses would have the means of communicating their concerns about patient care to administration. MARGARET D. MCLEAN: In reference to the work of the three standing committees, we have, as Miss Tod said, increased our collaboration and referral. For example, during the biennium the nursing service committee discussed ways to increase the effectiveness of administrative and supervisory personnel in nursing service. We referred this item to the committee on social and economic welfare, which has now made a statement about it. Also. the committees on nursing education and nursing service worked together to polish up the statements on CNA's beliefs about continuing education and the clinical specialist. This collaboration has been very helpful. LOUISE TOO: The social and economic welfare committee's THE CANADIAN NURSE 1 '\ -, "'-- " ; "" Louise Tod: "Somehow we have to convince our members. who are knowledgeable about their particular area of nursing, to promote the association's goals and to encourage implemen- tation of research findings. " recommendation that CNA's no-strike policy be rescinded was really just a tidying up statement. CNA has supported collective bargaining for many years and recognizes it as a provincial prerogative. It follows that the provincial nurses' associations must use the steps available to them, and in several provinces one step is the strike. A group of nurses may be faced with the decision of whether to take strike action, and this should be their decision. They should not be hamstrung by statements made by the national association. Q. Should the national association set a salary goal each year? SISTER M. FELICITAS: Some provinces say this hinders their bargaining effort, others say it helps. At least this is what they told the ad hoc committee on functions, relationships, and fee structure. LOUISE TOD: The committee on social and economic welfare believes it is important that CNA provide leadership in this area. The national association's recommended salary is a goal toward which each province should work. Some provinces will come close to meeting this goal in the near future. but others will still be far from it. SISTER M. FELICITAS: Let us hope that the day may soon come when we no longer need to present salary goals! 0 MAY 1970 Canadian Nurses' Association TICKET OF NOMINATIONS Biennium 1970-1972 President-Elect: (1 to be elected) Margaret D. McLean, Marguerite E. Schumacher Vice-Presidents: (2 to be elected) Margaret L. Bradley, Jean Church, Isabel T. Colvin, Kathleen G. DeMarsh. Shirley R. Good, Huguette Labelle, K. Marion Smith Representative of Nursing Sisterhoods: (1 to be elected) Sister Marie Barbara, Sister Kathleen Cyr, Sister Cecile Gauthier, Sister Rita Kennedy, Sister Cecile Leclerc, Sister Grace Maguire President: E. Louise Miner ... .. " I E. Louise Miner. Royal Alexandra Hospiral School of Nursing, Edmonron, Alta.: Diploma public health nursing, U. of Toronro: B.N.. McGill; M.P.H.. U. of Michigan. Presenr Position: Direcror. Division of Public Health Nursing, Saskatche....an Deparrmenr of Puhlic Health. MAY 1970 Associarion Activiries: vice.presidenr SRNA. 1957-59; presidenr SRNA, 1959-61; executive CNA. 1959-61, 1964-66; firsr vice-presidenr CNA, 1966-68: presidenr-elecr CNA, 1968-70. All Canadians should have equal opportu- nity to benefit from the best nursing service available. This service should be provided to all people regardless of where they are, not only to those confined toll bed surrounded by four walls; nursing education programs should reflect this belief. The Canadian Nurses' Association has a major responsibility to assist in ensuring that the changing nursing needs of Cana- dians are met. Many more nurses must become actively involved in assessing these needs and in developing and imple- menting plans to meet them. Canadian nursing has a proud heritage, which we have a responsibility to main- tain and strengthen. A strong national nursing association to speak in a united voice is essential. Less privileged countries are entitled to our support as they plan for provision of required nursing serv- ices. The maximum participation of the nurses we seek to lead is vital. We are blessed with a wide variety of cultural backgrounds that fonn part of the fascinating Canadian mosaic. We must learn to communicate more effectively among ourselves without prejudice. We know that the whole is only as strong as the weakest part. Our task requires the utmost intellectual honesty, self- discipline. and personal integrity. We must continue to develop our inner capacity to live with truth, to know ourselves, and to practice self-adjustment. A profession is a combination of competence and integrity. Full profes- sional status is not reached until the profession is willing to assess and improve its practices and to detennine the validity of its goals and to what extent these are being attained. Only to the degree that all members participate effectively in this continuing process will the goals of the CNA be achieved. I look fOlWard to your involvement and your considered support as I accept the position you have asked me to assume. .. THE CANADIAN NURSE 39 "- , -J ......... CANDIDATE FOR PRESIDENT-ELECT Margaret D. Mclean. Royal Vicroria Hospiral School of Nursing, Montreal; B.Sc.N., V. of Wesrem Ontario, London, Ontario, A.Moo Columbia u., New York; special course in methods improvemenr. Present Position: Senior Nursing Consulrant, Hospital Insurance and Diagnosric Services, Healrh Insurance and Resources Branch, Deparrment of Narional Health and Welfare, Orrawa. Associarion Acriviries: execurive of AARN; Board of Examiners, AARN; commirree work, RNAO; chairman, education commirree, Ortawa Wesr Chaprer, RNAO; chairman, CNA nursing service commirtee 1966-68, and 1968- 70; 2nd vice-presidenr CNA, 1968-70; has served on many orher CNA ad hoc and special committees; member, joint advisory council, Nursing Vnir Administrarion Exrension Course; member, planning commirree for first confer- ence on hospiral-medical staff relarionships. I accepted the nomination for the same reasons that I did two years ago. I believe that nursing has a unique and important contribution to make to society and I believe in nurses. I believe they will increasingly make this contribution and in a more excellent way. Many of my colleagues know that I have tried throughout my professional life to seek, encourage, and reward excel- lence in nursing. I believe being an officer of the Canadian Nurses' Association provides another avenue through which one can seek, encourage, and reward excellence in nursing practice, nursing services, nursing education, and nursing research. At this time I am very happy to be taking immersion courses in French so that I can make a greater contribution to nurses and nursing in Canada. / CANDIDATE FOR PRESIDENT-ELECT Marguerite E. Schumacher. Victoria Hospiral, Winnipeg, Maniroba; B.Sc., Wesrem Reserve V.. Cleveland, Oh,o; MA. and Ed.M.. Columbia V., N.Y. Present Posirion: Direcror, Health and Social Services, Red Deer College, Red Deer, Alberra. Associarion Acriviries: vice-president, AARN /961-63; president, AARN 1963-65; CNA executive 1963-65; 2nd vice-president CNA, 1966-68; 1 sr vice president CNA. 1968-70. Nursing, being a personal service, is involved with relationships. In the prac- tice of nursing the relationship may be with two people, namely, the patient and the nurse, but the relationships may become more complex as members of the patient's family are included and as the nurse collaborates with other members of the health disciplines and nursing team. I believe that the nurse is in the unique position of being the one who serves in an expressive role. The nurse is the one who can keep the health team functioning smoothly if she recognizes her important role in this area of human relations. Bertrand Russell once remarked that the problems in our world are less and less like those (,f driving in the desert, and more and more like those of driving in midtown Manhatten. The need then is for skills in working with other people. I believe we need to construct an ideology that will be responsive to new notions of man's relationship to his fellow man. As a member of the CNA executive, I see my role as being one of "facilitator" to use the skills that I may have to assist and support the group in all of their deliberations. · t-- .... --- ( - CANDIDATE FOR VICE-PRESIDENT Margaret L. Bradley. The Montreal General Hospiral School of Nursing; B.N., McGill. Present Position: Lecturer and Coordinator of basic degree program, School of Nursing, Dalhousie Vniversiry, Halifax, Nova Scoria. Associarion Acriviries: chairman, Board of Examiners (Montreal-English section); member and later chairman, Quebec Cu"iculum Commirree; chairman, Montreal Insrrucror's Group; member and later chairman of Montreal Disrricr Educarion Commirtee; chairman, commirree socio-economic welfare, RNANS; president, Atlantic Region, Canadian Confer- ence Vniversiry Schools of Nursing. It is my belief that many new, exciting, and controversial developments are about to take place in the health services field, particularly in the area concerned with delivery of health services to the Canadi- an people. This is a time when nurses must speak out on behalf of nursing, and take an active part in detennining their own destiny and the future of their profession. I t is urgent that we interpret our nursing role and function to the people of Canada; that we lay to rest the image of nursing that portrays us as efficient administrators and organizers who leave the task of nursing to others; that we create the image of a nurse as one involved in the skills of nursing, the planning of coordinated health care, and the one who establishes sound relation- ships with patients and health workers. Because I so firmly believe that nurses must speak for nursing, I therefore feel obligated to become involved in the work of the professional association and so accept the nomination for office in the Canadian Nurses' Association. 40 THE CANADIAN NURSE MAY 1970 ..... CANDIDATE FOR VICE-PRESIDENT Jean G. Church. Royal Vicroria Hospiral School of NursIng, Monrreal, Que., B.Sc., Dalhousie University, Halifax, Nova Scorio; Certiflcare in Teaching and Supervision, McGill University, Monrreal; M.A., Columbia u., N. Y. Presenr Posirion: Assistant Direcror, School of Nursing, Dalhousie Universiry, Halifax, Nova Scoria. Association Activiries: past presidenr RNANS; chairman of various RNANS commirtees; member, advisory commirree on nursing educa. rion NSHIC; member, selections commitree CNF; member, CNF Board: member, CCUSN. I believe that our profession has the responsibility of providing a high quality of nursing for the people of Canada. I believe, too, that this goal can be achiev- ed most effectively when the nurses from the 10 provinces are united in a strong national association. I believe that the Canadian Nurses' Association is in the unique position of being able to provide the leadership that is necessary in detennining the direction that nursing will take as we seek solutions to the dilemmas facing the profession. I have been active in professional association work on the provincial level, and I am convinced that the provincial associations need the support and the stimulation that can come from a dyna- mic national association. In accepting nomination for office in the CNA, I am affinning my belief in our national association, and at the same time supporting my conviction that each mem- ber has a responsibility to contribute to the professional organization. .. - - , CANDIDATE FOR VICE-PRESIDENT Isabel T. Colvin. Regina General Hospiral School of Nursing; B.N. and M.Sc., McGill Universiry. Presenr Posirion: Adminisrraror (Patienr Care), Regina General Hospiral. Associotion Acriviries: chairman, nursing serv- ice commirree, ANPQ; chairman, nursing servo ice commirree, SRNA; chairman of orher provinciol commirrees. Our professional association is a key factor in obtaining for nursing the prestige and support that we need in order to guide our own destiny and not haye our decisions made for us by more powerful voices in the health care field. It is our responsibility to assess our rightful place in the delivery of health services, and in this collective task each individual has her own part to play and a contribu- tion to make to the best of her ability. At this time, also. nursing associations are engaged in an appraisal of their traditional role, particularly so in relation to the more active participation of all members in the decisions that will affect their careers. We must look realistically at the demands for involvement that charac- terize many institutions today, and satisfy those legitimate aspirations that arise in our own association. 1 would consider it a privilege to be associated with the Canadian Nurses' Association at this period of change and challenge in the field of nursing and in the health care services generally. CANDIDATE FOR VICE-PRESIDENT ".thleen G. DeMarsh. Saskatoon Ciry Hospital School of Nursing; diploma in teaching and supervision and B.A., U. of Toronro. Present Posirion: Assisrant Executive Director, The Winnipeg General Hospiral, Winnipeg, Maniroba. Associarion Acrivities: member, sub.commirree to study minimum cu"iculum srandards for diploma schools of nursing, RNAO; past chair- man, nursing education commirtee, MARN and member of orher commirrees; member, nursing education commitree, CNA. When one stands on the threshold of a new century - as we do in Manito- ba - one is apt to take liberties one would not dream of taking at any other time. The liberties I propose to take could close the door forever to me being elected to office or they could open the door so wide as to usher in a major change in the very mechanism by which we handle our affairs as an association! I am not suggesting that I am a radical, though heaven knows our profession could do with a few. What I am suggest- ing is that we urgently need to find a way to shake the grate of our beliefs about nursing so the cold ashes of the past may be swept away and the warm embers of worth that have survived through the ages may once again burn brightly in the hearts of all nurses everywhere. I believe that part of the dilemma we fmd ourselves in as a profession stems from the credibility gap. which I would define as the difference between what is MAY 1970 known by "the few," and what has been the experience of "the many." Can we. in the next century, generate a quality of care for each other as human beings and as professional persons of worth, such as will enable us to bridge that gap effective. ly? Can we create a climate of trust within our profession and within each setting where nursing is practiced, which will foster innovation and encourage the professional growth of each individual nurse? Unless we can, I am concerned about what we may give to our patients. and they, after all, are the main raison d'être for our existence as a profession! If I did not care about people - nurses as well as patients I would not have accepted this nomination. Whether elected or not. I will continue to place a high value on the worth of the individual human beings with whom I come in contact. I want to see nursing perceived as a profession that is more interested in listening and in learning than in lecturing and in "laying down the law." Albeit if we are to survive, we will undoubtedly fmd ourselves doin a little of both! THE CANAUIAN NUR 1: -'1 .. . 11 - CANDIDATE FOR VICE-PRESIDENT Shirley R. Good. Women's College Hospiral School of Nursing, Toronto; B.Sc.N. and M.Ed., Dmry College, Springfield, Missouri; Ed.D. in nursing educarion. Teachers College, Columbia U.,N.Y. Present Position" Director of Nursing, Universi- ty of Calgary School of Nursing, Calgary, Alberta. Associarion Acrivities: chairman, Middlesex chapter, RNAO nursing education committee, 1963-64; member, CNF selecrions commirtee, 1968. My acceptance of the nomination for the office of vice-president is a reaffinnation of my belief in organized nursing - pro- vincial, national, and international in scope. Canadian nurses to date have traversed a long and arduous route to delineate and clarify the various roles and functions of nursing practice, to fonnulate two systems of nursing education, and insti- t ute economic security realistically, consistent with the times. These are formidable gains. However, we cannot afford the complacency of a plateau existence. The decade of the '70s and beyond will find us in continued conflict of crisis of values. Nor can we deal with problems of "how to" without first posing the problems of "why." Therefore, it is my contention that the CNA members, executive and staff, through collective voice and action, can and must deal with the problems of contemporary society, which means above all else qualitative patient care, supported by education and research. Also, as nurse citizens we must further influence the bodies politic to action for improved health resources and services for the well-being of all citizens. CANDIDATE FOR VICE-PRESIDENT Huguette Labelle. U. of Ortawa School of Nursing; B.Sc.N.Ed., B.Ed., and M.Ed., U. of Otrawa. Presenr Posirion: Director, Vanier School of Nursing, Orrawa, Onrario. Association Acrivirles: chairman, commirree on conrinuing educarion, Ottawa Easr Chaprer, RNAO; acrive in professional acriviries at chapter and provincial levels; planning and conducring conferences in orher provinces. It is inevitable that during the next decade a new pattern of health services will emerge with an expansion of the nurse's role as a key member of the health team. Concentrated efforts will be necessary to utilize more effectively all present health personnel and resources in an attempt to provide the best possible health care for all citizens. More creative organizational patterns will have to evolve to meet the demands for comprehensive health services. Since these services will be diversified and take place in different settings, the educational preparation of the nurse will need to undergo further modifications to permit them to cooper- ate fully with developing patterns, to test those against previous practices, and to serve as innovators of new designs. Will Canadian nurses be able to meet this challenge? Nurses will be in a posi- tion to meet this challenge to the extent that individually and collectively they have been able to participate actively in planning, implementing, and evaluating plans for attainment of a higher degree of excellence in nursing and overall health care. Only through this involvement, accompanied by the freedom to explore and to experiment, will each nurse discov- er the outstanding challenge of being a nurse today. This active role of the nurse has been advocated in educational programs and in nursing practice, but it must become a reality instantly in order to end the present exodus of nurses to other fields. Today, perhaps more than at any other time in history, there is a need for a powerful professional organization that will direct the efforts of its members in reaching high levels of excellence in nurs- ing and simultaneously safeguard the welfare of its members. A professional organization will therefore be successful in its endeavors to the extent that it succeeds in involving its members in attaining set goals and in sharing the interpretation of these to government and general public. i1I" CANDIDATE FOR VICE-PRESIDENT K. Marion Smilh. B.S.N., U. of Brirish Colum- bia; M.Sc., McGill U. Present Posirion: Assisrant Director of Nursing, The Vancouver General Hospital, Vancouver, B.c. Association Acriviries. acrive member of RNABC, having served on rhe execurive com- mirree and a number of other commirtees; member of rhe ad hoc commirtee studying the funcrions of rhe CNA. Just as the profession has a responsibility to the community, so have the members of this profession an individual responsi- bility to the profession. r believe this responsibility encompasses the contem- plation of new ideas, creative thinking, and the expansion of knowledge. lt is necessary to continue to develop policies in accordance with the needs and wishes of the membership, then help put such policies into effect. There is continuing need to uphold efforts to match state- ments of public purpose with what is actually done and to provide the climate in which group action can solve problems that will pennit individuals to concen- trate on their work and do a better professional job. 42 THE CANADIAN NURSE MAY 1970 ) .." Sister Marie Barbara Sister Rita Kennedy '-- --- '.... Sister Kathleen Cyr .II Sister Cecile Gauthier I 'to ... .. - , ,\ ..., "" Sister Cecile Leclerc Sister Grace Maguire Candidates for Nursing Sisterhoods Representatives Sister Marie Barbara. New Warerford General Hospital; 8.S.N.. Sr. Francis Xavier University; M.S. in Nursing, Bosron University. Present Posirion: Director, School of Nursing, Sr. Marrho's Hospiral, Antigonish, Nova Scotia: and Acring Direcror, Depr. of Nursing, St. Francis Xavier Universiry. Association Acriviries: secretary, cu"iculum council, RNANS; has held office of president, first and second vice-president. RNANS and chairman, commirree on nursing educarion; represenrative of RNANS on advisory commit- ree on nursing educarion ro Nova Scotia Hospi- tal Insurance Commission. I am justly proud to belong to the Canadian Nurses' Association, and to serve in any capacity on its board of directors would indeed be a privilege and an opportunity. As the official voice for nursing in Canada. the CNA has attained prestige and an enviable record in promoting the scholarship and welfare of its members. It has given tremendous leadership to the various provincial associations and has been successful in making its voice heard both by government and its confrères in the other health professions. Over the years, CNA has been fortunate in having MAY 1970 some of the most outstanding Canadian nurse leaders as its officers and commit- tee members. This in itself offers a unique learning and professional opportunity, besides ensuring the continued develop- ment and enhancement of the goals of the association. Nursing must not be concerned solely with its self-image or even the welfare of its members, laudable as the latter may be. Because nursing was born of the need for care by man, the CNA is pledged to work toward the goal of expediting the delivery of optimum health care to all its citizens. Concerned health professions, along with government officials and concerned citizens, are wrestling with this gigantic problem. The other pressing problems of our age, such as hunger. proverty, pollu- tion, and over-population will yield to enlightened and intelligent solutions supported by cooperative efforts among all men of every race, creed, and color. Canadians can play decisive roles in help- ing to solve these world-wide threatening problems. I believe that the CNA, on national and regional levels, can make significant contributions in support of citizen and government action by having an infonned membership. through The Canadian Nurse and direct communications with the provincial associations; by encourag- ing its members and officers to partici- pate in welfare and community organiza- tions; and by engaging in articulate and persuasive dialogue with government and other influential agencies. Sister Kathleen Cyr. 8.S("., Seattle U. Present Posirion: Instructor in Psychology. Sr. Joseph's Hospiral School of Nursing, Vicroria, B.C. Associatlon Activities: active memher of the RNABC, presently on the execlUil'e committee and the commirree on registrarion. The national association is a vital force in shaping the future of nursing in Canada. I believe I have the responsibility, as a member of a professional organization, to become personally involved and to try to contribute in a real way to the develop- ment and maintenarft:e of a strong nation- al association. THE CANADIAN NURSE 43 Si ter Cecile Gauthier. St. Boniface General Hospiral School of Nursing; B.Sc.N., U. of Montreal; M.S.N., Catholic University of Ameri- ca, Washington, D.C. Presenr Posirion: Director, School of Nursing, Sr. Boniface General Hospital, St. Boniface, Manitoba. Associarion Activities: member, board of direc- tors, MARN; member of various MARN com- mirtees. For the last few years it has been a challenging and rewarding experience for me to serve on committees and the board of directors of my provincial association. I have come to believe that the nursing profession can live and continue to grow only if individual members show concern and responsibility for its development. The board of the Canadian Nurses' Association has in the past given leader- ship and established the necessary guide- lines to support and assist the provincial associations. To serve at the national level would be an opportunity to gain knowledge and insight into a higher level of organization. It would offer the occasion to join efforts with nurses from other parts of the country who, like myself, have a desire to foster the development of nursing in our rapidly changing society. Sister Rita Kennedy. (formerly Sisrer St. Leo- nard). Lorrain School of Nursing, General Hospital, Pembroke; B.Sc.N.Ed., U. of Ottawa; M.Sc., Carholic University of America, Washing- ton, D. C. Presenr Position: Direcror, Sf. Mary's School of Nursing, General Hospital, Saulr Ste. Marie, Onrario. Associarion Acriviries: member of RNAO commitrees, including the commirree on nurs- ing service and rhe planning commitree for school of nursing improvemenr programs; pasr presidenr, Carholic Hospital Conference of Onrario; formerly member, coordinating com- mitree of rhe Quo Vadis Project; member, Council of the College of Nurses of Onrario 1963-66 and 1966-69; and secretary-treasurer, Algoma Regional School of Nursing. As a nurse I am profoundly concerned about the future of nursing generally and the practitioner of nursing and her educa- tion more specifically. The increased complexity of health care offers broader avenues for the professional nurse and a great challenge for her traditional role. I believe nurses have a responsibility to promote the professional growth of the nurses of Canada and. therefore, ensure optimal nursing care to our citizens. 44 THE CANADIAN NURSE At no other time in the history of nursing in Canada has there been such a need for nurses to direct and control the future of nursing. We must not jeopardize our heritage by abdicating our responsi- bilities to other bodies; we cannot attempt to achieve our goals in isolation as individuals or in groups. Rather, we must realize that our goals can be achiev- ed only through cooperation and commit- ment to the principles in which we believe. Hence I welcome the opportunity to serve and learn through the Canadian Nurses' Association if it be the wish of the electorate. I believe that education is a process of learning that fosters growth, creativity, freedom, and unity. I believe that the primary goal of nursing education is to unlock, open doors to awareness, competence, knowledge and skill in ful- filling the nurse's role in meeting commu- nity health needs. The advent of the space age and changing social structures, with all of their implications, has modifi- ed and expanded the role of the nurse. She must keep ahead of the pace lest h r unique functions in meeting health needs be usurped by others_ Change, however, to be significant and purposeful, must come through the educative process. To provide this process for the best nursing care of the Canadian community is the responsibility of the CNA. With its broad perspective on Canadian health needs and recognition of the inherent dignity and worth of every Canadian citizen, the CNA is challenged to take the initiative in bringing about fruitful change in nursing practice in Canada for today and tomorrow. Sister Cecile Leclerc. Notre Dame Hospital, Monrreal; B.Sc.N., Universiry of Montreal, M.A., Catholic University, Washingron, D.C. Present Posirion: Director of Nursing Educa- tion, Edmonton General Hospital School of Nursing, and Director, Deparrment of Nursing, College Sr. Jean, Edmonton, Alberra. Associarion Acrivities: vice-presidenr, chairman of commitree on finance, and member of other committees for rhe AARN, 1956-67; represen- rative of rhe nursing sisterhoods on the CNA execurive, 1962-64; member of rhe CNA com- mirree on consrirution and bylaws, 1964.66. My reason for accepting the nomination is that I believe personal involvement is one of the most tangible ways of giving evidence of my desire to contribute, as well as I can, to .the betterment of our association. Having had the privilege of serving on the board of the Canadian Nurses' Asso- ciation as nursing sisterhoods representa- tive a few years ago, I consider that experience as most valuable and enriching both personally and professionally. (t is my belief that through active participation in the affairs of our national association I shall be a more effective member of our provincial and local nurs- ing associations. Sister Grace Maguire.Sr. Mary's Hospital, Mon- treal; Diploma in Teaching and Supervision, U. of Alberra; B.S.N., U. of Orrawa; M.S.N., Catholic Universlry of America, Washingron, D.C. Presenr Position: Director of Nursing, Provi- dence Hospiral, Moose Jaw, Saskarchewan. Associarion Activities: member, board of nurs- ing educarion, departmenr of educarion, province of Saskarchewan; member, board of examiners, SRNA. My purpose in accepting the nomination for office in the Canadian Nurses' Asso- ciation for the 1970-72 term is as follows: 1. to share some of my learning and experience with others in order to better understand the problems that face nursing in each of the provinces in Cana- da and other countries; 2. to gain a greater appreciation of the Canadian Nurses' Association and its many contri- butions; 3. to be able to bring or share the knowledge acquired through this contact to the local and provincial level to help promote a greater awareness, a desire for participation, and a need for unity on the part of the individual members and the provincial and national associations. 0 MAY 1970 )éf/\: \ ,:j @ I )cl! ( '- , w-. .... .;;; f - TõJfÆ fl '1ll \'" 0 0 IlJ[f CNA ---- O'9 -rr-- r- -. ) en Z Æ S ; -... - MAY 1970 We're not telling. You'll have to come to N.B. to find out. Fredericton - here we come! A recipe to help each CNA biennial conventioneer plan her strategy for next month's meeting in Fredericton. Carol Kotlarsky, B.'. The 1970 biennial meeting in June has something going for it that no other CNA biennial has had: Fredericton. For nurses who have yet to see this charming New Brunswick capital. or the province, or even the Maritimes, there is lots to look forward to. Whether your interest lies in history, photography, gastronomy, or athletic activity, this part of the country will be for you. Whatever way you look at it, whatever road you take to get there, plenty awaits each visitor to Fredericton. The only question is: how do you make the most of one event-packed week? Read on, and feel free to pack any of the following tips that might help some- where along the convention route. Mi!.S Kotlarsky, a graduate of Carleton Universi- ty's School of Journalism, is Editorial A i tant. The Canadian Nurse. Planners win Once you get to Fredericton, it will be easy to get swept off your feet in the bewilderment of scheduled business and social events that do not leave too many spare minutes. Nothing pays off more than a close examination of the program before arriving in the convention city. Once you have decided that a particular session is important to you, some last- minute distraction is less likely to prove tempting. Make notes before and during the week. And keep them handy! Since you can't remember everything, jot down names of people you want to meet during the week, as well as new names, ad- dresses, and ideas for future reference. This kind of organization can pay big dividends. You may also wish to compare notes with fellow coavention goers. Once the week's meeting is over, you THE CANADIAN NURSE might want to think over all you did, what you missed, or would do differently the next time. With these thoughts in writing, you will have some good prepara- tion for your next conference. Social do's and don'ts Do you think of social events as essential aspects of any convention, or simply as "fillers" if nothing more serious is in the offing? One secret of getting the most from a large meeting is knowing how - and when - to mix social gatherings with business sessions. Whether it is over an informal cup of coffee or over a formal lobster, people are more relaxed than they are at work sessions. Committee reports, interest sessions, and speeches have their place, but they can't dominate every waking hour. Informal get-togethers often provide those little extras that make a convention especially memorable. Don't hesitate to introduce yourself to people you haven't met, whether it is during a coffee, lunch, or dinner break. That person standing or sitting alone is probably waiting for an introduction too. If, on the other hand, you're already part of a group, you can always invite another person to join. Try to keep on the go and meet as many people as possible. Even breakfast can provide a convivial meeting time - if you're an early riser. Taste the varied menu Throughout the week, an assorted fare of dinners, concerts, receptions - to name only a few of the offerings - wiII satisfy all appetites. Tuesday night the government of New Brunswick is giving a banquet for all registrants. This should give everyone a good preview of the hospitality planned for Wednesday. Just because one full day in the middle of this fast-paced week has been set aside for sightseeing. doesn't mean a conven- tioneer can take it easy! There's so much to see in and around Fredericton, that this one day will only help you realize how long you would like to spend there. While sightseeing, take advantage of the generously- offered hospitality. Meet the Maritimers and find time to marvel at CANADIAN NURSE 1..- the beautifully varied landscape and seas- cape. There are 600 miles of seacoast in the province, so whether you're looking for a sandy beach, sheltered cove, quiet lake, or tumbling river, you won't have far to go. Gourmet's guide Seafood worshippers will not be the only gastronomic connoisseurs who will find an unusual assortment of epicurean delights in this province. [n addition to such delicacies as lobster à la Bretonne, devilled crab, and Kromeskies (oysters, chicken, and mushrooms), you will be able to enjoy fiddleheads. Tuesday night's menu, says the New Brunswick Association of Registered Nurses, will include seafood, fiddleheads, and New Brunswick wine. To avoid sus- pense, NBARN has described the fiddle- head as a rather strange-looking, tender green vegetable that "will no doubt be a popular topic of dinner conversation." For those who really like to know what they're eating, fiddleheads are the early growth of the ostrich fern. They have to be picked during the short delicacy stage as the leaves poke through the soil. Each spring New Brunswickers can be seen along the rivers harvesting the greens for a family treat. Also popular is the frozen variety. The province boasts the only commercial company in North America that freezes fiddleheads. Tour Maritimes If you have time for a week's explora- tion after the biennial, this one-week tour package, announced by NBARN, may be for you. Beginning June 20, take the conducted tour from Fredericton along the Saint John River to the Bay of Fundy and the port city of Saint John. There you will see the Reversing Falls, Martello Tower, and New Brunswick Museum. Then continue to Fundy National Park, Hope- well Rocks, and on to Moncton for a visit to Magnetic Hill. From Fort Beausejour you will go by ferry to the garden province - Prince Edward Island. Enjoy the famous sandy beaches, a tour of Summerside, and an overnight stop in the capital of Charlotte- town. Take another ferry to picturesque Cape Breton and arrive at the famous Keltic Lodge at Ingonish for one night's stay. Then follow the historic Cabot Trail; see the beauty of its mountains, interspersed with glimpses of the Atlan- tic. Cross the Canso Causeway to mainland Nova Scotia and Halifax. After touring the city's historic Citadel, a drive along the province's scenic south shore will take you to the Lunenburg Fisheries Museum, Peggy's Cove, and Mahone Bay. On June 26 the tour bus will leave Halifax and drive through Annapolis Valley, stopping at Grand Pré Memorial Park, then continuing to Digby to board the ferry for Saint John, N.B. Arrangements for this $150 tour can be made through Me. R.V. Lenihan, President, Moncton Travel Agency, 735 Main Street, Moncton, New Brunswick. Summing up Although the following lines by James De Mille were written about New Bruns- wick a century ago, they have not completely lost their meaning. Sweet maiden of Passamaquoddy, Shall we seek for communion of souls Where the deep Mississippi meanders, Or the distant Saskatchewan rolls? Ah, no! in New Brunswick we'll find it- A sweetly sequestered nook- Where the swift gliding Skoodoowab- skooksis Unites with the Skoodoowabskook. * *Robert M. Hamilton, Canadian Quotations and Phrases, Toronto, McClelland and Stewart Limited, 1965, p.146. MAY 1970 books The Intimate Enemy: How To Fight Fair in Love and Marriage by George R. Bach and Peter Wyden. 405 pages. New York, William Morrow & Co., 1969. Canadian Agent: George J. Mcleod Ltd., Toronto. Reviewed by Dr. s.R. Laycock, Vancouver, B.C, formerly Dean of Education at the University of Saskat- chewan, Saskatoon. Dr. George R. Bach, the senior author, is a psychologist and director of the Insti- tute for Group Therapy in Beverley Hills, California, where he developed the theory of constructive aggression in marriage counseling. His collaborator, the author of several books, is executive editor of Ladies Home Journal. The authors believe that true intimacy in marriage can thrive in healthy men and women only if the partners learn how to fight and to do so by fair, clean. above- the-belt fighting and by leveling with each other. Training in doing this is given by the senior author through the use of group therapy with several couples in a group. The authors' aim is to replace "game playing" with true intimacy. They discuss the dangers of storing up grievances; how to deal with Vesuvius temper outbursts; why winning a fight may be more costly than losing; the importance of making a fight-appointment; finding a partner's "fair-belt-line"; how drinking affects fighting; avoiding Virginia Woolf fighting; the use of warming-up exercises before fighting; how to end a good fight; dirty and sick fighters and how to stop them; exercises to improve intimate communi- cation; using sex as a strategic weapon; and fighting before, during, and after sex; teaching aggression-control to children; how to reduce needless fights with child- ren; making intimate living work; genera- tion gap fights; courtship fights; and fights about extramarital sex. The book is applied mostly to husband-wife relationships. However, most of the rules apply to any intimate relationship, such as a close friendship. where two people make themselves vulnerable to each other and must, there- fore, learn the arts of leveling, honesty, and fairness in their dealings with each other. Although not all psychologists and marriage counselors would approve of, or be able to use. Bach's technique of fighting, his method, especially when carried out in his type of group therapy, MAY 1970 could be of real value to many couples. If the book were made available to young people in their late teens and early twenties, it would help them to discard rose-colored glasses that make them see marriage as a guarantee of living happily ever after. It might even make them realize that the goals of happiness and intimacy in marriage have to be bought by a great deal of leveling and honesty with the marriage partner. Mosby's Comprehensive Review of Nurs- ing, 7th ed., by Editorial Panel. 590 pages. Toronto, C.V. Mosby Co., Ltd., 1969. Reviewed by Doris Weiler, Evening Charge Nurse, Almonte General Hospi- tal, Almonte, Ontario. This text is a pleasure to read. It is not heavy reading and for the most part, is easily absorbed. The presentation makes it interesting - a trait seldom found in textbooks. It would greatly assist nurses who have practiced for many years, those studying for registration, students, and nurses who have been out of nursing and plan to return. Anatomy and physiology are easy to assimilate, but more illustrations would facilitate learning. The sciences. including social science. are well presented and the pertinent factors. especially in chemistry and microbiology, are covered. This is important, as the nurse needs an easy-to- read, overall picture. not a lot of ponder- ous detail that results in loss of interest. The history of nursing is contempor- ary and mostly national. It creates a desire for a more detailed, international picture of the struggle of nurses for a rightful place beside and with the patient. The section on communicable disease nursing is most interesting and, with one exception. is one of the best accounts I have read. Contact direct or indirect - is considered at the beginning; however. one exemple of contact includes conflict- ing statements. Psychiatric nursing is well presented with good case histories, although more emphasis should have been placed on the method and approach to mentally ill patients. For example. if the patient feels the nurse is timid or fearful. rapport can never be established. The answer sheet method is good. can be processed readily. and is advocated extensively. However, this method has disadvantages. In I.Q. tests. people with game aptitude and a good memory can score high. but may lack proper know- ledge of the subject. Jensen's History and Trends of Profes- sional Nursing, 6th ed. by Gerald Joseph Griffin and Joanne King Griffin. 339 pages. Toronto. C.V. Mosby Company, 1969. Re 'iewed by Glennis Zilm, fonnerly an instructor in history of nursing. This revised edition of a standard Ameri- can history of nursing text has a bigger format with larger two-column pages and more illustrations. Few changes have been made in the sections on the early history of nursing. The section on the contributions of Kaiserworth remains one of the best offered in any basic text. Changes in organization, as in the section on nursing publications, have improved the book, and new sections. such as the one on lobbying. will interest many. This edition starts on a less preachy, student-oriented note than did the fifth edition; the opening unit, list of major trends, and a note about how to use the book. have been removed. The general concept of relating trends to movements in history - one of the strengths of this text - has been retained, however. Unit seven, on contemporary developments and trends. is considerably updated and improved. It will be of considerable value to United States nurses. This American text has little to offer on contemporary nursing or trends for Canadians. The unit on history and present-day activities of nursing in Cana- da is too brief and outdated to be really useful to Canadians. Although revised somewhat, it still contains errors. such as the spelling of the name of Alice Girard. ICN president from 1965 to 1969. It concentrates far too much on using On- tario as an example, rather than consider- ing that each province has its distinct standards. The unit on nursing in other countries is poorly done. The chapter on nursing in the British Isles. for example, ends with the recommendations of the Lancet Com- mission m 1932 and fails to show modern trends and conflicts in Britain. The unit also fails to point out some of the differences in patterns of nursing educa- tion and practice around the world. such as the differences qf the health worker system in the U.S.S.R. 0 THE CANADIAN NURSE 47 accession list For nursing . convenIence. . . ,... Soothing, cooling TUCKS provide greater patient comfort, greater nursing convenience. TUCKS mean no fuss, no mess, no preparation, no trundling the surgical cart. Ready- prepared TUCKS can be kept by the patient's bedside for immediate appli- cation whenever their soothing, healing properties are indicated. TUCKS allay the itch and pain of post-operative lesions, post-partum hemorrhoids, episiotomies, and many dermatological conditions. TUCKS save time. Promote healing. Offer soothing, cooling relief in both pre-and post-operative conditions. TUCKS are soft flannel pads soaked in witch hazel (50%) and glycerine (10%). Publications on this list have been received recently in the CNA library and are listed in language of source. Material on this list, except Reference items, may be borrowed by CNA mem- bers, schools of nursing and other institu- tions. Reference items (theses, archive books and directories, almanacs and similar books) do not go out on loan. Requests for loans should be made on the "Request Form for Accession List" and should be addressed to: The Library, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario. No more than three titles should be requested at anyone time. patient ease TUCKS offer an aid to healing, an aid to comfort - ---- TUCKS - the valuable nur- sing aid, the valuable patient comforter. BOOKS AND DOCUMENTS ]. Accouchement sans douleur par ]a psycho-physio-prophylaxie et son extension à la puerpéra]ité par A. Notter. Lyon, France, Simep, 1968. 190p. 2. Aide - mémoire de parhologie à l'usage de l'infirmière. Suivi d'un lexique médical. Préparation au diplôme d'état. Par Henri Diriart et aL Paris, Baillière et fils, 1969. 389p. 3. Ambulatory nursing care an annotated bibliography prepared by Vivian V. Clark assist- ed by Leanne P. Davidson. New York, Health and Hospital Planning Council of Southern New York, ] 969. 69p. 4. A nalysis of rhe whire paper on tax reform. Don Mills, CCH Canadian Ltd., Ont., ] 969. 94p. 5. An approach to formularion of clinic nursing standards New York, Health and Hos- pita] Planning Council of Southern New York, ] 969. 55p. 6. Associate degree education - cu"ent issues. Papers presen ted at the second confer- ence of the Council of Associate Degree Pro- grams held at Atlanta, Georgia, March 6-8, ]969. New York, National League for Nursing. Dept. of Associate Degree Programs, 1969. 50p. 7. Arrirudes féminines devanr 10 prévenrion des naissances par P.A. Gloor. Paris, Doin Deren, ] 96 8. ] 98p. 8. Breaking the language ba"ier - a serv- ice to nurses from Warner-Chilcott. Morris Plains, N.J., Warner-Chilcott, ]969. 73p. 9. Dicrionary of Canadian biography. General editor, George W. Brown. Toronto, University of Toronto Press, 1969. 759p.R 10. Drugs in current use 1970 by Walter Modell, New York, Spnnger, 1970. n.p. ] I. Educarion srudies in progress in Canadi- an Universities 1968/69. Toronto, Canadian Education Association, Research and Informa- tion Division, ] 969. 88p. ] 2. Educational relevision by Earl Rosen. Toronto, Canadian Association for Adult Education, ]969. 95p. (Canadian Association for Adult Education. Trends) ] 3. Le français, langue des affaires par André Clas et Paul A. Horguelin. Montréal, McGraw-Hili, 1969. 394p. ]4. Handbook of clinical laborarory dara. MAY 1970 .... "'0 . "rUOk. 1 .... Specify the FULLER SHIELD@ as a protective postsurgical dressing. Holds anal, perianal or pilonidal dressings comfortably in place with- out tape, prevents soiling of linen or cloth- ing. Ideal for hospital or ambulatory patients. vJ WINLEY-MORRIS 8.!:,. M MONTREAL CANADA TUCKS is a trademark of the Fuller Laboratories Inc. THE CANADIAN NURSE 48 2d. ed. Edited by Henry C. Damm, William R. Faulkner and John W. King. Cleveland, Ohio, Chemical Rubber Co., 1968. 71Op. 15. Level objectives; development and use in the cu"iculum. Report of the 1969 Regional Workshops of the Council of Diploma Pro- grams. New York, National League for Nursing, Dept. of Diploma Programs, 1970. 62p. 16. Medical education in the service of /1Ii1nkind. Report of World Conference on Medical Education, 3d. New Delhi, 1966. Chicago, 1968. p.99-328 (Journal of medical education, v.43, no.2) 17. Notions pratiques sur la paraplégie par J. J. Walsh. Paris, Masson & Cie, 1969. 117p. 18. Nursing in community action agency; an experience with ghetto teenagers, by Eileen Callahan Hodgman. New York, National League for Nursing, 1970. 86p. (League exchange no.9l) 19. Le nursing; principès généraux prac- tique de base, Soeur Marie-Claire Rheault, redactrice. e.ed. Rédigé en collaboration Insti- tut Marguerite d'Youville. Montréal, Renauveau Pedagogique, 1968. 685p. 20. The origin and evolution of the l.L.O. and its role in the world community by David A. Morse. Ithaca, N.Y., New York State School of Industrial and Labor Relations, Cornell University, 1969. 125p. 21. Perspectives on clinical teaching by Dorothy W. Smith. New York, Springer. 1968. 243p. 22. Proceedings of Annual Conference. 1968. Chicago, American Library Association, 1969. 199p. 23. The research process in education by David J. Fox. New York, Holt, Rinehart and Winston, 1969. 758p. (Chapter on Electronic data processing by Sigmund Tobias.) 24. Sexuolité et education familiale par S. R. Laycock traduit de l'anglais par Le Centre Catholique de l'Université Saint-Paul. Ottawa, Novalis, 1969 151p. 25. 16mm. films used in nursing education. Toronto, Metropolitan Toronto Schools Ltd. Nursing Audio Visual Aids Committee. 1970. Iv. (loose-leaf) 26. Slides of International Council of Nurses Congress 1969. Montreal. The Gazette. 1969. 20 slides. 27. Standards for nursing service in health care facilities; a self-evaluation guide. Ottawa, Canadian Nurses Association, 1969. 45p. PAMPHLETS 28. Annual report to boards of nursing from NLN measurement and evaluation serv- ices, 1969-70. New York, National League for Nursing, 1970. lOp.R 29. Folio of reports, 1969. Montreal, The Association of Nurses of the Province of Quebec, 1969. 24p. 30. Manual for the administration of the State Board Test Pool examination for register- ed nurse licensure. New York, National League for Nursing, 1968. 13p. 31. Report 1968-69. Toronto, Home Care Program for Metropolitan Toronto. ] 969. 15p. 32. Responsabilités et obligations concer- fliJnt Ie soin des malades, par Rollande Gagné, MAY 1970 redacteur, en collaboration avec Gu tane Gin- gras et Jo eph Vallières. Montréal, ]ntermonde, 1970. 32p. GOVERNMENT DOCUMENTS Canada 33. Bureau of Statistics. Survey of educa- tion finance 1966. Ottawa, Queen's Printer, ]970. 52p. 34. Dept. of Finance. Proposals for tax reform by E. J. Benson. Ottawa, Queen's Printer. ] 969, 96p. 35. Dept. of NatIonal Health and Welfare. Proceedings of National Health Manpower Conference, Ottawa, Oct. 7-10, 1969. Ottawa, 1970. 306p. 36. Minister of Industry, Trade and Com- merce. White paper on metric conversion in Canada. Ottawa, Queen's Printer, ] 970. 22p. 37. Post Office Department. A hlueprint for change. Ottawa, 1%9. 134p. 38. Economic Council of Canada. Annual review. Ottawa, Queen's Printer, ]969. 277p. (Its annual review no.6) 39. National Science Library of Canada. Report 1968/69. Ottawa, 1970. 35p U.S.A. 40. Dept. of Commerce. Busines and Defence Administration. Audio,visual equip- ment and materials; a guide to sources of information and market trends. Wa\hington, U.S. Gov't Print. Off., 1%9. ]5p. f ...... Just Press the Clip and It's Sealed It takes but a moment to identify your pa- tient, positively and permanently, with Ident-Ä-Band. Then just a glance is all you'll need to be sure that this is the right patient. Ident-A-Band- 1 j-IOLLIS .K Write today for free samples and literature ,80 BAV B TORONTO 1 THE CANADIAN NURSE 49 41. National Cancer Institute. Research Information Branch. Cancer cause and preven- tion: em'ironmental factors, permnal factors, occupational hazards, research approaches. Washington, U.S. Gov't Print. Off., 1966. 16p. (U.S. Public Health Service publication no. 959) 42. -. Reading on cancer: an annotat- ed bibliography. Washington. U.S. Gov't Print. Off., 1969. 23p. (U.S. Public Health Service publicdtion no. 457) 43. National Center for Chronic Disease Control, Kidney Disease Control Progrdm. The artificial kidney; what it is, how it works. Washington, U.S. Gov't Print. Off., 1967. 36p. (Public Health Service publication no. 1409) 44. National Heart Institute, Heart Information Center. Cerebral vascular disease and strokes prepared by.. and National Imtitute of Neurological Disease and Stroke. Rev. Washington, U.S. Gov't Print. Off., 1969. 19p. (U.S. Public Health Service publication no. 513) 45. -. Hypertension; high blood pres- sure. Bethesda, Md., U.S. Dept. of Health, Education and Welfare, 1969. 48p. (National Institute of Health publication no. 1714) 46. National Institute of Neurological Diseases and Blindness. Multiple sclerosis, hope through research prepared by... and the National Multiple Sclerosis Society. Rev. Washington, U.S. Gov't Print. Off., 1967. 7p. (U.S. Public Health Service- publication no. 621) 47. Dept. of Health, Education, and Wel- fare. Public Health Service. Glaucoma, Washing- ton, U.S. Gov't Print. Off., 1968. pam. (U.S. Public Health Service publication no. 1736) 48. -. List of public health service publications issued by the Public Health Service 1968. Washington, U.S. Gov't Print. Office, 1969. n.p. 49. -. Nursing careers in mental health. Washington, U.S. Gov't Print. Off., 1969. 15p. (U.S. Public Health Service publica- tion no. 1051) STUDIES DEPOSITED IN CN'" REPOSITORY COLLECTION 50. Development of Likert scale to identify one nursing behaviour practiced in general nursing by Helen Frances (McCarty). London. 1969. 89p. (Thesis (M.Sc.N) - Western Ontar- io)R 51. Diabetic survey. Kirkland Lake, Timis- kaming Health Unit, Ontario Dept. of Health, n.d.2p.R 52. Effects of different nursing approaches upon psychological and physiological responses of patients by Jacqueline Sue Chapman. Cleve- land, Ohio, Frances Payne Bolton School of Nursing, Case Western Reserve University, 1969. 97p.R 53. Fantasy in communication of concerns of one five-year-old hospitalized girl by Judith Anne Ritchie. Pittsburgh, 1969. 85p. (Thesis (M.N.) - Pittsburgh)R 54. Organization of elements of a selected nursing curriculum as revealed III course out- lines, by Sister Cecile Gauthier. Washington, 1966. 112p. (Thesis (M.Sc.N) - Catholic University of America)R 55. Report of breakfast survey conducted on preschool children and their mothers by the Timiskaming Health Unit, Staff nurses of Engle- hart, Elk Lake and Thornlac. Kirkland Lake, Timiskaming Health Unit, Ontario Dept. of Health, 1965. 7p.R 56. The role of the director in ten Canadian schools of nursing by Sister St. Leonard Kenne- dy. Washington, 1960. 85 p. (Thesis (M.Sc.N) - Catholic Univ. of America)R 57. Senior citizens survey. Kirkland Lake, Timiskaming Health Unit. Ontario Dept. of Health, 1967. 4p.R 58. A study of activities performed by nurses in the quarantine service of the quaran- tine and immigration medical service. Canoda by Heather P. McDonald, Chapel HilI, North Carolina, 1968. 53p. (Thesis (M.P.H.) - North Carolina)R 59. A study of communicative behaviour in young hospitalized children by Mary Ann Whitemore. Montreal, 1969. 75p. (Thesis (M.Sc.(App.) - McGiII)R 60. A study to determine how patients view their digoxin therapy, by Rita M. Brkich, Montreal, 1969. 35p. (Thesis (M.Sc.(App.) - rdcGiII)R 61. A study of the relationship between patient involvement and patient attitude in transfers occuring in a selected unit of a general hospital by George Middleton. Montreal, 1969. 65p. (Thesis (M.Sc. (App.) - McGiII)R 0 Request Form for "Accession List" CANADIAN NURSES' ASSOCIATION LIBRARY ASSISTANT EDITOR Send this coupon or facsimi e to: LIBRARIAN, Canadian Nurses' Association, 50 The Driveway, Ottawa 4, Ontario. Please lend me the following publications, listed in the . . .. . . issue of The Canadian Nurse, or add my name to the waiting list to receive them when available. Item Author Short title (for identification) No. The Canadian Nurse invites applicationi for the position of Assistant Editor to begin as soon as possible. Requirements: R.N. and member of provincial nurses' association; bachelor's degree in nursing, journalism, general science, or arts; a minimum of eight years recent experience in bedside nursing, clinical teaching, in- service education, or head nurse responsibilities; experi- ence and or interest in writing, willingness to travel. Request for loans will be filled in order of receipt. Reference and restricted material must be used in the CNA library. Borrower Registration No. Position Address Date of request Please send detailed history of past academic and work background to: MAY 1970 50 THE CANADIAN NURSE Editor The Canadian Nurse SO The Driveway, Ottawa 4 June 1970 MISS MTM ,.,nRRIS - - - ------ 290 NELSON ST APT 812 _ OT T WA 2 ON T _ J0005784 The Canadian Nurse monitoring the patient with chest pain for variant angina the case for permanent shifts needed: a positive approach to the mentally retarded - ...... -.;:: ... We want a nurse who can handle two jobs: one who can nurse the men of the Canadian Armed Forces and who can accept the responsibilities of being a com missioned officer. It's interest.. ing work. You could travel to bases all across Canada and be employed in one of several different hospitals. It's challenging.You'll never find yourself in a dull routine. And, in addition, you have the extra pres e want tige of being made a commis sioned officer when you join us. If the idea intrigues you, you're probably the kind of special person we're looking for. We'd like to have you with us. W rite: The Director of Recruiting and Selection. Canadian Forces Headquarters, . Ottawa 4, Ontario. a special kind of nurse.-., .,....: THE CANADIAN ARMED FORCES v _".ii " ' 1_ ', "' " VB2102.A , The "Saneen" disposable diaper concept. What are its advantages? In providing greater comfort and safety for the infant: More absorbent than cloth diapers. "Saneen" FlUSHABYES draw moisture away from baby's skin, thus reducing the possibility of skin irritation. Facial tissue softness and absence of harsh laundry additives help prevent diaper derived irritation. Five sizes designed to meet all infants' needs from premature through toddler. A proper fit every time. Single use eliminates a major source of cross- nfection. Invaluable in isolation units. In providing greater hospital convenience: Polywrapped units are designed for one-day use, and for convenient storage in the bassinet. Also, Saneen Flushabyes do not require autoclaving-they contain fewer pathogenic organisms at time of application than autoclaved cloth diapers.. Prefolded Saneen disposables eliminate time spent folding cloth diapers in the laundry and before application to the infant. Easier to put on baby. Constant supply. Saneen Flushabyes eliminate need for diaper laundering and are therefore unaffected by interruptions in laundry operations. Elimination of diaper misuse, which may occur with cloth diapers. .Th / Rich Bac<>.'a - Thirty-nine recommenda- tions from the task force reports on the cost of health services in Canada, were discussed by an ad hoc committee at the Canadian Nurses' Association April 20-22. The committee reviewed those sections of the reports that applied to nursing and nurses. Com- menting on the meeting, chairman Lois Graham-Cumming, head of CNA's research and advisory services, said six of the task force reports contained recommendations that re- lated specifically to nursing: operational efficiency; salaries and wages; beds and facilities; price of medical care; cost of public health services, and utilization of hospital services and manpower. Mrs. Graham- Cumming said preparation for the meeting had been carefully set out in a questionnaire, Sent out to each committee member prior to the Ottawa discussions. Members were asked to study the recommendations and state their reactions - agreeing or disagreeing, and the reasons why. A summary of the advance questIon- naire was prepared by Mrs. Graham- Cumming for the April meeting. The outcome of the discussions will be submitted to the CNA board of direc- tors for action before the general meet- ing of the CNA in Fredericton, New Brunswick, June 14-19. The 14 mem- ber committee included the chairman of three CNA standing committees: nursing education; nursing service; and social and economic welfare. Pro- vincial associations were represented by an appointed member. The commit- tee wilI meet again for a four-day dis- cussion on those sections of the reports which do not specificalIy mention nur- sing, but stilI affect the profession. Issue!ì of Journal Needed The Canadian Nurses's Association needs the following issues of The Ca- nadian Nurse: 1969: January, April, September; 1967: February; 1966: January, February March, July, Sep- tember; 1965: January. March, April. Please send these issues to the CNA Circulation Department, 50 The Dri- veway, Ottawa 4, Ontario. Please send these issues to the CNA Circulation Department, 50 The Driveway, Ottawa 4, Ontario. JUNE 1970 -,.- L t '"V' .- "j l L '...... ..s:- I ..-- . ..... '- . )' ,-., . .. .. .. ., - ....,... . .... . , , \ ,.-#".;. . ':'f7"_I' S, ... , : : : : F ..5_'1":". " - ; .: : 7 ,_ '..1 _i'.",:,' 11 7'.....:.'":,...... , "'""- Although discussions centered on the health costs of Canada at the April CNA ad hoc committee meeting in Ottawa, time out for reflection on what might occur at the June general meeting took over during coffee break. Five of the committee showed interest in preconvention advertising. Commenting on the artwork are (left to right) Dr. Rae Chittick, now retired; Joyce Bailey, director of nursing, WelIesley Hospital, Toronto; Joan Toner, director, school of nursmg, Carleton Memorial Hospital, Woodstock, N.B.; Olivette Gareau, director of public health nursing. health unit division. Ministry of Health, Quebec; and Roy Harding, head nurse, Victoria General Hospital, Halifax, Nova Scotia. CNA Awarded National Health Grant Onawa - A national health grant of $9,746 was awarded in May 1970 to the Canadian Nurses' Association to- ward a research project on "factors pre- venting nurses from achieving their edu- cational goals." National Health and Welfare Mini- ster John Munro announced the grant for the 1970-7 I fiscal year under the new national health grant program. The project was begun in May and should be completed by June 30, 197 I . The study is designed to determine what prevents registered nur es in lead- ership positions in Canada from ob- taining the educational preparation necded for their work. A great discre- pancy exists between the academic qual- ifications the Canadian nursing profes- sion believes nurses should po!-osess and the qualifications actllalIy held. This discrepancy wa pointed out in the annual national inventory of regis- tered nurses compiled by the CNA re- search unit, and was also identifIed by the recent federal government task for- ces on health care costs. The study aims to answer the follow- ing: I. the proportion of nurses with some university education who desire additional academic preparation; 2. the proportion of these nurses who are mak- ing satisfactory progress toward or are delayed in achieving their goal; 3. the factors that are delaying nurses in achiev- ing their goals. and the remedial action indicated. Questionnaires designed to reveal this information will be sent to nurses having some educational preparation in a university. Project director is Lois Graham-Cumming, director, CNA re- search and advisory services. Nurses In The Future Ottawa - What will he the role of the nur!-oc in the future'! This question was answered b} the executive director of the Canadian Nurses' Association in two recent speaking cn agements in the United States. Dr. Helen K. Mussallem depicted the THE CANADIAN NURSE 7 - .- news nurse of the future as one who will be the primary health professional contact in the community. The nurse. as per- ceived bv Dr. Mussallem. will be re- quired tó take on many responsibilities of the doctor in general practice. Speaking to audiences at Rockland Community College. Suffern, and Teachers College. Columbia U ni versi ty, N.Y., Dr. Mussallem said the expanded role of the nurse in health care delivery systems is not new in Canada. "In remote areas of the countrv the nurse has already assumed this rolè:" she said. For the nurse of the future, Dr. Mussallem felt the greatest problem will be, "How to determine if nursing will be provided by nurses as we know them now." The pattern of medical practice is changing, she told her audiences. "If the decline in the number of family doctors continues. it will inevitably lead to a new pattern for health care delivery." The role of the nurse was also dis- cU sed at the recent Commonwealth Foundation Caribbean Seminar on Nursing, held in Barbados. Dr. Mus- sallem attended as a consultant. - . .J . --- 1'\ I _7' -.......- -....- ----. I r. \ .a" i , . ì "" - Margaret D. McLean, (standing, center), chairman and coordinator for the national seminar for directors of nursing held by the Department of National Health and Welfare, reviews registration preparations for the four-day meeting. vincial nursing consultants found useful in assessing and improving nursing service and its management. Sixty-three French-speaking and 64 English-speaking nursing directors at- Directors Of Nursing tended the seminar, the first of its type. Attend Federal Seminar Chairman and coordinator was Marga- Ottawa-Directors of nursing from ret D. McLean, senior nursing consult- across Canada attended a seminar held ant hospital insurance and diagnostic here April 7 -I 0 by the department of services branch of the federal health national health and welfare. Its department. objective was to share with the di- Three major topics were discussed: rectors tools that the federal and pro- organizing nursing service to meet . " , \ , \- , }J ..: 'I!' iíAt. . "' - . -,;. .. - .. " - 1Þ- . . - 4 <. , . ....- - , , J These second-year nursing students from the Ottawa Civic Hospital participated !n the first Mi.les for .Millions walk held in Canada this year, on April 18. Start- mg off on their 40-mlle walk through Ottawa are, from left, Sue Saint, Joyce Baldwin, Liz Matheson, Marg Rook, and Barb Redmond. 8 THE CANADIAN NURSE objectives; use of level of care assess- ment which categorizes patients ac- cording to nursing needs; and delivery of nursing care designed to meet the individual patient's needs, rather than relying on routines. The two language groups met separately for discussion except at the opening session and at the closing meeting, when methods of implementa- tion were discussed. Miss McLean told The Canadian Nurse many directors agreed to use level of assessment as one means of implementing what they had learned during the seminar. They felt it would help to staff more realis- tically for patients' needs, she said. Nursing directors who attended the seminar would try to share what they learned with other directors in their province through regional meetings, said Miss McLean. Directors also listed many aspects of care proce- dures that were routinized and agreed to review these on their return to determine if all patients need these routines, added Miss McLean. The directors of nursing were chosen to attend by provincial hospital insurance groups; most from hos- pitals with more than 200 beds. In October an appraisal form will be sent to seminar participants to find out how implementation procedures have progressed, Miss McLean said. Nurses Serve Abroad With Miles For Millions Funds Ottawa - This spring thousands of Canadians have been walking in Miles for Millions marches to raise money IUNE 1970 .. - ...- ... '""', '" , -- "'" ,. fI:!JiII" :t., .....r ... # , .. -; I /'1 I I ", , . . . Keynote speaker at the institute on human relations in the health services sponsored by the RNANS and the Dalhousie University School of Nursing was Dr. James Gill of Harvard University, seen here with Joan Fox (center), RNANS president, and E. Electa MacLennan, director of the Dalhousie University School of Nursing. for 15 national agencies that work for international development. Several of these agencies send nurses abroad. In 1969, 114 sponsored walks in- volved 400,000 Canadians and raised nearly $4.5 milJion. This year 150 walks are expected to take place. May 2-3 was declared National Walk Week-end, but some walks will be held in the fall and at other times. One agency in which nursing stu- dents can participate is Canadian Crossroads International, which uses Miles for Millions funds to sponsor university students on summer service projects in Africa. Nursing students have been sent to help in the health programs of various African countries. The Canadian University Service Overseas sends nurses to work in de- veloping countries with Miles for Millions money. These nurses are working in more than 40 countries around the world to improve health standards; they are paid by their overseas employer at local rates. Care of Canada is supporting three young Canadian nurses in Afghanistan through Medico, a service of CARE. Several other agencies aid health pro- grams abroad, in which nurses are mvolved. These include the Canadian Save the Children Fund; the Canadian UNICEF committee; and Oxfam. BC Operating Room Nurses Meet Vancouver, R.C. - Use of drugs and their interaction with anesthetics were among the subjects discussed when the JUNE 1970 British Columbia Operating Room Nurses Group held its second biennial institute, March 13 to 14 in Vancouver. Other subjects on the program were: future concepts in operating room nursing; recent advances in the sur- gical treatment of arthritis; cardiac arrest; principles and methods of sterilization. Gloria Stephens of St. Pauls Hos- pital, Vancouver, was elected president of the group during the meeting. The registration was more than 400. The majority were operating room nurses, but there was representation from emergency rooms, central supply rooms, recovery rooms, intensive care and public health. RNANS Sponsors Institute On Human Relations In Nur!ling Hahfax. N.s. - "Human relations in the health services" was the topic at a two- day Institute held here March 9 and 10. Some 400 registered nurses, representing all areas of nursing service in the Atlan- tic Provinces, attended the institute. which was co-sponsored by the Register- ed Nurses Association of Nova Scotia and Dalhousie University School of Nurs- ing. Dorothy Wiswall, Dalhousie School of Nursing, and Marianne Fightlin, RNANS nursing service adviser, coordi- nated the program. Dr. James Gill. a psychiatrist at Harvard University, opened the sessions. Dr. Gill stressed that in health care it was of utmost importance for all in the health team to care about those involved. 1 Nlm. Pin Dilly 2 Pins (um. nom.' *IMPDRTANT Pilist Iðd 25c per or.r hlndl..'1 Chlrl' on III ordtrs of ] PIns or leu GROUP DlSCOUlns. ð.gg pins. 5"'-. 100 or mot'l. 10% Sind cBsh, m.O., Dr check. No blllinlS Dr tOO'.. Sel-Fix NURSE CAP BAND --,. 81ack wel..et bInd maler,,'. Self-ad L \ hes'...- presses on, pulls on; no sewnn, --... or plnmn,. Reus.ble seweral limes ,.. :}' w :s:2 -I il :' e-:,':st:; ::. 'n- (8 per box), - (6 per box). .- No. 6343 W :f n po W lh desired In Cap B.nd . ..1 bOk 1.65 3 or more 1..40 el. NURSES CAP-TACS .......---:: Remowe Ind refaslen cap band inslantly for launderin, and replaeemenf ' r,ny - - - : r:: :c B :;'. : rl o ' rc :i . wllh Gold Caduceus, or all black (Pram). No. 200 Set of 6 TIcs. . 1.00 per set ' SPECIAL! 12 or mare sels....80 per set Nurses ENAMELED PINS Æb' ) (j Be.utlfully sculptl.lred slltus insllnl'; 2-color keyed. = e:N L I f: I:r ' u::.bKk No. 2O!S Enlmilid Pin. . ....... .1.65 el. ppd. . Waterproof NURSES WATCH O SWISS m.de r.!Sed sll.,er full numer.ls, IUlmn m.rll- . Inp Red-lipped sweep second hand chrom. sl"nless . toiS' Stamless pp,ns.lon Nnd plus FREE black leath.r strap 1 yr IUllanlee. No. 06-925 . " .. .. .. . .. . . .. . 16.50 0'. ppd. Uniform PDCKET PALS Protects a"lnst st'lns Ind wllr_ Plilble white plastrc with lold sllmped clduc.us Two com- p.rtmenls for pel'ls. shelrs. elc. Idll1 token Ilfb orflwrs_ ----, ? I t No. 21 E ! I> for 1.75,10 for 2.70 S.ven 25 or more .25 II ,.11 ppd. Personalized BANDAGE ::: SHEARS _- 6- professional precisIon shelrs. forled In Ilee1. Guarlnteed to Illy Iherp 2 yeln. No. 1000 Sh..n (no Inltl.'s).. .....2.75 e.. ppd. SPECIAL! 1 Doz. Sh..n . . . . . . . . . . . . $26. tatll Inill.11 (up to 3) .Ichld . ., .... .dd SOc plr p.lr " "SENTRY" SPRAY PROTECTOR Protecls you a,.mst wlol.nt m.n or do, . Instanlly d,ubl" .,Ihout perm.nent InJury. No. JD-1& .nh'" 2.211. . nip" I . ORDER NO. I I COLOR QUANr. PR/Cf ITEM I I PIN LEn. COLOR, 0 BI_ck 0 Blue n WhitD (No. 169) I METAL FINISH, 0 Gold 0 Solver INmALS _ _ _ ILm I I 2nd LIne I I enclose S I Send to I I I Street. I 'c;.... :;t... :.... I PI.,se .110. .utllc..n' tlm. for d.llvery. THE CANADIAN NURSE 9 It's Finger-lickin' Good! - ..:-..... ,- ,- . ..-.............- ý ., ..... Colonel Sanders, of Kentucky Fried Chicken fame, celebrated his 79th birth- I day recently during a stay at The Wellesley Hospital, Toronto. H re he cuts in.o a birthday cake appropriately decorated with .a chicken. Look.mg on. tIre, from left: Doreen Nakamura, Mefus Ensor, GlorIa Demessa, AItred Klessl, all of The Wellesley. (Photo courtesy of Wellesley World.) J t , J< JI, .' \I . !if ...." I }: > ..." . " ( - .. .- . .,. '"" .,... ' \or ;0.....; _ . .. ." , ! ..... He emphasized that both nurses and patIents need to know and to talk to each other since illness is a crisis and the nurse must enter into this crisis by listening, caring, and doing. Yet it is essential that, in belonging to this health group, the individual develops a sense of self-esteem and fulfillment, he added. Also discussed at the two-day meeting were the psychological aspects of commu- nication; how well nurses communicate; communication and the delivery of health services; health priorities and the team concept in health care; communica- tions between health services and the public; and communications as a nursing concept. Dr. Gill will return to Halifax on May 20, 1970 for a follow-up of the institute with directors of nursing service, their assistants, and supervisors from the Atlan- tic provinces. MARN Recommends $600 A Month Starting Salary Winnipeg, Manitoba. - The Manito- ba Association of Registered Nurses has recommended a basic starting sal- ary of $600 per month for registered nurses with a diploma, beginning September I, 1970. This recommendation was made in a booklet on employment standards for registered nurses distributed to mem- bers in March. The booklet was also sent to all hospital administrators in Manitoba, 10 THE CANADIAN NURSE \. , - ..,. J t. f r f cI ., tJ . .'" ..t ".'" " ". "," .1> ) .. I i r )\ I . . ... ..' the provincial health department, and the Manitoba Hospital Commission. Basic pay in Manitoba for nurses is now $470 a month, but will increase to $500 in September under collective bargaining contracts signed between four hospitals and nurses' bargaining units two years ago. These agreements were later expanded by the province to include most nurses working in Manitoba. The basis for the $600 a month recommendation was a membership vote at MARN's last annual meeting, which expressed agreement with the national salary goal set by the Canadian Nurses' Association for 1970; CNA recommends the $600 a month basic starting salary. The MARN booklet recommends six yearly increments, bringing the basic pay of a registered nurse to $766 per month in the sixth year of service. The recommended salary for a beginning practitioner with a baccalau- reate degree is $720 per month. Laurel Rector, MARN employment relations officer, said the recommend- ed starting salary "is not necessarily the figure MARN will use at contract bargaining time." Herman Crewson, executive director of the Manitoba Hospital Association, said hospital staffs now under contract will be bound by the present contract - giv- ing $500 a month basic salary in September until the end of the year. RNAO Supports Concept Of Expanded Role For Nurse Toronto, Ont. - Ontario nurses are strongly in favor of an expanded role for the nurse. At the annual meeting of the Registered Nurses' Association of Ontario, April 30-May 2, delegates voted unanimously in favor of a reso- lution that supports the concept of an expanded role for the nurse in the delivery of health care services, "such a concept to be identified, defined, and interpreted by the nursing profession in collaboration with the medical pro- fession. .. The resolution also stated that RNAO would cooperate with other appropriate groups in the development of models for the delivery of health care. Delegates also approved a resolu- tion that directs RNAO to investigate the circumstances under which nurses are asked to assume standby duty, and to propose a fair standard of standby allowance. Several members explained that in many small hospitals nurses who work in areas such as the operating room and the obstetrical department re required to assume standby duty frequently, and receive little, if any, financial remuneration. They pointed out that there are too few nurses in these small hospitals to form nurses' associations for collective bargaining. A resolution to investigate the possibility of setting up an "employ- ment referral service" was defeated by the voting delegates, mainly be- cause other centers in the province already provide this type of place- ment service. Few changes were made in the RNAO's standards of employment for 1971. The main change involved a recommended increase in the mini- mum salary for a registered nurse, from $7.000 to $7,500. The Canadian Nurses'Association's 1970 salary goal for the beginning practitioner from a basic diploma nursing program is $7,200 per annum, and for the be- ginning practitioner from a baccalau- reate program. no less than $8.640. Delegates also approved a recom- mendation that there should be 10 annual increments of not less than $300. The salary proposals called for an additional increment of $600 a Notice Changes of name and address that have been forwarded by the Post Office to the CJ N Circulation Department have proven unreliable in recent months and therefore will no longer be accepted. In future, only changes signed by the member or subscriber will be processed. JUNE 1970 year for a nurse with a university certificate or diploma; $1,200 a year for a nurse with a bachelor's degree; and $1,800 for a nurse with a master's degree. The RNAO's recommended 1971 fees for private duty nurses are: $36.50 for an eight-hour day; $18 for four hours or less; and $22 (for each pa- tient) for shared nursing for eight hours. Friendship Lounge At CNA Biennial Fredericton, N.R. - The Nurses'Chris- tian Fellowship of Canada will have a Fellowship Lounge in the Beaverbrook Hotel during the biennial convention of the Canadian Nurses' Association, June 14-19, where nurses can relax and meet friends. NCF plans include a breakfast and short devotional period in the lounge each day, as well as coffee served throughout the day. After the biennial there will be a national NCF weekend June 19-21 at St. Andrews-by-the-Sea. Brochures and further information will be available at the Friendship Lounge. Give Priority To Members, RNAO President Tells Nurses Toronto, Onto - "Our overwhelming concern for non-member nurses has. . . inhibited our own progress," the president of the Registered Nurses' Association of Ontario, Laura E. Butler, told an attentive audience at the association's annual meeting April 30 to May 2. Speaking of RNAO's problems of low membership, Miss Butler said members must face the fact that com- pulsory membership is not possible in Ontario at this time. She suggested that RNAO members concentrate on the quality and involvement of the mem- bership they do have, and less on non- members. Later in the meeting, delegates defeated a resolution that would have directed the RNAO board to set up a task force to investigate the possibility of initiating compulsory membership or investigating alternatives. Miss Butler expressed concern about RNAO's present financial situation. Admitting that the problem was a real one that could not be ignored, she made it clear that RNAO was not bankrupt. "It is true that the services and struc- tures which our membership has said it wants exceed considerably the fee that membership seems to be willing to pay to maintain them," Miss Butler said. "We can no longer go on," she warned, "even in our credit-oriented society, extendins;!; ourselves in services and projects to which 30,000 members JUNE 1970 committed us and which 13,000 are left to maintain." On the second day of the meeting, RNAO members were presented with details of the association's financial difficulties by president-elect M. Josephine Flaherty, and asked to con- sider a "Course of Action" prepared by the RNAO board of directors, Dr. Flaherty gave these facts: During the 1968-69 fiscal year, it cost $41.50 per member to finance the association's activities; the pre- sent membership fee is $35. The association has had four deficit budgets in five years, even though approved expenditures have been re- duced and unexpected donations re- ceived from various sources. The association has had to eat into its investments and, as a result, the investments have decreased by 35 per- cent - from $404,602 to $263,975 in 1969. To cut expenses, the RNAO's board proposed a "Course of Action," which recommended that the professional development department be made self- supporting; that income relating to publications be increased; that professional librarian services be re- duced to half time; that income from -- -....... "'- :"- ,", '. A rewarding way of life in America's most fascinating city. Let us help you with your immigration papers. Check the areas of interest to you, 1st, 2nd, 3rd. o MEDICAL.SURGICAl 0 SCHOOL OF NURSING o HEMODIALYSIS 0 CORONARY CARE UNIT o OPERATING ROOM 0 INTENSIVE CARE UNIT o RECOVERY ROOM o PEDIATRICS o OBSTETRICS o GYNECOLOGY SALARY RANGES: Staff Nurse with: Staff Nurse in Special care areas with: Diploma $626 to $679/Mo. Diploma $661 to $715/Mo. Degree $643 to $697/Mo. Degree $679 to $732jMo. Plus $80/Mo. Shift differential for eveninas or niahts. For an illustrative booklet and personal response send this coupon to: NURSE RECRUITER Touro Infirmary 1400 Foucher Street, New Orleans, La. 70115 LPN 0 RN 0 Student 0 Nam. Addr... City Provine. , An equal opportunity employer _____________________ THE CANADIAN NURSE 11 news annual meeting registration fees be increased; and that an attempt be made to have the affiliation fees to the Canadian Nurses' Association reduced from $10 to $7. (The resolution rec- ommending that the affiliation fees to CNA be reduced was later defeated.) The RNAO board also proposed that at least two task forces be set up to study and recommend modification of the corporated structure of the asso- ciation and to determine the factors that influence members to remain in the association. A board proposal that received al- most complete acceptance involved an increase of the annual membership fee in RNAO from $35 to $42. Several members pointed out that membership in other organizations and unions demanded much more that the present RNAO fee. A nursing student brought laughter and applause when she :.aîd she would prefer to pay the $42 membership fee when she be- comes an RN, than to join an associa- tion that is so "hung up on fees." No vote was taken on the change in membership fees, as a bylaw must first be amended and approved at a general meeting to permit any change. A spe- cial meeting will probably be held next September, the RNAO president told The Canadian Nurse. Over 2,000 nurses registered for the three-day meeting at the Royal York Hotel. Sessions were well attend- ed, and the evening session had to be moved to a larger room to accommo- date the enthusiastic audience. E. Louise Miner, president-elect of the Canadian Nurses' Association, brought greetings to the RNAO mem- bers on behalf of the CNA. Alberta Nurses Reject Bill To Set Up Nursing Council Edmonton, A/fa. - The Alberta As- sociation of Registered Nurses has rejected Bill 80 - legislation that would have established a province- wide coordinating council on nursing. Following this April 9 decision, the Alberta government. which introdu- ced the bill in the legislature February 27, said it will not bring the bill before the House again. Although the AARN was originally in favor of the bill. which it helped redraft from controversial Bill 119, it claimed that amendments to Bill 80 were not acceptable to nurses in the province. The AARN said the major issue was the setting of standards of licensure for the professional nurse. The asso- 12 THE CANADIAN NURSE P.melists Debate Extended Role of Nurse {. , . .. '" .... .i / -, - . I'" _ '" ... ) - .. . , . I .. ... '""Ii t ' .,/ .., ... j I .. Toronto, Ollt. - Should the nurses' role be expanded, or should a new categor) of worker - the physician's associate - be introduced'! This topic brought frank and sometimes heated comments from both the audience and panel mem- bers during an evening session at the annual meeting of the Registered Nurses' Association of Ontario, April 29 to May 2. The panel. chaired by Verna Huffman. principal nursing officer. Department of National Health and Wel- fare, included, left to right: Dawn Marshall, a nurse clinician; John Sproule, Q.c., a taxpayer representing the community; Verna Huffman; Helen Singer, representing outpost nursing hospitals; Dr. George Wodehouse. a medical practitioner; and Ethel Irwin, a public health nurse. Replying to Mr. Sproule's comment that midwives could help relieve the apparently overburdened physician, Dr. Wodehouse said doctors would wel- come such a helper, but questioned whether women would accept her. Verna Huffman, panel chairman, received loud applause when she said that midwifery is accepted in many other parts of the world, and it would probably be accepted in this country, if "we didn't have so much resistance from the medical profession." A member of the audience said that nursing has shaken the "hand- maiden" role. but it appears that doctors have not. She pointed out that the nurse already sees herself as a "physician's dssociate" - in other words as the colleague and equal of the physician in the work setting. ciation stressed that the control of standards of service must be vested in the organized profession and it feared that the amendments to the bill would identify two standard-setting bodies - the coordinating council and the AARN. "Bill 80 as amended would fragment the responsibility for setting standards of practice for the professional nurse," AARN said. According to the association, Al- berta nurses could not accept the con- cept that a coordinating council on nursing would set standards of licen- sure, when only five members on a 17 -member council were to be ap- pointed by the organized profession. Ontario Report On Healing Arts Recommends Nursing Changes TOrollto, Ollt. - To have more regIs- tered nurses, and more nurses with higher qualifications working in Ontario dre twu uf the aims of the provincial report on the healing arts issued late April 1970. A three-man committee was appoint- ed almost four years ago by Ontario Premier John Roharts to study all aspects of the healing arts. Among the recommendations of the committee concerning nursing, are: . Legislation to aid collective bar- gaining for nurses, providing for com- pulsory arbitration and safeguards to maintain essential services in the event of a strike. This legislation should allow the Registered Nurses' Association of Ontario to act as bargaining agent when requested by the majority of nurses in a given bargaining unit. . Nursing specialties, including mid- wifery and psychiatry. with educational opportunities for personnel in each specialty. . Improvement of salaries and work- ing conditions for graduate nurses. JUNE 1970 . Use of inccntives. salary differen- tials. and other methods to bring back qualified nurses not now practicing. . Continuation of registered nursing assistants as a separate group whose discipline and certification should be removed from the College of Nurse of Ontario. . Better pay for nurse faculty. more space and expansion of programs to encourage enrollment in university de- gree programs in nursing. . Greater freedom for nurses to de- termine their own role. . Organization and financing of more nursing-oriented research. especially into professional roles and relation- ships. . Financing of new schools of nursing under the Ontario department of educa- tion. The Ontario Hospital Services Commission should not finance existing hospital. regional. and special schools of nursing; budgeting should be done it possible through the department of education. In recommending these measures the committee voiced its concern at the high rate of turnover among nurses in the province. where 4.000 or more nurses may be lost to active nursing every year. The committee recommended that the College of Nurses of Ontario should end its control over admission require- ments and curriculum standards to schools of nursing - these should be the responsibility ofthe nursing faculties involved (in cooperation with appro- priate advisory committees). However. the committee believed the College should retain the power to be sclf- regulatory; it should still license nurse graduates and assess the competence of applicants for licensure who have been educated outside Canada. The committee felt all the senior professions in the health field. including nursing. have been given too much power to govern themselves. and re- commended that the provincial govern- ment take a more active role in the functioning of their regulatory bodies. These bodies should have "'a sufficient number of lay representatives to make their presence felt." Senior professions should participate in compulsory programs to ensure continuing competence. which should be made a condition for re-licensure. according to the committee report. The committee also recommended that higher grade medical workers. such as nurses with postgraduate education. be developed to aid doctors in routine tasks. Keep Licensing Functions Separate Lawyer Tells RNAO Members Toronto, Dill. - A contlict of interest is bound to develop when the functions of the licensing body of a profession are not clearly distinguished from those that belong to a voluntary association. a professor of law told members of the Registered Nurses' Association of Ontario, May 2. Speaking at a luncheon at the RNAO annual meeting. Horace Krever. Q.c.. faculty of law at the University of Western Ontario and a member of the three-man Committee on the Healing Arts. said it is totally wrong for the body entrusted by the legislature with the task of protecting the public - by licensing or registration - to become entangled with the interests of the profession it governs. "Most professions now mak.e this distinction." Professor Krever said. "'but in nursing. Ontario is the only province to have seen the light and to have removed from the voluntary association the regulatory functions that are now performed by the College of Nurses of Ontario." Professor Krever gave the nurses his opinion of why the Committee on the Healing Arts recommended that the nursing profession in Ontario be allowed to retain its self-regulatory status. "My the BEST NURSING BOOKS for 1970 come from COLLIER-MACMILLAN CLINICAL NURSING 2nd Ed. Pathophysiological and Psychosocial Approaches By Irene L. Beland, Wayne State University 1,152 pages, $13.95. THE PROFESSIONAL NURSE Orientation, Roles and Responsibilities By Kathleen K. Guinee, Hunter College 175 pages, $5.95 TECHNICAL NURSING OF THE ADULT Medical, Surgical and Psychiatric Approaches By Sandra B. Fielo and Sylvia C. Edge, both at Middlesex County College, Edison, New Jersey 576 pages, $10.95. UROLOGIC NURSING By John G. Keuhnelian, the New York Hospital, Cornell Medical Center and Virginia E. Sanders, School of Nursing, Cornell University. 448 pages, $9.95. BEHAVIORAL COMPONENTS OF PATIENT CARE By John V. Gorton, Teachers College, Columbia University 256 pages. $6.95. Write for catalogue to: COLLIER-MACMILLAN CANADA LTD. 1125 B Leslie St., Don Mills, Ont. BASIC NUTRITION AND DIET THERAPY, 2nd Ed. By Corinne H. Robinson, Consultant in Nutrition Education and formerly of Drexel Institute of Technology 375 pages, $4.25. FOR FULL INFORMATION And be certain to visit our booth at the CANADIAN NURSES CONFERENCE, Fredericton, N.B. June 15-18, 1970 JUNE 1970 THE CANADIAN NURSE 13 news guess is that the recommendations -:vith respect to nurses represent a conscIous act [on the part of the Committee] of expressing confidence in the contribu- tion nursing can make, and to enable nursing to develop a stronger and louder voice when dealing with other profes- sions, hospital administrators, and government," he said. Professor Krever noted that nurses are reluctant to speak up, and said this reticence is observable. He urged RNAO members to speak out frequently and loudly, and to demonstrate that they can assume more responsibility than they are now being given. The Committee on the Healing Arts, Professor Krever explained, is no longer in existence, as its report was submitted to the Ontario government, Tuesday April 28 - four days before Professor Krever addressed the RNAO meeting. The Committee was set up nearly four years ago by the premier of the province to study all aspects of the healing arts in Ontario. RNAO Members Support CNF Toronto. - The Canadian Nurses' Foundation became $520 richer in May, as members of the Registered Nurses' Association of Ontario gave it their enthusiastic support. Over 180 RNAO members became new members of CNF at the association's annual meeting April 30-May 2. Any nurse can become a regular member of CNF - the only national organization in Canada that provides nursing scholarships for higher edu- cation and grants for nursing research - by paying an annual fee of $2. Business firms, corporations, and as- sociations can also be sustaining members or patrons of CNF by paying the required fee for these categories. All donations are tax deductible. Cheques or money orders should be sent to: The Canadian Nurses' Founda- tion, 50 The Driveway, Ottawa 4, Ontario. RNABC Urges Inquiry Into Health Care Financing Vancouver, Be. - The Registered Nurses' Association of British Colum- bia urged in April that a public in- quiry be made into the financing of health care in British Columbia. This was prompted by RNABC's concern about recent developments in the province's health care program, including an announcement by Ralph Loffmark, minister of health, that the 14 THE CANADIAN NURSE provincial government will meet only 70 percent of salary increases awarded hospital employees since January 1. RNABC pointed out that the eight percent increase approved in contracts signed by the B C Hospi als' Ass?Ci - tion and RNABC for this year IS In line with increases granted by the provincial governement to its employ- ees and by other groups. RNABC said that although it sup- ports present efforts to increase efficiency in hospital planning and ser- vice to curb rising costs, it deplores elimination of hospital personnel or reduction in the quality of service to the public as a means of cutting costs. The B C Hospitals' Association has estimated that proposed cost cutting measures would lead to elimination of approximately 1,200 positions in hospitals. Correction An error was made on page 41 of the May issue of The Canadian Nurse. The information given for Miss Kath- leen G. DeMarsh, a candidate for vice- president of the Canadian Nurses' Association, should have read: Kath- leen G. DeMarsh - Saskatoon City Hospital School of Nursing; diploma in teaching and supervision and B.A., University of Toronto; and M.Sc.N., University of Western Ontario. Some Women Suffer "Utter Hell" With Premenstrual Tension, MD Tells OMA Convention Ottawa - Almost all women between 35 and 45 years suffer some premen- strual tension for two or three days, some have it for five to seven days, anJ others go through two weeks of "utter hell," a Montreal gynecologist told an audience of physicians at the 90th annual meeting of the Ontario Medical Association, May 4 to 8. Speaking at the session "Women and Their Curses," Dr. Robert A. Kinch, professor, department of obstetrics and gynecology, faculty of medicine, McGill University, described the woman with premenstrual syndrome as being irrita- ble, depressed, and unable to sleep. He said she often had bowel problems, headaches, and weight gain, but fre- quently did not mention these problems to her physician. "But women do dis- cuss these problems with each other over the bridge table," Dr. Kinch said, and this probably does them some good as they are able to get rid of their feelings. " Dr. Kinch advised physicians to be forward in asking their female patients if they had premenstrual problems. He said that the physician should look into the patient's emotional environment to find out if anything there is making the situation worse, and should listen close- ly to her complaints. Suggesting that premenstrual tension can be heightened by too much social activity, Dr. Kinch said he advises his patients to cut down on the amount of formal entertaining they do in their homes at this time. Dr. Kinch told his physician audience that the edema found in women pre- menstrually responds well to diuretics. Before the session, several women demanding freer abortion laws picketed the OMA registration area in the Châ- teau Laurier. One of their placards read: "Women's Curses are Conserva- tive Doctors." At Press Time. . . Ottawa - A Canadian Press item in the May 13 issue of The Globe and Mail re- ports that the federal government plans to set up a program 10 train "doctor- assistants." The aim of the program, according to CP, is to graduate nurse practitioners who will be able to do many medical procedures now re- served for doctors. The program would be for nurses who work in remote de- partmental nursing stations. The story says that the first appren- ticeship group, probably 20 registered nurses, is expected to receive its spe- cial medical training at one or more universities. Preliminary talks have ap- parently taken place with McGill Uni- versity and the universities of Toronto and Manitoba. The CP item quotes Dr. J. H. Wiebe, director general of medical services, department of national health and welfare, as saying that the target date for the first class is this fall. In a telephone interview with The Canadian Nurse. Dr. Wiebe said that the federal- ly-employed nurses in the north assume considerable responsibility and should be given additional preparation. "We owe it to these nurses to provide them with exposure to the type of experience they will encounter," he said. Dr. Wiebe believes these nurses should have "credit in all ways, includ- ing financially," for the work they do. With the additional training recom- mended, they would receive this cred- it, he suggested. Dr. Wiebe denied using the term "doctor-assistants" to describe the nurses who would receive this additional l reparation. When aske if the decision to estab- lish this special program might set a precedent and enco rage other agen- cies to prepare physician's assistants. Dr. Wiebe said, if this happened it would be a by-product and not inten- tional. 0 IUNE 1970 names ->1010'", Australian Visitor in Ottawa " , - / "-'" .. \ 'f" ... .. -( .. --..... . , ì\ ""'-- -.... -- Winmfred M. Ride, right Nursing Adviser to the Minister of Health in Aust alia, spent.May. 6 at CNA House. Speaking with her is Lillian Pettigrew, aSSOCIate executIve dIrector of the Canadian Nurses' Association. On her three and one-half-month professional tour, Miss Ride visited Hong Kong, Geneva, Switzerland, Denmark, Sweden, Norway, Finland. England, and Scotland be- fore visiting Canada and the United States. Linda R. Long (R.N., Yorkton Un- ion H., Yorkton. Sask.; B.N., McGill U.; M.N., U. of Washington, Seattle) has been appointed associate director of nursing service and director of staff de- velopment at Moose Jaw Union Hospital. Moose Jaw, Saskatchewan. Miss Long has held a wide variety of nursing positions: general staff nurse at Regina Grey Nuns' Hospital; general staff nurse, head nurse, and assistant director of nursing at Y orkton Union Hospital. Yorkton. Saskatchewan; general staff nurse at the Montreal Neurological Insti- tute; supervisor of chest surgery at Saska- toon Sanatorium; night supervisor at Galt Hospital in Lethbridge, Alberta; instruc- tor and associate director of Y orkton Hospital school of nursing; director of Saskatoon City Hospital school of nurs- ing; and adviser to schools of nursing, Saskatchewan Registered Nurses' Associa- tion. Active on many SRNA committees, JUNE 1970 Miss Long has also served as chairman of the board of examiners, and as a consult- ant in continuing education programs. She was a member of the ad hoc commit- tee on nursing education, the committee whose report resulted in the establish- ment of two-year diploma programs under the department of education, rath- er thãn in hospitals. Dorothy J. Kergin has been named di- rector of the school of nursing at McMas- ter University in Hamilton. She suc- . ceeds Abna Reid, who retires next month after 20 years as head of nursing education at McMaster. Dr. Kergin (B.S.N., U. British Colum- bia; M.P.H.. Ph.D., U. Michigan) has had varied experience in nursing service and education. She worked as a public health nurse with the health branch of the British Columbia government in Prince- ton, Kitimat, and Port Alberni; as nursing supervisor with the Aluminum Company of Canada in Kitimat, B.C.; and as a faculty member in the school of public health at the University of Michigan. On her appointment as associate di- rector of the school of nursing and associate professor of nursing at McMas- ter in 1968, Dr. Kergin took charge of public health nursing preparation in the bachelor of science in nursing course. She has also participated in the development of new programs in nursing education and research and in the administration of the school of nursing. Dr. Kergin was a Canadian Nurses' Foundation fellow in 1966-67 and 1967-68. Alma Reid (Reg. N., Toronto Gen- eral H.; B.A., U. of Toronto; Dip\. Teaching, McGill U.; Cert. Teach. and Superv., U. of Toronto School of Nursing) was an instructor in nurs- ing at Cornwall General Hospital, Cornwall, Ontario, and a lecturer in nursing at the University of Toronto and Yale U. before her appointment as director of McMaster's school of nurs- ing. In 1954 MIss Reid was awarded a travel fellowship by the W.K. Kellogg Foundation, and in 1955 she was elected president of the Registered Nurses' As- sociation of Ontario. Virginia Henderson (R.N., Army School of Nursing, Washington, D.C.; B.S. and M.A., Teachers College, Columbia U., New York) has received an honorary Doctor of Laws degree from The University of Western Onta- rio in London. Dr. Henderson is known interna- tionally for her many achievements in nursing. She is the author of a number of important books and pamphlets, and has contributed numerous articles to nursing periodicals. Her Textbook of the Principles and Practice of Nurs- ing, which she and a Canadian nurse - Bertha Harmer - wrote. is consi- dered "The Bible" for schools of nurs- mg. Currently research associate and director of the Nursing Studies Index program in the S ool of Nursing at Yale University, New Haven. Connec- ticut, Dr. Henderson was formerly THE CANADIAN NURSE 15 When your day starts at 6 a.m... you re on charge duty... you've skimped on meals... ,r. and on sleep... 0 you haven't h1f; time to hem -- a dress... make an apple pie... wash your hair... even powder Î your nose ," In comfort...' It's time for a change. Irregular hours and meals on-the- run won't last. BUI your personal irregularity is another matter. It may settle down. Or it may need genlle help from DOXIOAN. use DOXI DAN@ most nurses do DOXIOAN is an elleclive laxative for the gentle relief of conslipation without cramping. Because DOXIOAN con- tains a dependable fecal softener and a mild peristallir stimulant. evacual;on is easy and comfonable. For detaIled informatIon consult Vademecum or Compendium. () rJ9M !jêr 3400 JEAN TALON W.. MONTREAL 301 DIVISION OF CAIliiADIAN HOECHST LIMITED ......- I M"'C ) 16 THE CANADIAN NURSE an instructor and associate professor of nursing education at Teachers Col- lege, Columbia University; clinical director at Norfolk Protestant Hospi- tal School of Nursmg m Kochester, New York; instructor and educational director at Norfolk Protestant Hospi- tal School of Nursing in Norfolk, Virginia; and a staff nurse with the Visiting Nurse Associations in New York City and Washington, D.C. At the request of The University of Western Ontario 20 years ago, Dr. Henderson became involved in the development of nursing education at Western. She has since been involved in many workshops in southwestern Ontario, at Victoria and Westminster Hospitals in London and at Western. M. Helena McMillan (B.A., McGill; R.N., Illinois Training School for Nursing, Chicago) died January 28 in Boulder, Colorado. She was 10 l. A well-known nurse in both Canada and the United States, Miss McMîllan was lady superintendent of the Kings- ton General Hospital, Kingston, Onta- rio, for three years. She was principal, superintendent nurse, and matron of Lakeside Hospital in Cleveland, Ohio, where she organized the hospital's school of nursing - now the Frances Payne Bolton School of Nursing at Case Western Reserve University. In 1903 she founded the Presbyterian Hospital School of Nursing in Chicago. At the American Nurses' Associa- tion convention in 1936, Miss Mc- Millan was awarded the Walter Burns Saunders Memorial Medal for "dis- tinguished service in the cause of nursing." The ANA members were told: "From the beginning of her work Miss McMillan had the concept of the school of nursing as an educational institution rather than as a hospital service. " ..- Adele Herwitz (R.N., Beth Israel H., Boston, Mass.; B.S. and M.A., Teachers College, Colombia U.) has left the position of associate executive director of the American Nurses' Association to take a six-month appointment as executive director of the International Council of Nurses in Geneva, Switzer- land. She succeeds Sheila Quinn of the United Kingdom who resigned to take a position in England. Miss Herwitz has been active in the ICN since 1958. In 1960 she served on a special ICN economic welfare committee, and has been economic correspondent to the ICN from the United States. In 1969 she was reelected to a four-year term on ICN's profes- sional services committee. A former director of the ANA economic security program, Miss Herwitz has held the positions of head nurse at Beth Israel Hospital in Boston; general duty nurse at Veterans Hospital and medical supervisor of Sydenham Hospital in New York City; and captain in the Army Nurse Corps, serving in the South Pacific during World War II. .. :...., ....... '.- .L' Susan McCallum Patricia Parker Several new instructors have joined the faculty of nursing at The University of Western Ontario. Susan McCallum (Reg.N., The Hos- pital for Sick Children, Toronto; B.N., McGill) has been appointed instructor in the faculty of nursing, The Univer- sity of Western Ontario. Mrs. McCallum worked as a staff nurse in emergency and in public health nursing for three years. Patricia Parker (B.Sc.N., U. of Toronto), a new nursing instructor at The University of Western Ontario, has experience in general hospital psychia- tric nursing and public health nursing in the Lambton Health Unit in Sarnia, Ontario. Janet Pfisterer (B.Sc.N., The Uni- versity of Western Ontario) is also a new instructor in The University of Western Ontario's faculty of nursing. Mrs. Pfisterer was formerly an assis- tant head nurse at New Mount Sinai Hospital in Toronto, and worked with the Victorian Order of Nurses in Lon- don, Ontario. Dorothy Rowles (R.N., S1. Paul's H., Saskatoon, Sask.; B.N., McGill U.; M.A., U. of Toronto) has left the position of chairman of the nursing department at Ryerson Poly technical Institute in Toron- to to become executive assistant to the vice-president, academic, at Ryerson. In her new position, Miss Rowles will devote more time to the development of educa- tional changes throughout the institute. Miss Rowles has worked as a matron of two community hospitals in Saskatch- ewan, lecturer in nursing at McGill Uni- versity, and inspector of schools of nurs- ing with the nursing branch of the Onta- rio Department of Health. While studying for her master of arts degree, she under- took a study, "The Ryerson Project," for the Registered Nurses' Association of Ontario. After completing her degree, she was appointed instructor-supervisor of nursing at Kyerson. JUNE 1970 names R. Roslyn Klaiman (R.N., Jewish General H.. Montreal; B.N., McGill U.; M.A., New York U.), has been named chairman of the nursing department at Ryerson Poly- technical Institute in Toronto. Miss Klaiman worked at the Jewish General Hospital School of Nursing in Montreal from 1959 until she joined the staff at Ryerson in 1965 as an instructor. At the Jewish General and Ryerson she was particularly interested in pro- grammed instruction and in new teach- ing techniques. Floris E. King (Reg.N., Toronto East General H.; B.Sc.N.. U. of To- ronto; M.P.H., U. of Michigan; Ph.D., U. of North Carolina) has been awarded a federal health re- search grant of $14.870. She will use this grant to study the utilization of the nurse prepared at the postgraduate level, and relate this to the adequacy of the nurse's educational preparation. In 1968. Dr. King joined the faculty of the University of British Columbia's School of Nursing, where she coordinated the school's master's program. Prior to this, she was program director and nurs- ing consultant for the Canadian Tubercu- losis Association. Dorothy Dick (R.N., Royal Victoria H., Montreal: cert. P.H.N., McGill; B.Sc. and M.A., Teachers College, Columbia U.) has been a i' pointed supervisor ..... of the Planned Nurs- ing Program of the Health Services at Red River Community College, St. James-Assiniboia, Manitoba. From 1964 until her recent appoint- ment, Miss Dick was director of nursing education at Victoria General Hospital in Winnipeg. In addition to general duty experience at the Royal Victoria Hospital in Montreal and The winnipeg General Hospital, she was a staff nurse with the Winnipeg City Health Department, an instructor in the University of Manitoba's School of Nursing, and for six years was clinical coordinator at The Winnipeg Gen- eral Hospital. Miss Dick is president of the Manitoba Association of Registered Nurses, and a member of the board of directors, Cana- dian Nurses' Association. JUNE 1970 . ....0 '1:' uo k.) - -=- For nursing . convenience. . . patient ease TUCKS offer an aid to healing, an aid to comfort Soothing, cooling TUCKS provide greater patient comfort, greater nursing convenience. TUCKS mean no fuss, no mess, no preparation, no trundling the surgical cart. Ready- prepared TUCKS can be kept by the patient's bedside for immediate appli- cation whenever their soothing, healing properties are indicated. TUCKS allay the itch and pain of post-operative lesions, post-partum hemorrhoids, episiotomies, and many dermatological conditions. TUCKS save time. Promote healing. Offer soothing, cooling relief in both pre-and post-operative conditions. TUCKS are soft flannel pads soaked in witch hazel (50%) and glycerine (10%). TUCKS - the valuable nur- sing aid, the valuable patient comforter. '- Specify the FULLER SHIELD as a protective postsurgical dressing. Holds anal, perianal or pilonidal dressings comfortably in place with- out tape, prevents soiling of linen or cloth- ing Ideal for hospital or ambulatory patients. vI'VINLEY-l\fORRISL(:gj, M MONTREAL CANADA TUCKS is a trademark of the Fuller laboratories Inc. THE CANADIAN NURSE 17 Next Month in The Canadian Nurse . Teachers - You're Trespassing! . The Charge - Negligence . New Product Evaluation in Hospital ð Photo Credits for June 1970 Photo Features, Ottawa, pp. 7, 8, 14 Dept. National Health & Welfare. Ottawa, p. 8 Jarvis Studios, Halifax, N.S., p. 9 Toronto Telegram Syndicate. Toronto, p. 12 Roy P. Strable. Photographer, Ottawa, p. 21 Tom Boschler Photography, Hamilton, Ont., p. 30 Terry Pearce, pp. 26-29 18 THE CANADIAN NURSE dates June 15-19, 1970 Canadian Nurses' Association General Meeting, The Playhouse, Fredericton, New Brunswick. June 17-20, 1970 20th annual meeting of the Canadian Psychiatric Association, Winnipeg. For information, write to: The secretary, Canadian Psychiatric Association, 225 lisgar St., Suite 103, Ottawa 4. June 22-July 3, 1970 Conference on administration for gen- eral duty staff nurses, Memorial Uni- versity of Newfoundland. Registration fee: $10. For further information write to the AARN, 67 leMarchant Rd., St. John's, Nfld. lune 22-July 3, 1970 Seminar for senior nursing executives, sponsored by the faculty of nursing, The University of Western Ontario london. Enrollment limited to 75. Course fee: $150; with residence: $300. July 6-10, 1970 Canadian Home Economics Associa- tion, and Canadian Dietetic Associa- tion second joint convention, King Edward Sheraton Hotel, Toronto. Pre- convention workshop at Glendon Col- lege, July 2-4. Educational tOurs and post-convention conference, sponsored by the College of Education, Univer- sity of Toronto, are also offered. Write to Elizabeth Thompson, CHEA and CDA Convention Publicity, 154 University Avenue, Toronto 1, Ontario. July 18-22, 1970 Annual meeting of the Canadian Pedi- atric Society, Fort Garry Hotel, Winni- peg. Write to: Dr. V. Marchessault, executive secretary, Canadian Pedi- atric Society, Department of Pediatrics, University Hospital Centre, University of Sherbrooke, Sherbrooke, Quebec. August 2-7, 1970 Congress of the International Associa- tion for Child Psychiatry, Jerusalem, Israel. Theme: The Child in his Family. Details on group air fare and travel programs are available from Domi- nion Travel Office ltd., 55 Wellington St. West, Toronto 1, Ontario. August 24-28, 1970 Workshop for library staff in nursing, hospital, and medical libraries, spon- so red by the OMA, OHA, and RNAO, Wilson Hall, New College, University of Toronto. Topics to be discussed in- clude administration of a library, col- lection development, organization of library materials, and library services. Applications are available from: Miss S.c. Maxwell, librarian, Ontario Med- ical Association, 244 Sf. George Street, Toronto 5, Ontario. September 1970 14th annual conference on personal growth and group achievement, spon- sored by the Registered Nurses' Asso- ciation of Ontario. Write to: Pro- fessional Development Department, RNAO, 33 Price Street, Toronto 5, Ontario. September 10-12, 1970 Convention of the Canadian Society of Extracorporeal Circulation Technicians and the Ontario Dialysis Association, Park Plaza Hotel, Toronto. More in- formation can be obtained from Mrs. Nancy Reid, Chairman, Convention Committee, Ontario Dialysis Associa- tion, Sunnybrook Hospital, 2075 Bay- view Ave., Toronto 12, Ontario. September 14, 1970 American Academy of Medical Admin- istrators, 13th annual convocation, luncheon and reception, Hotel Sonesta, Houston, Texas, U.S.A. Write to: Amer- ican Academy of Medical Administra- tors, 6 Beacon Street, Boston, Mass., 02108. September 28-0ctober 9, 1970 Symposium in respiratory disease and tuberculosis nursing, Winnipeg. Or- ganized by Miss E.l.M. Thorpe, Chair- man, Ad Hoc Steering Committee, nurses' section of the Canadian Tuber- culosis and Respiratory Disease Asso- ciation. For further information write to Miss Thorpe, Consultant, Sanitorium Board of Manitoba, 800 Sherbrook Street, Winnipeg 2, Manitoba. October 7-10,1970 Annual conference, Canadian Associa- tion for the Mentally Retarded, Hotel Vancouver, Vancouver, British Colum- bia. Special emphasis will be on the preschool child, residential services, and occupational-vocational programs. October 26-28, 1970 Annual meeting of the Association of Registered Nurses of Newfoundland, St. John's. Write to the AARN, 67 le Marchant Rd., St. John's, Nfld. 0 JUNE 1970 in a capsule Catchy heads How often have you read an article in a newspaper or magazine because of an unusual headline - one that raised a provocative question, made you chuckle, or baffled you? Your curiosity was aroused. so you had to read on. This is the art of headline-writing. For example, the following newspaper "head" caught our attention: "Canadian Medical Brains Stay Home." What does that mean? It's obvious. of course - Canada is now losing less medical brainpower to the United States - but not until after you read the first paragraph. And once you get that far, chances are that you'll keep going. The originality for this partic- ular head came from the Sault Ste. Marie Star, Sault Ste-Marie, Ontario. Then we came across this headline: "You'll join STOP THAT- after you have read this." In case you don't know what STOP THAT stands for, it's the Society to Stop Proliferating Those Horrible Acronymic Titles. According to an article in the March 7 issue of Editor & Publish- er, a New York newspaper reader. fed up with seeing long names condensed into capsule terms, attempted to STOP THAT popular practice. The next time you're mystified by a CNJ, CP, ETC CAP-tion. take the Editor & Publisher's advice and resign yourselves to becoming ACORNS - Acronym- Oriented Nuts. Females driven home The problem of night safety for nurses was examined in an article in the Feb- ruary issue of The Canadian Nurse. This question has since received attention in newspapers. The Gazette asked: "Ladies, do you know what you should do to walk in safety on streets at night?" This story gives young women a Montreal police ser- geant's advice on safe travel at night. One of the suggestions was "Stay on well-traveled, well-lit streets, walk- ing near the curb..." And another: "Take a good look for loiterers before entering a poorly-lit street." Ladies were also advised not to "go to cocktail lounges alone at night, and to refuse the overtures of the over-friendly man." Progress is being made to give women much-needed protection at night. The Alberta cabinet has passed regulations, effective June I, that re- quire Alberta employers to provide JUNE 1970 transportation to and from home for female employees who must leave or go to work between midnight and 6:00 a.m. It is good to see that governments, as well as female employees, are aware of the dangers of loitering in the dark. Don't overdo it These days you don't have to look very far to find advice on how not to get heart disease. Of course, the chances are good that you might have to give up your favorite foods, trade in your car for a bicycle, and leave your job and head for the nearest uncivilized island - if you want to remain hearty. Although much of this advice comes from doctors, the doctors themselves talk as though they don't necessarily want to follow it. For example, a Globe and Mail news item quotes Dr. R.L. MacMillan of Toronto saying that he would give "a couple of years for a good bordelaise sauce and steak." Then there was The Canadian Press report of a talk by Dr. Richard Bates from Lansing, Michigan. He told the Canadian Club in Toronto: "It profits a man very little. " if he has never felt the soft glow of drunkeness, the joy of an after-dinner cigaret, the plea- sures of illicit love." Even if a person drank in modera- tion or not at all, did not smoke, exer- cised 20 minutes a day, got regular medical checkups, and had normal blood pressure and low blood choles- terol, his chances of reaching 100 would only be I in 100,000, Dr. Bates said. And he added: "I'm not going to try it. Once you're that old all the joys are gone. After 40, half your taste buds are gone. Peanut butter tastes like library paste." 'I \ I I I r 1/ ß /" ' / \\ /' _ \ \ Ul VI JI S1J,ll . ,r== li li I 1 1[[1 I t., 1 " t . f\ 1= \ . lIt' _ L f: I T K\\ I J:: '\ , 1 ( , I. -". I - l.':> ' ' '- ' .' t eNA .,.. - .. L\BRAR'Ý --," .' \ ' , ' f CI Î , - ... I !- L' [ \ c;;; .&.. . "My Area of Interest Is..." Never let it be said that everyone who friend, who spent their time in the visits the library of the Canadian library looking at each other over their Nurses' Association is interested only books, signed their "area of interest" in books. As proven by the library in the register as "my boyfriend" and register, romance can rival reading in "my girlfriend.... AQ we thought the this library. only dates the hbranan saw were on One nursing student and her boy- overdue books! THE CANADIAN NURSE 19 Pinworms can be a problem . ere. """ .... . , . . .. , " .. ... \ ... J , - ...... 41 _4- ........ - '- ,. ..".'....... ....... '\ ... ....... . CVA UI (pyrvinium pamoate, P. D. & Co.) PARKE-DAVIS Parke, Davl. & Company, Ltd., Montreal 379. .. - .. .... .. 6'" ..::. 't. ..,.. .. , . .,,:'- , ""'-1.- , f .' . ..'..: .. '\ .... '-. - -- " )" .. .. '- .. ..... ..... .. '- :i- ...... '0(' . ... Pinworms may spread in any family, at any time. Usually a single dose of VANOUIN is effective for eradication of pinworms. Therapy is well tolerated, economical. and convenient. VANOUIN Suspension or VANOUIN Tablets provide a convenient dosage form to administer to patients of virtually every age... from grandchild to grandmother. Dosage: Children and adults, a single oral dose equivalent to 5 mg. per Kg. body weight. This is approximately equivalent to one 5-cc. teaspoonful of VANOUIN Suspension or one VANOUIN Tablet for each 22 pounds of body weight. Precautions: Tablets should be swallowed whole to avoid staining teeth. Pyrvinium pamoate will stain most materials. Stools may be coloured red. Side Effects: Infrequent nausea and vomiting and intestinal complaints have been reported. How supplied: VANOUIN is available as a pleasant-tasting, strawberry-flavoured suspension in 1-oz. and 2-oz. bottles; and as sugar-coated tablets in packages of 12, and bottles of 25 and 100. V ANOUIN Suspension contains the pamoate equivalent of 10 mg. pyrvinium base per cc. Each VANOUIN Tablet contains the pamoate equivalent of 50 mg. pyrvinium base. Detailed prescribing information available on request. JUNE 1970 OPINION Let's have permanent shifts Nursing administrators should allow nurses to work onlv one shift rather than having them rotate through all three shifts. The permanent shift has administrative advantages, advantages for the nurse and, most important, it has advantages for the patient. Helen Saunders, B.A., B.A.Sc. (Nursing), M.N. , The ratio of acutely-ilI patients to the less ill on each nursing unit continues to rise in general hospitals. Nursing care is be- coming increasingly complex and de- mands more specialized skills. To provide this skilled nursing care. hospital staffing policies and practices need to be reas- sessed. I submit that staff on pennanent shift. as opposed to continual rotation to all shifts, is one policy that would improve the health and job satisfaction of the hospital general duty nurse, increase sta- bility and efficiency in nursing adminis- tration, and make possible a more consis- tent level of patient safety and care on all shifts. The term "permanent shift" may not convey the same meaning to alL In this article it means that a person is employed to work on the shift of her choice - steadily, without rotation to the other two shifts. Permanency of shift should be temper- ed, however, with common sense. For example. a new nurse should be required to have a thorough orientation to the hospital and the nursing service unit on whIch she will work. This should be given on whatever shift it can be given best. . ....... Miss Saunders, a graduate of The Vancouver General Hospital, the University of British Columbia, and the University of Washington, is presently lnsetvice Education Supetvisor at the Royal Jubilee Hospital, Victoria, B.C. -\s well, each nurse should be assigned to the other two shifts for about one week every six months. This would keep her aware of the 24-hour care given in her unit, of the differences and similarities in the pace of work, and the administrative problems of the staff on each shift. With these two conditions realized, permanent shift offers nothing but advan- tages. Advantages for the nurse Permanent shift can have sociaL educa- tional, psychologicaL and health advan- tages for the nurse. To begin, the nurse would be able to choose the shift that best fits her personal and family life. She would be able to take part in sports groups or teams, hobby groups, community organizations, church activities, professional association work - in fact. in all social activities that require fairly constant attendance to maintain active membership. It is impossi- ble to keep up many social activities while on a continually rotating shift. For nurses who are also mothers. baby-sitting arrangements could be stable and would not have to be constantly rearranged every few weeks, sometimes on an irregular basis. Permanent shift would not only simplify the baby-sitting problem for parents. but also would surely benefit the ""dren. For nurses who wish to continue their education while working. permanent shift THE CANADIAN NURSE 21 makes it possible for them to take courses. The day nurse can sign up for an evening course, the evening or night nurse can take day courses. No one can take any course - and attend all classes - if she is perpetually rotating shifts. Even on-the-job inservice education courses tend to be less effective when each class in a series is attended by different individuals because of shift rota- tion. Permanent shift also offers psychologi- cal advantages by giving each nurse a feeling of belonging to an area of respon- sibility that is hers. Rotating shifts cannot do this, any more than assigning a nurse to "float" to all units can give her a sense of belonging. Some nurses are psychologically suited to one shift more than to another. They are happier, feel better, and work better on a shift that suits them. And it isn't always the day shift that is preferred. Evening and night shifts appeal to some nurses, at least for a while, for the opportunities they offer for added re- sponsibility, exercise of initiative, and professional growth. Research on the physiological effects of continual adaptation to different hours for sleeping, eating, and peak mental and physical activity in a 24-hour period show damage to health. A basic rule of health is: maintain regular hours for sleeping and eating. Although working and eating by day and sleeping at night is the pattern most people follow, studies show we can adapt to other patterns, without harm, provided we are given the time needed to adapt and provided the new patterns are con- stant. Advantages to administration Supervision of nursing service and administration of the hospital on evening and night shifts would be easier with staff on permanent shift. Permanent shift staff would gain the knowledge and experience needed to ease the burden of supervision of the evening and night supervisors. A permanent evening or night nurse on a unit can gradually assume a great deal of responsibility for patient care and she will also know more of the administrative problems of her shift and how to handle them. Because she can develop her own organizational plan, the pennanent shift nurse will become the master rather than the slave of routines and thus can spend 22 THE CANADIAN NURSE more time in patient care. The nurse on a rotating shift, on the other hand, will fmd herself needing time to readjust to rou- tines and will have little authority to work out her own plan for patient care on her brief shift assignments. Permanent shifts would obviate the need to put a new staff member on the evening or night shifts within a few days of her arrival on the unit to fill a vacancy in the shift rotation. On many units, shift rotation becomes as inexorable as death or taxes. An objection sometimes raised to per- manent shift concerns the problem that head nurses would have in trying to evaluate performance of permanent eve- ning and night staff. The answer to this objection is that it is easier for evening and night supervisors to know the staff on their shifts as individuals and to judge the quality of care given when the nurses are on permanent, rather than rotating, shift. Alternatively, it would be good for patient care as well as staff evaluation if the day supervisor or the head nurse of the unit occasionally worked an evening or night shift. This would give her the opportunity to assess the nursing per- formance and care given on these shifts. Surely evaluation by the above two methods is more valid than that of a head nurse assessing the evening and night performance of a rotating staff based on her knowledge of how the individual functions on days! Success of team nursing depends to some extent on how a group works together as a team. One of the greatest obstacles to team spirit and efficiency is a constant change of team members and team leaders. Mandatory rotation of staff obviously compounds this problem. On day shift, patients on a unit usually are divided under several team leaders, and one team may not know the patients of another team. When the team member moves to another shift where she is required to know all the patients, the problem is made worse. Advantages to the patient Pennanent shift also enhances continu- ity of patient care. When shifts constantly rotate, no nurse is responsible for a patient on anyone shift for longer than a few days at a time. This situation con- fuses and upsets patients and relatives, infuriates doctors, and is most frustrating to nurses. Patients - and their relatives - like to get to know their nurses, to have, for example, the security of knowing who will come if they wake up at 3 :00 a.m. Permanent shift would help to lessen the number of complaints that "I never know who my nurse is." Every hospital wants to provide a safe level of care for patients on all shifts, but do we do this? To rotate all general duty nurses in turn to take charge on evening and night shifts - regardless of their experience or their own need for guid- ance and teaching - does not assure a safe level of care on these shifts. Some hospitals with schools of nursing still rotate students to take charge on evening and night shifts. The time-honor- ed nursing myth militates against chang- ing this pattern because "this is the best way to learn how to take responsibility." Even if there is truth in this belief, what about the safety of the patient during this supposed learning process? What about the patient's side of the question when there is continual rotation of nurses, each "learning the hard way"? If students must go on the night shift to learn, then even one experienced, permanent shift nurse in charge would ensure greater safety to patients and still allow for increased responsibility, with guidance, for students or inexperienced graduates. Staff on permanent shift would have to understand that in emergencies they might be called to replace another nurse on another shift. However, if this were for only one or two shifts or until regular relief could be employed, most nurses would be willing to accommodate the needs of the unit. Any nurse wishing to change from the shift for which she was employed could ask for a transfer, just as she might ask for a transfer from one nursing unit to another. But at least she would have the oppor- tunity to benefit from the advantages of permanent shift. And so would her patients. 0 JUNE 1970 Prinzmetal's variant angina . . I n a coronary unit Early recognition of this abnormality by nurses in a coronary unit can lead to appropriate treatment and a lowering of the mortality rate in acute coronary disease. Sharon Dolman, Cynthia Paget, and Jean Walkden In 1959 Printzmetal described a variant form of angina) This consists of cardiac ischemic pain that occurs at rest and is accompanied by an elevation of the S-T segment of the electrocardiogram, rather than a depression of the S-T segment. which usually accompanies cardiac ische- mic pain. Changes in the electrocardio- gram that he described were frequently confused with those of acute myocardial infarction. but between the attacks the electrocardiogram returned completely to nonnal. Because of the transient nature of the changes, such patients are hard to rec.og- nize. With the availability of continuous monitoring in coronary units, the disor- der may be recognized more easily as shown in the following patient history. The tracing obtained on the monitor approximates Lead I. Patient history A 46-year-old man who had previously been welI came to the emergency depart- ment of the Toronto General Hospital following three episodes of severe squeez- ing pain in the anterior part of the chest. Mrs. Wa1kden is Head Nurse of the Coronary Unit, Toronto Genera] Hospital. Mrs. Dolman and Mrs. Paget are fonner staff members of the Unit. The authors express their appreciation to Dr. R.L. MacMillan and Dr. K.W.G. Brown, Directors of the Coronary Unit, for assistance in producing this article. JUNE 1970 The pain had radiated to the neck, jaw, and left ear. The attacks were similar in severity, each had occurred while the patient was at rest, and had subsided spontaneously after 5 to 10 minutes. The pain was associated with sweating, but there was no shortness of breath. These attacks had occurred approximate- ly two days apart the week preceding admission. There was no significant family history of heart disease. The patient had smoked 15 to 20 cigarettes a day for 25 years. On examination, the blood pressure was 170/105 and there were no other abnonnal physical findings. The first elec- trocardiogram, taken a few minutes after the third attack of pain had subsided, showed elevation of the S- T segments in leads II, III, and a VF . * The T wave in lead 1 was flat. The diagnosis was consid- ered to be acute posterior myocardial infarction and the patient was transferred to the coronary unit. The next electrocardiogram, taken I I hours after admission, showed a return of the S- T segments to the baseline with a negative T wave in leads [ and aVL. *The following designations are used for augmented unipolar leads: a VF - when the positive termina1 of the electrocardiograph is connected to the left foot; aVR when the positive tenninal is codDected to the right arm; and aVL - when the positive tennina1 is connected to the left arm. THE CANADIAN NURSE 23 The Electrocardiogram .04 sec - R 1 t v. T p S I O. m Normal electrocardiogram tracing During each contraction of the heart, a pattern of electrical activity, known as the electrocardiogram (ECG) can be recorded. The letters P,Q,R,S, and T are used to denote the differ- ent waves that make a single heart beat. It is the spread of the electri- cal impulse to different parts of the heart muscle that produces the char- acteristic wave form of the healthy heart. The P wave is the first deflection in the tracing and is due to the spread of electrical activity throughout the atria. R It is followed by the QRS complex caused by excitation of the ventricles. The T wave reflects recovery of the ventricular muscle following stimu- lation. The (R-T) or S-T segment begins at the end of the S wave and runs along the baseline until the be- ginning of the T wave. Character- istically this segment is depressed be- low the baseline if the blood supply to the heart muscle becomes temp- orarily inadequate, for example, in an individual during the pain of angina pectoris. R Figure I. Segments of monitor record taken at intervals of two minutes. Elevation of R-T Segment shown in B preceded chest pain. which di not occur until C(2 minutes later}. Maximum pain occurred 4 minutes after onset of ECG changes. E and F show return of R-T segments to normal, as pain subsided. R A B C R R kJJJ D E f 24 THE CANADIAN NURSE JUNE 1970 Shortly after this another attack of pain occurred, accompanied by elevation of the S- T segments on the monitor tracing. The changes subsided with the disappear- ance of pain. On the monitor, three more transient elevations of the S-T segments occurred during the next 12 hours. The first occurred during sleep and lasted only three minutes. The patient did not wake up. During the second episode, the pa- tient was awake. The S-T segments be- came elevated one minute before the patient experienced pain (Figure 1). This time the elevation persisted for five min- utes and again returned to normal. Twenty-four hours after admission, the S- T segments again became elevated while the patient was sleeping fitfully. When he awoke, he complained of slight pressure in his chest. The discomfort persisted over the next four hours, culmi- nating in a very severe, crushing type of pain that required morphine gr. 1/6 on two occasions for relief. When the pain subsided, The SoT segments again returned to normal. Frequent ventricular premature beats were noted on the monitor record and an anti-arrhythmic agent, procainamide hydrochloride 500 mg., was given by intramuscular injection. The next day, his third in hospital, the patient remained comfortable. The day following, however, a short burst of ventricular tachycardia occurred for 15 minutes, accompanied by more chest pain that again required morphine. This time the T waves were inverted in leads I, aVF, V 2 -V 5 .** These changes persisted **Y, to Y6, the precordia1leads, designate the six standard positions on the chest where the ECG leads are placed. JUNE 1970 and the diagnosis of anterior myocardial infarction was made. One week later, signs of mild left ventricular failure developed with rales being heard over the lung bases. These changes disappeared following an injec- tion of Thiomerin (a mercurial diuretic) and daily dose of Lasix (a diuretic). Q waves appeared in leads I, a VL, V 3- V 5. The remainder of the convalescence was uneventful and the patient was discharged home four weeks after admission. Discussion Eleven days after the onset of tran- sient attacks of cardiac ischemic pain, this patient developed a proven anterior myo- cardial infarct. Following admission to the coronary unit, continuous monitoring enabled the staff to determine that the patient was suffering from Printzmetal's variant angina. It would have been diffi- cult to make such a diagnosis in an ordinary hospital setting. The electrocardiogram reverted to normal shortly after each attack. As the staff realized that Prinzmetal's angina may herald the development of an estab- lished infarct, they watched the patient carefully and gave him intensive nursing care. Transient elevation of the S- T segment occurred during sleep; the pain was not sufficient to wake the patient. On anoth- er occasion the electrocardiographic changes preceded the onset of pain. This has been previously reported. 2 Following the development of a proven myocardial infarct, ventricular irritability was noted on the monitor record with a short burst of ventricular tachycardia. This was promptly treated with procainamide hydrochloride. Mild signs of heart failure also appeared and were recognized promptly. Diuretic thera- py produced a good response. Summary Continuous monitoring of a patient with repeated episodes of chest pain revealed transient elevations of the SoT segments on the electrocardiogram and enabled the nursing staff to assist in the diagnosis of variant angina. The electro- cardiographic changes may precede the onset of pain. The recognition of this abnormality reflects the close nursing supervision avail- able to patients in a coronary unit. Appropriate treatment may contribute to a lowering of the high early mortality in patients with the symptoms of acute coronary disease. References l. Prinzmetal, M., Kennamer. R., Merliss, R., Wada, T.. and Bor, N. Angina pectoris. A variant form of angina pectoris. A mer. J. Med. 27:375, 1959. 2. Lunger. M., and Shapiro, A. Continuous electrocardiographic monitoring in noctur- na1 angina. A mer. J. Làrdiol. 13: 119. 1964. o THE CANAUIAN NURSE 25 - .... ."""'" _. ..r ì .. ". ) - .JI< - - , _u -=:. -- ..... I ': ;. ,. , ... '- 't ,V , t' { , 't þ . - "- . . \ ' ..... .\ ., .\ 4W1".\.. \ .! .. þ"', .. ( '\\ .. þ- Nurse on James Bay I . - Once a week, nurse Nancy Leach travels with her guide-interpreter, John Nakogee, from Port Albany on the west coast of James Bay up the Albany River to the small Indian village of Kasheshewan. The first call is "Halfway Place," where about four Indian families live in a small clearing beside the river. Reprinted with permission from north, vol. 16, no. 5, Sept. - Oct., 1969. 26 THE CANADIAN NURSE . .. I v .1 , " .--,-1''' ,; t: X . . ' ... ,., .:t' " ' -,,. >,' .._1 01" ". t,,-co ,... , .: .1Ii< "'3 ' .... ., ... f, =='- t. r- .... "I.. ::..J-I . - J" '. ' .' ,... . ''1'. J ,... . t ;.-- ,." . " . . ..... . 'þ '"L : .- , '" _ 4: . .. .. JI!o::! . ''!' '0\0 J"". , ' .' .,...... Terry Pearce , · & :;;.r.:-. ' .. - .. - 1: .r- J -r. , ' .... " . l' :.- - S- ....... f.iI.. ,"t :., fA ,%';'t. ,'", -Ii 10" .:: . I' . .. , A .,-.3 .. '.' .. . ... ,)-. .. ,:siJ!'1. / '" , .. I of I f . .. .. .. \ V '-... * a{ .." "..c.. .- . '": .... .:.. .:-r ,.. ",- ... ': ,. :ÿ ft.... --r. . .,. ,.' ... , . ... i' .l':" 7t: . '. 11'" ., "'" .-...... . .... ,-: . t . .;;.\ '":.'7-. ' I .... I. ._ .JIiiiii \. ... ... .... ... -j oIIt.. .-"" ...... , JUNE 1970 .............., "'" - c , ,) I to \ \. "- þ 1/ I . ........ -- w- e " " ,-" , . -, - - ... t .. I .. 4A . ,. " , , to ... Miss Leach gives members of a family a medical check, then talks through John Nakogee about beaver skins and the weather , t , "\ She spends time with Maggie Nishinapay, takes her temperature and blood pressure, and promises to call on the way back with pills from the clinic at Kasheshewall. JUNE 1970 o / 'I \t ' , . : . . . , . . " \ 1 .. Sensltlsed mast cells. disrupted after antigen challenge .. 4 "'*' t Mast cells sensitised and challenged, but protected with INTAL They are substantially intact Intal defends against asthma attack INDICATIONS Bronchial asthma. ADMINISTRATION INTAl shows significant clinical effect only when administered by inhalation. The drug is supplied in a single dose cartridge, which is administered by a specially developed insufflator, the Spinhaler. Each cartridge contains 20 mg. disodium cromoglycate (INTAL) in ultra-fine powder form, with lactose B.P. as a carrier. DOSAGE-ADULTS AND CHILDREN Initial treatment-one cartridge four times per day. In more severe cases, and during periods of high challenge. the dose may be increased to eight per day (one every three hours). It is important that the patient should appreciate that INTAl is not intended to provide symptomatic relief in acute attacks. Maintenance therapy-when adequate response has been obtained, the frequency of inhalations may be reduced to three or even two cartridges per day. Patients should be warned against suddenly discontinuing therapy when symptoms have been partially or completely controlled by INTAL. CONCOMITANT THERAPY Other asthma medication should be continued until clinical improvement with INTAl permits a pro- gressive reduction in their dosage. INTAL therapy alone will often control symptoms of moderately severe asthma, especially in children and young adults. In severe asthma, particularly in older patients, INTAL therapy alone may be insufficient to control symptoms. In a proportion of such cases, significant improvement can be obtained by combining INTAL with corticosteroid therapy. In steroid-dependent patients, the addition of INTAL therapy to the regimen often permits a slow, progressive and significant reduction in the maintenance dose of steroids. The dangers of sudden withdrawal or reduction of corticosteroids are well recognisecJ. particularly in patients on long-term administration. For full details of steroid dosage during INT AL therapy, please see the INTAL prodUct literature or packing leaflet. WITHDRAWAL OFINTAL Continuity of therapy is important in patients whose asthma is controlled by INTAL. If for any reason I NT AL is withdrawn, a suggested regimen is the progressive reduction of dosage over at least one week. It should be borne in mind that symptoms of asthma may recur when INTAL is discontinued. SIDE EFFECTS No serious adverse effects attributable to INTAL therapy have been reported. Transient irritation of the throat and trachea has been the most frequently reported reaction, particularly following local infective episodes. There has been a small number of cases of an erythema or urticaria of the face. In each case the rash disappeared within a few days of withdrawal of the drug. At the beginning of INTAL therapy, in a small proportion of cases, transient bronchospasm follows the inhalation of the dry powder into hyper-irritable airways. It has been found that this effect, should it occur, may be minimised by the prior inhalation of a bronchodilator aerosol. CAUTION Teratogenicity experiments in animals have indicated that the use of INTAL in humans is unlikely to carry teratogenic risks. Nevertheless, as with any new drug, it is advisable where possible, to avoid its use during the first trimester of pregnancy. PRESENTATION INTAL cartridges are supplied in bottles of 30. Spinhaler turbo-inhalers are supplied in individual containers. STORAGE Important: INTAL cartridges should be stored in a cool dry place. Further information on INTAL is available from Fisons (Canada) Ltd, 26 Prince Andrew Place. Don Mills, Ontario, Canada. Telephone: 445-5700 FISONS I NT AL is a trade mark of Fisons Ltd.-Pharmaceutical Division. Loughborough, England I nta I @ J_\ ( =: J Printed in the United Kingdom INT/CAN/J1 LQ. .. Joseph is a 19 year-old high school graduate who works as a shoe clerk in a large department store. He has no family. Harry is a 35-year-old farmer, a father of two teenage girls. Brian is a 28-year-old accountant whose wife is pregnant with their first child. These three men have at least one thing in common: each has been diagnosed as having Hodgkin's disease. This disease is eventually fatal, yet with treatment, remissions may last from 5 to IS years. The nursing care required by these patients is in many ways similar; however, the needs of each patient differ. To formulate a plan for nursing care, the nurse must understand the person who has the disease, the disease process itself, and the therapeutics involved. The di t'a e Hodgkin's disease, the mildest form of the lymphomas, is divided into three classifications: Hodgkin's paragranuloma, Hodgkin's granuloma, and Hodgkin's sar- coma. Four clinical stages have been defined to indicate the severity of the disease. This clinical staging can be used for any lymphoma. Stage / - Disease limited to one anatom- ic regIon or to two continuous ana- tomic regions on the same side of the diaphragm. Stage 1I - Disease in more than two anatomic regions or in two non- ,UNE 1970 Three patients with Hodgkin's disease Each patient reacts differently when he learns he has a disease with a poor prognosis. This individual reaction must be accepted and understood by the nurse if she is to help him. Marion 'ackson, B.Sc.N. continuous regions on the same side of the diaphragm. Stage II/ - Disease on both sides of the diaphragm, but not extending beyond involvement of lymph nodes, spleen, or Waldeyer's ring. Stage /V - Involvement of bone mar- row, lung parenchyma, pleura. liver. bone, skin, kidney, gastrointestinal tract, or any other tissue or organ in addition to lymph node involvement. Hodgkin's paragranuloma has a relati- vely good prognosis for life expectancy and therapeutic response. Hodgkin's gran- uloma is less benign, but not a highly malignant disease. With early treatment, therapeutic remissions have lasted from 5 to 15 years. Hodgkin's sarcoma is highly invasive and rapid in growth. Symptoms and findings Often the patient seeks medical advice when he discovers enlarged lymph glands. Fever, weight loss, excessive sweating, pruritis, and fatigue are other symptoms that may persuade him to seek medical advice. Respiratory difficulty may be a Miss Jackson, a graduate of the University of Saskatchewan School of Nursing, has been employed as a Clinical Instructor at both the Toronto Westem Hospital and the Regina Grey Nuns' Hospital. She is presently Director of Medical Nursing at the University Hospital, Saskatoon, Saskatchewan. complaint if mediastinal nodes are involv- ed. Physical examination reveals lymphat- ic nodes that are firm, non-tender, and of various sizes. Liver and spleen may be enlarged. Laboratory findings indicate lymphopenia and eosinophilia. Lymph node biopsy confirms the diagnosis. More sophisticated diagnostic procedures, such as inferior vena cavagraphy, lymphangi- ography, liver and renal function studies, lung tomograms and splenic scan, indicate the degree of involvement and further manifestations of the disease. Late complications of the disease include hemolytic anemia. intractable itching and fever, respiratory difficulty, superior vena cava obstruction. and pleu- ral effusion. In Hodgkin's sarcoma, the glandular enlargement may be painful and tender. Treatment The objectives of treatment are to halt the growth of malignant cells, to compen- sate for any damage caused by pressure from the growth, and to provide sympto- matic relief from discomfort and pain. The method of treatment depends on the clinical stage of the disease. Radio- therapy to the localized glandular enlarge- ment may be used, generally over a four-week period. THb treatment is usual- ly reserved for specific symptoms or complications. THE CANADIAN NUK 3] Chemotherapy has been used with a degree of success in treating Hodgkin's di eJse. Although there are many chemo- therapeutic agents available, only the more commonly used drugs will be dis- cu sed here. Nitrogen Mustard: The usual dose is 0.4 mg. per kilogram of body weight, given intravenously in divided doses. Because of the nausea and vomiting caus- ed by this drug, it is often administered late in the day after a light lunch and no supper. Antiemetics may be used to control the nausea and vomiting. The patient usuaIly shows improvement in one to three days. If there is no bone marrow depression, the treatment may be repeated every two months. /.cukeran (chlorambucil): May be used as a maintenance drug three to six weeks foIl owing nitrogen mustard therapy. The usual oral dose is 0.2 mg./kg.. given in divided doses foIlowing meals. Improve- ment may not occur for three to four weeks. with the maximum effect seen in two to four months. Since the : is d::nger of bone marrow depression, weekly blood counts are taken. Cytoxan (cyclophosphamide): The usual dose is 2-3 mg'/kg., given intra- venously daily for six days. This is foIl ow- ed by 50 to 100 mg. oraIly, one to three times daily as a maintenance dose. With this drug there is a high incidence of alopecia. The patient should be forewarn- ed of this possible side effect. Other antineoplastic agents in use in- clude Velban, Alkeran, and Thiotepa. Further treatment is supportive, pro- tective, and symptomatic in nature. Nursing care Skin care is given frequently, using tepid water. non-irritating soaps, and soothing lotions to combat fever, exces- 34 THE CANADIAN NURSE sive sweating, and pruritIs. Sometimes medications are ordered to relieve these symptoms. Nutrition is most important for the patient who is losing body fluid through excessive sweating. Since he may be fatigued and anorexic, the nurse may have to assist him with his meals. Foods should be high in caloric value. The nurse prepares the patient for diagnostic and therapeutic procedures and in many instances stays with the patient as these are carried out. She also assists with his rehabilitation and conva- lescence, teaching him the importance of his foIl ow-up care. It is easy to indicate the physical nursing care required by the patient. Much, however, depends on how it is carried out and on how the patient, his family, and the nurse react to the disease. The unique role of the nurse is to support the patient - to help him con- tend with the problems that arise because of his disease. Many of the diagnostic and therapeutic regimes are most uncomforta- ble, but if the patient knows that the nurse understands how he feels, he is better able to cope with the situation. The nurse's relationship can be vitaIly important to him. She is the one who spends the greatest amount of time with him while he is hospitalized. If she effectively uses this time by being under- standing, giving good explanations, and being supportive, she can have a therapeu- tic effect. It is difficult to look after any patient who has a disease with an ominous prognosis; however, the nurse must not dwell on the poor prognosis, but rather on the positive effects that can be achiev- ed through treatment. She can do this only by accepting the realities of the disease and by finding out how the patient feels about his illness and his future. She must not decide how the patient should react. Reaction to disease Joseph, the 19-year-old clerk, had been found to have Hodgkin's disease during a pre-employment physical exam- ination. The physician noted lymphatic swellings on the left side of his neck and in his left axilla. Joseph said these swel- lings had been present for some time but were painless and had not bothered him. Diagnostic tests taken in the outpa- tient department confirmed the diagnosis of Hodgkin's disease, and the physician arranged for Joseph's admission to hospi- tal. The nursing staff were confronted with a rather agitated lad who had no desire to be hospitalized. Joseph's doctor told him his diagnosis and what to ex- pect. He had one of the milder foons of Hodgkin's disease and his prognosis was good with treatment. Despite our efforts, we were unable to convince Joseph that he needed treat- ment and follow-up care. He discharged himself, saying he was weIl and not a thing was wrong with him. Two years later, he was readmitted. He was coma- tose and never regained consciousness. Harry, the 35-year-old farmer, was admitted to hospital with a two-month history of extreme fatigue, weight loss, and excessive sweating, particularly at night. He had lost 30 pounds in the two weeks prior to admission. In hospital he continued to lose an average of two pounds per day for the first two weeks (total weight loss: 60 pounds). He was so weak that he required complete help with all his needs. He had severe generalized discomfort and, after extensive diagnostic tests, it was discovered that he had Hodgkin's JUNE 1970 sarcoma. His prognosis was extremely poor. It was doubtful that he would ever leave hospital. This was three months before Christmas. Overtly, Harry seemed able to accept his disease and its outcome. He discussed it with his family and informed them he would have one more Christmas at home. He was extremely determined and grad- ually began to do more for himself. As he had predicted, he went home for Christ- mas. Shortly after the holiday season, he returned to the hospital with further involvement. He had pleural effusion, severe anemia, and a retroperitoneal mass. He lived only three more days. Brian, the 28-year-old accountant, was admitted to hospital with a temperature of 104 degrees Fahrenheit, excessive sweating, and severe pruritis. His progno- sis was a therapeutic remission of from 5 to IS years. After being informed of his disease and prognosis, he was unable to discuss his illness with anyone, even his wife. He seldom spoke, seldom asked for anything. He accepted all treatments and nursing care willingly and seemed to live each day as it came with no thought for lhe future. Perhaps he was unable to look at the future. He did not look sad. bitter, or cheerful. He looked apathetic. His physic- al response to treatment was good, but his attitude continued to be passive. Brian was discharged from hospital after an eight-week stay. Three years have passed since that admission. Physically, he has continued to do well. Because we have not had personal contact with him since hospitalization, his present attitude toward his illness is unknown. These patients give only three exam- ples of the varied reactions to an illness that is long-term, permanent, and poten- tially fatal. Joseph denied that he had the tUNE 1970 disease. He felt well, so therefore would not admit that he had an illness. refused treatment, and thus ended his own life. probably prematurely. How does the nurse react to this patient? How should she react? Harry had a very positive outlook about his illness. He seemed to possess an inner strength, which gave him the ability to accept and live within the confines of his illness. He made the most of whatever was left, setting goals for himself. discus- sing them with his family, and being realistic about these goals. He too exhibit- ed denial - not about the disease per se, but about its ability to interfere with his Christmas goals. This would seem to be healthy denial. Brian, on the other hand, was rather passive and indifferent to his illness. He did not deny its existence, nor did he make the most of his relatively good prognosis. He appeared to have given in to the disease and involved no one in his illness, not even himself. He did not appear to have the inner strength to contend with such a disease. How does one nurse this patient? Perhaps a clergy- man or social worker could give guidance to the nurse in this instance. Of these three patients. the most seriously ill was by far the easiest to nurse. Harry accepted his illness, or at least acknowledged its presence, and became involved with it; therefore. it was easier for the nurse to accept his illness and provide his care. He was always pleasant and it was always a pleasure to visit his room. It was an easy situation for the nurse. The most difficult patient to approach was Brian, mainly because the nurse found it difficult to become involved with him. But it is by becoming involved, by really caring on a professional basis, that a patient such as Brian can be helped. Although the nurse is tempted to avoid his room except when essential. she must realize the importance of spending as much time as possible with him. A positive attitude from those who provide his care could give Brian and patients like him hope. and possibly stimulate a posi- tive attitude. Often the patient's attitude toward a disease seems to influence his prognosis. The nurse must be prepared to look for and recognize individual differences. She must toss out preconceived notions about patients' behavioral patterns and not expect them to conform to a stereo- typed classification of reactions. There are as many different reactions to a disease as there are patients with a particular disease. The nurse's role is to try to understand the patient's reactions toward illness and his method of coping with problems. She can then help the patient find, in his own way. the best solution. Bibliography Beland, Irene. Clinical Nursing: PathophysIOlog- ical and Psychosocial Approaches. New York. MacMillan, 1965. Brunner, Lillian S. et al. Textbook of Medical. Surgical Nursing, 4th. ed. Toronto. J.B. Lippincott, 1964. Cecil, Russell, and Loeb, Robert. A Textbook of Medicine, Philadelphia. W.B. Saunders. 1959. Washington Univ., St.Louis, School of Medi- cine. Manual of Medical Therapeutics. J.W. Smith, ed., 19th ed., Boston. little Bro\\n. I% 0 THE CANADIAN NURSE 35 Decentralized nursing service Nursing has traditionally had a hierar- chical type of organization with centraliz- ed authority and a long line of communi- cation. In most hospitals the nursing organization is complex with many levels of authority. The nurse in the ward finds it difficult to make decisions about pa- tient care, yet is responsible for it. The staff at the University Hospital in Saskatoon believed this problem could be attacked by trying to simplify either the individual ward organization or the total nursing service structure. Since change would be possible only if authority were delegated by nursing administration, we agreed to try a decentralized form of nursing organization and, at the same time, to reduce by one the levels of authority within that organization. Further impetus to the plan was given by other factors in the total hospital organization. For example, the former position of director of nursing had be- come "nursing admmistrator," with more involvement in general hospital adminis- tration. Also, we had found that centrali- zation of authority in the traditional nursing office was more often a bottle- neck than a channel of communication. Supervisors who were perfectly capable of making decisions relating to their own areas often developed into the best paid messengers in the organization. Moreover, the supervisor's role in rela- tion to department heads was an ambig- uous one. Although responsible for a large group of patients and staff, her position often did not permit her to talk on equal terms with other department heads. At the same time, other hospital func- tions were developing specialized depart- ments. There was no longer just a labora- tory, but several departments providing laboratory services. Meanwhile, nursing 36 THE CANADIAN NURSE Under this system, now in operation at the University Hospital in Saskatoon, Saskatchewan, the role of the senior nursing staff changes from one of authority to one of leadership. Madge McKillop service, representing 40 to 45 percent of the total staff, was lumped together in one department. No one person could expect to be aware of the many needs of this complex group. Plan for decentralization To overcome some of these problems, we decided to divide the nursing service into six departments of nursing, each with its own department head, a director of clinical nursing. Each director of nursing of a clinical area would report to the executive director of the hospital through the nursing administrator in the same way as other department heads report to an administrative officer. These department heads would then be responsible for the organization and administration of their area in accord with general hospital policies. This would include staffing, assignments, promotions, budget, and so on. The department heads would be expected to work closely with the medical chiefs in their area to provide the best possible patient care; to help meet the objectives of the educational programs of the many students who come to the wards; and to participate in or initiate research projects. Implementation of plan As seen on the organizational chart, a senior nurse is still assigned to evening and night duty. Although each director of clinical nursing is responsible for planning the nursing services in her area for the 24-hour period, there is a need for nurs- ing supervision at all hours and there are also administrative duties that must be assigned to some responsible person for the evening and night shifts. At this stage Miss McKillop is Nursing Administrator, Univer- sity Hospital, Saskatoon, Saskatchewan. it would not seem economically sound to employ additional administrative staff when the present evening and night staff are handling these responsibilities well. The position of administrative adviser is a new one. This is an individual well qualified in nursing administration who acts as a resource person for the directors and who undertakes special studies in problem areas. She reviews policies and recommends revision as required. The director of inservice education has a dual responsibility: She is responsible for orientation and staff education within the hospital, and acts as liaison between the university school of nursing and the hospital nursing service. A joint nursing service-nursing education committee sets policies. Planning for this change took almost two years. The proposed plan was discus- sed with the hospital administrative staff and received approval in principle. Week- ly seminars were arranged for the supervi- sors to give them help in upgrading their a dministrative knowledge and skills. Assistance in this program was provided by the executive director, the business administrator, the director of personnel, and members of the nursing staff. They covered topics such as hospital philoso- phy and policies, preparation and man- agement of budgets, personnel policies and their application, staff development, the union contract and their role in relation to the union, and interdepart- mental relationships. Other departments were brought into the planning early. Discussions were held with the medical department chiefs who expressed interest and support. The per- sonnel department took on more respon- sibility for the recruitment and screening of applicants for nursing - a responsibil- ity that had previously been carried out tUNE 197( PREVIOUS ORGANIZATIONAL CHART Ass'\. Director of Inservice Education } Head Nurses REVISED ORGANIZATIONAL CHART Executive Director Nursing Administrator Administrative Adviser Ass't. Nursing Admin. (Eve.) Director Peds. & Emerg. Nursing Director Surgical NUßing Director OR NUßing by a senior member of the nursing office staff. This change made it possible for the department head to work with personnel in hiring staff for her area. The nursing operating budget. prepar- ed by the supervisors in consultation with the head nurses, was broken down into clinical areas and reported monthly. Board approval for the change was sought and given wholeheartedly. Finally, job descriptions were developed for each of the positions. Problems Naturally, there was resistance to change. Some staff felt safer in a known setting. People had to change their atti- tudes. As the scope of the former super- JUNE 1970 Director of Inservice Education Ass't. NUßing Admin. (Nights) Director Medical NUßing Director Obs.&Gyn. NUßing Director Special Services } Head Nurses visory position increased to that of de- partment head. the responsibilities of each head nurse increased as well. Staff had to adjust to this and it took time. Another problem has been that of coordination. Constant vigilance is re- quired to make sure hospital policies are being carried out; at the same time. staff must be given enough scope to allow individual development. Priorities must be established for assignment if more than one area wants to hire the same person. If these cannot be settled at the departmental level. the nursing adminis- trator must make the decision. The major change - and the one that has taken longest - concerns the image of the traditional nursing office: we had to change it so that it would no longer be recognized as the sole decision-making area for nursing. The nursing adminis- trator had to learn to work as a coordina- tor. a resource person who identifIes trends and helps to initiate change. She now must let others make many decisions that were formerly her responsibility, and has to realize that there is more than one way to achieve a desired end. Other departments, too, have had to learn to refer questions to the director of clinical nursing in an area. rather than channel everything through the nursing office Results To date. the organization seems to be working well. The directors are growing in their positions and are taking full responsibility as department heads. Head nurses have found that their role has expanded to the point that they are now writing a new job description for them- selves. Service department heads say they are finding their work easier now that a decision can be made at ward level. New staff are more likely to be assigned to the clinical area of their choice because the staff in personnel refer an applicant to the director in that area. One of the concerns expressed was that the nursing administrator would become a mere figurehead. cut off from the actual work situation. This has not happened. In fact, communications have improved and it is easier to keep abreast of what is happening. There is more time for consultation and discussion. Directors of nursing in each clinical area have made a point of keeping the nursing adminis- trator aware of changes and develop- ments. Budgetary controls have improved. Because each director is responsible for her own budget and gets a monthly report of the financial picture. it is easier for her to establish controls and to take corrective action if required. The direc- tors take pride in working within their budgets. Final results cannot yet be assessed as this is still an evolving situation. We hope, however. that the continued delegation of authority will permit more scope for the nurse giving care at the bedside. Decisions will relate more closely to the work situation. The role of senior nursing staff will change from one of authority to one of leadership, and a more colleague-type of relationship will develop. 0 THE CANADIAN NUKS 37 books Surgery for Students of Nursing, 5th ed. by John Cairney and J. Cairney. Edit- ed and revised by Richard Orgias. 471 pages. N.M. Peryer Limited, Christ- church, New Zealand. 1969. Reviewed by Leita Nemiroff, Instruc- tor, Medical-Surgical Nursing, Miseri- cordia General Hospital, School of Nursing, Winnipeg, Manitoba. The objective of this book is to help nursing students understand the princi- ples on which surgical treatment is based. The beginning student can easily under- stand the book. As an introduction to various types of surgery specific to body systems, the authors have wisely discussed important topics, such as infections and asepsis, body fluids, hemorrhage and shock, wounds and skin grafting, and anesthesia. These are only a few of the topics related to surgery that are dealt with. Each type of surgery discussed is preceded by a brief review of anatomy and physiology of that body system or specific body organ, accompanied by b lack and white photographs. The authors discuss preoperative management of the patient and outline the various surgical approaches. Illustrations help the nurse understand the specific surgical treatment. Discussions of postoperative management of the patient are procedure oriented. This book can best be used as a well-illustrated dictionary of surgery and surgical techniques. It is particularly use- ful for the beginning and more senior student as a handbook, rather than a textbook. Neurological and Neurosurgical Nursing, 5th ed. by Esta Carini and Guy Owens. 386 pages. Toronto, C.V. Mosby Company, 1970. Reviewed by Marilyn Kavanagh, Head Nurse, Intensive Care Unit, Peel Memo- rial Hospital, Brampton, Ontario. This book is the most recent edition of a popular neurological nursing text. In the preface the authors stress, "In this time of elaborate monitoring devices, of intensive care units, and of specialized teams, let us not overlook the continuing importance of the personal nursing care of the patient." This concept, found throughout the book, is of foremost importance, no matter what aspect of nursing care we deal with. The format of this book is excellent. 38 THE CANADIAN NURSE There are 19 chapters that review in detail the care of the neurological patient, with many precise diagrams and photo- graphs describing anatomy and reviewing diagnostic procedures. In the chapters dealing with the surgi- cal correction of the disease, the pre- and postoperative nursing care is clearly de- scribed, with specific observations requir- ed for the particular surgical procedure, as well as posturing and turning, nutri- tion, elimination, and division. The medications used most commonly in the treatment of neurological patients are grouped according to their specihc and systemic effects. This would be an excellent reference book for any nursing library. My only objection is that there are no references to any of the great Canadian achieve- ments in this field. Materia Medica and Pharmacology for Nurses, 7th ed. by J.S. Peel. 209 pages. Christchurch, Nol., N.M. Peryer Limit- ed, 1969. Reviewed by David M. Quinn, Phanna- cy Department, Royal Inland Hospital, Kamloops, B.C The author is a hospital pharmacist in New Zealand who has been introducing materia medica and pharmacology to nurses for the past 20 years. This book, printed biennially, reflects a direct and experienced approach to the subject. The author knows what to teach and how to teach it. The chapters on weights, measures, and calculations are excellent. This is traditionaUy a weak area for nurses. How we could all be helped by the long overdue elimination of the apothecary and "teaspoonful" system! The section on pharmacology foUows the usual textbook format, with just enough detail for the student to absorb. Doses are given, but not the route or suggested frequency of administration (except in an appendix that lists pediatric doses). There are omissions: isoprenaline aero- sols, the meaning of idiosyncrasy, Gram staining, and the idea that certain combinations of seemingly innocuous drugs, such as mineral oil and dioctyl sodium sulfosuccinate, can be dangerous. A reference list of drugs that are contrain- dicated with MAO inhibitors and with oral anti-coagulants would be useful. More careful editing would have caught the odd spelling mistake and such delightful statements as: "Cephaloridine . . . is a derivative of an antibiotic obtain- ed from a sewage outlet in Sardinia" and "its toxicity is slow." There are occasional areas of dispute: we are told that penicillin G is effective against Brucella and that sodium bicar- bonate causes "rebound gastric acidity." The differences between Canadian and New Zealand practice - the legal matters, official and trade names of drugs, methods of treatment in poisoning, and drugs used - will confuse the stu- dent. The dose given for aldactone, for example, suggests that we have a different formulation here; and surely tandearil is not an antihistamine. NPH insulin and syrup of ipecacuanha are not used in New Zealand, and B.N.F. mixtures are no longer à la mode here. These variations are sufficiently numerous for me to wish that we had a Canadian version of this book. Patient Care In Respiratory Problems by Jane Secor. 229 pages. Saunders, Monographs in Clinical Nursing - 1, Toronto, W.B. Saunders Company, 1969. Reviewed by L. MacDonald, Director of Nursing, Provincial Sanatorium, Charlottetown, Prince Edward Island. The major aim of this book is to present a nursing specialization as an inseparable blending of technical skills and persona- lized patient-centered care. This is a valuable reference book and should be of particular interest to nurse clinicians, nurse educators, and nursing students. The author points out that the expan- sion of knowledge of health and illness has brought about the extension of the responsibilities of the nurse. She is now becoming a skilled therapist, and is as- suming more of the tasks that formerly fell in the realm of medical practice. One part of the book deals with signs and symptoms and major complications of specific conditions in respiratory disor- ders; understanding these enables the nurse to adjust nursing care safely and efficiently. Special treatments are clearly defined, and equipment, such as respira- tors, nebulizers, and closed drainage systems are well-illustrated. One particularly interesting chapter is on clinical studies of pulmonary emphy- sema, laryngectomy, cancer, pulmonary tuberculosis, pulmonary embolism, and traumatic injuries. 0 JUNE 1971r A V aids Multimedia System Launched In Canada Nurses from a number of Montreal hospitals saw the Multimedia Instruc- tional System demonstrated at the Queen Elizabeth Hospital early in April. So far this product of Hoffmann- LaRoche Inc. provides a program of instruction only in intensive coronary care, although the company promises additional programs. The multimedia system incorporates different educational techniques into an integrated teaching system. The techniques include films, sound film- strips, audio tapes, textbooks, and testing and evaluation. The system is divided into 13 instructional units, each self-contained yet interrelated to reinforce each other. If a course already exists in a hospital, any of these units can be used to supplement or replace portions of it. A complete system contains: . 9 films that give a broad overview of key subjects in coronary care nurs- ing and introduce the other instruc- tional elements in the system. Live ac- tion and animation are both used ef- fectively. Scripts come with the films. . 29 sound filmstrips, which present specific subjects in depth, describe l?rocedures, develop principles of prac- tIce, and instruct in arrhythmia detec- tion and treatment. Scripts are includ- ed. . 12 audio tapes, which expand on aterial in the films through ques- u ns and answers; express differing vIews on management of nursing prob- lems; and present lecture-type material. Scripts are provided. . II copies of the text Intensive Coro- nary Care- A Manualfor Nurses, by Lawrence E. Meltzer, Rose Pinneo, and J. Kitchell. The multimedia system ex- pands and updates the basic course content of this manual. . I copy of Cardiopulmonary Resus- citation Conference Proceedin8s, edit- ed by Archer S. Gordon. . JO student workbooks, with 73 ECGs to be interpreted by the student, reading assignments, an outline of each film and filmstrip, and clinical experience record. . An instructor's manual, which gives details on how to prepare for the course and how to conduct it, suggest- ed schedules, outlines of films and JUNE 1970 .I - I -- , ..... .....: ,- at!P"- .r---;,. . ... .. filmstrips. and interpretation of ECGs. . A pre-test of the student's general knowledge of cardiac nursing and a final examination of objective ques- tions that cover the course. . An audiovisual equipment instruc- tion book. . A technicolor super 8mm projec- tor with rear screen attachment and earphones for individual learning. . An Elco Mastermatic sound filmstrip projector, with rear SCreen attachment and earphones, which also plays the audio tapes. Projector load- ing is made easy - the films, filmstrips. and tapes are packaged in plastic cart- ridges. One cartridge contains both sound and picture for each filmstrip. Advantages of this system are: it can be used in the hospital to instruct groups of nurses or individuals; a nurse can re- peat any section of the course on her own; filmstrips can be stopped for ex- planation or discussion and easily con- tinued; and instructors do not have to repeat lectures on the same material. There is a suggested schedule for this course. If given in an intensive program, the course would take 20 days to com- plete. This is based on a 120-hour sche- )ç- ii, ((tTr fllllill [ .. ((( (( , IIIIIII I ,1,1.\ ".[11 . -- .._-"" ---r dule of 40 sessions. According to Hoffman-LaRoche, the Multimedia Instructional System is being tested in 10 hospitals in the Uni- ted States by the U.S. Public Health Ser- vice. It will be kept up-to-date by re- commendations of a board made up of current users of the system. Dr. Law- rence Meltzer. the U.S. Public Health Service, and practicing cardiologists. Nurses questioned by The Canadian Nurse after the two-hour presentation in Montreal were enthusiastic about the system. The supervisor of inservice edu- cation at the Queen Elizabeth Hospital thought the audiovisual equipment could be put to excellent use in Mon- treal hospitals. and that the course should be a requirement for nurses in coronary care. The head nurse of the coronary moni- toring unit at The Montreal General Hospital said she would highly recom- mend the system. She thought some parts of it could be used for students, although it was "definitely a postgrad- uate course." It could be used to train key people in the hospital, she said. This nurse found the series on cardiac pacing particularly interesting. THE CANADIAN NURSE 39 A V aids (Continued from paKe 39) A clinical instructor at The Montreal General Hospital thought some parts of the system were good for students, but expressed doubt concerning the workbooks. "Once you understand the principles, you don't need one at hand," she explained. The effectiveness of the system. she believed, would depend on the instructor. For complete information about the Multimedia Instructional System, write to Hoffmann-LaRoche Inc., 1956 Bour- don Street, Montreal 378, Quebec. Film catalogue A group of Toronto librarians and nurse educators interested in audiovisual aids have pooled all available resources in the area on 16 mm films used in nursing education. The result is an impressive film catalogue compiled by the Metropolitan Toronto Schools of Nursing Audiovisual Aids Committee. The catalogue includes a table of contents, list of sources for obtaining films, film résumés, and a subject index. Copies, at a cost of $8.50 each, are available from Miss M. Seguin, 35 Shuter Street. Toronto 205, Ontario. Free films directory A brochure entitled "Free Films Directo- ry" is available from Crawley Films lim- ited. This excellent guide lists 488 sources of free 16 mm sponsored films in Canada. It also provides helpful suggestions on how to borrow films, and gives projection tips. For a copy of this film directory, write to Crawley Films Limited. 19 Fair- mont Ave., Ottawa 3, Ontario. accession list Publications on this list have been received recently in the CNA library and are listed in language of source. Material on this list, except Reference items, may be borrowed by CNA mem- bers, schools of nursing and other institu- tions. Reference items (theses, archive books and directories, almanacs and simi- lar basic books) do not go out on loan. Requests for loans should be made on the "Request Form for Accession List" and should be addressed to: The Library, Canadian Nurses' Association, 50, The Driveway, Ottawa 4, Ontario. No more than three titles should be requested at anyone time. BOOKS AND DOCUMENTS 1. ABC de statistique à ['usage des étudiants en médecine et en biologie, par Sach Geller. Paris, Masson, 1967. 220p. 2. Advanced cardiac nursing, presented by American College of Cardiology and Baptist Hospital, Nashville, Tennessee. Philadelphia, Charles Press, c1970. 213p. 3. The age of discontinuity; guidelines to our changing society, by Peter F. Drucker. New York, Harper and Row, c1968, 1969. 402p. 4. An approach to technical translation; an introductory guide for scientific readers, edited by C. A. Finch. Oxford, Pergamon Press, 1969. 70p. (library of Industrial and Commercial Education and Training) 5. L 'autonomie provinciale; les droits des minorités et la théorie du pacte, 1867-1921, par Ramsay Cook. Ottawa, Imprimeur de la Reine, 1969. 82p. (Etude de la Commission royale d'enquête sur Ie bilinguisme et le biculturalisme no. 4) 6. Brady's programmed orientation to medical terminology. Washington, Brady; dis- tributed by J. B. Lippincott, Toronto, 1970. 158p. 7. Canadian education index: a quarterly index to books, reports, pamphlets and periodi- cal articles on education published in Canada. -- ,- " ?:. .. ... " . .4J...... . .!.. . \. .""'1:.'; "': 9. " .-,.... .. ",...... ,,- w : . ".- 1- 1,_ ; . ::1.! , ...... ..II' . : r t-' .,; ,.. ..,' .. . - t' 1 :. , \" . ;. t'.... ' , ..--" ,: . JI- .:.J;-:....._... , , .. . ..-,. ::! ".f' .iot , '; . . 'v . '.' '> essential information in time- A New Book! ORTHOPEDIC NURSING: A Pro- grammed Approach By Nancy A Brnnner, R.N, B.Sc. This self- study guide teaches principles and their application: indications for treatment, current methods, and expected results. It clearly explains mechanical and medical principles of casts and traction, as well as specific instructions for nursing care. It shows care of patients before and after selected surgical procedures, and management of non-surgical conditions. September, 1970. Approx. 224 pages, 7" x 10", 126 illustrations. . New 2nd Edition! á_ PROGRAMMED INSTRUCTION / ,I , IN ARITHMETIC, OOSAGES, ': _ (, ANO SOLUTIONS By Dolores F. ?- Saxton, R.N, B.S., M.A., and { John F. Walter, Sc.B., M.A., Ph.D. T!1is self-teaching manual combines basic theory with practice problems, to teach the arithmetic necessary to prepare and administer medications. This new edition now reviews basic concepts of arithmetic in terms of both "old" and "new" math. It introduces the metric and apothecary systems, then assigns mathematical problems commonly encountered in actual nursing situations. June, 1970. Approx. 68 pages, 7" x 10". About $3.85. MOSBY TIMES MIRROR THE C. V. MOSBY COMPANY, LTO . 86 NORTHLINE ROAO . TORONTO 374, ONTARIO, CANAOA 40 THE CANADIAN NURSE JUNE 197( accession list (Continued from page 40) Ottawa, Canadian Council for Research in Education. 1969. 83p.R 8. Canadißn medical directory; compiled from the daily medical seIVice bulletins. Toron- to, 1970. 740p.R 9. Catalogue de l'édition du Canada françai- se publiée par Ie Conseil du Livre aVec Ie concours du Ministère des Affaires Culturelles du Québec 1969-1970. Montréal, 1966. 503p.R 10. La chirorgie plastique esthétique par Armand Genest. Montréal, Editions de l'Hom- me, 1969. 125p. 11. Clinical aspects of oral gestogens; report of a WHO Scientific Group. Geneva, World Health Organization, 1966. 24p. (WHO Tech- nical report series no. 326) 12. DißKTlostic methods, edited by John Mills. London, Butterworths, 1968. 176p. 13. Direct care nursing; a teaching program for psychiatric nurses, by Kenneth H. Larson et al. New York, Macmillan, 1968. 271p. 14. Directory of Canadißn welfare services. Ottawa, Canadian Welfare Council. 1970. 18Op.R 15. Equipment and supplies for hOYpitals and nursing homes. Milwaukee, Wise., Will Ross, Inc. 1970. 782p. 16. Experiments in the physiology of human performance, by Benjamin Ricci. Phila- delphia, Lea & Febiger, 1970. 208p. 17. A guide to radiotherapy nursing by T. J. Deeley et al. Edinburgh, Livingstone, 1970. 92p. (Livingstone nursing texts) 18. Family planning with the pill; a manual for nurses. Chicago, G. D. Searle & Co., 1968. 60p. 19. Les fiches méthodologiques. Collection "Santé et Sécurité" Ton livre de Santé; ler livre par Gabrielle D'Armour et al. Montréal, Lidec, n.d. Iv. 20. From studenc to nurse; training and qualification. A study of student nurses in training at five schools of nursing. Oxford, Oxford Area Nurse Training Committee, 1966. 69p. 21. From studenc to nurse; the induction period. A study of student nurses in the Just six months of training in five schools of nursing. Oxford, Oxford Area Nurse Training Commit- tee, 1961. l06p. 22. The hospital ward clerk, by Ruth Perrin Stryker. Saint Louis, Mosby, 1970. 179p. 23. How to TUn a P.R. campaiKTI; a practical application of public relations, by Mike Wil- liams-Thompson. Oxford, Pergamon Press, 1969. 65p. (library of Industrial Commercial Education and Training) 24. In horizontal orbit; hOYpitals and the cult of efficiency, by Carol Taylor. New York, Holt, Rinehart and Winston. 1970. 203p. 25. Intensille and recovery room care, edited by John M. Beal and J. E. Eckenhoff. Toronto, Collier-Macmillan, 1969. 297p. 26. Interim report on nursing service and social & economic welfare with respect to nurses in the province of Manitoba. January 1970. Winnipeg, Manitoba Association of Regis- tered Nurses, 1970. 8p. 27. International film guide, 1969. edited by Peter Cowie. London, Tantivy Press, 1969. 336p. 28. Introduction to obstetrics. 4th ed. edit- ed by George Herbert Green. Christchurch, New Zealand, Peryer, 1970. 273p. 29. Laboratory apparatus equipment. Mil- waukee, Wise., Matheson Scientific, 1968. 1112p. 30. Laboratory chemical caralog. Chicago, Ill., Matheson, Coleman and Bell, 1969. 291p. 31. Le langage et Ia pensée dans 10 déficien- ce mentale profonde. Etude experimentale, par N. O'Connor et B. Hermelin. Paris, Gauthier- Villars, 1966. 1321'. 32. Meeting the realities in clinical teaching, by Ernestine Wiedenback. New York. Springer, 1969. 166p. 33. New advanced first-aid, by A. Ward Gardner with P. J. Roylance. London, Butter- worths, 1969. 288p. 34. Nursing care of children, by Florence G. Blake et al. Philadelphia, Lippincott, 1970. 568p. 35. Parmers in development: report of the commission on international development, by , :" J 't1 . . =-t ã . "? .: '.' " , -f . I " .,. j' , \ :4 .\. { , F,: ..: ' . .. '. -r ( ... T .r-:. . :;::::::.. - ;::.-- !'.: \ ........... . Jean Leask, left, director in chief of the Victorian Order of Nurses, gave a IO-year review of VON activities at the Order's nnd annual meeting in Winnipeg last May. She is shown with Christine MacArthur, assistant director in chief, at VON House, Ottawa. The chairs in this library at VON House are from the living room of lady Aberdeen, the founder of the Victorian Order of Nurses. 6 THE CANADIAN NURSE .. services of the community," she added. Between 1960 and 1969 a significant change took place in the organization of branches at the local level. In 1960 there were 119 VON branches, which mostly served an urban area. Since then services have been discontinued in eight small communities and six new branch- es have been opened. Thirty-one branches were reorgan- ized into 12 new ones and many branch- es extended their boundaries. The num- ber of branches was reduced to 98, but visiting nursing service was available to many more citizens. During the I 960s the role of the pro- vincial branches became increasingly important, Miss Leask said. Each of the Iiine provinces in which VON branches are established now has a pro- vincial branch. "Originally established to approach provincial governments for financial support for branches in their province, their activities now include interpretation and extension of service as well as functioning in a coordinating capacity at a provincial level," she said. In 1969 patients visited numbered almost 105,000. More than 1,351,000 visits were made to these patients. In contrast to 1960, most patients had medical or surgical conditions and the service they received accounted for 90 percent of all visits. Of every 10 patients, six were adults, (continued on page 8) JULY 1970 Jot 81u4 vl'w --- Jot !?ø!øtØI1(}Ø .Laløt Law Every Nurse Should Know New Second Edition Abdallah's Nurse's Aide Study Manual New Second Edition The Nursing Clinics of North America By Helen Creighton, B.S.N., R.N., A.B., A.M., J.D., Southwestern Louisiana Institute. The long-awaited revision of this classic book is now in press. Written by a nurse and nursing educator who is also a lawyer, this book sets forth the facts of law that every nurse - from student to superintendent - should know. It covers every aspect of the law that is important to the nurse, from her obligations as an employee to her responsibilities in witnessing a will. Tens of thousands of nurses found the first edition of this book valuable for study and for reference; the new edition is sub- stantially larger, with added coverage of such topics as "good samaritan" laws, child abuse, telephone orders, supervision of paramedical personnel, sterilization, and organ transplantation. Canadian law is fully covered. About 300 pages. About $8.75. Just ready. By Mary E. Mayes, R.N., Supervising Nurse, Emergency Room, Ventura County General Hospital, Ventura, California. The new Section Edition of this widely used handbook for nurse's aides has been considerably expanded, with many new topics added. Designed for use in inservice training programs, it is equally valuable for individual use as a review guide. It starts with the necessary orientation to the hos- pital and a summary of human anatomy; then it describes virtually every hospital procedure an aide might be called upon to perform. Each proce- dure is explained in specific, numbered steps, ond review questions check the student's comprehension of each chapter. This edition coverS advanced procedures that aides sometimes perform under supervision, such as tracheostomy care, catheterization, and oxygen therapy. About 250 pages, illustrated. Soft cover. About $4.00. Just ready. The most recent issue of this famous hardbound periodical carries two symposia on topics of current importance to nurses. The first dis- cusses in depth the care of the ambulatory patient. Hester Y. Kenneth is Guest Editor. The second symposium is on administration on the patient's behalf, with Helen W. Dunn as Guest Editor. Sixteen full articles and two special features are included in this issue - 172 pages with no advertising, baund between hard covers for permanent reference use. The Nursing Clinics brings you four such issues each year, all written specifically for nUrses by famous nursing authorities. By annual subscription only, $13.00. --------------- W. B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7 Please send an approval when ready and bill me: o Creighton: law Every Nurse Should Know (about $8.75) o Mcyes: Abdallah's Nurses' Aide Study Manual (cbout $4.00) o Please enter my subscription to the Nursing Clinics, to stcrt with the June issue ($13 per year) Ncme Address City JUL Y 1970 Zone Province . CN-7-70 THE CANADIAN NURSE 7 news (continued from page 6) one a sick child, and three expectant mothers or mothers with newborns- the reverse of the picture in 1960. By 1969 the VON was participating in 29 coordinated home care programs in four provinces - Saskatchewan, Manitoba, Ontario, and Quebec. "Through them we have developed a closer partnership with government, with hospitals, and with other commu- nity health and welfare agencies," said Miss Leask. "Development of these programs has affected the personnel we employ, has enhanced the nursing serv- ice we can give, and has been one stim- ulant for the initiation of new programs." By 1969 nursing was still the basic fundamental program of the VON, but in a few branches it had been joined by others, said Miss Leask. These include the provision of physiotherapy; five programs in home help service; and two "meals on wheels" services. In several branches in Ontario a VON nurse is carrying out pre-employment health assessment examinations as well as reassessment on a regular basis in a part-time occupational health nursing program. The changes in structure and program over the past decade are reflected in the type and number of personnel employed in 1969, said Miss Leask. There were 835 permanent positions in 1969, com- pared with 650 in 1960. Of these, 798 were nursing positions. In addition to nurses and nursing assistants, the VON employs medical directors of coordinated home care pro- grams, physiotherapists, a social worker, a supervisor for meals on wheels and homemaking service, and the home help staff. "The rapidly shifting emphasis in our visiting nursing program to the care and rehabilitation of persons ill at home has brought new responsibilities and new opportunities for teaching," Miss Leask said. "It is essential that we maintain an adequate proportion of nursing staff with public health preparation," she added. Last year 61 percent ofthe nurs- ing staff held this qualification, and 25 percent held baccalaureate or master's degrees in nursing. RNAO Announces Greylisting Toronto, Ontario.- The Registered Nurses' Association of Ontario, fol- lowing a request from the Muskoka- Parry Sound Health Unit Nurses' As- sociation, announced the greylisting of the health unit in May. After prolonged negotiations, In- 8 THE CANADIAN NURSE CNF Board Meets ;/- \ ., --- Ottawa. - The board of directors of the Canadian Nurses' Foundation met at CNA I House May 15 to ratify the choices by I the CNF selections committee of reci-\ pients of 1970-1971 CNF scholarships. CNF president Hester J. Kernen, center, associate professor of public health nurs- ing at the University of Saskatchewan, Saskatoon, talks with board members Sister Marie Bonin, left, faculty of nurs- ing, University of Montreal, and Marion C. Woodside, associate professor, Univer- si t of Toro nt On.!.a.!io. I cluding the services of a conciliation officer and a mediator, the association and the employer were unable to reach agreement and the association exercised its right to strike. All public health nurses and registered nurses, with the exception of the supervisor, are on strike. RNAO recommended that registered nurses not accept employment with the health unit until a satisfactory collective agreement has been negotiated on be- half of the present staff. NBARN Annual Meeting Sticks To Business Only Fredericton, N.b. - Haniett Hayes of Moncton, N.B., was elected presi- dent of the New Brunswick Association of Registered Nurses at its 54th annual meeting May 21 and 22. The meeting, which usually runs three days, was held in two days this year because of NBARN's involvement in hostess plans for the Canadian Nurses' Association's general meeting in Fredericton June 14 to 19. The short- ened program featured business sessions only. Highlighting the first session on I May 21 was the address given by the outgoing president Irene Leckie, fol- lowed by a lunch at which life and hon- orary memberships in NBARN were presented. Business sessions continued May 22 and concluded following the election of officers. Other officers elected were Apolline Robichaud, first vice-pres- ident; Lorraine Mills, second vice- president; Margaret MacLachlan, hon- orary secretary. The 12th annual meeting of the New Brunswick Student Nurses' Association was held in conjunction with the NBARN meeting. Three Staff Associations Certified In Nova Scotia Ha/(fax, N.S. - Three staff associa- tions for registered nurses have been certified by the Nova Scotia Labour Re- lations Board. Certification includes in the bargaining unit all nurses except evening and night supervisors and those in positions above this level. Margaret Bentley, employment re- lations officer f('r the Registered Nur- ses' Association of Nova Scotia, said there are now five such certified staff associations in the province. The three newly-certified associations are the New Waterford Consolidated at New Water- ford, the Dawson Memorial at Bridge- water, and Colchester at Truro. Neurosurgical Nurses Form World Federation New York, N. Y. - The World Fed- eration of Neurosurgical Nurses was set up at a meeting during the fourth international congress of neurologi- cal surgery, which took place in Sep- tember 1969. The new federation is affiliated with the World Federation of Neurological Surgeons. At the meeting, Agnes M. Marshall was elected president. She is course di- rector in neurosurgical nursing at the Chicago Wesley Memorial Hospital and instructs in surgery at North- western University Medical School. Elected secretary was Doris McDon- ald, staff nurse, department of neuro- surgery, Charles Le Moyne Hospital, Greenfield Park, Montreal. The next meeting of the Federa- tion's executive committee will be in Pra ue, Czechoslovakia, in June 1971; its first international congress is sched- uled for 1973 in Tokyo, Japan, in col- laboration with the fifth international congress of neurological surgery. Membership in the Federation is limited to nurses in the specialty field of neurosurgery as determined by its member societies throughout the world. Inquiries on membership should be sent to Miss McDonald. JULY 1970 US Nursing Students Protest Suffocating Education Miami Beach, Fla. - Student nurses concluding their annual convention May 3 had a message for the American Nurses' Association, and it came through loud and clear: they want the opportunity to be involved with, and "to be human with," the people they are caring for. Members of the National Student Nurses' Association presented their ideas at a joint meeting of NSNA and ANA with a demonstration, placards, and music. In a skit the students charged the nursing profession with fostering a suffocating educational system, with "murdering" ideals, and stifling in- volvement with patients. Throughout the dialogue between students and experienced practitioners, students asked to be listened to and to be given a chance to demonstrate the depth of their commitment to humanity. Practitioners suggested that some of the students' "bones of contention" were not so much with the professional orga- nization as with the system of delivery of care in health agencies. ICN Congress Papers Published Geneva. Switzerland - The Interna- tional Council of Nurses is publishing in one volume reports and papers from its 14th quadrennial congress held in Mont- real, June 1969. The book, entitled Focus on the Future, will contain: . A résumé of the meeting of the Council of National Representatives in article form. . Reports of the president, executive director, membership committee, and professional services committee. . A résumé of the congress in article form. . Papers presented in plenary sessions. . A selection of papers presented in special interest sessions. The expected publication date was April 30, 1970. The volume is available in English only. Price per copy of Focus on the Future is $12. (U.S. funds.) Orders should be addressed to: Inter- national Council of Nurses, P.O. Box 42, CH-1211 Geneva 20, Switzerland. ANA House Of Delegates Votes To Double Dues Miami Beach, Fla. - The house of delegates of the American Nurses' As- sociation approved a resolution to double ANA dues, effective September 1, 1970. The decision to increase the annual dues to $25 was made at the as- sociation's convention, held May 4 to 8. Approval of the dues increase fol- lowed several efforts to resolve the ANA's financial plight by varying the amounts of the increase, and even by proposing no dues increase at all. An- JULY 1970 other suggestion was to appeal for ad- ditional voluntary contributions to pay off debts. Many members argued that a nation- al professional organization such as ANA cannot operate on donations. that failure to face increasing costs of a posi- tive program would mean a weakening of the voice of nursing, and that ANA would have to "join the poverty group" as an association. One delegate pointed out that the dues increase from $12.50 to $25.00 annually means 7 cents per day for each member. Another delegate said that most other national professional orga- nizations have raised their dues in re- cent years "and we must put our money where our mouth is." The vote for the dues increase was 816 to 249. Many of those who opposed the increase cited financial stress of their state associations and opposition to a dues increase from state association members. Several delegates expressed fear that the dues increase would mean loss in membership. Other delegates felt that without the increase. ANA could do nothing, and "an organization that does nothing will lose member- ship." Delegates and members came to the .[NTRODUCING he new tJUMtv@ aspirator l MODEL 797 . Greater Convenience - Larger stand and new out-of-the-way pump and motor position provide ad- ditional. handy table top clearance for accessories and utensils. . Easier HandJing- Lower center of grav- ity and larger rubber casters promote safe. effortless mobility from station to station. . Exclusive Comco Features -Im- proved oiling sys- tem for longer. maintenance- free opera- tion. Gomco A e ro v e n t@ overflow pro- tection prevents pump damagp. Prpcision regulator valve for exact control of suction from 0" 10 25" vacuum. Ask your lÌt'aler for a free demon- "tration of the new Model 797 Gomco Aspirator or write: GOMCO SUR. I( ilL MANUFACTURING CORP. '- _ 821 F FI luffaln. r-.. \. 14211 ; /XJ..iEiiø..ßJ. DEPT.C2 __w._....__ 'VA UN f . -" . \ :.-- ..:,.- . "UM'\JJ . '_M -:' 0.{ , w . \ - THE CANADIAN NURSE 9 news convention concerned about the serious financial difficulties of ANA. In sever- al serious sessions they scrutinized fi- nancial reports and questioned elected officials and staff. They assessed the extent of indebtedness, the cost of maintaining minimal programs and staff, and the demands of the future. Late in the evening of the day before adjournment, they made their decision. The debts will be paid, and new and existing programs to permit nursing to make significant contributions to im- prove health care will be carried out. Over 1,500 Nurses Attend First National OR Convention MOnIreal. - What was a dream for operating room nurses in Quebec 12 years ago, became a reality last May 4.7. During these four days the first Na- tional Operating Room Nurses Conven- tion was held in Montreal. Some 1,500 nurses registered at the Queen Elizabeth Hotel. President of the Association of Nurses of the Province of Quebec, Hel- en Taylor, and second vice-president of the Canadian Nurses' Association, Margaret McLean, attended. Throughout the convention interest in the agenda and the extensive range of exhibits was held at a high key. Speak- ers commented on a variety of subjects, including "Acute Emergencies," "Basic Hazards in OR to Patient and Staff," .. Role of the OR in Kidney Transplant," and "The Professional OR Nurse and the OR Technician." Claire Brault, operating room super- visor, Notre-Dame Hospital, Montreal, discussed the risks and dangers of the operating room. Miss Brault stated, "if the nurse is free to take a risk, she is also free not to expose herself to that risk nor to expose the patient." "The latter," said Miss Brault, "is sufficiently handicapped without being exposed to an additional risk which could be fatal." Explaining why she felt it was im- portant for the role of the operating room nurse to be discussed, Miss Brault said, "The patient is always more or less anxious before surgery. He is aware surgery represents a certain amount of risk, for instance - he fears he may not wake up after the operation, that he may be deprived of his faculties, and he has other concerns. "It is up to the nurse to give the pa- tient the needed explanations, and make sure that this is done in a climate of calm trust," continued Miss Brault. Risks involving the patient and the 10 THE CANADIAN NURSE 7E9 MeN'"'...... "oIIoMI - \'" . r ' - ,. ""'t. " \. ., l' -:-\ . " ... "- . - , .... '" , , ... 0 ;j- " At the first National Operating Room Convention, held in Montreal, May 4-7, the main theme was on the work of the operating room nurse and the technician. Two groups faced each other representing the doctors and the nurses. From left to right in this picture are, Dr. l. Shragovitch, chief surgeon, Jewish General Hospi- tal, Montreal, and Dr. Shirley Stinson, associate professor, division of health services, University of Alberta, Edmonton, who defended the role of the technician in the operating room. Dr. Maurice Falardeau, surgeon, Notre-Dame Hospital, Montreal. and Thérèse Guimond, assistant director of nursing services, Maison- neuve Hospital, Montreal (not in the above picture) argued in favor of male and female nurses in the operating room of hospitals in Canada. , . ..... . l' ..".- /., . ill , " ... \J ) _1\ ...",. i' ,\ I , l .... ... "at ./ Ao Ja Cartoonist Normand Hudon did not lack models when he opened his sketchbook at the first national convention of operating room nurses, held May 4 to 7. An exhibitor at the convention guessed rightly, Mr. Hudon did prove popular. IULY 197(] operating room personnel were covered in Miss Brault.s talk. She felt every precaution should be taken to safe- guard all those concerned during surgery, and stressed that the operating room nurse must be able to assum her responsibility and so fully play her role as a member of the team responsible for the well-being of the patient. Many of the speakers used audio- visual aids to illustrate their comments. This form of communication was well received by the audience. Dr. R.A. Béique, physicist and chief of the medical biophysics department, Notre-Dame Hospital, Montreal, spoke on radium and radiology. He pointed out the risks of radiation for human beings, particularly somatic, genetic, and psychic effects. , The danger of explosions in the op- erating room was discussed by Jacques Degenais, biochemical engineer at the Cardiology Institute, Montreal. He outlined the need for good ventilation in the operating room, explaining that it also acts as a prevention against con- tamination. A seminar on asepsis and sterilization was illustrated by cartoons. Bilingual legends were used throughout the dis- cussion. Discussing the role of the operating room technician, Dr. I. Shragovitch, chief surgeon, Jewish General Hospital, Montreal, said he was pleased to have an opportunity to, "try and further their role in our operating room milieu." According to Dr. Shragovitch, an OR T program was started 15 years ago in the Jewish General Hospital, and was accepted by the ANPQ. He said the program had proved satisfactory, and illustrated the need for "further devel- oping such a program." Following a lengthy commentary on the subject, Dr. Shragovitch said, "It is not only my own and our own hospital experience that I am emphasizing, but the fact that the Canadian Task Force, our nursing bodies, and the experiences in the United States should move us all, especially the ORN, to continued efforts to develop this program." Although the convention was packed with work sessions and discussions on subjects related to the operating room nurse and the technician, time was scheduled for relaxation each day. Dur- ing these get-togethers, nurses and speakers continued their favorite topic - the operating room nurse and how best to serve the patient. CNA President Addresses RNANS Annual Meeting Nova Scotia - Focusing attention on the word love, Sister Mary Felicitas, president of the Canadian Ñurses' As- sociation, told the May annual meeting JULY 1970 ; - .ar , \ - , ..... t . I Nurses attending the three-day annual meeting of the RNANS at Acadia Univer- sity.Wolfville, Nova Scotia, heard speakers discuss education and its application by the nurse. Four participants were, left to right, Sister Mary Felicitas, CNA president; Virginia Dunlop. inservice supervisor, Victoria General Hospital, Halifax; Isabel Brown, director of nurses, Scarborough Regional Hospital, West Hill, Ontario; and Sister Clare Marie, Glace Bay, who chaired the morning session. of the RNANS here. that she felt love is an important factor in nursing care. Definitions of the word, Sister said, included nourish, preserve, and cherish, each a vital force in itself. Speaking to the three-day meeting at Acadia University. Wolfville. Sister Felicitas welcomed members of the RNANS before summarizing her con- cepts of the nurse-patient relationship, and its response to love. Discussing an inservice program in a general hospital, Virginia Dunlop. inservice supervisor, Victoria General Hospital, Halifax, said. "industry has developed programs that assist em- ployees to find their proper place in the organization and to develop their capabilities to the fullest." An inservice program, according to Mrs. Dunlop, "should be developed around the areas of personnel needs - orientation. skill training, development of leadership. management abilities. and continuing education." A representative from the Halifax Youth Agency. Alistar Watt. told the nurses, "We are a drug taking society. Half the commercials on television are aimed at making you take some kind of drug." Referring to the widespread use of non-medical drugs and the rehabilita- tion of the addict, Mr. Watt stressed. "Unless society can give the addict that which he needs to be able to cope with- out drugs. he will be back on the street." Posing a tantalizing question, bar- rister Qeorge Cooper asked his audi- ence if the law should take upon itself the job of, "dictating morals to these [drug addicted] people." Isabel Brown, director of nurses, Scarborough Regional Hospital, West Hill, Ontario. presented a synopsis of the two-year program in action. Fol- lowed by a question and answer session. the symposium detailed the various facets involved in the program. Reports from local branches were received from committees on nursing education. nursing service. and social and economic welfare. Membership in the RNANS was re- ported as 4.665 in 1969, and the enroll- ment in schools of nursing 500. Other points of interest in the reports included: the repeal of the present Board of Examiners by-law. enabling broader representation to meet the needs of the CNA testing service; a two-year diploma program for five schools of nursing approved. and ap- proval given to shorten affiliation pro- grams in obstetrics. pediatrics, and psychiatry to eight weeks; the G.E.D. test accepted for assessing the prospec- tive mature student; and $3.000 voted to the Canadian 'urses' Foundation Scholarship Fund. THE CANADIAN NURSE 11 V .Vi1i __ . '\ \ :' l.l- . . . . -4Þ c.;. -; t . .. - . .. ., '\ ... - .... - ... , ... wi ..../ .. . , " t ' ,) ) ...... \; .... ) Attaching footswitch electrodes to the foot of secretary Joan Bryan at the NRC Laboratory is a tedious but important rou- tine before the gait study can commence. Dr. Morris Milner (center) and his work associate, Arthur O. Quanbury, are seen taping metal pads in position. A closeup of the footswitch electrodes and electromyographic electrodes, located on the outer side of both legs, is seen as the subject begins her walk along the metal strip on the sixty-foot wooden walkway. Computerized Walking Ottawa- "Watching the girls go by" is more than a light-hearted phrase for two bioengineers at the National Re- search Council in Ottawa. Their concern is the study of human locomotion and the development of programmed elec- trical stimuli to activate paralyzed lower limbs. Walking on a metallic strip, down a 60 foot walkway, to the tune of a con- stantly beeping machine, has been a 21-year-old secretary's contribution to the study. Dr. Morris Milner and Arthur 0. Quanbury, bioengineers in the Con- trol Systems Laboratory, NRC, care- fully noted her gait as they researched data on muscle stimuli. Under conditions programmed by the engineers, the secretary's walkway preambulations were paced by a moving study-cart. Affixed to her heels and toes were metal pads. As the pads made con- tact with the metallic strip, an electronic beep in the study-cart recorded gait measurements in signals transmitted by wires attached to her legs, and ajunction box carried at her waist. To the watchful engineers, the con- stant beep alerted them to peculiaritiö in walking habits and muscle use. 12 THE CANADIAN NURSE Describing their work to The Cana- dian Nurse, Dr. Milner referred to his comments in Nature. August 9. 1969, where he and his associate, Arthur Quanbury, noted that the stud) "... deals with the effects of surface stim- ulation on normal human beings. Elec- trodes of various areas. and stimuli consisting of square wave voltage pulses of SO Hz, 0-2 ms wide and going neg- ative at the stimulus site. were used. These pulses were applied in trains last- ing for one second. with an intervening rest period, also of one second. This regimen corresponds roughly to the pe- riods of activity of the various muscle groups in an average walking cycle." Interest in the study started a year ago, when the two bioengineers discov- ered little attention had been given to the evaluation of problems and develop- ment of devices, enabling totally par- alyzed lower limbs to be moved. They feel the value of their work "will depend on the ability to relate joint trajectories to specific abnormal- ities and deficiencies, and to extract pertinent data for electro-stimulation of useful muscles." Full understanding of the detailed, complex process of human locomotion is the initial aim of the study . To achieve this, and to find answers to involved questions. undergraduates fromCarleton University in Ottawa have experimented with a human leg formed in clear plas- tic. They have "explored internal elec- tric fields produced by electrically active surface electrodes," attempting to gain greater knowledge of the "best surface stimulation arrangements." The leg is fitted inside with leg bone structure and filled with a "physiologically normal solution. " Other experiments include the use of rats in a study on "how muscles might best be used as transducers, to extract information about the forces they exert and the motions they impart to the limbs." '"If found fea ible:' says Dr. Milner, "our experiments will be a positive way to monitor the position and behavior of the neuromuscular system. subject to programmed electro-stimulation. A research group in Winnipeg, with "similar. but more immediate clinically oriented interests" has been collabo- rating with the NRC team. Dr. Milner, who came to Canada from South Africa to take part in the study, will be returning to his homeland this JULY 1970 news summer. He will introduce the locomo- tion study in the Groote Schuur Hospi- tal. Capetown. where he has been ap- pointed head of medical physics in bio- engineering. Asked if the nursing profession would be involved in the hospital application of this study. Dr. Milner said, "Although nurscs have not been involved in the NRC experiment. I expect the nurse to take active participation eventuaIly. "They will definitely be of great as- sistance to me and mv work in South Africa." he added. . American Indian Nurse Is ANA Choice Miami Beach, Fla. - Audra Pambrun a member of the Montana Blackfeet In dian tribe, was named national winner of the American Nurses' Association BE-INvolved Nurse contest. The an- nouncement came May 5 at the ANA annual convention. AIl registered nurses in the United States were eligible for nomination in the ANA search for exceptional per- formance in improving the health. so- cial, or economic climates of their com- munities. Miss Pambrun, who received a $2,000 award from Schering Labora- tories, is contributing half of this award to Montana's first suicide crisis inter- ve'"!tion center in Browning, Montana, which she opened a year ago. This cen- ter is manned by aides trained by Miss Pambrun. As director of community health aides for the Office of Economic Op- portunity' community action program m Brownmg. Miss Pambrun covers a territory that has a caseload of 7.000 Blackfeet Indians. Each month she drives 2,000 miles to visit at least 50 families. S e has trained local people, mostly Indians, to work as community aides. They visit almost every home on the Iackfeet reservation to help with serv- Ices such as transportation to hospital, housing repair. sanitation, and coun- seling. Miss Pambrun has also set up an accident prevention workshop for com- munity aides in Browning. Student Nurses In U.S. Show They "Give A Damn" Miami Beach, Florida. - More than I ,000 members of the National Student Nurses' Association in the United States set the stage for the 18th annual con- IULY 1970 *T.M. "l' ASSISTOSCOPE, DESIGNED WITH THE NURSE IN MIND Acoustical Perfection . SLIM AND DAINTY . RUGGED AND DEPENDABLE . LIGHT AND FLEXIBLE . WHITE OR BLACK TUBING . PERSONAL STETHOSCOPE TO FIT YOUR POCKET AND POCKETBOOK Order from vi M WINLEY-MORRIS CO. LTD. venti on of the organization. held April 30 to May 3, with a one-day hunger strike. Wearing white armbands, many fas- tened with "Give a Damn" buttons to indicate the day's theme, the students bought food with the amounts allotted to welfare recipients in their respective states. These amounts ranged from 3 cents per meal in Puerto Rico to 28 cents in New York State. Sparked by a resolution introduced by the District of Columbia Student Nurses' Association. the protest diet spread throughout the convention. This meant sharing a jar of peanut butter and \\ a loaf of bread or a meal of crackers and water. Senator George McGovern, in his keynote speech at the convention, noted that 15 million Americans suffer daily from lack of food. He pointed out that the average taxpayer contributes $400 annuaIly to military expenditures and $2 annuaIly to feed the hungry. The National Student Nurses' As- sociation includes representatives from all states except Alaska, plus the Dis- trict of Columbia and Puerto Rico. The four-day convention preceded the biennial meeting of the American Nurses' Association, May 3 to 8. 0 Surgical Products Division MONTREAL 26 QUEBEC ASSISTOSCOPE DESIGNED WITH THE NuRSE IN MIND Acoustical Perfection ... SLIM AND DAINTY ... RUGGED AND DEPENDABLE ... LIGHT AND fLUIBLE ... WHITE OR BlACK TUBING ... PERSONAL STETHOSCOPE TO FIT rOIJl/ POCKET AND t'OCKETBOOK tfIII'C Mace In Canada , r Ey ----l' I 2795 BATES RD MONTREAL, P.O. I I Please accepl my ...der I... I I _ 'A$s,sloscope(s)' al $1295 each I I I 0 WhIle tubmg 0 Black tubl'1! I I I I NAM' I I ADORESS I I CN" I L_______________J Re.idenh of Quebec add 1% Provincia' Sol.. . Tax. THE CANADIAN NURSE 13 names \.. , \ - p. .\ - __.-!f '" " ... , ,. " . " . II r I ..,. f \-- iff r . J' (: I , , . "\ . .. Florence H.M. Emory, second from left, received an honorary Doctor of Laws degree from the University of Toronto, May 29. Until her retirement in 1954, she was associate director of the University of Toronto School of Nursing. Con- gratulating Dr. Emory are, left to right, Dr. Claude Bissell, president of the uni- versity; Dr. Omond Solandt, chancellor; and Dr. Helen Carpenter, director of the school of nursing. The citation read, in part: "Miss Emory influenced the devel- opment of public health nursing in Canada and throughout the world through her publications and through the students she taught." Dr. Emory is author of the well-known text Public Health Nursing in Canada, published in 1945. An honorary Doctor of Laws degree has been awarded by the University of To- ronto to Florence H.M. Emory, pro- fessor emeritus of the university's school of nursing and an international- ly honored nursing leader. Because of her early interest in pre- ventive medicine, Dr. Emory entered the Grace Hospital School of Nursing in Toronto, graduating in 1915. She then joined the Toronto department of public health, working as a district superintendent and later supervisor of the school health service. In 1924, after a year of studies in preventive medicine and public health at the Massachusetts Institute of Tech- nology and Boston College, Dr. Emory joined the department of public health nursing at the University of Toronto as assistant director. This department became the school of nursing in 1933, and in 1938 Dr. Emory became asso- ciate director of the school. She is also well known for her work 14 THE CANADIAN NURSE as professor of nursing with particular responsibility for public health teach- ing, and her leadership in establishing the bachelor of science in nursing course, the first of its kind in Canada. Dr. Emory has contributed greatly to many professional and community organizations. She was chairman of the public health nursing section of the Canadian Public Health Association from 1925 to 1927; first president of the Registered Nurses' Association of Ontario from 1927 to 1930; president of the Canadian Nurses' Association from 1930 to 1934; chairman of the membership committee of the Interna- tional Council of Nurses; and national chairman of nursing services for the Canadian Red Cross Society. In 1953, Dr. Emory was awarded the Florence Nightingale Medal by the International Committee of the Red Cross. After her retirement in 1954, she served as honorary adviser in nurs- ing to the Red Cross Society. Eileen M. Jacobi has been appointed executive director of the American Nurses' Association. She succeeds Hil- degard E. Peplau, interim executive di- rector since September 1969, who was elected president of the association at the ANA convention in Miami Beach. Dr. Jacobi has served as ANA asso- ciate executive director since December 1968. She has a diploma in nursing from Cumberland Hospital School of Nurs- ing in Brooklyn, New York; bachelor's and master's degrees from Adelphi University, Garden City, New York; and a doctoral degree from Teachers College, Columbia University. The new executive director has a wide range of experience in clinical nursing, education, research, and ad- ministration. From 1956 to 1968 she was an assistant professor, associate professor, professor, and dean at Adel- phi University. She has worked as psy- chiatric nursing consultant, Veterans Administration Hospital, New York City; instructor in nursing education and consultant in psychiatric nursing at Teachers College, Columbia University; and supervising research nurse at Creed moor Institute for Psychobiologic Studies, Queens Village, New York. Dr. Jacobi is consultant and ANA liaison to the National Institute of Men- tal Health Advisory Council, and is active in numerous professional, com- munity, and educational organizations. E. Jean Mackie (R.N., Royal Alex- andra H., Edmon- ton; certificate in teaching and super- vision, U. of Toron- to; B.N., McGill; M.N., U. of Wash- ington, Seattle) has been named director of nursing at Selkirk College, Castlegar, British Columbia. The college's new nursing program will begin in Septem- ber 197 l. Miss Mackie was previously director of the Algoma Regional School of Nurs- ing in Sault Ste. Marie, Ontario. She has been chairman of the department of nursing education at Mount Royal Jun- ior College in Calgary; medical-surgical nursing teacher at Everett Community College in Everett, Washington; assist- ant director of nursing education and clinical teacher at the General Hospital IUL Y 1970 ? ,,-. #..r ..} Nurse Elected President of CPHA ........ .... "- ".., , " 111 111 " . ... " ... .' I . . f. ... or. " t), ..ì , . [ ;: I'H ' .it ; ,i((ì ..;:J. r_ '" I . 't. t t r '---: I, r .J' :-;.. . e:-" C , . ! . IIII - --- - - --- - - Geneva Lewis, director of public health nursing for the Ottawa-Carleton region, accepts the congratulations of two staff members in her office at the public health unit. Mrs. Lewis is the first nurse and the first woman to be elect- ed president in the 61-year history of the Canadian Public Health Association. Here, she looks at press clippings of the CPHA convention, held in Winnipeg May 19 to 22, with Wilhemina Visscher, left, assistant director of public health nursin for the Ottawa-Carleton region, and Catherine McGregor, right, a supervisor at the health unit. A graduate of Hamilton General Hospital and the University of Buffalo, Mrs. Lewis has had 20 years experience in public health. After 10 years with the Weiland istrict health unit, she accepted her present position in 1960. Mrs: LewIs told The Canadian Nurse that, as president, she hopes for increased lay Involvement in the association and for a closer liaison with other health agencies. She would also like a closer relationship between associations such as the CPHA and the Canadian Nurses' Association. in Calgary; clinical teacher at the Gen- eral Hospital in Medicine Hat, Alberta; and nursing arts teacher at the Royal Alexandra Hospital School of Nursing in Edmonton. - - \ D. Jean Passmore Elizabeth E. Hartig The Saskatchewan Registered Nurses' Association has announced two appoint- ments to its professional staff: D. Jean Passmore and Elizabeth E. Hartig. D. Jean Passmore (R.N., Royal Jubilee H.. Victoria, B.c.; dip/. teaching and superv., V. of Saskatchewan, Saskatoon) is the new assistant registrar for SRNA. Mrs. Passmore, a native of Calgary, JULY 1970 Alberta, was an obstetrical instructor at Providence Hospital in Moose Jaw, Sas- katchewan, before her appointment. She has also worked in general duty, surgery, and obstetrics at Providence Hospital. An active member of SRNA, Mrs. Passmore has been vice-president, secretary-treasurer. and chairman of the education committee of the Moose Jaw chapter, and a member of the committee setting examinations for nursing assistant certification in Saskatchewan. Elisabeth E. Hartig (R.N., Royal Vic- toria H., Montreal; B.Sc.N., V. of Western Ontario, London; M.N.. V. of Washing- ton, Seattle) is the newly-appointed nurs- ing consultant for SRNA. In this position, Miss Hartig is responsible for providing consultative services to the general mem- bership of SRNA. with major emphasis on continuing education programs. Miss Hartig has worked as an operating room nurse at Victoria General Hospital and Deer Lodge Hospital in Winnipeg, Manitoba For 10 years she served with the Lutheran Church in America's board of world missions in India, where she << I worked as a director of a school of nursing, in nursing service, and in hospital administration. I Since her return to Canada, Miss I Hartig has been a clinical instructor at the Royal Alexandra Hospital in Edmonton, Alberta, and matron of Good Samaritan Hospital in Edmonton. From 1961 to 1963. she was director of the centralized teaching program for student nurses in Saskatoon, Saskatchewan. She has also been medical-surgical coordinator at the Vniversity of Saskatchewan school of nursing in Saskatoon; assistant professor in nursing education at The Vniversity of Western Ontario in London; and assistant superintendent of nursing education and director of the school of diploma nursing at the Saskatchewan Institute of Applied Arts and Sciences in Saskatoon. . Ruth C. MacKay (Reg.N., Hamilton Gen- eral H.; B.A., McMaster V., Hamilton; M.N. and M.A., Emory V., Atlanta, Geor- gia; Ph.D., V. of Kentucky, Lexington) has been appointed associate professor at Queen's Vniversity School of Nursing. Dr. Mackay was an instructor in nurs- ing at Emory Vniversity and the Vniver- sity of Kentucky; coordinator of the sophomore year at the University of Kentucky College of Nursing; public health nurse in St. Petersburg, Florida, and Dalhousie, New Brunswick; and gen- eral duty nurse at Mount Hamilton Hospi- tal in Hamilton. Ontario. Margaret J. Brack- stone (Reg.N., Pub- lic General H., Chatham, Ont.; Dip/. Nurs. Educ. and B.Sc.N., U. of West- ern Ontario, Lon- don) is the new as- sistant director, school of nursing, at Public General Hospital in Chatham. Before this appointment, Mrs. Brack- stone worked as an instructor at Hamil- ton Psychiatric Hospital. and at Hamilton Civic Hospitals School of Nursing in Hamilton, Ontario. ...... .....- Jean Dobson (R.N., Victoria General H., Halifax; Dipl. Nurs- ing Servo Admin.. Dalhousie V.; B.Sc.N., Mount Saint Vincent V., Halifax) is the new director of nursing at Nova Scotia Sana- torium in Kentville, Nova Scotia. Miss Dobson has experience as a staff nurse at Victoria General Hospital in Halifax, The Montreal General Hospital. }(jng Edward VII Mtij110rial Hospital in Bermuda, and Blanchard-Fraser Memorial THE CANADIAN NURSE 15 -- .. ,... ........-- -' 40 '1:'u. O Ic._J - """- For nursing . convenience. . . patient ease TUCKS offer an aid to heal ing, an aid to comfort Soothing, cooling TUCKS provide greater patient comfort, greater nursing convenience. TUCKS mean no fuss, no mess, no preparation, no trundling the surgical cart. Ready- prepared TUCKS can be kept by the patient's bedside for immediate appli- cation whenever their soothing, healing properties are indicated. TUCKS allay the itch and pain of post-operative lesions, post-partum hemorrhoids, episiotomies, and many dermatological conditions. TUCKS save time. Promote healing. Offer soothing, cooling relief in both pre-and post-operative conditions. TUCKS are soft flannel pads soaked in witch hazel (50 % ) and glycerine (1 0%). TUCKS - the valuable nur- sing aid, the valuable patient comforter. '- Specify the FULLER SHIELD as a protective postsurgical dressing. Holds anal, perianal or pilonidal dressings comfortably in place wIth- out tape, prevents soiling of linen or cloth- ing. Ideal for hospital or ambulatory patients. vi WINLEY-MORRIS St. M MONTREAL CANADA TUCKS is a trademark of the Fuller Laboratories Inc. 16 THE CANADIAN NURSE names Hospital in Kentville, Nova Scotia. She has also been a staff nurse, head nurse, supervisor, and director of nursing service at the Nova Scotia Sanatorium. An active member of the Registered Nurses' Association of Nova Scotia, Miss Dobson is a past president of the Valley branch, a member of the RNANS nursing service committee, and a third vice- president of the association. Alberta G. McColl (R.N., Regina Gener- al H.; Dipl. P.H.N., V. of Saskatchewan, Saskatoon; B.S.N., V. of British Colum- bia; M.S., V. of Cali- fornia, San Francis- co) has been ap- pointed associate director of nursing education at Royal Columbian Hospital school of nursing in New Westminster, British Columbia. Miss McColl first joined the hospital school faculty in 1960 as surgical nursing instructor. From 1965 until her new appointment, she was psychiatric nursing instructor in the affiliate program. Her previous experience also includes work as a public health nurse with the department of public health in the Weyburn-Estevan district of Saskatchewan. As an active member of the Registered Nurses' Association of British Columbia, Miss McColl is a past secretary and president of the New Westminster chap- ter. She is currently a member of the RNABC committee on nursing education and a member of the board of examiners. ,. ... ..... Miriam Pill (S.R.N., Kings College H., London, England; S.C.M., maternity hospitals in Cam- , bridge and Dorset, England; Cert. Teaching and Admin. and B.Sc.N.E., V. of Ot- tawa) has been named director of nursing at Maimonides Hospital and Home for the Aged in Montreal. Before coming to Canada, Miss Pill worked as an operating room staff nurse at Freedom Fields Hospital in Plymouth, England. She was a supervisor of nurses at the Ottawa Civic Hospital and was assist- ant administrator at New Orchard Lodge in Ottawa prior to her appointment. Active in the Registered Nurses' Asso- ciation of Ontario, Miss Pill was first vice-president of the Ottawa West ChaE=- ter in 1969. U JULY 1970 new products { Descriptions are based on information supplied by the manufacturer. No endorsement is intended. Urethral Catheter Tray Urethral Catheter Tray This generously-sized. closed system collection bag can accommodate the con- tents of even greatly distended bladders without the need for disconnecting, em- ptying, and reconnecting. Because the system is completely closed, there is no danger of spilling or leakage during use. The specially designed, screw-<>n con- nector protects the funnel end of the catheter from contamination and permits collection of sterile specimens without contamination of the catheter or speci- men container. The 1,500-ml capacity collection bag features an opaque white backing that permits excellent visual monitoring of urine coloration and flow. The tray is complete with all items needed for procedure, all sterile packaged within a CSR wrap. This MacBick product is distributed through the Stevens Companies in Toron- to, Calgary, Winnipeg, and Vancouver, and from Compagnie Medicale & Scienti- fìque Ltée. and Quebec Surgical Com- pany in Montreal. I - -------, J_ 1 L. , , 1;=- _ ',- - 1;-. -- c... _. I' . Ii , I \ ... . Safety Grip Bath Seat This safety grip bath seat overcomes difficulties experienced in using a bathtub and aids in personal washing. The eleva- tion of the seat permits its use as a Sitz bath in a regular bathtub. Constructed from chrome-plated tubing, this unit is fitted with non-slip rubber tips to give extra holding power. The bath seat features an open frosted seat 6 inches hIgh, with a wide base of 14 inches. For complete details write to Everest & Jennings Canadian Limited, P.O. Box 9200, Downsview, Ontario. and subsequent patient discomfort are eliminated. Specific material and design advan- tages, plus the benefits of a matched components system. represent a signifi- cant advance to the postoperative man- agement of bladder drainage. The Silastic Cystocath is packaged sterile and is dis- posable. More information is available from the Medical Products Division, Dow Corning Silicones, I Tippet Road. Downs- view. Ontario. 0 -- .OQIVC SLun.ç. C Ðf .. Bladder Drainage A new self-contained suprapubic system for bladder drainage followmg gynecolog- ical surgery has been introduced by Dow Corning. The Silastic Cystocath features a soft, flexible, incrustation-resistant silicone rubber catheter; an easily-applied body seal for catheter fìxation and protection of catheter entry site; and a non-irritat- ing, pressure-sensitive, silicone adhesive that affords maximum protection for the duration of use. This system promotes early spontane- ous voiding and minimizes the possibility of bladder contamination. In addition. trauma due to urethral catheterization JULY 1970 -... - ::. .. ....... -, .... -- p .. "'- Bladder Drainage '" THE CANADIAN NURSE 17 blli3[;tw and Special Selections tor Nurses MRS. R. F. JOHNSON SUPERVISOR ... TIII.rld AI MIIII .... 169 ------=-= ------=-: 1 DR. JOH N WILLIAMS I RESIDENT . u OL BROO'" - A tN COHN. LPN. Mltll Framed N'.111O All WIIite PlIStiC NI.510 Largest.selhng among nurses I Superb hfetlme quahty. smooth rounded edges . . . fealherweight, lies flat . . . deeply engraved, and lacquered Snow.while plaslic wIll nol yellow. Salistaclion guaranteed. GROUP DISCOUNTS SAVE. Order 2 Identical Pins as pre. caution Ifainst loss, less chlnging. 1 Naml Pin only 2 pins (slml nlml) *IMPORTANT P1tase 16<<1 2St per order h1ndh"l dllrl' on III orders of 3 J)lf\\ 01 len GROUP OISCDUHTS 2 .99 pins, 5%. 100 or more. 10%. Send cash. m.D., Dr check. No billings or coe... Sel-Fix NURSE CAP BAND : t:v;: e: p rst ff lñD ; n '---- Dr pmning. Reusable several times. \ r:rh ':: s:2 -' if' e t :x't *" 18 pe' box). 1ó" 16 per box), I" No. 6343 (6 per bod. Specify width desired In Cap Band. ..1 bUJ{ 1.65 ITEM column on coupon 3 Dr marl 1.40 ea. NURSES CAP-TACS _ _ Remove Ind refasten cap band Instantly for launderm, and replacement l Tm1 C : &: tc B i W o ad r :1 - with Gold Ceooceus, or all black (plaIn) __ :;;::- No.200Setof6Tacs.. 1.00 per set SPECIAL I 12 Dr more sets... .80 per set i' Nurses ENAMELED PINS \: --' Beautifully sculptured st,tus rnsigm.; 2-color keyed, :I ;e:" lp f: t 1 e u 11. No. 205 En.meled Pin. . ....... .1.65 ea. ppd. , Waterproof NURSES WATCH G SWISS made. raised sliver full numerals. lumirl. mark. . r inp Red.llpped sweep second hand. chrome stamless .' ' Clse St'mless expansion band plus fREE black le.lher ' slrap I wr.,uaranlee. _2: No. 06-925 . .. .. . . .. . .. . . .. . 16.50 01. ppd. Uniform POCKET PALS -----. Protecls agalnsl stems Ind wear. Phable white L ,. n I o: :.I:= . ::' 'I:: ; l IJr fllvors :v: O-E J ':r å :a ' ppd. Personalized BANDAGE L"' SHEARS "-" 6" professional precIsion shears, forged m steel. Guaranteed to stay sharp 2 ye.s No. 1000 Shean (no imtl"S) . . . . . . . 2.75 ea. ppd. SPECIAL! 1 Doz. Shear, .. .. . ...... . $26. total Imtlals (up to 3) etched. .. .... . add 5ac per pair "SENTRY" SPRAY PROTECTOR Protecls you agamsl wlolenl man or dOl . mSlanll1 disables wllhoul permanent inlUrJ'. No. AP.16 Sontry . . . 2.25 oa. ppd. :1 I I ITEM COLOR QUANT. PRICE I . OROER NO. . . PIN LETT. COLOR, 0 Black 0 Blue 0 WhitelNo. 169) . METAL FINISH, 0 Gold 0 Silver INIJlALS _ __ . LETTERING . . 2nd Lone. . I enclose $ . Send 10 . . Str.et . "c ... at... .:....1 Please .lIow sufficient time far delivery. 18 THE CANADIAN NURSE dates August 2-7, .1970 Congress of the International Associa- tion for Child Psychiatry, Jerusalem, Israel. Theme: The Child in his Family. Details on group air fare and travel programs are available from Domi- nion Travel Office ltd., 55 Wellington St West, Toronto 1, Ontario. August 24-28, 1970 Workshop for library staff in nursing, hospital, and medical libraries, spon- sored by the OMA, OHA, and RNAO, Wilson Hall, New College, University of Toronto. Topics to be discussed in- clude administration of a library, col- lection development, organization of library materials, and library services. Applications are available from: Miss S.c. Maxwell, librarian, Ontario Med- ical Association, 244 St. George Street, Toronto 5, Ontario. September 1970 14th annual Registered Nurses' Asso- ciation of Ontario conference on per- sonal growth and group achievement. For further information write to: Pro- fessional Development Department, RNAO, 33 Price Street, Toronto 5, Ontario. September 26, 1970 The Nightingale School of Nursing in Toronto is marking its 10th anniver- sary with an open house and recep- tion for alumni and invited guests. For further information, write to The Nightingale School of Nursing, 2 Mur- ray Street, Toronto 2B, Ontario. September 28-0ctober 9, J970 Two-week symposium on the nurse's role in prevention and treatment of acute and chronic respiratory insuf- ficiency, Manitoba Rehabilitation Hos- pital, Winnipeg. Further details are available from Miss E.l.M. Thorpe, Consultant, Sanatorium Board of Manitoba, 800 Sherbrook Street, Win- nipeg 2, Manitoba. October 5-6, 1970 Institute on operating room and cen- tral supply room procedures, audi- torium, Calgary General Hospital School of Nursing. Sponsored by the Alberta Association of Registered Nurses. For further details write to the AARN, 10256 - 112 Street, Edmonton, Alberta. Ocrober 5-30..1970 Advanced program in health services organization and administration, The University of Toronto School of Hy- giene. The second part of this pro- gram will be held March 1-26, 1971. Fee: $200 for each part. For further information. write to: Dr. R.D. Barron, Secretary, School of Hygiene. Univer- sity of Toronto, Toronto 5, Ontario. October 7-10, 1970 Annual conference, Canadian Associa- tion for the Mentally Retarded, Hotel Vancouver, Vancouver, British Colum- bia. Special emphasis will be on the preschool child, residential services, and occupational-vocational programs. October 25-29, 1970 National conference on the impact of the environment, sponsored by the Canadian Council on Children and Youth and The Vanier Institute of the Family, Winnipeg. For more informa- tion, write to The Vanier Institute of the Family, 170 Metcalfe Street, Ot- tawa 4, Ontario. October 26-28, 1970 Ontario Hospital Association annual convention, Royal York Hotel, Toronto. Write to the OHA, 25 Ferrand Dr., Don Mills, Ontario. October 26-28, 1970 Annual meeting of the Association of Registered Nurses of Newfoundland, St. John's. Write to the AARN, 67 le Marchant Rd., St. John's, Nfld. November 3D-December 4, 1970 Conference for nurses in statt educa- tion and staff development, Westbury Hotel, Toronto. Sponsored by the Reg- istered Nurses' Association of Ontario. Write to: Professional Development Department, RNAO, 33 Price Street, Toronto 5, Ontario. 0 JULY 1970 in a capsule Arte riosderosis studied Which comes first in vascular disease - arteriosclerosis or atherosclerosis? According to an article in the April 7 issue of The Medical Post, the terms are often used interchangeably, and both are correct, but only at a certain stage of the disease. The author of the article, Derek Cassels, reports that a research team from New York's Cornell University believes that fibromuscular thickening of the inner arterial coat - arterios- clerosis - comes first. After this initial change a secondary phase leads to deposition of fatty tissue to transform the disease to atherosclerosis. The researchers have been studying these disorders for many years, using rabbits in their experiments. In their report they conclude: "These results [of the various experiments] indicate that fibromuscular thickening of the inner arterial coat can be a preferential site of fat deposition. The results also suggest that in man the primary event in atherosclerosis is not necessarily deposition of fat as is widely believed but is, at least in some instances, arterial injury." Phenacetin warning Phenacetin has been in the news a good deal lately. Following The Vancouver General Hospital's decision in January to re- place tablets containing phenacetin with others that are free of this ingre- dient, a number of doctors have com- mented on the possible dangers of phenacetin. According to a news item in The Globe and Mail January 22, Dr. Wil- liam Mahon, clinical pharmacologist at the Toronto General Hospital, said he planned to recommend that TGH also change to phenacetin-free pills. Phenacetin ought to be taken off the market, he said. Dr. Mahon pointed to research in Australia that indicates this compound can be a substantial hazard if taken in large amounts. Another Canadian authority, Dr. Jeffrey Bishop, director of the federal government's Drug Advisory Bureau, t'ood and LJrug LJirectorate, listed 217s, 222s, Exedrin, Sinex, Sinutab, and Coricidin as preparations con- taining phenacetin that do not require prescriptions in Canada. He lists the following over-the-counter prepara- tions that do not contain the compound: IUl Y 1970 Contac-C, Dristan, Bufferin, Anacin, Neocitran, Instantine, and Bayer Decongestant capsules. Dr. Bishop told The Canadian Nurse that phenacetin has been suspected of causing renal damage. Since 1965, the Food and Drugs Act has required that labels on preparations containing phenacetin carry a warning. The Food and Drug Directorate is now studying all reports of renal damage associated with phenacetin, and is looking at acetaminophen, another antipyretic- analgesic agent. The Directorate is considering further regulatory action, Dr. Bishop said. In an article in The Canadian Nurse in December 1964, Dr. John B. Dosse- tor, a leading Canadian nephrologist, wrote: "Analgesic preparations can damage the kidneys when ingested in excessive amounts. Phenacetin is a common ingredient of such pills and is believed by many to be the toxic factor. " Concluding his article. Dr. Dossetor said: "It may be necessary to do no more than caution users of phenacetll1- containing compounds. by means of the label on the bottle, that excessive intake might cause kidney damage." Don't rock the boat With water sports no\\ in full """ing. it's a good time to folio\\' the advice of the Canadian Red Cross Society. . If you use a power boat. see that the motor matches the boat. Attaching a large motor to a small boat can be dan- gerous. . Make sure your boat is large enough for the number of passengers you intend to carry. A small metal plate on the boat gives safe load and ptmer "peci- fications. . Outfit your boat with légalI} spe- cified safety equipment - one life- jacket for each person on board, two oars or paddles, a bailing bucket or manual pump, and a tIre extinguisher. It is also advisable to carry red distress flares, tool kit. first aid kit. and anchor on a 50-ft. line, and spare gas. 0 l , 1 ( ( ! i' J \) \1/ \ { "011 Nllrse BVllcllel- I'd {,/..e Iv lal/.. 10 WJ/I "",Ift( vour lengtlly coffee brell/..S -" J THE CANADIAN NURSE 19 if the thou,ght of all those heavy IV bottles depresses you, ;::.. , \ 1 #:' \ \ i . . , ..... " , .., .' ... ..... I \ I'!Þ \ \ . -4- I I \ \ I J ...... I l ''I. ,(\ \ v V1AFLEX WILL GIVE YOU A BG LIFT LV. solutions in glass bottles are heavy enough to begin with-but the longer the procedure, and the more bottles you use, the heavier they seem to get. It's hard to make light of a heavy subject like this, but we did-with VIAFLEX' plastic solution packs. They're much lighter and easier to handle than glass bottles. And, since there are no metal closures or caps to fumble with, set-ups and changeovers are faster. The whole procedure is safer, too. Because VIAFLEX is a completely closed system. No vent; no room air enters the container; no airborne contaminants get inside the system. Empty bags go into the wastebasket. VIAFLEX is the first and only plastic container for LV. solutions. For safer, easier, faster procedures, it's the first and only one you should consider. v olh R 2 TORIES OF CANADA 6405 Northam Dnve. Malton. Ontano Vialle" -Reg. Trade Mark Teachers Most nurses are aware of the hostility that exists between nursing service per- sonnel and nurse educators. What is the reason for this antagonism? Conversations I have had with edu- cators and ward staff in my own hospi- tal and in others lead me to believe that the hostility between these two groups is too widespread to be written off in terms of individual personalities. Question of territory A key factor responsible for this hostility is "territory." As Robert Ardrey notes, "What territory promises is the high probability that if intru- sion takes place, war will follow."* In the hospital, the unit is the ter- ritory of the staff members working there. This is clearly shown by the ad- jectives commonly used by staff mem- bers to describe their place of work: "This is my ward," or "How are your patients today?" Into this private territory intrude the clinical instructor and her students. The degree of hostility directed to the instructor and her students is re- lated to the length of time they spend on the ward. At one point when I was a student in a hospital school of nursing, I was assigned to the same ward for several weeks. My classmates and I joined the permanent nursing staff and received most of our clinical teaching · Robert Ardrey. The Territorial Imperative, New York, Dell Publishing Co.. Inc., 1966. JULY 1970 OPINION - you are trespassi ng! The author suggests that the question of "territory" is responsible for the hostility between nurse educators and ward staff. Daphne Walker Mesolella, R.N., B.N. from the head nurse and the registered nurses on the unit. The staff members accepted us and showed no hostility- perhaps because we worked the same hours and rotated shifts with them. Thus, we were not considered intruders. In those days, university nursing students, accompanied by their own in- structors, came to our wards periodi- cally for clinical experience. As "hos- pital-trained" students, we resented these "intruders" and often interpreted their short ward visits and small pa- tient assignments as an indication of their disregard for the needs of our patients. Problem grows Recent developments in nursing ed- ducat ion have intensified the problem of territory. Community college programs in some provinces and the CEGEPs in Quebec have diminished the time students spend on the wards. Also, with hospital schools of nursing gaining more control over their students' time. with programs being enriched by more clinics, and with more instructors assigned to the wards with students. the students and their instructors are no longer consi- dered members of the ward team. They The author is a graduate of the Royal Victoria Hospital School of Nursing in Montreal, and received her Bachelor of Nursing degree from McGill University. She was a Clinical Instructor at Douglas Hos- pital in Verdun. Quebec, when she wrote this article for The Canadillfl Nllr.\('. come to the ward several times a day generating even more hostitility. How can this hostility be reduced? Few educators would want to revert to the days when student nurses worked long hours, rotating evening and night shifts, and were often too tired to absorb lectures and planned learning experiences. Nor would the solution be to eliminate the role of clinical in- structor. Students have benefited from a nurse educator whose primary func- tion is to guide their learning. Perhaps, as Maxwell Jones suggests, hospitals should be totally decentra- lized. with each unit autonomous, and each area responsible for teaching its students. ** In line with this thinking, the clinical instructor would join the ward staff as a permanent member of the team. Between periods of teaching, she could become more involved in direct patient care. Such involvement would keep her up-to-date and would give her a chance to become better acquainted with the rest of the nursing staff. She might even act as a consul- tant for staff members if requested. Only when such a plan is adopted, or when students' clinical experience closely approximates the ward sched- ule, will nurse instructors and their students be accepted by ward staff- not as trespassers. but as members of the team. .. Maxwell Jones, Social Psychiatry in Practice, Middlese, England, Penguin Books. 1968. pp. 179-180. 0 THE CANADIAN NURSE 21 She's a regular at the racetrack... " . i ; J --'" " .. .. . , _\ ;ø Author Valerie Fournier, left, inter- views Mrs. Geoffrion in her first-aid room under the grandstand at Blue Bonnets racetrack in Montreal. . " and as the registered nurse at Blue Bonnets about the only thing she hasn't done yet is look after the horses! Valerie fournier, B.A., B.'. Someone you're always sure to find at the BIue Bonnets Racetrack in Mon- treal is Denise Geoffrion - she's been a regular for 14 years. She knows alI the jockeys, sulky drivers, and staff at the huge, modern track. Yet the most she ever bets on the horses is $10 or $15 a year. "I'd be a fool if I spent more than that," says Mrs. Geoffrion, who is the registered nurse on duty during every race at BIue Bonnets. In her years of working at the track she has seen too many people with heart attacks, anxi- ety, and empty wallets to feel the gam- bling urge herself. Mrs. Geoffrion has many potential patients to worry about every night: 950 employees in the stands, more than 1,200 persons working in the stables, and up to 35,000 spectators in the stands - though the nightly average is between 8,000 and 10,000. "It's like a smalI town after 7:00 p.m.," says Mrs. Geoffrion. Last year she treated over 3,000 patients and sent 300 of them to hospital. H 'to " . \ ., Present for all races The presence of a registered nurse and a doctor at race time is specified in the contracts of the jockeys and sulky drivers at Blue Bonnets. Mrs. Geof- frion, whose first language is French, is also on hand to treat visitors and staff. This season there are 210 days of harness racing and 63 days of flat racing at the track. "Sulky drivers and jockeys are two entirely different breeds," Mrs. Geoffrion says. "The drivers don't come ""-' .. .. .A ... - , "- yo . ............ = . . Mrs. Fournier, a graduate of Carleton Uni- versity's School of Journalism, is Public Re- lations Officer at the Canadian Nurses' As- sociation, Ottawa, Ontario. "f'..... ..... .... . . þ' o ,. . .. ... '" . .. ..JA "'- " . .- þ fill': t"'" .. f") 0 II' , , f . A . .. . '. <. . '. " j , .. . . ........ - .. . :J '. .. . '. i " . .. .-::- - ,. .. - <.>> .... 1 " - .. -' " -. . ..' -,. - .", " Þ 1_-' .,..c- -- . . On quiet nights at the racetrack Mrs Geoffrion keeps herself busy. Here she finishes crocheting a mauve and white hac made of raffia. As part of her job Mrs. Geoffrion checks on the health of the staff at Blue Bonnets. Here she takes the blood pressure of Harold Woolgar. an elec- trician at the track. o. 24 THE CANADIAN NURSE " . - - - . .. ,; , i . . ... - """" ...:.; t. ' ""c" . .:. .;;;:'c.-. - r' . . \ .. " )": ?.\.' - ,..,:, . . ., " "'... 4'. ;'. ,,,,;.-..'!9 f, '1-- #Ý ., ..... 't ,..." , , ;.. ".:...! . '" -. .........._ . ..-:,. ... .. " ,. , \ . . . . a , A F ' ..j - \ , , \ , "'- ...... " , t JULY 1970 to me for first aid unless there is a bad accident on the track. Most of the time I have to run after them to treat them. They figure it's closer and easier to get treatment along with their horses from the track veterinarian!" On the other hand, the jockeys are always coming in with minor ailments. Mrs. Geoffrion says they tend to be fussy and temperamental and keep her very busy. Flat racing is also more dan- gerous than harness racing. The jockeys worry over a smaIl scratch or a headache, and expect Mrs. Geoffrion to come over to their rooms on the other side of the stands for an examination, even though all medical equipment is kept in the first-aid room. If a jockey claims he cannot race be- cause of some ailment, Mrs. Geoffrion must go through a complicated proce- dure that involves bringing in the su- perintendent and track judges to confirm that he is incapable of riding. If he misses a race without due cause, he is fined at least $40. "I must know all my boys," she says of the jockeys and drivers. "I have to train them to come to me when neces- sary, and I am careful how I handle them." After 14 years at the track, she knows the individual problems of each jockey. One regular is a hemophiliac, and she is particularly anxious when she knows he is riding. A full-time job Mrs. Geoffrion started her job as track nurse when it was a part-time po- sition. In those days the racing took place at Richelieu Park, a smaIler track in Montreal, and races were held for only 100 days a year. The racing season has lengthened each year, and now her job keeps her working five evenings a week for eleven and a half months. "I also work 50 Sunday afternoons a year," she says, "but for some reason I'm still considered a part-time employ- ee. I don't know how much more regular I can get!" Mrs. Geoffrion starts work around 6:00 p.m. each evening and stays until after the crowds leave before midnight. Sometimes Mrs. Geoffrion is swamp- ed with calls, especially during special events when a large purse is at stake. The excitement is apparently too much for some people. Sunday afternoons during the summer are also busy. "Preg- nant women and people with epileptic or cardiac conditions watch the races and forget they are standing in the sun for two or three hours," she said. IUL Y 1970 Heart attack is the most serious emergency the nurse encounters, and it happens frequently at the racetrack- usually once every three or four days. A police ambulance can be on hand within four minutes for visitors, and those who require hospitalization are usuaIly taken to St. Mary's, the nearest hospital. Mrs. Geoffrion has treated many arm and leg fractures resulting from acci- dents during races, and an ambulance is kept on the track at all times for emergencies that involve jockeys and drivers. She is alerted to a crisis on the track by the closed circuit television and the loudspeaker in her room. Accidents big and small One of the most spectacular accidents occurred this year when the lead horse in a harness race tripped and feIl. Five horses, their drivers, and sulkies piled into the first team. Luckily only one driver was hurt when a horse fell on him and broke his coIlarbone. Four of the six drivers involved came to Mrs. Geof- frion for treatment of minor injuries. In fact, minor problems, such as scratches, splinters, headaches, and burns, are the most common ailments Mrs. Geoffrion treats. But with so many people in the stands, these often keep her more than busy. Every night she compiles a full report on the number of patients and their treatment. Most of these visits are quite routine, but she does have the occasional story to tell. There was the time, for instance, when a rotund man being treated for a minor burn fainted and fell right on top of her. And it is not unusual for men to bring their wives who are feeling ill to her office, asking her to keep them until the end of the night's racing so they can go back upstairs and bet! "Fortunately, I've never had to deliv- er a baby during the job, though I've had two extremely close calls," says Mrs. Geoffrion. "I'm just as glad, since I'm no longer interested in obstetrics - after 16 years spent in maternity wards, who would be?" Six stretchers are kept around the stands, and one is in the first-aid room below the stands. A room adjoining the first-aid room holds two beds, a wheel- chair, and an oxygen tank; the doctor on duty also has his own office. These doctors are usuaIly from one of the Montreal hospitals, and they change frequently. Other equipment includes a special spotlight for removing splin- ters, and equipment for locating foreign bodies in eyes and ears - a common problem on the track and in the stands. A few quiet nights Some nights are quiet, and then Mrs. Geoffrion keeps busy reading. knitting or crocheting. She makes mod hats out of raffia and knits beautiful dresses; her work has been sold to many Montreal boutiques. The main reason Mrs. Geoffrion took the job at the racetrack and has stayed for 14 years is that she is interested in people and wants to learn as much as she can about them. An enterprising person, she once worked at the Royal Victoria Hospital in Montreal to im- prove her English, and she also took a job at the Santa Cabrini Hospital to learn Italian. "Some of the jockeys are Italian and are delighted to hear a few words of their own language," she says. The nurse at Blue Bonnets is a well- known character among the staff. On quiet nights someone always drops in for a chat, and Mrs. Geoffrion is usuaIly the first to hear the latest news. She says the staff is like one large family to her; she checks on those who have hyperten- sion or who need a series of injections for allergies. In short, she looks after them well. What with the staff, jockeys and driv- ers, and the steady stream of visitors to the track, Mrs. Geoffrion has had more than enough to keep her interested and enthusiastic about her unusual job. And although she likes horses, about the only thing she has not had to do yet is to stand in for the veterinarian! 0 ',/ ,", THE CANADIAN NURSE 25 Friday, April 22, 1966 began as a normal day in the post-anesthesia recovery room of a well-equipped western Canadian hospital. The five operating rooms were booked for that morning, two patients were in the P.A.R. room, and the two nurses on duty had things well under control. At approx- imately 10.15 a.m., and with the full knowledge and approval of her super- visor, one of the nurses left the room for her coffee. In the interval between her departure and her return, events occurred in the P.A.R. room that set in motion a lengthy lawsuit in which it was alleged that the doctors involved and the hospital were negligent. In this interval a patient, a 44-year-old school teacher and mother, who had undergone a cholecystectomy, was brought to the P.A.R. room and while there, according to the trial judge, "suffered a lack of oxygen to the brain for such a length of time that this directly resulted in per- manent brain damage which has reduced her to an infantile state." The patient and her husband brought suit, alleging negligence. The task that confronted the court in this instance was to investigate the responsibility for the result and, if anyone or any organization was found to be negligent, to direct that they pay damages to the patient and her family. As background to this kind of situ- 26 THE CANADIAN NURSE Negligence in the recovery room Some months ago, an injury received by a patient in the post-anesthesia recovery room in a Canadian hospital was the basis of a lawsuit brought against several doctors and the hospital. The action was dismissed against the doctors. The hospital was found liable. Here, sharply condensed, is how the trial judge interpreted the evidence that led to the verdict. ation it should be recorded that not every disaster of necessity indicates that there has been a negligent act. Some years ago in a leading case, it was said that the court would be doing a disserv- ice to the community were it to impose liability on hospitals and doctors for everything that goes wrong, and it was held that the court must have regard to conditions in which doctors and hospi- tals have to work and should "not condemn as negligence that which is only misadventure." In the same case it was also said that "... in medical cases the fact that something has gone wrong is very often not in itself any evidence of negligence. In surgical operations there are inevi- table risks." The trial lasted eight days and brought out reams of evidence - vastly more than could be included in an article of this nature. Among the elements of particular significance to nurses involved was evidence of ambiguities in the recording of the time of specific events in the P.A.R. room. This of course brought into question the exact time when the nurse was absent This article was prepared in collaboration with E. Peter Newcombe. Q.c., of the firm of Gowling. MacTavish, Osborne & Hen- derson. Ottawa. The editors thank Mr. New- combe for his valuable assistance. and the relation of this time to those particular moments in history when the patient suffered the injury. Also involved was the judge's appraisal of the responsibilities devolving on the P.A.R. room and its staff. Other elements were also examined, but in view of the conclusions of the trial judge this article will focus largely on these two aspects as seen through the eyes of the trial judge and recorded in his reasons for judgment. For the purpose of anonymity, all participants in these events are identified by initials. The patient was Mrs. L, and the two nurses most closely associated with the event are identified here as Nurse Sand Nurse M. How did this situation in this partic- ular hospital develop in a manner that became the basis of legal action? Here in excerpted and abridged form is how the trial judge summarized it after hearing evidence from the plaintiffs and defendants. Trial judge's comments "Various times were given both verbally and by way of nurses' charts as to the happening of certain events. I find that these times are all approximate times, were not accurate times and cannot be relied upon. U When I refer to any times they will be merely approximations and I do not find them to be facts. IULY 1970 "Around 10.25 a.m. Nurse M left the P.A.R. room to go for coffee. She had gone on duty at 9.30 a.m. This left Nurse S alone in the P.A.R. room with patient T and baby H. While Nurse M was still absent, and after her departure from the P.A.R. room. patient M ar- rived. This put Nurse S alone in the P.A.R. room with three patients. "Nurse S said that she started to attend to M when he was brought in, but she had to leave M because Mrs. L was brought in. It was definite that Nurse S was alone in the P.A.R. room when Mrs. L was brought in. This placed her, Nurse S. in the P.A.R. room with T. M. Mrs. L, and possibly baby H was still there. The next event took place still in the absence of Nurse M, namely the arrival of the patient R at the P.A.R. room accompanied by his anesthetist, Dr. T. and a nurse who had been in the operating room with R. I am satisfied that patient R arrived just after Mrs. L came into the P.AR. room and that Nurse M was still not in the P.A.R. room. "Nurse S then left Mrs. L to go to R, because R's anesthetist, Dr. T, gave her an order...that he wanted an injec- tion of Demerol to be forthwIth given to his restless patient R. Nurse S then left Mrs. L to give this injection to patient R. It is to be noted that Nurse S had not finished her check of Mrs. L when she left Mrs. L to go to administer the Demerol to the patient R. "At this stage of the proceedings T. M, Mrs. L. and R were all in the P.A.R. room (baby H most likely having been returned to the ward by this time) and Nurse M was still absent from the P.A.R. room. "Various mechanical steps had to be gone through by Nurse S in order to go to the narcotics drawer in the P.AR. room, unlock same, measure out the required amount of Demerol for the patient R, administer same, before being in a position to return to attend to Mrs. L whom she had left. Before returning to Mrs. L, however. the telephone rang and Nurse S answered same. This call was a personal call from a nurse who was away ill and who wanted to have somebody pick up her pay cheque. Mrs. L was unobserved by anyone at least during these events. "When Nurse S returned from where she had left off in her check of Mrs. L, she noticed that the patient was not breathing or was in trouble with her breathing and thereupon moved the patient and the stretcher on which she JULY 1970 was lying to another station where she felt the suction outlet operated better. She also stated that she called Dr. C who was in the P.A.R. room using the telephone..:' (Editor's note: There followed some observations on the movements of patients and doctors that indicated by the time Nurse M returned to the P.A.R. room. the injection had been given to R and that Nurse S called to her for assistance.) "...Nurse S said that ordinarily there are two nurses on duty in the P.AR. room and that they can call for extra help if needed. She said that on the arrival of Mrs. L. she checked to see if her respiration was adequate. that same was adequate and normal and that her pulse was regular. She did not have time to take her blood pressure. She said that Dr. C brought in patient M and that he. Dr. C, \\ required. Ob- jectives of the committee are: to ensure that the patient gets the best possible THE CANADIAN NURSE 29 --- / ft' t service from the product; the hospital gets the best cost value; and that stand- ardization of products is achieved throughout the hospital. The formation of the committee was not unique, but it did become obvious to the nursing administrator and the purchasing agent that a cohesive force was needed to coordinate the commit- tee's duties. It seemed essential to have someone who would be responsible for planning and establishing a program for investigating, selecting, and testing products. And so a new role in the hos- pital's nursing service department evolved - a nurse coordinator, with responsibilitIes to: develop an interest in, and awareness of, new trends and new products in relation to nursing needs and improvement of patient care; maintain contact with the nursing areas by being aware of nursing needs and keeping nursing staff informed of new trends; make the initial assessment and selection of potentially useful products through discussion with the purchasing agent and sales representatives and, after consultation, set up evaluation programs in specific hospital areas; function through the evaluation com- mittee, preparing and suhmitting reports with recommendations, follow-up re- ports at required intervals, and promote standardization in the hospital. 30 THE CANADIAN NURSE '>:r .. - " \ ... þ" . #, ;, - -- Philosophy and method At the University Hospital we be- lieve that products to be tested have to be given a fair evaluation. We also feel this must be done at point-of-use (the patient care area) by the nursing and medical staff, and all concerned with using the product. HO\" do we do this'? What is our approach'? When a sales representative brings a new product to the attention of the purchasing agent, the Nursing Coordi- nator is consulted and an appointment with her and the salesman may be made. Similarly, requests from the nursing department, for the need of or informa- tion on a new product, are channelled through one source (the nursing coordi- nator) to the purchasing agent. who makes the necessary enquiries. When the information is received, meetings with the sales representatives might in- clude other nursing staff. This is decid- ed by the nursing coordinator. If the product is considered to have potential, a sample is obtained and displayed at a weekly nursing administrative meeting (including evening and night supervi- sory staff). Following the meeting. di- rectors of nursing have an opportunity to request an evaluation carried out in a specific clinical area, or they may prefer to delay decision until after dis- cussion with the head nurses. Discussion of a new produc1 by the evaluating committee evolves around three main questions - patient needs, consultation, and who decides for or against the product. Chaired by the assislant purchasing agent, 1he com- mittee represents most areas of the hospital. At this session, author Rita Dolan {third from right}, gives her reactions 10 the product under discus- sion. Other members from left to right: Beno Enns, controller; Lottie Rea, director, O.R. Nursing; Dr. William B. MacDonald, anesthetist; Beth Bouey, central supply supervisor; Rila Dolan, nursing coordinaror; Ronald Nuthrown, assistant purchasing agent; and Dr. Clarence Berg, surgical staff The responsibilities of the nursing director (in some hospitals k.nown as supervisor) in planning total patient care are vital. Her functions also include developing patient care in harmony with the objectives and policies of the hospi- tal. All of which point to a sound reason why the nursing director plays an im- portant role in evaluation and standard- ization. The coordinator has to consult many people before accepting a new product for evaluation; there may be implications involving several departments. It is possible the medical staff, central sup- ply services supervisor, the laundry manager. the bacteriologist. or the build- ing services department might have opinions on the product - foresight has proved to be better than hindsight! After all these people have consider- ed the product, the coordinator ap- proaches the nursing area. She plans for evaluation with the nursing staff and all others concerned. Effective testing is accomplished by establishing specific criteria, and checking the product against it for a variable period of trial use. An evaluation record or form, which accompanies the product to the nursing unit, is completed by the user for follow-up information. Personnel are given thorough instruction in the use of the product, and close follow-up is JULY 1970 During evaluation of a new product, the hospital personnel are given thorough instruction in its use. Sometimes a sales representative displays the product, as in this picture. Peter Groves demon- strates the use of an elastic sheath bandage to nurses (left to right), Diane Walker, head nurse; Annie Bannon and Sylvia Swan, both certified nursing assistants; and Correlia Vanderhoeff, R.N. kept during the trial period. Failure to do this could adversely affect accep- tance of change from one product to another. There are certain factors to be con- sidered when making a decision on a product, and answers to many questions are sought. . Will a disposable product fulfill the same function as the reusable one it replaces? . Will it improve patient-care? . Will professional personnel approve its use? . Will other hospital departments be affected by its use? . Is it labor-saving? . Will its use be feasible economically? . Does the packaging meet acceptable standards of sterility? . Is it launderable? If so, will it with- stand repeated washing? . Is it likely to require maintenance or repair? . Will there be storage or disposal problems? . Will adequate supplies be available? . Will it promote standardization? . What are the implications for teach- ing many categories of staff? If the evaluation results are favorable, the Coordinator prepares a report with recommendations to the chairman of the evaluation committee, who takes JULY 1970 J I 'P . i t ""\ t t IIII k " ..,/ \ .- , , - -.- ,. , --pital serving a large urban population. A checklist of teaching activities and an opinion questionnaire were used to collect data. Observation schedules were arranged to correspond with the peak load of nursing care activities on three medical-surgical units and one emergency service unit from 7:30 to 10:30 a.m., I :00 to 2:30 p.m., and 4:00 to 6:30 p.m. for six days. The sample consisted of II nurses - staff nurses employed on these four units during day and evening tours of duty. A total of 42 hours was spent observing the teaching activities of the II nurses. Of the 234 teaching occasions in which these nurses were observed, I SO were devoted to teaching physical care of the patient, and most of this teaching was directeù to the nonprofessional nursing personnel. On 127 occasions ..ides and orderlies were taught nursing activities involving physical care. Act- ivities concerned with emotional sup- port of patients were taught considera- bly fewer times. Patients were taught 37 times; on 55 occasions teaching was overlooked or omitted. The nurses agreed that teaching the nonprofessional nursing personnel and student nurses was necessary during their nursing practice, and accepted this teaching responsibility. Only one nurse, who graduated before 1950, did not accept her teaching role, claiming the teaching she did delayed her too much in her nursing duties. The nurses' answers to the situation-type questions dealing specifically with patient teach- ing indicated a varying understanding anù recognition of their responsibilities for teaching patients. The conclusions of the study were: the staff nurse engages in teaching ac- tivities during her nursing practice and recognizes this as she directs and in- 42 THE CANADIAN NURSE structs student nurses and nonprofes- sional workers; the staff nurse teaches both administrative and nursing care procedures; nursing care procedures are taught most often by the staff nurse, and physical care of the patient receives the most emphasis in this teaching; the staff nurse directs most of her teaching to the nonprofessional workers; emo- tional support is not given proportion- ally the same emphasis as physical care; and the staff nurse, although recogniz- ing and accepting her responsibility for teaching students and nonprofessional workers, does not readily recognize her responsibilities for teaching patients. Griffiths, Helen Frances. Development of Likert scale to identify one nursing behavior practiced in general nursing. London, 1969. Thesis (M.Sc.N.), The University of Western Ontario. This study comprises an initial phase in the development of a research tool. which was intended to identify one nursing behavior in general nursing. The problem was to construct a Likert-type scale to identify this "one nursing behavior." The behavior in this study most closely ap- proximated the concept "therapeutic use of self," found in the literature. In this study, this one nursing behavior has been called "H-behavior in nursing' and was the number that resulted from the total score on the 90-item, 7-point Likert-type scale, by any respondent. The method was to construct a 90- item, 7-point summated attitude scale of the Likert type, composed of common sayings about nurses and nursing. Forty- five items were worded so that agreement indicated a high understanding, and 4S items were worded so that disagreement indicated a high understanding of thera- peutic use of self by the nurse. The subjects were a group of 380 nursing students, excluding first-year stu- dents, in five schools of nursing in south- western Ontario. Methods of data analysis were frequency distributions and frequen- cy polygons, determination of bimodal items by three different methods, correla- tion matrix using PM correlations, item- total correlation arranged in descending order of magnitude, inspection of a grid derived from the correlation matrix, and coefficient alpha of the original 90 items. Criteria for selection of items were bimodality of distribution and item-total correlation of 0.3 or above. Ten items met the criteria of this study, as showing promise for use in future. 0 Next Month in The Canadian Nurse · CNA Convention Report · Drug Misuse in Teenagers · Body Image in Pregnancy ð Photo Credits for July 1970 Crombie McNeill Photography, Ottawa, pp. 5, 6, top Rapid Grip & Batten, Ottawa, p. 6, bottom Studio C. Marcil, Ottawa, pp. 8, 15 Graetz Bros. Ltd., Montreal, pp. 10. 22, 24 Registered Nurses' Association of Nova Scotia, Halifax, p. II National Research Council, Ottawa, p. 12 Robert Landsdale, Etobicoke, Ont., p. 14 Miller Services Ltd., Toronto, pp. 22, 23 University Hospital. Saskatoon, Sask. pp. 30 - 32 The Recorder and Times. Brockville, Ont., pp. 33 - 35 Ottawa Civic Hospital. Ottawa, p.37. I JULY 1970 books On Death and Dying by Elisabeth KÜbJcr-Ross. 260 pages. Toronto. Collier-Macmillan Canada Ltd.. 1969. Re}JieH'ed by Jeanne Qllim Benoliel, Associate Professor, School of Nursing, University of California. San Francisco, California. Bdscd on intervie,,",s with more than 200 hospitalized patients. this book is a valuable addition to the growing number of volumes concerned with the psychology of dying. Using a psychi- atric perspective, the author proposes that dying in the psychologic sense takes place through five sequential, though overlapping, stages: denial, anger, bargaining, depression. and acceptance. Each stage and its behavioral manifes- tations are described in detail, and case materials from actual interviews are effectively used to illustrate the major points made. The central concern ofihe book is the difficulties patients have in communicating their needs during serious and fatal illnesses. One chapter is devoted to the mt1uence of families. emphasizing the patient's problems when his family cannot "give him up" psychologically. Another important chapter deals with hope and with the unfortunate conse- quences for the dying person when he and those around him differ in their reactions to his dying. According to the author, these contlicts have their origins mainly in two sources: when other individuals respond with feelings of hopelessness while the patient is still in need of hope, and when the patient is ready to die and other people continue to cling to hope, no matter how unreal- istic it may be. The interviews on which the book is based began as an effort to assist theology students in learning to talk with dying patients. The author frankly describes the resistance encountered in getting the project started. Despite many problems. the interviews even- tually came to be used as the Core of an interdisciplinary seminar for medical students, nurses. chaplains, and many other professional workers. The author provides persuasive argument that those in the helping occupations can learn from persons who are dying, if they allow the dying patient to be their teacher during this difficult time. JULY 1970 The book provides evidence that an interdisciplinary seminar on the prob- lems of the dying can do a good deal to improve communication among the many disciplines involved. By providing a mechanism for open discussion of the conflicts and pressures posed by death. this type of seminar encourages the development of mutual respect and understanding among those partici- pating. The author makes no pretense that talking with dying patients is easy. Rather, the problematic aspects of death for the patient, his family, and hospital staff are described and dis- cussed with respect and understanding. In simple and clear terminology, the book provides direction for anyone interested in improving his ability to talk meaningfully with those who are dying. Nurses interested in this aspect of their work should find it a valuable reference, as should teachers of nursing. In Horizontal Orbit, Hospitals and the Cult of Efficiency by Carol Taylor. 203 pages. Toronto, Holt, Rinehart and Winston of Canada Ltd., 1970. Reviewed by Madge McKillop, Nursing Administrator, University Hospital, SasJ..atoon, Saskatchewan. In this book, the author attempts to show the effect of centralized adminis- tration, with its cult of efficiency, on patient care. The horizontal orbit of the title is the movement of the patient to many different areas of the hospital, frequently in the horizontal position. The book is divided into three sections: the hospital. hospital roles and relationships, and society and the hospital. In the first section, the author examines today's hospitals and the various decision-making methods used in them. In the second section. she describes the roles of various members of the hospital, with particular reference to the doctor, patient, and nurse. She also suggests some ways in which these roles might be modified to benefit everyone, particularly the patient. In the final section, she looks at changes occurring in society and their impli- cations for the hospital, and especially nursing. She uses some of the work done at the University of Florida Hospital as an example. Unfortunately, the author attempts too much. Interesting topics arc merel touched on, leaving the reader still questioning the basis of some state- ments. There is a tendency. particularl} in part I, to stereotype the nurse as a slavish follower of rules. It would have been valuable te define the effect of the cult of efficiency more clearly. As usual, there are sections that have application only to the United States. For example, medicare American st Ie is quite different from medicare Cana- dian style. Despite these shortcomings. this is a valuable book, particularly for nursing administrative staff who are loo"-ing criticalIy at present practices. The concept of the role of nursing as the "patient protector" is a valuable one. The description of the "conveyor belt approach to people centered operations" may be somewhat exaggerated. but it does emphasize that big business practices cannot be introduced into hospitals without modifying them to meet the special needs of the institution. The author describes one method of decentralization that gives more scope for decision-making by the nurse providing patient care. The many references suggest areas for further study and more detailed examination of the topics discussed. This boo"- would also be of value to graduate _students in nursing adminis- tration or for faculty. However, junior students would find it confusing. Symptoms of Psychopathology: A handbook, edited by Charles G. CostelIo. 679 pages. Toronto, John Wiley and Sons. 1970. ReVIewed bv R. Barnl'u, Ph.D.. Psychology Department, Carleton University, Ottawa, Ontario. Thomas Kuhn, author of The Structure of Scientific RevolUTions, suggested that textboo"-s play a conservative role in science. that is, they propagate the current facts and theory of the day. The present handbook is such a volume. Ostensibly it is aimed at both the clin- ician and researcher. It may be of some use to the clinician unversed in experimental psychopathology, but it wilI be of little use to the researcher who demands more han token summd- ries of topic areas. The book should find its major use THE CANADIAN NURSE 43 POSEY PONCHO VEST The Posey Poncho Vest is one of the many products included in the complete Posey Line. Since the introduction of the original Posey Safety Belt in 1937, the Posey Company has specialized in hos- pital and nursing products which provide maximum patient protec- tion and ease of care. To insure the original quality product always specify the Posey brand name when ordering. The Posey Poncho Vest gives broad gentle support to wheelchair patient and prevents falling forward. There are eight different safety vests in the com- plete Posey Line. #5163-3633 (with snaps), $7.50. The Posey Deluxe limb Holder has synthetic fur lining to prevent wrist burns and a Velcro closure to insure perfect fit. This limb holder is one of fifteen in the complete Posey Line. #5163-2625, $6.00 pro I., ... /' i The Posey Patient Restrainer with shoulder loops and extra straps keeps the patient from falling out of bed and provides needed security. There are eight different safety vests in the complete Posey line. #5163-3131 (with ties), $7.80. "'- ,: " .. ) 'f \- ) The Posey Safety Roll Belt permits the patient to roll from side to side, yet prevents him from falling out of bed. This belt is one of seventeen Posey safety belts which insure pa- tient comfort and security. #5163- 1231 (with ties), $8.10. The Posey Ventilated Heel Protector allows free movement, yet protects heel and prevents irritation from con- tact with sheets. The Posey Line includes twenty-two other rehabilita- tion products. #5163-6120 (without plastic shell), $5.25 pro Send for the free all new 1970 POSEY catalog - supersedes all previous editions. Please insist on Posey Quality - specify the Posey Brand name. POSEY PRODUCTS Stocked in Canada ENNS ð. GILMORE LIMITED 1033 Rangeview Road Port Credit, Ontario, Canada 44 THE CANADIAN NURSE books ]\ in educational settings where the reader needs a quick review of a sub- ject area. The average chapter length is 25 pages. The amount of technical knowledge the reader must possess for understanding varies from chapter to chapter, from a prerequis- Ite undergraduate course in abnor- mal psychology to familiarity with work in learning, perception, and psychophysiology. The book's aim is to examine a set of "symptoms" indicative of "psycho- pathology." Unfortunately, there is no attempt to examine analytically what constitutes a symptom or what is the referent of the term psychopa- tho logy. The major chapter concerns the problem of classification and psy- chopathology. Here the above prob- lems should have been examined, but were not. This lack of foresight contributes to the wandering subject matter of the entire volume. Since the editor provided no guidance in what constitutes a "symptom," the contributing authors never confront this focal problem. Consequently, in a chapter on disorders of thinking, the author discusses the behavior of a variety of patients on perceptual and cognitive tasks and avoids the topic areas of hallucinations and delusions. Further, language disorders and the psycholinguistics of schizophrenic speech are ignored in this chapter. Instead there is frequently cited research in "overinclusion" and "concreteness. " The format of the book is designed around these topic areas: cognitive and perceptual disorders, disorders of affect, disorders of behavior, and psychosomatic disorders. The subject areas within each of these topics are sometimes theoretically and pragmat- ically important, e.g., chapters on disorders of memory, attention, and depression, and sometimes trivial on both counts, e.g., chapters on tics and thumbsucking. The major value of the book is the select bibliography following each chapter, which allows the reader to locate primary sources readily. Cornerstone for Nursing Education by Teresa E. Christy. 123 pages. New York, Teachers College. Press, Teachers College, Columbia Univer- sity, 1969. Reviewed by Margaret Steed, Advi- ser to Schools of Nursing, University of Alberta, Edmonton, Alberta. This book is a study that traces the de- JULY 1970 velopment of the division of nursing education at Teachers College, Col- umbia University, from its inception in 1899 through the administration of its first two directors, M. Adelaide Nutting and Isabel M. Stewart. It portrays a broad movement toward better, more informed education for nurses. The belief that education is an instrument of social change permeates the book. The book captures and holds the reader's attention, then leaves the read- er overwhelmed with the vision, cour- age, and leadership capacity of the many nurses mentioned. At the same time, it is perplexing to think that many of the concepts that were promoted and advocated some SO years ago are still being debated. This study is extremely interesting in the way it demonstrates the need to construct a perspective for analysis of current activities. Through a recon- struction process, professional groups can measure, evaluate, and predict so- cial change. The author relates current social forces that have always affected nursing, for example, changes and advances in science and technology, in the social structure, in intellectual con- cepts, and in economic and political establishments. The book identifies many concerns for nursing that are still evident. These include the lack of standardization in nursing education, the lack of resem- blance to education in hospital schools of nursing, the need for a sound econo- mic basis for schools of nursing, de- velopment and growth of auxiliary nursing personnel, the need for empha- sis on prevention by the community nurse, courses for teacher preparation, and opportunities for night classes for postbasic study of nursing. The concepts of pre-service and in- service education, continuing educa- tion, and the role of the clinical special- ist were promoted during the years covered, and the need for research as a foundation for nursing was advocated. Comments show that the major critics of nursing education continue to be members of the medical profession and hospital administrators. The true delight of the book is the series of achievements and goals of the issues in nursing during that time. The question that arises, and is asked, is: Are there nurses today astute enough to recognize the value and needs of nursing, and well enough prepared to pursue them, so that we may build on this cornerstone of nursing? This book is particularly valuable for the study of history and trends in nurs- ing and nursing education, and for those seeking reference to debate the many issues in nursing. I believe all nurses would find this book a reward- ing experience. JULY 1970 Persuasion, 2nd ed.. by Marvin KarIins and Herbert I. Abelson. 179 pages. New York. Springer Publishing Company, Inc., 1970. Reviewed by D.G. Ogston, FaCIlity of Arts and Science, The UnÎ1'ersÏly of Calgary. Calgary, Alberta. In his 1969 presidential address to the American Psychological Association, Dr. George MilIer encouraged psychol- ogists to explain to the public exactly what they were doing in their labora- tories. He predicted little future for a discipline that remained encapsulated in a mystique. Persuasion, though not a response to Dr. MilIer'scall. is a volume that doe much to open social psychol- ogy to public view. The book i more than two psychologists' review of thoughts and theorie on opinion and attitude. I t is a comprehensive colIection of the research and evidence that 'iUp- ports our contcmpOfélr) understanding of persuasion. The authors "iew persuasion as an everyday occurrence in any society or interpersonal relationship. The means of persuasion may be subtle or severe. and the consequences minor or crucial. Most of us are usually unaware of our daily persuaders until an issue is made Hollister ostomy products with karaya seal ...... , a boon to ileostomy and colostomy patients alike! " " Karaya Seal, a Hollister development. makes it possible for a patient's rehabilitation to begin in the hospital soon after surgery and offers him a simple, comfortable method of self -care after he goes home. The Karaya Seal Ring combines the protective qualities of karaya gum powder and the adhesive properties of cement-elimi- nating the need for dressings. Designed to fit securely around the stoma, Karaya Seal con- forms to body contours, protects the skin from intestinal discharge, thus avoiding painful ex- coriation. Each Hollister ostomy appliance is a lightweight. disposable, one-piece unit, with no gasket to retrieve, no parts to clean. Write (on professional letterhead) for free samples and information on Hollister ostomy products. OSTOMY PRODUCTS by HOLLISTER TM HOLLISTER LTD., 160 BAY STREET. TORONTO 116, ONTARIO THE CANADIAN NURSI: 45 books of them and images of brainwashing or subliminal advertising spring to mind. Certainly there is the extreme side of persuasion, as the authors indicate by citing some of the relevant research, but generally persuasion is a product of human interaction. As such. its study is important to our understanding of behavior and each other. To its credit, the book presents research that has stood the test of rigor. The research cited is representative of the best conducted during the past few years. Within its nine chapters, the book covers questions, such as: What kind of people arc the best persuaders? Who is most easily persuaded'! Under which conditions is persuasion best achieved? How long does the persuasion effect last'! One chapter is devoted to research methods and one to definitions. Their inclusion provides a depth of under- standing seldom found in books of this kind. The authors operate on the premise that persuasion can be viewed as a science, amenable to scientific method- ology. In their attempt to demonstrate that this is the case, they present and review some 30 issues with dispatch. The advantage of this approach is brevity. However, the brevity results in rather choppy reading as the reader attempts his own integration of the evidence. This book should be of particular value as a reference in schools of nurs- ing. Instructors may find it useful in preparing their own courses. The information in it makes it a regular mini-handbook. It would be a valuable complement to psychology or sociology courses. Anyone who wonders why he is persuasion-prone or immune to persuasion, will find the book interest- ing and informative. Healthier Living 3rd ed., by Justus J. Schifferes, 578 pages, Toronto, John Wiley & Sons, Inc., 1970. Reviewed by Mona C. Ricks, assis- tant editor, The Canadian Nurse. As a college course in health education, Healthier Living gives a comprehensive introduction to health standards and the knowledge of life situations. It would seem to be necessary reading for all col- lege students, especially as an essential contact with the mores and health con- trols today's social foibles demand. Treated under five major divisions: mental health, personal health, family living, health hazards, and environmen- tal health, the text gives a historic 46 THE CANADIAN NURSE glimpse of health through several dec- ades. Educational approaches to teach- ing health, appropriate readings, and teaching aids are also important topics. Instructors can assign parts of the book for study and other parts for free-time reading. Updated three times since the first publication in 1954, Healthier Living is complemented by Essentials of Healthier Living, now in its second edi- tion. New to Dr. Schifferes' third edi- tion of Healthier Lil'ing are selected readings from a variety of sources: The prevalent controversy on drugs, their use and abuse, takes the student through explanations on drug definitions, and gives an insight into the use of drugs on the campus. Perspectives in sexuality is given thorough treatment under "Ed- ucation for Family Living" (descriptive passages tell of the function of a family in marriage and as it relates in a techni- cal society, the social control of sexual behavior, and the control of sexual de- sires commanded by personal philoso- phies). Also new is a section on environmen- tal health, showing man's physical en- vironment, its changes, and problems. Key health questions are asked on the future of man's environment. The author's premise that the promo- tion of health ("for which you may read happiness") is a matter of concern in a constantly changing world, is indeed vital; especially when we are told the coming decade is predicted as an era of massive change. Therefore, instruction and guidance in health matters is a commodity that should be available to all educational levels. Perhaps the author might be per- suaded to write a version of Healthier Living for students of all ages. Couched in language easy to compre- hend, yet challenging to the reader who wants to know more, this book can be used for home study and/or by the classroom instructor. For the nurse, it could be a valuable source of philosophical evidence, shed- ding light on the healthful interpretation of the word "well-being," and exposing why the demanding word "happines!>" is still an integral part of healthier living in an all-consuming electronic age. 0 AV aids Medical film library A catalogue of medical films is avail- able without charge from the Ayerst Medical Film Librarv, Room 402, 4980 Buchan St., Montreal 9, Quebec. All films are 16mm. and for use with a sound projector. New Super-8 Movie System This Synchronex sound-on-hlm movie system consists of a Super-8 camera and easy-to-carry transistorized cassette tape recorder. The system uses standard Super-8 color film cartridges and tape cassettes. The only difference from si- lent movie making is that while filming, the recorder and camera are connected by a coil cord that carries synch pulses from camera to recorder. Sound films made with this system can be shown on any Super-8 sound projector. No separate tape machine is required. When the film is completed. the film and tape cassette are sent to the Synchronex laboratory for process- ing. The developed film, which has its own magnetic sound stripe with the sound on the film, and the reusable tape cassette are returned to the sender. This sound-on-film system permits editing and splicing without synchro- nization problems, since the sound and film cannot be separated. The complete system, including car- rying case, costs $295 in the United States. Made by the Synchronex Cor- poration of New York, this equipment is distributed in Canada by Hagemeyer Ltd., 18 Banigan Drive, Toronto, On- tario. New Cancer Film A 10-minute film on cancer research has been produced by the Canadian Cancer Society. "The Flower" tells about the discovery in 1958 of a cancer- killing drug called \'LB (vincaleuko- blastine) by a team of Canadian scien- tists. The team was directed by Dr. R.L. Noble, now head of the Cancer Research Centre and professor of physiology at the University of British Columbia. This drug, made from the periwinkle plant, is still one of the best for treat- ing Hodgkin's desease. The film was produced by Westmin- ster Films and is being distributed by Astral Films Ltd. For further informa- tion write to the Canadian Cancer So- ciety, 25 Adelaide St. East, Toronto, Ontario. 0 accession list Publications on this list have been re- ceived recently in the CNA library and are listed in language of source. Material on this list, except Reference items may be borrowed by CNA mem- bers, schools of nursing and other in- stitutions. Reference items (theses, ar- chive books and directories. almanacs and similar basic books) do not go out on loan. JULY 1970 Requests for loans should be made on the "Request Form for Accession List" and should be addressed to: The Library, Canadian Nurses' Association, 50, The Driveway, Ottawa 4, Ontario. No more than three titles should be requested at anyone time. BOOKS AND DOCUMENTS I. L'accord en franfais modeme par Ri- chard Bergeron 3. éd. rev. Montréal. Editions Pedagogia. 1966. 124p. 2. The accreditlltioll guide for extended care facilities. Toronto. Canadian Council on Hospital Accreditation. 1970. 31 p. 3. Attendre ,m enfallt par Marianne Ro- land Michel. Tournai Belgium. Casterman. cl970. 171 p. (Collection "vie effectuelle et sexuelle") 4. Birth: the slory of IIOW you wme to be by Lionel Gendron. Translated by Alice Co- wan. Montreal. Harvest House. 1970. 93p. 5. Brady's proRrammed ill1roduction to mi- crohiology. Washington. Brady. distributed by J. B. Lippincott. Toronto. 1970. 174p. 6. Canadian Hospitlll Association office and association directory March 1970. To- ronto, Canadian Hospital Association. 1970. 60p. 7. Collection flInté et sécurité. Montreal. Lidec Inc.. 1967. I. Ton livre de santé. 2. Une bonne journée. 3. Au grand air. 6. Pour votre santé. 8. COll1inuing education for women ill Callada; trends and opporlllflÎtie.\ by Marion Royce. Toronto. Ontario Institute for Studies in Education. 1969. 167p. (Monographs in adult education. no.4) 9. Cornerstone for nursing education; a his- tory of the Dh'ision o( Nursing r:.ducation of Teucher.r College, Columhia Unil'ersitv 1899 1947 by Teresa E. Christy. New York. Tea- chers College Press. 1969. 123p. 10. Dynamic psychiatry in simple terms by Robert R. Mezer. 4th ed. New York. Springer. 1970. 179p. II. L'écolier sa samé-son éducation par Pierre Debray-Ritzen. Tournai. Belgium, Casterman. 1970. 235p. IColiection "E ") 12. Emergency nursing by C. Luise Riehl. Peoria III.. Chas. A. Bennett. 1970. 286p. "Suggested reading: p. 241-246" 13. L'enjám del'all1 Ie film par Jean-Noël Jacob. Montreal. Marcel Didier. 1969. I lOp. 14. Everyman's United Nations. 8th ed. New York. United Nations. Office of Public Information. 1968. 634p. 15. Family life education; community res- ponsihility; report of symposium on se; edu- cation for those involved in any aspect of education. Don Mills. Ontario. Ortho Phar- maceutical (Canada) Ltd.. 1967. 81p. 16. The first day of life; principles of neo- natal nursing by Helen R. McKilligin. New York. Springer. 1970. 117p. 17. Health and the developing world by John Bryant. Ithaca. N.Y.. Cornell Univ. Press. 1969. 345p. 18. Higher education in the Atlantic prov- inces for the 1970's. A study prepared un- der the auspices of the Association of Atlan- tic Universities for the Maritime Union Stu- dy. Halifax. The Association of Atlantic Uni- versities. 1969. 121p. 19. l/lness and health. Action for mell1al health; final report of the Joint Commission ,UL Y 1970 on Mental Illness and Health. 1961. New York. Wiley. 1961. 338p. "ScIence editions" 20. Ill1l'1 "ell1ion in pwchiatric nuning' process in the one-to-one relationship by Joyce Travelbee. Philadelphia. Davis. 1969. 280p. 21. I.r there a nell' desigll for the (unctioll.\ (!( nUHinR sen'ices. Papers presented at the third annual meeting. Oct. 9-10. 1969. Cin- cinnati. Ohio. New York. National League for Nursing. Council of Hospital and Related Institutional Services. 1970. 47p. 22. NeuroloRical and ne/ll'os/ll'Kind nul".\- inK by Esta Carini and Guy Owens. 5th ed. Saint Louis. Mosby. 1970. 386p. 23. Nursing and the law edited by Eric W. Springer. Pittsburgh Penn.. Health Law Cen- ter. Aspen Systems Corporation. 1970. 188p. 24. On death and dyinR by Elisabeth Ku- bler-Ross. Toronto. Collier-Macmillan. 1969. 2(,Op. 25. Preparation for childbearing. 3d. ed. New York. Maternity Center A"ociation. 1969. 47p. 26. P.\yclwthérapie et relatioll.f IW/llaine.\; théorie et pratique de la thémpie Iwn-direc- ti,'e par Carl Rogers el G. Marian Kinget. 4e éd. Montreal. Institut de recherches psy- choJogiques. 1969. 2v. - Contems v.1 Exposé generaL- v.2 La pratique. 27. The role of the n/ll'.\e in the Oll1pariell1 depmtment: a pre/iminary report by Warren G. Bennis et aL New York. American Nurses Foundation. 1961. 88p. 28. Social worf.. in the Iw.rpitlll org(/Ili;:a- tion by Margaret Gaughan Brock. Toronto. Univ. of Toronto Press. 1969. 117p. 29. The unit management concept in }IO.\- pital patiell1 care. St. Louis Mo.. 1969. 174p. 30. La I'ieille.\.re par Simone de Beauvoir. Paris. Gallimard. 1970. 604p. 31. Vocatiollal and per.\OlIal ad,justmell1s in practical nursing by Betty Glore Becker and Sister Ruth Ann Hassler. Saint Louis, C. V. Mosby Co.. 1970. 156p. Teaching guide and test manual. St. Louis. C. V. Mosby Co.. 1970. 39p. 32. WorJ..hooJ.. for pediatric lIurses by Nor- ma J. Anderson. Saint Louis. Mosby. 1970. 159p. PAMPHLETS 33. AI/I/ual I"l'port. Toronto University. Faculty of Medicine. Behavioural Science Department. 1968-1969. Toronto. 1969. pam. 34. Execwi,'e comp('ll.flItion in CUI/ada. Toronto. H. V. Chapman Associates. 1970. pam. 35. Gl'Ileric plwrl/lacell1icals; the re(/.\Oll.\ ,,'hy. Cleveland. Ohio. Strong Cobb Arner Inc.. 1970. 13p. 3(,. Importllll1 thillgs to cOlI.\ider alld do aho1l1 family planllillg. Bramalea. Ont.. G.D. Searle and Company. n.d. pam. 37. N LN program.\ alld Sen'in'.r 1969; a report from MarKaret E. WaÜh, Gel/l'Itll Director alld Secretar\'. New York. National League for Nursing. 1970. 8p. 38. Report of Fi,st Natiollal Conjerellce on Mediwl Malpractice, Feh.7-8, 1970, Chi- cago. III. Sponsored by the American Osteo- pathic Association with the support of the United States Dept. of Health Education and Welfare. Chicago. American Osteopathic As- sociation. 1970. 39p. 39. Selected papers from International Seminar on Rehabilitation Programs in WorJ..mall's Compel!Satioll amI Rl'Iat('d FÎl'hl.\, Toronto. Canada. Mar. 2-6. 1969. Ottawa. When your pay starts at L 6 a.m... you're on charge duty... you've skimped on mea/s... ,q,. and on sleep... c;ø you haven't har[ time to hem D> adress... make an apple pie... wash your hair.: even powder i:Jj your nose . In comfort...- it's time for a change. Irregular hours and meals on-the. run won't last. BUI your personal Irregularity is another matter. It may settle down. Or It may need gentle help from DOXIDAN. use DOXI DAN@ most nurses do DOXIDAN is an effective laxative for the gentle relief of constipation without cramping. Because DOXIDAN con- tains a dependable fecal softener and a mild peristaltic stimulant. evacuation is easy and comfonable. For detailed intormat;, , co ult Vadem n or CompendIum. tH g g, ÞIVISION OF CA ADIAN HOECHST LIMITED --.-R 'pMAC) ..- THE CANADIAN NURSE 47 accession list Dept. of Manpower and Immigration. 1970. 38p. (Rehabilitation in Canada Supp. no.2) 40. SIIITCY 0,- lIIil/ois il/aui,'e registered """.\(' ; a repol"/ 10 parliCÎpctfllS. Conducted by Illinois Regional Medical Program in co- operation v. ith Illinois Nurses' Association. Chicago. 1970. pam. GOVERNMENT DOCUMENTS Cal/ada 41. Bureau of Statistics. Census of Canada, /96/; administrative report Ottawa. Queen's Primer. 1970. 371p. 42. - .C el/.\u.\ of Canada. /966; Households and fllll/ilie.\; house/wId afll/ JÚII/i/y staWs of il/dil'idllals. Ottawa, Queen's Printer. 1970. 28p. 43. - .Mcntal heallh stalistin, 1968. 191 p. 44. Dept. of Labour. Economics and Re- search Branch. Strit..cs and lockouts in Can- ada /968. Ottawa. Queen's Printer. 1970. 92p. 45.-.Mana1(cII/el/t COfl.wltarÎT 12 n_TT ^ Wf\ Z 'JT nn '01) 1 4 - The Can ad ian Nurse , J I . ,.) ,, I . r' '\ r . L ........_______, 1 .t{.. --<1 , D j1 " ,, - - - , I .. ., 1 - , convention report , . . I , my, you're getting big! --- the Shouldice story . 8ó 8/u4 w -- loA l?øjøAßneß LaløA Second Edition Creighton: LAW EVERY NURSE SHOULD KNOW By Helen Creighton, B.s.N., R.N., A.B., A.M., J.D., University of Wisconsin, Milwoukee. The long-awaited revision of this classic book is now in press. Written by a nurse and nursing educator who is also a lawyer, this book sets forth the facts of law that every nurse - from student to superin- tendent - should know. It covers every aspect of the law that is important to the nurse, from her obliga- tions as an employee to her responsibilities in wit- nessing a will. Tens of thousands of nurses found the first edition of this book valuable for study and for reference; the new edition is substantially larger, with added coverage of such topics as "good samar- itan" laws, child abuse, telephone orders, supervision of paramedical personnel, sterilization, and organ transplantation. Canadian law is fully covered. 246 pages. $8.10. June 1970. Second Edition Keane & Fletcher: DRUGS AND SOLUTIONS By Claire Brackman Keane, R.N., B.S., formerly of Athens (Ga.) General Hospital, and Sibyl M. Fletcher, R.N., Athens General Hospital. This text uses the proven methods of programmed learning to teach the administration of medications. The information is presented in short, easy-to-follow steps, with questions (and answers) that check the student's comprehension and reinforce her learning at every step. The conversion of dosages and cal- culation of fractional doses is made so clear and simple that the student can see the logic of each problem. All problems are solved by ratio and pro- portion, without confusing formulas. At the end of each section is a post-test, presented as an actual ------ nursing situation. The answers are given at the end of the book, as is a final examination that reviews and reinforces the entire book. About 240 pages, mustrated. Soft cover. About $4.00. Just ready. Flint & Cain: Fourth Edition EMERGENCY TREATMENT AND MANAGEMENT By Thomas Flint, Jr., M.D., formerly of Permanente Medical Group and Kaiser Foundation Hospitals, and Harvey D. Cain, M.D., Permanente Medical Group and Kaiser Foundation Rehabilitation Center. This handy pocket-sized book has helped tens of thousands of physicians and nurses in managing medical emergencies. The new Fourth Edition has been updated and expanded to inch,Jde care not only at the gite of injury. or illness but also in the emergency department of the hospital. This book gives a quick summary of diagnostic and therapeutic information on more than 100 emergency situations from angina pectoris to attempted suicide. 733 pages, mustrated. $12.45. May, 1970. Smith: RECOGNIZABLE PATTERNS OF HUMAN MALFORMATION By David W. Smith, M.D., University of Washington School of Medicine. This valuable new reference offers practical infor- mation on the etiology, natural history, and manage- ment of 135 patterns of human malformation. The author discusses morphogenesis, single syndromic , malformations resulting in secondary defects, genet- ics and genetic counseling, dysmorphic syndromes of multiple primary defects, and minor malforma- tions as clues to more serious problems. Original charts aid in counseling. 368 pages with 618 mustrations. $17.30. February, 1970: W.B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7 Please send on approval and bill me: o Creighton: Law Every Nurse Should Know ($8.10) o Keane & Fletcher: Drugs and Solutions (about $4.00) o Flint & Cain: Emergency Treatment ($12.45) o Smith: Pa<sess comments on the task forces report issued in November 1969, and get its recommendations implemented. The committee is reviewing all recommendations of volume one of the three-volume task forces report to develop possible t hniques for im- plementation. It has also established a program of activities that includes: THE CANADJAN NURSE 1] news setting up some 60 main target areas from the 348 recommendations to achieve impact within the health care system; a time schedule for this impact; starting development of spe- cific reports on danger areas in costs; and federal allocation of resources to meet objectives. The progress report highlighted three other developments. The steering committee has recommended a sub- committee be set up to include repre- sentatives of the health professions and consumers. The sub-committee would advise on implementation of some of the task force recommendations in regard to timing, economic impact, and other factors. Membership of the steering commit- tee has been broadened to include representatives from British Columbia and the prairie provinces. It already had representatives from the Mari- times, Quebec, and Ontario. The steering committee has asked all provinces to nominate persons who would act as liaison officers to help implement the recommendations. ANPQ Workshop Studies Misuse Of Drugs Mvntreal- Misuse of drugs was the topic of a workshop held on two suc- cessive days in April by District XI (English Chapter) of the Association of Nurses of the Province of Quebec. Some 240 nurses attended on the first day and 260 on the second. The involvement of all nurses professional- ly and personally in the drug scene was emphasized by A. Arundel-Evans, Queen Elizabeth Hospital, Montreal. She called the drug question one of the most challenging problems in society. Guest speaker Dr. Sidney Lecker of the Montreal Children's Hospital dis- cussed the evolution of the drug scene. He pointed out the need for the tradi- tional "humanistic" role of the nurse in all her relationships with drug users, and mentioned the lack of facilities available for treatment. A panel of young adults, some of who had been drug addicts, described their experiences with drugs. Panelists conveyed their social background, phi- losophy of life, and their present needs and concerns for understanding and acceptance. Another panel, which included peo- p e who work with youth using drugs, dIscussed the problems of helping drug users and preventing further misuse. Two films on the drug problem were also shown. 14 THE CANADIAN NURSE 1 . ... ,;t JJ t · , - ...... ." " - e \.., -- - A" ,- .ro ... .. .. '\.. .. .... \ "i;;." t ,....., -'"4 . ,. , , ,...... I , ". ' "t. " ... ì"" ".. .... .. " t. I " I ! -. ". .' . " . \" .T t - ... .. , á ' .. . , ' . " , ' , ' ; !. ,"." J C. .... "\ t' · 't". ' \ : :':'.: -J ," ..,. 0\".) . . .' t., > ,':"/t, 1 "I :.J='" .' -,. .... .. "1 ... ., f \ ... . fl' .,. ....., .,.;. It was breakfast at 7 a.m. under the trees for these students at the CNA 35th biennial in Fredericton, New Brunswick. Dianne North (standing), whose experiences as the only Canadian RN in Biafra appears in The Canadian Nurse, March 1970, leads the group in an "after bacon and eggs singsong." The students were observers at the week-long convention. One word expressed their reaction to the sessions - great! They felt their understanding of nursing involvement in medicine was broadened as they listened to discussions on patient care. Canadian Nurses Should Be licensed By Endorsement, US Council Urges New York - The USA Council of State Boards of Nursing agreed at a recent meeting to urge nursing boards to license by endorsement nurses licens- ed by the new Canadian Nurses' Asso- ciation National Testing Service exam- inations. This license by endorsement should last until a study can be conducted on the comparability of the CNA testing Service and State Board Test Pool exam- inations, said the Council. This decision was based on informa- tion that Canadian examinations are being developed along the lines of the SBTP examinations and will include the same clinical nursing areas. "Many US jurisdictIons now require the SBTP examination of all applicants for licensure," explained Eleanor Smith, coordinator of the Sate Boards of Nurs- ing Program of the American Nurses' Association. "In some instances this Nursin Studies Wanted The Canadian Nurses' Association Li- brary welcomes additions to its collec- tion of nursing studies. Any nurse who has a thesis or a report on a research project conducted at a hospital or other agency is invited to send it to the CNA Library, 50 The Driveway, Ottawa 4, Ontario. Short abstracts of studies re- ceived are published in the CN]. is required by board regulation, so boards of nursing should have no dif- ficulty in amending the regulation to waive the examination for Canadian nurses licensed by the CNA examina- tion. " The first set of examinations prepared by the CNA Testing Service will be written this month. Patient care Highlighted At NBARN Workshops Fredericton, N.R. - Nursing service took the spotlight during February-April in New Brunswick when a series of workshops on planning patient care was presented in 11 centers throughout the province. Some 970 nurses from Monc- ton, Edmundston, Fredericton, Saint John, Chatham, Perth, and Bathurst had attended the sessions at press time. Workshops were still to be held in Tracadie, St. Stephen, Cambellton, and Sussex. The one-day workshop was repeated in most areas so more nurses could attend. The workshops were sponsored by the New Brunswick Association of Registered" Nurses' nursing service and education committees. Chapter presidents and nurs- ing service and/or education committees completed arrangements at the local level and served as coordinators during the workshops. Workshop leaders included New Brunswick nurses skilled in the area of planning care, who worked in pairs when presenting the program. How to assess the needs of patients AUGUST 1970 news and plan the care to meet these needs was the general theme ot the workshops. The principles discussed were applicabl to any nurse-patient situation. whether in the hospital. community, or nursing home. Three areas in planning individualized care were outlined by the leaders: assessing needs, nursing action, and evalu- ation of the action. The participants then broke into groups to develop a nursing history guide. Following the presentation of a patient situation, each group applied its gUide to the presentation from which a nursing care plan was written. Nursing care plans from each group were present- ed and discussed by the total group. NBARN hopes results of these work- shops will lead to written nursing care plans for each patient in the province. CNF Fellowship Awards OIlUIt'U - The Canadian Nurses' Foundation has awarded a total of $61.237 to 19 Canadian nurses to pursue graduate studies in the 1970-7 I academic year. They were selected for leadership potential and scholastic ability. Indi- vidual awards range from $ 1.500 to $4.500. Lorene M. Bard. Regina. Saskatche- wan; Jeannine Baudry. Boucherville. Quebec; E. Gail Carleton. Montreal. Quebec; Patricia Christensen, Vancou- ver. B.c.; Joan Crook. Halifax. N.S.; Lesley F. Degner. Winnipeg. Manitoba; Jean E. Fry. Windsor. Ontario; Agnes M. Herd. Regina. Saskatche\l innipeg. Manitoba; Rita J. Lussier, Latleche City. Quebec: Joce- lyne Nielsen. Halifax. N.S.: Nora I. Parker. Toronto. Ontario; June R. Scollie. Winnipeg. Manitoba; Joan Shaver. Calgary. Alberta; Sharon E. Simpson. Toronto. Ontario; Phoebe Stanley. Montreal. Quebec; Marilyn M. Steels. Hamilton. Ontario: M. Louise Tod. Edmonton. Alberta; M. Anne Wyness. Toronto. Ontdrio. One hundred and twenty-nine a\l. Tooley. Chairman of the committee is G.B. Rosenfeld. \l, n." she said. Although the nurses voted in favor of strike action if the board refused their request fÓr arbitration. the) have not yet set a strike date. According tl) the current issue of RNAO Nnn, present salaries for Peel County puhlic health nurses are: minimum - $6.250 \\ ith four annual incremcnts of $350 to a maximum of $7.450. The hoard of health offers a 1970 minimum of $6.687. and for the second year of the contract. 197 I, a minimum of $7.155 with the same annual increment of 5300 for a maxi- mum of $9.300. In Ontario. hospital employee., are not allowed to strike. so disagreements go to compul lIry arbitrati n: As hea.lth units have no such provIsIOn. stnke action is the nnly solution open to nurses if the emplo)er refuses to meet their reyuests. 0 THE CANADIAN NURSE 15 new products { Descriptions are based on information supplied by the manufacturer. No endorsement is intended. " ... . - ...... ,",,- ...,........ ,-" ... .,. '" ß- ..... v. þ.. ......- s Un. CHACUNE 4Wß!IUf;;UW S aD UR -, ., ...",j,A,J PRETE-A-SERV f"'I'I-OTfl ,-VEC roUT fNSE",ØL! DE r{T1N. 5TAoo.