The Canadian Nurse Volume 66

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January 1970

The

Canadian
Nurse

Happy New Year!

new in psychiatry:
Moditen injectable therapy

nurse to the performing arts

iShfiJl^tnl

We want
a special kind

of nurse* #

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-
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.
Write: The Director of
Recruiting, Canadian
Forces Headquarters,
Ottawa 4, Ontario.

.^:^

THE CANADIAN ARMED FORCES O^i

MAFLEX WILL GIVE \OU A BG LIFT

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container; no airborne contaminants get

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inside the system. Empty bags go into the

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Ready for Second Semester.

New Edition!

Lippincott

NURSING CARE OF CHILDREN

(formerly Essentials of Pediatric Nursing)

By Florence G. Blake, R.N., M.A., F. Howell Wright, M.D.,

and Eugenia H. Waechter, R.N., Ph.D.

586 Pages 188 Illustrations 8th Edition

January, 1970 JIO.OO

PHILADELPHIA • TORONTO

The

Canadian
Nurse

^

^^F

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. Kotlarsky

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 views of the authors and do not
necessarily represent the policies or views of the Canadian Nurses' Association.

5 News

12 Names

15 Dates

16 New Products

18 In a Capsule

41 Research Abstracts

42 Books

44 Accession List

Executive Director: Helen K. Mussiilleni •
Editor: Virginia A. Lindabury • Assistant
Editor: Eleanor B. Mitchell • Editorial Assist-
ant: Carol A. Kotlarsky • 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
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-
ciation, where applicable. Not responsible for
journals lost in mail due to errors in address.
© Canadian Nurses' Association 1970.

.Manuscript Information: "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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
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. 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 remembei
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 ir
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
beUeve 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.A.L.

THE CANADIAN NURSE 3

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exclusively from
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There's no disputing the fine

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other instrument manufacturers use

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and we have case histories that prove it.

Available only from

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For additional
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Quebec and
Maritime Provinces

Guy Bernier

862 Charles-Guimowd

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Ontario and
Western Canada

John Kennedy
2750 Slough Street
Malton, Ontario

4 THE CANADIAN NURSE

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-
ister gave no reason for his decision.

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
performance 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 this 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 performance 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: S9,050 will be granted to
CHA by the government to help finance

JANUARY 1970

Four nurses from Trinidad currently studying at the Clarke Institute of Psychiatry are
from left: Maria Keith, Hollis Lashley, Josephine Parris and Barbara Harding.

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 terms 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 within the existing structure of
pubhc health services. The project's goal
is to 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, Ont. - As 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 sL\ 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. IContinued on page 6J

THE CANADIAN NURSE 5

news

Playhouse Is Hub Of CNA Biennial

(Continued from page 5)

The four nurses are: Barbara Harding,
Josephine Parris, and HolHs 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
cHnical 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

Fredericton, N.B. - 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
firms, 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. Out. - 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 wUl 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 governmental
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 Talon 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. Provisional-
ly accredited centers are resurveyed in
one year. Non-accredited may seek re-
survey when ready for reassessment.
JANUARY 1970

proves its smoothness

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
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refreshing-'^""'''''©.

ALCOJEL

Send for a free sample

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I Jellied

RUBBING
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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 S300.00
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,
work 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
of nursing, and other groups.

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 may be attached to the hat for winter wear.

Dr. Du Gas is working with the re-
search and advisory services of the Cana-
dian Nurses' Association to gather statis-
tics on nurses, and to set up ongoing
research. Studies on mobility, attrition,
and career patterns of nurses are particu-
larly needed. Dr. Du Gas told The Canadi-
an Nurse. She pointed out that CNA has
gathered more statistics on its members

Dr. Beverly Du Gas, nursing consultant, and Dr. George P. Evans, medical consultant,
work together on health manpower studies for the Department of National Healtn and
Welfare. Dr. Evans is head of the team, which also includes an economist and a
statistician. This team is carrying out studies on health personnel in Canada.
8 THE CANADIAN NURSE

than has any other professional associa-
tion in Canada.

Dr. Du Gas is a graduate of The
Vancouver General Hospital School of
Nursing, has a bachelor of arts degree
from the University of British Columbia,
a master's degree in nursing school ad-
ministration from the University of
Washington in Seattle, and a doctoral
degree in adult education from UBC.
She has worked as a staff nurse in
Seattle, San Francisco, and Vancouver; an
instructor in San Francisco and Vancou-
ver; and associate director of nursing
(education) at The Vancouver General
Hospital. From 1965 to 1967 Dr. Du Gas
was a nurse educator with the World
Health Organization in Chandigarh, India.

The new nursing consultant is co-
author of the book Fundamentals of
Patient Care: a Comprehensive Approach
to Nursing by Kozier and Du Gas, a text
that has sold thousands of copies in the
United States and Canada since its pu-
bhcation by W.B. Saunders in 1967.

Teaching Problems Discussed
At RNAO-OHA Conference

Toronto, Ont. - A professor of
education who believes that group discus-
sions tend to be too chairman-orient-
ed, made 190 nurses create their own
learning program as part of the confe-
rence for senior nurse adminstrators in
Toronto November 24-27.

Dr. William S. Griffith, assistant
JANUARY 1970

professor of education at the University
of Chicago, presented a session on "Con-
tinuing staff development — the director's
challenge" at the conference, which was
jointly sponsored by the Registered Nur-
ses' Association of Ontario and the Ont-
ario Hospital Association.

Dr. Griffith used shdes to demons-
trate what he described as the basic
difficulty of teaching: the various approa-
ches students bring to problem-solving.
He asked the audience to identify a confi-
guration within a pattern, then asked two
volunteers who had successfully identi-
fied the configuration to try to teach
the rest of the group to see it as they
saw it. "I know it, but I just can't
teach it" and "You can tell me that,
but I don't perceive it that way," were
the ways Dr. Griffith summed up the
difficulty the audience and the volunteers
had in understanding one another.

Dr. Griffith emphasized the diffi-
culty in communication as he spoke to
the group about adult education. He
pointed out that unless the student un-
derstands the instructor's view of the
problem, much of the teaching time
can be wasted. Often, he added, the
student does not even see that there is
a problem.

Dr. Griffith listed some guidelines
for adult education, and outUned the
steps in preparing a program for adult
learning. He warned the nurses that stu-
dents must be involved in the planning
process and that they must beUeve they
are being asked to contribute, not mere-
ly being asked to accept the instructor's
point of view.

Dr. Griffith asked the audience to
suggest some of the most difficult prob-
lems they face in setting up programs in
their own hospitals. The answers included:
time for training, motivation, a reluctance
of junior staff to assume responsibility,
selling the program to the hospital ad-
ministration, recognizing learning priori-
ties, lack of money and instructors. During
the afternoon the participants formed
round-table discussion groups to choose
one of these topics and to suggest pos-
sible answers to the problem; each group
appointed a reporter to explain its solu-
tion to the rest of the audience.

The conference also included dis-
cussion on communications, collective
bargaining, and the human relations as-
pect of nursing administration. A pres-
entation and discussion of the manage-
ment by objectives program at The Hos-
pital for Sick Children in Toronto was
also part of the program.

Canadian Red Cross Fellowship
Available For Graduate Study

Toronto, Ont. - The National Nur-
sing Committee of the Canadian Red
Cross Society has announced that a fel-
lowship of $3,500 is available for a
JANUARY 1970

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 vy/itch hazel
(50%) and glycerine (10%).

TUCKS — the valuable nur-
sing aid, the valuable patient
comforter.

w

M

Specify the FULLER SHIELD^ as a protective
postsurgical dressing. Holds anal, perianal or
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out tape, prevents soiling of linen or cloth-
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WIN LEY- MORRIS Si

TUCKS is a trademark of the Fuller Laboratories Inc.

THE CANADIAN NURSE 9

news

nurse to undertake graduate study in
an allied profession such as education,
law, industrial relations, or architecture.
A candidate's qualifications should
include: professional maturity, registra-
tion in Canada, at least a baccalaureate
degree, and professional experience of
not less than five years in which pro-
fessional leadership has been shown. Pre-
ferably, the preparation sought should
be for a specific position available and
accepted by the candidate. Nurses wish-

ing to study at the doctoral level re-
ceive preference.

The deadline for receiving appli-
cations is April 1, 1970. Apply to:
The National Commissioner, The Cana-
dian Red Cross Society, 95 Wellesley
Street East, Toronto, Ontario.

Quebec Registered Nurses
Get 20 Percent Wage Increase

Montreal, P.Q. - Over 11,000 regis-
tered nurses in Quebec received a 20
percent wage increase in three-year agree-
ments signed by the provincial govern-
ment and the Association of Hospitals of
the province of Quebec in December.
The new contract is retroactive to July

at
your

fingertips...

secure

umbilical cord
ligation

\

When it's time to ligate the umbilical cord, a HoUister
Double-Grip"^" 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.

s

HOLLISTER

IN CANADA: 160 BAY ST.. TORONTO I, ONT.

211 f.. CHICAGO AVE., CHICAGO, ILL. 60611

1, 1968 and will remain in effect until
June 20, 1971.

The previous salary scale for RNs
started at S390 a month; the present
scale starts at $M1. Agreements were
also signed for 56,000 non-medical hos-
pital employees, giving total benefits that
will cost the provincial government $164,
000,000.

The agreements end 18 months of
negotiation 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 infirmieres de Que-
bec, and the Alliance des infirmieres de
Quebec.

In an interview with The Canadian
Nurse, Gloria Blaker, president of the
3,000-member UNM, said that the govern-
ment agreed to include salary 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 RNABC.

Panel members included: Dr. W.P.
Brown, psychiatrist and consultant
chemotherapist for Riverview Mental
Hospital, 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. D

BE A
BLOOD
DONOR

B

10 THE CANADIAN NURSE

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 Cross 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 therapeutic 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. Hymovich, University of Florida.

A workbook in pediatric nursing that teaches creative
thinking about nursing care problems.

389 pages, illustrated. $5.95. May 1969.

Mercer & O'Connor: FUNDAMENTAL SKILLS IN
THE NURSE-PATIENT RELATIONSHIP

By Lionne S. Mercer, formerly of the University of Michigan, and
Patricio 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 Morlow, Villonova University.

The most widely used text in its field, "Marlow" has
now been thoroughly revised and updated.

687 pages with 572 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 core of patients with
respiratory problems.

229 pages, illustrated. $8.40. September 1969.

Simmons: THE NURSE-PATIENT RELATIONSHIP
IN PSYCHIATRIC NURSING

By Janet A Simmons, University of Mossachussets.

A workbook to guide the student nurse during her
institutional affiliation in psychiatric nursing.

189 pages. $4.05. 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 connbining structure and function,
now revised and redesigned for foster learning.

432 pages with 212 ilhistrations plus 8 pages of color plates on
transparent overlays. $9.45. September 1969.

W. B. SAUNDERS COAAPANY CANADA LTD., 1835 Yonge Street, Toronto 7

!&

Please send on approval and bill me:

Author: Book title:

Name:

Address:

City: Zone: Province:

CN 1-70

lANUARY 1970

THE CANADIAN NURSE 11

names

lane 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.

Sister Therere Cas-
tonguay (R.N., St.
Boniface General H.,
Man.; B.Sc.N., L'lns-
titut 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

lH/'/il

~*_>1

w

The position of associate director of
nursing at Victoria Hospital in London,
Ontario, has been filled 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-

I^^^B/^^ tive director of the
^HHiilll^H International Council
Ig ^R ofNurses for the past

^^^R Wf^^W ^° 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.

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
position she held
since 1961.

Miss Pittuck, who
was bom 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

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 Bumaby 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
Hosp.; B.Sc.N., U. of
Montreal) recently
was appointed direc-
tor of the school of
nursing sciences, Ed-
munston Regional
Hospital, 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.

The University of British Columbia
School of Nursing has announced a num-
ber of new faculty appointments.

Helen Elizabeth Elfert (Reg.N., The
Hospital for Sick Children, Toronto;
B.N., McGill U., Montreal; M.A., New
York U.) has been appointed assistant
professor.

Mrs. Elfert 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. Elfert was a 1965-66 Canadian
lANUARY 1970

Nurses' Foundation Fellow.

Kirsten Weber
(R.N., Victoria Hos-
pital School of Nurs-
ing, Winnipeg;
P.H.N, diploma.
School of Nursing,
U. of British Colum-
bia, Vancouver;
B.N., McGUl U.
School for Graduate
Nurses, Montreal; M.S., School of Nurs-
ing, U. of California, San Francisco) has
been appointed assistant professor at UBC.
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; B.M.,McGill U.;
M.N., U. of Washing-
ton, Seatle) has been
appointed assistant
professor at U.B.C.

Prior to this ap-
pointment, Miss Dol-
phin was assistant professor at the school
of nursing. University 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 U., Delaware, Ohio; M.A., Colum-
bia U., N.Y.; M.N., Yale U. School of
Nursing, New Haven, Connecticut) has
been appointed clinical instructor in pedi-
atrics at UBC.

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, Utah; part-time
staff nurse at Salt Lake County General
Hospital; school nurse at the University
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., St. Paul
H., Vancouver;
B.S.N., Seattle U.,
Seattle, Wash.) has
been appointed ins-
tructor at the Uni-
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 St. Mary's Hos-
pital, New Westminster, B.C. for one
year. Before that she worked as a nursing
supervisor at St. 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.

Barbara Mary Nitins
(S.R.N. , Middlesex
Hospital, London,
England; Cert, in
industrial nursing,
Birmingham U., Eng-
land; Sister Tutor
Diploma, Queen Eli-
zabeth College, Lon-
don U.) has been
appointed instructor at UBC.

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 UBC.

Sister Delia Clermont (R.N., St. Boni-
face H., Manitoba; B.Sc.N.Ed., St. Louis
U., 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 St. 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 of 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 U.; M.Sc.N., Boston U.) 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 U.) has
been appointed as-
sistant director of
public health nurses
for the Nova Scotia
Department of Pub-
lic Health.
Miss Cook, 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
Lacava (R.N., B.S.,
U. of Connecticut;
M.Ed., U. of Hart-
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 programs.

Miss Lacava has held positions as
instructor at the St. Francis Hospital
School of Nursing, Hartford, Conn., and
the Kaiser Foundation Hospital School of
Nursing, Oakland, Calif.; as public health
staff nurse with the New Britain Visiting
Nurse Association, Conn.; and as di-
rector of nursing services, Winsted Me-
morial Hospital, Conn.

For the past two years she has been
involved in research 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
Lacava has served as consultant to the
New England board of higher education;
to the state-wide planning department of
Rliode Island; and to the board of direc-
tors, state colleges and universities.
Rhode Island. She was a member of the
Rhode Island governor's advisory com-
mission on vocational rehabilitation. D
THE CANADIAN NURSE 13

Fleet

ends ordeal by

Enema

for you and
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.

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 bow/el are expelled after
administration. Repeated administration
at short intervals should be avoided.

Full information on request.

■Kehlmann, W. H.: Mod. Hosp. 84:104, 1955

FLEET ENEMA® — single-dose disposable unit

QUALITY PMAFJMACfLJTtCALS

KIRKLAMO IMONTHEWI CANADA j
fOOIOfO in CAHADA It '«»> /

14 THE CANADIAN NURSE

JANUARY 1970

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, Ont.

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 6061 1. Miss Doris
Kirk, Operating Room Supervisor, The
George Washington University Hospital, is
chairman of the nurses' program.

March 19-20, 1970

Symposium on "Problems in Delivering
Cardiac Care," sponsored by the sub-com-
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-
lANUARY 1970

shop in Washington, D.C. sponsored by
the National League for Nursing. For
more information, write to the NLN, 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.

lune 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.

D

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Each band 20~ long, pre-cul to pop-
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Protects against stams artd wear Pliable white
plastic with gold stamped caduceus Two com<
partments for pens, shears, etc Ideal token gifts
or favors

N0.21O-E I 6for 175. 10 for 2.70
Savers ) 25 or more .25 ea.. all ppd.

BANDAGE
SHEARS

jC^^>

Personalued

5" pfOffsstonai precisioo sr*ears, forged ''-

in steel Guaranteed to slay sharp ? years "

No. 1000 Shears (no initials) 2.75 ea. ppd.

SPECIAL ! 1 Doi. Shun $26 total

Initials (up to 3) etclied add 50c per pair

"SENTRY" SPRAY PROTECTOR

Protects you agamst violent man or dog
instantly disables wittwut permanent miury

No. AP16 Sentry 2.25 ea. ppd.

TO REEVES COMPANY. Bo> 719. Attleboro. Mass. 02703

COLOR QUANT. PHICt

^

PIN LETT. COLOR: n Black n Blue □ White (No. 169|

METAL FINISH: n (Sold DSihm INmUS

LETTERING

2nd Line

I enclose $

Send to

Street

■ City

a,..

Pteasi allow lufticient lima for dahvarY.

ii/

THE CAN>^IAN NURSE 15

new products

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

V 'It

^m jt^ ™

>»^

Teaching Nursescope

The Littmann Teaching Nursescope,
developed by the 3M Company, has an
ultra slim, diaphragm-type chest-piece to
permit 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.

This 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 propping: 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

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, which 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.

This 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,
while 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

—or** EMsB

Disposable Prep Tray

JANUARY 1970

moving?

married?

wish an adjustment?

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

n Receiving duplicate copies?

C Actively registered with more
than one provincial nurses'
association?

Permanent reg. no. Provincial association

Permanent teg. no. Provincial association

D 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

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:

^•^^Canadian Nurse ^

Cxcuixt'on Oept . SO The Ori«c«ay. Ottsiaa I, C<r>ad<

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.

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, Ont.

New Fluff Underpad

A new Princess Fluff Underpad by
Texpack can save hospitals up to 50
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 are available
from Texpack Limited, 30-40 Craig
Street, Brantford, Ontario. D

Whenyourday
starts at ^^^^
6 a.m... you're on
chargeduty..
you've skimped'
onmeals...^^^
and on sleep... "
you haven't had^
time to hem
adress...i
ma/ceana^piepie...
wash your hair...
even powder 4Si
your nose,
mcomfort.^

it's lime for a change. Irregular hours and meals on-the-
nin won'l last. But your personal irregularity is another
mailer. 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 softenet and a mild peristallic
stimulant, evacuation Is easy and comfortable.

For detailetJ information consult Vademecum
or Connpendium.

HOECHST

PHARMACEUTICALS

3400 JEAN TAION W MONTRCAL 301
OIVrSfON OF CANADIAN HOICHST LIMITED

I'"*"!

JANUARY 1970

THE CArS^DIAN 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
tlie kickoff. Dr. Mussallem found out tliat
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

"im ATS THE Ticket.' c^€tn6c;i^s and gome

IN FREI^R/CTONl NBv IM s^Ul^E i

18 THE CANADIAN NURSE

Capsule" tries to strike a light, bright,
humorous note. But this is not always
easy. We, here in the depths of CNA
House, are not ideally situated for hearing
about nurse-patient or nurse-nurse anec-
dotes that are humorous or interesting.

So please send us accounts of experi-
ences that have made you laugh, or
chuckle, or just plain happy. We'll repeat
theni In A Capsule.

Dance It off

At least one person we know has
managed to conquer the North American
weight problem without succumbing to
expensive clubs and gadgets. Madeleine
Shaw, a Toronto geriatric nurse, simply
wiggled and bounced off 32 pounds in
two months.

According to a story in the Toronto
Daily Star, Miss Shaw invented the Wiggle
Bounce when she bought a stereo and
discovered pop rock. "My body reacted
to the music," she said. "1 couldn't stay
still, 1 began to bounce, wiggle, twist and
gyrate for an hour or two at a time." She
noticed after the first week that she had
lost four pounds, and she's been losing
ever since.

Away from it all

Something in the African and Asian
diet or way of hfe seems to prevent the
major killing heart diseases that are found
in North America and Europe.

The November 1969 issue of World
Health, published by the World Health
Organization, describes new studies of
heart function and heart disease in
developing countries.

In affluent societies, it is still common-
ly considered normal for blood pressure
to rise with age, particularly after forty.
However, among the nomads of northern
Kenya, for example, blood pressure re-
mains the same. Although the inhabitants
of the Cook Islands do not show a
tendency for blood pressure to rise with
age, other Polynesians, who are exposed
to the modern way of life, do.

To find out the reasons for this,
research workers are closely examining
food habits, among other factors. In
Singapore there are three ethnic com-
munities: Malay, Chinese, and Indian.
The Indian community, whose eating
habits are quite special, is particularly
prone to heart disease. It is hoped that
research will be able to find what it is
that the Malay and Chinese are eating, or
not eating, that acts as a barrier to heart
disease. D

JANUARY 1970

This decongestant tablet contends that a
cold is not as simple as it seems on television

Coricidin* "D" 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 "D "
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?

Coricidin "D"

comprehensive relief

of cold symptoms

DESCRIPTION: Each CORICIDIN
D" tablet contains 2 mg.
CHLOR-TRIPOLON- (cfilorptieni-
ramine maleate). 230 mg. acetyl-
salicylic acid. 160 mg. phena-
cetin. 30 mg. calfeine. 10 mg.
phenylephrine.

DOSAGE: Adults: one tablet
every 4 hours, not to exceed 4
tablets in 24 hours. Children (10-
14 years): Vi the adult dose.
Children under 10 years: as di-
rected by the physician.

SIDE EFFECTS: Adverse reac-
tions ordinarily associated with
antihistamines, such as drowsi-
ness, nausea and dizziness occur
infrequently with Coricidin "D"
when administration does not
exceed recommended dosage.
PRECAUTIONS: May be injurious
if taken in large doses or lor a
long time. Additional clinical
data available on request.

'reg Trade Mark.

^xAetina

Corporation Limited
Pointe Claire 730, P.Q,

For colds of all ages:
Coricidin tablets,
Coricidin with Codeine,
Corlforte ' for severe colds.
Nasal Mist, Medilets
and Coricidin D" Medilets
for children.
Pediatric Drops.
Cough Mixture
and Lozenges.

Give new depth
to your
students'
understanding
of their future
responsibilities .

New Volume E!

CURRENT CONCEPTS
IN CUNICAL 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 students!

Edited By Betty S. Bergersen, R.N., Ed.D.; Edith H. Anderson, R.N., Ph.D.;IVIargery Duffey,
R.N., Ph.D.; Mary Lohr, R.N., Ed.D.; and Marion H. Rose, R.N., M.A. With 37 contributors.
October, 1969.361 pages plus FM l-XII,7"x 10", 19 illustrations. Price, $13.20.

MOSBY

TIMES MIRROR

THE C.V MQSBY COMPANY LTD.

86 NORTHLINE ROAD
TORONTO 374. ONTARIO. CANADA

A New Book! Douglass- Bevis

TEAM LEADERSHIP IN ACTION

Principles and Applications to Staff Nursing Situations

Every nurse must practice leadership, by the very nature of nursing. Choose this
paperback as a supplementary reference to your lectures and required text in
various courses, particularly "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.

7^ 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 l-XVI, 6%" x 9%", 9
illustrations. Price, $16.50.

20 THE CANADIAN NURSE

JANUARY 1970

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.

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
CUnic, is set up at the London Psychiatric
Hospital to do two things: first, 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

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 Lving
and characterized by apathy, desocializa-
tion, and deteriorated work skills and
interests.

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, closely attached to the
THE CANADIAN NURSE 21

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

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-heahh-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-

ric Hospital in October 1967 by Dr. W.N.
Andrews. He had previously used it with
excellent resuhs 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 1 5 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 cUnic through a

cooperative arrangement with the provin-
cial laboratory.

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

The Moditen Clinic team in conference with a patient who has recently been able to return to her work in the community.
lANUARY 1970 THE CANADIAN NURSE

23

The author (right) counseling a patient at the Moditen Clinic. This patient was released from hospital over a year ago, but returns to
the Clinic weekly for an injection of Moditen.

depend on the individual patient's sensi-
tivity, but dosage levels and age are also
factors.

The doctor usually prescribes an anti-
parkinsonian agent when Moditen injec-
tions are started. Patients must under-
stand the importance of taking these.
Many patients on Moditen are against
taking pills of any kind. They often omit
the antiparkinsonian drugs at first, but
because the effects are so uncomfortable
they quickly see the value of taking them
regularly. Patients with severe reactions
occasionally come to the clinic and
require an immediate intramuscular injec-
tion of an antiparkinsonian agent. The
intramuscular injection usually gives
symptomatic relief much more quickly
than the oral form of the same drug.

Toxic effects on the autonomic nerv-
ous system must also be known by the
nurse. Hypotension of delayed onset,
hypertension, and fluctuation of blood
pressure have been reported in the litera-
ture, but not seen at our clinic. Blurred
vision is reported fairly often; this may
disappear spontaneously in a few weeks
or may be relieved by changing the
antiparkinsonian drug.

Aggravation of glaucoma may occur
and so we recommend periodic eye exam-
inations. Frequently a patient may need

24 THE CANADIAN NURSE

to wear magnifying glasses for reading or
close work for a short period. Dry mouth
occurs commonly and we advise the
patient to take unsweetened fruit juice
twice daily to help activate the salivary
glands; increased fluid intake does not
help.

Allergic or toxic reactions to the drug
itself are quite rare. Cholestatic jaundice
has never been observed at our clinic. We
had one case of blood cell depression and
a reduced dosage soon corrected this.
Asthma, dermatological disorders,
itching, erythema, or seborrhea have not
been reported at the clinic.

Nurses are alerted to watch for meta-
bolic or endocrine effects. Weight
changes, peripheral edema, abnormal lac-
tation, menstrual irregularities, impoten-
cy in men, and increased hbido in women
have all been reported.

Case history

An attractive girl in her early thirties,
diagnosed as a paranoid schizophrenic
and very suicidal, was discharged to the
clinic a year ago. She had just started on
Moditen and was still extremely hostile
and used abusive language.

Today she is living in a pleasant
rooming house and is looking for a job.
She looks well and has a quick smile and

a pleasant word for others, although she
is not a talkative person. She receives 75
mgm. of Moditen (3 cc) every 14 days, a
recent dosage cut from 4 cc.

This is her longest stay out of hospital
in years and she is much happier - and,
incidentally, much less of a burden on the
tax-payer's pocket. This girl is lonesome,
and we at the clinic think how wonderful
it would be to have enough staff to find
volunteers to serve as a real friend for her,
or even to provide her with someone to
talk to when necessary.

Conclusion

Moditen appears to do for many
psychiatric patients what insulin does for
the diabetic. It is rewarding to see the
progress made by patients on this drug.
We have readmitted some, mainly because
of increased environmental stress or be-
cause they discontinued the antiparkin-
sonian drug. But each time, the stay in
hospital is shorter.

It is rewarding, too. to see the nurse's
role extended into the community. The
role of the clinic nurse truly illustrates
the changes in nursing predicted for the
"future," about a year ago.** D

**Helen K. MussaUem, The changing role of the
nurse, Canad. Nurs., Nov. 1968, p. 35

JANUARY 1970

Nurse to the performing arts

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.|.

'% IT''''' jB

\

4f

1

Barbara Duncan, head of the Arts
Centre's nursing team, on her way to the
fnain foyer. The red carpeting on the
stairs is one of the many colorful features
found throughout the Centre.

JANUARY 1970

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 800-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 fioor 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
200 NAC staff members.

Miss KoUarsky, a graduate of Caileton Univer-
sity's School of Journalism, is presently Editor-
ial Assistant, The Canadian Nurse.

The nurses agree that nuning 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-
fool! 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
1 5 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 CAf^DIAN NURSE 25

ushers were busy. There is a special
hallway 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 allow the nurse to help her, and

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 daugliter
to a doctor for tetanus antitoxin.

At least four or five people have fallen

on the steps leading to the underground
garage, and there have been several bad
falls in the garage. Not all the falls 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.

Preparing for the next patient. Although small, the Centre's first-aid room is well-equipped to handle the most common complaints:
headaches, cuts, dizziness, allergies, and upset stomachs. A record of each person treated is kept by the nurses.

Intermission in the theater foyer during the Ottawa premiere of "La Visite de la Vieille Dame," per fortned by l.e Theatre du

Capricorne. Opening nights are particularly good occasions for people-watching -but this one was better than most.

26 THE CANADIAN NURSE JANUARY 1970

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
doorman took him to the garage to look
for his "lost" car.

As for accidents occurring during per-
formances, Mrs. Argue remembers one
performance of "Les Feux Follets." 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.

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

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 uniform. D

Tliis front view 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.

Backstage after the first night's performance of "La Visite de
la Vieille Dame. " Mrs. Duncan removes a speck from eye of
actress.

JANUARY 1970

77ie 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 CAN4PIAN NURSE 27

Public health nurses

work with family physicians

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 describes a similar project in London, Ontario.

D.A. Hutchison, M.D., D.P.H., and Dorothy M. Mumby, B.Sc.N., M.A.

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 beUev-
ed that their knowledge of community
resources would be valuable to the physi-
cians. Thus the major duties would be
28 THE CANADIAN NURSE

those of any pubUc health nurse in a
traditional program.

In addition, it was agreed that the
pubUc 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 Uaison 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,
Qty of London (Ontario) Health Department.

physicians at this Centre are on the
facuhy 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-to-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 pubHc health nurse at this Centre

has tried with limited success to establish

regular meeting times with the physicians.

lANUARY 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 estabhsh-
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. In 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-to-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 caseload 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

Dr. M. Hickey, left, senior resident at the family medical center, and Dr. B. Hennen. center lecturer in family ^'/^f "f .^''/''^
faculty of medicine at the University of Western Ontario, discuss a patienfs progress with Mrs. Marcm Fuller, public health nurse
assigned to the family medical center by the London Health Department.
)ANUARY1970 THE CANf^DlAN NURSE 29

I

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.

Mrs. Knierim, the public health nurse assigned to the private practice, dictates notes
for the physician's record. Mrs. Joan McGinnis (top right), the private practice
secretary, transcribes the nurse's notes onto the physician 's record.
30 THE CANADIAN NURSE

Mrs. Pauline Knierim, left, public health nurse assigned to the private practice by the
London Health Department, discusses 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.

JANUARY 1970

Mrs. Jane Guthrie, fright) public health
nurse assigned to the group practice by
the London Health Department, consults
with Mrs. Helen Steams, supervisor 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. "^

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,
lANUARY 1970

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 interpretatipn 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 contains 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: 1. 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-

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 health care needs to be
looked at critically.

References

1. Brannan, Dennis. The public health nurse
and the family physician. / Coll. 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. □

THE CANADIAN 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 heahh
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
multidisciplinary learning experience
from group practices for advanced stu-
dents in nursing and medicine. We envi-
sioned students from both discipUnes
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 arrangement 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 extensively 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
visits.

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. LJ

THE CANADIAN NURSE 33

idea
exchange

Part of display at book fair. Mrs. Gladys Owen, P.H.N. , librarian for the Sudbury health
unit, and Dr B.J. Cook, medical office of health, 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 inservice 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
wanted.

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 smoothly 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 particularly
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
pollution 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 reahsm, 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. D

Bradford Frame Covers

Bradford Frame

See Insert

Supporting
Box (raises
frame to allow
bedpan beneati

Opposing

Velcro

Strips

Nurses on pediatric 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

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
easUy laundered. - Maureen Brenchley,
formerly employed by the Children's
Psychiatric Research Institute, London,
Ontario as head nurse of the metabolic
investigation unit. D

THE CANADIAN NURSE 35

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
10-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

36 THE CANADIAN NURSE

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 1 4-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 10 to 15 minutes, 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 tlie 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

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,
in 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 Hoor outside the
nursing station. !

To get attention, Brian refused his
meals. I would sit with him and 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 i
THE CANIkDIAN NURSE 37

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-
ment.

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
10-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? " "Will 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 restraint.

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. D

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 first saw Bob the morning after his
admission to hospital. As 1 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 1 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 School of Nursing, is nurse-in-charge.
Employee Health Service, at Toronto Western
Hospital. She is editor of The TGH Quarterly.

lANUARY 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
him."

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 CANADIAN 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 feeUngs 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 learned 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? "
"Just 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 as 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 Hghtly, 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 hft others to a higher level. D

JANUARY 197a

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.

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 general 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 quality
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 collect-
ed using a modified version of Amstein'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 quality of
nursing care as given by all registered
nurses on the ward did improve by 1 1
percent over the three phases. However,
the professionally prepared nurses did not
appear to be performing specifically in
the redefined roles which provided for
increased planning for directing and as-
sessing of patients' nursing care needs.

Griffith, |. Kirstlne (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
"Evaluation of Persoimel" as an educa-

JANUARY 1970

tional 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 eUcit 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
analysis, 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 behavioral concept of
learning was used throughout.

The results revealed that 9 1 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 half perceived a
change in all 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 latter 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, social 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 small 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 behavioral
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 revealing 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-
tory 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-
ly-centered philosophy.

Ten students from a three-year diplo-
ma school were interviewed following the
completion of their maternity nursing
experience. With the use of an interview
schedule, data were collected 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, n
THE CANADIAN NURSE 41

Diseases That Plague Modern Man by

Richard Gallagher. 230 pages. New
York, Oceana Publications, Inc., 1969.
Reviewed by Justine Delmotte, 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 find 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,
Sherbrooke, 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 deformities. 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
bladder 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 unit, 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 hfe" in her profession will be delighted
with Anthea Cohen's book.

New Guinea Nurses by Elizabeth Burchill.
151 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 Aish, Assistant
Professor, School of Nursing, Queen's
University, 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 nursing 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's judgment.

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
highly 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
f)erceptual-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 disciples 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 fine 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 drawings,
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.

Personal and Vocational Relationships in
Practical Nursing, 3rd ed. by Carmen
F. Ross. 266 pages. Toronto, J.B.
Lippincott Co., 1969.
Reviewed by Helen 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 formed 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 CANADIAN NURSE 43

Next Month
in

The

Canadian
Nurse

• Ritualism and Tradition
vs. Judgment

• Night Safety - a Problem
for Nurses

• Tracheotomy Suctioning
Technique

^^17

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 Daily Star, Sudbury,
Ont., p. 34

(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,
III, 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 well 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. D

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

44 THE CANADIAN NURSE

requested at any one time.

Stamps to cover payment of postage
from library to borrower should be in-
cluded when material is returned to CNA
Ubrary.

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. 11 Op.

6. Classification internationale type des pro-
fessions. Rev. edition 1968. Geneva, Bureau
international 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 1967 by James A. Tait and F. Douglas
Anderson. London, Qive Bingley, 1968. 95p.

11. Dictionnaire de la langue franfaise par
Emile Little, edition integrale 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. Elements de bacteriologie a I'usage des
infirmieres 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.

1 7. 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.

1 9. Introduction to clinical nursing by Myra
Estrin Levine. PhUadelphia, Davis 1969. 468p.

20. Jensen's history and trends of pro-

JANUARY 1970

fessional nursing by Gerald Joseph Griffin 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 Bemice Levin Neugarten. Chica-
go, University of Chicago Press 1968. 596p.

23. Modern bedside nursing. 7th ed. by
Vivian M. Culver. Philadelphia, Saunders, 1969.
841 p.

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. Nursing, a challenge: that we may serve
society better by Helga Dagsland. Oslo, Norwe-
gian Nurses Association, 1955. 218p. (Brief in
English p.i-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.

3 1 . 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 bibliothecaire par Charles
Henri Bach et Yvonne Oddon. 7e edition. Paris,
Librairie Armand Colin, 1967. 182p.

34. The politics of the family by R.D.
I^ng. Toronto, Canadian Broadcasting Corpo-
ration, 1969. 49p. (Massey Lecture, Eighth
Series, 1968)

35. Psychiatric nursing by Marguerite Lucy
Manfreda, 8th ed. Philadelphia, Davis, 1968.
4 74 p.

36. Rapport des journees d 'etude regionales
organisees a I 'intent ion des directrices de serv-
ices infirmiers d'hopitaux du 27 fevrier au ler
mars, 1968, Montreal, Quebec. Ottawa, 1969.
Association des Infirmieres canadiennes. 72p.

37. Rapport des journees d'etude regionales
organisees a I 'intent ion des directrices de serv-
ices infirmiers d'hopitaux du 28 novembre au
ler decembre 1967. Quebec, P.Q. Ottawa.
Association des Infirmieres canadiennes 1969.
70p.

38. La recherche en education des adultes
au Canada 1968. Toronto, 1969. Canadian
Association for Adult Education. 103p.

39. Repertoire des fondations et organismes
JANUARY 1970

de subventions aux universites du Canada. 2.ed.
Ottawa. Association des Universites et Colleges
du Canada. 1969. llOp.

40. Resources of Canadian academic and
research libraries by Robert Bingham Downs.
Ottawa, 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. Sydney s' nurse crusaders by Isadore
Brodsky. Neutral Bay, N.Z. Old Sydney Free
Press, 1968. 132p.

45. Textbook of pediatrics. 9th ed. by
Waldo E. Nelson. Philadelphia, Saunders, 1969.
1589p.

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. 421 p.

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 Felix Quinet. Toron-
to, 1968. 16p.

5 3 . Current issues and their 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 ecoles d'infirmieres
en hygiene maternelle et en pediatrie reconnues
par la Croi.x-Rouge suisse. Berne, Croix-Rouge
Suisse, 1966. 16p.

56.Directives pour les ecoles d'infirmieres et
d'infirmiers en psychiatrie reconnues par la
Croix-Rouge suisse. Berne, Croix-Rouge Suisse,
1968. 29p.

57. Directives pour les ecoles d'infirmieres

et d'infirmiers en soins generaux reconnues par
la Croix-Rouge sui se. Berne, Croix-Rouge
Suisse, 1966. 36p.

58. Final report and recommendations to
be presented to the executive council 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 Mandelkom 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 Affain
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 copyright by Mary Lou
Parker. Ottawa, Canadian Library Association,
1969. 14p. (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. Reglement concernant la reconnais-
sance d'ecoles d'infirmieres en hygiene mater-
nelle et en pediatrie par la Croix-Rouge suisse.
Berne, Croix-Rouge suisse, 1966. 4p.

70. Reglement concernant la reconnaissan-
ce par la Croix-Rouge suisse d'ecoles d'infirmie-
res et d'infirmiers en psychiatrie. Berne, Croix-
Rouge suisse. 1968. lOp.

71. Reglement concernant la reconnaissan-
ce par la Croix-Rouge suisse d'ecoles d'infirmie-
res et d'infirmiers en soins generaux. Berne,
Croix-Rouge suisse, 1967. 9p.

72. Some statistics on baccalaureate and
higher degree programs in nursing- 1 968. New
York, National League for Nursing, Dept. of
Baccalaureate & Higher Degree Programs. 1969.

Up.

73. Television: how to use it wisely with
children by Josette Frank. Rev. ed. New York,
(Thild Study Association of America, 1969.
24p.

THE CANAI^IAN NURSE 45

74. Venereal disease, a renewed challenge
by Abe A. Brown and Simon Podair. New
York. Public Affairs Pamphlet, 1964. 20p.
(Public Affairs pamphlet no. 292 A)

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 Aline 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. lip.

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. (loose-leaf)

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 Immigration.
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 socioeconomic
aspects of health in Canada, 1969. Ottawa.

1969. 187p.

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 A merica.

90. Public Health Service. Oral care for oral
cancer patients. Report of a conference held in
Chicago, 111., June 1968. Washington, 1969.
67p. (U.S. Public Health Service publication
no.l958)

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 supervisor concept in nursing
service by Siste Mary Michael Demers. Toron-
to, Ont., 1968. 158p. (Thesis (Dipl. 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 (Dipl. 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 for registered nurses by George
Brian Doyle. Ottawa, 1968. 83p. (Thesis
(M.H.A.) - Ottawa)R D

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46 THE CANADIAN NURSE

JANUARY 1970

February 1970

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The

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invitation to a checkup

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THE CAN/^IAN NURSE 1

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2 THE CANADIAN NURSE FEBRUARY 1970

The

Canadian

Nurse ^^

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

3 1 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
necessarily represent the policies or views of the Canadian Nurses' Association.

4 Letters

7 News

16 Names

18 Dates

19 New Products

21 In a Capsule

49 Books

50 AV Aids

50 Accession List

72 Index to advertisers

Executive Director: Helen K. Mussallem •
Editor: Virginia A. Lindabury • Assistant
Editor: Eleanor B. Mitchell • Editorial Assist-
ant: Carol A. Kotlarsky • Circulation Man-
ager: Berjl Darling • Advertising Manager:
Ruth H. Bauinel • Snbscription 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-
ciation, where applicable. Not responsible for
journals lost in mail due to errors in address.
® Canadian Nurses' Association 1970.

.Manuscript Information: "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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
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.O. Permit No. 10.001.
50 The Driveway, Ottawa 4, Ontario.

tUKUAKY iy/0

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. Advocates of this medical

assistant role use the feldsber system in

Russia as a model when arguing that such a

category should be created. Nowhere in

the report, however, could we find an

admission that Russia is planning to phase

out her feldshers, because the system is

no longer useful.

^ — V.A.I.

THE CANADIAN 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. 1 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 — 111 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 Zibn 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
sliort 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, Loma Linda
University, Loma 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

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Be sure to notify us six weeks in advance,
otherwise you will likely miss copies.

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MAILTO;

The Canadian Nurse

50 The Driveway
OTTAWA 4, Canada

have symbolized submissiveness and
conformity - qualities wliich, 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,
St. 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
$20 per 100. - Editor. D

FEBRUARY 1970

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THE CANyyjIAN NURSE

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news

Members Appointed

To CNA Ad Hoc Committee

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 will 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, B.C., 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 Candidate
For 3 M Award in 1970

Ottawa. - The Canadian Nurses' As-
sociation will not nominate a candidate
for this year'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

.sji

t?>"f Tf^

^^,

t^n^

A

o

4'> ^

NWT. - Tliis circular symbol has been chosen to commemorate the Northwest
Territories "Centennial 70," which is being celebrated this year. It features three '
figures in black with linked hands, which are intended to express the unity of all
the people in the North and the spirit of celebration The figures represent the
Franklin, Mackenzie, and Keewatin geographic areas that form the Northwest
Territories. The parka hood of one of the figures has been rounded to represent the
pattern worn by the people of the Mackenzie. The three figures are encircled by
blue lettering on a white background. NWT permission required to reproduce symbol

choose a candidate before the deadline.
However, a candidate will be chosen for
the 1971 1CN3M 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 S6,000 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 quadrennial con-
gress of ICN last June. Nurses from more
than 60 countries are eligible for the
fellowship.

CNA Librarian Visits Libraries
In Manitoba Schools of Nursing

Ottawa. Margaret L. Parkin, librari-
an at the Canadian 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 Hospital. The Winnipeg Gener-
al Hospital. Misericordia General Hospi-
tal, and 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
said. "However, there has been a shortage
in the past, and for economic reasons it
has not been possible for any oi these
THE CAN>^IAN NURSE 7

news

libraries to have 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 wUI
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 Carry Out
Some Medical Procedures

Toronto, Ont. - 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 Assist 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 ,3 1 1 . Provincial member-
ship is shown below.

Canadian Nurses ' Foundation
Membership

as of 31 December 1969

Province Membership

British Columbia 170

Alberta 126

Saskatchewan 1 53

Manitoba 128

Ontario 319

Quebec 74

New Brunswick 211

Nova Scotia 70

Prince Edward Island 6

Newfoundland 9

Outside Canada 28

1,294

16

1,310

1

1,311

Total

Sustaining

Patron
Grand Total

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
firms, corporations, 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 51.

Students Need C<.unselors
To Interpret Information

Toronto, Ont. - Information 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'Institut National pour la Formation des

Adultes in Nancy, France, suggested that

students must also be informed of the

FEBRUARY 1970

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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 liiring
ghetto unemployed to train on the job.

The seminar was one of a series of six
that formed the international conference
on continuous learning held during the
Education Showplace.

First Male Nurse Licensed
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 Hotel Dieu de Montreal with
a baccalaureate degree from Universite de
Montreal, 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
schools 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 "I'Association des infirmieres et

10 THE CANADIAN NURSE

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 1946 to have men legally admhted 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 Quebec."

Bill 89 also lowers from 21 to 18 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 S40 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.

Quota Remains The Same
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 1 969-70 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-
ly, two of the four male nurses are serving
at the Canadian Forces Hospital, Halifax,
and one is at the Canadian Forces Hospi-
tal, Esquimau, British Columbia. The
other nurse serves with 1 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, Ont. - 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 information 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 31st 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 Cross Booklet Available
On Rights And Duties Of Nurses
Under The Geneva Conventions

Geneva, Switzerland. - The Inter-
national Committee of the Red Cross
published in May 1969 a 45-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, information
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-I2II Geneva 1, Switzer-
land.

THE CANADIAN NURSE 11

Whenyourday
starts at ^l^
6 a.m... you're oji
charge duty... ^
you've skimped
onmeals...^j
and on sleep...
you haven't had^
time to hem
a dress...
makeanajjplepie...
wash your hair...^
evenpowder ^
your nose ^' "
in comfort.^

it's lime for a change. Irregular hours and meals on-lhe-
run won't last. But your personal irregularity is another
matter. It inay settle (iown. 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 OOXIOAN con-
tains a dependable fecal softener and a mild peristaltic
stimulant, evacuation is easy and comfortable.

For detailed informalicm consult Vademecum
or Compendium.

HOECHST

PHARMACEUTICALS

3400 JEAN TALON W, MONTREAL 301
DIVISION OF CANADIAN HOECHST LIMITED

Me Mot i-

(PMAC I

12 THE CANADIAN NURSE

news

New Pattern Developing
In Collective Bargaining
For Ontario Nurses

Toronto, Ont. - 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
1, 1969, in four cases, and to April II,
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 increases retroactive to January
1, 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 1 1th. 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 Warns

Ottawa. According to a release
from the Food & Drug Directorate,
Department of National Health and Wel-
fare, unsatisfactory patient response to
treatment witli NPH 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 C)."

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 education 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 role 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. Students with

a B average from either of Western's two

(Coiiliiiiicd 1)11 paiii' l-^l

FEBRUARY 1970

Self-
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., formerty 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 ansv^^ers 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 patient 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 Maja C. Anderson, B.A., M.N., SUNY Upstate Medical Center

Part I: Basic Patient Care

Part il: Basic Nursing Techr»iques

These volumes cover the first and second halves of the
basic 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 1968.

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 Barrett 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 coses and asks
questions that review your knowledge of anatomy,
physiology, pharmacology, and all the natural and
social sciences. You ore 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.

W. B. SAUNDERS COMPANY CANADA Ltd., 1835 Yonge Street, Toronto 7

Please send on approval and bill me:

Author: Book title:

Zone:

Province:

FEBRUARY 1970

CN 2-70
THE CANADIAN 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
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. #5763-3731
(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. #5763-2526
(wrist), $19.50 doz. pr.

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. #5763-7333 (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. #5763-5605
(non-conductive), $24.00 set.

The Posey Footboard tils any stan-
dard size hospital bed and is fully ad-
justable to any comfortable angle.
Helps prevent foot drop and foot ro-
tation. Complete Posey Line includes
twenty-three rehabilitation products.
#5763-6420 (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

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14 THE CANADIAN NURSE

(Continued from page 12)

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 Cote 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. Ont. - 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-of-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, CARE /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 Higlily 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, Ont. ~ 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 1967, compared to 383 schools
in 1968, and 629 schools in 1969. 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, Mr. 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." CJ

*T.M.

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Residents of Queb«c add 8% Provincial SalM Tax J

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iM»^ftca<£anada

THE CANA»IAN NURSE 15

names

A number of new staff members have
joined the faculty of The University of
Alberta School of Nursing in Edmonton.
!■'■ ..^ftrt ^ Devamma Purusho-

tham (R.N.. Mid-
wife, dipl. teaching
and superv., Vellore,
India; B.N.Sc.,
Queen's U.. King-
^^^—r ^. ston; M.Sc.N., Mc-
^mWl^^Kk ^'" '-'■) '^ assistant
^V ^^^^ professor The

^" ^^^B 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., St. Paul's H.,
Saskatoon; B.Sc.N.,
U. of Alberta, Ed-
monton) is a lecturer
^A — ^ in the community

^^^^k " V^k health and home
^^^^^k ^H visiting areas of the
^^^^^B ^^1 basic degree program
^^^■1 HI 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., Dipl.
P.H.N. , U. of Saskat-
chewan, Saskatoon;
f-v M.Ed., Colorado
State U.) is assistant
professor at The
University of Alberta School of Nursing.
Miss McAdoo is working in the postbasic
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
Hospital.

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.

■■■■■■■jjL Karen R. Stevens

^■[^■|k.M (R.N.. The Montreal
W^^^^k ■ General H.; B.Sc.N..
^^^^HH U. of Western Onta-

^ -. ^» rio) is a lecturer in

"*■ the junior medical-

^f ■**' -w. surgical and pediat-

^fc* I w ric nursing areas of

Ik ^^k JT Jk "le basic degree pro-
» ^^ Jmm gram at The Univer-
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-
morial Institute, 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
Service Admin.,
Dipl. P.H.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 Hospital in
Halifax, Nova Scotia. Her experience
includes medical nursing at The Montreal

I.

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

(R.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, St. Albert,
Alberta; and the department of national
health and welfare in Cambridge Bay,
Northwest Territories.

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 Pavilion,
Edinburgh, and
Royal Maternity H.. Glasgow, Scotland;
B.N., McGill 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 Bristol
Royal Hospital, England, and The Mon-
treal General Hospital.

FEBRUARY 1970

Lucy D. Willis
(Reg.N., Atkinson
School of Nursing,
Toronto Western H.;
Cert, in teaching and
supervision, U. of
British Columbia;
B.S. and M.A.,
1 eachers College,
Columbia U., New
Yorlc; 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 former 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.

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 1949 to 1952, 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 organizational structure of NLN.
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
Florence Nightingale Medal of the Inter-
national Conference of Red Cross
Societies. In addition. Miss Sheahan has
been awarded honorary doctor of human-
ities and doctor of laws degrees. □

FEBRUARY 1970

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.

\A/ win ley- morris ,%.

AA MONTREAL CANADA

TUCKS is a trademark of the Fuller Laboratories Inc.

THE CANADIAN NURSE 17

largest selling among nurses ! Superb lifetime quality .

smooth rounded edges featherweigtit, lies fiat . . .

deeply engraved, and lacquered. Snow wtiite plastic will

not yellow. Satisfaction guaranteed. GROUP DISCOUNTS.
SAVE: Order 2 identical Pins as pre
caution ifainst loss, lass changing.

1 Nunc Pin only

2 Pins (same name)

1 Name Pin only

2 Pins (sami nama)

1.75*
2.60*

.85*
1.35*

2.05"
3.10*

1.15*
1.90*

* IMPORTANT Please t4d ?k pef order riirKtling charge on til orders of
3 pms or less GROUP DISCOUNTS 25 99 pms, 5%. 100 or rrwre. 10%
Send cash. m.o.. or check. No billings or COO'i.

Sel-Fix NURSE CAP BAND

Black velvet band material. Self-ad-
hesive: presses on, pulls off; no sewing
or pinning. Reusable several times.
Each band 20" lone, pre-cut to pop-
ular widths: Vi" 11? per plastic boi),
yi- (8 per box), V4" (6 per box). 1"
(6 per box). Specify widtn desired in
ITEM column on coupon

3 or more 1.40 ea.

NURSES CAP-TACS

Remove and refasten cap band instantly
for laundering and replacement! Tiny
molded plastic tac. damty caduceus.
Choose Black. Blue. White or Crystal
with Gold Caduceus, or all black (plain).
No.200Setof6Tacs.. 1.00 per set
SPECIAL! 12 or more sets ... .80 per set

®

Nurses ENAMELED PINS

Beautifully sculptured status Insignia; Z-color keyed,
hard fired enamel on gold plate. Oime-siied pin-back
Specify RN, LPN, PN, LVN, fJA, or RPh. on coupon.
No. 205 Enameled Pin 1.65 ea. ppd.

^^^Tj^w. Waterproof NURSES WATCH

Swiss made, raised silver lull numerals, lumm mark'
ings Red-tipped sweep second hand, chrome stainless
case Stainless expansion band plus FREE black leather
strap 1 yr guarantee.
No. 06-925 16.50 ea. ppd.

Uniform POCKET PALS

Protects against stains and wear. Pliable while
plastic with gold stamped caduceus. Two com-
partments for pens, shears, etc. Ideal token gifts

or favors.

N0.210-E
Savers

6for 1.75, 10 for 2.70

25 or more .25 ea., all ppd.

Pers.„3..ed ^^^^^^l

,jQ^jg)

6" prolesslonal precision shears, forged '-^'""

in steel Guaranteed to stay sharp 2 years "^

No. 1000 Shears (rto initials) 2.75 ea. ppd.

SPECIAL ! 1 Doz. Shears $26. total

Initials (up to 31 etched add 50c pet pair

"SENTRY" SPRAY PROTECTOR

Protects you agamst violent man or dog .
instantly disables without permanent injury.
No. AP16 Sentry 2.25 ea. ppd.

TO: REEVES COMPANY, Box 719. Attleboro. Mass. 02703

COLOR auANT PRICE

PIN LETT. COLOR! D Black D Blue n White (No. 169)

METAL FINISH; Q Gold Q Silver INITWLS

LETTERING

2nd Line

I enclose $

Send to

Street

a City State Zip m

Please allow sufficient time for delivery.

18 THE CANADIAN NURSE

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 Inn, Calgary
For further information write to: AAR^
10256 - 112 Street, Edmonton. Alberta

May 19-22, 1970

Canadian Public Health Association
annual meeting, Marlborough Hotel, Win-
nipeg. For further information write to
the CPHA, 1255 Yonge Street, Toronto
7, Ontario.

May 31-Iune 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.

lune 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.

lune 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. D

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.

Memory tape svitem

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 Model 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 402. 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 15 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 system

The new Bard Sterii-Peel Packaging
System is designed to meet all steriliza-
tion packaging needs. Small and large
instruments and even odd-shaped items
can be neatly, easily, and securely heat-
sealed for either steam or gas sterilization.

The packaging material is available in
100-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., 22 Torlake
Crescent. Toronto 530. Ontario.

Walking aid

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. Ihe 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 tape

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, adhesive 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 external 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. Terminal A. Toronto 1,
Ontario.

Dressing Cutter

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)
Ltd.: Quebec and Maritime prov-
inces - Guy Bernier, 862 Charles-
Guimowd. Boucherville, Quebec; Ontario
and Western Canada - John Kennedy,
2750 Slough Street. Malton. Ontario.

Literature available

A new catalog describing the complete
line of more than 200 products manufac-
tured by the Posey Company is available
free of charge. (Continued on page 20/

THE CANA[^AN NURSE 19

Next Month
in

The

Canadian
Nurse

• Fredericton, New Brunswick

- Something for Everyone

• Something to Say

- and How!

• CNA Ad Hoc Committee Repoi
on Functions, Relationships,
and Fee Structure

^^

Photo credits for
February 1970

Graetz Bros., Ltd., Montreal, p.8

Julian LeBourdais,
Toronto, pp. 34,35,36

Drummond Photos,
Montreal, pp. 41,42

The Hospital for Sick Children,
Toronto, pp. 45,46,47

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 emer-
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, Illinois
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 arid
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 meat 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 1 23, Elmhurst,
N.Y. 11373.

A colorful, illustrated leafiet 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 higli power pump 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 Limited,
P.O. Box 9200, Downsview, Ontario.

20 THE CANADIAN NURSE

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 weiglit of the heaviest
patient, and the smallest size can be used
successfully by children. It provides a
new approach to retraining bed-ridden
legs to walk, and is especially valuable in
solving gait-training problems of polio,
cerebral palsy, multiple sclerosis, and
similar disabilities.

The unit, available in three sizes, is
made of tubular steel and chrome-plated
for lasting beauty. For complete informa-
tion write to: Everest & Jennings Canadi-
an Limited, P.O. Box 9200. Downsview,
Ontario. D

FEBRUARY 1970

in a capsule

Watch those writing rules

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.

1. 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.

Unemploymenl insurance for nurses?

Hunters, trappers, and nurses take
note. The federal government has promis-
ed to present a wlute 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
510,000, 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. D

MERe'^ k BRI6HTIDG\! WMV Kk>T (a)MB\NE
A HOLIDAY IN NEW BRUt^QNC< WITH A
TRIPTO O^A'S BlEl^N'AL CONVENTIOM
IN FREDERICR^N IN JUNE:?

THE CANApiAN NURSE 21

Kij>^-« »

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.

Lakeside Laboratories (Canada) Ltd.
64 Colgate Avenue • Toronto 8, Ontario

'Trade marl<

SPECIAL REPORT

Task Force on

the Cost of Health Services

in Canada

November 1969

//; November 1968 a special commit-
tee was set up by the ministers of health
in Canada to study ways to curtail the
spiralling costs of health care. This com-
mittee, consisting of representatives of
federal and provincial governments, then
appointed seven task forces to examine
costs in specific areas of hospital and
health services.

When examining hospital services, the
task forces looked at utilization, opera-
tional efficiency, salaries and wages, beds
and facilities; when examining health
services, they looked at the methods of
delivery of medical care, price of medical
care, and cost of public health services.

Late last November, the task forces'
report was presented to the provincial
ministers of health. A three-volume
document of nearly 1,000 pages, the
report contains 348 recommendations on
ways to improve this country's health
services and to curb the rising costs.

The task forces' report is now to be
studied by a joint federal-provincial com-
mittee. It will undoubtedly be scrutinized
carefully by health organizations and
laymen as well. The minister of national
health and welfare, John Munro, has
proposed that the report "be regarded as
a progress report and that the study
group be retained to make further re-
commendations on implementation. "

Here are some comments from the
FEBRUARY 1970

report, along with a few of the 348
recommendations.

General commenis from report

The task forces obviously agreed on at
least one major fact as they started their
assignment: the country faces a real
dilemma in its health services, mainly
because of the skyrocketing costs. The
report puts it this way:

"The cost of health services has risen
so rapidly in Canada in recent years that
three alternatives are now imminent: the
standards of health care now available can
be reduced; or, taxes, premiums, or
deterrent fees can be raised even higher;
or, ways must be found to restrain the
growth of cost increases through better
operation of the health service structure
now in existence, and serious considera-
tion must be given to a future major
revamping of the entire system."

The task forces found the first alter-
native, reduction in health services, un-
acceptable; the second alternative, in-
creased taxes, unpalatable, both to the
people and to government. The third
alternative, cost restraint, was accepted
by the seven task forces, and they then
proceeded to look for ways to achieve
economies without diminishing the
quality of care.

The task forces were apparently dis-
turbed by much of what they found.

They report that in many instances the
introduction of modern cost efficiency
techniques might well produce better
service at less cost.

For example, more than one of the
task forces reports says that acute treat-
ment beds - by far the most expensive
to build and operate - are being misus-
ed. Persons are admitted to these elabo-
rate facilities when their real medical
condition requires a less sophisticated,
and therefore less expensive, level of care.
Or, patients are sometimes kept in an
acute bed longer than necessary, the
report says.

Other comments, which are more fully
developed in the task force reports, are:

• There is competition and duplication
between public and private interests in
the health field.

• At some point in the health system
there is need for those concerned to
arrive at a philosophical balance between
highly expensive services of limited
general application and facilities that can
be used by greater numbers of people.
Heart transplants in a major city versus
the lack of any doctor at all in a rural
town, for instance.

• Mass immunization should be under-
taken by public health agencies, not
private doctors.

• Regional organization of all health
services, involving central coordination of

THE CANADIAN NURSE 23

many facilities and agencies, is needed.

Recommendations re hospital services

The recommendations listed here,
which represent only a fraction of the
large number submitted by the task
forces, have been shortened and para-
phrased in some instances.

• Accreditation should be mandatory for
all hospitals. A national, non-government-
al body should operate the accreditation
program, but the provincial health author-
ity should be responsible for examining
in depth those hospitals that failed to
obtain accreditation.

• Nursing service administrators should
be prepared through educational pro-
grams and experience to manage their
departments.

Rationale: Many nursing service adminis-
trators lack skills in modern methods of
business and personnel administration.
This results in ineffective management
and ultimately a decrease in operational
efficiency and an increase in the cost of
the delivery of nursing care to patients.

• Objective standards for nursing care
should be established, and a method of
measuring the quality of nursing care
should be developed. Criteria for measur-
ing the productivity of individual nursing
personnel should be established. Job
standards for each position in the nursing
service department should be clearly out-
lined, and an evaluation of the quality of
nursing care and performance of individu-
al personnel should be done at regular
intervals. The numbers and categories of
personnel required to meet the needs of
patients should be determined systemati-
cally.

Rationale: The nursing service depart-
ment is responsible for the expenditure of
about 50 percent of the hospital person-
nel budget, yet there are no acceptable
objective standards for evaluating the
quality of nursing care or for measuring
the productivity of nursing personnel.
There is no adequate system for deter-
mining the numbers and categories of
nursing personnel required to deliver
nursing care to patients. This is not
conducive to cost saving efforts.
• The nursing service department should
be reorganized to reduce the number of
categories and the levels of supervisory or
administrative personnel. Orderlies should
24 THE CANADIAN NURSE

be prepared to the level of registered
nursing assistants. The clinical nursing
specialist should be introduced.

• Registered nurses are not needed in the
central sterile supply department, admit-
ting office, pharmacy, etc. Should a hospi-
tal continue to employ nurses in these
areas, these nurses should be regarded as
staff of that department, not of the
nursing service department. The number
of registered nurses in operating rooms
should be reduced and operating room
technicians employed.

• Nursing care should be planned on the
basis of an analysis of the individual
patient's needs, not on "routine" or
traditional practices. This would tend to
eliminate activities done on a ritualistic
basis, save nursing care time, and pro-
bably lead to more equitable staffing on
days and evenings.

• Nursing units should not be staffed for
the maximum nursing care load. Person-
nel should be employed as required to
take care of an increased nursing care
load.

• There should be a greater effort made
to reduce turnover rates by giving general
duty nurses an opportunity to use their
knowledge and judgment; by granting
salary increments according to standards
of performance, not by years of service
only; and by providing better personnel
policies.

• The principle of progressive patient care
within an individual hospital, a hospital
system, and a health region should be
adopted as a basic requirement for the
efficient operation of a regional health
system.

• Priority should be given to the develop-
ment of graduate educational programs
for clinical specialists in nursing and for
postbasic speciality programs in clinical
nursing.

• The authority for decisions concerning
the provision of "necessary nursing care"
for each patient should be clearly desig-
nated as a nursing responsibility.

• The annual salary increment programs
for health service workers based solely on
time in employment should be phased
out.

• Nursing stations or outposts having
adequate arrangements for communica-
tion with and transportation to a hospital
should be used to provide service to small
and remote communities.

Recommendations re health services

• A pilot project, funded by the National
Health Grants, should be set up to train
(and later evaluate) a class of "practioner-
associates", i.e., medical assistants, in
a university teaching unit under medical
direction.

• Expansion of home care programs
should be encouraged. The services offer-
ed should include: nursing; physician's
care; occupational, physical, and speech
therapy; dietary counseling; certain drugs,
appliances, and laboratory services; home-
maker and housekeeper services; and
ancillary services, such as transportation,
meals-on-wheels, social work, etc. The
provision of home care programs is a
responsibility of the public health agency;
the coordination of services, including
hospital liaison, should also be the
responsibility of the agency staff.

• University educational programs in
public health should be strengthened
through increased financial support.

• The public health nurse should be
trained to give routine immunizations and
to recognize and be able to treat any
sensitivity reactions that might occur.

• The public health agency, in conjunc-
tion with the family physician, should
ensure that selective family planning
services are made available to all people.

• The proportion of pubHc health nursing
time spent giving service in the school is
too great and should be reduced.

• Since "single disease" oriented agencies
tend to create duplication and fragmenta-
tion of service, their development should
be discouraged.

Editor's Note: Orders for the three-
volume report (cost: approximately $10.)
will be accepted and filled as soon as
copies are available. Write to the Health
Insurance and Resources Branch, Depart-
ment of National Health and Welfare,
Tunney 's Pasture, Ottawa. Copies are also
available on loan from the Canadian
Nurses' Association Library, 50 The
Driveway, Ottawa 4.

Readers wishing to comment on any of
the task forces ' recommendations should
write to the Honourable John Munro,
Minister of National Health and Welfare,
Ottawa. Readers are also invited to send
their comments to the Editor, The Canad-
ian Nurse, 50 The Driveway, Ottawa 4,
Ontario. D

FEBRUARY 1970

Nurse,

please show me

that you care!

Until nurses learn to set priorities and to base their nursing care on an assessment
of each patient's needs, we will continue to hear the cry "I haven't enough time!"

What IS written on the next tew pages
is either going to make you angry or
pleased: angry because you disagree and
think it unjust, or pleased because you
are as concerned as I am about nursing
care and believe it can be improved.

Nurses in hospitals all over the country
say they do not have time to give the
kind of care they want to give. They are
always rushing to get routine things done
and consequently have little time left for
individualized nursing care.

Well, what is individualized nursing
care and what prevents us from giving it?
To me, individualized care is that nursing
care which is provided to a patient based
on an assessment of his need for the care.
It is not care that is automatically provid-
ed to every patient either because we
have always done it or because it is a
hospital routine.

For instance, when a patient is admit-
ted, do we make any real attempt to learn
his pattern of personal hygiene care at
home? Do we then plan his care so that
we follow his pattern as closely as possi-
ble within his medical limitations? Or do
we, in most instances, have him fit into
the ward routine of daily personal clean-
liness activities between 8 and 10 each
morning?

Rigid routine

It seems to me that we make things
difficult for both the patient and our-
selves by our morning bath routine. First,
FEBRUARY 1970

Pamela E. Poole, R.N., M.S.

we have somehow decided that everyone
needs or should have some kind of bath
each day. On what physiological theory is
this founded?

1 suspect that instead of having any
scientific basis, this practice derives from
the late 1800s, when the need to wash
patients was very appropriate. At that
time hospitals, which were developed
from hostels and soup kitchens, cared
mainly for the needy and the derelict,
who were sick. Infections were rife and
nurses and doctors had to protect them-
selves and other patients from infectious
diseases and lice.

Today, the Judeo-Christian ethic of
cleanliness has become almost a religion
in itself in regard to personal hygiene.
Television advertising for soap, deodo-
rants, and shampoos perpetuates the need
to be clean to be acceptable. Although we
may deny that we are consciously influ-
enced by such product promotion, we do
have evidence in hospitals that personal
cleanliness rates a high priority in nursing
care.

Contrary to such practices there is
evidence that soap can be harmful to the
skin.i What may be even more important
is that by ignoring the patient's pre- and

The author, Pamela E. Poole, is Nursing Con-
sultant, Hospital Services Study Unit, Hospital
Insurance and Diagnostic Services Directorate,
Dept. of National Health and Welfare, Ottawa.

probably post-hospitalization pattern of
living, we are disrupting his circadian
rhythm.2 This is an individual's physio-
logical clock or timetable. It relates to the
time he usually rises, eats, bathes, works
or is otherwise occupied, and the time of
retiring. We each have our own and they
differ.

To the extent that the hospital routine
conflicts with the patient's physiological
timetable, he has to establish a new one
to conform. This takes five days. If, on
discharge, he chooses to reestablish his
former timetable, it takes five more days.
What we have done to him then is to put
another physical demand on him. namely
change, at a time when our goal should be
to support his physiological resources and
help him muster them for reparative
purposes. Of course this assumes our
overall goal is to assist people to get well.

We do not know to what extent we
have increased the patient's hospital stay
and the nursing care load by interfering
with the patient's circadian rhythm. How-
ever, we should be able to see that we are
providing unnecessary care to some pa-
tients by having them bathe every day.
We have made ourselves very "busy" by
having most patients meet what we have
decided are their personal hygiene needs
during the morning.

The morning is also the time of the

hospital day when service departments

other than nursing literally bombard the

patient. X-ray, physiotherapy, occupa-

THE CAN>^IAN NURSE 25

tional therapy, and other services all
make their demands. Although we cannot
control the scheduling of these services,
we can prevent the patient from becom-
ing exhausted by not adding all our
services to an already crowded few hours.
As a doctor said to me not long ago, "You
have to be in pretty good shape to be a
patient these days."

If a patient has not slept well and if, in
fact, we believe that sleep is therapeutic,
do we have to waken him to take a
routine T.P.R. 3 or a routine specimen
before the night nurse goes off duty?
Does the patient have to wash his hands
and face because the breakfast tray has
arrived? Is there no priority setting for
his needs? If sleep is important, why
can't he have his breakfast when he
wakens naturally?

Whether we have discovered it or not,
there are dietitians in Canadian hospitals
who believe and have shown that they are
there because of the patient. These dieti-
tians are aware that they, too, have a
therapeutic role and will help nurses help
the patient if given half a chance. It may
require more flexibility in meal delivery,
but this is not only possible, it is already
in practice.

Hospitals now have a system of "hold"
for meal trays. We have accepted this
need prior to x-rays and certain lab tests,
why not for the patient's need for sleep?
Couldn't the night nurse notify the diet
kitchen to hold a breakfast and then
make sure through change-of-shift report
that the day staff will not awaken the
patient for an 8:00 a.m. tray? Wouldn't
your dietitian be willing to discuss such a
plan? Why not try her?

Scheduling of cdre

But what about the scheduling of
nursing care itself? It seems to me as I
read medical orders that there is much
more flexibility in many of them than is
taken advantage of by nurses. If there is
no time tied to a b.i.d. or t.i.d. order, do
we carry out the order at the most
appropriate time for the patient?

For instance, if a patient is allowed up
in the chair for 10 minutes b.i.d., what
information goes into the decision to get
him up at a particular time? Do we get
26 THE CANADIAN NURSE

him up in the morning so we can make
his bed while he is in the chair? If so, is it
because we have decided this will best
meet his needs - or ours? Or do we
even think about it?

Are we aware that a patient has
become fatigued by other activities and
his need for rest is a priority? Do we
have to make his bed first thing in the
morning, or would it be better if he were
left to rest until 1 1 :00 a.m.? Couldn't he
sit in the chair in the afternoon and again
in the evening if it better suited his
needs?

Why are t.i.d. treatments or clinical
monitoring activities such as blood pres-
sure scheduled at 10 - 2 6 or
8 - 12 — 4, and once-daily activities at
10:00 a.m.? Are the times of t.i.d.
activities varied from one patient to
another? Or are all t.i.d.s the same for
everyone? If they are the same, this is
not rational organization. And it certainly
isn't individualized care.

In practice, probably only one or two
patients actually receive the treatment at
10:00 a.m.; the rest receive it sometime

before 10:00 and up to 1 1:00 a.m., with
the same occurring at 2:00 p.m. and at
6:00 p.m. This is a fact of life because a
nurse can usually do only one treatment
at a time.

And do the doctors' orders specify
that a t.i.d. order will be carried out three
times a day with four hours between each
time? If they do not, can the the nurse
not use her judgment to create a wider
spread if that better meets the patient's
needs?

I have learned that if a medical practi-
tioner has confidence in a nurse, he will
permit much flexibility for nursing judg-
ment. Have we really tested this profes-
sional colleague relationship or have we
developed rigid routines in the name of
efficiency, perhaps because some individ-
uals in the organization have strong needs
to control the behavior of others? Only
the secure supervisor, head nurse, or
director of nursing service can permit
flexibility in decision-making on the part
of her staff. But even the secure one must
have evidence of behavior that demon-
strates reasoned judgment before rigid
controls can be lifted. After all, the
director of nursing service is ultimately
responsible for the nursing care of all the
patients in the hospital.

Ritualism vs. judgment

The need for security has resulted in
the creation and perpetuation of many
hospital policies and routines. Some of
these have become highly ritualistic, that
is, they have meaning for the people
carrying them out, but are not necessarily
oriented to meet the goals of the organi-
zation.^ We are all committed to do the
patient no harm while he is within our
walls. But are we also committed not to
things that will do him no good?

For instance, I believe we are all
concerned with the costs of the operation
of our hospitals. The patient is paying
these expenses, but others who are not
patients are also paying through hospital
insurance plans. This is so because our
insurance scheme is based on actual costs
of operating our hospitals. As these costs
rise, the tax dollars will rise to meet
them. As taxpayers we need to look
carefully at practices that may not do the
FEBRUARY 1970

patient any harm, but also may do him
no good.

Twenty years ago patients who under-
went surgery for an inflamed appendix or
inguinal hernia were kept in bed for ten
days to two weeks. They were discharged
after a few days of being up and around,
hence they were physically weak from
being in bed. To protect the patient from
falling, or perhaps more correctly the
hospital from lawsuit, we took the pa-
tient to the front door of the hospital in a
wheelchair and accompanied him to a
waiting vehicle. Since surgery and anes-
thesia have changed so dramatically and
with them post-surgical convalescence,
what is the rationale for continuing this
practice for a patient who has probably
not been bedridden continously for even
24 hours? Have we thought about it at
all? If we have and have retained the
practice, are we hiding behind the threat
of an accident and lawsuit?

What about our nurses' notes? Do
they meet the goals of the organization if,
in fact, the goal is for relevant, accurate
information? The patient record serves
many purposes. Two of its reasons for
being are the provision of a medium of
communication for hospital personnel
and the production of a document des-

cribing the patient's care, which may find
itself in a court of law.

If these are justifiable functions of the
patient's record, it is imperative that the
contents contain relevant, accurate in-
formation. Both treatment decisions and
legal decisions are based on the informa-
tion contained in these notes.

How relevant and how accurate is
"slept well" or "good day"? It seems to
me that it would be more useful to know
how the patient slept last night relative to
the night before; at least then a decision
to act or not to act would be based on
descriptive information. If patients are in
hospital because they are ill, how "good"
are their days anyway, and good in
relation to what — the kind of day the
nurse usually has?

If we are nursing the patient, we
should know enough about him to de-
scribe not the day as a whole, but those
things in the day that are relevant to his
progress or maintenance of his optimum
state of health. If we don't know these
things, then "good day" or similar cliches
add nothing worthwhile to a record that
is to serve the purposes previously de-
scribed. The amount of time consumed in
such documentation might better be
spent in learning what the patient's needs
are.

It is unrealistic to claim that a nurse
meets the physiological, psychological,
social, spiritual, and, you name them,
needs of her patients. If a nurse can
accurately assess what some of these
needs are, she can meet some and assist
the patient to meet others, through use of
self and the climate she creates. But she
cannot assess a patient's needs unless she
spends time with him. If he perceives that
she cares about him as a person, he will
help her to determine his needs.

For instance, most patients have the
need for some information about what is
and will be happening to them, even
though the amount of information and
the words used to convey it differ. Fear
of the unknown is an eternal truth, but
we must learn what is appropriate to
discuss with this patient.

Until we examine ourselves and our
practices, with the object of providing
care based on an assessment of the

individual patient's needs, and until we
learn how to set priorities, we will con-
tinue to hear the cry "I haven't enough
time." Patients can help themselves to a
much greater degree than they are now
generally allowed. To what extent do we
involve them in their care? To what
extent do they contribute to their care
plan? If there is a care plan, do they even
know it exists? And is it an appropriate
plan?

Every nurse who has 35 to 40 hours a
week to give to patients might well ask
herself, "how do I use this time? " The
answer could be quite revealing; the result
might be that together the nurse and the
patient could put caring back into nursing
care.

References

1. Bettley, Ray F. Effects of soap on the skin.
Nurs. Mirror, 14 April 1967. p.i.

2. Beland-Marchak, Nicole. Circadian rhythms.
Canad. Nurs. 64:12:40-44, Dec. 1968.

3. Poole. Pamela E. The Routine Taking of
Temperature, Pulse and Respirations On Hos-
pitalized Patients. Ottawa. The Department of
National Health and Welfare. Dec. 1968.

4. Walker, Virginia H. Nursing and Ritualistic
Practice. New York, The Macmillan Co., 1967,
p. 11-22.

FEBRUARY 1970

THE CANADIAN NURSE 27

Night safety

— a problem for nurses

In September 1969 a registered nurse in British Columbia was fatally stabbed as
she walked home from work after midnight. Following this tragedy,
The Canadian Nurse telephoned at least one hospital in each province to find
out if any provisions are made tor the night safety of nurses.

Eleanor Mitchell, B.N.

If you are a nurse who works after-
noon or night shifts, you have probably
never given a second thought to the
method or route you take to get to and
from the hospital.

What precautions do you take to
ensure your own safety? Do you use a
well-hghted route as you walk three
blocks to the bus? Do you walk with
another nurse? Or do you rely on the
assumption that "I've gone this way
many times, and nothing has ever happen-
ed," as you proceed alone along a dark
but familiar route.

The laws

The Canadian Nurse investigated the
laws in each province to see what provi-
sions are made for women who work at
night. According to the Labour Standards
in Canada, December 1968, five provinces
include regulations concerning night work
for women.

In Quebec, under the Industrial and
Commercial Establishments Act, as
amended in 1968, women are permitted
to work on the niglit shift under certain
conditions. The eight-hour shift must not
begin before 11:00 p.m. or after mid-
night. The employer must ensure the
safety of women who leave work before

Miss Mitchell is Assistant Editor of The Canadi-
an Nurse. She expresses her appreciation to the
hospital personnel who participated in the
telephone survey.

28 THE CANADIAN NURSE

7:00 a.m. by providing them with conve-
nient and safe transportation to their
homes at his expense. Unfortunately,
hospitals do not qualify under this act;
nurses and other female employees are
exempt from the provision.

In January 1969, the Ontario legisla-
ture amended its Night Work Policy.
According to this Policy, "If a woman
works on a shift that begins or ends
between midnight and 6:00 a.m. she must
be provided with private transportation
from or to her home by her employer.
Nurses, dietitians and most paramedical
workers are now covered by this provi-
sion."

An order under the Alberta Labour
Act prohibits the employment of women
on shifts that begin between midnight
and 6:00 a.m. unless the employer pro-
vides free transportation for the employ-
ee to or from her place of residence. Any
period during which the employee is
required to wait on the employer's
premises for transportation is considered
to be part of the working time. The order
applies to women employees who work
within a five-mile radius of home in cities
that have a population of over 2,000.
Unfortunately, the order exempts those
who are employed in hospitals and nurs-
ing homes.

Manitoba regulations are similar to
those in Alberta.

In Saskatchewan, female employees in

hotels, restaurants, educational institu-

FEBRUARY 1970

tions, hospitals, and nursing homes who
finish work between 12:30 a.m. and 7:00
a.m. must be provided with free trans-
portation to their homes by the employ-
er. Once again, nurses, nursing assistants,
and student technicians are not covered
by this provision.

None of the other provinces have laws
or regulations regarding transportation
for female workers at night.

The telephone survey

Responses to our inquiries on what
hospitals do to ensure the safety of nurses
traveling to and from work varied
considerably from province to province.

The director of nursing service at St.
Paul's Hospital in British Columbia told
The Canadian Nurse that all unusual
incidents observed by anyone are to be
reported to the hospital security officer
and to the police. Nurses are encouraged
to use the "buddy system" coming to and
going from work.

Seven sessions on self-protection have
been arranged with the Pinkerton Protec-
tion Agency. The hospital plans to video-
tape a session so that it can be repeated at
frequent intervals as part of the inservice
education program at St. Paul's. Person-
nel from other nearby hospitals have been
invited to attend.

At another hospital in British
Columbia the assistant director of nursing
said that no special provision is made for
the transportation of nurses coming on
and going off duty at night.

When this nurse was asked if she
thought nurses should receive transporta-
tion home at night, she said: "If any-
thing, all female employees should be
included." She explained, however, that
it is difficult to ensure a nurse's safety.
"Even if a nurse is taken home, there is
no guarantee that she will not go to the
corner store at the last minute," she said.
FEBRUARY 1970

Early in October, two hospitals in
British Columbia gave their nurses the
opportunity to learn the art of self-
defence. Twice-weekly classes are
conducted on the hospitals' premises by
members of a local karate association.
The nurses, who pay a nominal charge for
this instruction, concentrate on the basics
of kicking an attacker in the groin and
jabbing him in the eyes.

According to British Columbia At-
torney-General Leslie Peterson, the prov-
ince once had legislation that required
employers to provide female night em-
ployees with transportation to their
homes. It was cancelled after women's
groups claimed it was discriminatory and
affected their chances for employment.

In Alberta, the director of nursing said
that for the past two years her hospital
has made transportation available for
nurses who are changing shifts at mid-
night. "They can pick up a taxi chit from
the hospital if they wish," she said.
Nurses living close to the hospital may
ask a security guard to call a taxi for
them, but this is their choice, the director
explained. She believes the present
system is working satisfactorily.

At a large teaching hospital in Saskat-
chewan the director of nursing service
said if a nurse comes off shift too late to
take public transportation home, the hos-
pital is responsible for providing her with
free transportation. She emphasized there
must be a legitimate need for a taxi, since
taxi tickets are not handed out auto-
matically. Few nurses require them be-
cause they use public transportation or
their own cars. The hospital pays for taxis
if nurses are called back to work at night.

A director of nursing at a large teach-
ing hospital in Manitoba said her hospital
tries to have nurses finish duty before
public transportation stops. If this is not
possible, the night supervisor can author-

ize taxi fares for nurses. She explained
that nursing supervisors listened to the
concerns expressed by the nurses and
gave them consideration. This director
thought the provision for transportation
home at night was written into nurses'
contracts in some hospitals in Canada.

Because the afternoon shift ends at
11:30 p.m. and public transportation is
still in operation, the director of nursing
service at another hospital in Manitoba
said the hospital did not legally have to
provide transportation home for nurses.

In Ontario, several different practices
are used since the new regulation became
effective in January 1969. At a military
hospital, the director of nursing said no
special provision is made for nurses
changing shifts. It is left up to the
employee, whether military or civilian, to
make her own way home at whatever
hour she leaves work. Night transporta-
tion is not a major problem since many
military nurses live on the base.

The directors of two other hospitals in
Ontario said they provided taxis for their
nurses because it is now a requirement of
law. Prior to this law, one of the hospitals
had provided taxis for nurses on Saturday
and Sunday nights.

A large teaching hospital in Ontario
provides taxis between 11:30 p.m. and
6:00 a.m. for approximately 100 female
nurses. Those requiring transportation
obtain a ticket from the nursing office.
This policy was in effect before the law
was amended.

The spokesman for another hospital in
Ontario said that the hospital is in no
financial position to provide free trans-
portation for the many nurses coming off
afternoon shift or going on night duty.
Since the shifts end or begin before
midnight, the hospital does not legally
have to provide transportation home for
nurses. Public transportation is nearby
THE CANADIAN NURSE 29

and continues until 2:00 a.m. However,
any female woricer called back to work
during the night is provided with trans-
portation paid by the hospital.

Because of the new Ontario law, this
hospital changed its hours of duty. The
employees resisted the change as it meant
the day shift had to report for work at a
very early hour. The spokesman suggested
it was the individual's responsibility to
travel with another nurse, rather than
alone.

At another Ontario hospital the after-
noon shift also ends before midnight.
Nurses who must work past this time are
provided with free transportation. The
spokesman expressed the opinion that if
nurses demanded free transportation, the
hospital would be forced to employ fewer
nurses, because of budget problems.

The Canadian Nurse found one hospi-
tal nurses' association contract in Ontario
that requires the employer to provide
transportation for nurses to their place of
residence when the shift ends at midnight
or later. This contract stipulates that the
nurse must live within a 10-mile radius of
the hospital.

At a large teaching hospital in the
province of Quebec, the evening shift
ends at 11:30 p.m. Public transportation
is still available at this hour. The director
of nursing explained that if nurses are
detained until after midnight a few of
them are sent home by taxi, especially if
they live in a "rough" or poorly-lighted
area. The only other nurses who are given
taxi tickets are those on call for the
operating room who may be called in at
any hour of the night.

As far as this director knows, there has
been no discussion of the night trans-
portation problem in Quebec by any
nurses' groups or hospitals. There have
been no difficulties at her hospital and
the director is satisfied with current
30 THE CANADIAN NURSE

arrangements. She believes, however, that
the provincial law should include trans-
portation home for nurses after midnight.

The assistant to the director of nursing
at another teaching hospital in Quebec
said that female nursing students benefit
from the services of a protection agency.
From midnight to 1:00 a.m. a guard
stands by as students cross the street to
the nurses' residence. Most of the register-
ed nurses have cars in the parking lot,
which is under surveillance day and night.
Some nurses share their cars or travel in
groups on a bus, she said.

At another large hospital in Quebec,
the director of nursing said that most
female nurses on night duty travel to
work by car. At this hospital nurses on
the afternoon and night shifts receive
additional pay to provide for transporta-
tion. The afternoon shift receives an
additional $40 per month and the night
shift, $24. This additional salary is
provided to pay for taxis, the director
explained. This supplement was negotiat-
ed by the union for this purpose, and is a
clause typical of most hospitals in
Quebec, she said.

In New Brunswick, a director of nurs-
ing service said her hospital makes no
special provision for transportation of
nurses changing shifts at night. However,
the hospital will pay for a taxi for any
nurse on call after 4:00 p.m. If this nurse
provides her own transportation, the hos-
pital will reimburse her $2.00. Female
x-ray technicians and laboratory techni-
cians are also included in these arrange-
ments. As far as this director knows,
there have been no problems concerning
night transportation.

In Nova Scotia, the director of nursing
at one hospital said that no provisions are
made for nurses' transportation at night.
Since the afternoon shift ends at 11:30
p.m., nurses can use public transporta-

tion. Only those nurses on call are entitl-
ed to taxis paid by the hospital. Many
nurses arrange car pools. There have been
no problems with transportation as far as
this director knows. For more than 10
years a commissionaire has patrolled the
area between the main hospital and an
affiliating hospital where student nurses
live.

In Prince Edward Island, the director
of nursing service at one hospital reiterat-
ed what most of the other hospitals
surveyed had said: that no special provi-
sions are made for the safety of nurses
changing shift at night. However, the
nurse is advised to be careful, she said.
She explained that there is no real
problem as most nurses travel in groups
rather than alone.

Nurses in Newfoundland are not
provided with free transportation at
night, although one hospital does pay for
the transportation of female laboratory
technicians who are called back at night.

Summary

From this brief survey it appears that
most nurses are expected to ensure their
own safety when traveling to and from
work. Five provinces in Canada have laws
concerning women who work at night,
but only in Ontario is the employer
required to provide nurses with trans-
portation home after midnight. Other
provinces do not have laws concerning
night work for women.

Some hospitals provide taxis for nurses
changing shifts at night, although legally
they are not required to do so. In other
hospitals, shifts end or begin before mid-
night when the law does not require the
employer to provide nurses with trans-
portation. CI

FEBRUARY 1970

1

Examining student nurses'
problems by the case method

The skills needed by the nurse educator to identify and analyze student nurses'
problems can best be developed by the "case" method, the author says.
This method presents the prospective teacher with actual problems that have
confronted school of nursing faculties, and gives her an opportunity to resolve
real, rather than hypothetical, issues.

Vivian Wood, R.N., M. Ed.

One of the teacher's most important
responsibilities concerns student guidance.
Often the teacher is the only source of
help available to the student who has a
personal, social, or academic problem.
Thus her understanding of student behav-
ior and her ability to react helpfully are
fundamental to her success as teacher.

Teachers in nursing education need a
high degree of skill in identifying and
reacting to student nurse problems. Inad-
equate performance in this counseling
role affects the individual student as well
as the total environment in which the
school functions. The reactions to poor
situations, as recent events in other edu-
cational settings have shown, can even
threaten the existence of the school.
Obviously, the development of counseling
skills is an integral part of any teacher
preparation program.

Types of courses

Courses in student personnel services
tend to fall into two categories. The first,
and probably the most popular, empha-

Mis. Wood, Associate Professor, Faculty of
Nursing, University of Western Ontario, has
l)een instructing in the teacher-preparation
programs. She has been responsible for the
following courses: "Student Personnel Services
in Nursing Education," "Measurement and
Evaluation in Nursing Education," and "The
Diploma School Program." During the past two
years Professor Wood has been conducting
seminars for teachers in schools of nursing.

FEBRUARY 1970

sizes concepts of counseling and guidance
with particular stress on interaction theo-
ries, review of vocational opportunities,
and the use of standardized measures of
aptitude, interest, and intelhgence in
career planing.''

The second type of course concen-
trates on behavioral change by developing
the prospective teacher's skill in recogniz-
ing and helping to resolve student aca-
demic, social, and personal problems. The
basic teaching approaches used require
the student-teacher to practice the above
processes in various contexts. This ap-
proach, through the case method, exposes
the prospective teacher to the frustrations
and difficulties in sensing a student's
problems and enabling her to cope suc-
cessfully with them.*

This second type of course is the one
recently developed in the master's pro-
gram at the University of Western Ontar-
io.

When the use of cases was first consid-
ered, teaching materials and appropriate
texts were scarce or nonexistent: there-
fore, the course of necessity assumed an
experimental approach. From the begin-
ning of the experiment, the use of cases
as a basic teaching tool was planned. No
other approach combined effectiveness in
expanding student values and boundaries

*A similar concept about teaching can be found
in Case Analysis and Business Problem Solving
by Kenneth Schnelle, New York, McGraw-HiU
Company, 1%7.

THE CAN/^IAN NURSE 31

with economy - although initial devel-
opment cost is not small. Before describ-
ing the experiment, however, more back-
ground on each approach is desirable.

The course In the past

Prior to the development of the nurs-
ing education option for teachers in the
master's program at UWO, a course in
student personnel services was offered to
student-teachers in the diploma program
in nursing education. This course started
with an overview of student personnel
services in nursing and education. Counse-
ling theories were studied, followed by
exercises to provide experience. The
course then gave the student-teachers an
opportunity to study institutional prob-
lems of nursing education, such as recruit-
ment, admissions, and the setting of
educational policy. The final sessions
were devoted to group activity mecha-
nisms.

One year, as part of this section, the
class observed a group of graduate busi-
ness students at UWO discussing a case
assignment. Our students later analyzed
the group using concepts previously rais-
ed in class. The class showed ingenuity
and enthusiasm in carrying out this par-
ticular assignment.

Although the course in student person-
nel services was well received and showed
reasonable results, there were some ob-
vious shortcomings. First, the interaction
process was already being taught in sever-
al courses offered by the nursing faculty.
The benefit of providing another point of
view was marginal at best. The unit on
problems in nursing education tended to
drift into a discussion of problems en-
countered by class members when they
received their basic nursing education.

Also, few of the teaching materials
were oriented to Canadian problems.
32 THE CANADIAN NURSE

Since student problems are heavily influ-
enced by environment, some problems
unique to Canada do exist. Finally, al-
though awareness of student nurse prob-
lems may have been heigluened, there
seemed to be little development of skills
to deal with those problems. The move to
the master's program provided an oppor-
tunity to remedy these shortcomings.

The experiment

The major change in the course has
been the introduction of cases as major
teaching tools. Since appropriate cases
did not exist, part of the course was
dedicated to their development through
class projects. Students visited diploma
schools of nursing and investigated partic-
ular student nurse problems. They then
described in a written case the problems
facing the faculty and director of nursing
education. After release from the agency
these cases were subsequently discussed
in a disguised form in class.

The course changed in other ways.
Although we still begin with an overview
of student personnel services, we now put
more emphasis on their value in teaching
and learning. A discussion of student
nurse needs leads into a study of related
concepts, and a major part is devoted to
analysis of student nurse problems. Here
the cases are used and class members
develop skills in utilizing concepts and
developing sensitivity to student prob-
lems.

Sufficient course time is allocated to
ensure that each member of the class gets
sufficient practice to improve her skills in
student guidance and in structuring ap-
propriate school policies and procedures.
The course ends with consideration of the
educational, occupational, and placement
services that a school of nursing might
implement.

The case method

What is a case? How can it be used
within the context of a course?

A case in nursing education is a de-
scription of an issue that has been faced
by the faculty or the director of nursing
education. Specifically, in our course, the
case is a descriptive account of some
problems encountered by student nurses
during their educational experience. In-
cluded are surrounding facts and opinions
upon which faculty decision is to be or
has been reached.

Cases may be categorized into two
types: The "issue case" poses a problem
for the student-teacher to analyze and
help to resolve. 2 The "appraisal case"
describes a decision already made and
asks the student to assess and evaluate it.

A case describes real problems that
require solutions; within the limits of the
written word, it puts the student and the
class in the position of the decision-
maker. These real cases are presented to
students for analysis, open discussion,
and final decision as to the action that
should be taken.

The use of actual situations involves
the student in real problem solving, and
provides a basis for concept generation
and evaluation. For example, when dis-
cussing withdrawal and dropout of stu-
dents in a diploma program, "live" case
material illustrates by demonstration the
infinite variety of goals, facts, conditions,
conflicts, and personalities that occur in
our daily lives. From the situations de-
scribed, generalizations of psychological
and sociological concepts can be drawn.
At the same time the inadequacy of
theoretical analysis of oversimplified
examples can be appreciated.

Readings from nursing and research

journals are used in conjunction with and

following related case discussions, de-

FEBRUARY 1970

pending on the teaching strategy. The aim
is to graduate professionals, not theoreti-
cians.

The cases developed to date treat
problems of recruitment, admission, as-
sessment, and personal problems. Several
cases describe problems of student with-
drawal. One. for example, concerns a
bright young student nurse who became
pregnant and left nursing. Should she be
encouraged to return to the program?
What student policies were in existence at
the time of her marriage? Were these
policies relevant and current? What was
the cost of the student's education to the
province?

These are only a few of the kinds of
questions raised and discussed by the
class. Without the case as a vehicle,
student discussion tends to be intellectual
but uncommitted, interested but lacking
in depth, and, above all, decisive but
unrealistic.

Teaching by the case method assists
the graduate student to develop inde-
pendent thinking and at the same time to
gain experience in discussing and defend-
ing her analysis and position. 3 As in the
actual situation, the problem may or may
not be clearly defined. Similarly, the facts
presented may or may not be complete.

The case may present complex prob-
lems that are not apparent. From the
same set of facts, students define totally
different problems. Each fact may be
related to a different possible course of
action. Often the obvious problem is only
a symptom of a more important one.
Thus, the case projects the student-
teacher into the realm of practical expe-
rience and gives her a preview of the
concerns she will face as a practitioner.

Evaluation

The learning that takes place with the
FEBRUARY 1970

case method differs from that in the
previous course. Briefly, the graduates
seem better prepared to take action when
confronted by student problems in their
future positions.

The advantages of the case method are
many. The student-teachers learn, by
personal involvement and by an exchange
of ideas with their classmates, the "how"
and "why" of the current problems of
student nurses in diploma programs."*
Careful guidance from the faculty leader
helps the students to acquire confidence
in their abilities in situations where the
consequence of error is relatively innoc-
uous. Thus, student-teachers learn quick-
ly, easily, and naturally as they are
constantly required to apply the knowl-
edge they have gained to new problem
situations. They learn the importance of
research in nursing, of independent think-
ing, and cooperative work relationships.

The instructor may take a passive or
active role.s She must be thoroughly at
home with the content of her course. She
must keep the class moving — get the
discussion started and help the partici-
pants to stay involved with the issues.

Naturally, the discussion depends on
the quantity and quality of students, as
well as on their previous nursing experi-
ence. A student-teacher may tend to
dominate the discussion or to polarize
arguments about herself. In such cases she
may find herself, rather than the case, the
subject of discussion.

It takes time for students to develop
skills in analyzing and decision-making.
This is not achieved by using one case. In
our course seven or eight cases are used
and more will be used as new ones are
written. Even here we fall short of our
objective because of insufficient time.
The new cases under preparation should
help to remedy the problem.

Conclusions

Examination of student nurses' prob-
lems in an evolving, dynamic society is a
crucial aspect of the prospective teachers'
graduate program. Identifying these prob-
lems, reacting sensitively and effectively,
requires a high degree of skill. Such skills
can be developed by analyzing cases that
describe student nurses' problems.

At the University of Western Ontario
School of Nursing, data collected from
Ontario schools of nursing are used for
case discussion. Future plans include the
writing of cases collected from schools of
nursing in other provinces to expand the
coverage of problems to a national level.

References

1 . Arbuckle. Dugald S. Pupil Personnel Services
in the Modern School. Boston, AUyn and
Bacon, Inc., 1966.

2. Davis, Robert T. Some suggestions for writ-
ing a business case. Unpublished manuscript.
Harvard Business School. Reprinted June,
1965.

3. Gragg, Charles I. Because wisdom can't be
told. In The Case Method at the Business
School, ed. by Malcolm P. McNair, New
York, McGraw-Hill. 1954, pp. 6-14.

4. Hunt, Pearson. A professor looks at himself.
Harv. Bus. School Bull. Jan.-Feb. 1964.

5. Andrews, K. R. The role of the instructor in
the ca.se method. In The Case Method at the
Business School. Malcolm P. McNair, ed.
New York. McGraw-Hill, 1954, pp. 98-108.

D

THE CANADIAN NURSE 33

An invitation to a checkup

"Walk in" was the invitation displayed on footprint-shaped signs outside a
particularly crowded room at the Ontario Hospital Association convention last
October. The author did, and discovered five screening clinics doing a
brisk business on convention participants.

Tara Dier

In an estimated crowd of 7,500 there
are sure to be some undetected cases of
glaucoma, tuberculosis, heart disease,
cancer of the cervix, or diabetes. When a
crowd that size is attending a convention
of the Ontario Hospital Association in
Toronto, uncovering a few of these condi-
tions could be an effective way of
promoting a new method of screening the
public.

Early in 1969, representatives from
the GHA and Dr. B.T. Dale, medical
officer of health and director of the
Wellington-Dufferin-Guelph Health Unit,
got together to discuss the feasibility of
setting up such a mass screening program
at the OHA convention in October. The
result was a highly successful "prevention
package" for hospital personnel attending
the convention. Based on the clinics Dr.
Dale has been running in the Guelph area
for six years, the five OHA clinics were
designed to demonstrate the advantages
of mass screening clinics by using the
convention participants as patients.

"Walk in," the large, footprint-shaped
signs in the lobby invited. I did.

The signs directed me to a room where
tests were conducted for glaucoma, tuber-
culosis, and diabetes. One of the hospital
auxiliary workers who helped with the

Miss Dier, an editorial assistant at The Canadian

Nurse for the past three summers, is a second-

The author holds her breath while a technician from the Ontario Department of year student in arts at the University of

Health takes a chest x-ray at the OHA "Walk in" clinic. Toronto, Ontario.

34 THE CANADIAN NURSE FEBRUARY 1970

paperwork at the clinics explained that
these three tests were the combined
efforts of many agencies: The glaucoma
test was conducted by the Canadian
National Institute for the Blind, with
staff from the University of Toronto and
the Toronto General Hospital. The Onta-
rio Department of Health contributed
one of its mobile chest x-ray units and a
technician, and the Canadian Diabetic
Association ran the test for diabetes.

Industry also made a contribution.
Equipment and assistance were received
from the Imperial Surgical Company.
Kimberly-Clark of Canada Limited, the
Stevens Companies, and Allan Crawford
Associates Limited.

The volunteer shepherded me to the
beginning of an assembly-line that led to
the chest .x-ray. on to the glaucoma test,
and ended at the blood test. I emerged at
the end in less than an hour.

The last two tests of the convention
screening clinics, the electrocardiogram
and the Papanicolaou test for cancer,
were given in two hotel rooms upstairs. I
decided to rely on the usual good health
of youth and skip them, but I went up to
investigate.

The ECG, I discovered, was a team

effort in itself. Student nurses from St.
Michael's Hospital in Toronto connected
the electrodes to the patient under super-
vision of staff from the Toronto Western
Hospital. The signals were transmitted by
telephone to a computer at The Hospital
for Sick Children, where cardiologists
from Toronto Western interpreted the
results and returned them to the hotel
clinic.

"Eventually we hope to perfect the
system," said research associate H.
Tegelaar of Toronto Western Hospital,
"so that doctors in remote parts of the
country, for instance Northern Ontario,
can connect their patients to a computer
in Toronto by telephone. The signals
would be received and interpreted in
Toronto, and the results returned
immediately. What we are doing here is
only an indication of what could be
done."

Then I crossed the hall to talk to Dr.
Margaret Braund. who gave Pap tests to
116 women during the three-day clinic.
Dr. Braund is associate medical officer of
health at the Wellington-Dufferin-Guelph
Health Unit, and she and Dr. Dale ex-
plained the clinics they have been running
in the Guelph area, which were the

models for the OHA clinics.

"We move into a new area around
Guelph every 7 to 10 days," explained
Dr. Braund, "conducting tests similar to
the ones here, plus a test for hearing. The
only exception is the Pap test, which we
don't have the facilities to give. We
recommend that women go to their
family doctors for it." She added that
many of the women who had the test at
the OHA clinic had never had it before,
although they were associated with hospi-
tals.

"We conduct six or seven thousand
individual tests in each area," continued
Dr Dale. "Ten to fifteen percent of them
indicate that further examination is
required. Again, we send them to their
family doctors. Our purpose is to screen
the patients for symptoms, not diagnose
and treat them.

"We don't want to replace the family
doctor, only help him," he said. "Less
than half the doctors in Ontario are
general practitioners, and screening clinics
such as ours can help to reduce the
resulting strain on doctors and com-
munity hospitals."

At the OHA convention screening
clinics, a total of 1,722 tests were

Before the test for glaucoma, anesthetic drops are instilled
into the author's eyes.
FEBRUARY 1970

The author did her best to stare at her hand while the
tonometer tested her eyeball for high pressure, an indication
of glaucoma.

THE CANADIAN NURSE 35

conducted in three days. The patient's Despite fairly steady business in all five of the screening clinics an annual event

own doctor will be notified if he needs clinics, it was possible to go through all of for Canadian families. Personally, I still

further examination, and Dr. Braund them in less than two hours. prefer the more human approach' of my

estimates that 1 0 percent of the patients Perhaps this saving in time will eventu- own family physician. D

screened will hear from their doctors, ally make a trip through the assembly line

One drop of blood was enough for the Canadian Diabetic Association's test for hypcrglycciuia and possible diabetes.

I i^.j>

A patient waits while student nurses from St Michael's Hospital in Toronto dial his heartbeat into a computer at The Hospital for

Sick Children for the results of his electrocardiogram taken at the OHA "Walk in" clinic.

36 THE CANADIAN NURSE FEBRUARY 1970

Sleep

So far, we know remarkably little about the third of our lives that we spend in
sleep — or, at least, we know little about how to regulate it. We do know
that there are different stages of sleep, that each of us has his own sleep cycle
and circadian rhythm, that there are different kinds of insomnia, and that
sedatives sometimes have strange effects. This author illustrates how the current
knowledge about sleep may be used to better understand and predict the
needs of hospitalized patients.

We know that patients in hospitals,
away from their usual sleeping environ-
ments and beset by the problems created
by illness, frequently have difficulty
meeting one of their most basic physio-
logic needs - the need for sleep - at a
time when they require it most. But how
can the nurse, who every evening passes
out the sedatives, assess an individual
patient's need for sleep or for sedation?
What is going on when a patient says, "I
didn't sleep a wink last night," and the
night nurse's report reads, "Slept well"?

In the past 10 to 15 years, research
into the phenomenon of sleep has given
us some data to use in assessment. It is
only a beginning, however, because most
research has concentrated so far on
identification of the intrasleep pattern.
Little is known so far about the real
reason for sleep, or how sleep behavior
can be controlled. "i

The sleep phenomenon

Electroencephalograms have given re-
searchers a better picture of what is
occurring during sleep. When a person is
wide awake and alert, his EEG recordings
show rapid, irregular waves. But as he
settles down to rest, there emerges the
first of two wave patterns that occur
during sleep. This is the alpha rhythm and
consists of a regular wave pattern of low
voltage, with frequencies of about 8 to 1 2
cycles per second.

The other EEG pattern is the delta
rhythm, present during deep sleep. Delta
FEBRUARY 1970

Barbara Long

waves occur at a slow I to 2 cycles per
second and are of high voltage. Sleep
spindles, which occur during certain
stages, are sudden, short bursts of sharply
pointed alpha waves of about 14 to 16
cycles per second.

Four different stages of sleep have been
identified by researchers using EEG read-
ings.

In Stage I, alpha rhythm is present
although the waves are more uneven and
of lower voltage than when the individual
is at rest with his eyes closed. The person
will have fleeting thoughts and can be
awakened easily. If he is awakened, he
may say that he has not been sleeping.

In Stage II, sleep spindles appear at
intervals. The person is more relaxed;
however, he may still be awakened as in
Stage I, and report that he had been
"thinking or indulging in reverie."^

In Stage III. delta waves begin to
occur. Sleep spindles are still present. The
person's muscles become more relaxed
and vital signs decrease, and he is more
difficult to awaken.

Stage IV is a deep sleep, and delta
waves are the dominant EEG pattern. The
person is very relaxed and rarely moves.
If awakened, he will respond very slowly.

Mrs. Long (B.A., Ohio Wesleyan University.
Delaware, Ohio; M.N. and M.S. in nursing. Case
Western Reserve University, Cleveland. Ohio) is
assistant professor of nursing at Case Western
Reserve.

It is during Stage IV that most sleepwalk-
ing and enuresis occurs.

In the general pattern of cycles of
sleep over a seven- to eight-hour period,
the individual will descend from Stage 1
to Stage IV and then back to Stage I
REM sleep in about 60 to 90 minutes.

Stage I REM sleep is a stage that the
person enters when ascending from Stage
II. The EEG readings are similar to those
in Stage 1, but there are physiologic
differences. Rapid eye movements (REM)
occur, respiration and pulse rates increase
and are irregular, and the blood pressure
fluctuates widely. This is something to
remember if a patient must have his vital
signs checked frequently during the night.
One might look closely at a patient who
shows wide variations in his vital signs,
yet seems to be asleep. It is during this
stage, too, that most dreaming occurs.

After about 10 to 15 minutes in Stage
I REM sleep, the person will descend
again to Stage IV. The cycle will repeat
itself tliree to five times during the night,
but each time the individual returns to
Stage I REM sleep, he spends a corre-
spondingly longer time in that stage.
Thus, in the first third of the night, more
time will be spent in Stage IV, but in the
last third of the night. Stage I REM sleep
will predominate. 3 In the early part of
the night, dreams in Stage I REM sleep
are shorter, more likely to be on the dull
side, and contain aspects of activities of
the preceding day. As the night prog-
resses, the dreams become longer, more
THE CANADIAN NURSE 37

vivid, and less concerned with daily life.''
The time spent in each stage is highly
individual, but normally it is consistent
for the same person on different niglits.

Physiologic changes

The sleep-wakefulness cycle appears to
revolve around the biologic circadian
rhythms of the body. The point at which
the basal metabolic rate is low (as illus-
trated by the person's body-temperature
cycle) occurs at approximately the same
time every 24 hours for a person on a
regular sleep-wakefulness schedule. But, if
the person suddenly reverses his sched-
ule - if he starts a night job, or jets
halfway around the world - it will take
several days for his body to readjust to
the new pattern. He will feel more tired
and may make more errors at the time
when his basal metabolic rate has been
accustomed to being at the low point.

Likewise, a patient who usually works
night shifts may feel more tired during
the early afternoon for a few days after
his admission to the hospital while his
body adjusts to the different circadian
rhythm.

Those who schedule shifts for nurses
and other hospital workers should be
aware that a person who suddenly
changes from working the day shift to the
night shift is more likely to commit errors
during the low point in his circadian
rhythm.

Physiologically, the vital signs, peristal-
sis, urine production, and possibly some
of the blood constituents undergo identi-
fiable changes during sleep.

Vital signs and oxygen consumption
decrease, with the exception of the varia-
bility that occurs during Stage I REM
sleep.

The digestive tract is not affected by
sleep, except that peristalsis slows in the
sigmoid colon. In patients with gastric
ulcers, gastric acidity increases during
Stage I REM sleep.

Urine production decreases. Pituitary
and adrenocortical activity appear to be
on a 24-hour cycle that influences re-
absorption of water in the kidney tubules
during the night.

Researchers have found that the pe-
rcentages of some of the blood constitu-
ents decrease during the night. Kleitman

states, however, that this is due to the
increased blood volume that occurs when
a person is in a horizontal position (as a
result of decreased capillary filtration
pressure) rather than an actual decrease in
the blood constituents. s

The biochemistry of sleep is a new
field of research, and little is known so
far. Certain endogenous compounds
appear to have some effect on sleep and
are being studied, including serotonin,
dopa, and the sex hormones primarily
progesterone. As more is known about
the biochemistry of sleep, methods to
control sleep may become more specific
and effective.

The percentage of time a person
spends in the different stages of sleep
differs with age. Stage I REM time
remains fairly constant throughout life,
but the percentage of time spent in Stage
IV sleep decreases with age.^ The elderly
patient spends less time in Stage IV due
to a shorter total sleep time and more
frequent awakenings during the night. An
elderly person's adjustment to sleep
seems to depend on the degree of his
arteriosclerotic changes. The alert patient

THE CANADIAN NURSE

FEBRUARY 1970

who has httle memory loss seems to sleep
about the same as the young adult. The
patient who shows senile changes awak-
ens often, especially during Stage 1 REM,
sleeps 20 percent less than the young
adult, and tends to wander around at
night.''

Medical crises are thought to occur
during Stage 1 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. 8

Thus, one might 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 stimuli, the nurse's
reassuring explanation, along with the
ordered p.r.n. medication, may help de-
crease his perception of the pain.

Control of sleep

Although we know better what to
expect in a sleep pattern, we still know
relatively little about how to control
sleep. The important 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 more 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 muscle 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
nightmares, insomnia, and a feeling of
having slept poorly. These uncomfortable
changes have persisted for up to five
weeks. 10

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 home, omitting 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 admitted 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.

Loss of sleep

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.^ i

After 48 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 catalyst 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 that 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 niglits, 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 apparent;
the reason for this need has not yet been
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 increased sensitivity to
pain if he has not had enougli sleep. When
at all possible, care should be planned so
that the patient has blocs of uninterrupt-
ed sleep.

Insomnia

Insomnia 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. 1^
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
most 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.

Psychologic - 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. 1 5

If the patient complains of insomnia,
the nurse can try to determine the possi-
ble cause. Are there any apparent physi-
cal causes? If so, measures to reheve
these symptoms may be all that are
needed, is the patient anxious or upset
about something? Psychogenic factors
are the most common 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 reheve 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 problem. 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 may 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 problems 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 may 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 Health.
Current 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.ll.

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, ^liihumeX. Sleep and Wakefulness.
rev. ed. Chicago, Dl., 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. 1094.

9. Oswald, Ian. 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 Heahh,
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. Q

Reprinted, with permission, from ihe American
Journal of Nursing, September 1969.

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.

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. Epps, and L.D. Hanes, eds.. Day care of
psychiatric patients from the National Day
Hospital Workshop, Kansas City, Mo.. 1963.
Springfield, 111., C. Thomas, Publisher, 1964.
FEBRUARY 1970

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 number 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 family. Sometimes he comes on
his own. An assessment of each applicant
is presented to the team by the nurse and
the social worker. To be eligible for
admission, an applicant must be ambula-
tory.

Some 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 from using
public vehicles.

Mrs. Cooper, a graduate of The Jewish General
Hospital School of Nursing in Montreal,
Quebec, is a clinical instructor at the Catherine
Booth Hospital School for Nursing Assistants.
Previously, die was head nurse at the Day
Hospital at Maimonides Hospital and Home for
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 individu-
al's potential, the staff use examinations,
interviews, and observation. The goals for
each patient are reviewed by the day
hospital team 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.

Some patients are encouraged to
participate in community activities, such
as "Golden Age" 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.

The team approach

The staff members include a psychia-
trist who is team leader, a resident psy-
chiatrist from a nearby general hospital, a
THE CANADIAN NURSE 41

The physiotherapist leads the patients in the biweekly exercise group held at Maimonides Hospital.

medical doctor available for clinics and
emergencies, 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 members of the team. For
example, she may 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 from 9:00 a.m. to 5:00 p.m. Group

therapy sessions, occupational therapy,
and medical services are provided.

Group therapy sessions help the elder-
ly to relate better to one another.
Through sessions led by staff members,
the patients are encouraged to express
their feelings and to interact. Five group
sessions, limited 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. Wlien their articles
are sold they receive a small 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 formed 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 medications
are distributed by the hospital pharmacy;
specific instructions for any medication
or treatment are explained to the patient
by the nurse. If the patient suffers from
memory loss, the nurse gives the instruc-
tions to his family.

To help maintain body functioning at
an optimum 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
meet the needs of the people it serves.
For example, the discharge program was

A group of patients gaiheis Joy a weekly therapy session led by the autlior (baek. right). Patients attend at least one session

42 THE CANADIAN NURSE FEBRUARY 1970

revamped to make it more 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 became 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 to her peers and felt
guilty about expressing any anger toward
her husband. Most of the other women 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 therapy 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

Mr. R. soon became dependent on his
son and daughter. He moved to his
daughter's home where there was contin-
ual conflict between liim and the rest of
the family. His periodic visits to his son's
home resulted in many disagreements as
well. The resulting tension led Mr. R.'s
daughter to seek help from 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
ctMldren, and the staff social worker.

The occupational therapist's assistant gives instruction to a group of patients hooking nigs. Later these articles will be sold at the
Open House, held annually at the Maimonides Hospital and Home for the Aged.

Patient histories

Throughout most of their 10-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 from his small business. Mrs. S..
who is 70 years old, became 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 them 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 team 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
time she was attending the program only
one day per week and had returned to the
monthly meeting of an organization she
belonged to prior to her admission. 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 expressed a
need to live independently. Mr. R. was
helped to find accommodation in a senior
citizen's apartment. Here he was able to
be independent and to develop new
relationships among his peers. His
relationship with his family improved
considerably. Mr. R. began attending the
day hospital less frequently and a dis-
charge plan was discussed.

The day hospital program at Maimon-
ides Hospital and Home for the Aged has
proved to be of value in remotivating and
reintegrating into the community elderly
persons who might otherwise have
remained isolated and depressed. Perhaps
this day hospital will serve as a model and
as a stimulus for the creation of similar
facilities for the elderly in other towns
and cities in Canada. LJ

THE CAN^piAN NURSE 43

Tracheotomy suctioning
technique

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.

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 emergency procedure to relieve
increasing respiratory distress and
hypoxia. The emergency procedure is
generally required for the following
common conditions.

Inflammatory diseases

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 assumes 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

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 commonly affected is from
four to nine years.

Congenital anomalies

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 internal lumen.
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 Instructor on the Eye,
Ear, Nose, and Throat Unit at The Hospital for
Sick Children in Toronto.

tracheal lumen and impedes air flow in
and out of the lungs. Radiation therapy
has been successful in reducing the size of
the mass and improving the airway.

Pierre-Robin Syndrome: This includes
a congenitally small 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 development of the jaw has taken
place to support the epiglottis adequately
and relieve the distress.

New growths

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 tracheotomy tube.
This condition normally resolves itself at
puberty.

Other causes

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 biisic facts

Q] To live, the human organism must

have an airway free of obstruction to

allow for adequate exchange of O2 and

CO2 with its environment. Partial or total

occlusion may le d to hypoxia, coma and

death.

[H 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.

[U 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 tcacheal mucosa and dries
secretions, making them difficult to raise.
B 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.

lU Suctioning produces a cough that
helps clear the airway of secretions and
initiates deep breathing.

m Because of its anatomical structure,
the shape of the trachea and right and left
bronchi can be altered sliglitly 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 IS [H [l El [E or [D to indicate
which basic fact (as previously listed) is
being considered as the maneuver is carri-
ed out.

THE SUCTIONING PROCEDURE

Step 1 . Establish the need for suctioning.

See l.The signs of increasing respiratory distress are:

Fact increased pulse and respiration; stridor; indrawing

I ] I (subcostal, supracostal, etc.); restlessness, anxiety; pallor

'-—' with circumoral cyanosis, generalized cyanosis.

Step 2. If the child requires suctioning, place him flat in bed
rr-j or on some firm surface.

Step 3. Wash hands thoroughly.

m

Step 4. Unlock and remove the inner cannula, keeping a
steadying finger on the outer cannula.

m

ANTICIPATED PROBLEMS AND COMMENTS

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. I 4 |

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. | 1 |

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.

Step 4: Removal of inner cannula.

FEBRUARY 1970

THE CAN>^piAN 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

ml :I000, using gloved hand. Always use a rubber catheter
for a long-term patient as it is less traumatic to the
I 4 I 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.

Step 10. Immerse the catheter completely in dish of sterile

rri H2O and flush it through.

Step 1 1 . With ungloved hand, position the child's head. Turn

I 4 I head acutely to the opposite side of the bronchus that

' — j requires clearing.

0

Step 1 2. With the gloved hand, introduce the catheter into the
I 4 I outer cannula. Suction is not applied on insertion. Feed
'^^ it through your fingers quickly but gently.

m

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 1 1: Head is held to left before catheter is introduced to
clear right bonchus.

46 THE CANADIAN NURSE

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

■^^ iditll^^

/

Step

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 enougli.

Step 14. As the patient begins to cough, create suction by
rri placing thumb over the open end of the "Y".

/

\

/

J

V:

Step

15. Withdraw the catheter slowly, creating on-off

E suctioning by thumbing the open "Y". This helps
prevent grabbing of the tracheal wall by the catheter tip.
The catheter must be rotated on withdrawal, 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. If 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 Oj 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 stage. I 4 I

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. I 4 I

Step 14: After catheter is fully inserted, suction is produced
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 as
secretions from the lungs. I ] I

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 "Y" connector in the manner
described and by keeping within the 10-second time limit.
Appropriate suction pressure for a child is 80-1 20 mm. Hg.

THE CANy^lAN NURSE 47

THE SUCTIONING PROCEDURE

Step 16. After the first suctioning is completed, insert sterile
rri normal saline into the outer cannula using a plastic
1 — 1 pipette in the ungloved hand: infants - one-half cc.

3 toddlers - one cc; older aged - two cc.

P" '■ ' ' f A

Step 17. Allow 10 seconds or so for the saline to loosen the
1 . secretions before repeating the suctioning procedure.

Step 18. Repeat suctionings until patency is reestablished,
2 clearing both right and left bronchi.

Step 19. Flush the suction catheter through with a small
amount of aqueous Zephiran 1:1000.

Step 20. Disconnect the catheter from the connector and
replace it in the aqueous solution.

Step 21. Remove dirty plastic glove.

Step 22. With a Kleenex, wipe the outer cannula clean.
rj] Include the skin around the tracheotomy tube. Pay
1— — ' special attention to the area under the chin. Secretions

4 1 left in the chin crease can cause tissue breakdown and
— infection.

Step 23. Pick up alternate clean inner cannula, insert and lock
[ . in place, keeping a finger on the outer cannula as you do
1 — 1 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 considerations

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

F'earon, B. et al. Airway problems in children
following prolonged endotracheal intuba-
tion./t«n. Otol. 75:4:975, Dec. 1966.

Fearon, B. Acute obstructive laryngitis in

infants and children. Hospital Medicine.

4: 12:51, Dec. 1968. D

FEBRUARY 1970

Practical Paediatrics: A Guide For Nurses,
3rd ed. by James Michael Watt. 213
pages. Christchurch, New Zealand,
N.M. Peryer Ltd., 1969.
Reviewed by Mrs. E. Fitzgerald. Ins-
tructor, Sydney City Hospital. Sydney,
Nova 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.

Psychology As Applied To Nursing, 5th

ed., by Andrew McGhie. 340 pages.
Edinburgh and London, E. & S.
Livingstone Ltd., 1969. Canadian
Agent: The Macmilian Company of
Canada, Ltd., Toronto.
Reviewed by Margaret Lounds,
Instructor in Psychiatric Nursing, Cal-
gary General Hospital, 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 intelligence and
personality testing. 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 motivation
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, and 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, 1 1 th ed., by
Betty S. Bergersen and Elsie E. Krug.
695 pages. Saint Louis, C.V. Mosby
Company, 1969. Canadian Agent:
C.V. Mosby Company, Toronto.
Reviewed by J. Louise Gillman, Lec-
turer, The University 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 enlianced 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 asepsis.

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 capaci-
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.

Fundamentals of Nursing, 4th ed.. by
Elinor V. Fuerst and LuVerne Wolff.
446 pages. Toronto, J.B. Lippincott
Company, 1969.

The fourth edition o'i Fundamentals of
Nursing continues to reflect the authors'
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 that
details of certain activity can be stressed
to such a degree that they cloud the
principles."

THE CANADIAN NURSE 49

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 prevent 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. □

AV aids

EVR communications system

The latest addition to audiovisual
materials. Electronic Video Recording, will
be available in July, 1970.

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
sent by a school to the CBS processing
plant in Rockleigh, New Jersey.

The EVR system offers a unique new
approach to teaching. Schools of nursing
would find it a valuable asset. However,
the inifial 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 S47 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.

The stroke 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. □

accession list

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

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 any one 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. 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 I'iducation permanente
des infirmieres fran^aises, Paris, Association
Nationale Fran^-aise des Infirmieres et Infir-
miers Diplomes d'Etat, Commission de I'Ensei-
gnement et de la Promotion Sociale, 1968.
125p.

3. Classification internationale type des
professions. Ed. rev. 1968, Geneve, Bureau
international du travail, 1969. 415p.

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.

(Continued on page 52)
FEBRUARY 1970

DO YOU

WANT 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:

^AEMBERSHIP (payable annually)

Nurse Member — Regular $ 2.00

Sustaining $ 50.00

Patron $500.00

Public Member — Sustaining $ 50.00
Patron $500.00

BURSARIES $ RESEARCH $

MEMORIAL $ in memory of

Name and address of person to be notified of
this gift

REMIHER

(Print name in full)

Address

Posit io n

Employer

N.B. CONTRIBUTIONS TO CNF
ARE DEDUCTIBLE FOR INCOME TAX PURPOSES

"I'm leasing this
Renault 10 for
less than S80
a month...

...so can you with the

RENAULT
PROflAN

99

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 "budgeting 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?

To RENAULT OF CANADA

50 Progress Avenue, Scarborough, Ontario

I want to know more about the Renault PRO-PLAN.

NAME . . .
ADDRESS

CITY PROV.

FEBRUARY 1970

THE CANADIAN NURSE 51

accession list

(Continued from page 50)

6. Concepts and practices of intensive care
for nurse specialists. Edited by Lawrence E.
Meltzer, Faye G. Abdellah, J. Roderick Kit-
chell. Philadelphia, Charles Press, cl969. 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 psychologic par Nor-
bert Sillamy, Paris, Larousse, 1967. 319p.
(Dictionnaires de Thomme du XXe siecle.)R

9. Diseases that plague modern man: a
history of ten communicable diseases by Ri-
chard Gallagher. New York, Oceana Publica-
tions, c 1969. 230p.

10. Excerpts from papers read at Royal
Society of Health, Health Congress. Eastbourne
28 April to 2 May 1969. London, 1969. 6 pts.
in I. 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
pattern of midwifery training; cause or effect?
by Miss M. I. F'arrer. - Practical aspects of
nursing the acutely ill patient at home.

1 1 . Fundamental statistics in psychology
and education, 4th ed. by J. P. Guilford, New
York, McGraw-Hill, c 1965. 605p.

1 2. Glossaire de psychiatric de psychologic
pathologique et de neuro-psychiatrie infantile
par Lisette Moor, Paris, Masson, cl966. 195p.

13. Health career fact sheets. Madison. Wis-
consin, Health Careers Program, 1969. Iv.
(loose-leaf)

14. / presume you can type; the "mature"
women's guide to second careers by Sonja
Sinclair. Toronto, Canadian Broadcasting Cor-
poration, cl969. 16 Ip.

15. Intensive coronary care: a manual for
nurses, by Lawrence Edward Meltzer et al.
Philadelphia, CCU Fund, Presbyterian Hospital,
C1965. 201p.

16. Medical reference works 1679-1966: a
selected bibliography edited by John Bellard
Blake, and Charles Roos. Chicago, Medical
Library A.ssociation, cl967. 343p.

17. Mental health and the community:
problems, programs, and strategies. Edited 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.
Maslow, New York, Harper & Row, cl954.
411p.

19. Ne^ comme (a, par Denise Legrix, Paris,
Kent-Segcp, cl960. 2v.

20. Proposal for a comparative study of the
positions, roles and norms of medical practi-
tioners: by Anne Crichton, Vancouver, Dept. of
Health care and Epidemiology, Univ. of British
Columbia, 1969? 3 1 p.

21. Report of Workshop for Public Health
Nurse Administrators, Detroit Mich., May 18,
52 THE CANADIAN NURSE

1969. New York, National League for Nursing,
Council of Public Health Services, 1969. Iv.
(various paging)

22. Resume de gynecologic, par Denise
Lemay. Ottawa, Renouveau Pedagogique,
cI967. 95p.

23. Sample cataloging forms: illustrations of
solutions to problems in descriptive cataloging
by Robert B. Slocum and Lois Hacker. 2d rev.
ed., with a section on comparison of the
Anglo-American cataloging rules and the A.L.A.
cataloging rules. Mctuchen, N.J., Scarecrow
Press, 1968. 205p.

24. Scientific writing for graduate students:
a manual on the teaching of scientific writing.
Edited by F'. Peter Woodford. New York,
Rockefeller University Press, cl968. 190p.

25. The semi-professions and their organiza-
tion: teachers, nurses, social workers. Edited by
Amitai Etzioni. New York, Free Press, cl969.
328p.

26. The service manager system: nurse effi-
cacy and cost by J. V. McKenna. St. Louis,
Mo., St Louis University, 1968. I92p.

27. The theory and practice of convention
management. New York, Sales Meetings, vol. 8
no. 7, October 1969. 208p.

28. Training the ward clerk. Chicago, Hospi-
tal Research and Educational Trust, cl967. Iv.
(various paging)

29. Values in management by Lawrence A.
Appley, New York, American Management
Association, c 1969. 269p.

30. Vocabulaire de la psychanalyse, par
Jean Laplanche et J.B. Pentales. revue. Paris,
Presses universitaires de France, 1968. 525p.

Pamphlets

31. Deuxiime rapport de I'organisation
mondiale de la Sante Com it e d 'experts de la
readaptation medicale. Geneva, 12-18, nov.

1968. Geneva, cl969. 25p. (Its Serie de rap-
ports techniques no.419)

32. Droits et devoirs des infirmieres et du
personnel sanitaire militaire et civil definis par
les conventions de Geneve du 12 aout 1949.
Geneve, 1969. 46p.

33. Guide pour le developpement de I'ensei-
gnement infirmier superieur, Geneve, Organisa-
tion mondiale de la Sante, 1969. 18p.
(WHO/NURS/ Tech Guide 69.4)

34. 7Vit' home nursing scene in California
just prior to medicare. Berkeley, Calif., Dept. of
Public Health Bureau of Adult Health and
Chronic Diseases, 1969. 106p.

35. It takes more than words: a teacher
listens in at the 1965 Canadian Youth Confer-
ence on Smoking and Health, by W. J. Melior,
Ottawa, Information Services, Dept. of Nation-
al Health and Welfare, 1967. 7p.

36. Nurses and collective bargaining, by
David Handel. Chicago, Univ. of Chicago
Graduate Program in Hospital Administration,

1969. 36p.

37. Orientation of graduates of associate
degree programs of hospital nursing. Presented
at a conference of directors of Schools of
nursing in New York State by Esther Zimmer-
man. New York, National League for Nursing,
Dept. of Hospital Nursing, 1959. 28p. (League
exchange no.41)

38. The battle for clean air by Edward
Edelson, 1st ed. c 1967. 28p. (no. 403)

39. Cerebral palsy: more hope than ever by
Jacqueline Seaver. 1st ed. cl967. 27p. (no. 401)

40. Emphysema: when the breath of life
falters by Jules Saltman. cl962. 20p. (no.326)

41. Enjoy your child ages 1,2 and 3 by
James L. Hymes. cl950. 28p. (no.l41)

42. Good news for stroke victims, by Eliza-
beth Ogg. cl957. 28p. (no.259)

43. How to help your handicapped child by
Samuel M. Wishik. cl955. 28p. (no.219)

44. Mental health is a family affair by Dallas
Pratt and Jack Neher. cl949. 28p. (no. 155)

45. New hope for the retarded child by
Walter Jacob. cl954. 28p. (no.210)

46. Rehabilitation counselor: helper of the
handicapped by Elizabeth Ogg. 1st. ed. cl966.
28p. (no.392)

47. The retarded child gets ready for school
by Margaret Hill. 1st ed. 1963. 28p. (no.349)

48. Understand your child from 6 to 12 by
Clara Lambert. cl949. 28p. (no. 144)

49. Understanding your menopause by Stel-
la B. Applebaum and Nadina R. Kavinoky.
cl956. 28p. (no.243)

50. Viruses, colds, and flu by Michael Henry
Knox Irwin. 1st ed. 1966. 20p. (no.395)

5 1 . When should abortion be legal by Har-
riet F. Pilpel and Kenneth P. Norwick. 1st ed.
cl969. 24p. (no.429)

52. Your operation by Robert M. Cunning-
ham, 1st ed. 1958. 20 p. (no. 267)

5 3. Quality care - community serv-
ice - library service. Papers presented at the
program meeting of the Interagency Council on
Library Tools for Nursing at the 1969 conven-
tion of the National League for Nursing. New
York National League for Nursing, cl969. 14p.
(League exchange no.89)

54. Rights and duties of nurses, military and
civilian medical personnel under the Geneva
Conventions of Aug. 12, 1949. Geneva, Interna-
tional Committee of the Red Cross, 1969. 45p.

55. Roles on today's health team: relation-
ships, doctor, administrator, director of nurs-
ing. Papers presented at the program meeting of
Council of Hospital and Related Institutional
Nursing Service at the 1969 NLN convention,
Detroit, Michigan. New York, National League
for Nursing, c 1 969. 28p.

56. Statistics of health services and of their
activities. 13th report of World Health Orga-
nization. Expert Committee on Health Statis-
tics, Geneva, 12-18 November, 1968. Geneva,
World Health Organization, cl969. 36p. (World
Health Organization Technical report no.429)

57. Survey of salaries of teaching and ad
ministrative personnel in nursing educational
programs. Sept. 1968. New York, American
Nurses' As.sociation. Research and Statistics
Dept., 1969? Iv. (various paging).

58. Trading center on what's new and
developing. Convention Program Meeting,
CPHNS-NLN. Detroit, Mich., May 21, 1969.
New York, National League for Nursing
Council of Public Health Nursing Services,
1969. 25p.

59. Vocabulaire bilingue des assurances sur
la vie par Jean-Paul De Grandpre. Quebec, P.Q.
Ministere des Affaires culturelles, 1969. 39p.

FEBRUARY 1970

Government Documents

Canada

60. Bureau of Statistics. Survey of Voca-
tional education and training, 1966-67. Ottawa,
Queen's Printer, 1969. 88p.

61. Committee on Costs of Health Services.
Task force reports on the cost of health services
in Canada. Ottawa, cl969. 3v.

62. Ministere du Travail. Direction de la
Legislation. La reparation des accidents au
Canada. Ottawa, Imprimeur de la Reine, cl969.
11 7p.

63. National Science Library. Health Sci-
ences Resource Centre. Conference proceedings
in the health sciences held by the National
Science Library. 1st ed. Ottawa, 1969. 288p.

64. Treasury Board. Subject classification
guide for housekeeping records, compiled by
Records Management Association. Ottawa,
Queen's Printer, cl969. Iv. (various paging)
(Paperwork management series)
Newfoundland

65. Provincial Nursing Assistant Advisory
Committee. Nursing assistant curriculum. St.
John's, 1969. 5p.

Ontario

66. Department of Labour. Women's Bu-
reau. Women returning to the labour force: a
staff study by Linda Bell. Toronto, 1969? 26p.
U.S.A.

67. Civil Service Commission. Federa/ o//yce
assistant examination: stenographer, typist,
clerk, and office machine operator. What it is
and how it is given prepared by Llizabeth D.

Johnson. Washington, U.S. Gov't Print. Off.,
1969. 60p.

Studies Deposited in CNA Repository
Collection

68. Deprofessionalization in nursing by
Shirley Marie Stinson. New York, 1969. 4I7p.
Thesis - Teachers College, Columbia Univer-
sity. R

69. The development of an ordinal scale for
observing adaptive responses in the hospitalized
toddler by Joy Durfcc Calkin. Madison, Wise,
1969. 5 Ip. Thesis (M.S.) - Wisconsin.R

70. 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 (Diploma in Hosp.
Admin.) - Toronto.R

71. An exploratory study to determine if
the stated objectives of a maternity nursing
program provide senior diploma nursing
students with a family-centered philosophy by
Catherine Shirley MacLeod. Boston, 1969. 53p.
Thesis (M.S.N.) - Boston.R

72. Extrait de Tetude des verifications cou-
tumieres de la temperature, du pouls et de la
respiration des malades hospitalisees par Pamela
E. Poole. Ottawa, Ministere de la Sante Na-
tionale et du Bien-€tre social. 1968. lOp.R

73. Factors involved in the reactions of a
selected group of parents to mental retardation
in their child by Margaret Mowat MacLachlan.
Seattle, Wash., 1961. 134p. Thesis
(MA) - Washington.R

74. The family physician and the public

health nurse: an investigation of one method of
collaboration by Phylhs Edith Jones. Toronto,
1969. 189p. Thesis (M.S.) - Toronto.R

75. The formulation of an instrument to
evaluate performance of nursing students in
clinical nursing based on correlated behavioral
objectives by Janet C. Kerr. Madison, Wise.
1967. 68p. Thesis (M.Sc.) - Wisconsin.R

76. An institute as an educational experi-
ence in the continuing education of a selected
population of nurses by Jean Kirstine Griffith
(Buckland). Vancouver, 1969. 143p. Thesis
(MA) - British Columbia.R

77. Management initiative in the organiza-
tion and staffing of the patient care unit: old
problems, new trends and opportunities, by
Claus A. Wirsig. Toronto, 1968. 91p. Thesis
(Dipl. Hosp. Admin.) Toronto. R

78. Mental health study: PUN involvement
in mental health services. Victoria. British
Columbia. Department of Health Services and
Hospital Insurance, Health Branch. 1966. 8p.R

79. Opinions of nursing students of Pro-
testant religious affiliations about experiences
in selected Canadian Catholic schools of nursing
relating to students' religeous beliefs and
practices, by Sister Cecile Leclerc. Washington,
D.C., 1965. 82p. Thesis (M.S.N.) - Catholic
University.R

80. 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 ' D

OPPORTUNITY FOR NURSES
IN NATIONAL OFFICE

The Canadian Nurses' Association, in its continuing
efforts to strengthen the profession and serve its
members, is seeking qualified nurses to identify
factors for studies in the areas that influence the
profession of nursing nationally.
These are challenging positions for persons with the
ability to analyze, synthesize and communicate.

The successful candidates will be active members of
a professional nurses' association, with a demon-
strated interest in professional advancement and a
depth of general nursing knowledge and experience.
Fluency in both English and French is an asset.

Please reply fully and in confidence stating
qualifications and experience to:

Executive Director

CANADIAN NURSES' ASSOCIATION

50, The Driveway, Ottawa 4

Request Form
for "Accession List"

CANADIAN NURSES'
ASSOCIATION LIBRARY

Send this coupon or facsimite 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)

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

FEBRUARY 1970

THE CANADIAN

NURSE 53

classified advertisements

ALBERTA

GENERAL DUTY NURSES for active, ac-
credited, well-equipped 65-bed hospital in grow-
ina town, population 3.500. Salaries range from
$465 - $555 commensurate with experience,
otner oenems. iNurses- residence, bxcelleni per-
sonnel policies and working conditions. New
modern wing opened in 1967. Good communica-
tions to large nearby cities. Apply: Director of
Nursing, Brooks General Hospital, Brooks. Al-
berta.

GENERAL DUTY NURSES (2) for small,
modern hospital on Highway no. 12, East
Central Alberta. Salary range $477.50 to
$567.50 including regional differential.
Residence available. Personnel policies as per

ADVERTISING
RATES

FOR ALL
CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additional line

Rotes for display
advertisements on request

Closing date for copy and cancellation is
6 weeks prior to Ist day of publication
month.

The Canadian Nurses' Association does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Associotion of the
Province in which they are interested
in working.

Address correspondence to:

The

Canadian ^
Nurse -

^Z7

50 THE DRIVEWAY
OTTAWA 4, ONTARIO.

ALBERTA

H

REGISTERED NURSES FOR GENERAL
DUTY in a 34-bed hospital. Salary 1968,
$405-$485. Experienced recognized. Residence
available. For particulars contact: Director of
Nursing Service, Whitecourt General Hospital,
Whitecourt, Alberta. Phone: 778-2285.

AARN and A.H.A. Apply to: Director of
Nursmg, Coronation Municipal Hospital
Coronation, Alberta. "^t^noi.

GENERAL DUTY NURSES for 94-bed General
Hospital located in Alberta's unique Badlands.
$405— $485 per month, approved AARN and
AHA personnel policies. Apply to: Miss M.
Hawkes, Director of Nursing, Drumheller Gene-
ral Hospital, Drumheller, Alberta.

GENERAL DUTY NURSES for 64-bed active
treatment hospital, 35 miles south of Calgary
Salary range $405— $485. Living accommoda-
tion available in separate residence if desired.
Full maintenance in residence $50.00 per month
Excellent Personnel Policies and working condi-
tions. Please apply to: The Director of Nursing
High River General Hospital, High River, Alber-

GENERAL DUTY NURSES required for a
34-bed general hospital located in northern
Alberta. $465 to $555 per month, plus $15
differential. Experience recognized. Residence
available. For particulars, contact: Director of
Nursing, Manning Municipal Hospital, Manning,
Alberta. Phone: 836-3391.

GENERAL DUTY NURSES are required by a
230-bed, active treatment hospital. This is an
ideal location in a city of 27,000 with summer
and winter sports facilities nearby. 1968 salary
schedule $405 — $485. 1969 schedules present-
ly under negociation. Recognition given for
previous experience. For further information
contact: Personnel Officer, Red Deer General
Hospital, Red Deer, Alberta.

PUBLIC HEALTH NURSING VACANCIES IN
ALBERTA Are you interested in a challenging
position which demands initiative and mature
judgement? Two Staff nurse vacancies exist in
the Athabasca Health Unit, Athabasca, Alberta.
Good working conditions. Pension Plan. Salary
range $5,280.00 to $8,220.00 depending on
qualifications and experience. Previous
experience in Public Health essential. For
further details apply: Medical Officer of Health,
Athabasca Health Unit, Athabasca, Alberta.

BRITISH COLUMBIA

DIRECTOR OF NURSING Applications are
invited for the position of Director of Nursing
for the Cariboo Memorial Hospital, Williams
Lake, B.C. Accrdited 75-bed hospital with
building program underway, serving colourful
British Columbia interior district of 18,000
population. Applications to be in writing out-
lining details of qualifications, experience,
salary expected and date available. Preference
will be given to applicants with University
preparation in Nursing Administration.
Information will be treated strictly confidential
and should be addressed to the: Administrator,
Cariboo Memorial Hospital, Box 4300, Williams
Lake, B.C.

HEAD NURSE required for Labor and Delivery
Suite In 242-bed hospital expanding to 669
beds. Diploma or degree in nursing administra-
tion plus post graduate obstetrical course
desirable. Apply to: Director of Nursing, Burna-
by General Hospital, 3800 Ingleton Avenue
Burnaby B.C.

54 THE CANADIAN NURSE

"OBSTETRIC NURSING INSTRUCTOR — to

conduct a concurrent program in a school of
nursing in a 450-bed hospital with a family
centred maternity unit. Requirements: B.S.N.,
degree; experience in obstetric nursing; registra-
tion in B.C. Attractive personnel policies.
Salary $643. - $788. Apply — Director of
Nursing, Royal Columbian Hospital, New West-
minster, B.C."

GENERAL DUTY NURSES for new 30-bed hos-
pital located in excellent recreational area. Salary
and personnel policies in accordance with
RNABC. Comfortable Nurses' home. Apply: Di-
rector of Nursing, Boundary Hospital, Grand
Forks, British Columbia.

GENERAL DUTY NURSES for 96bed acute
hospital, fully accredited. RNABC personnel

BRITISH COLUMBIA

I]

policies and salary scale, plus $15 Northern
differential. Excellent recreational area, bowl-
ing, skiing, skating, curling and fishing Hot
Springs swimming nearby. Nurses' residence
and cafeteria meals available. Apply to- Direc-
tor of Nursing, Kitimat General Hospital
Kitimat, British Columbia.

"GENERAL DUTY NURSES for 63-bed active
hospital in beautiful Bulkley Valley. Boating
fishing, skiing etc. Nurses' Residence; Salary
$498. — $523.; Maintenance $75.; recognition
for experience. Travel brochure on request
Apply: Administrator, Bulkley Valley District
Hospital, Smithers, B. C."

GENERAL DUTY and OPERATING ROOM
NURSES for modern 450-bed hospital with
School of Nursing. RNABC policies in effect.
Credit for past experience and postgraduate
training. British Columbia registration is re-
quired. For particulars write to: The Associate
Director of Nursing, St. Joseph's Hospital,
Victoria, British Columbia.

Graduate Nurses (2) required about March IS,
1970 for new 26-bed hospital in the sunny
Interior of British Columbia. Starting salary
$536.00 per month, with probable substantial
increase in 1970, and annual vacation of 21
working days and 10 paid statutory holidays.
Full board and room in TV equipped residence
at $60.00 per month with free uniform laun-
dry. Other usual employee benefits. For further
information apply: Director of Nursing, Prince-
ton General Hospital, Princeton, B C ''

GRADUATE NURSES for 24-bed hospital,
35-mi. from Vancouver, on coast, salary and
personnel practices in accord with RNABC.
Accommodation available. Apply: Director of
Nursing, General Hospital, Squamish, British
.Columbia.

GRADUATE NURSES for active 21-bed hos-
pital, preferably with obstetrical experience.
Friendly atmosphere, 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.

ti}i?^^^' 5°*^^ 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 allowance 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 BRUNSWICK

"Registered Nurses (2) & Registered Nursing
Assistant required for 1 7-bed active hospital,
modernly equipped. For further information
contact:-The Administrator, Albert County
Hospital, Albert, N.B."

NOVA SCOTIA

3

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.

"PUBLIC HEALTH NURSING SUPERVISOR

with preparation in advanced Public Health

FEBRUARY 1970

March 1970

MISS KTH KCRBIS

290 NELSCN ST APT 812
OTTAWA 2 ONT CCCC578^

The

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2 THE CANADIAN NURSE

MARCH 1970

The

Canadian
Nurse

A monthly journal for the nurses of Canada published

In English and French editions by the Canadian Nurses' Association

^^^

Volume 66, Number 3

March 1970

35 Special Report: CNA Ad Hoc Committee on Function,
Relationships, and Fee Structure

39 From Canada to Biafra C. Kotlarsky

43 Adapting Instruction to Individual Differences B. Mclnnes

45 Fredericton - Something for Everyone V. Fournier

49 Changing Horizons in Psychiatric Nursing N. Hyde

52 Something to Say . . . And How! H. Evans Reid

55 Are We Getting to You? B. Darling

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

24 Names

28 Dates

30 New Products

33 In a Capsule

58 Research Abstracts

60 Books

61 Accession List

80 Index to Advertisers

Executive Director; Helen K. Mussallem •
Editor: Virginia A. Lindabury • Assistant
Editor: Eleanor B. Mitchell • Editorial Assist-
ant: Carol A. Kotlarsky • 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
Nurses' Association. • Change of Address:
Six vieeks' notice: the old address as 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.
ffi Canadian Nurses' Association 1970.

.Manuscript Information: '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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
diagrams (drawn in india ink on white paper)
arewelcomed 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. Permit No. 10,001.
50 The Driveway, Ottawa 4, Ontario.

Editorial

MARCH 1970

The eyes tell the story. They tell of a
father's anguish as he holds his child
who is dying of starvation and lack
of medical care; they tell of his
bitterness as he asks himself why this
had to happen to his child, why
war came to his homeland; and, finally,
they tell of his inabilty to understand
why governments of other countries
were unable — or unwilling — to
overcome the diplomatic barriers that
prevented food and medical supplies
from reaching his child-

Our cover photo was taken in the
former state of Biafra before
hostilities officially ceased. It
ties in with a staff-written article based
on an interview with a Canadian RN
who was working in the area when
the war ended.

Recent photos in the news media
confirm observers' reports that the
suffering continues in Eastern Nigeria,
that thousands more will die if food does
not reach them immediately. Perhaps
it was with this in mind that Dr.
Edward H. Johnson, moderator of
the Presbyterian Church, said at a
national ecumenical service for
world development in Ottawa
February 13: There are two time
bombs about to go off — the
underprivileged who won't sit there
indefinitely, and the affluent peoples
who will suffer "a loss of human
integrity that will explode inside us-"

Being professional health workers
in an affluent society, we have a
special obligation to help de-fuse these
bombs, whether they be on the
national or international scene. Our
strategy will, of course, take time.

For the people of Eastern Nigeria,
however, there is no time. Immediate
help is needed to save lives. Donations
for food and medical supplies can
be sent to UNICEF, 737 Church
Street, Toronto 5, Ontario. All
contributions to this organization
will be forwarded without deduction
of administrative expenses.

— V.A.L.

THE CANADIAN 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.

Checking image

I would like to express my gratitude
for the excellent article, "Check Your
Image - It's Slipping! "(Oct. 1969).

The topic, photos, and writeup were
to the point. I just hope that it hits those
persons who really need it! We are
making good use of this article at our
university as a stimulus for all in the
nursing profession to be on guard in
looking our best at all times.

Thank you for keeping such pertinent
items before us. - Marilyn J. Christian,
Dean, School of Nursing, Loma Linda
University, Loma Linda, California.

I was struck by the effectiveness of the
article "Check Your Image - It's Slip-
ping! " in getting a clear message across,
and by its applicability to the current
New Zealand scene. The same reactions
have come from my colleagues regarding
the photos, captions, and short discussion
that together have such a striking effect.

As it appears that many of our journal
readers would appreciate this article, I am
requesting your permission to publish the
article and photographs in The New
Zealand Nursing Journal. - Mrs. Muma
C. Thomson, acting editor. The New
Zealand N rsing Journal, Wellington,
N.Z.

Trying to find alumnae

The Alumnae of Misericordia General
Hospital in Winnipeg would like to hear
from members with whom they have lost
contact. Please drop us a note and let us
know where you are and what you are
doing. Those wishing to renew their
alumnae membership at this time can do
so by enclosing $2.00.

Please send information to Miss Ethel
Morris, Apt.8 - 430 Stradbrook Ave.,
Winnipeg 13, Manitoba, or to Miss Diane
Litwin, 219 Greene Ave., Winnipeg 15,
Manitoba. - Ethel Morris, Membership
Committee.

Responsibility in education

I read with interest and enthusiasm the
article "On the Delegation of Resposibili-
ty" (November, 1969). As a senior nurs-
ing student in a degree program, I am
personally interested in the issue of teach-
er vs. student responsibility in education.
Rigidity and external controls are not
unique to nursing. They permeate our
entire educational system, killing initia-
tive and creativity. Though nursing may
not be able to undo the damage, it
certainly should not add to the injury. We
4 THE CANADIAN NURSE

need more experiments such as Miss
Nance's to foster the development of
independent, intrinsically-motivated
nurses.

Although nursing is one of the more
rigid disciplines, partially due to the
standardized knowledge necessary for
licensure, this reason is a poor excuse for
making nursing school a drudgery. There
is evidence that the rat-race pace and the
strangulation of initiative and creativity
contribute significantly to the low morale
and high attrition rate in schools of
nursing.

A method that would provide both
standardization of knowledge and op-
portunity for self-direction is programmed
instruction. This method at least
allows the learner to proceed at his own
pace. I find this generally a more efficient
and enjoyable method of learning than a
large lecture class. To supplement the
programmed instruction, students should
be given opportunity to identify areas in
which they need and want additional

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otherwise you will likely miss copies.

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The Canadian Nurse

50 The Driveway
OTTAWA 4, Canada

knowledge and experience and to choose
appropriate methods of acquiring it. The
material learned could be shared with
other students in seminars, and evaluation
could be by self or by peers. There should
also be opportunity for learning ex-
periences in which students are free to
practice and explore without being evalu-
ated, as evaluation that becomes part of
one's academic record inhibits creativity.
Nursing schools cannot afford to
spoon-feed their students if they expect
to produce nurses who will provide
optimum quality nursing care, will accept
responsibility for their professional
growth after nursing school, and will be
creative leaders in the health field and in
the community. - Elaine Zuck, Univer-
sity of Virginia School of Nursing, Char-
lottesville, Virginia.

Metric conversion kits

I noticed in the December issue that
there was a news item about Metric
Conversion Kits for Hospitals. This item
indicated that the kits are now being
distributed exclusively by the Canadian
Hospital Association.

This is not correct. The OHA contin-
ues to be responsible for supplying the
kits to hospitals in Ontario at a cost of 50
cents each, not $1.00. Our arrangement
with the CHA is that they will distribute
the kits to hospitals outside Ontario
only. - Peter Wood, Director, Public
Relations Division, Ontario Hospital
Association.

Minister of Health questioned

As 1 indicated in a letter to the
Honorable John Munro, minister of
national health and welfare, I was disturb-
ed that the Canadian Nurses' Association
was given no reasons for the rejection of
its application for a research project to
study factors preventing registered nurses
from achieving their educational goals.
(News, January 1970, page 5.)

There seem to be only two logical
reasons for rejecting the application: an
unfavorable appraisal by peers, or a lack
of funds that necessitated rejection of
some worthy submissions, including
CNA's.

If the application was rejected because
some qualified appraisers considered it
to be unworthy of support, their reasons
should be communicated to the CNA. If
it was rejected because of lack of funds to
support all worthy applications, this too
should be communicated. As a member
of CNA, I asked the minister to let (he

MARCH 1970

association know why its application was
rejected.

My letter to the minister also pointed
out that an illogical reason for refusal of
funds, which should be untenable in a
democratic society, was that CNA had
less political influence than other
health-related organizations. Certain or-
ganizations, such as the Canadian Hospital
Association, seem to have been more
successful in getting applications ap-
proved.

To help prepare for future applica-
tions for research project funds, the CNA
should appoint an advisory committee
to its research and advisory unit. It is
reasonable for members who have had
experience developing research projects
or evaluating submitted proposals to use
their experience to assist CNA in carry-
ing out its responsibilities with respect to
studies of nursing. - Dorothy J. Kergin.
Reg. A'., Ph.D.. Member, RNAO Research
Committee.

The traveling nurse

1 always felt it was unjust that registered
nurses could not travel from place to
place outside their own country and still
hope to practice their profession. Now 1
have had the misfortune to discover that
this also applies to Canadians within
Canada. It is most frustrating to experi-
ence!

1 spent three long years learning to be
a good nurse. I passed my registration
exams in Ontario in August 1969 and five
months later I discovered that I was not
qualified to be an RN in Nova Scotia.

At one time nursing was something
special, something to be proud of. But
now it is beginning to lose its appeal.
How long will it be before nursing be-
comes something 1 do because 1 can't do
anything else? Never. I hope. But how
many nurses has Canada lost for this
reason'.'

It is a sad situation when a Canadian
nurse who is educated in Canada cannot
travel within the boundaries of Canada
and still hope to practice as a registered
nurse. Is it fair to the individual nurse? -
Mrs. Roberta Parker, RN, Antigonish,
Nova Scotia. D

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THE CANADIAN NURSE 5

By JESSIE BERNARD. Ph.D.,

Research Professor Honoris Causa,

Department of Sociology, Pennsylvania State

University, University Park, Pa.; and

LIDA F. THOMPSON, R.N., M.S.,

Associate Professor in Nursing,

Idaho State University,

Pocatello, Idaho. June, 1970.

Approx. 328 pages, 82 illustrations.

Knowledge

is the measure

of a nurse

Help your students measure up—
choose these fundamental texts
and workbooks for your classes!

New 8th Edition!

Bernard-Thompson

SOCIOLOGY

Nurses and Their Patients in a Changing World

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 patterns. Well-written new discussions present the many roles a
nurse must play, and examine health implications of community life. This study
can give your students new insight into their identity as nurses and the changing
world in which they live.

New 4th Edition!

Gebhardt

A New Book!

Lerch

MICROBIOLOGY

This newly revised introduction to general microbiology is
ideally suited to your nursing program. Its exceptional
presentation of pathogenic microbes includes important
new developments in virology. An accurate new section
describes concepts in molecular biology and microbial
genetics. A brief discussion on rejection immunity indicates
problems in organ transplanation. An expanded glossary
and revised classifications are practical features!
By LOUIS P. GEBHARDT, M.D., Ph.D., Professor and Chairman,
Department of Microbiology, University of Utah College of Medi-
cine, Salt Lake City. March, 1970. Approx. 448 pages, 133
illustrations. About $10.75.

A New Book!

Gebhardt

MICROBIOLOGY
LABORATORY MANUAL

A Sequence of Experiments

This new manual, correlated with the text above, presents
basic principles of microbiology in 26 flexible experiments.
It includes work on sanitary microbiology, and problems
involving pathogenic organisms.

By LOUIS P. GEBHARDT, M.D., Ph.D. March, 1970. Approx. 112
pages, 5 illustrations.

MATERNITY NURSING

This new text is planned for concurrent classroom and
clinical learning. It presents the entire maternity cycle as a
normal physiological process, with sections on the prepara-
tory phase, pregnancy, labor and parturition, the post-
partum period, and the neonate. Its stimulating discussions
stress the nurse's role as a counsellor. Practical teaching
features include a complete glossary, study questions after
each chapter, and blank pages for student's notes.

By CONSTANCE LERCH, R.N., B.S. (Ed.). Instructor in Maternity
Nursing, Helene Fuld School-West Jersey Hospital, Camden, N.J.
May, 1970. Approx. 480 pages, 7" x 10", 112 illustrations.

New 2nd Edition!

Lerch

WORKBOOK FOR
MATERNITY NURSING

This meaningful workbook, the most widely adopted in its

area, now gains added significance as an adjunct to the

correlated text described above. Case examples, situation

questions for discussion, self-examinations, and carefully

selected references help students learn theory and

applications.

By CONSTANCE LERCH, R.N., B.S. (Ed.) April, 1969.311 pages,
33 illustrations. $5.40.

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6 THE CANADIAN NURSE

MARCH 1970

news

Alberta Nurse

To Represent CNA

At ICN Seminar

Ottawa. - Helen Sabin, executive secre-
tary of the Alberta Association of
Registered Nurses for the past 10 years,
has been selected as the Canadian Nurses'
Association delegate to the international
seminar on nursing legislation. This
decision was made at the CNA board of
directors meeting January 26-27.

The 10-day seminar, sponsored by the
International Council of Nurses, will be
held in Warsaw, Poland, in April.

Mrs. Sabin was chosen because of her
wide experience with nursing legislation.
Recently she helped to prepare an AARN
brief to the Alberta government to re-
quest that the association be represented
when decisions concerning health needs
were made. She also helped to revise the
AARN bylaws.

In an interview with The Canadian
Nurse, Mrs. Sabin said that Canadian
nursing could bring experience to the
international seminar. In particular, she
referred to the nurse's favorable public
image in Canada. This, she said, is impor-
tant when nursing seeks to change legisla-
tion in the health field. Mrs. Sabin also
mentioned that meetings between provin-
cial nurses' associations and the govern-
ment help to keep the latter informed of
nursing's accomplishments and problems.
"This method is employed by many
provincial nurses' associations in Canada
and could be employed effectively else-
where," she said.

This international seminar is the sec-
ond stage of a project initiated in 1967
with funds from the Florence Nightingale
International Foundation and adminis-
tered by the ICN. The first stage,
completed in 1968, resulted in the
publication of Principles of Legislation
for Nursing Education and Practice - A
Guide to A ssist National Nurses A ssocia-
tiotis, prepared by a five-member group.
The seminar in 1970 will use this publica-
tion as a basis for its deliberations.

CNA Board Approves Policy
To Ensure High Standards
Of Nursing Care

Ottawa - The board of directors of
the Canadian Nurses' Association has
recommended that all provincial associa-
tions or nurses' bargaining agents estab-
lish professional practice committees
within collective agreements to interpret
nursing needs and ensure high standards
MARCH 1970

of nursing care. This decision, based on a
recommendation from the committee on
social and economic welfare, was made at
the board meeting January 26 and 27 at
CNA House.

"We want nurses more involved in
interpreting nursing needs and ensuring
high standards of nursing care," Louise
Tod, chairman of the committee on social
and economic welfare, told 77?^ Canadian
Nurse. She said that although it may not
always be possible to establish profession-
al practice committees within collective
agreements, committees formed inde-
pendently have been helpful in Alberta.

The board also approved the following
motions made by the committee on social
and economic welfare:

• That the nursing service and nursing
education committees develop well-
defined standards of excellence in nursing
practice and seek ways to promote pro-
grams that would upgrade nursing service
personnel by improving their skills in
staff motivation and development and in
personnel evaluation.

• That each provincial nurses' association
establish an assessment board to set cri-
teria for evaluating the post-basic (degree)
preparation of nurses from foreign
countries. The evaluation would help to
determine salaries.

• That provincial nurses' associations re-
view the provisions of the Unemployment

Official Notice

of

General Meeting

of

Canadian Nurses' Association

The 35th General Meeting of the Cana-
dian Nurses' Association will be held
June 14-19, 1970, in the Playhouse
Theatre, Fredericton, New Brunswick.
The opening ceremony will be held on
Sunday evening, June 14 at 20:30
hours, followed by daily sessions com-
mencing Monday, June 15 at 09:00
hours and concluding Friday, June 19 at
16:00 hours. Only member of CNA are
eligible to attend general meetings of
the association. Students enrolled in
schools of nursing in Canada are invited
as guests to observe the proceedings of
the general meeting. In addition, a
program will be arranged especially for
students who attend the meeting.

Insurance Act and the Adult Occupa-
tional Training Act and report their find-
ings at the next meeting of the committee
on social and economic welfare.
• That CNA rescind its policy on strike
action by nurses. The committee pointed
out that the original 1946 policy state-
ment that opposes strike action is in
conflict with the provisions of certain
provincial labor legislation.

The policies approved by the Canadian
Nurses' Association board of directors
will be presented to membership for
ratification at the association's 35 th gener-
al meeting in Fredericton in June.

Ad Hoc Committee Set Up
To Study Health Cost Reports

Ottawa. ~ An ad hoc committee will be
set up to study the reports of the federal
government's task force on health care
costs. This was decided at the meeting of
the Canadian Nurses' Association board
of directors January 26-27.

Committee members will include the
chairmen of the three CNA standing
committees: Kathleen Arpin, nursing
education committee; Margaret D.
McLean, nursing service committee; and
Louise Tod, social and economic welfare
committee.

Each provincial association will also
appoint a member to this committee.
Chairman is Lois Graham-Cumming, head
of CNA's research and advisory depart-
ment.

The board commented briefly on the
reports, and commended the minister of
national health and welfare for the feder-
al government's efforts to restrain the
rate of increase in health service costs,
while maintaining and improving the
quality of care. The board agreed that
CNA would welcome dialogue and
collaboration with other health profes-
sions and groups in efforts to contain
costs.

CNA Represented

On Health Care Committee

Ottawa. - Lois Graham-Cumming,
director of research and advisory services
for the Canadian Nurses' Association,
represented CNA at the first meeting of
the nucleus committee on the delivery of
medical care in Canada, held at Canadian
Medical Association headquarters January
29, 1970.

This committee was formed by the

CMA to study and recommend ways in

which the efficiency of the health care

THE CANM)IAN NURSE 7

system can be improved.

The committee is composed of three
members representing the CMA and one
member from each of the CNA, Associa-
tion of Canadian Medical Colleges, Royal
College of Physicians and Surgeons of
Canada, College of Family Physicians of
Canada, and the Federation of Medical
Licensing Authorities.

CNA To Withdraw
Application For Letters Patent

Ottawa. - The Canadian Nurses'
Association is requesting the minister of
consumer and corporate affairs to with-
draw its application for Letters Patent
under the Canada Corporations Act until
the matter of individual and corporate
membership in the association can be
resolved by the provincial nurses' associa-
tions.

This was decided at the CNA board of
directors meeting January 26-27. Two
provinces voted against the resolution and
others abstained.

The board was notified that two pro-
vincial associations, the Registered
Nurses' Association of British Columbia
and the Registered Nurses' Association of
Ontario, have sent letters to the depart-
ment of consumer and corporate affairs,
requesting withdrawal of their consent to
the Letters Patent. This consent was given
at a special meeting held November 5,
1969 in Ottawa to adopt several bylaws
required to allow CNA to comply with
the requirements of the Canada Corpora-
tions Act.

All 10 provincial associations agreed to
the amended bylaws at the meeting,
including one that would allow individual
members of CNA to withdraw from the
association.

RNABC mentioned a technicality by
which it hopes the department will call
the special meeting null and void. RNAO
has told the department it is concerned
about the bylaw on individual member-
ship and believes that once CNA became
incorporated under the Canada Corpora-
tions Act it would be hard to amend this
bylaw.

If CNA became so incorporated, any
amendment to the bylaws would have to
be approved by the federal minister of
consumer and corporate affairs.

Three Health Groups
Study Transfer Of Duties

Toronto, Ont. Canada's three major
health groups - the hospital, nursing,
and medical associations, have initiated
Phase 1 of a four-phase, two-year study
on the transfer on medical-nursing func-
tions and responsibilities within the hos-
pital.

The Canadian Hospital Association,
the Canadian Medical Association, and
the Canadian Nurses' Association, met to
discuss three major topics and obtain a
8 THE CANADIAN NURSE

Representatives from the Canadian Hospital Association, the Canadian Medical
Association, and the Canadian Nurses' Association met in Toronto in January to
initiate a study on the transfer of medical-nursing functions within the hospital.
Standing, left to right: Dr. A.F.W. Peart, general secretary, CMA; Dr. A. Mercer, CMA;
E. Louise Miner, president-elect, CNA; Dr. B.L.P. Brosseau, executive director, CHA;
Dr. Gaston Rodrigue, president-elect, CHA; Margaret D. McLean, 2nd vice-president,
CNA; Chaiker Abbis, executive committee member, CHA; and Dr. D.L. Kippen,
president-elect, CMA. Front row left to right: Dr. Helen K. Mussallem, executive
director, CNA; L.R. Adshead, president, CHA; Sister Mary Felicitas, president, CNA;
and Dr. R. M. Matthews, president, CMA.

joint consensus on the federal-provincial
task force report on cost of health serv-
ices in Canada, the classification of health
workers, and proposed medical assistants.
They met in January at CHA head-
quarters in Toronto.

A joint statement issued by the presi-
dents of the three organizations, L.R.
Adshead, CHA president. Dr. R.M. Mat-
thews, CMA president, and Sister Mary
Felicitas, CNA president, said: "Our three
bodies are endeavoring to meet regularly
because we are continually examining the
quality of our contribution to health care
in Canada. Jointly, we can achieve the
highest quality of patient care through
communication with each other and
cooperation in programs, policies, and
objectives."

Mr. Adshead said that the three asso-
ciations have initiated a joint research
project into the transfer of functions and
responsibilities of the various health pro-
fessions in the hospital. The purpose, he
said, is to determine which procedures
and responsibilities could be transferred
from the more highly skilled and trained
professions to other groups requiring less
preparation.

The total project is expected to take
three years at a total cost of $100,000.
The federal government has given a
partial grant for phase one, an in-depth

survey of existing practices to establish
the possibility of transferring certain
responsibilities between the medical and
nursing professions in the hospital.

Phase two will be an implementation
of the first phase affecting recommended
transfer of functions, with due recommen-
dation for the ramifications such changes
would create. Phase three will deal with
the transfer of functions among other
health professionals, and phase four will
implement the findings of phase three.

The CHA, CMA, and CNA held a
preliminary discussion on the importance
of the task force report and decided to
set up a working party to examine it in
depth. Each association will do its own
analysis, and joint meetings will be held
to discuss the findings and to develop a
consensus. The associations will then sub-
mit their recommendations to the minis-
ter of health.

NBARN's Biennial Plans Progress

Fredericton, N.B. - Nurses attending
the 35th biennial meeting of the Cana-
dian Nurses' Association here June 14 to
19 will also have the opportunity to
become acquainted with New Brunswick
and its people. This is the promise of the
planning committee of the New
Brunswick Association of Registered
(Continued on page 10)
MARCH 1970

Gome to New Brunswick

the picture province of Canada, for your holiday

.) this year and attend the 35th Biennial

Convention of the Canadian Nurses' Association

June 14 to 19 in Fredericton

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 province 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

MARCH 1970

the historically minded, including the oldest museum in
Canada, at Saint John; the French-built Fort Beausejour;
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 accommodation everywhere, and you
can savor the famous Atlantic cuisine, including lobsters,
salmon, oysters, fiddleheads, and dulse!

THE CANADIAN NURSE 9

news

(Continued from page 8)

Nurses, the hostess association.

A major objective of the committee is
to give visitors an appreciation of New
Brunswick's culture and heritage. Enter-
tainment, welcome, social activities, and
tours have all been planned to illustrate
the unique personality of the province.
Nurses will be presented with a special
souvenir of New Brunswick.

The government of New Brunswick
will sponsor and host a banquet for
registrants, the menu to feature provincial
dishes and products. The city of Frederic-
ton is also making special plans to wel-
come nurses from across Canada.

New Brunswick nurses at the meeting
will act as hostesses; they will wear
swatches of New Brunswick tartan for
identification.

Tours of Fredericton and other points
of interest in the province are being
arranged for the meeting's "hospitality
day," Wednesday June 17. Tourist and
general information services will be pro-
vided throughout the week.

Arrangements for alumnae meetings
and other reunions during the general
meeting are being coordinated by a spe-
cial committee. Groups requesting infor-
mation and bookings should contact Eliz-
abeth Foran, 492 Parkside Drive, Apt. 2,
Bathurst, N.B., before April 30.

Activities planned for nursing students

Members of NBARN's planning committee for the 1970 biennial meeting represent
every chapter in the province. They are: (seated, left to right) Elizabeth Foran;
Nancy Rideout, NBARN Liaison Officer (secretary); Catherine Bannister, (chair-
man); Diane Flower, (vice-chairman); Lois Smith. (Standing, left to right) Margaret
McGee, Raymonde Hanson, Elizabeth Kelly, Jennifer Sherwood, Carolyn MacFar-
lane, Aulda Yerxa, Evelyn Patterson, Odette LeBlanc. Absent is Nicole Lajoie.

include a special tour on June 17 and
other social activities.

Board Approves

Biennial Meeting Program

Ottawa. - The program for the Canadi-
an Nurses' Association 35th biennial
convention was approved by the CNA
board of directors January 26-27. The
general meeting runs June 14 to 19 in
Fredericton, New Brunswick.

CNA Membersh

'P

Now More Than

80,000

Ottawa. - All 10 provincial associations have reported an increase in active
members for 1969, compared with 1968 figures. Total active membership in each
association, which together makes up the Canadian Nurses' Association member-
ship, is given below for both years. j

1968

1969

Alberta

8,326

8,726

British Columbia

10,441

11,120

Manitoba

4,779

5,094

New Brunswick

3,535

3,649

Newfoundland

1,824

1,830

Nova Scotia

3,956

4,353

Ontario

12,241

12,961

Prince Edward Island

618

634

Quebec

26,796

28,353

Saskatchewan

5,900

6,106

Total

78,416

82,826

10 THE CANADIAN NURSE

The official opening on Sunday June
14 will feature an address on health and
welfare services for the '70s. Later in the
week another guest speaker will discuss
the role of the professional association in
the new decade.

Special interest sessions proved so
popular at the last biennial meeting in
Saskatoon in 1968 that they will again be
featured. Six sessions are planned cover-
ing the topics: legal aspects of nursing;
psychodrama; planning of patient care;
delivery of nursing care; the expanded
role of the nurse; and a research symposi-
um.

Business sessions feature largely in the
program. Items for discussion include the
report of the CNA ad hoc committee on
functions, relationships, and fee struc-
ture; proposals of the ad hoc Committee
on legislation; and the budget for the
1970-72 biennial.

Entertainment on the program
includes a banquet, a whole day left free
for sightseeing and hospitahty, and a
presidents' reception to end the meeting.

Test Service Board

To Set Up And Operate

CNA Testing Service

Ottawa. - The board of directors of
the Canadian Nurses' Association will
appoint a special committee to establish
and operate the CNA Testing Service.
Transfer of the Registered Nurses' Asso-
ciation of Ontario Testing Service to CNA
takes place May 1 , 1970.

The special committee, to be known as
the test service board, will be set up
under the present CNA bylaws, as re-
commended by the ad hoc committee on
CNA Testing Service. The first meeting of
(Continued on page 12)
MARCH 1970

Off Press Early 1970

Falconer, Norman, Patterson & Gustafson:

THE DRUG, THE NURSE, THE PATIENT 4th Edition

By Mary W. Falconer, R.N., M.A., formerly of O'Connor Hospital
School of Nursing; Mobelctaire R. Norman, R.N., M.S., University of
Guam; H. Robert Patterson, Pharm.D., San Jose State College; and
Edward A. Gustafson, Pharm.D., Valley Medical Center.

This well-known pharnnacology text for student nurses
has been thoroughly revised and updated for this
new edition. New drugs hove been included and
information added on the chemical and physical
characteristics of the drugs and their action and fate
in the body. Drugs are grouped according to the
"concept approach" into such chapters as Drugs Used
for Patients with Restricted Motion, Drugs Used for
Patients with Guarded Prognosis, and so on. The book
is ideal for courses in which pharmacology is inte-
grated throughout the curriculum. The text includes
the entire Current Drug Handbook described below.

About 750 pages, illustrated. About $10.50. Just ready.

Falconer, Patterson & Gustafson:
CURRENT DRUG HANDBOOK 1970-72

By Mary W. Falconer, H. Robert Patterson, and Edward A. Gustafson.

Revised every two years, this convenient handbook
lists 1500 drugs in current use, giving names, source,
preparations, dosage, uses, contraindications, etc. in
convenient tabular form.

About 224 pages. About $5.00. Just ready.

Jacob & Francone:

STRUCTURE AND FUNCTION IN MAN

2nd Edition

By Stanley W. Jacob, M.D., University of Oregon Medical School,
and Clarice Ashworth Francone.

This superbly illustrated text has been mode even
more valuable by the addition of a new set of
audiovisual teaching aids. The text has been revised
and brought up to date, with new tables of muscles;
new sections on genetic biology, cancer, carbohydrate
and fat digestion, and contraceptives; and many new
references and drawings. A Teacher's Guide includes
references and on annotated list of films.

About 600 pages with about 470 illustrations. About $9.50. Second
edition just ready.

To augment the text:

A LABORATORY MANUAL OF STRUCTURE AND

FUNCTION IN MAN

presents 85 experiments keyed to the text, all of them
tested in actual use.

About 320 pages with about 100 illustrations. About $5.75. Second
edition just ready. Filmstrips for classroom use or individual study:

Ten 35mm filmstrips of about 60 frames each, each
accompanied by a 15 to 20 minute narration on a
long playing record and a printed script of the
narration.

Complete set of ten: about $162, Individual filmstrips, about $16.20
each. All sales at list price.

Jodais: PERSONAL CARE OF PATIENTS

By Janet Jodais, R.N., M.S., Colorado Associated Nursing Homes.

This new text for nurse's aides describes techniques of
personal care, including simple treatments. Such
important concepts as observation, interpersonal
relationships, communication, safety, and rehabilita-
tion are stressed.

About 350 pages with about 275 iHustratiens. About $5.50. JuM
roady.

W. B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7

MARCH 1970

Please send on approval and bill me:
Author:

Book title:

Name: ...
Address:
City:

Zone:

Province:

CN 3-70

THE CANADIAN NURSE 11

Whenyourday
starts at §^
6 a.m. ..you re 0(1
charge duty...
you ye skimped
onmeals...^^
and on sleep...
you haven't had^
time to hem
a dress... ^
mal(e an apple pie.,
wash your hair...^
evenpowder ^i
yournose "^
in comfort^

it's time for a change. Irregular hours and meals on-the-
run won't last. But your personal irregularity is another
natter. It may settle down. Or it may need gentle help
from DDXIDAN.

use

DOX I DAN"

most nurses do

news

DOXIOAN is an effective laxative for the gentle relief of
constipation without cramping. Because DOXIOAN con-
tains a dependable fecal softener and a mild peristaltic
stimulant, evacuation is easy and comfortable.

For detailed information consult Vademecum
or Compendium.

HOECHST

PHARIVIACEUTICALS

3400 JEAN TALON W, MONTREAL 30t
DIVISION OF CANADIAN HOECHST LIMITED

IPMAC I

12 THE CANADIAN NURSE

(Continued from page 10)

the test service board will be held no later
than March 7, 1970.

The test service board will be com-
posed of registered nurse representatives
recommended by nurse registering or
licensing authorities. Each authority will
be allowed at least one representative,
with a maximum of five possible, de-
pending on the number of nurse candi-
dates tested by the authority. There will
also be one representative from a separate
nursing assistant authority, to be rotated
biennially. Provincial representatives will
be appointed for two-year terms.

The functions of the test service board
will include: establishing policies for the
CNA Testing Service; approving the con-
tent of basic contracts; recommending
the nature of data to be compiled; ap-
pointing committees and subcommittees;
preparing the budget and recommending
the appointment of the director of the
testing service, subject to the approval of
the CNA board of directors.

Among the committees appointed by
the test service board will be a blueprint
committee for the registered nurse exami-
nation and one for the nursing assistant
examination. These blueprint committees
will be chosen to represent the different
types of RN programs, specialities,
nursing service, French and English lan-
guages, and regions of Canada. The first
set of examinations must be ready for the
provinces by August, 1970.

A joint committee of the test service
board and the CNA board will meet
within five years to review initial action
and look at the possibility of the testing
service being formed as a separate corpo-
ration.

AARN Presents Views

On Bill 119

To Health Minister

Edmonton, Alta. - A coordinating coun-
cil, compulsory licensure for all who
nurse, and retention of nursing's profes-
sional prerogatives were recommenda-
tions made by the provincial council of
the Alberta Association of Registered
Nurses to the province's health minister
last fall. The meeting between the AARN
and the minister, James D. Henderson,
followed the task committee's composite
report of AARN members' views on Bill
119, an Act to incorporate a council on
nursing.

The minister gave initial approval to
AARN recommendations, and agreed that
the AARN should retain disciplinary
responsibility for the registered nurse, set
the standards for licensure through
registration, and have increased represen-
tation on the 16-member coordinating
council.

Helen Sabin, AARN executive secreta-
ry, told The Canadian Nurse the associa-
tion believes the coordinating function of
the council must be maintained through-
out the Bill to be of value to nursing.
Planning for nursing service cannot be
done in isolation — services must be
coordinated to cover total health needs
and trends in education, she explained.

Currently, over 90 percent of the
employed nurses in Alberta are voluntary
members of the association. Mrs. Sabin
said the association has recommended
that registration in the AARN be a
prerequisite for licensure as a professional
nurse.

"We anticipate that new legislation
will be introduced at the next session of
the legislative assembly, provided there is
general agreement on our recommenda-
tions," Mrs. Sabin said.

(Continued on page 15)

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

This decongestant tablet contends that a
cold is not as simple as it seems on television

Coricidin* "D" tablets
shrink swollen mem-
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them (note the 10 mg. of
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Unfortunately, the mis-
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That's why Coricidin "D "
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
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patient so many helpful
also's?

Coricidin "D"

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phenylephrine.

DOSAGE: Adults: one tablet
every 4 hours, not to exceed 4
tablets in 24 hours. Children (10-
14 years): Vi the adult dose.
Children under 10 years: as di-
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SIDE EFFECTS: Adverse reac-
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14 THE CANADIAN NURSE

MARCH 1970

news

(Continued from page 12)

ANPQ Donates
$15,000 To CNF

Ottawa. - The Canadian Nurses'
Foundation received a welcome boost
from a provincial nurses' association in
January. The SI 5, 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
S35,000 the amount of funds available on
February 1, 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

f 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 RNABC.

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 FOR A LIFETIME

- a^i'tikinr,'-

Marriage is a responsibility thai often re-
quires both spiritual and medical assistance
from professional people. In many instances
a nurse may be called upon for medical
counsel for the newly married young wo-
man, mother, or a mature woman.

"To Plon For A Lifetime, Plan With^Your Doc-
tor" is a pamphlet that was written to assist
in preparing a womon for patient-physician
discussion of family planning methods. The
booklet stresses the importance to the indi-
vidual of selecting the method that most
suits her roligieus, medical, and psychological
neods.

Nurses are invited to use the coupon below
to order copies for use as an aid in coun-
selling. They will be supplied by Mead John-
son Laboratories, a division of Mead John-
son Canada Ltd., as a free service.

Meadjiliiisijn

l_ A B O R ATO R I E S

ORDER FORM

Pl*a«* Mnd

Nam*

Addrats

n

To: Mead Johnson Laboratories,
95 St. Clair Avenue West,
Toronto 7, Ontario.

copies of "To Plan For A lifetime. Plan With Tout
Doctor" to:

THE CANADIAN NURSE 15

2

6

8
9

10
11

12
13

ELASTOPLAST
elastic adhesive
bandages

give strong support, allow air to
reach the skin and moisture to
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GYPSONA

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JELONET

Paraffin Gauze Dressings are
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Now available in individual
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ELASTOPLAST
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are continuous elastic adhesive
porous dressings. Strips are cut
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ELASTOCREPE

Cotton Crepe Bandage is a
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bandage with unique properties
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NIVEACREME

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SUPER-CRINX

Softstretch Bandages conform
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PLASTAZOTE

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ELASTOPLAST
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DISPOSABLE

gowns, masks, caps, sheets, bed
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CELLOLITE

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ELASTOPLAST
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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, B.C. - 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 67,000-member Royal College
of Nursing. Each letter contained a simple
message: "I, a member of the general
pubhc, 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 Whitly 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 1, 1971. The present salary
for a staff nurse is 785 pounds per year
(52,009.60) The Royal College of Nurs-
ing requested 1 ,000 pounds (S2,560).

According to an Ren 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.

*T.M.

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THE CANADIAN NURSE 17

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

who woric 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:

Whynota^t7MC[7®
portable aspirator at
every nursing station!

When time is more important than anything else
in providing positive, safe aspiration to a patient,
this proven Gomco Portable Aspirator is a friend
indeed 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

GOMCO SURGICAL MANUFACTURING CORP.

828 E. Ferry Street, BuOalo, New York I42II oept. c-2

for the next emergency.

The Gomco No. 789 "Portable Aspirator" weighs
only 16 pounds, is easily carried, requires less
thanlsq. ft.of space, provides up to 20" of vacuum.
Ask your nearby Surgical Supply dealer for com-
plete information and demonstration or write:

Ii^.^.C^.^.

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
CM. 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 ICN Headquarters, P.O. Box
42, CH-121 1 Geneva 20, Switzerland.

Study Shows Hospitals 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,
(Continued on page 21)

MARCH 1970

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20 THE CANADIAN NURSE

DePuy, Inc.

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Indiana 46580 U.S.A.

MARCH 1970

news

(Continued from page IS)

and 1 1 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 Involve-
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.19-1374).

UBC 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
estabhshed 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 UBC'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
UBC'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
heahh 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 UBC's
faculty of medicine, explained that the

Discussing the events of another busy day at the Universit> .liunbia s new

Family Practice Unit are its two public health nurses, Pat Ohaslu, left, and Elinoi
Joensen, right, and social worker, Lucille Cregheur, center.
MARCH 1970

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THE CANADIAN NURSE

21

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-

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-

I Hoiiisier's complete

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The sure way to collect pediatric urine specimens
easily . . . every time . . . Hollister's popular UBag
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first time, a UBag style is available for 24-hour as
well as regular specimen collection, and both styles
now come in two sizes ... the familiar pediatric size
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Each UBag offers these unique benefits: ■ double-
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Now the UBag system can help you to get any infant
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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. - ICN 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 multihngual bulletin
distributed during the 14th quadrennial
congress of ICN in Montreal in June
1969.

Persons wishing to subscribe to ICN
Calling should write to: S. Karger AG,
Arnold-Bocklin-Strasse 25, 400 Basel 11,
Switzerland. Subscription price for one
year is $2.15. D

22

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THE CANADIAN NURSE

MARCH 1970

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«

MARCH 1970

THE CANADIAN 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.ScJ^., McGiU 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

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-
■•%* ^^llli^ ^'^ ^ January after a
M '^wKk distinguished nursing
m _^ -jfllp career that brought
%** k^K 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 Army 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 Award 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.HJM., 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 Perma-
nent Commission and International Asso-
ciation on Occupational Health. She was
a member of its new subcommittee on
nursing during the last trieimium.

MARCH 1970

Four public health nurses from Saskat-
chewan, Manitoba, Ontario, and New
Brunswick have been awarded S500
scholarships by G.D. Searle Co. of Canada
Limited. The scholarships cover two
weeks' training at the United 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.H.N. ,
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, U. of Saskat-
chewan; M.Sc, U. of
Washington, Seattle)
has been awarded
the Abe Miller Me-
,^._ mo rial Scholarship

I \^ -a*. by the Alberta Asso-

ciation of Registered Nurses.

The S 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 University 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 U.) is the

^ ^wH^'^^h recently appointed
H -""^1 i^H 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., U.
of British Columbia;
M.Sc. (App.),McGiU
U.) has been named
assistant research
and planning officer
(nursing) with the

research and planning branch of the

Ontario Department of Health.

MARCH 1970

Mrs. Stanojevic began her nursing
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 LeCIair

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 University 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
University Hospital in Sherbrooke. He
joined the medical faculty at the Universi-
ty of Sherbrooke in 1965, after serving as
associate professor of medicine at the
University of Montreal.

A native of Quebec, Dr. LeClair
attended College Notre-Dame in Montreal
and McGill Univershy. 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 quahfications 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.

Mary E. Barrett

(Reg.N., Victoria H.,
London, Ont.; B.N.,
McGill U.; B.A., Sir
George Williams U.,
Montreal; M.S.N.,
Case Western Re-
serve U., Cleveland,
Ohio) has been
appointed chairman
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
En^ish-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 former 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-chairman 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., U. 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., Hopital
Hotel-Dieu de I'As-
somption, Moncton,
N.B.; DipL Nurs.
Serv. Admin., Dal-
housie U., Halifax,
^ ^"m^^^ I^-S-) is the new
^^C^^^H^M director of nursing
^^U^^^K^^k services at Hopital
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-
tario.

Miss Oudot
(B.Sc.N., School of Nursing, U. of Toron-
to; M.A., Nursing Education and P.H.
Superv., Teachers College, Columbia U.)
has worked as a staff nurse, assistant
supervisor and supervisor, and assistant
director with the Metropolitan Toronto
THE CANADIAN NURSE 25

E. Oudot

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

WIN LEY- MORRIS ^li.

AA MONTREAL CANADA

TUCKS is a trademark of the Fuller Laboratories Inc.

26 THE CANADIAN NURSE

branch of the Victorian Order of Nurses.
Before her RNAO appointment, Miss
Oudot was a teacher at the Niglitingale
School of Nursing in Toronto.

Miss Stearns (B.Sc.N., and B.A., U. of
Toronto; Alliance Fran9aise diplome de
language Fran^aise, Sorbonne U., Paris,
France) has had experience in Toronto as
a general duty nurse at New Mount Sinai
Hospital, clinical instructor and part-time
lecturer at the University of Toronto
School of Nursing, and team leader on
the nursing research unit of Sunnybrook
Hospital.

Catherine Bartleman

(R.N., Royal Jubilee
H., Victoria, B.C.;
Dipl. Teaching and
Superv., McGiU U.;
Dipl. in Advanced
^jJ^^A Obstetrics, U. of Al-

■^^'"'"'^Mt berta, Edmonton;

Midwifery, Bristol
Maternity H., Eng-
land) has been named director of nursing
at Vernon Jubilee Hospital, Vernon,
British Columbia.

Miss Bartleman has worked as a staff
nurse at Davidson-Hay Hospital in Port
Angeles, Washington; an instructor at
Archer Memorial Hospital in Lament, Al-
berta, and at Queens Hospital in Honolu-
lu, Hawaii; supervisor of obstetrics at
Swedish Hospital in Seattle, Washington;
and director of pediatric nursing at Uni-
versity Hospital in Saskatoon, Saskatche-
wan.

Susan D. Taylor (R.N., Cornell U. - New
York H. school of nursing; M.S., Hunter
College) has been appointed acting execu-
tive director of the American Nurses'
Foundation. Mrs. Taylor has worked for
the ANF since 1965, most recently as
assistant executive director.

Before joining the Foundation, Mrs.
Taylor worked as assistant head nurse.
New York Hospital; Public Health Nurse,
New York City Health Department; and
PHN at the Greenwich House Counseling
Center. Mrs. Taylor has published several
articles about her employment experience
at Greenwich House, where personnel
from a variety of disciplines counsel drug
abusers.

Marguerite Hornby (R.N., Halifax
Infirmary; B.Sc.N., Mount Saint Vincent
U., Halifax, N.S.; M.S., Boston U., Mass.)
is the new director of nursing at Mount
Saint Vincent University in Halifax, Nova
Scotia.

The new director has been a staff
nurse at the Halifax Infirmary and at
Beth Israel Hospital in Boston, Massachu-
setts, and a lecturer in nursing at Mount
Saint Vincent University.

Miss Hornby has served as chairman of
the nursing education committee of the
Halifax branch of the Registered Nurses'
Association of Nova Scotia. D

MARCH 1970

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; April
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 8, 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, Ont.

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 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, Ont.

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 RN ANS, 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 Yonge Street, Toronto
7, Ontario.

May 25-|une 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.

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

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-|une 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 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 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. □

MARCH 1970

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 in 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.

Five Peel- Pack Sets

To accommodate patients of various 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 1 6-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 sterile "peel-
pack" envelopes. Just peel the envelope
apart. Drop the set onto a sterile tray—
It's ready for use in any sterile area. Your
Abbott Man willgladlygiveyou
material for evaluation. Or
write to Abbott Laboratories, g ascott
Box 61 50, Montreal, Quebec.

Abbott's Butterfly

s

BUTTERFLY-23

INfliSIONSEI

rciWl ;*•! S!»» »»* i^lt* Vf

Infusion Set

MARCH 1970

435Y
THE CANADIAN NURSE 29

new products {

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

Stelabid Forte

Stelabid Forte, an addition to the
Stelabid line, is now available from Smith
Kline & French Canada Ltd.

Stelabid Forte contains 50 percent
more of the anticholinergic Darbid than
its companion products (Stelabid No.
1 , 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.

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
eUminates 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 Medicale & Scientifique Ltee.
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.

x^8k ^

Ear Drops

Burroughs Wellcome & 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.

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
flexibihty of dosage.

Further information can be obtained
from E.R. Squibb & Sons Ltd., 2365
Cote de Liesse Road, Ville St. Laurent,
Montreal 9. P.Q. D

MARCH 1970

Fleet

ends ordeal by

Enema

for you and
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.

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
administration. Repeated administration
at short intervals should be avoided.

Full information on request.

•Kehlmann, W. H.: Mod. Hosp. 84:104, 1955

FLEET ENEMA® — single-dose disposable unit

MARCH 1970

QUALITY PMANMACCUTICALS
• 'vtMj •nam AiTi ,%ir*jtat ti u tHtriA I

THE CANADIAN NURSE 31

ELI LILLY AND COMPANY (CANADA) LIMITED, TORONTO. ONTARIO

For four fenerations
we've, been making
medicines as if
people's lives
depended on them.

*identi.oodeT" (formula identification code, Lilly) provides quick, positive product identification.

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:

"1 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 nm 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 ICU
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 diose 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.

come: ^d savor tme.

DELICIOUS V^BUZCk^-^
AWAIT! MO- VOU AT

CNA's BlEWMIAUCONVHNJnoKJ IK)OUNJE

THE CANADIAN NURSE 33

f ■

:\?

II

■^^Jf^

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-

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

(Selenium Sulfide Detergent Suspension U.S. P.)

A PRODUCT OF ABBOTT LABORATORIES, LIMITED

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:

1 . "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 difficulties 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

McKUlop, representing the Prairie Provinces; Miss E. Marie

Sewell, Ontario; Mile Madeleine Jalbert, Quebec; Mrs. Marilyn

Brewer, New Brunswick; Miss Dorothy Wiswall, Nova Scotia;

Miss Ehzabeth 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 information
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 31,
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

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 II, rather than private bills, the
CNA currently is considering steps to accomplish this.
The objects of the association are stated in the present Act of
Incorporation as follows:

1. 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: 1 . honorary
member; 2. association members; 3. ordinary members;
and 4. any other class or classes of members wliich 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 poHcies 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 re-
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 CNA 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.

1. 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-
ere canadieniie 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. It 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.

1 . 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 interpretation 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.

CHAPTER 5

Recommendations and Summary

Recommendations

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 financed on a

per capita fee basis with the amount to be determined

according to the bylaws.

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

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
interest.

4.6 To explore with the provincial associations methods to
improve the exchange of information.

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 formulate 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 information.

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 all
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:

6.1 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 CNA 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 Hbrary 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 any one 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 formulate 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. D

MARCH 1970

From Canada to Biafra

In October 1%9, 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 Sao Tome. Even so, the editorial staff
believe this article will be of interest to nurses. The war is over, but the suffering
continues.

The nurse is Canadian, but the setting is
African. Dianne North is shown here on
the grounds of the Queen Elizabeth Hos-
pital in Umuahia, Eastern Nigeria. She
was the only Canadian nurse working in
this region throughout its 31-month fight
for independence as Biafra.
MARCH 1970

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 modem,
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 fitting ceased
January 1970.

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 challenging, Dianne
said, to do her surgical teaching in the
classroom and then relate this to patients
with special ward assignments. For
example, a student nurse would be assign-

Miss Kotlarsky, a graduate of Carleton Univer-
sity's School of Journalism, is presently Editori-
al Assistant, The Canadian Nurse.

The Canadian UNICEF Committee is launching
a national appeal for funds to support UNl-
CEF's specialized work with mothers and child-
ren in Nigeria. Donations would be gratefully
accepted at UNICEF, 737 Church Street.
Toronto 5, Ontario.

THE CANADIAN NURSE 39

This Biafran mother and her child mirror the plight of the
thousands of victims who crowded the medical and surgical
wards at the Biafran refugee camps during and after the war.

A nurse tube-feeds a Biafran child in a refugee camp in the
Eastern Region of Nigeria.

ed three or four patients, would have to
go to them and assess their condition,
decide what she had to do for them,
discuss this with the teacher and, in
Dianne's words, "get on with the busi-
ness."

In another type of ward assignment,
students prepared nursing care studies by
talking with patients and observing them
carefully. The students then gathered in a
circle on the verandas to talk about their
patients, the care they were getting,
should have been getting, and so on.
Dianne found that this was a good learn-
ing experience as these ward clinics were
popular with the students. One problem,
however, was that there were not enough
nurses to give this complete care.

War means change

The war, which began in 1967, dis-
rupted the hospital's teaching program.
Classes were forced to stop temporarily,
but resumed when the number of casual-
ties admitted to the hospital decreased.
Fourth-year students were prepared for
their final examinations twice and both
times military uncertainty made the
administration of the tests impossible.

"By this time the girls were so
demoralized and disappointed that we
felt it was too hard on them to keep them
40 THE CANADIAN NURSE

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 first 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, hosphal 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-

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 EHzabeth
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.

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
sometliing 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

There was not room for these wounded soldiers at the Queen Elizabeth Hospital in Umuahia. Eastern Nigeria. In April 1969 the

900 patients in the 185-bed hospital had to be evacuated because of nearby Jightmg.

MARCH 1970 THE CANADIAN NURSE 41

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 Mbaitoli, Owerri, on Sun-
day, 1 saw the matchstick legs and bony
ribs of the children rather than the puffy
faces and tummies characteristic of the
protein deficiency disease, kwashiorkor,
which was rampant here about a year ago.
I don't know which is worse." D

42 THE CANADIAN NURSE

Progressive stages of kwashiorkor, causea
by severe protein deficiency. The suffering
of the children in the region known as.
Biafra was the most tragic outcome of
the Nigerian war.

MARCH 1970H|

Adapting instruction
to individual differences

Grouping students by ability gives the teacher a better opportunity to meet
their individual needs.

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. 1.2 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

Betty Mclnnes, B.Sc.N., M.Sc. (Ed.)

Teacher responsibility

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 terms 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 Mclnnes, 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, Ontario.

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 1 2 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 may or 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 may or 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 high school biology.

Variables Jo 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 160-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
first 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: 1. interest in biology as
demonstrated by class participation;
2. special ability for 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 enliance 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

1. Conant, James B. The American High
School To-Day. New York, McGraw-HiU,
1959.

2. Conant, James B. Some Problems of the
American High School. Phi 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-Hill, 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 L
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. D

MARCH 1970

Fredericton —
something for everyone

History, culture, and beauty combine to make New Brunswick's capital,
Fredericton, a delightful place for nurses to visit during the biennial convention of
the Canadian Nurses' Association, to be held here June 14-19, 1970.

Valerie Fournier, B.J., B.A.

Known as the city of stately elms and
as "the poets' comer of Canada," Frede-
ricton is also fast becoming the hub of
central New Brunswick's economic ex-
pansion. It is a city of pleasing contrasts,
combining old world charm with a bright,
modern face.

Fredericton's origins lie deep in the
early history of Canada. The city owes
much to its river, the Saint John, which
was a natural highway for the MaUseet
Indians who first camped at the site of
Fredericton. Next came Acadian settlers,
who estabUshed a thriving vill^e known
as St. Anne's Pomt as early as 1 73 1 .

Later, United Empire Loyalists made
their way from the United States. Some
settled in St. Anne, renaming it Frede-
rick's Town in honor of the Duke of
York, second son of England's George IIL
The earliest records show a total popula-
tion of 40 persons.

Because of its location in the center of
the province and at the head of deep
water navigation, Fredericton was chosen
as the seat of provincial government and
also as the center of education in New
Brunswick. In 1788 provincial legislators
gathered for the first time in the new
capital.

After early years of hardship, the
settlement received a large influx of

Mrs. Fournier, a graduate of Carleton Univer-
A bronze statue of Lord Beaverbrook dominates historic Officer's Square in central sity's School of Journalism, is Public Relations
Fredericton The beaver sculpture was an 80th birthday present to Lord Beaverbrook. Officer at the Canadian Nurses Assoc.at.on.
MARCH 1970 THE CANADIAN NURSE 45

British immigrants, who helped open up
the countryside in the early 1800s. Land
was cleared and a lumber industry was
established.

In 1845 the city's first bishop - John
Medley - began construction of Christ
Church Cathedral, wliich remains today
as one of the most perfect examples of
Gothic architecture in North America. It
is the first Anglican cathedral built on
British soil outside the United Kingdom
since the Norman conquest of England in
1066. This cathedral brought a special
honor to the town of Fredericton. Be-
cause a cathedral must be erected in a
city, Queen Victoria decreed that Frede-
ricton should be so named: in 1848 she
proclaimed it a city.

From that time until the present the
growth of the city was rapid. Today the
population within a 15-mile radius is about
70,000. This includes the town of
Oromocto, permanent headquarters of
Camp Gagetown, Canada's newest and
most modern military installation. This
camp has had great impact on Frederic-
ton's economic growth.

Rapidly increasing population is
spreading residential construction in new
areas both within and outside the city.
Fredericton has the greatest population
increase of any comparable city in Cana-
da, and if the trend continues it will more
than double its population in tlie next 20
years.

Points of interest

Today Fredericton has 72 miles of
elm-shaded streets, several parks, and a
parkway along both sides of the river. It
is a particularly green and pleasant place
in June. In addition, many historical and
cultural attractions await the visitor.

Officers' Square is a colonial gem in
the midtown section of Fredericton. It is
a beautiful park, centered by a bronze
statue of Lord Beaverbrook, New Bruns-
wick's greatest benefactor. The statue was
raised by public subscription, much of it
by school children, and was officially
dedicated during his lifetime. A stone
sculpture of two beavers, an 80th birth-
day gift to Lord Beaverbrook, stands by
the adjacent pool. More recently an
attractive triangular shelter has been rais-
ed in the Square to house a memorial
plaque to the late John F. Kennedy.

The Square also contains the Officers'
Barracks, one of the oldest buildings in
the city, whose stone arches and iron
balustrades once echoed the brisk step of
British "redcoats" when Fredericton was
an imperial garrison town. The building
now houses the York-Sunbury museum,
which holds much to interest either the
46 THE CANADIAN NURSE

serious student of history or the more
casual enthusiast. The extensive military
collection is impressive, but perhaps of
more interest to female visitors are the
parlor, bedroom, and kitchen completely
furnished in period style.

Lord Beaverbrook's influence

The gifts of the late Lord Beaverbrook
elevated Fredericton from a provincial
capital to a major cultural center. Bom
Max Aitken, New Brunswick's famous
benefactor was brought up in a Presby-
terian manse in Newcastle, N.B., and
became the peer of London's Fleet
Street. But he maintained an enduring
loyalty to the province of his youth.

Lord Beaverbrook realized a dream of
nearly half a century when he presented
the Beaverbrook Art Gallery to Frederic-
ton in particular and to the province in
general. Some of the world's most famous
artists have pictures on display here,
including an impressive British section
containing works by Reynolds, Consta-
ble, Turner, Gainsborough, Hogarth, and
Sir Winston Churchill.

Among the Canadian holdings is the
largest single collection of works of
Cornehus Krieghoff held by an institution
of art. The main gallery is dominated by a
magnificent painting by the Spanish sur-
realist, Salvador Dali. Companion piece to
the art gallery and last of the Beaver-
brook gifts to Fredericton and the provin-
ce is The Playhouse, opened in 1964. The
theater seats about 1,000 and there is
plenty of room for exhibitions or conven-
tions. The Playhouse is now the major
center of the performing arts in the
Maritimes.

Stretching from the art gallery along
the river is The Green, a fine park of
lawns and trees. Here you will find a

statue of the Scottish poet Robert Bums.
This was erected in 1906 by the Frederic-
ton Society of St. Andrew; other Scottish
societies in the province contributed to
the cost. There is also a beautiful marble
fountain given by Lord Beaverbrook in
memory of his friend Sir James Dunn.
This fountain originally stood in the
gardens of Stowe House in Buckingham-
shire, England.

Oldest provincial university

The University of New Brunswick, on
a hill overlooking the city and the Saint
John River, is important historically as
well as educationally. The United Empire
Loyalists brought the standards of
Harvard and of Columbia University,
(then King's College) to the New Bruns-
wick wilderness. In 1785 they petitioned
the provincial governor for a provincial
academy of arts and sciences.

In response, a "draft charter" was
drawn up and 6,000 acres of land in the
parish of Fredericton was reserved for the
use of the proposed institution. As a
result UNB shares with the University of
Georgia the distinction of being the first
provincial or state institution of higher
learning in North America.

The academy became a college in
1800, and until it was made a university
in 1859 it was predominately devoted to
the arts. UNB is non-denominational and
coeducational. Facilities for 6,000 stu-
dents "up the hill" include more than 30
permanent buildings.

The picturesque arts building,
completed in 1828 in the center of the
campus, is the oldest college building still
in use in Canada. The initials of the
university's pioneer students can be
found carved in the antique desks and
benches of one of the classrooms. Close

/'/if arts building on tlic campus at the University of New Brunswick is the oldest
college building in Canada. Close by is the first observatory built in Canada.

MARCH 1970

A statue of Robbie Bums faces the impressive Legislative Assembly 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 fine
contrast with the old buildings. The
library contains many priceless historical
and literary treasures from his personal
collection. The position of chancellor of
UNB 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' comer of Canada. The
earliest Englisli speaking poet in Canada,
the Loyalist Jonathan Odell, came from
Fredericton. Other famous poets include
Joseph Sherman, Bliss Carman, and Sir
Charles CD. Roberts; these three are
commemorated by the UNB memorial.

Bliss Carman's house is still standing
and is on view. Fredericton also containsi
several homes that once slieltered histori-
MARCH 1970

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
Englisli 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, winch
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-
formed 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-
hshed 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 S5 million
building is practically designed, with
clean, modem 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 spacious 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-filled
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 find
48 THE CANADIAN NURSE

Christ Church Cathedral, a good example of Gothic architecture in North America.

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

length of New Brunswick; it is known as
"the Rhine of America." Talking of
water, one of the best attractions of
Fredericton is the availability of all the
fresh seafood you can eat!

Fredericton — the capital of New
Brunswick - really lives up to the old
cliche: "a city that has something for
everyone." D

MARCH 1970

Changing horizons
in psychiatric nursing

The author examines the problems of social position, role conflict, and lack of

professional identity that affect nurses working in mental hospitals.

She stresses the need for a clinical specialist as a role model in psychiatric nursing.

Naida Hyde, B.Sc.N.

The provincial psychiatric hospital
system is an anachronism in today's
society. Although rapid changes are
occurring all around us, we still find
psychiatric patients in antiquated build-
ings that are located in overcrowded cities
or in the country, isolated from the
community.

These buildings, which house almost
half of Canada's hospitalized patients,
exist to treat and rehabilitate the
emotionally ill. However, the walls and
the land that separate the psychiatric
patient from the community symbolize
the hospital's function of protecting the
community from social deviants who are
labeled mentally ill. Thus the hospital and
its staff are required to function both as
custodian and therapist.

The mental hospital as a social system
and as a total institution has been studied
and researched extensively. Although
much useful data have been accumulated
about such things as the hierarchical sys-
tem, social positions, and interaction
systems within the mental hospital, these
findings have not always reached the staff
who could benefit the most from them.

For instance, for many years the nurs-
ing department in the mental hospital
accepted almost total responsibility for
providing patient care. No other staff was
available or interested in doing the job. In
recent years, however, other professions,
such as social work, psychology, and
MARCH 1970

sociology, have become progressively
more involved in patient care and have
used available knowledge to help them
deal more effectively with the psychiatric
patient. Unfortunately, there is little evi-
dence to suggest that nurses in psychiatric
hospitals are using research data to im-
prove their care and to examine their
role.

Bottom of totem pole

The hospital's organizational structure
can be seen as a pyramid with psychia-
trists at the apex, as the medical model
still holds sway in psychiatric treatment,
despite efforts of non-medical personnel
to dislodge it. Social workers and psychol-
ogists share the second position and
status, followed by nurses at the broad
base.

Nursing staff have little status compar-
ed to other members of the health team.
Yet they are expected to assume a great
deal of responsibility for the care and
treatment of patients.

Mrs. Hyde, a graduate of the University of
Toronto School of Nursing, has worked as an
instructor in psychiatric nursing and as assistant
director of nursing education at the Ontario
Hospital Toronto, and as a staff nurse at the
Clarke Institute of Psychiatry. She has observed
patient care in mental hospitals in Whitby, New
Toronto, and Boston, Massachusetts. She is
now doing graduate work in psychiatric nursing
at Boston College, Massachusetts, U.S.A.

Underlining the low-man-on-the-
totem-pole syndrome is the lack of clarity
that nurses have regarding their profes-
sional identity and competence. They
often feel that their role consists merely
of the sum total of others' expectations
of them. This difficuhy generates prob-
lems throughout the psychiatric team in
relation to professional roles and expecta-
tions; this, in turn, influences patients
and their treatment.

The multiple subordination that
nurses are subject to compounds the
problem. The nurse is expected to take
orders from various persons, including the
psychiatrist, psychologist, and social
worker; at the same time, she is urged by
them to assume her rightful role on the
team. She is also subject to the authority
of the nursing service department, which
expects her to carry out a host of
non-nursing duties. An example of con-
flict occurred when a nursing supervisor
reprimanded a head nurse for not having
someone available to answer the ward
telephone during the patients' ward meet-
ing; the psychiatrist, on the other hand,
had strongly urged the nurses to partici-
pate at these meetings.

Nursing office directives often are
more custodial than therapeutic. Super-
visors want patients to receive the best
care possible, but are uncertain how
nurses can give this in any but a custodial
way. Since each staff nurse is dependent
THE CANADIAN NURSE 49

on nursing office personnel for job securi-
ty and working conditions, the latter's
power over each nurse's functioning is
considerable.

In interviews with one researcher,
nurses said that when they had a choice
of a high visibihty task, such as charting,
or a low visibility task, such as talking to
patients, they invariably chose the high
visibility task, although they prefered
association with patients.*

Educational conflicts

The majority of RNs working in
psychiatry, including head nurses, are
graduates of diploma schools of nursing
where they received a maximum of 12
weeks of theory and clinical experience in
psychiatric nursing. Today, many of these
courses are only eight weeks in length.
Their ability to prepare a beginning
practitioner in psychiatric nursing, let
alone a psychiatric head nurse, is
questionable.

Today's head nurse is expected to
understand psychotherapeutic proce-
dures, such as individual psychotherapy
and group therapy techniques; to know
how to develop and utilize meaningful
relationships with patients; and to be able
to guide her staff in the same direction.
Too often nursing service leaders are
chosen because of seniority in the institu-
tion rather than because of suitable
educational or personal qualifications.
These persons' views of psychiatric nurs-
ing and treatment are completely outdat-
ed.

The head nurse occupies a crucial
position in the social structure and func-
tioning of the ward. In many situations
the psychiatrist in charge of the ward is a
busy resident just learning his profession.
This leaves the head nurse in a power
position with a great deal of responsibili-
ty. She is expected to be administrator,
intermediary among staff members and

*A. Wesson, The Psychiatric Hospital as a
Social System, Springfield, Illinois, Chailes C.
Thomas Press, 1964.
50 THE CANADIAN NURSE

between staff and patients, and an exam-
ple of good mental health. In practice,
however, this person often feels the weak-
est and least prepared to cope effectively
with all her responsibilities.

Lack of sufficient and relevant educa-
tional preparation heightens the nurse's
difficulties, whatever her position. In
Ontario, for example, nurse aides and
attendants are required to complete a
course to prepare them to work with the
mentally ill. Until two years ago, how-
ever, the course was abysmally outdated,
geared more to prepare these assistants to
work with chronic geriatric patients than
with the acutely or chronically ill mental
patient. These persons often developed
skill in working with the mentally ill in
spite of their poor preparation. Even so,
many aides are in the paradoxical posi-
tion of having long tenure and consider-
able intuitive skill and sensitivity, but at
the same time feel left out and inade-
quate because of the team's more sophis-
ticated discussions about patients.

On the other hand, aides and attend-
ants in Ontario who graduate from the
new, nine-month registered nursing assist-
ant course that prepares them to work
with the mentally ill find themselves in an
equally untenable position. Their course
contains six months of theoretical materi-
al relating to mental health and psychiat-
ric nursing, with supervised clinical
experience. After graduation, these RNAs
often find that they are more knowledge-
able and more clinically proficient than
many RNs they are assigned to work
under.

The RNs may say they are glad to have
such able assistants, but the RNAs experi-
ence a great deal of subtle pressure to
return to their former, custodial, sub-
servient role. The pressure increases as the
psychiatrists and social workers recognize
the therapeutic potential of these nursing
assistants and try to increase their in-
volvement in patient care.

These role conflicts, status problems,
and educational deficiencies severely
affect the nurse's functioning within the

ward setting. Thus regardless of how
much nurses care about patients and want
to help them, they are ill equipped to do
so. Feelings of frustration, helplessness,
and inadequacy produce defensive reac-
tions. The ward nursing station or medi-
cine room becomes a sanctuary where the
staff gain some security by reinforcing
each other's right to withdraw from the
patients, whom they feel emotionally and
intellectually unprepared to help.

Problems and solutions

Strict adherence to institutional rules
and policy may also be used as a defense
mechanism by nursing staff. For example,
one of my patients showed regression and
depression following an epileptic seizure.
He was unable to communicate much
during one session except to ask me for
his breakfast. This was important to him
not only for the food's sake, but also in a
symbolic sense as I would be functioning
in a mothering role. However, the head
nurse and senior aide refused to let me in
the kitchen in the middle of the morning.

Their insecurity , fear of criticism from
above and of me as an outsider, and
uncertainty about seeing a nurse function
in a therapist role prevented them from
considering the therapeutic value of my
request. This placed me in a conflict
situation of wanting to meet the patient's
need, but at the same time understanding
the importance of maintaining good rela-
tions with the staff - for my sake and
the patient's.

Are nurses inextricably bound by the
difficulties outlined, or are there solu-
tions?

Psychiatric nursing has a contribution
of great value to make in the care and
treatment of psychiatric patients. Solu-
tions must be found and implemented.

Three areas of change should be
considered if patient care is to be improv-
ed: change in administrative structure;
improved educational preparation for
nursing personnel; and the implementa-
tion of a suitable role model in psychiat-
ric nursing. The nature of both the social

MARCH 1970

system of the mental hospital and the
solutions proposed indicate that the
changes will be evolutionary, rather than
revolutionary, in nature.

Decentralization needed

Problems of role conflict and multiple
subordination would decrease if nursing
became decentralized and functioned
within each ward setting under the super-
vision of the team leader and the clinical
specialist assigned to that ward. De-
centralization would help the nurse focus
her interest and attention on her ward
and its milieu, rather than on the
demands and expectations of the nursing
department.

Decentralization calls into question
the role and function of the ward's team
leader, who is usually a psychiatrist. If
the psychiatrist's influence is positive,
that is, if he sees each nurse as a therapist,
decentralization is advantageous. How-
ever, if the psychiatrist's frame of refer-
ence is more reactionary and traditional,
the nursing staff and clinical specialist
have to assume a much more active role,
interpreting to him the need for nursing
involvement with patients. Nurses who
believe in their own therapeutic potential
and who are willing to say that they do,
can exert a powerful influence on a ward
program.

Education and role model needed

Diploma schools of nursing are moving
away from specialty areas and concentrat-
ing on preparing a better quality of
generalist in nursing. Psychiatric nursing
as a cUnical specialty is taught on a
postbasic level within a university, either
as part of a masters program or in a
program of continuing education. Thus,
the diploma school graduates, who are
the main source of recruitment for staff-
ing psychiatric hospitals, have had only 8
or 12 weeks of psychiatric nursing in a
two- or three-year program geared to
general nursing.

Inservice education as it now exists
cannot meet the needs of this group of
MARCH 1970

nurses. What is needed is a suitable role
model for psychiatric nurses.

Until now, the ward psychiatrist,
usually by default, has assumed responsi-
bility for helping nurses understand how
they can help patients. Often, however,
his efforts have been unsuccessful as
nurses and many doctors are unaccustom-
ed to treating each other as equals. In
addition, nurses often lack adequate
theoretical knowledge to understand
what the psychiatrist is trying to teach
them. This situation results in the nurse
feeling inadequate, which can lead to a
poor doctor-nurse relationship.

Nurses will learn, but only when there
is supervision of their clinical work with
patients. The clinical specialist in psychiat-
ric nursing can best give this supervision
and serve as a role model for nurses as a
therapist and as an agent of change. In an
ideal situation, she is assigned to one
ward where she becomes an integral part
of the ward team, working with patients,
teaching the nursing staff on a day-to-day
experiential basis, and collaborating with
other disciplines on the therapeutic role
of nursing.

This clinical specialist is a person with
whom the nursing staff can identify. The
nurses see the clinical specialist as a
therapist who enjoys working intensively
with patients. They also see her as a nurse
who is secure enough to work on a
person-to-person basis with patients,
rather than in a traditional and structured
nurse-patient framework. Such a frame-
work has been called "professional" in
nursing circles; in most instances it
amounts to stereotyped, uninvolved, and
non-creative behavior.

The clinical speciaUst understands and
reacts to socially unacceptable behavior
in patients as symptomatic of intra-
personal and/or interpersonal problems.
She remains objective in her work with
patients, aware that her behavior and
feelings about a patient affect him, and
that his behavior affects her.

This example illustrates the value of a
clinical specialist. A young 22-year-old

girl was admitted to hospital, having
threatened suicide. She was frightened
and felt alone in the new environment,
but did not show these feelings. Her life
had been a series of disappointing experi-
ences with people, so she was now adept
at keeping people at a distance.

Her method was simple, effective , and
was aimed primarily at the nursing staff
who threatened her because of their
attempts to get close to her. She kept up
constant demands for medication, inter-
spersed with hostile, sarcastic complaints
about the nursing staff, hospital policies,
and her treatment. Soon the nurses be-
came angry and defensive toward her.
Because of guilt feelings, they avoided her
or were cool to her, which only intensifi-
ed her underlying fear, helplessness, and
anger.

A clinical speciaUst could have helped
the nurses understand their part in per-
petuating this girl's unhealthy behavior
and their responsibility in helping her
find more appropriate ways of relating to
people. This could be done only by
learning to understand the patient, rather
than by reacting blindly to her behavior.
What this patient desperately needed was
someone to accept her and give her the
security she needed.

The clinical specialist can also give
help and support to the head nurse.
Recently I heard a head nurse say, "I
communicate very well with my staff, but
they don't communicate with me." This
statement illustrated her faulty under-
standing of the mutual nature of com-
munication and relationships. The clinical
specialist would have the time, skill, and
understanding to guide the head nurse's
understanding of the dynamics of staff
communication and group functioning.

Fear of mental illness may hinder a
nurse's ability to care for the patient.
Again, the clinical specialist can help staff
learn to understand their own feelings
and reactions to patients. As understand-
ing develops, the staff are less likely to
use distancing defenses or to act out their
anxiety. D

THE CANADIAN NURSE 51

Something to say... and how!

Though mastery of the mechanics of writing will never make you a literary giant,
it may prevent you from becoming a boring scribe, the author says.

Helen Evans Reid, M.D.

As a professional you have knowledge
and skills you must communicate, if you
are to fulfill your complete role. Your
concern for all patients is the imperative,
the reason you must write.

What you have to say may vary from a
simple description of a more efficient
way to collect a sample or make a patient
comfortable, to the detailed account of a
carefully organized research project. How
well your message is delivered is a com-
pound of many things, including your
enthusiasm for your subject and your
knowledge of it, your abihty to write,
and the time you spend polishing your
article before you consider it finished.

Know your reader

Obviously you must know your reader
before you begin to write an article. The
form of your communication depends on
his identity.

The following appeared in a scientific
journal:

The Effects of Continous Compression
on Living Articular Cartilage

The problem that prompted the
present investigation arose from clini-
cal observations of the sequelae of
immobilization of Joints in patients
who were receiving various forms of
orthopaedic treatment, etc. 1

Suppose the same item had been writ-
ten to appear in the local newspaper. It
might have read like this:

52 THE CANADIAN NURSE

Surgeon Claims Casts Damage Joints

Dr A.C. Jones, surgeon-in-chief at
Smithtown Children 's Hospital said, in
a paper delivered before the American
College of Surgeons meeting this week
in Atlantic City, that immobilization
of a joint by the application of a
plaster cast to a limb can cause deteri-
oration of the cartilage lining the joint,
and this damage can be permanent.

Or, written as a magazine article, it
would go something like this:

The Cure That is Worse Than the Disease

Jimmy Doyle was just like any other
boy of nine, racing with his playmates,
playing baseball on the corner lot,
climbing trees and riding his bicycle
"no hands, " until that February day
disaster struck

The writer would then go on to
describe the accident in detail, and in-
clude the weary hospitalization, the perma-
nent cripple from long immobilization,
and then the punch line.

Dr. A.C. Jones of the Smithtown
Children's Hospital estimates that at
least 200 Canadian children suffer
some permanent disability, etc.

Dr. Reid is Director, Department of Medical
Publications, The Hospital for Sick Children,
Toronto, Ontario.

MARCH 1970

The story in all three versions is the
same. The reader made the difference. In
the first case he was a scientist; in the
second, probably a business man or
housewife who wanted news in a quick
package; and in the last, a parent.

Capture the reader

You have identified the reader, now
you must capture his interest. The title is
the bait. For the lay press, a catchy title,
strong and positive, is needed; for the
scientific press, a precise title, complete
enough that the communication can be
readily retrieved from the stored medical
literature, is often used, particularly for
technical material.

The reader is captured. Now how do
you hold his interest? There is a sign on
my bulletin board that reads "All subject
matter is boring if no ideas show
through. - Thomas Mann." If you are
not enthusiastic about what you want to
say, don't say it. And don't bother to
write it, for no one sells anything he does
not care about, least of all an idea.

How well your message is delivered
also depends on what it is you want to
say. Write down in simple words — your
words - what has been said in the past
and what you have to add. This exercise
will eliminate those things that are irrele-
vant. What you write 'i%your theme, >'owr
message.

Choose the journal by examining its
general quality and prestige and the sub-
MARCH 1970

jects it has published in the past year. As
competition for editorial space is brisk, it
is wise to select a topic that has not been
covered during the previous year. A jour-
nal is unlikely to accept an article on a
particular subject more than once in a
single year unless the submission is re-
markable for its novelty or timeliness.

Then read the "Instructions to
Authors" column that appears in all
journals, although not in every issue, to
learn the journal's preference for the
length of the article, the number of
copies to be submitted, the form of the
references, and the acceptable number of
illustrations, charts, and tables. Profes-
sional writers usually send an outline of
their topic to the editor for approval
before writing the article.

When you have chosen the form for
your article, decide on the headings and
write each on a separate sheet of paper.
Read over the material you have collect-
ed. Ask yourself if the item is really
necessary and where it belongs.

With your material now logically ar-
ranged, construct a sentence outhne for
each section. The skeleton of your article,
the shape to come, will be apparent. You
are ready, at last, to write the first draft.
Write it continuously from beginning to
end, always keeping your message clear.

At this point construct any tables or
graphs you may wish to submit with your
article, making them as complete as pos-
sible with headings, footnotes, and labels.

Tables and graphs should be a synopsis of
the entire work, complete in themselves
without reference to the text. They obvi-
ate the tedious repetition of data in the
"results" section of a technical or re-
search paper, where only the unusual, the
unexpected, the highlights, should be
mentioned.

Polish your article

No author, not even the most ex-
perienced, produces a perfect manuscript
at the first writing. Your article should be
revised several times and polished before
it is submitted for publication.

Usually a paper can be shortened
considerably by careful, conscientious
revision. This does not mean that you
leave out relevant material as you revise;
rather, you ruthlessly eliminate un-
necessary words by dropping "wind-up
phrases" - those expressions that
indicate your difficulty in getting a para-
graph or sentence started. For example,
"It has been our observation that many
consider measles a benign condition,"
would be better expressed by, "Many
consider measles benign." Writing, rewrit-
ing, choosing the precise word, the
perfect word, the apt expression - these
are the tools of the competent communi-
cator.

There are other ways of improving a
text's quality. Avoid monotony, a literary
sin guaranteed to bore your reader and
make him turn to the next article. When
all ideas are equal, none is important. The
product is like food without spice, a nice
cold porridge of thoughts. For interest,
vary the structure and the length of the
sentences. Since few readers can tolerate
more than an occasional sentence over 25
words, try a short, sharp sentence to
dramatize a point.

Master the mechanics of writing

Style in writing is a function of the
writer, as personal and as characteristic of
him as the clothes he wears. The sen-
tences you build and the words you
choose clothe your thoughts and identify
them as yours. A good style makes dull
prose literature, makes words and ideas
sparkle and How, and delivers your mes-
sage accurately and effortlessly.

THE CANADIAN NURSE 53

To achieve a good style you must
master the mechanical details of writing.
These are well set out in The Elements of
Style, by William Strunk Jr. and E.B.
White.2

Though mastery of the mechanics of
writing will never make you a literary
giant, it may prevent you from becoming
a boring scribe.

Here are a few reminders of how to
achieve a good style in writing.

The verb you use may be in either the
active voice (the subject is acting) or the
passive voice (the subject is being acted
upon). For example, /o/in caught the ball
(active). The ball was caught by John
(passive).

Use the active voice when possible to
make your writing more concise and
forceful. Consider this sentence: The
course of action will always be deter-
mined by the physician. Very wordy.
Change this so that the person taking the
action is the subject. The physician will
always determine the course of action.
This is concise, precise, and straightfor-
ward.

You may wish to use the passive voice
for variety, but remember it can confuse
your reader and dull the lustre of your
style.

Put statements in a positive form.
"Not" is the warning word. He did not
remember that enlarged glands in the
groin are not unusual, would be better as:
He forgot that enlarged glands in the
groin are common.

Strive to use definite, simple words,
choosing the concrete over the abstract.
The position with regard to food con-
sumption exhibits a maximum of non-
availability. Why not just say. Food is
scarce?

Many people who speak well bury
their ideas in unnecessary words when they
write. Consider: Let me call your atten-
tion to the fact that, would be better as: /
remind you. If it is of interest to note,
then say what you have to say without
this venerable preface. If what you have
to say is uninteresting, you shouldn't be
saying it.

Strong verbs make good writing. Un-
fortunately many authors hide good verbs
54 THE CANADIAN NURSE

in abstract nouns. For example, Man has
an appreciation of beauty. The word
"appreciation" is an abstract noun, so
why not make it a verb? Beauty is
appreciated by man. That's better.
"Appreciation" has become a verb, but it
is in the passive voice. Try, Man appreci-
ates beauty. A vigorous verb, a vigorous
sentence. From this example you can see
that brevity is a by-product of vigor.

Avoid jargon. Whole vacabularies have
been built up by the professionals of a
particular discipline to facilitate com-
munication among themselves. The
danger is that these words become over-
worked, and "abuse may turn them into
mere plugs for the holes in one's
thoughts."^ Originally specific, such
words lose their meaning and become
jargon. Nouns, such as evaluation, motiva-
tion, breakdown (analysis); verbs, such as
structure, trigger, update; and modifiers,
such as basic, key, and overall, are weary
words that should be laid to rest.

Submit your article

Naturally the things you write and the
ideas you express are distilled from what
you have experienced and what you have
read. But to quote someone without due
acknowledgement, or to repeat his words
as though they were your own, is plagia-
rism and inexcusable. So indicate what
you have borrowed and from whom by
numbering and listing all the references in
the manner approved by the journal.

Of course the manuscript you submit
will be well typed, the illustrations apt,
clear, and precisely labeled. Enclose a
covering letter to the editor of the journal
and a self-addressed, stamped card on
which the editor can indicate that the
manuscript has arrived safely.

Then wait. Allow six weeks to two
months to elapse before sending a courte-
ous letter to the editor to find out if a
decision to publish has been reached.

Don't be too discouraged if your
manuscript is rejected. Few persons who
write for publication have escaped the
experience of having at least one paper
turned down by a publisher. Try to
determine why the paper was rejected,
and resolve to avoid this particular pitfall
in the future.

The writing and eventual publication
of an article is satisfying experience for
you, the author. As you transmit your
personal experiences or research to
others, you are truly fuUfilling your role
as a professional.

References

1. Salter, R.B. and Field, Paul. The effects of
continuous compression on living articular
cartilage: an experimental investigation. /
Bone Joint Surg. 42-A: 31-49, Jan. 1960.

2. Strunk, William Jr. and White, E.B. The
Elements of Style. New York, The Mac-
millanCo., 1959.

3. Follett, Wilson. Modern American Usage. A.
Cu/c^e Ne w York, HUl and Wang, 1 96 7 . [D

MARCH 1970

Are we getting to you?

The Canadian Nurse travels a busy road, sometimes with unexpected detours,
before it arrives at your door each month. The circulation department of
the Canadian Nurses' Association, with your help, makes the road smoother.

Beryl Darling

•■i^*"*^ » m^ ^

>v\.

The author, left, discusses the details of a subscriber's enquiry with Pierrette Hotte, a
member 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 'infirmiere 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

Frangoise Charbonneau prepares an
addressograph plate for a personal sub-
scriber in Africa.

provincial nurses' association, unless an
individual request is received from the
member.

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
file is maintained at CNA, filed 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 1 1 1 ,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.

This "up-date" provides the final
information that will be printed on the
56 THE CANADIAN NURSE

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

^^C**«-—

Gloria Wilcox checks CNA 's copy of
February labels to confirm that an issue
was sent to a member.

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-
clude 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 hbraries and
health agencies, and individuals all over
the world are Usted among our personal
subscribers.

Postal regulations

New postal regulations brought other
changes in addition to the overwhelming
increases in postage costs. Prior 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 t}ie
profession, we suspect that hundreds of
copies are currently being sent to the
dead-letter office for disposal each
month.

MARCH 1970

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.

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

<

>

Miss B.A. Nurse
10 Skyway Drive
Montreal 352, P.Q.
B066-3295

<

A personal subscriber or a member
outside Canada, such as the subscriber
hsted 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 in 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! LJ

MARCH 1970

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 formulation of an
instrument 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 professionahzation 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: 1. 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 posifion 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 interviews 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 findings 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 CathoUc 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: 1. 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 interview 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 formal
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-
burg, 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 1 7 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 (11 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 feeUngs
surrounding hospitalization.

Shepherd, Audrey Elizabeth. A study of
the attitudes of public health nurses in
a selected agency toward direct patient
care. Seattle, 1969. 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 1 level
evidenced a more positive attitude toward
the patient than nurses employed at the
public health nurse II level. D

Next Month
in

The

Canadian
Nurse

# Cancer Detection Clinic

# Counseling Nursing Students

# Nurse on James Bay

&

^^P

Photo credits for
March 1970

Canadian Hospital Association,
Toronto, p. 8

Joe Stone & Son Ltd.,
Fredericton, N.B., p. 10

AARN Newsletter, p. 12

University of British Columbia,
Vancouver, p. 21

Canadian Press, pp. 39, 4 1

Church World Service, New York,
R.G. Shaffer, p. 40

Church World Service, New York,
p. 42, cover

N.B. Travel Bureau, Fredericton,

N.B.,pp. 45,46, 47

The Harvey Studios,
Fredericton, N.B., p. 48
Photo Features. Ottawa,
pp. 55, 56, 57

THE CANADIAN NURSE 59

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. There
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.
Saint Louis, Mosby, 1969.
Reviewed by M. McCloy, Assistant
Dietitian, South Peel Hospital, Missis-
sauga, Cooksville, Ont.

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 form, 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
beUeve 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 automatic, self-
regulating, and self-repairing. Witii the
central nervous system as the computer,
man-made 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.

Illustrated 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 cUnical
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 individual
nurse practitioner would be limited. D

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 any one 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. Les complications en chirurgie el leur
traitements, par Curtis P. Artz et James D.
Hardy. Paris, Maloine, 1968. 1005p. (Traduit
de la 2. edition Americain par Ch. Alamowitch
et J. Bezier)

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, cl969. 50p.

4. Facts about nursing, 1969. New York,
American Nurses Association, 1969. 250p.

5. International standard classification of
occupations, rev. ed. 1968. Geneva, Inter-
national Ubour Office, 1969. 355p.

6. Introduction to work study, 2d ed.
Geneva, International Labour Office, 1969.
436p.

7. Manuel de gironto-psychiatrie, par
Christian Miiller. Paris, Masson, cl969. 275p.

8. Les medicaments. Paris, Editions du
Seuil, 1969, par Jean-Marie Peltz. 190p. (Col-
lections microcosme. Le rayone de la science,
29)

9. Nursing en obstetrique, par Fran^oise
Piquette. 3.ed. Montreal, Renouveau Pedagogi-
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 Examination Publishing, 1969. 211 p.

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THE CANADIAN NURSE 61

(Nursing examination review book no.8)

11. Pediatrie par Marie-Claude Turcotte-
Daoust. Montreal, Renouveau Pedagogique,
1969. 4 24p.

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, c 1968. 11 Op.

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 psychiatric facilities: a
revision of the standards for hospitals and
clinics. Washington, American Psychiatric
Association, c 1969. 115p.

17. Threshold to nursing: a review of the
literature on recruitment to and withdrawal
from nurse training programmes in the United
Kingdom, by Jillian MacGuire, London, G. Bell
& Sons, cl969. 271 p. (Occasional 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

1 9. Declaration of principles and code of
professional 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 SyMa Lande. New York,
National League for Nursing, 1969. 8p.

2 2. Report, 1968. Toronto, Canadian
Mental Health Association, 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 Caldwell. 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, 1969. 63p. (Science Council 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 therapeutiques de la fonction
"expressive" de I'infirmiere dans I'accomplisse-
ment d'une de ses activites autonomes. Mon-
treal, 1969. 76p. (Thesis (M.Nurse)-Montreal)R

33. Jeanne Mance; infirmiere missionnaire
laique, 1606-1673, par Soeur AUard, Montreal,
Centre Jeanne-Mance Hotel-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 D

SCARBOROUGH CENTENARY HOSPITAL

(Located Within Metropolitan Toronto)

Invites Applications for all services and positions
within the Nursing Department

This modern 525-bed hospital is fully equipped with the latest
facilities to assist personnel in patient care and embraces the most
modern concepts of team nursing. Excellent personnel policies are
available. Progressive staff end management development programs
offer the maximum opportunities for those who are interested.
Salary is commensurate with experience and ability.
Some Single Room Residence Accommodation Available.

For further information, please direct your enquiries to:
Personnel Department

SCARBOROUGH CENTENARY HOSPITAl

2867 Ellesmere Rd., West Hill, Ontario

Request Form
for "Accession List"

CANADIAN NURSES'
ASSOCIATION LIBRARY

Send this coupon or facsimiie 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)

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

62 THE CANADIAN NURSE

MARCH 1970

April 1970

MISS MTM MORRIS

~290^ NELSON ST APT 812
OTTAWA 2 ONT 0000578A

The

Canadian
Nurse

university schools of nursing
in Canada

a split in the family
cancer can be beaten

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2 THE CANADIAN NURSE APRIL 1970

The

Canadian
Nurse

^

^^F

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 views of the authors and do not
necessarily represent the policies or views of the Canadian Nurses' Association.

4 Letters

22 Names

26 New Products

54 Research Abstracts

56 AVAids

9 News

24 Dates

28 In a Capsule

55 Books

56 Accession List

Executive Director: Helen K. Mussallem • Ed-
itor: Virginia A. Lindabiir> • Editorial Assist-
ant: Carol A. Kotlarsky • Production Assist-
ant: EUzabetli A. Stanton • Circulation Man-
ager: Berjl Darling • Advertising Manager:
Ruth H. Baumel • Subscription Rates: Can-
ada: One Year, S4.50; 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-
ciation, where applicable. Not responsible for
journals lost in mail due to errors in address.
® Canadian Nurses' Association 1970.

Manuscript Informalion: "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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
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.O. Permit No. 10,001.
50 The Driveway, Ottawa 4. Ontario.

APRIL 1970

Editorial

For Smokers Only

Having read that the Great Man
Himself — Dr. Sigmund Freud —
tried all his life without success to giv(
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 Twai
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 cams
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 librarian — 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 hai
a puff. That's 15 LONG weeks.
But we're living proof that it can be
done. Furthermore, we've given heart
a physician friend who had doubts
that a heavy smoker really could
quit. "If you 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 smoker'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 OW^ADIAN 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.

Show me that you care

The article. "Nurse, Please Show Me That
You Care! " (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. - / 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 1 am unconcerned about nurs-
ing care. I certainly hope to see it
improved, but 1 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, BJV, Halifax, Nova Scotia.

After reading Pamela Poole's article,
"Nurse, Please Show Me That You
Care! " (February 1970), I was in no way
angered, but 1 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.

1 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
anxieties, this article contains no solu-
tion. Maybe, as 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 falling 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 nurses 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

1 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. 1 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

Letters 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 Bntser. MD, Mall
Medical Group. Winnipeg, Manitoba.

Health 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 February issue of 77je
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. D

APRIL 1970

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-partunn 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
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w

WINLEY-MORRISa'y.

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TUCKS is a trademark of the Fuller Laboratories Inc.

THE OWMADIAN NURSE 5

. . for Fall Classes .

New (2nd) Edition! TEXTBOOK OF MEDICAL-SURGICAL NURSING

By Lillian S. Brunner, R.N., M.S., Charles P. Emerson, Jr., AA.D.,
L Kraeer Ferguson, M.D., Doris S. Suddarth, R.N., M.S.N.

Specifically designed to develop clinical expertise. Out-
standing in its deptli of pathophysiologic as well as
psychosociologic factors involved in patient care. In-
cludes entirely new or expanded material on vascular/

1 1 30 Pages • 325 Illustrations «
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
student with a true understanding of the nature of
drug action and a sound rationale for nursing inter-
vention. Covers sources, dosage, physiologic action,

(Includes "NURSES GUIDE TO CANADIAN DRUG LEGISLATION")

cardiac/ respiratory intensive care nursing/ neurologic
and neurosurgical problems/ burns/ genitourinary and
gynecologic disorders/ rehabilitative measures.

2nd Edition, April 1970 • About $14.95

untoward effects, contraindications, and implications

for nursing action. "A textbook of superb quality . . ."

— American Journal of Nursing.

738 Pages

lustrated

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 Morjorie 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 ore relevant con- knowledge are included.

1206 Pages • 406 Illustrations • 2nd Edition, 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 for students

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 in Color, plus Videogrof®

of nursing and allied health fields.
Chapter-end summaries and review questions combine
to stimulate and guide the student.

2nd Edition, 1969

$10.25

SCIENTIFIC FOUNDATIONS OF NURSING

By Modelyn 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

This completely revised and expanded edition of a very
popular text offers increased emphasis on growth and
development at each age period from infancy to ado-
lescence. Recent findings in all areas of core ore re-
flected — growth and development; medical entities;

588 Pages

and Eugenia H. Woechter, R.N., Ph.D.

associated nursing therapies. Special attention is given
to recent trends in minority group problems, adolescent
development, and cultural differences as they relate to
nursing care.

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
essential to the practice of professional nursing in the

phasis is on nursing care and the nurse's significant
position.

583 Pages • 2nd Edition, 1967 • $7.50

Lippincott

PHILADELPHIA • TORONTO

APRIL 1970

THE C/«^ADIAN NURSE 7

Fleet

ends ordeal by

Enema

for you and
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Now in 3 disposable forms:

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27 minutes per patient — and a world of trouble.

WARNING: Not to be used when nausea. In dehydrated or debilitated

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Frequent or prolonged use may result in determined since the solution is hypertonic

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CAUTION: DO NOT ADMINISTER should also be taken to ensure that the

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OF AGE EXCEPT ON THE ADVICE administration. Repeated administration

OF A PHYSICIAN. at short intervals should be avoided.

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8 THE CANADIAN NURSE APRIL 1970

news

CNA Legislation Committee
Recommends Bylaw Changes

Ottawa. — The ad hoc committee on
legislation of the Canadian Nurses' Asso-
ciation met February 26-28 to revise the
bylaws of the Association.

In preparing the draft, members
considered the bylaws recommended by
the CNA ad hoc committee on functions,
relationships and fee structure as well as
comments and recommendations made
by the provincial nurses' associations.

A copy of the revised bylaws wUl soon
be sent to the provincial associations for
study. The bylaws will be put to the vote
at the general meeting of CNA in Freder-
icton, June 14-19.

The committee was chaired by Jeanie
S. Tronningsdal, British Columbia.
Members included Eileen Flanagan,
Quebec; Marie Sewell, Ontario; MarceUe
Dumont, New Brunswick; CNA President,
Sister Mary Felicitas; and George Hynna,
CNA legal counsel.

Few |obs Available,
RNABC Warns Nurses

Vancouver, B.C. - The Registered
Nurses' Association of British Columbia is
advising out-of-province nurses who make
enquiries about registration that employ-
ment opportunities are very limited in
B.C. at present. Most vacancies occur
during the spring or summer months.

Nurses from out-of-the-province are
being urged by RNABC to be assured of a
position in B.C. before leaving their
present employment. Registration in B.C.
is required before a nurse can be employ-
ed in any hospital where the clinical
facilities are used by a school of nursing.

However, at present nurses with post-
basic preparation and experience have a
wide choice of positions in B.C. above the
general staff level both in teaching and in
administration. For this reason RNABC is
advising its members to take further
study to prepare themselves for super-
visory or administrative positions in such
fields as psychiatric nursing, extended
care, and operating room nursing.

McGill Hosts Conference

Montreal, Quebec. - Some 200 nursing
students from 15 Canadian universities
met in Montreal the weekend of February
13-15 for the annual Inter-University
Nursing Conference.

The Conference, hosted by the stu-
dents and faculty for the^ School For
Graduate Nurses, McGill University,
included both basic and postbasic
APRIL 1970

Test Service Board Holds First Meeting

Three members of the Test Service Board take time for coffee. The board met at
CNA House March 4-7 and chose Helen Grice (left), as permanent secretary, Jean
Dalziel (center), chairman, and Anna Christie (right), vice-chairman. Mrs. Grice is a
representative of the Registered Nurses' Association of British Columbia; Mrs.
Dalziel, a representative of the College of Nurses of Ontario; and Miss Christie, a
representative of the New Brunswick Association of Registered Nurses. There are
18 members on the board, which was appointed by the board of directors of the
Canadian Nurses' Association to establish and operate the CNA Testing Service.

baccalaureate nursing students. Universi-
ties represented were: Lakehead,
Windsor, Laurentian, Queen's, Western,
McMaster, Toronto, Ottawa, Montreal,
New Brunswick, Moncton, Dalhousie, St.
Francis Xavier, and Mount Saint Vincent
College. Among those attending were
several faculty members and master's
students.

The first meeting of the Inter-
University Nursing Conference was held
in Toronto in 1968. The original purpose
was to get nursing students in universities
together to compare programs. A similar
idea was behind the 1969 conference held
at McMaster University in Hamilton, On-
tario. This year, the objective was to
exchange ideas and opinions about the
nurse's perception of her role as defined
by her education.

To meet this objective, an inter-
disciplinary panel discussion was held,
followed by small group workshops.
Panel members were Reverend Howard
Christie, chaplain at The Montreal Gener-
al Hospital; Olive Goulet, associate
professor of nursing, Laval University; Dr.

J. Leila, assistant professor, department
of sociology, McGill University; and Dr.
N. Steinmetz, department of epidemiolo-
gy, McGill University. Dorothy Rowles,
assistant to vice-president — academic, at
Ryerson Polytechnical Institute, Toronto,
Ontario, was guest speaker at the banquet
for official delegates on Saturday evening.
At the concluding meeting, delegates
decided to form an Inter-University Nurs-
ing Association. Ground work for this
will be laid during the coming months,
and final plans will probably be made at
next year's conference in Ottawa.

Post-Convention Tour

Of Maritimes Offered Nurses

Fredericton, N.B. - A week-long post-
convention tour of the Maritime prov-
inces is being offered to nurses attending
the 35th biennial convention of the
Canadian Nurses' Association here June
14 to 19.

The tour, running June 20 to 27, will

explore the natural beauty and historic

sites of New Brunswick, Nova Scotia, and

Prince Edward Island. The tour package

THE CANADIAN NURSE 9

news

Federal Government Nurses Meet

will cost about $150, which includes
transportation, accommodation, break-
fast and some other meals.

Among other places, nurses will visit:

• New Brunswick - Saint John, in-
cluding the New Brunswick Museum and
the Reversing Falls, Hopewell Cape,
Fundy National Park, Moncton, the
Magnetic Hill, Fort Beausejour.

• Prince Edward Island - Summer-
side, Charlottetown, and the island's
sandy beaches.

• Nova Scotia - Cape Breton, Ingonish,
the Cabot Trail, Halifax, the south
shore, Annapolis Valley, Digby, and back
to Saint John, N.B., where the tour
ends..

The tour has been arranged for nurses
by the New Brunswick Association of
Registered Nurses. Arrangements may be
made directly through: R.V. Lenihan,
president, Moncton Travel Agency, 735
Main Street, Moncton, N.B.

Many PEI Nursing Students
Must Study In Other Provinces

Charlottetown, P.E.I. — The Association
of Nurses of Prince Edward Island ex-
pects that many prospective nursing stu-
dents from PEI will have to seek entrance
to schools of nursing in other provinces
this year.

The PEI School of Nursing, which
opened in September 1969 and is the
only nursing school in the province, could
accept only 60 nursing students in
September 1969. The same number will

Some 30 federal government nurses from across Canada atteiiUcd a scinui nurses'
conference in Ottawa March 2-6. The conference was conducted as a workshop on
orientation and continuing inservice education, sponsored by the medical services
branch of the Department of National Health and Welfare. Enjoying Wednesday
night's banquet are (left to right) Alice Smith, Adviser, Nursing Services; Catherine
Keith, Adviser, Nursing Education; and Ethel Martens, Adviser, Health Education,
medical services branch, Dept. of National Health and Welfare, Ottawa.

be accepted this year. Last year there
were some 200 qualified applicants for
these 60 positions.

Applicants for the school of nursing
will no longer be required to pass the
Atlantic Provinces Examining Board
examinations as a prerequisite for admis-
sion. This is because the University of
Prince Edward Island has established new
admission criteria in lieu of passing the
examinations, and the school is following
suit.

TV's Marcus Welby, MD, Honored

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
opening session of the 1 7th Annual AORN Congress held in California in February.
Mr. Young welcomed the 6,000 operating room nurses and other health industry
leaders to the Los Angeles area. Other participants in the opening ceremonies
shown here are Betty Thomas of Denver, who was installed as the new president;
and Dr. Denton Cooley, of Houston, Texas, famous heart transplant surgeon.

10 THE CANADIAN NURSE

Hospital Budget Restrictions
Put Damper On Bargaining

Amherst, N.S. - Negotiations between
the board of commissioners of Highland
View Hospital and the registered nurses'
staff association of the hospital broke
down in late February when the board
said it could not offer any wage increase
or additional fringe benefits for 1970.

The board said this was a direct result
of budget restriction placed on the hos-
pital for 1970 by the Nova Scotia Hos-
pital Insurance Commission. Provincial
hospitals' 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 believes this situation will
hamper all collective bargaining by nurses
in 1970. To date 12 nurses' staff associa-
tions have been formed in the province.

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 S684. The base rate for that
level in 1971 will be S590 to a maximum
of S740. The base rate in 1969 was S508
to S633.

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 SI. 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 S6,000
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.

Berenice King took her basic nursing
training at the Christchurch School of
Nursing, New Zealand. A registered

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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-121 1
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-
(Continued on page 14)

Whenyourday

starts at _
6 a.m... you're oji
charge duty... ^
you've skimped
onmea/s...^^
and on sleep...
you fiai/en't had
time to hem
a dress... ^
make an apple pie...
i/i/ash your hair...
even powder ^-
your nose
in comfort.':^

ii's time for a change. Irregular hours and meals on-ihe-
run won't last. Bui your personal Irregularity is another
matter. It may settle down. Or ii may need gentle help
from DOXIDAN.

use

DOXIDAN"

most nurses do

DOXIDAN is an effective laxative lor the gentle relief of
constipation without cramping. Because DOXIDAN con-
tains a dependable fecal softener and a mild peristaltic
stimulant, evacuation is easy and comfortable.
For derailed information consult Vadernecum
or Compendium.

HOECHST

PHARMACEUTICALS

3aOO JEAN TALON W MONTREAL 301
DIVISION OF CANADIAN HOECHST LIMITED

[""'"=1 I....

THE CAPJ^VDIAN NURSE 11

sterimedIc

TM

SYSTEM

r^.. ft

spitals operating budgets will not in-
ease this year over 1969 despite
quests for an overall 10 percent in-
ease.

The Registered Nurses' Association of
ova Scotia believes this situation will
mper all collective bargaining by nurses

1970. To date 12 nurses' staff associa-
lons have been formed in the province.

ew Two-Year

ontract For RNABC

'ancouver, 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 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 S549 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 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 ^V2".

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 pacicaging 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 quicic, 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 Pales 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
direction of a physician. As with all sterile disposable items, the packaging
should always be checked. It 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 icey to convenience, adaptability and safety dur-
ing delivery of medications. Lightweight, durable, only ^3V2" 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:

Sterilon Corporation 1505 Wuhlngton Streot . Bralntrea, Mass. 02184 Storllon of Canada, Ud. 3269 American Drive • Malton, Ontario 'U. S. Patent 3,114,«55

Subsidiaries of The Gillette Company Sterimedic ■•* Is a trademark of Sterilon 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 MNA
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 Thome; 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. Ont. - Judy Sharpe, nurse in-
tern at St. Joseph's School of Nursing in
Peterborough, Ontario, has been chosen
"Miss Hope 1970" in the competition

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BEING MARRIED?

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OTTAWA 4, Canada

TV personality Fred Davis congratulates Judy Sharpe of Peterborough, Ontario, who
was chosen "Miss Hope 1970" by the Ontario Division, Canadian Cancer Society.

14 THE CANADIAN NURSE

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.

Sf. Lawrence College
Teams With Regional
School of Nursing

Brockville, Ont. - 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

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

Vancouver. - 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

The

disposable

diaper
concept

What are its advantages?

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— 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:

MEDICAL TOWELS. "PERIWIPES" TISSUE, CELLULOSE WIPES. BED PAN DRAPES. EXAMINATION SHEETS AND GOWNS.

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-jnfection.
Invaluable in isolation units.

aneen

»*^ Facdie Company Limited. 1350 Jane Street. Toronto 15. Ontario. Subsidiary of Canadian International Paper Company m^ COmTOrl • SaTeiy • COnvenienCO

"Saneen", "Flushabyes", "Pen-Wipes" Reg'd T.Ms. Facelle Company Limited

Come to New Brunswick

the picture province of Canada, for your holiday

J this year and attend the 35th Biennial

Convention of the Canadian Nurses' Association

June 14 to 19 in Fredericton

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 province 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 Beausejour;
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 1 80 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 accommodation everywhere, and you
can savor the famous Atlantic cuisine, including lobsters,
salmon, oysters, f iddleheads, and dulse!

APRIL 1970

news

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 Heahh Organization
has requested that those attending its
meetings refrain from smoking. The
board welcomed similar action taken on
cigarette smoking by WHO's regional
committees for the Americas and Europe.

(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 RN ABC.

CMHA Council Discusses
Mental Health Problems

Toronto. Ont. - 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.

Gebhardt's text, students learn basic microbiology labora
tory principles and procedures, and explore soil and sanitarjC.
microbiology, microbial genetics, and pathogenic micrcW
organisms. The 26 relatively simple experiments includglSTOSCOPE
sub-units which may be assigned for added depth. Thef'''°i*'MrND"' ""
realistic design makes use of naturally occurring micro-'^ic^l Perfection

The board's resolution recognizes
"that the individual must decide for
himself whether he will risk endangering
his health by smoking 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.

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APRIL 1970

THE CAflADIAN NURSE 17

New 5th Edition! NEUROLOGICAL AND NEURO-
SURGICAL NURSING By Esta Carini, R.N., Ph.D.; and
Guy Owens, M.D. 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 his 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 broad
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 Carroll 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 Ulustra-
tions and an enlarged bibliography ^"i

expand this text's teaching value.
February, 1970. 500 pages, 377 illus-
trations. $10.45. '» \

New 5 th 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-
hneate 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 tneoiaesi muiv-u... „,
Canada, at Saint John; the French-built Fort Beausejour-
and the Auld Kirk at St. Andrews.

Not to be missed is Fundy National Park, 80 square miles of
-pectacular 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 1 80 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 accommodation everywhere, and you
can savor the famous Atlantic cuisine, including lobsters,
salmon, oysters, fiddleheads, and dulsel

APRIL 1970

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. 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.

New 6th Edition! SCIENTIFIC PRINCIPLES EN 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.

easier to teach,
easier to learn!

New 4th Edition! MICROBIOLOGY By Louis P. Gebhardt,
M.D., 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 highlight 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. 1 12 pages, 5 illustrations. About $5.25.

New 2nd Edition! BASIC CONCEPTS IN ANATOMY AND
PHYSIOLOGY - A Programmed Presentation By Catherine
Parker Anthony, R.N, M.A., 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! INTEGRATED
BASIC SCIENCE By Stewart M.
Brooks, M.S. This compact fusion of
basic physics, chemistry, micro-
biology, anatomy and physiology can
help you eliminate 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.

APRIL 1970

MOSBY

TIMES MIRROR

THE C.V. MOSBY COMPANY. LTD. • 86 NORTHLINE ROAD • TORONTO 374. ONTARIO. CANADA

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 wUl 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, felt 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

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.

ICN 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 ICN 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; Renee 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 Overseas. The CESO
undertaking began in 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 Alta Vista
Drive, Ottawa 8, Ontario. D

APRIL 1970

WHITE
UNIFORM

hy saVagG

Fatigue Boots*

C ^ (A havitijiil way to win the battle ot toot tatiguc.)

p- Maybe you feel like this after your tour

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; above and beyond the call . . .
/ / Then it's time to call in White Uni-
. y^ form Oxfords. Here's a heaiitijtil way to

win the battle of foot fatigue. They're

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give your feet comfort.

Day in. Day out. No

matter what your orders.
So if you're looking

for a pair of Oxfords

that will stand up

for you, buy

White Uniform

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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 ChUdren,
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 clinical 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.

fKr^

Joyti 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 Mukerjee 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; Dipl. 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. Cower

(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.

E. Margaret Nugent

Alma McKone

E. Margaret Nugent (B.A., Dipl.
Education, U. of Manitoba; R.N., The
Winnipeg General H.; M.A., Teachers
College, Columbia U., N.Y.) has been
named director of nursing service at The
Winnipeg General.

A native of Winnipeg, Miss Nugent has
worked as a staff nurse, clinical instructor
in surgical nursing, and clinical coordina-
tor at The Winnipeg General Hospital;
evening charge nurse, instructor, and
surgical nursing supervisor at Cornell
University - New York Hospital; and

APRIL 1970

administrator at Shriners Hospital for
Crippled Children in Winnipeg. Before her
new appointment. Miss Nugent was
administrative assistant in intensive care
nursing at The Winnipeg General Hospi-
tal.

Miss Nugent is president-elect of the
Manitoba Association of Registered
Nurses. She served as first vice-president
of MARN, as a board member, as chair-
man of MARN's board of examiners, and
as a member of its education committee.

Alma McKone (R.N., Saskatoon City
H.; B.Sc.N., U. of Western Ontario) has
been named director of inservice educa-
tion at The Winnipeg General Hospital.

Mrs. McKone has held positions in
Nipawin, Prince Albert, and Saskatoon.
Saskatchewan. She is currently the
representative of the Manitoba Associa-
tion of Registered Nurses on the Licensed
Practical Nurse Advisory Council, and is
chairman of the committee of inservice
education directors in Manitoba.

Patricia M. Wads-
worth (R.N., Van-
couver General H.;
B.Sc.N., U. of Brit-
ish Columbia) has
assumed the position
of staff training
coordinator at The
Vancouver General
Hospital.

Mrs. Wadsworth has held a number of
positions at The Vancouver General Hos-
pital. After working as a staff nurse and
head nurse, she was appointed assistant
building supervisor and then supervisor of
the outpatient department.

An active member of the Registered
Nurses' Association of British Columbia,
Mrs. Wadsworth has served as president of
the Greater Vancouver District. She was
the first chairman of the RN.4BC com-
mittee on economic and social welfare in
1965, and has served on a number of
other committees.

Mrs. Wadsworth is completing work
for a master's degree in adult education at
the University of British Columbia.

Gertrude Robertson

( S.R.N. , Royal Infir-
mary, Dundee, Scot-
land; Dipl. Teach-
ing & Superv., B.N.,
McGill U.) has been
appointed associate
director of nursing
service at the Royal
Columbian Hospital
in New Westminster. British Columbia.
Miss Robertson has been a staff member
at the hospital since January 1969.

Before coming to Canada in 1955,
Miss Robertson served with the British
Army Nursing Service for three years. She
has worked as a staff nurse, head nurse,

APRIL 1970

and supervisor in Britain, the United
States, and Canada. From 1960 until she
joined the staff at the Royal Columbian
Hospital, she was maternity supervisor at
the Jewish General Hospital in Montreal.

|H^^IIHBB| Jeanne S. Martin

m^^^^KM (R.N.,

B^^^^^BKJ Alberta, Edmonton)
■HjV ,r^fll has joined the teach-
^^^p -S^H ''^S stsff of the nurs-
^^BFW '"^^H ing education de-
^^r iM^^H partment at Mount
^^^ ^^^V Royal Junior College
^^^^ ^^Bi ''^ Calgary, Alberta,
™B^^ - ^Bl as instructor in med-
ical-surgical nursing.

Mrs. Martin has held a variety of
positions in Alberta and Ontario. She was
a clinical instructor at Holy Cross Hospi-
tal in Calgary: a general public health
nurse with the City of Toronto Health
Department and the Victorian Order of
Nurses in Ottawa; and classroom instruc-
tor at the Ottawa Civic Hospital.

A number of appointments have been
made to the faculty of nursing at The
University of Western Ontario.

Jessie Mantle (R.N., Royal Jubilee H.,
Victoria. B.C.; B.N., McGill U.; M.Sc, U.
of Cahfornia, San Francisco Medical
Center) is assistant professor at The Uni-
versity of Western Ontario.

Miss Mantle has worked as a head
nurse and instructor in anatomy and
physiology at St. Paul's Hospital school
of nursing in Vancouver. She was a
Canadian Nurses' Foundation Fellow in
1968-69.

Mary Buzzell (R.N.. The Montreal
General H.; B.N., McGill U.; M.S., Boston
U.) is assistant professor at The Universi-
ty of Western Ontario.

Miss Buzzell taught at The Montreal
General Hospital, at St. Paul's Hospital in
Vancouver, and at the University of
British Columbia, and was assistant direc-
tor of nursing in charge of inservice
education at The Montreal General Hospi-
tal.

Jocelyn A. Hezekiah (S.R.N. , Royal-
Sussex County H., England; S.C.M., Ox-
ford. England; B.N., McGill U.; M.Ed.,
Ontario Institute for Studies in Educa-
tion) is also a new assistant professor at
The University of Western Ontario.

Originally from Trinidad, West Indies,
Miss Hezekiah has worked at The Mon-
treal General Hospital in a variety of
positions in nursing service and nursing
education, most recently as clinical
coordinator in the school of nursing.

Sheila Kelton (B.Sc.N., The University
of Western Ontario) and Sandra Fisher
(B.Sc.N., Syracuse U.) are new instructors
in the faculty of nursing at The Universi-
ty of Western Ontario. Mrs. Fisher was
formerly a staff nurse in pediatrics at St.
Joseph's Hospital in London, Ontario. D

♦ IMPOBIWT PIMM KM Zk Otr tyiti h»rt(Jlifi( cMrg* on ill orders of

3 pins or ini CROUP DISCOUNTS 2S 99 pini. S\ 100 or more. 10\

Send cash, m.o.. or check. No billings or COD'*.

Sel-Fix NURSE CAP BAND

Black velvet band material. Setf-ad-
hesive presses on. pulls oft^ no sewing
or pinning Reusable several times
Each band 20' lonj, pre<ut to pop-
ular widths- V4" 112 per plastic box).
V4- (8 per boil, *4' (6 per boi). K
(6 per boi). Specify width desired in
ITEM column on coupon

No. 6343

Cap Band ... 1 box 1.G5
3 or more 1.40 •«.

NURSES CAP-TACS

Remove and refasten cap band instantly
tor laundering and replacement! Tiny
molded plastic tac. damty caduceus
Choose Slack. Blue. White or Crystal
witti Gold Caduceus. or all black (plain).
No. 200 Set of 6 Tacs . . 1 .00 per set
SPECIAL ! 12 or more sets ... .80 per set

Nurses ENAMELED PINS

Beautifully sculptured status insignia: 2-color keyed,
ttard-fired enamel on gold plate Dime-stied: pin-back
Specify RN. LPN. PN. LVN. KA. or RPti on coupOft.
No. 205 Enamtttd Pin 1.65 ea. ppd.

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Swiss made, raised silver full numerals, lumin mark-
ings Red-tipped sweep second hand, chrome stamless
case Stainless eipansion band plus FREE black leather
strap 1 yr guarantee
No. 06-925 16^ ea. ppd.

Uniform POCKET PALS

Protects against stams and wear Pliable white
plaslic with gold stamped caduceus. Two com-
partments tor pens, shears, etc Ideal token gifts
or favors

No. 210-E ] 6 for 1.75, 10 for 2.70
Savers J 25 or more .25 o«.. all ppd.

BANDAGE
SHEARS

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Personalized

6' professional precision shears, forged '^'

in steel Guaranteed to stay sharp 2 years ^^

No. 1000 Sfiears (no initials) 2.75 ta. ppd.^

SPECIAL! 1 Ooz. Shurs $26. total

Initials (up to 3) etched add 50c par pair

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Protects you against violent man or dog . .
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No. AP-I6 Sentry 2.25 ea. ppd.

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Send to

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PleiM illow tuflicient lime for tJeliverr.

THE CANADIAN NURSE 23

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, Ont.

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-)une 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, Ont.

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.

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 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, Ont.

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.

lune 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. D

APRIL 1970

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 SVa" x 11" 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.

TAMPAX

tampan^
SANITARY PROTECTION WORN INTERNALLY

MADE ONLY BY CANADIAN TAMPAX CORPORATION LTD.. BARRIE. ONT.

FREE CHARTS IN COLOR

Canadian Tampax Corporation Ltd., P.O. Box 627, Barrie, Ont.

Please send free a set of the Dickinson charts, copies of the
two booklets, a postcard for easy reordering and samples ot
Tampax tampons.

Name_

Address_

THE CANADIAN NURSE 25

new products {

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

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- 1000, 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 central 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.

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- 1000 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 administration units. Ad-
vantages of the system are a rigid, wide-
mouthed spout for filling; screw-on, ad-
ministration sets that are attached after
filling; large bore tubing with retention
balloons, air contrast, and a wide range of
insertion tips; one-piece, dielectrically
sealed bag with built-in sediment trap and
a large 3,000 cc. capacity; and finger
loops at both ends of the bag for easier
mixing, carrying, and hanging.

26 THE CANADIAN NURSE

Barium enema units, pre-charged with
Barimex, Baraloid, or Baracoat, or empty,
are individually packaged with the widest
choice of media and administration sets
available. Any of the 18 variations may
be ordered by catalog number.

This Macbick product is distributed in
Canada through the Stevens Companies in
Toronto, Calgary, Winnipeg, and Vancou-
ver. In Montreal, Compagnie Medicale &
Scientifique Ltee, and Quebec Surgical
Company are the distributors.

the robe in place. The strap across the
knees prevents any forward sliding move-
ment and holds the feet in position on
the footrest. The shoulder Y-strap pre-
vents the patient from slumping forward.
The item may be easily laundered. The
robe comes in one size and is adjustable
to all patients.

The Posey safety lap robe with
shoulder strap. Cat. No. 5163-4532, is
available from Enns & Gilmore Limited,
1033 Rangeview Road, Port Credit, On-
tario.

Automatic Dialysis

A dialysis apparatus, which cleans the
blood directly inside the abdominal
cavity, has been developed by LKB
Medical, Stockholm, Sweden. The treat-
ment is claimed to be safer and less
expensive than previously applied dialytic
equipment.

Conventional artificial kidneys feature
a permeable membrane through which
the blood is kept in contact with the
dialysis fluid. The new apparatus, PD
700, utilizes the permeability of the
abdominal membrane itself. The dialysis
fluid - a glucose solution - can work
inside the abdominal cavity for 10 to 60
minutes. The liquid is then changed and
the cycle repeated for some 10 hours
until the treatment is complete.

The entire process is automatic. The
apparatus measures temperature, volume
of dialysis fluid pumped in and out, as
well as computing the difference between
durations of treatment. If the pre-set
values are not followed, the treatment is
automatically interrupted.

The PD 700 is especially suitable for
acute dialysis and for treatment of pa-
tients at home, LKB Medical says. D

APRIL 1970

Coming Up This Spring

Freeman: COMMUNITY HEALTH NURSING PRACTICE

By Ruth B. Freeman, R.N., Ed.D., The Johns Hopkins University School
of Hygiene and Public Health.

Designed for advanced nursing students and for
teachers of LPN's and health aides, this new text
introduces modern concepts of community health
nursing as a dynamic and societolly-oriented discipline.
Dr. Freeman bases her presentation on two funda-
mental concepts: the family as the unit of service and
"community diagnosis" (assessment of community
health needs) as the keystone of public health practice.
She devotes special attention to problems of current
importance, such as poverty, family planning, and
mental health. Recent research is incorporated
throughout the book, and extensive lists of up-to-date
recommended readings ore provided.

About 500 pages. About $9.75. Ready May, 1970.

Thompson: PEDIATRICS FOR PRACTICAL NURSES

Second Edition

By Eleanor Dumont Thompson, R.N., formerly of Mary Hitchcock
Memorial Hospital and Hanover (N.H.) School of Practical Nursing.

A new edition of this established text is now in press.
In clear, easily understood language it tells the
practical nursing student what she needs to know to
core for children. The arrangement follows a develop-
mental sequence; for each of seven age groups there
is a chapter on normal growth and development
followed by a chapter on disorders characteristic of
the period. Learning thus proceeds from the known
to the unknown. Among the topics to which AArs.
Thompson has given special attention in this new
edition ore emotional growth and development, the
value of play, drug abuse, and newer programs for
child care on the local, national, and international
levels. A glossary has been added and an Instructor's
Manual will be available.

About 380 pages, illustrated. Soft cover. About $5.25. Just ready.

Falconer, Norman, Patterson & Gustafson:
THE DRUG, THE NURSE, THE PATIENT

4th Edition

By Mary W. Falconer, R.N., M.A., formerly of O'Connor Hospital
School of Nursing; Mobelclaire R. Norman, R.N., M.S., University of
Guam; H. Robert Patterson, Phorm.D., San Jose State College; and
Edward A. Gustafson, Phorm.D., Valley Medical Center.

This well-known pharmacology text for student nurses
has been thoroughly revised and updated for this
new edition. New drugs have been included and
information added on the chemical and physical
characteristics of the drugs and their action and fate
in the body. The text includes the entire Current Drug
Handbook described below.

About 750 pages, illustrated. About $10.50. Ready May, 1970.

Falconer, Patterson & Gustafson:
CURRENT DRUG HANDBOOK 1970-72

By Mary W. Falconer, H. Robert Patterson, and Edward A. Gustafson.

Revised every two years, this convenient handbook
lists 1500 drugs in current use, giving names, source,
preparations, dosage, uses, contraindications, etc. in
convenient tabular form.

About 224 pages. About $5.00. Just r«ady.

Jodais: PERSONAL CARE OF PATIENTS

By Janet Jodais, R.N., M.S., Colorado Associated Nursing Homes.

This new text for nurse's aides describes techniques of
personal care, including simple treatments. Such
important concepts as observation, interpersonal
relationships, communication, safety, and rehabilita-
tion ore stressed.

About 350 pages with about 275 illustrations. About $5.50. Just
ready.

W. B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7

APRIL 1970

Please send on approvol and bill me:

Author: Book title:

Nome:

Address:
City:

Zone:

Province;

CN 4-70
THE CAWADIAN NURSE 27

in a capsule

Now here's Max . . .

The Canadian Nurse on radio? It doesn't
happen every day, so we have to tell
those who missed the early-morning Max
Ferguson show on CBO radio February
1 1 just what they missed!

Every morning around 8:25, Max
takes a light look at one story in the
news. On that particular day, the news
was Pamela Poole's article, "Nurse, Please
Show Me That You Care," featured in
our February issue and carried in To-
ronto's Globe and Mail. And Max even
mentioned the journal twice in his intro-
duction.

Miss Poole, Max explained, was
advocating Christian charity in nurses so
that they don't wake up patients at odd
hours for their own convenience.

In his skit. Max portrayed two
characters - an old lady who was hospi-
tahzed, and her nurse. The nurse came to
wake up the patient, who said she wasn't
sleeping; she had phoned down to ac-
counting to find out her bill and had
received such a shock, she had been out
cold for the last two hours.

The patient was being allowed to go
home and had to get ready to leave. She
thanked her nurse profusely for not
waking her up at 2:00 a.m. for a bath, at
4:00 a.m. for a thermometer, etc. Each
time the nurse replied, "Well, it's just an
instance of our new attitude of Christian
charity to our patients. We're not in-

conveniencing them for our own sakes."
Finally, the old lady asked for a
wheelchair to take her to the front door
of the hospital. "Oh, but we don't have
wheelchairs anymore," the nurse replied.
"They're no longer necessary. Remem-
ber — Christian charity! "

"Well, but . . . how do I manage to get
to the front door then? "

"How? How do you think? Take up
your bed and walk! "

Depression follows colostomy

Depression is the initial reaction of most
patients after colectomy and permanent
colostomy because of carcinoma. And
this response seems worse in those who
claim they were not prepared adequately
for the operation.

The first year or so after surgery is the
crucial period for determining eventual
adaptation. The surgeon or nurses should
help patients gain a certain degree of
mastery over the colostomy before they
leave hospital. This is an essential factor in
the eventual adjustment of most patients.

The attitude of the family — especially
the spouse - often determines the pa-
tient's self-concept when he returns
home. It may be useful to include key
family members in initial plans for the
patient's recovery. The patient should be
made aware of colostomy mutual aid
clubs.

These facts were included in an ab-

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MAKE SURE you CSETTO FREDERl^TON /NiTiME RyR
CNA'5 35iy- BlElOtOlAL CONVENTION IN JUNE .'

28 THE CANADIAN NURSE

stract in the November 1969 issue of
Modem Medicine of Canada. The original
article, "Psychologic response to colecto-
my," by Richard G. Druss, John F.
O'Connor, and Lenore O. Stem, Colum-
bia University and Presbyterian Hospital,
New York City, appeared in a recent issue
of the Archives of General Psychiatry.

The authors reported the emotional
adjustments of 22 men and 14 women to
colostomies following surgery for carcino-
ma. A questionnaire and other follow-up
data were used in evaluating adjustments.
Most patients were in good physical
health a year after surgery; it was mainly
psychological factors that kept some
incapacitated.

The first sight of the colostomy was
always upsetting. It was impossible to
predict eventual adjustment from overt
hospital behavior, however. Some pa-
tients revealed their true feelings only at a
later date. Others, often younger patients,
who were most distressed immediately
after surgery, had adapted well a year
later.

Many patients said that confidence in
their doctor or nurse, as well as their
training in mastering their colostomy, was
decisive in helping them through the
postoperative period. A number of pa-
tients said they were glad to be alive and
that the colostomy was a small price to
pay for a longer life.

There was a definite deterioration of
social relationships in nearly three-fourths
of the group, the most common reason
being fear of producing an odor.

J. M. M. is not dead

A correction in a recent issue of The
Journal of The American Medical Asso-
ciation brought back a few memo-
ries — memories we could do without.
The JAMA correction read: "John
Montague Murphy is not dead."

It seems that the editorial gremlins,
which plague all magazines and news-
papers, had been at it again. They had
mixed up the names of the living and the
deceased. And presumably John Monta-
gue Murphy was a little perturbed to find
himself listed with the latter.

These rascals played a similar trick on
us a few years ago. A nurse who was
included in what was then known as the
"In Memoriam" column, turned out to be
very much alive and very angry. The
experience was as shattering for us as it
was for her; it was one of the reasons why
we decided to discontinue the "In Memo-
riam" column. n

APRIL 1970

PKOKKSSIONAl. UNIKOKMS

For a copy of our latest catalogue and
for tfie store nearest you, write :

La Cross Uniform Corp.

4530 Clark St.,

Montreal, Quebec

Tel: 845-5273

APRIL 1970

THE CYIADIAN NURSE 29

ahead

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a greaseless film to cushion .-,
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helping to prevent sheet
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Just think of the
welcome comfort a
Dermassage rub can be
to a patient's tender,
sheet-scratched skin.
And when you give
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have to worry about
rough, scratchy hands.
So go ahead... soften
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OPINION

A split in the family

This "beds-eye-view" of nursing by a non-nurse may not heal any breaches
among nursing groups, bul the author asks: Why does one branch of nursing treat
patients as intelligent, independent, whole persons, while the other treats
the same patients as mindless, dependent bodies?

Shelagh Rose

I had plans for the last trimester of my
pregnancy. Having left my job as a social
worker two months before the expected
arrival of my baby. 1 had little time to
make preparations. Tasks like reading for
my university course, painting nursery
furniture, and going to prenatal classes I
had purposely saved for this period.

It was therefore a shock to discover,
on a routine visit to my doctor in my
seventh month, that I had to go to hospi-
tal for the remainder of my pregnancy.

A good place to learn

Perhaps things would have worked out
differently if I had been feeling really
sick, but at first I was not. Once the rou-
tine of medication, laboratory tests, diet,
and bed rest had been established, I want-
ed to go on with my postponed tasks
within the limits of the maternity ward.

I reasoned this was an ideal place to
continue the prenatal instruction that I
had begun at the local public health
center.

Nothing could have surprised me more
than the reluctance of hospital nurses to
answer my questions. I was not asking for
information about my own condition: my
doctor, on his daily rounds, was always

The author has degrees in arts and social work
and is presently working toward her master's
degree in adult education at the University of
British Columbia, Vancouver, B.C.

APRIL 1970

willing to discuss this. My questions to
nurses were more general:

"What caused the childbed fever that
people used to die from? '"

"If the doctor delivers the baby, what
does the nurse do in the case room? "

I quickly learned that my questions
about labor and caserooms were regarded
with suspicion. I was put off with various
suggestions that it was better not to
know, or that 1 wouldn't be myself when
my turn came, or that it didn't help to
worry about these things.

However, I kept trying. This baby was
one of the most important things to have
happened in my life, and, naturally, I was
interested.

After about two weeks, I managed to
convince one young nurse that I should
have a tour of the case room, arguing that
I had missed going with my prenatal class.
She gave me the "grand tour" and I had a
chance to ask all sorts of questions:

"Why is the box for the baby elevated
at one end? "

"At what stage of labor does one move
from the labor room to the case room? "

"How much would 1 be able to see in
the overhead mirror? "

"Would I be allowed to see the placen-
ta? "

There was only one thing in the case

room that worried me, and because I saw

it I had a chance to discuss my fear with

my doctor and have his reassurance. The

THE C/V^ADIAN NURSE 31

nurse who had taken me on the tour,
however, confessed she was sorry she had.

Ignorance is not bliss

Finally, the attitude of the nursing
staff so annoyed me that, bursting with
frustration, I tackled my doctor on the
subject of hospital nurses. Why were they
so different from the public health nurses
who had been willing to answer my ques-
tions? I asked. Why did hospital nurses
greet my questions with indifference, sus-
picion, anxiety, or even hostility?

What was the matter with these
nurses? I stormed. They seemed to be-
lieve that ignorance is bliss - and surely
that idea went out with the nineteenth
century!

My doctor calmed me and I shall never
know if he discussed this with the nurses.
I only know that my relationships with
the nurses began to improve. Perhaps
they just grew accustomed to me, like the
pert redhead who asked, "Once you get
an answer you don't worry any more, do
you? "

There were also nurses who responded
to my private campaign of brainwashing,
which consisted largely of letting them
know how much easier it is to cooperate
in treatment if you know what to expect.

Only hospital nurses

During my convalescence, I continued
to be disturbed by my inability to re-
concile the attitude of hospital nurses
with that of nurses I had known in col-
lege classes and as colleagues in schools
and social agencies.

Why was it that public health nurses
tried to help the "whole person," but
hospital nurses did not? Public health
nurses encourage patients to participate
in their treatment and try to teach them
to accept responsibility for continuing
good health. In general, public health
nurses make demands appropriate to in-
telligent, independent adults.

32 THE CANADIAN NURSE

Hospital nurses seem content to deal
with patients as physical beings and to
encourage dependency, sometimes be-
yond the needs of the medical situation.

Do nurses not receive the same
emphasis in their professional training as I
did in social work ~ that people must be
viewed as physical, social, and emotional
beings? This doctrine must by now have
been adopted by all the service profes-
sions.

Yet, when I asked one nurse how she
would feel if a teacher treated her child-
ren as little bundles of intellect, without
regard for their physical comfort or
personality needs, she seemed not to
understand me.

Another example

I was not the only one. A lovely Spa-
nish girl on the ward was about to have
her second child, this time by Caesarean
section because of an Rh complication.
She had many fears about what she
would be facing.

Although I was a stranger, she express-
ed her doubts to me when she discovered
that I was recovering from a similar
operation.

Despite her problem with English,
there was no mistaking that three things
worried her: that this was not a "natural"
way to have a baby; that operations are
dangerous; and that she would have great
pain.

Not being a nurse, I could only reas-
sure her that for some, nature's way is
not the best way, and people like us
should be glad doctors have alternatives. I
agreed that there is a risk with surgery,
but added that a doctor weighs this
against the other risks when making a
decision. Finally, I admitted there was
pain, but assured her that the nurses
would do all possible to make her com-
fortable, and that she would not be able
to recall the feeling of pain once it was
gone.

Although she squeezed my hand and
repeated her thanks, I am quite certain
that it would have meant more to
her to have had this reassurance from
people who understood her medical
condition and were actively involved in
her care.

Epilogue

It is entirely possible my expectations
of hospital nurses are quite unreasonable,
and that I experienced conflict because I
was expecting something that is not in
keeping with the nurses' role as they
define it.

If, on the other hand, the present
trend toward automation in nursing care
necessitates a redefinition of the nurses'
role, then a worthy objective may yet be
found in caring for the "whole patient."

A preview of this paper was sent to the
administrative staff of the hospital and
they accepted the inherent challenge. A
high standard of patient care makes it
possible for this hospital to explore the
teaching function of the nurse without
detriment to other tasks, and it may be
that the results of their program will
provide a sequel to this story. D

APRIL 1970

Welcome to

the picture province

New Brunswick, with its picturesque countryside and 600 miles of sea shore,
Its quiet villages and bustling cities, will be the extra attraction for nurses who
attend the 35th general meeting of the Canadian Nurses' Association in |une.

A scenic wonderland surrounded on
three sides by the sea. New Brunswick
deserves its description as the picture
province of Canada. It is a giant rectangle,
some 28.000 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

Valerie Fournier, B.A., B.J.

beaches, safe for children and a delight to
adults. At night the moonlit beaches
become ideal settings for the famous
lobsterbakes.

But the province also has more inland
waters for its size than any other area on
the continent, which is one reason why it
is host to thousands of sportsmen every
year. In rivers such as the Restigouche
and the Miramichi you can do battle with
the Atlantic silver salmon, the "king of
the game fish." Or you can enjoy the
beauty of rivers like the St. Croix, the
"sentinel river," which makes part of the
border with the United States, or the
Saint John, known as the "Rhine of
America" - though most New Bruns-
wickers call it "The River."

These inland waterways invite you to
go sailing, power-boating or canoeing
while you enjoy the rolling farmlands and
pleasant landscapes. But the real sailing
enthusiast will prefer to brave the ocean:
sailing about the Fundy Isles is an un-
forgettable experience, and throughout
the summer Shediac Bay on the east coast
is bright with sails.

For those who prefer to travel on firm
land with tent or trailer. New Brunswick
offers some 60 parks, including five beach
parks and two wildlife parks, all conven-

Mrs. Fournier, a graduate of Carleton Universi-
ty's School of Journalism, is Public Relations
Officer at the Canadian Nurses' Association,
Ottawa.

iently situated along the province's main
highways. Facilities range from basic,
near-wilderness sites to fully-serviced
campgrounds, and many parks are located
near one of the beauty spots of the
picture province.

Past and present

The flavor of its colorful history exerts
a strong influence on life in New Bruns-
wick, which abounds in historic buildings
and monuments. Since 1534, when
French explorer Jacques Cartier recorded
his delight in the area, New Brunswick
has played its part in the history of North
America. Local museums dot the coun-
tryside, inviting you to look at the past.
Pioneer days come to life in Canada's first
public museum, the New Brunswick
Museum at Saint John. Here, the story of
the province is told through visual presen-
tations that evoke the Indian, French,
and English periods of the past. One
section of this museum is devoted to
antiques and toys of yester-year.

Other historic sites include: Fort
Beausejour, built in 1751 by the French
as a protection against the British when
New Brunswick was a pawn in the power
struggle between the two nations; the
Auld Kirk at St. Andrews, built in 1822
by the early Loyalists, where congrega-
tions still worship; or Dochet Island,
where Samuel Champlain and the Sieur
de Monts wintered with their men in
1604-5.

THE CANADIAN NURSE 33

Many towns and cities across the
province have a fascinating past. St.
Andrews is known far and wide as a
summer resort, and many distinguished
Americans and Canadians have built
beautiful homes here. It was founded in
1784 and is one of the oldest towns in
New Brunswick; it is also noted as a
commercial fishing center. From St.
Andrews you can drive on the sandy floor
of the ocean across to Minister's Is-
land — at low tide, that is. At high tide
the road is under 10 feet of water.

Saint John, largest city in New
Brunswick, is the oldest incorporated city
in Canada. The Saint John River mouth
was discovered by Champlain in 1604,
and the area was controlled by the
French until 1758, when it was captured
by a British expedition. In 1785 the
Loyalist settlements at Saint John were
made into a city by royal charter. You
can visit the Martello Tower, an unusual
form of fortification constructed in 1812,
Loyalist House, unchanged since 1817,
and many other historic sites. In contrast.
Saint John is one of Canada's principal
ports, with dry dock and shipyards built
to handle the largest ocean-going vessels.
It is also a busy industrial city.

North, south, east and west

Other towns in New Brunswick offer
everything from a waterfall to wildlife
sculptures to a lobster festival. First stop
on the Trans Canada Highway after the
Quebec border is Edmunston, where you

see part of the province's great pulp and
paper industry at work. The channel of
the Saint John River and other tributary
streams sometimes look like solid rivers
of pulp logs.

Forty miles down the highway is
Grand Falls, named after its waterfall,
which drops directly 75 feet. Twelve
miles from Fredericton* is Oromocto,
which has developed from a village of 675
inhabitants in 1956 to an up-to-date town
of more than 14,000. This extraordinary
growth was brought about by the estab-
lishment of Canadian Forces Base Gage-
town, the largest military training area in
Canada.

A couple of miles from Sussex, known
as the dairy center of the Maritimes, is
"Animaland", an unusual exhibition of
sculpture. Here Winston Bronnum, one of
the best-known sculptors of wildlife, has
set up a hundred of his carved animals in
natural woodland settings; the visitor
walks along paths among the trees and
discovers animals from moose to bobcat.

Moncton is known as the hub of the
Maritime provinces because of its geogra-
phical location; it has become the travel
and distribution center of the tfiree
provinces. The Miramichi district is a
history-steeped area, and the history of
the two main communities, Chatham and
Newcastle, is bound up with the days of
long lumber and wooden sailing ships.
Today the economy of these cities is still
largely dependent on extensive lumbering
and allied operations. The late Lord

Beaverbrook, famous British press lord,
spent his boyhood days at the Presbyteri-
an manse in Newcastle.

Situated on the Northumberland Strait
section of New Brunswick, Shediac is
known chiefly for its splendid views and
bathing beaches, which have made it one
of the most popular summer resorts on
the Atlantic coast - particularly since
the water temperature there is unusually
high. One of the highlights of any New
Brunswick vacation should be the annual
Shediac lobster festival, with its parades,
carnival, and games.

North shore

New Brunswick's main highway of
commerce and recreation - Highway
1 1 - hugs the north shore and gradually
sweeps along the east coast, offering the
visitor the picturesque charm of a section
inhabited mainly by Acadian-French.

The first city, Campbellton, an ocean
port and rail center, is landmarked by a
bald, 999-foot mass known as Sugar Loaf
Mountain, one of the province's tallest
peaks. Fifteen miles down the coast is
Dalhousie, home of a large newsprint mill
and a popular summer resort, with a
sandy beach noted for its strange fossils
and myriad colorful stones.

Skirting the 55 miles of Bai des Cha-
leurs (which means bay of warm waters)
from Dalhousie to Bathurst, another
prominent lumbering and paper port, is a
succession of summer resorts. Sandy
beaches are found all along this stretch.

Would you believe a hill where car
34 THE CANADIAN NURSE

J tUu^i

uphill withuui fji.

J rial 's wiiui nappens ai i\ew tsninswick s jamous Magnetic Hill!

APRIL 1970

The bustling docks at Saint John contrast
with a lamppost that evokes the historic
past of New Brunswick's largest city.

and the tourist armed with a shovel can
dig clams for added fun - and a deli-
cious meal.

From Bathurst, the shore route leads
to Caraquet, a picturesque Acadian fish-
ing community said to be the longest
village in the world. This colorful spot is
the home port for the largest fishing fleet
in the province and is also a busy port of
call for steamers and tankers. A new
marine museum is open to visitors. Far-
ther on is Shippegan, which rivals Cara-
quet in popularity, and Shippegan Island,
famous for its peat moss industry.

One of the most colorful events along
the north shore is the blessing of the
fleet, an annual ritual that takes place on
a Sunday in July at one of the main
fishing villages. Fishing draggers repre-
senting the various districts form a
procession and travel up the bay vying
with one another in the gaiety of their
decorations.

This area of the province is believed to
APRIL 1970

have been a pirate sanctuary. According
to local gossip one family lived it up for
quite a while after discovering gold coins
in an iron pot at Caron Point.

Fundy park and isles

A must for any visitor to New Bruns-
wick is Fundy National Park - 80
square miles of spectacular vacationland
sweeping in a wide panorama from the
coast. Along the park's eight-mile shore-
front are sheltered coves with sandy
beaches and towering cliffs buffeted by
the strong Fundy tides. Facilities include
an outdoor, warmed, salt-water swimming
pool, and a nine-hole golf course with its
first tee some 200 feet above the green.

There are deep forests, quiet lakes, and
tumbling streams for the angler. Wildlife
is plentiful and is protected. You can hike
or ride horseback along the many trails,
paint or take photographs of the magnifi-
cent scenery. Every kind of accommoda-
tion is available, and there are many camp
and picnic sites. The New Brunswick
School of Arts and Crafts operates in the
park during most of July and August each
year, offering visitors an opportunity to
learn simple craft xt-ork through courses
ranging from a single day to six weeks.

Leave the mainland behind for a visit
to the Fundy Isles — Grand Manan.
Campobello, and Deer. They form a
maritime world of their own, but you can
reach each island by ferry.

Largest island is Grand Manan, center
of the commercial fishing activity of the
islands and of the unique dulse-gathering
operation as well. Dulse is a seaweed that
grows on tidal rocks and is picked at low
water to be brought ashore and dried on
the beach. Dulse is a health food, and you
either love it or hate it! The towering
cliffs of the island's western edge contrast
with the gentle slope of its eastern
beaches.

Campobello, long-time summer home
of the Roosevelt family, is the site of the
first memorial erected to the late U.S.
President, and the property has now been
dedicated as a joint Canada-U.S. park.
Deer island is also a center of commercial
fishing, and the island's lobster pounds
- the largest in the world - ensure a
year-round supply to gourmets around
the world.

Unique natural phenomena

New Brunswick boasts several free
shows not to be found anywhere else in
the world, such as the Reversing Falls,
where the Saint John River meets the sea
at the head of Saint John harbor. The
freak action of the Bay of Fundy tides,
the highest in the world, causes the ocean

The strange-shaped rocks at Hopewell
Cape are one of New Brunswick's unique
natural phenomena.

water to push the river water upstream
for a while; later, when the tide is at low
ebb, the river tumbles over the deep
gorge, pursuing a normal course to the
ocean. Only when the water level is at
slack can boats navigate through the
Reversing Falls rapids. At other times it is
a boiling caldron of treacherous rapids
and tricky whirlpools, a delight for came-
ra enthusiasts and those interested in the
unusual.

Another display is put on by the
Petitcodiac River, where a broad wall of
water known as a tidal bore surges upriver
at certain times each day. One minute the
river is almost a dry bed of mud; the next
it is a roaring tide of water. Again it is the
Bay of Fundy tides that force the water
into the mouth of the river under tre-
mendous pressure twice a day.

Audience participation is needed to

appreciate Magnetic Hill, located seven

miles from Monet on. You drive your car

to the bottom of the hill, shut off the

THE C>WADIAN NURSE 35

Camping amid the scenic beauty of Fundy National Park is one of the joys of a New
Brunswick vacation. This park has an eight-mile shorefront.

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. Wliile 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

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.

Nobody knows her origin, and to date she
is simply known as "the phantom ship of
Northumberland Strait."

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,
1,282 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,
linaments, 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
find- a reversing falls, the world's longest
covejed bridge, and a phantom ship? D

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.

k

Fanny H. Cracknel!

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
Clinic, 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 finan-
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 1 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
12 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 1950 rose to 1,878.

THE C/WADIAN 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 brea.st. 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
protosigmoidoscopy 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 2,846
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 doctor's wife, a young
student, a famous author or artist, a
charwoman, a teacher, a nurse, or a
housewife. They all come. D

APRIL 1970

Cancer can be beaten

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

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
informed 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 hterature, 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

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, wa.s 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 g^NADIAN NURSE 39

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.

key word in the campaign to instill in the
minds of Canadians a rational attitude
toward cancer.

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

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 tum 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. D

APRIL 1970

University schools of
nursing in Canada

A brief, up-to-date account of the programs offered by university schools
of nursing.

University of
Alberta

The school of nursing of the University of
Alberta, located in Edmonton within the
university's health sciences 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

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 I
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 information about nurs-
ing programs, individuals should write to
Miss Ruth McCIure, Director, School of
Nursing, University of Alberta, Edmon-
ton, Alberta.

University of
British Columbia

The school of nursing of the University of
British 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 CANADIAN 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 SIO 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

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

b

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.

Lakehead
University

Laurentian
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 well laid-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 1 3 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.

APRIL 1970

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 (1);
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 (V^NADIAN 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-
ty experience.

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, Secretariat
general, Universite Laval, Quebec, 10,
Quebec.

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

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 for entrance
include Manitoba Grade 12 — senior
matriculation - and the prerequisite
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.

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 11. 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 (appUed)
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.

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 leaming 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 increasingly
complex nursing care to patients and
their families.

APRIL 1970

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 informa-
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,
integrated 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 CANADIAN NURSE 45

^

A

i»

4

i

^B^

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.

University of
Moncton

When the University of Moncton in New
Brunswick received its charter of in-
corporation, other French-language ins-
titutions for higher learning in the
province became affiliates of the universi-
ty. These included College Saint-Joseph,
College Saint-Louis, and the College
Sacre-Coeur. 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
hospitalieres. 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.

46 THE CANADIAN NURSE

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 faculty 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 in
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 Saint Vincent
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 jjositions in Nova Scotia, wUl 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^ Brunsv^ick

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-
hshed 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-
tinn, both include public health nursing
integrated 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

^7__^__^

University of
Ottawa

The University of Ottawa scliool 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 pubhc health nurs-
ing for registered nurses. Originally a
privately-owned, sectarian institution, the
university became a pubhc educational
enterprise in 1965.

In 1961 the school estabhshed 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 1 25 full-time students enrolled
in this program. Students in the school of
nursing may take general arts and science
subjects in French or Enghsh, ahhough
not all sections offer identical courses in
both languages. Nursing classes are given
in English, with options for written work
in French.

One-year, postbasic 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 generahzed 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 heahh 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 1 3 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
pubhc 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 1 2 — 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 in 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 nursing 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 CANADIAN NURSE 49

school students to each class. Registered
nurse enrollment is usually about 15. 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. In 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 enroU 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-
50 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 1 3 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.

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 500-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-
em. 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 1 3
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 heahh
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 apphcation should be directed to
Dean R. Catherine Aikin, Faculty of
Nursing, The University of Western
Ontario, London, Ontario.

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 live on campus.

In 1955 the department of nursing was
created within the facuhy 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
heahh 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 Ontario 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 Enghsh 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-
cations several months in advance and to
seek a personal interview. The Director of
the School of Nursing is Miss Florence M.
Roach. D

APRIL 1970

THE CANADIAN NURSE 51

Counseling students in

a hospital school of nursing

The authors, both registered psychologists, describe the functions, success, and
future of the counseling service for student nurses at the Calgary General
Hospital in Alberta.

Donald G. Ogston, B.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
functions: counseling 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 Calgaiy 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 counsehng 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
1 1 5 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

1967 - 1968

1968 - 1969

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

0
1
2
3
3
3
4
2
6
3
2
4

33

1
2
2
1
2
2
1
3
4
3
0
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*

0

29

* new counsellor

Table J. 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.'* 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 research

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 norms 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. Collegiate Education
for Nursing. New York, Russell Sage Foun-
dation, 1953.

2. Mussallem, Helen K. Nursing Education in
Canada. Ottawa, Queen's Printer, 1964.

3. Wrenn, C.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. Q

THE CANADIAN NURSE 53

research abstracts

Kikuchi, June F. One hospitalized pre-
school girl's way of dealing with separa-
tion aitxiet}'. Pittsburgh, Pa., 1969.
Thesis (M.N.) University of Pittsburgh.

A study of one preschool girl who
experienced separation anxiety during her
long hospitahzation 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 9 1 -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 contact with the nurse,
she gradually transferred her positive feel-
ings for her mother to the nurse. As this

54 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 preservice 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.

Withmore, Mary Anne. A study of com-
municative behavior 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. D

APRIL 1970

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 H.J. 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 information 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 information
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 Hon}. Associate
Professor, Community Nursing. Facul-
ty of Nursing, The University of West-
em Ontario.

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-Carle ton, 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 that still 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 CANADIAN NURSE 55

Next Month

in

The

Canadian
Nurse

• Male Patients:

One Standard ~ or Two?

• Interview with CNA executive

• CNA Ticket of Nominations

^Z7

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

tional physicians give more attention to
the social, psychological, and financial
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.

AV 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-Hill Company of
Canada Limited, 330 Progress Avenue,
Scarborough, Ontario.

accession list

56 THE CANADIAN NURSE

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 any one time.

Stamps to cover payment of postage
from 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 Scarabee, 1968. 75p (Bibliotheque de
I'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. 35 2p.

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, CoUier-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.

11. Guide to patient care: a procedural
rrmnual by Cedars-Sinai Medical Center, Cedars
of Lebanon Division. New York, National
League for Nursing, 1969. 113p. (League ex-
change no. 90)

1 2. 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
Stanley Jablonski. 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 1, 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.

1 7. Medical and surgical motion pictures: a

APRIL 1970

catalogue of selected films., 2d. rev. ed. Chica-
go, American Medical Association, 1969. 572p.

18. National 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 1 108 rev.)

19. Nurses technical manual, J 968/69 by N.
E. Broome. London, Butterworth's, 1969.
lOOp.

20. Nursing aspects in rehabiUtation and
care of the chronically ill by Elisabeth C. Phil-
lips. New York, National League for Nursing,
1956. 44p. (League exchange no. 12)

21. Planning and producing audiovisual
materials. 2d. ed. by Jerrold E. Kemp. San
Francisco, Chandler, 1968. 251 p.

22. Planning for nursing education in a
community college. Report of workshop on
Associate Degree Programs in Nursing, Stern
Hall, Univ. of California, Berkeley, Calif June
23-July 11, 1958. New York, National League
for Nursing, 1958. 37p. (League exchange no.
32)

23. Poverty Ipauvrete 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 ecouter; essais sur quelques
aspects de la documentation audio-visuelle dans
la bibliotheque par Paule Rolland-Thomas.
Montreal, Association canadienne des bibliothe-
caires de langue frangaise, 1969. 105p.

26. Report 1 968. 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 Curriculum, Center for Continua-
tion Study, Univ. of Minnesota, June 13-1 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, 1958-69. 6v. (Yearbook
of nursing, English language titles and abstracts)

31. Symposium on care of the cardiac
patient edited by Adeline C. Jenkins (In Nurs-
ing Qinics of North America. Philadelphia,
Saunders, 1968. v.4 no.4 p. 561-649)

3 2. 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 a leurs eleves. Led.
Ottawa, Association canadienne contre la tuber-
culose et les maladies respiratoires, 1968. 174p.

34. White-collar bargaining units under the
Ontario Labour Relations 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 prets entre bibliotheque Mon-
treal, As,sociation canadienne des Bibliothecai-
res de langue fran?aise, 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 la san-
te put Jacques Brunet. Ottawa, 1969. sanitaire,
octobre, 1969. 18p.

42. From head to toe, Washington, U.S. Pu-
bUc Health Services, National Centre for Chro-
nic Disease Control, 1968. 14p. (U.S. PubUc
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 dollars 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. lip.

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-
lar 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 associate; new types of health
professionals by Henry K. Sihrer and James A.
Hecker. 3p.

53. Personal medicine: health examinations
and the automated laboratory. Washington,
U.S. PubHc Health Service, National Center for
Chronic Disease Control, 1968. 9p. (U.S. PubUc
Health Service publication no. 1832)

54. The photography of H. Armstrong
Roberts, volume C. Philadelphia, n.d. I6p.

55. Potential for newer classes of personnel:
experiences with the Duke physician's assistant
program by Harvey E. Estes and D. Robert
Howard. Durham N.C., 1969. 13p.

56. trogramme 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 convention of the American
Psychological Association August 31, 1956,
Chicago, 111. 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.
11. New York, American Journal of Nursing
Co., 1969. p. 2423-2454.

61. Statement to the Joint Legislative 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 relating 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 Canadian 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 Commis-
sion on Teacher Education and Professional
Standards. Journal of Teacher Education. Wash-
ington. v.20 (1969) p.3 11-3 16).

65. Wine and health as food . . . in therapy.
Mario Park, Calif., Wine Institute, San Francis-
co, Calif., 1969. 13p.

66. The writings of Florence Nightingale, an

THE OkNADIAN 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 Immigration.
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 physicians 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 technicalinfor-
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 Information. 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

7 7. Department 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 infirmiere par Lorraine
Beaudin. Montreal, 1968. 68p. Thesis (M. N
urs.) - Montreal R

80. Etude du role educatif de I'infirmiere
aupres de la femme enceinte en afrique noire;
tendances actuelles, Montreal, Universite, Insti-
tute Marguerite d'Youville, 1966. 20p. (Travail

de recherche presente . . . par un groupe d'etu-
diantes, candidates au Baccalaureates Sciences
Infirmieres)R

81. /, 'hopital de Jeanne-Mance a Ville-
Marie; son evolution a trovers les siecles par
Jeanne Bemier (Soeur) Montreal, Therien Fre-
res, 1957. 119p. (These presentee a I'ecole d'ad-
ministration Hospitaliere pour I'obtention du
Diplome en administration HospitaUere,
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 O

TEACHERS OF NURSING

We invite YOU to join us!

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 on
exciting educational program in Nursing.

// you wish to know more about us, please, write to:

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CANADIAN NURSES'
ASSOCIATION LIBRARY

Send this coupon or facsimile to:
LIBRARIAN, Canadian Nurses' Association,
50 Ttie Driveway, Ottawa 4, Ontario.

Please lend me the following publications, listed in the

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or add my name to the waiting list to receive them when
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58 THE CANADIAN NURSE

APRIL 1970

May 1970

MISS MTM MORRIS

290 NELSON ST APT 812
OTTAWA 2 ONT 00005784

The

Canadian
Nurse

buoy up your spirits
in the Maritimes!

male patients deserve
better nursing care
than they're getting

nominees for
CNA executive

New 8th Edition! ESSENTIALS OF PSYCHIATRIC

NURSING By Dorothy Mereness, R.N., Ed.D. This
popular text clearly describes the basic knowledge and
nursing skills your students need to care for the mentally
ill. This up-to-the-moment revision includes four new
chapters which make the 8th edition a complete overview
of psychiatric nursing: they discuss emotionally ill chil-
dren and adolescents, mental retardation, community
psychiatry, and the nurse's role in group therapy. A more
logical sequence of chapters, new illustrations of psychi-
atric nurses in action, and a current ■ /
bibliography also enhance this edition ! ^^B
August, 1970. Approx. 336 pages, "^ ^^m
illustrations. About $8.00.

20

New 5th Edition! PSYCHOLOGY:
Principles and Applications By Marian
East Madigan, Ph.D. This popular in-
terdisciplinary approach correlates
topics in psychology with applications i / — v^ v,

to clinical nursing. This extensively (^ / '^/f\.

revised new edition was carefully reviewed by a prominent
nursing educator with a master's degree in psychology — a
guarantee of its relevance to your needs. Meaningful dis-
cussions present psychology as a science, concepts of
heredity and development, basic psychological processes,
the development of personality, and problems of adjust-
ment and mental health. A helpful Teacher's Guide is
provided without charge to instructors adopting this text.
July, 1970. Approx. 442 pages, 129 illustrations. About SI 0.45.

Today,

choose these

new Moshy

hooks 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.

A New Book! MATERNITY NURSING By Constance
Lerch, R.N., B.S.{Ed.) This sensitive new text is planned
for concurrent classroom and clinical learning. It presents
the entire maternity cycle as a normal physiologic process,
with sections on the preparatory (pre-pregnancy) phase,
pregnancy, labor and parturition, the post-partum period,
and the neonate. This richly illustrated book also includes
a chapter on high-risk pregnancy, as well as detailed
material on nursing measures to prevent postpartum
complications. Practical teaching features include study
^ questions, blank pages for student

notes, a comprehensive glossary, and
full bibliography. May, 1970. Approx.
480 pages, 190 illustrations. About $9.75.

2nd Edition WORKBOOK FOR
MATERNITY NURSING By

Constance Lerch, R.N., B.S.{Ed.) This
workbook, the most widely adopted
in its area, gains added significance
as an adjunct to the new correlated
text described above. Case studies, situation questions
for discussion, self-examinations, and carefully selected
references help students learn theory and applications.
This recently revised edition describes the influence of
heredity and environment on the developing fetus, and
places greater emphasis on nutrition, minor discomforts
of pregnancy, and high-risk pregnancy. This workbook
and its new companion text can give you an unmatched
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 tomorrow's nurses!

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, 1 970. Approx.
168 pages, 13 illustrations. About $5.45.

'^^Cl

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
NURSING: 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-Vision® insert of human
anatomy. About $8.50.

MOSBY

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THE C.V. MOSBY COMPANY • 3207 WASHINGTON BLVD.

MAY 1970

ST. LOUIS. MISSOURI 63103

THE CANADIAN NURSE

-^x

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
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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

(Selenium Sulfide Detergent Suspension U.S.P.)

A PRODUCT OF ABBOTT LABORATORIES, LIMITED

The

Canadian
Nurse

^

^^p

A monthly journal for the nurses of Canada published

in English and French editions by the Canadian Nurses' Association

Volume 66, Number 5

27 One Standard — Or Two?

May 1970

A.W. Wedgery

Editorial

29 Idea Exchange

32 Program for 35th General Meeting

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

22 Names

24 Dates

48 Accession List

7 News

23 In a Capsule

47 Books

72 Index to Advertisers

Executive Director: Helen K. Mussallem • Ed-
itor; Virginia A. Lindabur> • Assistant Ed-
itor: Mona C. Ricks • Editorial Assist-
ant: Carol A. Kotlarsky • Production Assist-
ant: Elizabeth A. Stanton • Circulation Man-
ager: Beryl Darling • Advertising Manager:
Ruth H. itaumel • 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-
ciation, where applicable. Not responsible for
journals lost in mail due to errors in address.

Manuscript Information: "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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
diagrams (drawn in India ink on white paper)
arewelcomed 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.O. Permit No. 10,001.
50 The Driveway, Ottawa 4. Ontario.
(!) Canadian Nurses' Association 1970.

MAY 1970

After the last CNA board of directors'
meeting, we talked to the association's
executive about some of the questions t(
be discussed at the general meeting
in Fredericton next month. The six
members of the executive spoke frankly
about the major issues facing CNA,
their reactions to the report of the ad
hoc committee on functions, relation-
ships, and fee structure, and their belief
about the association's role in the future
Their comments are published on page
33 of this month's issue.

In the interview, CNA President
Sister Mary Felicitas listed as the most
vital issue the relationship between the
individual member and the national
association. "I believe the average nurs(
lacks involvement with CNA, sees it
as something remote, and is unaware
of its goals and functions," she said.

We agree with Sister Felicitas and
with her remark that members will hav<
an opportunity to improve this relation'
ship at the general meeting in June.
At this meeting CNA members will
debate the recommendations of the ad
hoc committee on functions, relation-
ships, and fee structure, and decide
whether to accept or reject them.

Somehow, in some way, the national
association must be restructured so that
more members will recognize it as a
dynamic organization demanding their
participation. This will not be an easy
task, as we all tend to be somewhat
provincial — in every sense of the
word — in our thinking and in our
loyalties. Somehow, too, we must in-
volve more of our younger members.
Although their apparent disinterest in
CNA could come from their lack of
knowledge about it, part may result
from a feeling that their contribution
is not really welcome.

Ultimately, CNA's ability to involve
its members, young or old, rests with
the relevance of its goals. These goals
must not be restricted to member needs
alone. They must encompass the health
needs of society, and range from the
quality of nursing care being provided
in Canada to the problems of environ-
mental pollution and the population
explosion. Obviously, we can't hope
to solve all these problems. But with
more involvement and enthusiasm of
membership, we can at least make an
intelligent contribution.

V.A.L.

THE CAHJADIAN 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.

Heavy smoker

I enjoyed your tongue-in-cheek editorial
on the difficulties involved in trying to
break the smoking habit (April 1970). I
was surprised to learn that Dr. Freud had
been unable to stop his cigar smoking.

There's one thing you didn't mention,
however: Dr. Freud reached the ripe age
of 83. That's not bad for a heavy smok-
er! - NBJ, RN, Ottawa.

Questions nerve deafness

In the article "Aging and learning" (Nov.
1969) the author, Monica D. Angus,
writes: "High levels of noise have relative-
ly little effect on hearing by people with
nerve deafness; therefore older people
may work better than persons with nor-
mal hearing in situations where the noise
level is high." I believe this is an error
that is misleading to readers of The
Canadian Nurse.

Persons who have not experienced
nerve deafness or have not had much to
do with those who have this defect would
find it hard to understand how confusing
it is in a noisy environment. Those with
nerve deafness could be misunderstood in
such a setting, could misinterpret instruc-
tions, and be more fatigued than the
average person, just by being exposed to
noise during the working day.

I am pleased to see nursing research
being done on the subject of aging and
learning. I am convinced that a person is
never too old to learn, given the right
circumstances and the correct frame of
mind. - Elizabeth Egener, RN, London,
Ontario.

The author replies: The point you raise
about nerve deafness and the problems
for persons working in areas where there
is a high level of noise is interesting.
There are two problems related to nerve
deafness and work in "high levels of
noise": one is physiological and the other
involves communication Perhaps if we
consider these separately, we will see that
both our statements are correct.

With respect to physiology, persons
with normal hearing who work in areas
where there is a high level of noise usually
suffer damage to their ears. TJtis is not the
same for persons with nerve deafness.
That is, the latter are not going to damage
their ears to a greater extent by working
in conditions where high levels of noise
prevail.

With respect to communication,
persons with nerve deafness do have a
problem in that they do not hear as
4 THE CANADIAN NURSE

clearly in the presence of background
noise. Therefore, communication or con-
versation for them is, as you suggest,
confusing, tiring, and frustrating. Howev-
er, in situations where conversation is
unnecessary, for example, in many types
of factories or assembly-line work, per-
sons with nerve deafness may function
extremely well.

About 20 percent of persons with
nerve deafness experience the phenome-
non of "recruitment " In these cases the
inner ear is sensitive to increases in sound
in spite of nerve deafness. The other 80
percent who do not experience "recruit-
ment" should, as I suggested, Junction
extremely well in the kinds of work I
outlined above. - Monica D. Angus,
B.C.

Concerned about pollution

Your March editorial contains a sentence
that prompts me to write. I completely
agree with your statement, "Being profes-
sional health workers in an affluent socie-

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ty, we have a special obligation to help
de-fuse these bombs, whether they be on
the national or international scene."

One national bomb that must be
defused if we are to survive to help others
as well as ourselves, is that horrifying,
sometimes invisible bomb that has been
named "pollution."

Would it be possible for The Canadian
Nurse to publish the official policies of
the Canadian Nurses' Association, the 10
provincial nurses' associations, and the
National Victorian Order of Nurses as
they pertain to pollution? And could
there be presented an article on the
organized activities of registered nurses'
groups in this country-wide fight against
pollution?

"Being professional health workers . . .
we have a special obligation . . . ." Is
there an unanswered challenge here? —
Catherine Allan, R.N., B.C.

Show me that you care

I was pleased with Pamela Poole's article
"Nurse, please show me that you care! "

What patients need are nurses who
think of them rather than of dogmatic
hospital policies and antiquated tradi-
tions. Patients are individuals with specif-
ic problems, and nurses are individuals
with education and training that should
be put to use for the patient's comfort
and cure.

Unfortunately, a nurse comes up
against the various idiosyncracies of a
head nurse and often non-liberal hospital
policies that encroach on her free-
thinking processes. Such is the dilemma
of today's general duty nurse! - Anne
Luke, RN, Montrose, British Columbia.

I did not fully agree with the article by
Pamela Poole, "Nurse, please show me
that you care! "

The patient has to be treated as an
individual. However, his daily routine has
changed so much when he is in hospital
that it is irrelevant to consider his usual
times of work. Although a patient who is
used to a night shift requires some extra
understanding and cups of tea, he does
not usually have the energy to join in the
planning of his day.

I am all for morning baths, and believe
that each nurse can decide on the extent
of washing, after assessing the patient's
condition and wishes. A person who has i
been in bed for a number of days,
especially one with a fever, certainly
appreciates his sponge bath. Surely the
person who exclaims, "Nurse, that feels

MAY 19701

much better," is more ready to face the
morning activities.

Routine observations often can be
safely omitted at the nurse's discretion,
but I wonder if the doctor's orders would
cover such omissions.

I believe that a nurse or a nurse's aide
should still accompany the discharged
patient to the waiting relative, car, or
taxi - not for fear of a lawsuit, but to
carry through the nurse's personal inter-
est and contact.

I agree with much of the article, and
admit that more emphasis is needed to
consider the patient first as an
individual. - Elizabeth A. Watt, RCN,
SCM, Fort St John, British Columbia.

Must study task force report

It was reassuring to see in your March
issue that the Canadian Nurses' Associa-
tion has established an ad hoc committee
to study reports of the federal govern-
ment's task force on health care costs.

Because nurses play such an important
role in the dehvery of health care, they
should be aware of the many issues and
recommendations put forth by the task
force. We agree there are numerous
worthwhile recommendations; however,
we believe nurses should be aware of
those recommendations that are not fa-
vorable to our situation. As an example,
note recommendations 35 to 37 under
salaries and wages.

On the one hand, the task force has
suggested many limitations to nursing
personnel and. on the other hand, it has
suggested many areas of subsidization for
the medical profession. What other inde-
pendent contractors have such a Utopia?
Consider the physical plant in which they
have to operate and carry out their
services; for example, the fantastic
amount of equipment and personnel uti-
lized in one operation at no cost to the
doctor. Now they want a guaranteed
income; note recommendations 7 to 12
and 15 to 21 under the price of medical
care.

The medical profession has been clever
in controlling its supply over the years in
order to put itself in this enviable posi-
tion. However, it seems unfair and unjust
for it to attempt to administer the
nursing situation, just when nurses are
rising out of the mire of the minimum
wage bracket.

It is time for nurses to speak out,
instead of smiling sweetly under the guise
of professionalism, and to look at the
favorable recommendations. Nurses, as a
group or individually, must take time to
analyze this report. We have been placat-
ed far too long by the medical profession.
If we do not make our stand now, quality
patient care and determination of it will
slip out of our hands. "Too soon old we
get and too late smart." M.L. An-
nable. President, Nurses' Association,
Ottawa Civic Hospital, Ottawa. D

MAY 1970

POSEY SAFETY VESTS

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Since the introduction ol the
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which provide maximum patient
protection and ease of care. To in-
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always specify the Posey brand
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The Posey Patient Restrainer with
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and provides needed security. There
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This belt is one of seventeen Posey
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The Posey Retractable Stretcher Belt

can be adjusted to fit eyery stretcher,
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one of seventeen safety belts in the
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The Posey Footboard fits any stan-
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THE C/*MADIAN NURSE 5

Both are disposable. But it takes a lot more expensive
labor and special equipment to dispose of glass bottles.
VIAFLEX plastic containers, on ttie other hand, go right
into the wastebasket. VIAFLEX containers are lighter and
easier to handle, too. They need 30% less storage space

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6 THE CANADIAN NURSE

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MAY 1971

J

news

CNA Research Committee Meets

Ottawa. - The ad hoc committee on
research of the Canadian Nurses' Associa-
tion held its first meeting at CNA House
April 6-8. It met to formulate a possible
policy on research for CNA.

The committee worked out a general
policy as well as details regarding the
functions and activities CNA should en-
gage in as a professional association,
according to Dorothy J. Kergin, commit-
tee chairman and associate director of the
School of Nursing, McMaster University,
Hamilton.

Members of the ad hoc committee
pointed out the need to establish a special
CNA committee on research to fulfill the
responsibility inherent in this general
policy, said Dr. Kergin in an interview
with The Canadian Nurse. This commit-
tee would indicate a structure or frame-
work through which policies could be
implemented.

The committee believes that CNA
should initiate discussion with other
groups that have responsibilities for
research in the field of nursing, such as
the Canadian Council of University
Schools of Nursing and the Department
of National Health and Welfare. This
would ensure that the whole field of
research in nursing is covered, and that
there are no gaps or overlaps, said Dr.
Kergin.

The committee report will be present-
ed at the next meeting of the CNA Board
of Directors, June 13 in Fredericton, N.B.

Members of the committee are: Moyra
Allen, associate professor of nursing,
School for Graduate Nurses, McGill Uni-
versity; Shirley Stinson, assistant profes-
sor. School of Nursing, University of
Alberta; Lucy Willis, director. School of
Nursing, University of Saskatchewan; and
Margaret McPhedran, dean, faculty of
nursing. University of New Brunswick.

The ad hoc committee was set up by a
motion of the CNA Board at its January
1970 meeting.

CNA Meeting Won't be
"All Work And No Play"

Fredericton, N.B. - The New Brunswick
Association of Registered Nurses, hostess
to the 35th biennial convention of the
Canadian Nurses' Association, is prepar-
ing a packed program of pleasure activi-
ties for registrants. The meeting runs June
14 to 19 in Fredericton.

These activities will begin on Sunday
June 1 4 with an unusual musical treat for

MAY 1970

Lady With Lamp Born 150 Years Ago

May 12, 1970 is the 150th anniversary of Florence Nightingale's birth. To mark this
occasion The Canadian Nurse scoured the archives section of the Canadian Nurses'
Association library for relics of the great lady of nursing. This photo from the
archives collection was taken at the request of Queen Victoria after Miss
Nightingale's return from the Crimea in 1 856.

The most solid relic in the CNA archives collection is a yellow brick from Miss
Nightingale's last home at 10 South Street, London, where she lived from 1865 till
her death in 1910. It was presented to CNA on its 25th anniversary in 1934 by the
National Council of Nurses of Great Britain.

The CNA archives also contain a number of letters from Miss Nightingale. Several
are replicas of original letters sent to the Florence Nightingale International
Foundation, but at least two letters are originals.

Perhaps the most delightful is an undated note reproduced here in full: "From Miss
Nightingale to her Patient. Dear Sir, Send me the latest Bulletin of your
State - don't eat too many Oysters There is a Ward in the Pickenham Hospital
awaiting you where we have much experience in mending broken hearts as well as
sprained Ankles."

Another authentic letter mentions a new patient, a gardener. "Some days ago, apice
[sic] of grit entered his eye; and the means taken to get it out made him sick
physically (as they did me figuratively) ... I often think what 'robust' creatures we
must be to bear not only the Water cure but other means of (ignorance)? cure."
The CNA library is collecting a listing of all Miss Nightingales mementos, letters,
etc., in Canada and their whereabouts. The librarian would be pleased to hear from
anyone who can add to this listing. Write to CNA, 50 Driveway, Ottawa.

THE CANADIAN NURSE 7

news

A Cake For Street Haven's Fifth Birthday

(Continued from page 7}

those attending the interfaith service at
the beautiful and historic Christ Church
Cathedral.

Monday evening will feature a "down-
east" picnic barbecue hosted by the city
of Fredericton. This outdoors event
(weather permitting) will be informal,
and registrants should pack their most
relaxing garb to enjoy the picnic spirit to
the fullest. Tentative entertainment plans
for the picnic include the Elm Tree
Square Dance Club. Pool facilities will be
available nearby for those who wish to
swim after the picnic.

Wednesday is hospitality day, a com-
plete day to concentrate on the beauty
and entertainment that New Brunswick
has to offer its guests. Tours are being
organized. For example, you can drive to
St. Andrews, a beautiful coastal town
that is popular with summer visitors. Here
you can take a boat cruise, visit a lobster
plant, tour the town's historical land-
marks and magnificent mansions, or shop.

If you choose to tour the Loyalist port
of Saint John, Canada's oldest incorporat-
ed city, you will visit many of its scenic
and historic highlights. The trip includes a
visit to one of the city's breweries.

There is also much to see and do in
and around Fredericton. Tours to Oro-
mocto, billed as Canada's model town,
and Base Gagetown, the largest military
training base in the British Common-
wealth, have been organized.

Registrants can also drive to the Mac-
taquac fish hatchery, which boasts the
largest salmon hatchery in the world; the
Mactaquac hydro-electric power project;
Mactaquac Park; the historical settlement
of King's Landing at Prince William; and
the newly-created town of Nackawic with
its St. Anne-Nackawic pulp and paper
mill.

For those spending Wednesday evening
in Fredricton, tentative plans are being
made for a coffee house with entertain-
ment and bar facilities.

Thursday evening will be free for
shopping, local sightseeing, and private
get-togethers. Later in the evening, the
nationally known pipes and drums band
of the Black Watch (Royal Highland
Regiment) of Canada will give an outdoor
concert, their final performance before
disbanding.

An exhibition of NB arts and crafts
will be on display throughout the week at
the Beaverbrook art gallery. The exhibi-
tion will mark the first showing of this
provincial art collection.

There will be no charge for many of
these activities. Tickets for the Monday
barbecue and Wednesday tours will be on
8 THE CANADIAN NURSE

Toronto, Ont. - One of Toronto's most warm-hearted institutions celebrated its
fifth birthday in March with a party and a cake. Peggy Ann Walpole, the registered
nurse who founded Street Haven at the Crossroads, a drop-in center for female
offenders, cuts the cake while Linda Sutherland waits to serve it.
Street Haven began with a $20 mvestment in a former beverage room m downtown
Toronto, and is now located in a large, pleasant house nearby. Operating on an
annual budget of $60,000, it provides a refuge for alcoholics, drug addicts, lesbians,
prostitutes, even thieves. The 4 staff members and 70 volunteers who run the center
make home and hospital visits to girls, contact and assist them in court, and refer
them to community and welfare agencies, as well as providing "open house" 6 days
a week and a 24-hour emergency answering service.

"But no one is ever pushed into more assistance than she wants," emphasized
administrative secretary Maureen Marquardt. "We don't ask questions and there are
no forms to fill in. We simply provide a bed and a meal if necessary, and a place to
meet and talk to people. We do give such assistance as finding a permanent place to
live and a job, but only if the girl asks for it. Basically, Street Haven is somewhere a
girl can come to get off the street."

Finances for the center are provided by a fund-raising drive each September. About
$20,000 is donated by the Drug Addiction and Research, the United Church of
Canada, and city and provincial governments; another $40,000 comes from private
funds. This money, plus the time, effort, and concern of the staff and volunteers,
provides help for 100 to 120 girls per week. In five years of operation, a total of
some 1 ,200 girls have been helped by Street Haven.

sale at an information center in the Lord
Beaverbrook Hotel. The NB Travel Bu-
reau will also have a tourist information
and display center at the hotel.

In addition to information center serv-

ices, NBARN will publish an information
handbook for each registrant.

A first aid and survival station will
operate at The Playhouse, site of the
business sessions.

MAY 197C

NEW WAYS OF THINKING \ / ... AND DOING

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Doris S. Suddarth, R.N., M.S.N.

Dedicated to the pursuit of clinical
excellence, this edition empha-
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chosocial factors involved in pa-
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on vascular/ cardiac /respiratory
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logic disorders/rehabilitative
measures.

928 Pages 325 Illustrations 2nd
Edition, April 1970 About $14.95

2. NEW

BEHAVIORAL CONCEPTS

AND

NURSING INTERVENTION

Carolyn E. Carlson, R.N., M.S.,
Coordinator. With Sixteen Con-
tributors

This pioneering book is the first
to identify and examine in depth
relevant concepts from the behav-
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their application to nursing. Orig-
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nent to better understanding of
the interpersonal aspects of pa-
tient care as pathophysiology is to
physical care.

250 Pages Ready, April 1970

Paperbound, About $5.75
Clothbound, About $8.00

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cancer'
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A Programmed Textbook

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M.S., with Margot L. Pass, B.A.
Programming Associate

Structured for rapid assimilation,
this definitive text deals with the
psychological /physical care of
cancer patients of all ages. Em-
phasis is on the nurse's attitude
toward cancer, relief of pain, and
how the nurse can increase the
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Review questions follow each
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275 Pages Ready, May 1970

Paperbound, About $7.50

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4. Rodman and Smith
PHARMACOLOGY AND DRUG THERAPY
IN NURSING

Covers sources, dosage, physiologic action, un-
toward effects, contraindications, implications for
nursing action. Vital points to remember follow
chapters presenting drugs used in specific
disorders.
738 Pages Illustrated 1968 $10.75

5. Nordmark and Rohweder

SCIENTIFIC FOUNDATIONS OF NURSING

An indispensable tool for problem-solving, nurs-
ing diagnosis, intervention and review— that
bridges the gap between scientific theory and
clinical practice.

388 Pages 2nd Edition. 1967

Paperbound, $5.25: Clothbound, $7.50

6. Smith and Gips CARE OF THE ADULT
PATIENT: Medical-Surgical Nursing

Emphasis is on nursing care. Includes principles
and practices brought about by progress in
nursing and medicall<nowledge.
1206 Pages 406 Illustrations

2n<- - ---

nd Edition, 1966

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7. Seedor

THERAPY WITH OXYGEN AND OTHER GASES

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172 Pages lllusTrated 1966 Paperbound, $4.25

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227 Pages 125 Illustrations (\2 color plates)

4th Edition, 1968 $7.00

S. ASPECTS OF ANXIETY

A concise guide to understanding of common
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nition of anxiety and its various manifestations
148 Pages 2nd Edition, 1968 $4.75

10. Fuerst and Wolff 4tt, Ediiioi,
FUNDAMENTALS OF NURSING
The Humanities and the Sciences in Nursing

Covers "core" content common to every area of
practice.

446 Pages 166 Illustrations 4th Edition. 1969

$8.25

II Cusumano MALPRACTICE LAW DISSECTED
FOR QUICK GRASPING

A concise, but comprehensive discussion that
includes vital information on the liability and re-
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132 Pages 1962 $11.00

12. Price LEARNING NEEDS OF REGISTERED
NURSES

Report of a detailed study to determine content
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in hospitals. Recommendations for optimal staff
development included.

III Pages 1967 Paperbound, $3.00

13. Little and Carnevali

NURSING CARE PLANNING

Presents the rationale for systematically planned
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245 Pages 1969 Paperbound. $4.20

Clothbound. $6.25

U. N»w (4llt) EdiHoK

Rhoads, Allen, Harkins and Moyer
SURGERY: Principles and Practice

Completely revised and updated, this new edition
of a well-known work is an Invaluable guide to
understanding modern surgical procedures.
1830 Pages 660 Illustrations

4th Edition, March 1970 About $24.00

15. Nmw (5ih) Ediiion MacBryde

SIGNS AND SYMPTOMS

Updated and expanded— a unique examination
of patients' most common complaints: invaluable
in the development of intelligent observation.
985 Pases 233 Illustrations

5th Edition, May 1970 About $17.50

16. tUw Ritota

DlAfiNOSTIC ELECTROCARDIOGRAPHY

A concise, clearly-written guide to better under-
standing of electrocardiography that depicts
nearly 40 of the most common and important
patterns.
174 Pages 227 Illustrations 1969 $16.30

17. Metheny and Snively

NURSES' HANDBOOK OF FLUID BALANCE

A practical guide to body fluid disturbances that
explains what to look for— how to look for it—
and what to do about it.
279 Pages 90 Illustrations 40 Tables 1967 $8.00

18. Dean, Farrar, and Zoldos BASIC CONCEPTS
OF ANATOMY AND PHYSIOLOGY:

A Programmed Study

A skillfully programmed "short course" of the
human body stressing structure and function.
Designed for self-learning and review.
346 Pages 2-Color Illustrations 1966

Paperbound, $5.40

19. Ginsberg, Brunner and Cantlin

A MANUAL OF OPERATING ROOM
TECHNOLOGY

An introduction to the principles of O.R. tech-
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Discussions are accompanied by sample prac-
tices and chapter-end quizzes.
276 Pages 122 Illustrations 1966

Paperbound, $5.25

20. Hadley THE MEDICAL SECRETARY
AS A WORD TECHNICIAN

This well-organized manual facilitates rapid
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260 Pages Illustrated 1968 Plastic Bound, $7 50

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NURSING CARE OF CHILDREN

Reflects recent findings in all areas of care-
growth and development: medical entities; asso-
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to adolescence.

588 Pages 188 Illustrations 8th Edition. 1970

$10.00

22. Fitzpatrick, Eastman, and Reeder
MATERNITY NURSING

A family-oriented book that offers in-depth con-
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emotional needs: maternal-child nursing, nursing
management.

638 Pages 311 Illustrations Uth Edition. 1966

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23. Broadribb

FOUNDATIONS OF PEDIATRIC NURSING

Concise and to the point, this book clearly ex-
plains the cardinal principles underlying the nurs-
ing of children. Content is structured by age
f roups.
73 Pages Illustrated 1967 Paperbound, $5.60
Clothbound, $8.00

24. Barber and Graber

QUICK REFERENCE TO OB/GYN PROCEDURES

This time-saving, patient-oriented clinical manual
offers the most recent technics and procedures
in OB/GYN practice in easy-to-understand out-
line form.

366 Pages Illustrated 1969

Flexible Binding, $17.25

25. Chapman MANAGEMENT OF EMOTIONAL
PROBLEMS OF CHILDREN AND ADOLESCENTS

All of the childhood emotional disorders the non-
psychiatrist is likely to encounter are skillfully
covered from "temper tantrums to schizo-
phrenia."
315 Pages 1965 $11.50

26. Young and Lee LIPPINCOTT'S QUICK
REFERENCE BOOK FOR NURSES

A compact, concise reference covering nursing
technics, medical-surgical nursing, maternity
nursing, pediatric nursing, nutrition, and phar-
macology.

813 Pages Illustrated 1967 Printing with Drug
Revisions $5.80

27. Skipper and Leonard

SOCIAL INTERACTION AND PATIENT CARE

This well-researched anthology serves as a link
between the social sciences and clinical practice,
including the nurse's role.
399 Pages 1965 Paperbound, $5.50

28. Weaver and Koehler

PROGRAMMED MATHEMATICS OF DRUGS
AND SOLUTIONS

Step-by-step instruction on the application of
basic mathematics to the administration of drugs
and solutions: with a chapter on medication for
infants and children.
109 Pages 1966 Paperbound, $2.50

DETACH AND MAIL THIS POSTAGE-PAID ORDER CARD TODAY

J. B. LIPPINCOTT COMPANY

Pfeose tend me the books I havm ch»ek»d:

a 1. Brunn«r-TEXTBOOK OF MEDICAL-SURGICAL
NURSING About $14.95

D 2. Carlton-BEHAVIORAL COMCEPTS AND
NURSING INTERVENTION
C Cloth About $8.00 D Paper About $5.75

D 3. Craytor-THE NURSE AND THE CANCER
PATIENT About $7.50

D 4. Rodman-PHARMACOLOGY AND DRUG THERAPY
IN NURSING $107S

a 5. Nordmark-SCIENTIFIC FOUNDATIONS

OF NURSING

Q Cloth $7 50 D Paper $5.25

D S. Smlth-CARE OF THE ADULT PATIENT $13.00
D 7. Seodor-THERAPY WITH OXYGEN AND

OTHER GASES $4 25
D I. RoMfithal-DIABETiC CARE IN PICTURES $7.00
a ». ASPECTS OF ANXIETY $4.76
Q 10. Fuwit-FUNDAMENTALS OF NURSING $8.25

D Payment enclosed □ Charge and bill me.

Lippincoft books are on approval and are
returnable witfiin 30 days if you are not fully
satisfied.

CNJ-6/70

O 11. Cusumano-MALPRACTICE LAW DISSECTED FOR
QUICK GRASPING $1100

a 12. PrIce-LEARNING NEEDS OF

REGISTERED NURSES $3.00
a 13. Little-NURSING CARE PLANNING

D Cloth $6.25 a Paper $4.20

n 14. Rhoads-SURGERY About $24.00

n 15. MacBryde-SIGNS AND SYMPTOMS About $17.50

D 16. RItota-DIAGNOSTIC ELECTROCARDIOGRAPHY
$16.30

D 17. Metheny- NURSES' HANDBOOK OF

FLUID BALANCE $8 00
D 18. Dean-BASIC CONCEPTS OF ANATOMY

AND PHYSIOLOGY $6 40
D 19. Ginsberj-A MANUAL OF OPERATING

ROOM TECHNOLOGY $5.25
D 20. Hadley-THE MEDICAL SECRETARY AS A

WORD TECHNICIAN $7.50

Name

Address-
City

D 21. Blake-NURSING CARE OF CHILDREN $10.00

D 22. Fitzpatrick-MATERNITY NURSING $9.00

O 23. Broadribb-FOUNOATIONS OF PEDIATRIC
NURSING
a Cloth $8.00 D Paper $6.60

D 24. Barber-QUICK REFERENCE TO OB/GYN
PROCEDURES $1725

D 25. Chapman-MANAGEMENT OF EMOTIONAL
PROBLEMS OF CHILDREN AND
ADOLESCENTS $11.5C

D 26. Young-LIPPINCOTT'S QUICK REFERENCE BOOK
FOR NURSES $5.80

D 27. Skipper-SOCIAL INTERACTION AND PATIENT
CARE $S 50

a 28. Weaver-PROGRAMMED MATHEMATICS OF
DRUGS AND SOLUTIONS $2 50

-Position-

Province.

CNA Librarian Attends
Interagency Council Meeting

Ottawa - Margaret Parkin, the Canadian
Nurses' Association representative on the
Interagency Council on Library Tools for
Nursing, was pro tern secretary of the
Council's meeting in New York March 6.

A revised list of reference tools for
nursing, prepared by the Interagency
Council, received final approval at the
meeting. This list, published in the April
issue of Nursing Outlook, incorporates a
Canadian supplement that substitutes
Canadian publications for American refer-
ences.

Agencies represented on this council
include the American Journal of Nursing
Company, American Nurses' Association,
American Nurses' Foundation. American
Hospital Association, American Medical
Association, and CNA.

Council members meet twice a year to
exchange ideas, plans, and experiences;
explore the library needs of nursing; and
make suggestions to appropriate execu-
tive bodies on the development and use
of library tools and services. At the next
meeting in the fall, CNA's representative
will serve as chairman.

Three Senior Nurses

Leave Toronto General Hospital

In October 1969, the two associate direc-
tors of nursing at Toronto General Hospi-
tal were asked to resign immediately by
the executive director of TGH, Dr. J.D.
Wallace. Shortly after, the director of
nursing and the two associate directors
were told they had been suspended,
pending a report from consultants. In
November, after the Registered Nurses'
Association of Ontario had announced its
complete support of the three nurses, the
TGH board of trustees rescinded the
suspension. (For further details see
"RNAO Publishes Statement About TGH
Senior Nurses" on page 11 of the Febru-
ary 1970 issue.)

The Canadian Nurse received word
recently that the three senior nurses had
left Toronto General Hospital on March
15. 1970. The editor wrote immediately
to the chairman of the TGH board of
trustees, asking for further details. In
reply, the editor received a noncomittal
letter from TGH's executive director, Dr.
Wallace, suggesting that The Canadian
Nurse obtain its infonnation from the
RNAO.

The letter sent to the executive direc-
tor of the RNAO by the chairman of the
TGH board of trustees is printed below
with the permission of that Association.

Dear Miss Barr:

On November 4, 1969, I wrote to you
concerning the re-assignment, on a full-
time basis, of Miss M.J. Dodds, Miss I.
Hagan and Mrs. M. Decker to the Hospi-
tal's Task Force on Nursing as Special

MAY 1970

Assistants. Since that time, they have
contributed to special studies that are
resulting in beneficial changes in the
organization of our Nursing Services,
which changed considerably the positions
held by the three nurses.

During the past few weeks, proposals
for continuing education programmes and
for a further re-assignment to other posi-
tions in the new organization have been
discussed with the three nurses. After
much thought and consideration, they
have decided that they would prefer to
amicably leave their positions with our
hospital. Mutually acceptable conditions
that will protect their future security
have been agreed to and they will leave
on March 15, 1970.

Within the period of their employment
at Toronto General Hospital, there was
never any question of the professional

competence or personal integrity of Miss
M.J. Dodds, Miss I. Hagan or Mrs. M.
Decker - Yours sincerely, Thomas J.
Bell, Chairman, Board of Trustees.

RNAO Lifts Greylisting
Of Milton District Hospital

Toronto, Ont. - The Registered Nurses'
Association of Ontario hfted its grey-
listing of the Milton District Hospital
April 9, after the hospital's director of
nursing and assistant director had been
reinstated.

The greylisting of the Milton Hospital
was imposed by RNAO March 24 follow-
ing the written resignations of 61 register-
ed nurses employed by the hospital. The
nurses' resignations were to take effect
April 24. Their action was taken in
(Continued on page 12)

Hazardous Product Symbols

□ANGER POISON

DANGER FLAMMABLE

DANGER EXPLOSIVE

DANGER CORROSIVE

WARNING POISON WARNING FLAMMABLE WARNING EXPLOSIVE

WARNING CORROSIVE

CAUTION/POISON

CAUTION FLAMMABLE

CAUTION EXPLOSIVE

CAUTION CORROSIVE

Ottawa - New regulations that will require warning labels on poisonous,
flammable, explosive, and corrosive products in everyday household use were
announced in March 1970 by Consumer and Corporate Affairs Minister Ron
Basford.

Under the new requirements, a uniform set of symbols will show both the type and
degree of hazard; warning statements and basic first aid information will also appear
on labels in both English and French. The new regulations, the first issued under
the Hazardous Products Act of June 1969, deal specifically with consumer chemical
products such as bleaches, polishes, sanitizers, glues and cleansers.
The symbols developed by the Consumer Affairs Bureau represent four hazards: a
skull and crossbones mean poison; a flame means flammable; an exploding ball
means explosive; and a skeletal hand in a container of liquid means corrosive. Each
symbol is placed inside an outline that shows the degree of severity of the hazard.
An octagon, like a traffic stop sign, means danger; a diamond, like a traffic warning
sign, means warning; and a triangle, like a traffic yield sign, means caution. There
are 12 symbols in the full series, which may be used in various combinations. The
new symbols were pretested in Ottawa area schools, Mr. Basford said, and a lugli
percentage of children grasped their meaning. The rules apply to all regulated
products whether manufactured in Canada or imported. Since all prescribed
consumer chemical products sold in Canada must first be relabelled, the regulations
will not come into force until June 1 , 1971 .

THE CANADIAN NURSE 9

sterimedIc

SYSTEM

TV

V'v'^^

e

<i

<-|-

1

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
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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 ciean 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
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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 Vh".

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/
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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

direction ol a physician. As with all sterile disposable items, the pecl<agtng
should always be checked. It 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, 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:

SMrllon Corporation 1505 Washington Street • Bralntree, Mass. 02184
Subsidiaries of The Gillette Company

Sterilon of Canada, Ud. 3269 American Drive • Malton, Ontario *U. S. Patent 3.114,455

Sterimedic '■< is a tradenoarlt of 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, Ont. - 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 Issues

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 individuahzing 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, Ont - 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 (1 5 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 15)
MAY 1970

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

Schumacher, CNA
dent.

first vice-presi-

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.

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

2
3

4

5
6

7
8
9

10
11

12
13

ELASTOPLAST
elastic adhesive
bandages

give strong support, allow air to
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GYPSONA

Bandages and Slabs are available
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JELONET

Paraffin Gauze Dressings are
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Now available in individual
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ELASTOPLAST
dressing strips

are continuous elastic adhesive
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ELASTOCREPE

Cotton Crepe Bandage is a
smooth surface non-adhesive
bandage with unique properties
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NIVEA CREME

is beneficial in a wide variety of
skin conditions after deep
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SUPER-CRINX

Softstretch Bandages conform
to difficult body contours. It's
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PLASTAZOTE

Polyethylene Foam Splinting
Material is light yet strong enough
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ELASTOPLAST
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for the care of post-operative
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DISPOSABLE

gowns, masks, caps, sheets, bed
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CELLOLITE

All-Cotton Thermal Blankets
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ELASTOPLAST
skin traction kits

are ready-to-use and
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Next Month
in

The

Canadian
Nurse

• Decentralized Nursing Service

• A Positive Approach

to the Mentally Retarded

• Let's Have Permanent Shifts

^

"^7

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

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,
Ryerson Polytechnical 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 1 8 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

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MAY 1970

THE CANADIAN NURSE 15

Whenyourday

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16 THE CANADrAN NURSE

news

and medical services. "In hospitals, for
example, they can provide such services
as scheduUng hospital activities, E.C.G.
interpretations, and inventory control,"
he said.

Professor Blain Holmlund from the
University of Saskatchewan spoke on the
single use - system study group. "The
basic objective is how to improve hospital
systems, not how to use computers in
hospital," he said.

In his talk, Professor Holmlund re-
ferred to "Conway's law" - the hypo-
thesis that systems resemble the organiza-
tions that produce them. "Witness the
hospital systems proposed by the large
organizations in recent years," he said.
"They tend to have unique characteris-
tics, but all resemble corporate structures
- huge, expensive, impersonal, and con-
forming. Give primary responsibility for
the design of systems to a group of
'computer experts' and the system will
invariably use a computer. Moreover,"
the speaker continued, "the system will
tend to computerize people instead of
peoplize the computer,"

Professor Holmlund told his audience
that effective hospital systems improve-
ment requires a creative problem-solving
group of people with a variety of profes-
sional backgrounds. "Within such a
group," he said, "there should be a
sufficient number who despise and ridi-
cule computers and who continually
extol the virtue and superiority of human
common sense."

Among the resolutions passed at the
symposium was one calling on those
responsible for education courses in the
health field to include at least an intro-
duction to computer technology, infor-
mation, and communication sciences.

OR Nurses Question Panel
On Medico-Legal Problems

Toronto, Ont. - Consent forms, patient
identification, equipment, and drugs
seemed to be the areas of most concern
to nurses attending a panel discussion on
medico-legal aspects of operating room
nursing in Toronto March 20. The panel
discussion, part of a one-day seminar
sponsored by the Operating Room Nurses
of Greater Toronto, was based on ques-
tions sent in by the participants.

Robert Elgie, neurosurgeon at Scarbor-
ough General Hospital, one of five panel-
ists discussing the problems, said a nurse
would not be legally liable if she assisted
at an emergency operation that the sur-
geon considered necessary without the
patient's consent, but that she has a
moral obligation to question the surgeon
if she believes he may be wrong. Dr. Elgie
also was concerned with the question of

Two of the panelists at a discussion on
the medico-legal aspects of operating
room nursing warm up with a debate
before answering questions from the au-
dience. Dr. Robert Elgie, a neurosurgeon
at Scarborough General Hospital, talks to
chairman Florence Bestic, OR instructor
at the Wellesley Hospital, Toronto.

how informed a patient should be before
he is asked to sign a consent form. He
said that the patient should have a specif-
ic explanation, but not one that would
frighten him.

Panelist Frederick A. Jaffe, director of
laboratories at Queensway General Hospi-
tal, pointed out that the legal term
"informed" was a grey area involving
degrees of responsibility and liability.
"The degree would have to be established
in court," he said.

The problem of identification of pa-
tients is the surgeon's responsibility,
according to Dr. Elgie. Douglas Crowell,
anesthetist at St. Joseph's Hospital, To-
ronto, added that the anesthetist should
also check identification. "I would never
begin anesthesia without being sure of my
patient's identification," he said.

Sponge and equipment counts are also
the surgeon's responsibility, said Dr.
Elgie. However, he said, the nurse would
be liable if it were the hospital's policy to
have the nurse count equipment, and the
surgeon had not confirmed it. Sponge
counts are admissible in court as evi-
dence, he said.

When questioned about the legality of
administering drugs by a person not
qualified to do so, Eric R. Willcocks,
administrator of Toronto East General
Hospital, said that such a person would
have no support in court for his actions.

MAY 1970

"No one unqualified to administer drugs
should do so, even if he has the verbal or
written orders of a doctor," he said.

The panel was chaired by Florence
Bestic, OR instructor at the Wellesley
Hospital School of Nursing, Toronto.

RCAMC Offers Annual Bursary

Ottawa. - The Royal Canadian Army
Medical Corps Fund is inviting applica-
tions for an annual bursary of $300.

Applicants must be dependents of:
non-commissioned members of the
RCAMC who have been accepted for
career status; non-commissioned members
or former members of the RCAMC, who
have served a minimum of five years
subsequent to 1950; or former RCAMC
non-commissioned members of the Cana-
dian Army Special Force (Korea).

The bursary will go to a dependent
who has achieved satisfactory scholastic
standing in the entrance, first, second, or
third year of a recognized Canadian uni-
versity, teachers' college, school of nurs-
ing, or institute of technology course
requiring a minimum of 2,400 hours of
instruction.

Further details may be obtained from
the Secretary, RCAMC Bursary, Surgeon
General Staff, Canadian Forces Headquar-
ters, Ottawa 4, Ontario.

U of T Nursing School
Offers New Master's Program

Toronto.Ont - A new program leading
to the degree of master of science in
nursing will be offered by the University
of Toronto School of Nursing, starting in
the 1970-71 session. It will provide
opportunity for advanced preparation for
leadership roles in nursing and for special-
ization in community health nursing,
medical-surgical nursing (cardiovascular,
pulmonary and neurological), or psychi-
atric nursing.

Notice

of

Canadian Nurses' Foundation

Annual Meeting — June 15, 1970

Playhouse Theatre,

Fredericton, N.B,

The annual meeting of the Canadian
Nurses' Foundation will be held Mon-
day June 15, 1970, at 1600 hrs., in the
Playhouse Theatre, Fredericton, N.B.
Members will be seated on the main
floor and will be asked to present their
1970 membership card for admission.
Non-members will be welcome and will
be seated in the balcony.

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 informa-
tion or application forms, write to: The
Secretary, School of Graduate Studies,
University of Toronto, Toronto 5.

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MAY 1970

.y

THE CANADIAN NURSE 17

news

Speaker Relates Inservice
Education, job Satisfaction

Toronto, Ont. - 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 1ABSTICK

'^%

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%,
%

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.

MeadldiMni

l_ A B O R ATO R I E S

18 THE CANADIAN NURSE

•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 Mental 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 1 1 ) 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-121 1 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

The Renault 10.

Europe and a new Renault, too?
Quelle finesse!

If you want to tour Europe in style — at a
real saving — just plan now to lease or buy
a Renault. Leasing prices start as low as
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see what you want — and there's no
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•G months lease Renault 4

iAj

THE CANADIAN NURSE 19

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

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-

New Simplalablets

Sterilise baby's bottles and nipples
safely, quickly and conveniently

'S forstcriliMiijT jxHirsieriliser
'•|; fee(lill^l><)tlk■sk■shilKT(ms
■i and nipples itltMeiints

Just follow this routine

i.Wash the bonlethoroughly with
warm water and washing-up
liquid. Use a bottle brush.

2. Clean the nipple ihnroughly
with a small brush and a little salt.

3. Put one tablet in 4 pints dI
slightly warmed water. Use a non-
metalliccontainerwitha fitting lid.

YTmr.

4. Tablet dissolves in water to gi\ c
a sterilising solution of the right
strength.

5. Completely immerse bottle,
nipple, cap and disc in the sterilis-
ing solution.

6. Make a fresh sterilising solution
every 24 hours.

Manufactured in England by

20 THE CANADIAN NURSE

Maws

and distributed throughout Canada by :

Maltby Brothers Limited,

22 Elrose Avenue, Weston, Ontario.

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 spirit 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 Pubhca-
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. D

MAY 1970

Fleet

ends Trdeal by

Enema

for you and
your patient

Now in 3 disposable forms:

• Adult (green proleclive 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.

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
administration. Repeated administration
at short intervals should be avoided.

Full information on request.

•Kehlmann, W. H.: Mod. Hosp. 84:104, 1955

FLEET ENEMA® — single-dose disposable unit

MAY 1970

r~^^ OUALITV PHARMACeuTICAL* 7

(fi^ C*aifcj t.^ioMt & Co. /

KAXLAVMUCNtncAL' CANADA /

fOultOtO It Cthtlit It r#»» /

THE CANADIAN NURSE 21

names

Mona C. Ricks, of

Ottawa, has joined
The Canadian Nurse
as assistant editor.
Prior to this appoint-
. ment, Mrs. Ricks
I 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
letter beseeching students to remain in
school; the varied duties required of
wardens in Canada's national
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 most 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

Visitor To New Zealand

tf

I ^v-M.„

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 program 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-
spected 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,

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 CNATN 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 tinancial 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; Dipl. Nursing Serv.
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. D

MAY 1970

What a gas!

Our New Brunswick colleagues have been
telUng us about the pleasures awaiting
registrants to the 35 th 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 they 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 1 29 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 S40,000 - 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

n

miss.

"N

TWB FLAGS lA/iLL BE. FLVIK1<S- TO
WELCOME VOUlb FR^PERlCToN
WHEN VOU ATTBMP CMA'S 35Bi
BIE>4MIAU (CONVENTION INlOUNE

THE CANADIAN NURSE 23

This hand

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TUBULAR

GAUZE

It would normally take over 2 minutes.
But the Tubegauz method is 5 times
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are saving up to 50% on bandaging
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THE SCHOLL MFG. CO. LIMITED

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24 THE CANADIAN NURSE

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, Wolf\'ille, 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,
Saskatchewan.

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.

lune 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 3-4, 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.

lune 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.

lune 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.

lune 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.

lune 15-19, 1970

Canadian Nurses' Association General
Meeting, The Playhouse, Fredericton,
New Brunswick.

lune 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. D

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 Debro P. Hymovich, 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<entered care. Technical
innovation in the patient setting requires that the nurse hove 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.

Sutton: 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 approval or>d bill me:

□ Hymovich: Nursing of Children ($5.95)

D Secor: Patie.nt Care in Respiratory Problems ($8.40)

n Sutton: Bedside Nursing Techniques ($8.25)

Name:

Address:

City: ... Zone:

^

Province;

CN 5-70

MAY 1970

THE CANADIAN NURSE 25

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 ,<j^^
your patients against linens, r^^T
helping to prevent sheet i^ 7
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.

Lakeside Laboratories (Canada) Ltd.
64 Colgate Avenue • Toronto 8, Ontario

'Trade marl<

OPINION

One standard — 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.

1 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. ^
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^ — 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 Ontario.

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 not 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 10 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 estabUsh 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 uppermost 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 perform 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 aU our citizens are more or less
equal in terms of access to necessary
health care? - an access that we
have come to accept as a fundamental
human right, after all.""
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. 114.

3. Pearce, Evelyn C. Nurse and Patient. Toron-
to, J.B. Lippincott Company, 1954, p.78.

4. Munro, John. A challenge that confronts us.
Camid. Nurse Aug. 1969, pp.40-43. D

MAY 1970

idea
exchange

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.
MAY 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 undersAnd 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 programs; 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 wUl 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. n

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. D

30 THE CANADIAN NURSE

MAY 1970

FREDERICTON, NEW BRUNSWICK
JUNE 14-19, 1970

CANADIAN NURSES' ASSOCIATION

THIRTY
FIFTH

6ENERAL

MEETIN6

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

1 . Legal implications of nursing

(simultaneous translation)
Mr. L.E. Rozovsky, 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 1 • 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

(simultaneous 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. FELiciTAS: 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: [ 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
cliche: 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 nursing education.

THE CANADIAN NURSE 33

The author (back to camera) interviews the CNA executive. Left to right: Sister M. Felicitas, president; Marguerite Schumacher, 1st
vice-president; Kathleen E. Arpin, chairman, committee on nursing education; Margaret D. McLean, 2nd vice-president and
chairman, committee on nursing service; Louise Tod, chairman, committee on social and economic welfare; and E. Louise Miner,
president-elect. The six members of the executive discussed the issues facing CNA members.

is some difference of opinion among provincial nurses'
associations as to whether membership should be individual
and/or corporate. Obviously the decision made by CNA
members will affect the future of the association, hence its
contribution to society.

Q. Is there any possibility that a member association might
withdraw from CNA if this bylaw on the individual and/or
corporate membership is not resolved?

SISTER M. felicitas: It's not probable, but it's always a
possibility.

Another item of great significance is the fee that member
associations are willing to pay CNA. If this fee is reduced,
some part of CNA's planned program will have to be chopped.

MARGARET D. MCLEAN: Perhaps the real issue is this:
members have to decide what services they want from CNA
and what they consider to have priority. The fees are
secondary; we must look at the priorities first.

CNA'S ROLE FOR THE FUTURE
Q. The ad hoc committee on functions, relationships, and fee
structure has recommended that there be well-qualified nurs-
ing personnel in CNA's research and advisory unit to under-
take approved programs. In your opinion, what should the
association's role be in research?

E. LOUISE miner: CNA should help to identify the areas
where research is needed. The association wouldn't necessarily
be responsible for funding research, but could assist in getting
34 THE CANADIAN NURSE

money for a given project, locate persons to undertake it, and
possibly assist in developing the project.

KATHLEEN E. ARPIN: I don't see this as a cut and dry issue,
where we say "We will do this, we will do that . . . ." In
January the CNA board of directors agreed to set up an ad hoc
committee on nursing research to look at the question of
CNA's role in research. And I think we do need some
guidelines. But I don't see that we should have this role or
that role. Our policy should be flexible. We have to look,
think, and make our decision on what seems appropriate at a
given time.

E. LOUISE miner: The national association has a coordina-
ting function in research. It's up to CNA to know what
research is going on in the country at a given time, and who is
doing it.

MARGARET D. MCLEAN: I think we have to do more than
this. Our association must supply some money for research. At
times we might employ a researcher who designs a project and
is the principle investigator. I don't mean that this person
should be on staff at all times. It's like staffing the hospital
nursing service - you bring in people to meet the maximum
load.

MARGUERITE SCHUMACHER: Right now the association is
not "on top of it." We really don't know what research is
being conducted across the country. And I think it's time that
we did get on top of it. If there's a project that needs to be
done and no one else is going to do it, then we've got to do it

MAY 1970

ourselves. I agree that we may have to employ a qualified
person to do it.

KATHLEEN E. ARPIN: 1 see the CNA research and advisory
unit acting as a clearing house. The staff would have some
back work to do, finding out what kind of research has gone
on what is going or, and what is planned for the future.
1 guess 1 see this unit as an "on their toes" group.

MARGARET D. MCLEAN: One of the research and advisory
unit's major jobs sliould be to get research findings implement-
ed. I see this as a real role for the elected officers and staff of
CNA and its federated members. This could be done in various
ways: at meetings, workshops, conferences, and speaking
engagements. We have no right to ask the principle investigator
of a research project to be responsible for getting her own
findings implemented. Also, it's a misuse of her time.

MARGUERITE SCHUMACHER: We have to go even further.
We may want to implement some of these research findings,
but our hands may be tied because, like all organizations, we
do not operate in a vacuum. So there is a need for CNA to
collaborate even 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. Also, on a governmental level
there needs to be more interpretation and face to face contact.

SISTER M. FELiciTAS: 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.

Sister Mary Felicitas: "The most vital issue concerns the
individual member and her relationship with CNA. I believe
the average nurse lacks involvement with her national associ-
ation, sees it as something remote, and is unaware of its goals
and functions "
MAY 1970

E. Louise Miner: "In the future the Canadian Nurses' Associa-
tion should probably look at the problem of pollution. This is
even more important than the smoking issue. It 's in areas like
this where we can attempt to affect legislation at the federal
government level " *

THE CANADIAN NURSE 35

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. FELiciTAS: 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 tod: 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 consuUant 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 consuUant 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. FELICITAS: 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
well-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 Enghsh.

SISTER M. FELICITAS: 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 Umitations as set by
membership.

Q. The ad hoc committee also recommended a fixed per
capita fee structure. Do you believe that all 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 tod: 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 professionally and
should be setting an example.

SISTER M. FELICITAS: 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 sliould 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

revolution

in

preventive

therapy

Irrtal prevents asthma

SPECIFIC ANTIGEN

ABNORMALLY SENSITIVE
LUNG TISSUE CELL

INTAL ACTS HERE

REAGINIC ANTIBODY

INTAL ACTS HERE

RELEASE OF SPASMOGENS

AND INFLAMMATORY SUBSTANCES

■'**•'■■•.' . • . * •

Histamine
SRS-A
Bradykinin
and others

ACUTE

PULMONARY

RESPONSE

Bronchospasm

Edema

Vascular
congestion

Secretion
of mucus

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 atthe 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.

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.

f

K

»•

Sensitised mast cells, before antigen challenge

-;5-.

%

t*^i

■f %

4\.

k#

.'^h^v

>:i

0

'^^■^

Sensitised mast

▼

Mast cells sensitised and challenged, but protected with
INTAL. They are substantially intact.

Intal defends against
asthma attack

INDICATIONS

Bronchial asthma.

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.

ADMINISTRATION

DOSAGE— ADULTS
ANDCHILDREN

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 INTALtherapy 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 details of steroid dosage during INTAL therapy, please see
the INTAL 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
INTAL 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.

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.

CAUTION

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

INTAL is a trade mark of Fisons Ltd. — Pharmaceutical Division,

Loughborough, England

Printed in ttie United Kingdom INT/CAN/J1

IntalAHSONS

r PMAC 1

we could attempt to affect legislation at the federal govern-
ment level.

LOUISE tod: 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 sliould 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 committee 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 financial 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 nursing 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 chnical
resources. For example, are there other ways we can use the
MAY 1970

clinical resources? Is the student really learning to nurse when
she is practicing in the clinical area?

The committee on nursing education believes it is essential
for the profession to become more knowledgeable about this
area of student learning. It therefore recommended to the
board of directors that CNA stimulate, encourage, and become
involved in projects in this area.

The committee also recommended that the subject of the
proliferation of health workers be discussed with allied groups,
so that the whole area of collaboration, of examining goals
together, could be considered. The committee members
believe that the unique role of the nurse in the delivery of
health service could be interpreted at such meetings. The
committee has taken a stand against the proliferation of health
workers, but wants it understood that it does not focus only
on medical assistants. The members saw this as just one
dimension of a very large problem.

COMMITTEE ON SOCIAL AND ECONOMIC WELFARE
Q. What are this committee's most important recommenda-
tions to the general membership this June?

LOUISE tod: We broadened our approach in this biennium
so that our focus was not primarily on economics. More than
ever before we worked closely with the committees on nursing
service and nursing education, as we know the three cannot be
divorced. Also, we spent considerable time on the individual
nurse and the importance of her participation as a member of
a profession and the community.

Probably our most important recommendation is that the
nursing service and education committees seek ways and

Kathleen E. Arpin: "Our association has to move with the
times, 'be with it, ' and try to foresee what the demands of the
fitture will be." %

THE CANADIAN NURSE 37

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.

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. "

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 sliould, 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 tliis 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 tod: The social and economic welfare committee's
■^ THE CANADIAN NURSE

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 sliould 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, relationsliips, 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! D

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: (J 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

E. Louise Miner. Royal Alexandra Hospital
School of Nursing, Edmonton. Alta.: Diploma
public health nursing. U. of Toronto: B.N..
McGill: M.P.H., U. of Michigan.

Present Position: Director. Division of Public
Health Nursing, Saskatchewan Department of
Public Health.

Association Activities: vice-president SRNA.
1957-59: president SRNA. 1959-61; executive
CNA. 1959-61. 1964-66: first vice-president
CNA, 1966-68: president-elect 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 to^
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 form 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 determine 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 forward to your involvement
and your considered support as 1 accept
the position you have asked me to
assume.

MAY 1970

THE CANADIAN NURSE 39

CANDIDATE FOR PRESIDENT-ELECT

Margaret D. McLean. Royal Victoria Hospital
School of Nursing, Montreal; B.Sc.N., U. of
Western Ontario. London, Ontario; A.M.,
Columbia U., New York; special course in
methods improvement.

Present Position: Senior Nursing Consultant,
Hospital Insurance and Diagnostic Services,
Health Insurance and Resources Branch,
Department of National Health and Welfare,
Ottawa.

Association Activities: executive of AARN;
Board of Examiners, AARN; committee work,
RNAO; chairman, education committee,
Ottawa West Chapter, RNAO; chairman, CNA
nursing service committee 1966-68, and
1968-70; 2nd vice-president CNA, 1968-70; has
served on many other CNA ad hoc and special
committees; member, joint advisory council.
Nursing Unit Administration Extension Course;
member, planning committee for first confer-
ence on hospital-medical staff relationships.

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

beUeve 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 Hospital,
Winnipeg, Manitoba; B.Sc, Western Reserve U.,
Cleveland. Ohio; M.A. and Ed.M.. Columbia U.,
N.Y.

Present Position: Director, Health and Social
Services, Red Deer College, Red Deer, Alberta.

Association Activities: vice-president, AARN
1961-63; president, AARN 1963-65; CNA
executive 1963-65; 2nd vice-president CNA,
1966-68; 1st 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.
1 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 of 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.

CANDIDATE FOR VICE-PRESIDENT
Margaret L. Bradley. The Montreal General
Hospital School of Nursing; B.N., McGill.

Present Position: Lecturer and Coordinator of
basic degree program. School of Nursing,
Dalhousie University, Halifax, Nova Scotia.

Association Activities: chairman. Board of
Examiners (Montreal-English section); member
and later chairman. Quebec Curriculum
Committee; chairman, Montreal Instructor's
Group; member and later chairman of Montreal
District Education Committee; chairman,
committee socio-economic welfare, RNANS;
president, Atlantic Region, Canadian Confer-
ence University 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 determining their
own destiny and the future of their
profession. It 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 1 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

1

CANDIDATE FOR VICE-PRESIDENT

Jean G. Church. Royal Victoria Hospital School
of Nursing, Montreal, Que., B.Sc, Dalhousie
University, Halifax. Nova Scotia; Certificate in

Teaching and Supervision, McGill University,
Montreal: MA., Columbia U., N. Y.

Present Position: Assistant Director, School of
Nursing, Dalhousie University, Halifax, Nova
Scotia.

Association Activities: past president RNANS:
chairman of various RNA.MS committees:
member, advisory committee on nursing educa-
tion NSHIC: member, selections committee
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 determining 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 affirming 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 Hospital
School of Nursing; B.N. and M.Sc, McGill
University.

Present Position: Administrator (Patient Care),
Regina General Hospital.

Association Activities: chairman, nursing serv-
ice committee, ANPQ: chairman, nursing serv-
ice committee, SRNA; chairman of other
provincial committees.

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.

I 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

Kathleen Q.OeMitih. Saskatoon City Hospital
School of Nursing; diploma in teaching and
supervision and B A., U. of Toronto.

Present Position: Assistant Executive Director,
The Winnipeg General Hospital, Winnipeg,
Manitoba.

Association Activities: member, sub-committee
to study minimum curriculum standards for
diploma schools of nursing. RNAO; past chair-
man, nursing education committee, MARN and

member of other committees; member, nursing
education committee, 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! 1
am not suggesting that I am a radical,
though heaven knows our profession
could do with a few. What 1 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
find ourselves in as a profession stems
from the credibility gap, which I would
define as the difference between what is

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'etre for our existence as a profession!
If I did not care about people —
nurses as well as patients - 1 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 1 come in
contact. 1 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
find ourselves doinaa little of both!

MAY 1970

THE CANADIAN NURSE 41

CANDIDATE FOR VICE-PRESIDENT
Shirley R. Good. Women's College Hospital
School of Nursing, Toronto: B.Sc.N. and M.Ed.,
Drury College. Springfield, Missouri; Ed.D. in
nursing education. Teachers College, Columbia
U., N. Y.

Present Position: Director of Nursing, Universi-
ty of Calgary School of Nursing, Calgary,
Alberta.

Association Activities: chairman, Middlesex
chapter, RNAO nursing education committee,
1963-64: member, CNF selections committee,
1968.

My acceptance of the nomination for the
office of vice-president is a reaffirmation
of my behef 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 formulate two
systems of nursing education, and insti-
tute 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 Ottawa School of
Nursing: B.Sc.N.Ed., B.Ed., and M.Ed., U. of
Ottawa.

Present Position: Director, Vanier School of
Nursing, Ottawa, Ontario.

Association Activities: chairman, committee on
continuing education, Ottawa East Chapter,
RNAO: active in professional activities at
chapter and provincial levels: planning and
conducting conferences in other 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.

CANDIDATE FOR VICE-PRESIDENT
K. Marion Smith. B.S.N., U. of British Colum-
bia: M.Sc, McGill U.

Present Position: Assistant Director of Nursing,
The Vancouver General Hospital, Vancouver,
B.C.

Association Activities: active member of
RNABC, having served on the executive com-
mittee and a number of other committees:
member of the ad hoc committee studying the
functions of the 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. I believe this
responsibility encompasses the contem-
plation of new ideas, creative thinking,
and the expansion of knowledge. It 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 permit individuals to concen-
trate on their work and do a better
professional job.

42 THE CANADIAN NURSE

MAY 1970

Sister Marie Barbara

Sister Kathleen Cyr

Sister Ceciie Gauthier

Sister Rita Kennedy

Sister Ceciie Leclerc

Sister Grace Maguire

Candidates for Nursing Sisterhoods Representatives

Sister Marie Barbara. New Waterford General
Hospital; B.S.N. , St. Francis Xavier University:
M.S. in Nursing, Boston University.

Present Position: Director, School of Nursing,
St. Martha's Hospital, Antigonish, Nova Scotia:
and Acting Director, Dept. of Nursing, St.
Francis Xavier University.

Association Activities: secretary, curriculum
council, RNANS: has held office of president,
first and second vice-president, RNANS and
chairman, committee on nursing education:
representative of RNANS on advisory commit-
tee on nursing education to 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 confreres 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 informed
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. B.Sc. Seattle U.

Present Position: Instructor in Psychology, St.
Joseph 's Hospital School of Nursing, Victoria,
B.C.

Association Activities: active member of the
RNABC, presently on the e.xecutive committee
and the committee on registration.

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 maintenaifce of a strong nation-
al association.

THE CANADIAN NURSE 43

sister Cecile Gaulhier. St. Boniface General
Hospital School of Nursing; B.Sc.N., U. of
Montreal; M.S.N. , Catholic University of Ameri-
ca, Washington, D.C.

Present Position: Director, School of Nursing,
St. Boniface General Hospital, St. Boniface,
Manitoba.

Association Activities; member, board of direc-
tors, MARN; member of various MARN com-
mittees.

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 Sister St. Leo-
nard). Lorrain School of Nursing, General
Hospital, Pembroke; B.Sc.N.Ed., U. of Ottawa;
M.Sc., Catholic University of America, Washing-
ton, D.C.

Present Position; Director, St. Mary 's School of
Nursing, General Hospital, Sault Ste. Marie,
Ontario.

Association Activities; member of RNAO
committees, including the committee on nurs-
ing service and the planning committee for
school of nursing improvement programs; past
president, Catholic Hospital Conference of
Ontario; formerly member, coordinating com-
mittee of the Quo Vadis Project; member.
Council of the College of Nurses of Ontario
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,
Montreal; B.Sc.N., University of Montreal;
M.A., Catholic University, Washington, D.C.

Present Position; Director of Nursing Educa-
tion, Edmonton General Hospital School of
Nursing, and Director, Department of Nursing,
College St. Jean, Edmonton, Alberta.

Association Activities; vice-president, chairman
of committee on finance, and member of other
committees for the AARN, 1956-67; represen-
tative of the nursing sisterhoods on the CNA
executive, 1962-64; member of the CNA com-
mittee on constitution 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 1 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.

It is my belief that through active
participation in the affairs of our national
association 1 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 Alberta; B.S.N., U. of Ottawa; M.S.N.,
Catholic University of America, Washington,
D.C.

Present Position; Director of Nursing, Provi-
dence Hospital, Moose Jaw, Saskatchewan.

Association Activities; member, board of nurs-
ing education, department of education,
province of Saskatchewan; 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. D

MAY 1970

WHAT'S A FIDDLEHEAD?

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.

Miss Kotlarsky, a graduate of Carleton Universi-
ty's School of Journalism, is liditorial Assistant,
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 co«vention 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 — will
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

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. In addition to
such delicacies as lobster a 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 Maritlmes

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 AnnapoUs Valley, stopping
at Grand Pre Memorial Park, then
continuing to Digby to board the ferry
for Saint John, N.B.

Arrangements for this $150 tour can
be made through Mr. 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.l46.

MAY 1970

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.

lensen'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.
Reviewed by Glennis Zilm, formerly
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 in 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 of the health worker
the U.S.S.f . n

system m

THE CANADIAN NURSE 47

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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 w/itch hazel
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TUCKS — the valuable nur-
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Specify the FULLER SHIELD* as a protective
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THE CANADIAN NURSE

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
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 any one time.

BOOKS AND DOCUMENTS

1. Accouchement sans douleur par la
psycho-physio-prophylaxie et son extension a la
puerperalite par A. Notter. Lyon, France,
Simep, 1968. 190p.

2. Aide - memoire de pathologie a I'usage
de I'infirmiere. Suivi d'un lexique medical.
Preparation au diplome d'etat. Par Henri Diriart
et al. Paris, Bailliere 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, 1969. 69p.

4. Analysisofrhe white paper on tax reform.
Don MiUs,CCH Canadian Ltd., Ont., 1969. 94p.

5. An approach to formulation of clinic
nursing standards New York, Health and Hos-
pital Planning Council of Southern New York,
1969. 55p.

6. Associate degree education - current
issues. Papers presented at the second confer-
ence of the Council of Associate Degree Pro-
grams held at Atlanta, Georgia, March 6-8,
1969. New York, National League for Nursing.
Dept. of Associate Degree Programs, 1969. 50p.

7. Attitudes feminines devant la prevention
des naissances par P.A. Gloor. Paris, Doin
Deren, 1968. 198p.

8. Breaking the language barrier - a serv-
ice to nurses from Warner-Chilcott. Morris
Plains, N.J., Warner-Chilcott, 1969. 73p.

9. Dictionary 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, Springer, 1970. n.p.

1 1. Education studies in progress in Canadi-
an Universities 1968169. Toronto, Canadian
Education Association, Research and Informa-
tion Division, 1969. 88p.

12. Educational television by Earl Rosen.
Toronto, Canadian Association for Adult
Education, 1969. 95p. (Canadian Association
for Adult Education. Trends)

13. Le franfais, langue des affaires par
Andre Clas et Paul A. Horguelin. Montreal,
McGraw-Hill, 1969. 394p.

14. Handbook of clinical laboratory data.

MAY 1970

2d. ed. Edited by Henry C. Damn, William R.
Faulkner and John W. King. Cleveland, Ohio,
Chemical Rubber Co., 1968. 71 Op.

15. Level objectives; development and use
in the curriculum. 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
mankind. 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 paraplegic par
J. J. Walsh. Paris, Masson & Cie, 1969. 1 1 7p.

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.91)

19. Le nursing; principes generaux prac-
tique de base, Soeur Marie-Claire Rheault,
redactrice. e.ed. Redige en collaboration Insti-
tut Marguerite d'Youville. Montreal, Renauveau
Pedagogique, 1968. 68Sp.

20. The origin and evolution of the I.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. Sexualite et education familiale par S.
R. Laycock traduit de I'anglais par Le Centre
Catholique de I'Universite Saint-Paul. Ottawa,
Novalis, 1969 15 Ip.

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. 1969. 15p.

32. Responsabilites et obligations concer-
nant le soin des malades, par Rollande Gagne,
MAY 1970

redacteur, en collaboration avec Gustane Gin-
gras et Joseph Vallieres. Montreal, Intermonde,
1970. 32p.

GOVERNMENT DOCUMENTS

Canada

33. Bureau of Statistics. Survey of educa-
tion finance 1966. Ottawa, Queen's Printer,
1970. 52p.

34. Dept. of Finance. Proposals for tax
reform by E. J. Benson. Ottawa, Queen's
Printer, 1969, 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, 1970. 22p.

37. Post Office Department. A blueprint
for change. Ottawa, 1969. 134p.

38. Economic Council of Canada. Annual
review. Ottawa, Queen's Printer, 1969. 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. Business and
Defence Administration. Audio-visual equip-
ment and materials; a guide to sources of
information and market trends. Washington,
U.S. Gov't Print. Off., 1969. I5p.

Just Press the Clip and It's Sealed

It takes but a moment to identify your pa-
tient, positively and permanently, with
Ident-A-Band. Then just a glance is all you'll
need to be sure that this is the right patient.

fcfenf-A-Bancf'

Write today for free
samples and literature.

f_H0LLlST€R;

iaO BAV 9'^ TORONTO 1

THE CANADIAN NURSE 49

41. National Cancer Institute. Research
Information Branch. Cancer cause and preven-
tion: environmental factors, personal 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
publication no. 457)

43. National Center for Chronic Disease
Control, Kidney Disease Control Program. 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
Institute 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.

4 9. . 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

CNA 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 in 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. 85p. (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

5S. A study of activities performed by
nurses in the quarantine service of the quaran-
tine and immigration medical service. Canada
by Heather P. McDonald, Chapel Hill, 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.) - McGilDR

60. A study to determine how patients view
their digoxin therapy, by Rita M. Brkich,
Montreal, 1969. 35p. (Thesis
(M.Sc.(App.) - McGilDR

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.) - McGill)R D

Request Form
for "Accession List"

CANADIAN NURSES'
ASSOCIATION LIBRARY

Send this coupon or facsimite 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)

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

ASSISTANT EDITOR

The Canadian Nurse invites applications for the posiiion
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.

Please send detailed history of past academic
and work background to:

Editor
The Canadian Nurse

50 The Driveway, Ottawa 4

SO THE CANADIAN NURSE

MAY 1970

June 1970

MISS MTM MORRIS

290 NELSON ST APT 812
OTTAWA 2 ONT 30005784

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 special kind

of nurse* ^

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
responsibihties 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-
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.
Write: The Director
of Recruiting and
Selection, Canadian
Forces Headquarters,
Ottawa 4, Ontario.

4:^:'

THE CANADIAN ARMED FORCES ^

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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-jinfection.
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
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Prefolded Saneen disposables eliminate time spent
folding cloth diapers in the laundry and before
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Constant supply. Saneen Flushabyes eliminate need
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2 THE CANADIAN NURSE )UNE 1970

The

Canadian
Nurse

^

^^p

A monthly journal for the nurses of Canada published

in English and French editions by the Canadian Nurses' Association

Volume 66, Number 6

)une 1970

21 Let's Have Permanent Shifts H.A. Saunders

23 Prinzmetal's Variant Angina in a

Coronary Unit S. Dolman, J. Walkden, C. Paget

26 Nurse on James Bay T. Pearce

30 Needed: A Positive Approach to the

Mentally Retarded K. von Schilling

33 Three Patients With Hodgkin's Disease M. Jackson

36 Decentralized Nursing Service M. McKillop

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

15 Names

19 In a Capsule

39 AV Aids

7 News

18 Dates

38 Books

40 Accession List

Executive Director: Helen K. Mussallem • Ed-
itor: Virginia A. Lindabury • Assistant Ed-
itor: Mona C. Riclu • Editorial Assist-
ant: Carol A. Kotlarsky • Production Assist-
ant: Elizabeth A. Stanton • 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
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-
ciation, where applicable. Not responsible for
journals lost in mail due to errors in address.

Manuscript Information: "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 reserves
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sent, nor to indicate definite dates of
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Postage paid in cash at third class rate
MONTREAL, P.Q. Permit No. 10,001.
50 The Driveway, Ottawa 4, Ontario.
® Canadian Nurses' Association 1970.

Editorial

JUNE 1970

The newspaper report that the federal
government's health department plans
to start a program "to train nurses as
doctor-assistants" (see "At Press
Time," page 14, News), came as a
shock to nurses, who have been led to
believe that no such unilateral decisions
would be made by any group, let alone
by government. The news probably
shocked lay readers as well, because
no one has yet bothered to find out
if the public will accept "doctor-
assistants."

On the verge of irreversible shock
ourselves, we investigated. We were
assured by government spokesmen that
the main purpose of the proposed pro-
gram was to give additional preparation
to the federally-employed nurses in
the north, to help them cope with the
medical problems they are already
encountering; the purpose was noi to
establish a new category of health
worker.

Also, we learned that no definite
plans have yet been made with any
outside agency to provide this new
program, although three universities
have expressed interest. We were also
told that the graduates of such a pro-
gram would not be called "doctor-
assistant." No one seemed to know
just what they would be called.

On the surface, all looks well. No
one can argue with the principle
involved: that the nurses in the north
need all the education and experience
they can get to help them cope with
the medical problems they have to
handle.

However, despite assurances that
nothing new is being started, that the
issue is really an internal one concern-
ing only the medical services branch
of the government, we cannot help
but feel that this may be a backdoor
approach to create a new medical
category.

Our main question is this: As a
two-year program in outpost nursing
already exists at Dalhousie University,
why set up a new one?

Why, indeed, unless, as the news
item says, the program will create and
train "dcKtor-assistants." •

If, as a national association, we are
as concerned about patient care as
we say we are, we must take a stand
on this "doctor-assistant" issue and
take it quickly. Otherwise, we may
soon find this new category set up and
in operation, while we are still trying
to "initiate dialogue with appropriate
groups." •

V.A.L.

THE CANADIAN 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.

Reply from Minister

I recently received a letter from the
Honorable John Munro, Minister of
National Health and Welfare, in reply
to the letter I sent him earlier this year.
("Letters" page 4. March 1970'".)

In his letter Mr. Munro has attempt-
ed to clarify the facts with respect to
the action of the National Department
of Health and Welfare in relation to the
Canadian Nurses' Association's appli-
cation for a grant to carry out a nursing
education project. ("News," January
1970, page 5.) in his letter the Minister
states:

"In my letter to the Canadian Nurses'
Association 1 indicated that the pres-
sures developing in connection with the
recommendations of the Task Forces on
the Cost of Health Services made it very
difficult for me to approve this particu-
lar project at that time.

"You will be pleased to know, how-
ever, that a number of such projects are
presently being re-examined by my Re-
view Committee in the light of our
better knowledge of the number of
projects arising from the Task Force
activities, of priorities and of available
funds."

Since I had expressed my concern that
the Department, as reported in the Jan-
uary issue of The Canadian Nurse, had
given no reason for the lack of appro-
val for the Canadian Nurses' Associa-
tion's submission, I was interested in
receiving his letter. Other Canadian
Nurse readers may have had similar
concerns. Perhaps you might like to
clarify the situation by publishing this
letter. — Dorothy J. Kergin, Reg.N.,
Ph.D., Associate Professor, School of
Nursing, McMaster University, Ham-
ilton. Ont.

Task force report

I appreciated the interesting report on
"Task Force on the Health Services"
(February 1970). However, I do not agree
with the idea of reducing or not em-
ploying registered nurses in the operating
room, central supply room, admitting
office, etc.

I believe nurses should continue to
assume responsibility in the operating
room. They are more adequately trained
than operating room technicians and
other personnel, and academically and
professionally they have more knowledge.

As nurses, one of our goals and objec-
tives is to provide continuity of care
before, during, and after operations.
4 THE CANADIAN NURSE

Don't we consider nursing in the operat-
ing room as one of our specialties?

In the other departments, are the
non-nursing personnel aware of the basic
and scientific principles involved? I agree
that they know the how and when of
cleaning and sterilizing instruments and
other articles, but 1 doubt if they know
the why and the applicability of these
scientific theories. Does not nursing care,
planning, and meeting the individual's
needs begin as soon as the patient is
admitted, or even earlier?

To remove the registered nurse from
these different departments simply means
a reduction in the quality of nursing
care. - Solomon M. Guerrero, RN,
Winnipeg, Manitoba.

I have worked as a registered nurse for
nine years and was very pleased to read
the special report on "Task Force on the
Cost of Health Services in Canada"
(February 1970).

If the Minister of National Health and
Welfare puts a little effort toward making

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the task force's ideas possible, I think 100
percent of nurses and other hospital
personnel will rejoice. At least he will be
remembered for a long time. - Mrs.
Caliboso. RN. Prince Rupert. British
Columbia.

Need to economize

I recently attended two workshops —
one on the problems and priorities of
nursing, and one on continuing care
of the elderly patient. These workshops
were informative and covered the sub-
ject matter well; however, at the end
of each, those present were acutely
aware that the programs outlined could
never be implemented with the present
shortage of staff and funds in health
institutions.

Since extra financial assistance to
hospitals comes from taxes, each nurse
has a responsibility to be economical.
If she were made aware of hospital
costs, from the price of a syringe up-
ward, she might try harder to keep
costs down.

Much could be done to economize
at the administrative level. For instance,
are nurses employed to nurse, or do
many still function as clerks and clean-
ers? Are the best nurses available hired
to fill vacant positions? Are nurses
adequately prepared for the positions
they find themselves in, particularly in
specialized areas? Is any thought given
to maintaining a happy working envi-
ronment? Are hospital administrators
qualified to make studies of staffing
and work patterns, and institute change
where necessary? Are all administra-
tors in small hospitals necessary, or
could some functions be shared with
other small institutions in the area?

Conscientious nurses can tolerate
only so much of the poor quality of
nursing caused by these restrictive
practices. Then they must look else-
where for fulfillment, causing continual
staff turnover and an ever greater
strain on the hospital budget. — Mrs.
Phyllis McNey, Stony Plain, Alberta.

February issue best

As a Canadian nurse away from home,
I was extremely proud of the February
issue. It was the best one yet. All
the articles were interesting and
instructive.

Our journal more than holds its
own among its peers. — Mrs. Lois
MacRae, RN, Denver, Colorado. D

lUNE 1970

a little knowledge is not enough . . .
give teen-agers the facts about menstruation

Some teen-agers have heard they should n't bathe
or wash their hair during their menstrual periods.
Somethink unmarried girlsshouldn't use tampons.
Others say exercise brings on "cramps." No
wonder they call it the "curse."

Give them the facts . . . with the help of the
illustrations in charts like the one above prepared
by R. L Dickinson, M.D. and available to you free
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by giving teen-agers either of the two booklets we
will be glad to send you in quantity fordistribution.
One booklet is written for the young girl just begin-
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teen-ager. The booklets tell them what menstrua-
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can adjust to it normally and naturally.

Unmarried girls, of course, can use tampons. And
they have many good reasons to do so. Tampax
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JUNE 1970

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Tampax tampons.

Name_

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THE CANADIAN NURSfc 5

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6 THE CANADIAN NURSE

lUNE 1970

news

Committee Studies
Health Cost Reports

Ottawa — 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 will meet again for a four-day dis-
cussion on those sections of the reports
which do not specifically mention nur-
sing, but still affect the profession.

Issues 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.

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, Weilesley 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

Ottawa — 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 1970-71 fiscal year under the
new national health grant program. The
project was begun in May and should
be completed by June 30, 1 97 1 .

The study is designed to determine
what prevents registered nurses in lead-
ership positions in Canada from ob-
taining the educational preparation
needed for their work. A great discre-
pancy exists between the academic qual-
ifications the Canadian nursing profes-
sion believes nurses should possess and
the qualifications actually held.

This discrepancy was pointed out in
the annual national inventory of regis-
tered nurses compiled by the CNA re-
search unit, and was also identified by

JUNE 1970

the recent federal government task for-
ces on health care costs.

The study aims to answer the follow-
ing: 1 . 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 be the role of the
nurse in the future? This question was
answered by the executive director of
the Canadian Nurses' Association in two
recent speaking encagements 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 by Dr. Mussallem, will be re-
quired to take on many responsibilities
of the doctor in general practice.

Speaking to audiences at Rockland
Community College, Suffern, and
Teachers College, Columbia University,
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 country, the nurse
has already assumed this role," 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-
cussed at the recent Commonwealth
Foundation Caribbean Seminar on
Nursing, held in Barbados. Dr. Mus-
sallem attended as a consultant.

Directors Of Nursing
Attend Federal Seminar

Ottawa — Directors of nursing from
across Canada attended a seminar held
here April 7-10 by the department of
national health and welfare. Its
objective was to share with the di-
rectors tools that the federal and pro-

Margaret D. McLean, (standing, center), ch, . . . ,- .:inator 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-
tended the seminar, the first of its type.
Chairman and coordinator was Marga-
ret D. McLean, senior nursing consult-
ant hospital insurance and diagnostic
services branch of the federal health
department.

Three major topics were discussed:
organizing nursing service to meet

These second-year nursing students from the Ottawa Civic Hospital participated
m the first Miles for Millions walk held in Canada this year, on April 18. Start-
mg off on their 40-mile 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

lUNE 1970

Keynote speaker at the institute on human relations m tlie iieaiui ^eivice?, !,poiiiored
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 1 5 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 million. 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
involved. These include the Canadian
Save the Children Fund; the Canadian
UNICEF committee; and Oxfam.

BC Operating Room Nurses Meet

Vancouver, B.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 Nursing

Halifax, 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.

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THE CANADIAN NURSE 9

It's Finger-Lickin' Good!

Colonel Sanders, of Kentucky Fried Chicken fame, celebrated his 79th birth-
day recently during a stay at The Wellesley Hospital, Toronto. Here he cuts
inio a birthday cake appropriately decorated with a chicken. Looking on are,
from left: Doreen Nakamura, Mefus Ensor, Gloria Demessa, Alfred Kiessl,
all of The Wellesley. (Photo courtesy of Wellesley World.)

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 1, 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

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 are 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 CJN 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

Fredencton,N.B. — TheNurses'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, Ont. — "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, extending 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

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THE CANADIAN NURSE 11

news

Panelists Debate Extended Role of Nurse

annual meeting registration fees be
increased; and that an attempt be
made to have the affiliation fees to the
Canadian Nurses' Association reduced
from SIO 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 said 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, Alta. — 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

Toronto. Ont. — Should the nurses' role be expanded, or should a new category
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 Wodehousc, 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 associate" — 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

Toronto, Ont. — To have more regis-
tered nurses, and more nurses with
higher qualifications working in Ontario

are two of 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 Robarts 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.

lUNE 1970

• Use of incentives, 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 Nurses 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 if
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 self-
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, Ont. — 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 make 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

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lUNE 1970

THE CANADIAN NURSE 13

news

guess is that the recommendations with
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 RN AO
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, BC. — 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 Hospitals' Associa-
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 4 1 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, and
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 Cha-
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 1 3 issue of The Globe and Mail re-
ports that the federal government plans
to set up a program to 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 preparation.

When asked if the decision to estab-
lish this special program might set a
precedent and encourage other agen-
cies to prepare physician's assistants.
Dr. Wiebe said, if this happened it
would be a by-product and not inten-
tional. □

JUNE 1970

Australian Visitor in Ottawa

Winnifred M. Ride, right Nursing Adviser to the Minister of Health in
Australia, 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 Yorkton Union Hospital,
Yorkton, Saskatchewan; general staff
nurse at the Montreal Neurological Insti-
tute; supervisor of chest surgery at Saska-
toon Sanatorium; night supervisor at Gait
Hospital in Lethbridge. Alberta; instruc-
tor and associate director of Yorkton
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 than in hospitals.

Dorothy J. Kergin

has been named di-
rector of the school
of nursing at McMas-
ter University in
Hamilton. She suc-
ceeds Alma 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; Dipl.
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-
ing.

Currently research associate and
director of the Nursing Studies Index
program in the School of Nursing at
Yale University, New Haven, Connec-
ticut, Dr. Henderson was formerly
THE CANADIAN NURSE 15

Whenyourday

starts at __
6 a.m... you re oji
charge duty.. ^
you've skimped
on meals...
and on sleep...
you haven thad^
time to hem
a dress...
make an apple pie...
wash your hair,
evenpowder i/M
your nose.
mcomfort5

It's time for a change. Irregular hours and meals on-the-
run won't last. Bui your persona! Irregularity is another
matter. It may settle liown. Or ii may need gentle help
from DOXIDAN.

use

DOXIDAN'

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 comfortable.

For detailed information consult Vademecum
or Compendium.

HOECHST

PHARMACEUTICALS

3400 JEAN TALON W . MONTREAL 301
DIVISION OF CANADIAN HOECHST LIMITED
MEMBER

I »MAC I

16 THE CANADIAN NURSE

«i"~

an instructor and associate professor
of nursing education at Teachers Col-
lege, Columbia University; clinical
director at Norfolk Protestant Hospi-
tal School of Nursing in Rochester,
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 101.

A well-known nurse in both Canada
and the United States, Miss McMillan
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 1 969 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.

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., St. 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 Polytechnical 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 Ryerson.

lUNE 1970

names

R. Roslyn KJaiman (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 KJaiman 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 ap-
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

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

WINLEY-MORRIS aV

MONTREAL

LTD.

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

^^P

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

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
Lisgor 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.

June 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-

18 THE CANADIAN NURSE

sored by the OAAA, 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 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 con be obtained from Mrs.
Nancy Reid, Chairman, Convention
Committee, Ontario Dialysis Associa-
tion, Sunnybrook Hospital, 2075 Boy-
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-October 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
Merchant Rd., St. John's, Nfld. □

JUNE 1970

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 1, 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 1 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."

"My Are.1 of Interest Is . .

Never let it be said that everyone who
visits the library of the Canadian
Nurses' Association is interested only
in books. As proven by the library
register, romance can rival reading in
this library.

One nursing student and her boy-

friend, who spent their time in the
library looking at each other over their
books, signed their "area of interest"
in the register as "my boyfriend" and
"my girlfriend." A||d we thought the
only dates the librarian saw were on
overdue books!

THE CANADIAN NURSE 19

Pinworms

can be a problem

lanywfcere.

^* -

fM<

4 4

:«v

:•>

n,

:-'-=u*(^4

■•;-^

^srcy!

')i

1^%

(pyrvinium pamoate, P. D. & Co.)

PARKE-DAVIS

Parke, Davis 4 Company, Ltd., Montreal 379.

Pinworms may spread in any family, at any time. Usually a single dose of

Vanquin is effective for eradication of pinworms.

Therapy is well tolerated, economical, and convenient. Vanquin

Suspension or VANQUIN 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 VANQUIN Suspension or one

VANQUIN 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 : VANQUIN is available as a pleasant-tasting, strawberry-flavoured

suspension in 1 -02. and 2-oz. bottles; and as sugar-coated tablets in packages of 1 2, and

bottles of 25 and 100.

Vanquin Suspension contains the pamoate equivalent of 10 mg. pyrvinium base per cc.

Each Vanquin Tablet contains the pamoate equivalent of 50 mg. pyrvinium base. Detailed

prescribing information available on request.

OPINION

Lefs have permanent shifts

Nursing administrators should allow nurses to work only 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-ill 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.

1 submit that staff on permanent 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 Inservice Education Supervisor at the
Royal Jubilee Hospital, Victoria, B.C.

JUNE 1970

As 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 children.

For nurses who wish to continue their

education while working, permanent shift

THE CANADIAN NURSb 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 permanent 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 find
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

Permanent shift also enhances continu-
ity of patient care. When shifts constantly
rotate, no nurse is responsible for a
patient on any one 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. D

lUNE 1970

Prinzmetars variant angina
in 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.1 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
normal.

Because of the transient nature of the
changes, such patients are hard to recog-
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 well 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. Walkden is Head Nurse of the Coronary
Unit, Toronto General Hospital. Mrs. Dolman
and Mrs. Paget are former 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 1 0 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
1 5 to 20 cigarettes a day for 25 years.

On examination, the blood pressure
was 170/105 and there were no other
abnormal 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 11, III, and aVF.* The T wave in
lead I 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 1 1
hours after admission, showed a return of
the S-T segments to the baseline with a
negative T wave in leads I and aVL.

*The following designations are used for
augmented unipolar leads: aVF - when the
positive terminal of the electrocardiograph is
connected to the left foot; aVR - when the
positive terminal is collected to the right arm;
and aVL - when the positive terminal is
connected to the left arm.

THE CANADIAN NURSE 23

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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.

Figure 1 . Segments of monitor record
taken at intervals of two minutes.
Elevation of R- T Segment shown in B
preceded chest pain, which did not
occuruntilC(2 minuteslater). Maximum
pain occurred 4 minutes after onset of
ECG changes. E and F show return of
R-T segments to normal, as pain
subsided.

24 THE CANADIAN NURSE

lUNE 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 J). 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 S-T
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, V2-V5.** These changes persisted

**Vi to Vg, the precordial leads, 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 1, aVL, V3-V5.
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 S-T
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

1. Prinzmetal, M., Kennamer, R., Merliss, R.,
Wada, T., and Bor, N. Angina pectoris. A
variant form of angina pectoris. Amer. J.
Med. 27:375, 1959.

2. Lunger, M., and Shapiro, A. Continuous
electrocardiographic monitoring in noctur-
nal angina. Amer. J. Cardiol. 13:119, 1964.

D

THE CANADIAN NURSE 25

Nurse on James Bay

Terry Pearce

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

JUNE 1970

Miss Leach gives members of a family a medical
check, then talks through John Nakogee about
beaver skins and the weather.

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 Kasheshewan.
JUNE 1970

THE CANADIAN NURSE 27

/^ ,1

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■ *

f

"^''t

l^^H^^^

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t

^

At Kasheshewan, the busy clinic is in one room of
the small school. The patients are mothers, child-
ren, elderly men She weighs and checks the
babies . . .

28 THE CANADIAN NURSE

JUNE 1970

diagnoses an ailment
with the help of her
interpreter . . .
writes a last-minute
prescription for an ill
wife. For the next six
days she leaves the clin-
ic in charge of a mis-
sionary lay dispenser.

lUNE 1970

THE CANADIAN NURSE 29

Needed: a positive approach
to the mentally retarded

N

Negative attitudes of hopelessness and helplessness influence the social climate
and the experiential world of the retarded child. Nursing ar\d medical
personnel can help to dispel these negative attitudes and replace them with
positive, constructive attitudes that will help both child and family.

Karin C. von Schilling, B.Sc.N., M.S.

In our success-oriented culture, high
value is placed on intellectual achieve-
ment. Signs of mental deficiency in a
child invariably elicit feelings of disap-
pointment, hopelessness, and helpless-
ness.

These negative feelings, likely to be
most disturbing to the affected family
during the initial adjustment period, are
reflected in society's attitudes toward the
mentally retarded; in too many instances
they are also reflected in the attitudes of
medical and nursing personnel.

Why this negative attitude on the part
of professional health workers? Probably
because present-day medical technology
has no "cure" for mental deficiency and
it is therefore regarded as hopeless.

Parents of a child born with a physical
defect, such as clubbed feet or hare-lip,
receive some comfort in knowing that the
defect can be repaired in the future and
the child will eventually be normal. But
what comfort is or can be offered to
parents who have a child with an "incura-
ble" mental defect?

Medical-nursing support needed

When defects in a child are discovered,

Miss von Schilling, a graduate of the University
of Toronto and the University of California,
San Francisco, is Assistant Professor at McMas-
ter University School of Nursing in Hamilton,
Ontario. She is the author of another article on
the birth of a defective child, published in
Nursing Forum, Vol. VI 1, no.4, in 1968.

30 THE CANADIAN NURSE

medical-nursing efforts must be directed
toward improving transactions and inter-
actions during the initial traumatic expe-
rience. This is necessary either in the
maternity unit, when the child is born
with a recognizable defect, or later, when
a diagnosis of mental retardation is estab-
lished.

During the birth process, the mother is
likely to be acutely aware of verbal and
non-verbal communication around her.
As soon as the child is bom she expects
to be informed of its sex and that "the
baby is all right."

If such assurance is not forthcoming
immediately, the mother is often haunted
by fears of gross abnormality or even
death of the baby. She may seek informa-
tion from the attending nurse.

Nurses feel uncomfortable when con-
fronted with a fearful mother's questions,
and in such situations often respond by
avoiding contact and interactions with
her. Yet the situation calls for purposeful,
supportive action to help alleviate the
stresses of uncertainty and to help the
mother perceive and deal with reality.

The major principle for the nurse's
actions is honesty - and tact - about
her own feelings, about her knowledge or
lack of it, and about what is done around
the baby. This is not the time for
elaborate explanations or speculations.
Simple, honest answers are apt to be most
helpful in conveying a caring attitude, a
willingness to stand by, and a trust in all
members of the medical team.

lUNE 1970

When the mother poses the frantic
question "What's wrong with my baby? "
the nurse, if she does not have detailed
information but is aware of a concern for
the baby's condition, can reply: "Well
now, I don't know, but as soon as one of
the doctors is free we'll ask him over to
tell us. I'll stay with you."

It is rather obvious that the frequently
offered reply of "Just relax! Your baby
will be fine," is one of denial and
avoidance and is apt to increase, rather
than alleviate, anxiety.

Parents need each other

Parents should be together when they
learn about their baby's abnormality so
their feelings and reactions can be shared
from the beginning. Together, parents can
resort to established ways of comforting
and strengthening one another.

There appear to be few indications for
withholding the baby from his parents.
Any mother wishes to see and hold her
baby as soon as possible after delivery to
establish the reality of his existence and
his intactness as a human being. Parents
of a baby with a defect also need to see
the child so they can take hold of reality
and dispel some of their imagined fears.

Explaining a defect such as Down's
syndrome does not mean much to parents
who have a limited repertoire of medical
terminology and whose minds are cloud-
ed with anxiety under the initial impact
of the bad news. When they see their
child they are often surprised that he
looks and behaves much like any other
newborn.

After seeing and holding their mongo-
loid offspring, some mothers decide
against giving them up even if their
doctor does suggest institutionalization.
Nurses in the delivery room and on the
maternity ward should use every opportu-
nity to help parents view and hold their
child, as this seems to be an important
step in fostering a mutually rewarding
parent-child relationship. Such a relation-
ship offers the child a basis for the
security and trust that is so essential for
his growth and development.

Hospital nurses can help

Nurses are in an opportune position to
offer meaningful support when parents
cope with their initial grief, frustration,
anxiety, and guilt. 1 Parents may need
encouragement in expressing their sorrow
about the child's condition, and nurses
can encourage and support the grieving
process, which may take many forms,
^cognizing and accepting that the par-
1970

ents need to cry, express hostility, or be
quiet and withdrawn, is not easy for the
nurse who finds such situations stressful
and uncomfortable.

But the nurse can learn to acknowl-
edge perceived behavior and say, "It's all
right to cry," or, "It is difficult when so
many questions have no answer; it must
make you feel frustrated and angry," or,
"You have been so quiet. Is something
bothering you? "

By allowing expression of feelings,
nurses help parents voice their concerns
and talk about the problem. They need to
explore such questions as, "What did I do
wrong? " or "Why did this happen to
us? " A nurse cannot provide answers,
but by listening she encourages parents to
look at the situation and to begin to
anticipate ways of coping.

After helping parents with their initial
reactions, the nurse can assist them to
become more comfortable in caring for
the baby. They need to become acquaint-
ed with his individual characteristics and
his need for comfort and love, regardless
of his congenital defect.

All too often mothers tell a story of
how the baby was brought in and placed
on the bed, of how they were left alone
to feed him, not knowing what to expect
or what to do, and of how they were
afraid of their own feelings of anger
toward this child who was causing so
much upset and confusion. Parents need
to learn to care for their child under the
guidance of a nurse or a knowledgeable,
caring individual. This allows them to
gain confidence and feel capable of offer-
ing comfort and care to the baby.

By talking to the baby or commenting
on his attributes and responses, the nurse
can help the parents see him as a person,
not as a congenital anomaly. Her presence
when the mother is feeding the baby
offers opportunities for questions about
the child's condition and what it might
mean to the family and the child.

The type of questions asked will alert
the nurse of a need to clarify or a need to
consult other members of the team so
that available resources can be explored
and mobilized. A sense of success and
satisfaction gained from the first child
care experiences appear significant in
helping parents gain hope and confidence
in their own ability to care for the baby.

Community nurses help at home

Before mother and baby are discharg-
ed from hospital, steps can be taken to
initiate referral to a district nurse, the
local association for mentally retarded, or

other available community services that
might help. Some hospitals notify the
public health agency when a discharge is
planned for a child with a congenital
anomaly. This assures prompt visiting by
a nurse who is knowledgeable of the
child's defect and who can plan and offer
support and assistance.

Members of the local association for
the mentally retarded are often willing to
come and visit newly-afflicted parents.
Parents seem to get comfort from
knowing they are not alone in facing the
problem of their child's mental retarda-
tion. Knowledge that other parents have
managed and that there are facilities
within the community may constitute a
source of hope.

The first few days, weeks, and even
months at home constitute a critical
period for many parents. Regular visits by
a nurse and a close relationship with the
doctor contribute greatly to favorable
adjustments at home.

Most new parents live through anxiety-
provoking experiences when the baby
refuses to eat, regurgitates, cries exces-
sively, or does not sleep for several
hours. Parents of a retarded or abnormal
child need to hear that such occurrences
are common and "normal"; this adds to
their ability to provide care and comfort.

Their abUity to cope and their self-
esteem can be enhanced through praise
and recognition of their efforts. When the
public health nurse visits a family with a
retarded child, she needs to center her
attention on the family itself, with special
emphasis on the mother. The whole
family - including the baby benefits
when the nurse takes a sincere interest in
the mother and makes her well-being the
object of attention.

The goal is to foster a positive ap-
proach to mental retardation and to
attempt to strengthen the family unit.

Not always recognized

A deficit in mental ability is not
always apparent at birth. In many cases,
inability to meet the demands of acceler-
ated learning and maladaptation during
the pre-school and school years first
indicate a defect in cognitive ability.

These children may have been consid-
ered normal earlier and therefore received
normal psychosocial stimulation during
infancy and the first formative years,
perhaps establishing the sense of trust and
security so essential for later personality
growth. *

A child diagnosed at birth or shortly

after as mentally retarded is more likely

THE CANADIAN NURSE 31

to start in a social climate of hopeless-
ness. Mothers of mongoloid babies, when
asked, related to the author unhappy
stories of what happened to them during
their hospital stay when the child was
born and diagnosed as mentally defective.
The parents' own trust and confidence is
built up, reinforced, or undermined by
how doctors and nurses respond and
react.

Parents are often told to abandon their
newborn mongoloid child, to forget they
ever had a baby, to apply for institution-
alization of the child. Such advice,
although well intended, is insensitive and
hardly realistic.

Each case, each set of parents, and
each family needs careful assessment and
consideration. The newborn period, when
parents are dealing with their shock and
emotional responses, is hardly the time
for long-term decisions.

Is placement in an institution in the
interests of the parents and of benefit to
the child?

The argument against institutionaliza-
tion of mongoloids is well presented and
documented by Fotheringham and Mor-
rison.2 These writers explore a number of
questions commonly asked by parents
and others who envision the mentally
retarded child as a strain on parents and
siblings and hazardous to family integrity.

Their studies contradict the urgency
for institutionalization and lend support
to the concept that the child, at least
during infancy and early years, benefits
from living in the family milieu. They
found that the mongoloid child's needs in
infancy do not differ greatly from those
of normal infants and that he "generally
does not require elaborate physical care,
but desperately needs the . . . atmosphere
of love and security possible only through
maternal closeness."3 This should lend
support to efforts to promote home care
for such children.

Children with Down's syndrome show
wide vanations in achievement and men-
tal ability. Although the diagnosis is
usually established at birth, the learning
potential remains an unknown quantity
until much later. Even then, arguments
rage about the validity and rehability of
testing devices, which seem to determine
the educational experiences offered.

As well, there are questions about a
limited endowment in learning ability
versus environmental influences, such as
the quality of human relationships, and
about experiential sequelae and limita-
tions in sensory-motor stimulation at
optimal development levels.
32 THE CANADIAN NURSE

Although the retarded child shows
differences in development of mental
processes when compared with other chil-
dren, the differences in the organization
of the world around him appear even
more striking.^

A mentally deficient child needs added
protection to ensure his safety and securi-
ty. Nonetheless, much of this alteration
in his experiential world can augment
non-growth rather than facilitate poten-
tial development. The retarded
child — as any other - needs positive
feedback as fuel for his learning and for
the development of his self-system. His
experiences with the human and object
world should provide maximum stimula-
tion from which he can derive a sense of
achievement, mastery, and self-worth.
These are essential for a positive self-
image and the utiHzation of learning
potential.

All community resources

After a family has been assisted and
supported during the first stages, health
care and guidance should then emphasize
prevention of physical and emotional
isolation, which can occur in the home. A
creative approach in utilizing family and
community resources can provide stimu-
lation and rewarding experiences to the
child and his family.

The greatest hazard is the attitude of
hopelessness. A nurse working with fami-
ly members can help them develop games
and activities that involve the retarded
child; such activity offers him the neces-
sary motor-sensory stimulation. I once
witnessed a family's enjoyment in being
creative and doing something with and
for the child. Yet, in this case, the
physician had asked, "What good will it
do? He is retarded."

Physicians and nurses need to watch
their attitudes as these will influence
others. The premise "Every child can
learn" must be substituted for "He is
retarded; there is no hope."

The mentally retarded are all too often
viewed as tainted, less-than-human, and a
burden to society. Preoccupation with
"problems" precludes the realization that
many families and individuals have deriv-
ed growth-promoting experiences from
their associations with the mentally re-
tarded.

As one mother said: "Susan has helped
us all to become more sensitive and
appreciative of people. We find we have
more to offer to each other and to the
people we meet. I feel almost sorry for
some of the families in our neighborhood;

they don't know what they have and they
don't know what they are missing."

References

1. Hinshaw, Ada Sue. Early planning for long-
term care of children with congenital anom-
alies. In Bergersen, B.S. et al. Current
Concepts, in Clinical Nursing. St. Louis,
C.V. Mosby Co., 1967, pp.284-291.

2. Fotheringham, J.B. and Morrison, Mary.
Mongolism - the case against institutiona-
lization. Canad. Family Physic, June 1969,
pp.4 7-51.

3. Ibid.

4. Gardner, G.E. The next decade, expecta-
tions from the social sciences and education.
Mental Retardation. Chicago, American
Medical Association, 1 964, pp. 114-122. D

r

For the
asthma
patient

\

Intal

is a
revolution

preventive
therapy

Intal prevents asthma

SPECIFIC ANTIGEN

ABNORMALLY SENSITIVE
LUNG TISSUE CELL

INTAL ACTS HERE

^ REAGINIC ANTIBODY

INTAL ACTS HERE

RELEASE OF SPASMOGENS

AND INFLAMMATORY SUBSTANCES

Histamine
SRS-A
Bradykinin
and others

ACUTE

PULMONARY

RESPONSE

Bronchospasm

Edema

Vascular
congestion

Secretion
of mucus

before the attack begins

mo

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.

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.

%
f

^

^•

Sensitised mast cells, before antigen challenge

Sensitised mast

f > »

d

4

*.

I *

Mast cells sensitised and challenged, but protected with
INTAL. They are substantially intact.

Intal defends against
asthma attack

INDICATIONS

ADMINISTRATION

DOSAGE— ADULTS
ANDCHILDREN

CONCOMITANT
THERAPY

WITHDRAWAL
OFINTAL

SIDE EFFECTS

CAUTION

PRESENTATION

STORAGE

Bronchial asthma.

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 Splnhaler.
Each cartridge contains 20 mg. disodium cromoglycate (INTAL) In ultra-fine powder form, with lactose
B.P. as a carrier.

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.

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 details of steroid dosage during INTAL therapy, please see
the INTAL product literature or packing leaflet.

Continuity of therapy Is important in patients whose asthma Is controlled by INTAL. If for any reason
I NTAL 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.

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 bronchodllator aerosol.

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.

INTAL cartridges are supplied In bottles of 30.

Spinhaler turbo-inhalers are supplied in individual containers.

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

I NTAL is a trade mark of FIsons Ltd. — Pharmaceutical Division,

Loughborough, England

Printed in the United Kingdom INT/CAN/J1

IntalAHSONS

I PMAC I

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 Jackson, B.Sc.N.

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
15 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 disease

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 I - Disease limited to one anatom-
ic region or to two continuous ana-
tomic regions on the same side of the
diaphragm.
Stage II - Disease in more than two
anatomic regions or in two non-
lUNE 1970

continuous regions on the same side of
the diaphragm.
Stage III - Disease on both sides of the
diaphragm, but not extending beyond
involvement of lymph nodes, spleen,
or Waldeyer's ring.
Stage IV - 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 1 5 years. Hodgkin's sarcoma is higlily
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 Western 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. TiSs treatment is usual-
ly reserved for specific symptoms or
complications.

THE CANADIAN NURSt 33

Chemotherapy has been used with a
degree of success in treating Hodgkin's
disease. Although there are many chemo-
therapeutic agents available, only the
more commonly used drugs will be dis-
cussed 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 usually shows improvement in
one to three days. If there is no bone
marrow depression, the treatment may be
repeated every two months.

Leukeran (chlorambucil): May be used
as a maintenance drug three to six weeks
following nitrogen mustard therapy. The
usual oral dose is 0.2 mg./kg., given in
divided doses following meals. Improve-
ment may not occur for three to four
weeks, with the maximum effect seen in
two to four months. Since the ; is danger
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 follow-
ed by 50 to 100 mg. orally, 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 follow-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 vitally
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 forms 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 well 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

lUNE 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 1 5 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 the 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
JUNE 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, slie
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. MacMUlan, 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 Brown,
1969. □

THE CANADIAN NURSE 35

Decentralized nursing service

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.

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 administrator," 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

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
administrative 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

lUNE 197W

PREVIOUS
ORGANIZATIONAL CHART

Executive
Director

Director of
Nursing

Ass't. Director of
Inseruice Education

1

Ass't. Director of
Nursing (Nights)

Ass't. Director of
Nursing (Days)

Ass't. Director of
Nursing (Evenings)

Super-
visor

Super-
visor

Super-
visor

Super-
visor

Super-
visor

Super-
visor

Super-
visor

Super-
visor

—

—

—

—

—

—

—

—

^Head
Nurses

REVISED
ORGANIZATIONAL CHART

Executive
Director

1

Nursing
Administrator

Director of
Inservice
Education

Administrative
Adviser

Ass't. Nursing
Admin. (Eve.)

Ass't. Nursing
Admin. (Nights)

1

1

1 1

1

1

Director
Peds. &
Emerg.
Nursing

Director
Surgical
Nursing

Director

OR
Nursing

Director
Medical
Nursing

Director

Dbs.&Gyn.

Nursing

Director
Special
Services

—

—

—

—

—

Ihead
1 Nurses

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-
lUNE 1970

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. D

THE CANADIAN NURSt 37

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
black 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 specific
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, N.Z., N.M. Peryer Limit-
ed, 1969.

Reviewed by David M. Quinn, Pharma-
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
traditionally a weak area for nurses. How
we could all be helped by the long
overdue eUmination of the apothecary
and "teaspoonful" system!

The section on pharmacology follows
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 a 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. D

JUNE 197(

'i

AV 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
procedures, develop principles of prac-
tice, and instruct in arrhythmia detec-
tion and treatment. Scripts are includ-
ed.

• 12 audio tapes, which expand on
rnaterial in the films through ques-
tions and answers; express differing
views on management of nursing prob-
lems; and present lecture-typje material.
Scripts are provided.

• 1 1 copies of the text Intensive Coro-
nary Care — A Manual for Nurses, by
Lawrence E. Meltzer, Rose Pinneo, and
J. Kitchell. The multimedia system ex-
pands and updates the basic course
content of this manual.

• 1 copy of Cardiopulmonary Resus-
citation Conference Proceedings, edit-
ed by Archer S. Gordon.

• 10 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

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 EIco 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-

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 nurseof 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 coi^ 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,

AV aids

(Continued from page 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
toHoffmann-LaRochelnc, 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 resumes, 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 1 6 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 any one time.

BOOKS AND DOCUMENTS

1 . ABC de statistique a I 'usage des etudiants
en midecine 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, cl970. 213p.

3. The age of discontinuity; guidelines to
our changing society, by Peter F. Drucker. New
York, Harper and Row, cl968, 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 'autonomic provinciate; les droits des
minorith et la theorie du pacte, 1867-1921, par
Ramsay Cook. Ottawa, Imprimeur de la Reine,
1969. 82p. (Etude de la Commission royale
d'enquete sur le 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.

essential information in time-

A New Book!

ORTHOPEDIC NURSING: A Pro-
grammed Approach By Nancy A.
Brunner, 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!

PROGRAMMED INSTRUCTION

rc^^ IN ARITHMETIC, DOSAGES,

>^ AND SOLUTIONS fiyZ)o/orexF.

Saxton, R.N.. B.S., M.A., and
John F. Walter, Sc.B., M.A., Ph.D.
This 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.

M05BV

TIMES MIRROR

40

THE C.V, MOSBY COMPANY. LTD. • 86 NORTHLINE ROAD • TORONTO 374. ONTARIO, CANADA
THE CANADIAN NURSE

lUNE 1970

accession list

(Continued from page 40)

Ottawa, Canadian Council for Research in
Education. 1969. 83p.R

8. Canadian medical directory: compiled
from the daily medical service bulletins. Toron-
to, 1970. 740p.R

9. Catalogue de Vedition du Canada frangai-
se publiee par le Conseil du Livre avec le
concours du Ministere des Affaires Culturelles
du Quebec 1969-1970. Montreal, 1966. 503p.R

10. La chirurgie plastique esthetique par
Armand Genest. Montreal, Editions de I'Hom-
me, 1969. 125p.

1 1 . Clinical aspects of oral gestagens: report
of a WHO Scientific Group. Geneva, World
Health Organization, 1966. 24p. (WHO Tech-
nical report series no. 326)

12. Diagnostic 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. 271 p.

14. Directory of Canadian welfare services.
Ottawa, Canadian Welfare Council, 1970.
ISOp.R

15. Equipment and supplies for hospitals
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, 1 970. 208p.

17. y4 guide to radiotherapy nursing by T.
J. Deeley et al. Edinburgh, Livingstone, 1970.
92p. (Livingstone nursing texts)

1 8. Family planning with the pill: a manual
for nurses Chicago, G. D. Searle & Co., 1968.
60p.

19. Les fiches mithodologiques. Collection
"Sante et Sicurite" Ton livre de Sante: ler livre
par Gabrielle D'Armour et al. Montreal, Lidec,
n.d. Iv.

20. From student 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 student to nurse: the induction
period. A study of student nurses in the first six
months of training in five schools of nursing.
Oxford, Oxford Area Nurse Training Commit-
tee, 1961. 106p.

22. The hospital ward clerk, by Ruth Perrin
Stryker. Saint Louis, Mosby, 1970. 179p.

23. How to run a P.R. campaign: 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: hospitals and the
cult of efficiency, by Carol Taylor. New York,
Holt, Rinehart and Winston. 1 970. 203p.

25. Intensive 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, 1 970. 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 catalog. Chicago,
111., Matheson, Coleman and Bell, 1969. 291p.

31. Le langage et la pensee dans la deficien-
ce mentale profonde. Etude experimentale, par
N. O'Connor et B. Hermelin. Paris, Gauthier-
Villars, 1966. 132p.

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. i. Roylance. London, Butter-
worths, 1969. 288p.

34. Nursing care of children, by Florence G.
Blake et al. Philadelphia, Lippincott, 1970.
568p.

35. Partners in development: report of the
commission on international development, by

saving new Mosby books!

A New Book!

CRISIS INTERVENTION:
Theory and Methodology By Don-
..,^^na C. Aguilera. R.N.. B.S., M.S.,
<,^JL^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 precipitated by specific stress
situations. It explains the psychotherapeutic background of
this versatile technique, and its effective use. Clear,
non-technical discussions explore various contributing fac-
tors, and carefully examine the nurse's role. May, 1970.
135 pages, 6Vz" x Q'/j", 13 Illustrations. About $5.45.

New 2nd Edition.'

BASIC CONCEPTS IN ANATOMY
AND PHYSIOLOGY: A Programmed
Presentation By Catherine Parker
Anthony, R.N., B.A., M.S. A valuable
supplement to classroom work, this
efficient manual drills and tests students on basic concepts
of anatomy and physiology. This expanded edition includes
new units on the circulatory system and on kidney
function. In addition, almost every section contains new
diagrams and new frames. Concise, easily digested segments
not only furnish pertinent information, but require some
response by the student. July, 1970. Approx. 180 pages, 7"
X 10", 52 Illustrations. About $5.25.

MOSBY

TIMES MIRROR

JUNE 1970

THE C. V. MOSBY COMPANY, LTD. • 86 NORTHLINE ROAD • TORONTO 374. ONTARIO. CANADA

THE CANADIAN NURSE

41

accession list

(Continued from page 41)

Lester B. Pearson. New York, Praeger, 1969.
399p.

36. Physiologie et Industrie par Lucien
Brouha. Paris, Gauthier-Villais, 1963. 180p.
(Monographies de physiologie causale no.3)

37. Principles for first aid for the injured.
2d ed. by H. Proctor and P. S. London.
London, Butterworths, 1968. 253p.

38. Report of the director, 1968-69. Toron-
to. College of Nurses of Ontario. 23p.

39. Report of Inter-regional Conference on
Nursing. Workshop in Curriculum Develop-
ment-Nursing, New Delhi, 22 Nov. to 3 Dec.
1965. New Delhi, World Health Organization,
Regional Office for South Fast Asia, 1966. 69p.

40. Review, 1969. Ottawa, Canadian Inter-
national Development Agency, 1970. 55p.

41. The right to abortion: a psychiatric
view. Formulated by the Committee on
Psychiatry and Law. New York, Group for the
Advancement of Psychiatry Inc., 1969.
p.197-230 (Its vol. 7 series no. 6)

42. Staffing for patient care; a guide for
nursing service based on a research report by
Elmina M. Price. New York, Springer, 1970.
177p.

43. Team leadership in action: principles
and application to staff nursing situations by
Laura Mae Douglass and Em Olivia Bevis. Saint
Louis, Mosby, 1970. 139p.

44. Toujour s belle, jeune et en forme par
Qaudia Lamarche. Montreal, F.ditions Ici
Radio-Canada; F:ditions Lemeac, 1969. 91p.

45. Workshop in in-service education
conducted in Bangkok, Thailand, 28 Aug. to 8
Sep. 1967, report by E. M. Sewell. New Delhi,
World Health Organization, Regional Office for
South-east Asia, 1968. 39p.

PAMPHLETS

46. Female reproductive physiology and
oral contraceptives. Bramalea, Ont., G.D. Searle
and Company of Canada, n.d. 7p.

47. Human relations and the industrial
order. An address by Charles H. Malik. New
York, American Management Association,
1959, 12p.

48. Normes du service infirmiere dans les
services de sante: guide d'auto-evaluation.
Ottawa, Association des infirmieres canadienne,
1969. 45p.

49. The pill and you. Bramalea, G.D. Searle
and Co. of Canada Ltd., Ont. 1 969. pam.

50. Nurse testing bulletin no. 551, April
1955. New York, Psychological Corporation.
6p.

51. Planning your family. Bramalea, Ont.,
G.D. Searle and Company of Canada, 1969?
Iv.

52. A position paper on nursing in Manito-
ba. Prepared in 1969, revised in 1970. Win-
nipeg, Manitoba Association of Registered
Nurses, 1970. 19p.

42 THE CANADIAN NURSE

53. Statement on medical-nursing responsi-
bilities issued jointly by Manitoba Association
of Registered Nurses, Manitoba Medical Asso-
ciation and Manitoba Hospital Association,
Winnipeg, 1969. pam.

GOVERNMENT DOCUMENTS
Canada

54. Atlantic Development Board. Report,
1968-69 83p.

55. Bureau of Statistics. Annual report of
notifiable diseases, 1968. Ottawa, Queen's
Printer, 1970. 105p.

56. . Canada: the official handbook

of present conditions and recent progress.
Ottawa, Queen's Printer, 1970. 312p.R

57. . Canada yearbook: official sta-
tistical annual of the resources, history, institu-
tions and social and economic conditions of
Canada. Ottawa, Queen's Printer, 1970.
1329p.R

58. . Estimates of employees by

province and industry, 1961-1968. Ottawa,
Queen's Printer, 1969. 31p.

5 9. . Vital statistics: preliminary

annual report, 1968, Ottawa, Queen's Printer,
1970. 51p.

60. . Tuberculosis statistics 1968.

Ottawa, Queen's Printer, 1970. 54p.

61. . Training schools 1968. Otta.'*/^,

Queen's Printer, 1970. 44p.

62. Conseil du tresor. Guide de classement
ideologique des dossiers administratives. Otta-

MOVING?
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reg. no./perm. cert./ lie. no.

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MAILTO:

The Canadian Nurse

50 The Driveway
OTTAWA 4, Canada

wa, Imprimeur de la Reine, 1969. Iv. (Serie de
la gestion des ecritures)

63. Dept. of Labour, Economics and Re-
search Branch. Wage rates, salaries and hours of
labour, 1968. Ottawa, Queen's Printer, 1969.
434p.

64. Dept. of National Health and Welfare.
Report on the operation of agreements with the
provinces under the hospital insurance and
diagnostic services act for the fiscal year ended
March 31. 1968/69, Ottawa, 1970. 130p.

65. National Library of Canada. Canadian
theses, 1967/68. Ottawa, Queen's Printer,
1970. 43p.

Ontario

66. Dept. of Labour. Women's Bureau. Law
and the woman in Ontario. Toronto, 1970.
19p.

U.S.A.

67. Dept. of Health, Education and Wel-
fare. Public Health Service. Arthritis and rheu-
matism. Rev. Washington, U.S. Gov't. Print.
Off., 1965. pam. (U.S. Public Health Service
publication no. 29 rev.)

68. . Better teeth for life: fluorida-
tion. Washington, U.S. Gov't. Print. Off., 1968.
14p. (U.S. Public Health Service publication no.
636 rev.)

69. . Cancer: questions and answers

about rates and risks. Washington, U.S. Gov't.
Print. Off. 1966. 21p. (U.S. Public Health
Service publication no. 1514)

70. . Congestive heart failure: a

guide for the patient. Washington, U.S. Gov't.
Print. Off., 1963. lip. (U.S. Public Health
Service publication no. 1 056)

71. . Diet and arthritis. Washington,

U.S. Gov't. Print. Off., 1969. pam. (U.S. PubUc
Health Service publication no. 1857)

72. . The facts about smoking and

health. Washington, U.S. Gov't. Print. Off.,
1968. 13p. (U.S. Public Health Service publica-
tion no. 1712 rev.)

73. . Glaucoma and its effect on

eyesight. Washington, U.S. Gov't. Print. Off.,
1963. pam. (U.S. Public Health Service publica-
tion no. 1030)

74. . Health manpower source book,

section 2. nursing personnel Washington. U.S.
Gov't. Print. Off., 1969. 144p.

75. . Heart disease. Wa.shington, U.S.

Gov't. Print. Off., 1968. pam. (U.S. Public
Health Service publication no. 1731)

76. ■. Home care of the sick. Wash-
ington, U.S. Gov't. Print. Off., 1961. pam.
(U.S. Public Health Service publication no. 70)

77. . Home care: what it is. Washing-
ton. U.S. Gov't. Print. Off., 1966. 5p. (U.S.
Public Health Service publication no. 1655

78. Malaria. Rev. Washington, U.S.

Gov't. Print. Off., 1967. 2p. (U.S. Public Health
Service publication no. 166 rev.)

79. . Medical radiation information

for litigation. Proceedings of a conference
on November 21-22, 1968 at Baylor University
College of Medicine, Houston, Texas. Washing-
ton, U.S. Gov't Print. Off., 1969. 392p.

80. : Menopause. Rev. Washington,

U.S. Gov't. Print. Off., 1964. 3p. (U.S. Public
Health Service publication no. 179 rev.)

lUNE 1970

accession list

(Continued from page 42)

81.

Rabies. Rev. Washington, U.S.

Gov't. Print. Off., 1963. pam. (U.S. Public
Health Service publication no. 97 rev.)

82. . Smoking and health. Washing-
ton, U.S. Gov't. Print. Off., 1968. pam. (U.S.
Public Health Service publication no. 1732)

83. . When teenagers take care of

children: a guide for baby sitters. Washington,
U.S. Gov't. Print. Off., 1964. 60p. (U.S. Public
Health Service publication no. 1179)

84. National Cancer Institute. Office of
Information and PubUcations. Hodgkin's dis-
ease. Washington, U.S. Gov't Print. Off., 1966.
pam. (U.S. Public Health Services pubUcation
no. 864 rev.)

85. National Center for Chronic Disease
Control. Diabetes and Arthritis Control
Program. Diabetes and you. Rev. Arlington,
Va., National Center for Chronic Disease Con-
trol, 1968. 16p. (U.S. PubUc Health Service
publication no. 567 rev.)

86. National Institute of Allergy and Infec-
tious Diseases. /I sf/ima. Washington, U.S. Gov't.
Print. Off., 1966. lOp. (U.S. Public Health
Service publication no. 155 rev.)

87. . Poison ivy. oak and sumac.

Washington, U.S. Gov't. Print. Off., 1967. pam.
(U.S. Public Health Service publication no.
1723)

88. National Institute of Arthritis and
Metabolic Diseases. Information Office. CF:
facts about cystic fibrosis. U.S. Gov't. Print.
Off., 1967. pam. (U.S. Public Health Service
publication no. 1077)

89. National Institutes of Health. Division
of Biologies Standards. Blood and the Rh
factor. Rev. Washington, U.S. Gov't Print Off.,
1966. 7p. (U.S. Public Health Service publica-
tion no. 790 rev.)

90. National Institute of Neurological Dis-
eases and Stroke. Cerebral palsy: hope through
research. Washington, U.S. Gov't. Print. Off.,
1969. 7p. (U.S. Public Health Service publica-
tion no. 713 rev.)

91. National Institute of Neurological Dis-
eases and Blindness. Mental retardation, its
biological factors: hope through research. Wash-
ington, U.S. Gov't. Print. Off, 1968. 23p. (U.S.
Public Health Service publication no. 1152 rev.)

92. -. Mongolism (Down's syndrome)

hope through research. Washington, U.S. Gov't.
Print. Off., 1968. 7p. (U.S. PubUc Health
Service publication no. 720 rev.)

93. . Parkinson's disease; present

status and research trends. Washington, U.S.
Gov't. Print. Off., 1968. lOlp. (U.S. Public
Health Service Publication no. 1491 rev.)

94. National Institute of Neurological Dis-
eases and Stroke. Parkinson's disease: hope
through research. Rev. Washington, U.S. Gov't
Print. Off., 1969. 18p. (U.S. Public Health
Service publication no. 811 rev.)

95. Public Health Service. Diabetes. Rev.
Washington, U.S. Gov't. Print. Off., 1964. pam

(U.S. Public Health Service publication no. 137
rev.)

96. . Hepatitis. Washington, U.S.

Gov't Print. Off., 1966. 3p. (U.S. Public Health
Service publication no. 446 rev.)

STUDIES DEPOSITED IN CNA REPOSITORY
COLLECTION

97. Follow-up report on survey concerning
mental health problems in the Th-Town area.
Kirkland Lake, Dept. of Health of Ontario,
Timiskaming Health Unit. 1965. 38p.R

98. Report on auditory screening tests from
January 5 to May 25 at the Timiskaming Health
Unit Office in Kirkland Lake. Kirkland Lake,
Dept. of Health of Ontario, Timiskaming
Health Unit, 1965. 28p.R

99. Report to investigate the extent of
mental health problems in the Tri-Town area by
the staff nurses of the Timiskaming Health
Unit, Tri-Town Office, Kirkland Lake, Dept. of
Health of Ontario, Timiskaming Health Unit,
Tri-Town Office, 1965. 27p.R

100. A study of the verbal interaction
between master teachers and students during
clinical nursing conferences, by Emma Jean M.
HUl. New York, 1967. 198p. (Thesis - Teach-
ers' College, Columbia U.)R

101. University Hospital, Saskatoon, Sask.
nursing study phase 1 and phase 2. Saskatoon,
Sask., 1967. 2v.R

102. University Hospital. Saskatoon, Sask.
patient classification study. Saskatoon, Sask.
Saskatchewan University, Hospital Systems
study Group, 1968. 18p.R □

Request Form
for "Accession List"

CANADIAN NURSES'
ASSOCIATION LIBRARY

Send this coupon or facsimite to:
LIBRARIAN, Canadian Nurses' Association,
SO 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.

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

ASSISTANT EDITOR

The Canadian Nurse invites applications for the poslllon
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.

Please send detailed history of past academic
and work background to:

Editor
The Canadian Nu(se

50 The Driveway, Ottawa 4

JUNE 1970

THE CANADIAN NURSE 43

classified advertisements

ALBERTA

ALBERTA

BRITISH COLUMBIA

REGISTERED NURSES FOR GENERAL DUTY in a

34-bed hospital. Salary 1968. $405-$485. Experien-
ced recognized. Residence available. For particu-
lars contact Director of Nursing Service. While-
court General Hospital, Whitecourt. Alberta. Phone;
778-2285.

BASSANO GENERAL HOSPITAL REQUIRES NURSES
FOR GENERAL DUTY. Active treatment 30-bed hos-
pital in the ranching area of southern Alberta. Tovi'n
on Number 1 Trans-Canada Highway mid-way between
the cities of Calgary and Medicine Hat, Nurses on
staff must be willing and able to take responsibility in
all departments of nursing, with the exception of the
Operating Room. Single rooms available in comforta-
ble residence on hospital grounds at a nominal rate.
Apply to: Mrs. M. Hislop, Administrator and Director
of Nursing. Bassano General Hospital, Bassano. Al-
berta.

GENERAL DUTY NURSES for active, accredited,
well-equipped 65-bed hospital in growing town, pop-
ulation 3.500. Salaries range from $490 — $610 com-
mensurate with experience, other benefits. Nurses'
residence. Excellent personnel policies and work-
ing conditions. New modern wing opened in 1967.
Good communications to large nearoy cities. Apply:
Director of Nursing. Brooks General Hospital, Brooks.
Alberta.

GENERAL DUTY NURSES (2) for small, modern hos-
pital on Highway no. 12, East Central Alberta. Salary
range $477.50 to $567.50 including regional differen-
tial. Residence available. Personnel policies as per
AARN and AH. A. Apply to: Director of Nursing. Co-
ronation Municipal Hospital. Coronation. Alberta.

GENERAL DUTY NURSES for 94-bed General Hospi-
tal located in Alberta's unique Badlands. $405 — $485

ADVERTISING
RATES

FOR ALL

CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additiorxil line

Rates for display
advertisements on request

Closing dote for copy and cancellation is
6 weeks prior to 1st day of publication
month.

The Canadian Nurses' Association does
not review the personnel policies of
the hospitals and agencies advertising
in the Journol. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they ore interested
in working.

Address correspondence to:

The

Canadian
Nurse

50 THE DRIVEWAY
OTTAWA 4, ONTARIO.

per month, approved AARN and AHA personnel poli-
cies. Apply to: Miss M. Hawkes. Director of Nursing.
Drumheller General Hospital. Drumheller, Alberta.

GENERAL DUTY NURSES for summer relief and also
for permanent positions for a 50-bed active General
Hospital located on the main line between Calgary
and Edmonton, Residence accommodation, if desired.
Salary scale effective May 1, 1970, $490 to $585. Past
experience recognized. Apply to: Mrs. E. Harvie, R,N-,
Administrator. Lacombe General Hospital, Lacombe,
Alberta,

Inquiries are invited from GENERAL DUTY NURSES

for Dositions in a 330-bed active-treatment and aux-
iliary hospital complex. This is an ideal location in a
city of 27,000 with summer and winter sports facili-
ties nearby, 1970 salary schedules effective May 1,
1970, $490, — $610, Recognition given for previous
experience. For further information, please contact
Personnel Officer, Red Deer General Hospital, Red
Deer, Alberta,

BRITISH COLUMBIA

MEDICAL-SURGICAL NURSING INSTRUCTOR, with
University preparation, for a 450-bed hospital with a
school of nursing. Apply: Associate Director School
of Nursing, St, Joseph's Hospital School of Nursing,
Victoria, B.C.

HEAD NURSE required tor 30-bed hospital, B.C.

interior. New 41-bed hospital in late planning stage.
Salary and conditions of work in accordance with
RNABC Contract, Excellent accomodation available-
Community based on mining and ranching. Must
have or obtain B.C. registration. Demonstrated lead-
ership ability or capability required. Apply: Director
of Nurses, Lady Minto Hospital, Box 488, Ashcroft,
B.C.

"HEAD NURSE — required immediately for a 27-bed
men's med/surg. floor, including a 4-bed intensive
care/coronary care unit. Responsible for the in-ser-
vice education for this unit. Experience in l,C,U. and
a keen interest in teaching is mandatory. Terms of Ihe
RNABC contract are in effect. Please contact: Direr-
tor of Nursing, Chilliwack General Hospital, ChilM-
wack, B.C. '

REGISTERED NURSES WITH PSYCHIATRIC EXPE-
RIENCE for acute care modern 170 bed psychiatric
facility of a progressive general hospital with School
of Nursing. Credit for past experience and post-gra-
duate training, 40 hour week, statutory holidays, an-
nual increments, cumulative sick leave, pension plan,
20 working days annual vacation, B,C, registration
required. Apply: Director of Nursing, Royal Jubilee
Hospital, Victoria, British Columbia.

REGISTERED NURSES FOR GENERAL STAFF requi-
red by TRAIL REGIONAL HOSPITAL. Trail. has a
238-bed fully accredited regional referral hospital si-
tuated in the Columbia River Valley of southeastern
British Columbia. Salary $549 rising to $684 38 3/4
hour week. Apply to: Director of Nursing, Trail Re-
gional Hospita, Trail. B.C,

GENERAL DUTY NURSES for modern 35-bed hospital
located in excellent recreational area. Salary and per-
sonnel policies in accordance with RNABC. Comfor-
table Nurses' home. Apply: Director of Nursing, Boun-
dary Hospita. Grand Forks. British Columbia.

"GENERAL DUTY NURSES for 63-bed active hospital
in beautiful Bulkley Valley. Boating, fishing, skiing,
etc. Nurses' Residence; Salary $498. — $523.; Main-
tenance $75,; recognition for experience. Traval bro-
chure on request. Apply: Administrator, Bulkley Valley
District Hospital, Smithers. B.C, "

O.R. NURSE required for active modern Hospital. 2
Qualified surgeons and 2 ObslGyn specialists on
attending staff. Must be eligible for B,C. registration
and must have P.G. in O.R. Salary $574 — $628 per
month depending on education and experience.
Apply: Director of Nursing. Mills Memorial Hospital
2711 Tetrault St., Terrace. B,C,

OPERATING ROOM NURSES for modern 450-bed hos-
pital with School of Nursing. RNABC policies in ef-
fect. Credit for past experience and postgraduate
training. British Columbia registration is required.
For particulars write to: The Associate Director of
Nursing, St.Joseph's Hospital, Victoria, British Co-
lumbia.

GRADUATE NURSES for fully accredited 100-bed Ge-
neral Hospital. Starting salary $522 — $684,00 mon-
thly with credit for past experience. Apply to: Direc-
tor of Nursing. St, Joseph General Hospital, Dawson
Creek. B,C,

NURSES' COME TO THE PACIFIC NORTHWEST —

Gateway to Alaska. Friendly community, enjoyable
Nurses' Residence accommodation at minimal cost.
1970 RNABC contract salaries in effect. Registered
$549-$684. Non registered $522. Northern Differential
$15 a month. Travel allowance up to $60 refundable
after 12 months service. Apply to: Director of Nurs-
ing, Prince Rupert General Hospital, 551 5th Avenue
East, Prince Rupert, British Columbia,

MANITOBA

REGISTERED NURSE for a 44-bed Senior Citizens
Home in Notre Dame de Lourdes, Manitoba, She
IS considered Nursing Supervisor of the Home and
co-ordinates occupational therapy and nutrition.
She works a day shift only with every second
weekend off. Residence accommodation available
at nominal rate. Salary commensurate with experi-
ence and qualifications. Pease apply The Adminis-
trator. Foyer Notre Dame Inc., Notre Dame de Lour-
des, Manitoba,

NEW BRUNSWICK

GENERAL DUTY NURSES: Positions available for
Registered Nurses in modern 65-bed hospital.
Location on American border. Applicationa and
enquiries will be received by: Director of Nursing.
Hotel Dieu of Saint Joseph. Perth, New Brunswick.

NOVA SCOTIA

REGISTERED NURSES, PSYCHIATRIC NURSES, and
CERTIFIED NURSING ASSISTANTS: Positions
available in this modern, 270-bed psychiatric
hospital located in the Annapolis Valley, Expanding
treatment program requires enthusiastic nursing
personnel. Orientation and In-Service available.
Excellent personnel policies. For further informa-
tion direct enquiries to: The Director of Nursing,
Kings County Hospital, Waterville, Nova Scotia.

GENERAL DUTY NURSES applications are invited
for active treatment hospital caring for medium and
long term patients. Salary Range: $5,400. — $6,660,
Excellent Fringe benefits and working conditions.
Please apply to: Director of Nursing, Halifax Civic
Hospital, 5938 University Avenue. Halifax. N,S,

ONTARIO

44 THE CANADIAN NURSE

"PUBLIC HEALTH NURSING SUPERVISOR with pre-
paration in advanced Public Health Nursing and Su-
pervision or Baccalaureate degree with Administration
required for Hastings & Prince Edward Counties
Health Unit. 266 Pinnacle Street, Belleville. Ontario.
Good Personnel Policies, Apply to Dr. C. R. Lenk, Me-
dical Officer of Health and Director. Hastings & Prin-
ce Edward Counties Health Unit, 266 Pinnacle Street,
Belleville, Ontario."

PUBLIC HEALTH NURSING SUPERVISOR qualified,
recognized certificate in Public Health Nursing, a
baccalaureate degree, experience including super-
vision and administration. Good personnel policies.
Apply to: Dr, G. B, Lane, Medical Officer of Health,
Porcupine Health Unit, 70 Balsam Street South,
Timmins, Ontario.

PUBLIC HEALTH NURSING ASSISTANT SUPERVI-
SOR, (qualified), required for Lambton Health Unit.
Salary $9,100. Apply: Dr. G.L. Anderson, Director,
Lambton Health Unit, 333 George Street, Sarnia,
Ontario,

lUNE 1970

July 1970

MISS MTM MORRIS

?90 NELSON ST APT 812
ITTAWA 2 ONT 0O0Q578A

The

Canadian

Nurse

this nurse is a regular
at the racetrack

negligence in the recovery room

how one hospital evaluates
and introduces new products

f\

\

A

c:;

M

pJ<t^

^1

L,.

sterimedIc

SYSTEM

TM

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 tlie 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 IVz".

Velvet smootii aspiration and injection. Stable, multl-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.) lew restricts this device to use by or al the
direction ot a physician. As with all sterile disposable items, the packaging
should always be checked. II 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 13y2 " 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:

SMrllon Corporation 1505 Washington Street • Bralntree, Mass. 02184
Subsidiaries ol The Gillette Company

sterilon o« Canada, Ud. 3269 American Drive • Malton. Ontario *U. S. Patent 3.1 14.455

Sterimedic '■ Is a traden^rK of Sterilon Corporation.

Fleet

ends ordeal by

Enema

for you and
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 disposatile.
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.

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
administration. Repeated administration
at short intervals should be avoided.

Full information on request.

•Kehlmann, W. H.: Mod. Hosp. 84:104, 1955

FLEET ENEMA® — single-dose disposable unit

QUALITV PHARMACEUTICALS

Cfowfei f .^R<>»t & Co.

2 THE CANADIAN NURSE

JULY 197H

The

Canadian
Nurse

&

"^F

A monthly journal for the nurses of Canada published

in English and French editions by the Canadian Nurses' Association

Volume 66, Number 7

July 1970

21 Teachers — You Are Trespassing! , D.W. Mesolella

22 She's a Regular at the Racetrack V. Foumier

26 Negligence in the Recovery Room

29 New Product Evaluation in Hospital R. Dolan

33 This Nurse Coordinates Patient Services „ C. Kotlarsky

36 Use of Part-Time Teachers Benefits Students

and Faculty F.J. McPhail

38 Hospital Nursing and the Demand For Change J.I. Williams

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

14 Names

18 Dates

42 Research Abstracts

46 AV Aids

63 Index to Advertisers

5 News

17 New Products

19 In a Cajjsule

43 Books

46 Accession List

64 Official Directory

Executive Director: Helen K. Mussallem • Ed-
itor: Vii^inia A. Lindabury • Assistant Ed-
itor: Mona C. Ricks • Editorial Assist-
ant: Carol A. Kodarsky • Production Assist-
ant: Elizabeth A. Stanton • Circulation Man-
ager: Beryl Darling • Advertising Manager:
Rnth 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 o( Address:
Six weeks' notice; the old address as 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.

Manuscript Information: "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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
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. Permit No. 10,001.
50 The Driveway, Ottawa 4, Ontario.
(D Canadian Nurses' Association 1970.

Editorial

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.

Alberta orderlies comment

The article "One standard — or two?"
(May 1970) by Albert Wedgery is to
the point. The author is to be commend-
ed for speaking about a problem that
has existed for many years.

In some parts of the country, order-
lies have tried to organize programs to
prepare them for their work. Mr. Wed-
gery rightly states that in Manitoba the
problem of inadequately prepared or-
derlies has been partly solved by a
training program in operation for the
past 10 years.

This article also states that in Alberta
a school for nursing orderlies has been
operating since 1967. However, as far
back as 1961, orderlies in Alberta
have tried to improve their preparation.
Early in 1962 the Alberta Association
of Nursing Orderlies was incorporated.
This body, with the assistance of the
Alberta Association of Registered
Nurses and other associations interested
in upgrading patient care, was respon-
sible for establishing the Alberta Nurs-
ing Orderly School. Previous to this,
preparation of orderlies had been on an
inservice basis. Although not ideal, this
was at least an attempt to improve the
preparation of these members of the
nursing team.

It is to be hoped that other provinces
will act on the recommendation of the
Task Force on the Cost of Health Serv-
ices in Canada, that the nursing orderly
should be prepared at the level of the
registered nursing assistant. This, in
effect, is what is being done in Alberta
under the department of education. —
G.E. Lefebvre, president, Alberta As-
sociation of Nursing Orderlies.

Overcoming nursing routines

One of your best and most mteresting
articles was Pamela Poole's "Nurse,
please show me that you care!" (Feb.
1970).

I heartily agree that we are slaves to
routine, but is this due to the nurse her-
self? She is certainly frustrated to find
she cannot give all the care she wants
to give her patients during her eight-
hour shift.

However, beginning when she is a
student, the nurse is drilled in the "ac-
cepted" daily routine — medications,
meals, and treatments — according to
the clock, rather than the patient's de-
sires. The nurse comes to perform these
duties in an almost robot-like way, but
thankfully, usually in a friendly manner.
4 THE CANADIAN NURSE

Many nurses would like to adapt their
nursing care to each patient's needs at
a certain time; for example, the nurse
should have time to give more intense
care pre- and postoperatively.

So often a nurse leaves a patient's
bath until later in the day to allow him
to rest, only to have a head nurse or su-
pervisor find the patient resting and im-
mediately send an S.O.S. for the nurse:
"Mr. Jones is lying in bed and hasn't
had his bath or even been up yet!"

The need for individualism in nurs-
ing must be accepted by clinical in-
structors, nursing supervisors, and di-
rectors of schools and hospitals before
general duty nurses can give better,
more effective nursing care, which
meets patients' needs at a given time.
— Noreene R. Collins, R.N., Ottawa.

I was pleasantly surprised to read the
article by Pamela Poole, "Nurse, please
show me that you care!" 1 have felt the
same way for a long time.

At one point in my teaching exper-
ience I had to prove to myself that this
concept of individualized patient care
was not ivory-tower philosophizing, but
was applicable to nursing situations
commonly found in clinical areas.

Thus, one summer I returned to bed-
side nursing in a busy medical-surgical
unit. I asked that I be given my patient
assignment a day ahead. I arrived 20
minutes early in the morning to check
for changes in the medical plan of thera-
py; assessed patients' needs and set pri-
orities tor individual patient care; tried
to anticipate needs associated with fluid
intake and elimination so that I would
not have to retrace my steps in the midst
of caring for another patient; capitalized
on opportunities to combine a number
of nursing activities while giving care;
and explained to each patient that he
should call me when necessary and that
in the meantime I would try to see him.

Many times I was repaid for my ef-
forts by verbal and non-verbal expres-
sions of appreciation, a developing
sense of trust in my care, and patient
interest in his own care. Some days I
felt more successful than others, but my
spirits were never too dampened be-

Letters 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.

cause I believed I recognized the patient
as a person with a variety of needs and
did the best I could.

If we each shouldered our share of
responsibility for getting to know our
patients as Miss Poole pointed out;
worked together to cut down on ritualis-
tic, outmoded practices; carefully plan-
ned for the optimum utilization of
nurses' various levels of skill; and con-
cerned ourselves with the positive ef-
fects of a cooperative nurse-patient re-
lationship based on individual patient
needs, would there be so many disillu-
sioned nurses? — Lillian Douglass,
Reg.N., Ramathihodi Hospital, Bang-
kok, Thailand.

Scholarship available

The Regina General Hospital School of
Nursing Alumnae makes available a schol-
arship of S500 to active members of the
alumnae who are presently engaged in
nursing. This scholarship may be used in
any university school of nursing for post-
graduate study. Completed applications
must be received by June 1 , 1970.

Application forms and further infor-
mation may be obtained from: Mrs.
Shirley Newis, Chairman, Scholarship
Committee, 1016 Lorimer Place, Regina,
Saskatchewan.

Award winners announced

The Faculty of Nursing, The Univer-
sity of Western Ontario, is pleased to
announce the names of the students
who have been given awards this year
from the Mildred I. Walker Bursary
Fund. The students are Carol A. Black,
Linda N. Brown, and Jacqueline E.
Lewis.

This fund was established in the
Faculty of Nursing by the students and
friends of Miss Walker. — R. Cather-
ine Aikin, Dean, Faculty of Nursing,
The University of Western Ontario.

Copies available

A limited number of copies of Proceed-
ings, Conference on Continuing Nursing
Education held June 24, 1969 in Wilson
Hall, McGill University, under the spon-
sorship of the University of British Co-
lumbia School of Nursing, are available at
a cost of $3. They can be obtained from
the Division of Continuing Education in
the Health Sciences, University of British
Columbia, Task Force Building, Vancou-
ver 8, B.C. - Margaret Neylan, Associate
Professor and Director. School of Nurs-
ing, University of British Columbia. D

JULY 1970

news

Poverty Is Cause Of Illness,
CNA Tells Senate Committee

Ottawa. — The cause of illness among
the jX)or is rooted in their economic
conditions and is beyond the jurisdic-
tion of nursing care, the special senate
committee on poverty was told June 4
by the Canadian Nurses" Association.

"Poverty is a major, contributing
cause of ill health and an impediment
to the maintenance of good health,""
CNA said in a brief presented to the
committee. The association urged treat-
ment of the cause of illness — poverty
— rather than just the symptoms.

CNA also pointed out that the total
cost of health care will be decreased to
the extent that poverty can be removed
or lessened.

"By the sheer weight of numbers in
combination with the nature of their
work, the nursing profession probably
has more experience with poverty and
its effects than any other segment of
the Canadian population,'" said CNA.

CNA recommendations to the com-
mittee on poverty included:

• More fmancial assistance to prepare
the increasing numbers of nurses need-
ed to work in community health pro-
grams. This would especially involve
public health nurses, who are likely to
see the most forceful impact of poverty
on health. At present, only 8.3 percent
of working nurses are in public health,
and the need for their services has grown
rapidly.

• More experimentation to seek better
methods of bringing health care to the
poor, such as neighborhood health pro-
grams.

• Better coordination by health depart-
ments of the knowledge and services of
health and welfare agencies that aid the
poor. This would result in less fragmen-
tation, more continuity, and better
quality care.

• Establishment of an economic level
at which good health can be maintained
by the dependent p)oor. Also, the inde-
pendent poor should be helped to have
an income at least as good as that of the
dependent poor.

• A much extended program for giving
suitable care to the elderly poor. This
could include adequate assistance to
help them remain at home, and use of
day care centers, geriatric centers, or
health maintenance clinics.

• More attempts to train natural lead-
ers chosen by their peers in the poor
communities to work with public health
lULY 1970

Presenting the Canadian Nurses" Association"s brief to the special senate com-
mittee on poverty in June, were; Dr. Helen K. Mussallem, left, CNA executive
director, and Trenna Hunter, chairman of the CNA committee that prepared the
brief. Here they talk with Senator David Croll, chairman of the special committee.

agencies and assume some responsibil-
ities in the health program for their
group.

Members of the senate committee
also asked questions at the hearing
about subjects such as nurse registra-
tion, the number of male nurses, and
how to attract more nurses to the profes-
sion.

The brief was presented to the com-
mittee by Dr. Helen K. Mussallem,
CNA executive director, and Trenna
Hunter of Vancouver, B.C., chairman
of the CNA committee that prepared
the brief. Other members of the com-
mittee were Constance Gray, Toronto;
Catherine Keith, Ottawa; and Phyllis
Kenny, Walkerton, Ont.

Let Students Do Work Of RN,
BC Health Minister Tells Nurses

Vancouver, B.C. — Loud boos from
members of the Registered Nurses"
Association of British Columbia fol-
lowed a remark by the provincial health
minister, Ralph Loffmark, that student
nurses should be allowed to do the work

usually assigned to registered nurses.

Speaking at the 58th annual meeting
of the RNABC held May 27 to 29, Mr.
Loffmark said that students must be
given more resjwnsibility, if they are
"to grow and develop properly." He
said nursing education seems to be mov-
ing away from hospital schools into
schools of technology and universities.

Health minister Loffmark brought
greetings from the provincial govern-
ment on the first morning of the annual
meeting, and returned later, after the
regular sessions, to answer questions
posed by RNABC members during his
morning speech.

Responding to criticism of his gov-
ernment's decision to meet only 70
percent of salary increases awarded
hospital employees as of January 1, and
the effect this decision and others will
have on health care in the province,
Mr. Loffmark said the provincial gov-
ernment has already paid $10 million
more than its estimated hospital ex-
penditure for the current fiscal year.
To do this, he said, the government
has had to "seraph the bottom of the
THE CANADIAN NURSE 5

Testing Service Gets New Home

barrel." He said that hospitals are free
to use their 1970 budget in any way,
even on increased salaries, but they
won't get any more money from the
government when the till is empty.

Most of Mr. Loffmark's answers
brought applause from his audience.

Over 500 attended the RNABC an-
nual meeting. Dr. Helen K. Mussallem,
executive director of the Canadian
Nurses' Association, brought greetings
from CNA, and later was guest speaker
at an evening banquet.

VON Director Reviews Changes
In Past Ten Years

Winnipeg, Man. — The 1960s have
produced many changes in structure,
program, and personnel of the Victor-
ian Order of Nurses, Jean Leask, VON
director in chief, said during the Order's
72nd annual meeting. May 8.

"During the 1960s a major activity
within the organization was the explor-
ation of ways and means to extend our
service in response to community
needs," said Miss Leask.

Solutions included initiation of vis-
iting nursing service in new communi-
ties; extension of this service to neigh-
boring towns, villages, and rural areas;
reorganization and amalgamation of
adjacent branches to form new units
with a broader administrative base and,
in many cases, extended boundaries.

Ottawa. — The staff of the new Canadian Nurses' Association Testing Service
began moving into their offices at CMA House on May 1 . Looking through
some new books are Dorothy Colquhoun, left, acting director of the Testing
Service, and Nancy Wright, her assistant. The first set of registered nurse
examinations will be delivered to the province of New Brunswick — where
examinations are scheduled first — by August 10, 1970.

"Our response may also have been a
modification of program, the withdraw-
al from an area of service being met by
another agency, or the initiation of a new
program which was not being offered
and which would contribute to the health

Jean Leask, /f//, director in chief of the Victorian Order of Nurses, gave a 10-year
review of VON activities at the Order's 72nd 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 1 2 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 1 960s the role of the pro-
vincial branches became increasingly
important. Miss Leask said. Each of
the nine 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 1 0 patients, six were adults,
(continued on page 8)
JULY 1970

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About 250 pages, illustrated. Soft cover. About $4.00. Just ready.

The most recent issue of this famous hardbound periodical carries
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THE CANADIAN NURSE

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 of the 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

Ottawa. - The board of directors of the
Canadian Nurses' Foundation met at CNA
House May 15 to ratify the choices by
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 Benin, left, faculty of nurs-
ing, University of Montreal, and Marion
C.Woodside, associate professor, Univer-
, sity of Toronto, Ontario. |

eluding 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. — Harriett 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

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

Halifax, 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 for 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, A^.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
Prague, 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.

lULY 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 resume 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 resume 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-121 1 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 SI 2.50 to S25.00
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
8 1 6 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

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THE CANADIAN NURSE 9

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

Montreal. — 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

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. I. 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 Therese 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.

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.

lULY 1970

ofjerating 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 assume 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. Beique, 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
ORT program was started 1 5 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 Nurses' As-
sociation, told the May annual meeting

lULY 1970

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 George 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 purses' Foundation
Scholarship Fund.

THE CANADIAN NURSE 11

"iWS.

Attaching footswitch electrodes to the foot of secretary Joan Bryan at the NRC Laboratory is a tedious but impwrtant 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
O. 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 a junction
box carried at her waist.

To the watchful engineers, the con-
stant beep alerted them to peculiarities
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 study ". . .
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 50 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 feasible," 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, whocametoCanada from
South Africa to take part in the study,
will be returning to his homeland this

lULY 1970

summer. He will introduce the locomo-
tion study in the Grootc 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
ofthis study. Dr. Milner said, "Although
nurses have not been involved in the
NRC experiment, 1 expect the nurse to
take active participation eventually.

"They will definitely be of great as-
sistance to me and my 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.

All 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-
vention 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's community action program
in Browning, 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. She has trained local people,
mostly Indians, to work as community
aides.

They visit almost every home on the
Blackfeet 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
1,000 members of the National Student
Nurses' Association in the United Stales
set the stage for the 18th annual con-

lULY 1970

vention 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
annually to military expenditures and
S2 annually 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. D

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THE CANADIAN NURSE 13

names

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
1 968. 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
Creedmoor 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 nameddirector
of nursing at Selkirk College, Castlegar,
British Columbia. The college's new
nursing program will begin in Septem-
ber 1971.

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

JULY 1970

Nurse Elected President of CPHA

Geneva Lewis, director of public health luiising tor the CXtawa-C'arleton
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
nursing 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
Welland district 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.; dipl. teaching and
superv., U. 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., U. of Western
Ontario. London; M.N., U. 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

worked as a director of a school of
nursing, in nursing service, and in hospital
administration.

Since her return to Canada, Miss
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
University of Saskatchewan school of
nursing in Saskatoon; assistant professor
in nursing education at The University 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 U., Hamilton;
M.N. and M.A., Emory U., Atlanta, Geor-
gia; Ph.D., U. of Kentucky, Lexington)
has been appointed associate professor at
Queen's University School of Nursing.

Dr. Mackay was an instructor in nurs-
ing at Emory University and the Univer-
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.;Dipl.
Nurs. Educ. and
B.Sc.N., U. of West-
em Ontario, Lon-
■N,i,^^ don) is the new as-
'^ !i^^^ sistant director,
Mmbk school of nursing, at
i^ncral 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 Serv. Admin.,
Dalhousie U.;
B.Sc.N., Mount
Saint Vincent U.,
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,
King Edward VII M^orial Hospital in
Bermuda, and Blanchard-Fraser Memorial
THE CANADIAN NURSE 15

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

WIN LEY- MORRIS ^k

MONTREAL CANADA

TUCKS Is a trademark of the Fuller Laboratories Inc.
16 THE CANADIAN NURSE

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.,
U. of Saskatchewan,
Saskatoon; B.S.N.,
U. of British Colum-
bia; M.S., U. 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., U. 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 Chap-
ter in 1969. □

lULY 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-on 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-
fique Ltee. and Quebec Surgical Com-
pany in Montreal.

Safety Crip Bath Seat and subsequent patient discomfort are

This safety grip bath seat overcomes eliminated.

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.

Bladder Drainage

A new self-contained suprapubic system
for bladder drainage following 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 fixation 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
lULY 1970

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, 1 Tippet Road, Downs-
view, Ontario, n

Bladder Drainage

THE CANADIAN NURSE 17

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deeply engraved, and lacquered. Snow white plastic will
not yellow Satisfaction guaranteed GROUP DISCOUNTS.

SAVE: Order 2 identical Pins as pre

caution afainst loss, less changinf.

1 Name Pin only

2 Pins (same name)

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1.75*
2.60*

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1.35*

2.05*
3.10*

1.15*
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♦ important Ple«f iM 25c p«f order handling chjrge on all orders o(

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Send cash, m.o., or check. No billings or COD's.

Sel-Fix NURSE CAP BAND

Black velvet band material. Self-ad-
hesive: presses on, pulls oft; no sewing
Of pinning. Reusable several times.
Each band 20" long, pre-cut to pop-
ular widths: V*" 112 per plastic box).
W" 18 per boi). V*" (6 per box), 1"
(6 per box). Specify width desired in
ITEM column on coupon.

3 or more 1.40 ea.

NURSES CAP-TACS

Remove and refasten cap band instantly
for laundering and replacement! Tiny ,-
molded plastic tac, dainty caduceus.
Choose Black, Blue. White or Crystal
with Gold Caduceus, or all black (plain).
No. 200 S«t of 6 Tacs . . 1 .00 per set
SPECIAL ! 12 or more sets 80 per set

Nurses ENAMELED PINS

Beautifully sculptured status insignia; 2-color keyed,
hard-fired enamel on gold plate Dimesiied; pin-back.
Specify RN, LPN, PN. LVN, NA. or RPh. on coupon.
No. 205 Enameled Pin 1.65 ea. ppd.

^

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Swiss made, raised silver full numerals, lumin. mark-
ings ftedtipped sweep second hand, chrome stainless
case Stainless expansion band plus FREE black leather
strap i yr guarantee.
No. 06-925 16.50 ea. ppd.

Uniform POCKET PALS

Protects against stains and wear. Pliable white
plastic with gold stamped caduceus. Two com-
partments for pens, shears, etc. Ideal token gifts
or favors.

No. 210-E ( 6 for 1.75. 10 for 2.70
Savers I 25 or more .25 ea., all ppd.

Personalize- BA^.^DAa^E

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No. 1000 Shears {no initials} 2.75 ea. ppd^~

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Initials (up to 3) etched add 50c per pair

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THE CANADIAN NURSE

../

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. Maxw^ell, 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 on 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-October 9, 1970

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 port of this pro-
gram will be held March 1-26, 1971.
Fee: $200 for each port. For further
information, write to: Dr. R.D. Barron,
Secretary, School of Hygiene, Univer-
sity of Toronto, Toronto 5, Ontario.

Oclober 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 AAetcalfe 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
Merchant Rd., St. John's, Nfld.

November 30-December 4, 1970

Conference for nurses in staff 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. □

lULY 1970

in a capsule

Arteriosclerosis 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,
hood and Drug Directorate, listed
2 1 7s, 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:
JULY 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 phenacetin-
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 now in full swing,
it's a good time to follow 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 power speci-
fications.

• Outfit your boat with legally 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. □

"Oh.Nur.se Bouchet — I'd like lo talk to you tihiuii
your lengthy coffee breaks — " %

THE CANADIAN NURSE 19

VIAaEX WILL GIVE YOU A BG 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 into 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.

BAXTER LABORATORIES OF CANADA

DIVISION OF TRAVENOL LABORATORIES, INC

6405 Northam Drive. Malton, Ontario

Viaflex

•Reo. Trade Mark

OPINION

Teachers — you are trespassing!

The author suggests that the question of "territory" is responsible for the
hostility between nurse educators and ward staff.

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 p)oint 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.
lULY 1970

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-
ducation 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 Canadian Nurse.

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, MiddleseJ? England. Penguin

Books, 1968, pp. 179-180. D

THE CANADIAN NURSE 21

She's a regular at the racetrack . . .

. . . and as the registered nurse at Blue Bonnets about the only thing she hasn't
done yet is look after the horses!

Author Valerie Foiirnier, left, inter-
views Mrs. Geoffrion in her first-aid
room under the grandstand at Blue
Bonnets racetrack in Montreal.

Valerie Fournier, B.A., BJ.

Someone you're always sure to find at
the Blue Bonnets Racetrack in Mon-
treal is Denise Geoffrion — she's been
a regular for 14 years. She knows all
the jockeys, sulky drivers, and staff at
the huge, modern track. Yet the most
she ever bets on the horses is $10 or
$ 1 5 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 Blue 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 small town after 7:00 p.m.," says Mrs.
Geoffrion. Last year she treated over
3.000 patients and sent 300 of them to
hospital.

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

Mrs. Fournier, a graduate of Carieton Uni-
versity's School of Journalism, is Public Re-
lations Officer at the Canadian Nurses" As-
sociation, Ottawa, Ontario.

On quiet nights at the racetrack Mrs.
Geoff rion keeps herself busy. Here she
finishes crocheting a mauve and white
hat 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.

24 THE CANADIAN NURSE

lULY 1970

to me for first aid unless there is a bad
accident on tiie 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 small
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 smaller 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.
lULY 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 usually 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 fell. 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 collarbone. 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 usually 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 usually
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! D

THE CANADIAN NURSt

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.

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 10.25 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

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 Cowling. 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 S and
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.

" When I refer to any times they
will be merely approximations and I
do not find them to be facts.

JULY 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.A.R. 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.A.R.
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
lULY 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.A.R.
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, was in the P.A.R.
room on the telephone at the time that
she noticed that Mrs. L was in trouble.
There is a conflict here between the
evidence of Nurse S and Dr. C. The
doctor states that he was assisting in an
operating room as an anesthetist in
another operation when he received a
call that there was trouble in the P.A.R.
room; that he left this operation and
immediately ran to the P.A.R. room.
He fixed this time at 10.50 a.m., and
stated that his training in his work deals
with watching the clock at all times so
he knows how long a patient has been
under an anesthetic. I accept his
evidence in view of the inexactitude
of the nurses" times as shown by the
contradictions in the charts ....

"Nurse S claims that she was away
from Mrs. L for from three to four
minutes. If the time of the arrival of
Mrs. L is accepted as being 10.30, then
one can pinpoint the trouble as having
occurred between 10.30 and 10.50.
Nurse S stated that Mrs. L was in good
condition when she left her in order to
go to get the injection to administer to
patient R. She had not, however, had
time to check the blood pressure of
the patient, which would be an essential
part of checking her over. Nurse S
put the time that the patient stopped
breathing at 10.35. As stated, I do
not accept this time as being accurate.
She stated that there were four patients
in the P.A.R. room including Mrs. L
at the time she noticed that Mrs. L was
not breathing. She said she took the
blood pressure of Mrs. L for the first
time when Dr. C arrived and at that
time the blood pressure was very low.

She also stated that the gastric tube had
not been attached up to that time."
(Editor's note: Confiicting evidence
was also heard regarding the presence
of the pharyngeal tube, but as this
evidence was resolved in favor of the
doctor, details are omitted here.)

"I digress here to point out that it
seems to be the practice of the nurses
in this P.A.R. room to fill in times on
charts for one another. This practice
leads to inaccuracies. For example, on
page 33 of Exhibit 26, a time appears as
10.40, whereas underneath same the
previous figure seems to be 10.50.

"Nurse S stated quite frankly
that 'we (Nurse M and herself) did not
expect the patients to bunch up so
quickly." They had mutually agreed
that Nurse M go for coffee when she
did go. Nurse S said that she did not
feel that she needed any assistance
when Nurse M left for coffee. . . .

"There were five operating rooms
booked for operations that day and
Nurse S who was in charge of the
P.A.R. room knew this fact.

"The nurses' charts show that the
injection of Demerol to R and the
injection of methedrine to Mrs. L were
both administered at 10.40. This, of
course, was not possible and illustrates
the unreliability of the times recorded
on these charts.

"Nurse M said it was the practice
for two registered nurses to be in the
P.A.R. room. She said the room was
quiet, namely not much activity when
she went to coffee. She said that if they
in the P.A.R. room needed help they
could ask for same but that she requested
no help or relief when she went for
coffee. She said that she was only out
10 minutes, that she left between 10.20
and 10.25, and returned from 10.30 to
10.35. She said she wrote down the
time 10.40 for the administration of
Demerol to R. (She was not present
when this injection was given, I find,
and must have obtained the time from
Nurse S.) She said the narcotics sheet
would be the exact time of the adminis-
tration of the Demerol. There is a con-
flict on these two "times".

"Nurse M said that there was no time
set for her coffee break and that it was
up to the nurses themselves to agree on
same. She said that on occasions she has
been alone in the P.A.R. room with pos-
sibly four or five patients. She admitted
that the nurses in the P.A.R. room
should keep the patients therein under
constant surveillance and the doctors
rely on the nurses to do this.

THE CANADIAN NURSE 27

"The nursing supervisor who was on
duty on the day in question testified that
usually there are two registered nurses
in the P.A.R. room. These nurses are
expected to taice their coffee breaics be-
fore any patients arrive. If this is not
feasible, then they could obtain relief
by calling for a substitute while they
went on their coffee break. In effect, the
nursing supervisor left it to the discre-
tion of the P.A.R. room nurses as to
when they went for coffee.

"The director of nursing, who was
also the assistant administrator of the
hospital and has been such since 1965,
stated that the regulation of having two
registered nurses in the P.A.R. room
was in effect when she took over her
position as assistant administrator. She
said she could have assigned extra
nurses if requested, and that the matter
of relief for the nurses in the P.A.R.
room was a responsibility of the nursing
supervisor."

(Editor's note: The trial judge then
commented on the functions of the
P.A.R. room in the following manner.)

"The function of this room is to pro-
vide highly specialized care, frequent
and careful observation of patients who
are under the influence of anesthesia.
They remain in this room until they
have regained consciousness and their
bodies return to their normal functions.
Respiratory arrest is not an uncommon
occurrence in the P.A.R. room and
therefore the personnel in this room
must be watchful and alert at all times
in order to protect the patients in this
labile and vulnerable stage. The nurses
in this room are there for the purpose
of promptly recognizing any respiratory
problem, cardiovascular problem, or
hemorrhaging. They are expected to
take corrective action and/or to summon
help promptly.

"Many doctors gave evidence on this
trial. No one challenged the principle
that the patient is more prone to crises
after the operation than while in the
operating room where the respiration
is being controlled. From this point of
view it is my opinion that this is the
most important room in a hospital and
the one in which the patient requires the
greatest attention because it is fraught
with the greatest potential dangers to
the patient. This known hazard carries
with it in my opinion a high degree of
duty owed by the hospital to the patient.
As the dangers or risks are ever-present
there should be no relaxing of vigilance
if one is to comply with the standard of
care required in this room. One well-
28 THE CANADIAN NURSE

known anesthetist, namely Dr. M, stat-
ed that this care should be 'constant and
total care.' An eminent surgeon, Dr. M,
who testified in a most lucid and careful
manner, stated that the patient should
be observed 'every minute or two.' Var-
ious terminology was used by these doc-
tors and I conclude from the evidence
that close scrutiny and ever-present
watchfulness is required in this room
and the patient is entitled to expect
same.

"The prevailing standard of care in
the P.A.R. room as far as numbers of
staff personnel is a ratio of one register-
ed nurse for each three patients in the
recovery room but with always a min-
imum of two registered nurses present,
regardless of the number of patients in
the room. Some hospitals utilize nurses'
aides in these rooms as assistants to the
registered nurses. In either case the pre-
vailing medical opinions point out the
necessity of always having a minimum
of two staff bodies in the P.A.R., re-
gardless of the number of patients there-
in with the ratio of one for three.

"In my view the hospital was meeting
the standard of care requirements inso-
far as the numbers of nurses per patient
ratio was concerned — providing that
the two registered nurses assigned to
this room or relief substitutes were pre-
sent together in this room.

"Both Nurse S and Nurse M were
experienced P.A.R. room nurses.

"I find that Nurse S was negligent in
failing to provide the required obser-
vation of Mrs. L; in leaving her unob-
served for a period of time longer than
the three to four minutes which she
suggested. I accept the opinion of the
director of anesthesia that Mrs. L's pe-
riod of anoxia was probably longer than
four minutes. I find the damage done
to Mrs. L is more consistent with the
period of anoxia being longer than four
minutes. Nurse S in my opinion was also
negligent as the nurse in charge in
agreeing to the absence of Nurse M for
her coffee break at a time when they
expected or should have expected the
arrival of other patients from the op-
erating rooms.

"Nurse S should have arranged for
relief at this time. If she failed to realize
that she required relief, then she was
negligent in that regard in view of her
knowledge of the operations which were
going on in the operating rooms. These
items constitute in my view more than
mere errors in judgement. I am mind-
ful that the standard demanded by law
is not that of perfection; but an anes-

thetized person is entitled to expect a
high degree of performance, diligence
and observation on the part of the
nurses in the P.A.R. room because of
the great risk of an obstruction or other
trouble developing.

"I find that Nurse M was negligent
in leaving the P.A.R. room at the time
that she did without heed to the patients
present at that time or the reasonably
anticipated arrivals from the operating
rooms. Nurse M was experienced
enough to know that a respiratory ob-
struction can easily happen and go un-
detected if patients are not looked at
frequently. Armed with this knowledge
she nevertheless nonchalantly went for
her coffee.

"Nurse M has stated that there was
no set time for the coffee break. The
nursing supervisor testified that she ex-
pected these nurses to take coffee before
any patients arrived. It would appear
to me that a lackadaisical attitude had
arisen in regard to this matter of 'coffee-
breaks' and that this should have been
corrected by the administration of the
hospital through its nursing supervisor.
The control should have been more rigid
ensuring that there were always two
personnel in the P.A.R. room. Nurse
M, as stated, testified that on occasions
she herself has been alone in the P.A.R.
room with four or five patients. The
necessity for watchfulness had given
way to carelessness.

"These negligent breaches of duty on
the part of the nurses brought about the
injury suffered by Mrs. L and I find
that the injury, as Dr. G stated, 'could
have been prevented by adequate and
skillful nursing care.' The hospital is
liable in damages for the negligence of
these nurse employees." □

lULY 1970

New product evaluation
in hospital

Here is a step-by-step description of the methods employed by one Canadian
hospital to determine "What's new?" in medical products. It also tells
why team evaluation of the product is an effective tool.

Rita Dolan, B.S.N.

"What's new?" may have become a
well-worn cliche, but at the University
Hospital in Saskatoon it is more than
a mod expression. Whenever the ques-
tion is directed toward me, 1 am expect-
ed to come up with an answer! And that
means — knowing what new product
has come into the hospital for consider-
ation. By exploring with me the meth-
ods used at the University Hospital to
arrive at an answer, you may find
"What's new?" is also important in your
nursing area.

The introduction of a new product
originates in the hospital purchasing
department; but a specific product may
be requested by the department requir-
ing it. For each new product, whether
unsolicited or requested, three major
questions have to be answered: What is
involved in selecting products which
best serve patient needs? Who should be
consulted? Who should make the deci-
sion?

An increasing number of new prod-
ucts have come on the market in recent
years. Many of these have been brought
to the attention of the hospital purchas-
ing agent. But because research into and

Miss Rita Dolan. a graduate of the Regi-
na Grey Nuns" School of Nursing, is Nurs-
ing Coordinator of new product evaluation
at the University Hospital. Saskatoon. Sas-
katchewan. She had been operating room
supervisor in the same hospital.

lULY 1970

the development of new products is ex-
panding rapidly, a product is often ob-
solete before its merits can be assessed.
One Canadian hospital magazine re-
cently listed over 90 new products in a
single issue!

Although the purchasing agent is
vitally concerned with the welfare of the
patient, he cannot possibly determine
alone which new product is best, espe-
cially if he recognizes that the decision
should be made by the user at the point-
of-use — the patient's bedside. For this
reason, many large hospitals have set
up an evaluation committee, a widely
representative group whose knowledge
and judgment can be utilized to assist
the purchasing agent. It is this commit-
tee that forms the basis of an organized
approach to the assessment of a new
product's merits, before introduction
into the hospital.

Committee objectives

It was in March 1968, that the Uni-
versity Hospital appointed a committee
responsible for evaluation and stand-
ardization, and known as the medical
and surgical supply committee. Chaired
by the assistant purchasing agent, its
representatives come from the nursing
and medical staff, central supply ser-
vice, and administration; other depart-
ments are represe^jted as required. Ob-
jectives of the coinmittee are; to ensure
that the patient gets the best possible
THE CANADIAN NURSE 29

Discussion of a new product by the
evaluating committee evolves around
three main questions — patient needs,
consultation, and who decides for or
against the product. Chaired by the
assistant purchasing agent, the com-
mittee represents most areas of the
hospital. At this session, author Rita
Dolan (third from right), gives her
reactions to 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; Rita Dolan,
nursing coordinator; Ronald Nuthrown,
assistant purchasing agent; and Dr.
Clarence Berg, surgical staff.

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 submitting reports
with recommendations, follow-up re-
ports at required intervals, and promote
standardization in the hospital.
30 THE CANADIAN NURSE

Philosophy and method

At the University Hospital we be-
lieve that products to be tested have to
be given a/o//- 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. How 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 stafO- 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.

The responsibilities of the nursing
director (in some hospitals known 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
forfollow-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?

Ifthe evaluation results are favorable,
the Coordinator prepares a report with
recommendations to the chairman of
the evaluation committee, who takes
JULY 1970

the necessary steps to obtain approval
for purchase. If a product is not accept-
able (for valid reasons) it is withdrawn
from use. Whether recommended for
purchase or not accepted, the product
manufacturer and supplier are notified
by a written report. If final approval
to purchase is obtained, all nursing
areas and departments concerned are
informed of the proposed product
change, and time allowed for staff in-
struction. The director of inservice edu-
cation is also consulted, and, depending
upon the magnitude of the change, a new
product program is organized for the
nursing staff. Sales representatives are
always willing to assist, and their ser-
vices may be utilized in the instruction
program.

For convenient reference, records
of all completed evaluations are kept
by the coordinator, and a copy goes to
the purchasing department. It is also
essential for the follow-up report to be
continued after the new product is in
use throughout the hospital. Periodic
check-ups are made to ensure the prod-
uct continues to meet the standards set
up initially. Any difficulties encountered
are reported to the coordinator, and
through her, the information is relayed
to the purchasing agent and back to the
manufacturer. It is important to empha-
size that not only the nursing staff par-

ticipate in the evaluation programs.
When other disciplines are involved,
the same evaluation procedures are
followed.

In a recent evaluation of intravenous
catheters, the opinions and written
comments of medical staff and house-
staff (the user at the point-of-use) pro-
vided the necessary product information.
Staff of the departments of physiother-
apy, radiology, laboratory, and outpa-
tients have also been actively involved
in testing products relating to patient
care. Interdepartmental cooperation
and good communication are vital to
the success of the program.

Advantages

Among some of the advantages found
in new product evaluation, eight points
stand out: The comfort and safety of
the patient is increased by elimination
of the trial and error approach; nursing
staff satisfaction is heightened by being
involved in product selection, resulting
in increased awareness and interest in
new trends; the use of a product during
an adequate period of time is the only
way to discover its merits and limita-
tions; a more consistent feed-back of
information to the purchasing depart-
ment and to the n^nufacturer is possi-
ble; the flow of sales representatives to
various hospital areas is controlled (the
THE CANADIAN NURSE 31

Patient cooperation at the point-of-use
is another aspect of product evaluation
which is essential to the decision —
accept or not accept. Nurse Thelma
Strihhell, assistant head nurse, and
James Caister, nursing orderly, are seen
with a happy and cooperative patient,
Joseph Fisher, at the University Hospi-
tal, Saskatoon.

majority of salesmen have expressed
satisfaction with this method); stress on
the importance of greater awareness
of reporting malfunctioning products
or equipment noted; inter-departmental
relations have improved as a result of
the coordinated approach ; and standard-
ization and product control have helped
to decrease hospital costs.

Limitations

There is a degree of resistance to
change in most of us, and often first
reactions to a new product prove un-
reliable. It is not always easy to give an
unbiased, objective opinion, especially
if use of the product means a change in
procedures or techniques that have
operated for years. Also, an assessment
can take weeks, even months, if there
are many different product brands to
consider, and staff become tired of ad-
justing to each new change.

Obtaining recorded staff opinions
is a necessary and important part of the
evaluation procedure, and one of the
most difficult to accomplish. Staff some-
times seem reluctant to commit them-
selves to written reactions, or perhaps
time is involved. It takes time for the
staffto fully appreciate that theiropinion
is important, that they can help to make
decisions by being involved, and that
to do so is part of their patient care res-
ponsibility in the hospital.
32 THE CANADIAN NURSE

Cooperation

It would be impossible to success-
fully carry out the program without
willing patient cooperation. Cooper-
ation of the nursing and medical staff
is another key to success. This refers
also to all other departments involved,
the active participation of the eval-
uation committee, and the support and
encouragement of the hospital admin-
istration.

Are we completely satisfied with our
program at the University Hospital in
Saskatoon? No! With every completed
evaluation we learn something more
that improves our methods. Ideas and
suggestions are always welcomed to
help answer the challenging question
"What's new?"

Bibliography

Bindseil. Edwin R. Checklist for evalu-
ating disposables. Hosp. Admin, in
Canada. 9:9: 14, Sept. 1967.

Ericson, Mary H. Selecting and testing
potentially useful items. Hospitals,
J.A.H.A. 38:23:61-66, Dec. 1, 1964.

Fisher, Clifford W. A look at the use, pro-
curement, and safety of disposables in pa-
tient care. Hosp. Mange. 101:125, Feb.
1966, Part 1. 101:117-120, Mar. 1966,
Part 2.

Jacobson. Allan B. Disposables are here
to stay. Hosp. Manage. 103:99-100,
Feb. 1967.

Letourneau, Charles U. The evaluation

of a product. Hosp. Manage. 93:44-46,
May 1962, Part 1, 93:41-43, June 1962,
Part 2.
Schabraq, Andre. Key points for testing
new products. Hosp. Admin, in Can. 9:
9:17, Sept. 1967. O

lULY 1970

This nurse coordinates
patient services

If you have to be hospitalized, Brockville, Ontario, is a good place to be —
especially if you require long-term care. In this small but progressive city, one
nurse is doing a remarkable job of coordinating hospital and community
services so that fewer gaps are left in a patient's rehabilitation.

Carol Kollarsky, B.J.

Until September 1969. Ann Cole had
worked as a registered nurse in various
hospital positions and with the Victorian
Order of Nurses. But for almost a year
now she has been involved with patients
in a new, far broader role.

As patient services coordinator for
the 214-bed Brockville General Hospi-
tal and the 105-bed St. Vincent de Paul
Hospital, Mrs. Cole is involved with the
overall hospital experience of patients,
particularly patients who need extended
care, and their return to the communi-
ty. This work requires a thorough un-
derstanding of the patient's background,
medical situation, and emotional needs;
hospital procedures; and the agencies
that can help him when he leaves the
hospital.

Mrs. Cole stresses that she is not a
social worker. She explains that her past
work as a general duty nurse, head
nurse, instructor, coordinator of in-
service education, and VON nurse in
Brockville — as well as some upsetting
experiences she had as a patient —

Mrs. Cole is a graduate of the Kingston Gen-
eral Hospital. Kingston. Ontario. She has
worked as a general duty nurse in Guelph.
Oakville, and Brockville. and as part-time
evening supervisor in Hamilton. Ontario; as
an obstetrics instructor, head nurse, and in-
service education coordinator at Brockville

Ann Cole, patient services coordinator in Brockville. spends much oj her time

contacting community agencies and individuals who are able to help patients General Hospital: and with the Victorian

after they are discharged from either of the two hospitals in the area. Order of Nurses in Brockville. Ontario.
JULY 1970 ^"^ CANADIAN NURSE 33

made her aware of the need for a nurse
to coordinate the many factors that con-
tribute to a patient's successful reha-
bilitation. As coordinator, she works
closely with the medical and nursing
staff in both hospitals.

Hospital-community liaison

Mrs. Cole is well acquainted with
services available in Brockville and the
surrounding area. Community services
she works with are varied: nursing and
private homes, VON, Red Cross home-
makers, Alcoholics Anonymous, Child-
ren's Aid Society, municipal and pro-
vincial government departments, local
service groups, and other organizations.

One particularly complicated patient
situation Mrs. Cole encountered shows
how one person's problem can involve
many of the community's resources.

A woman with multiple sclerosis be-
came a paraplegic, and became almost
totally blind. While she was in and out
of hospital, her marriage became so
shaky that it was useless to try to main-
tain it.

The number of agencies and individ-
uals who helped this woman, which in-
volved getting her and her 18-year-old
son to relatives in England, was as-
tounding. Mrs. Cole says. She lists the
legal aid society, the Canadian National
Institute for the Blind, a Roman Catho-
lic priest, the Catholic Women's Lea-
gue, the Multiple Sclerosis Society, the
Lion's Club, the Oddfellows, a travel
agency, and numerous friends.

This community help involved coun-
seling, paying room and board in town
for the woman's son, buying him the
clothes he needed, supplying the woman
with a wheelchair, buying her shoes,
getting her passport renewed and getting
her son's passport and photographs,
checking with the airline and British
High Commission to make sure the rel-
atives understood the circumstances,
and paying both fares to England.

Finding the "right" nursing home

Soon after she began her job as co-
ordinator, Mrs. Cole visited the area's
nursing homes to assess their facilities.
What she looked for in homes for
chronic, long-term patients was com-
fort, cleanliness, good nursing care, and
34 THE CANADIAN NURSE

Mrs. Cole is a weekly visitor to the admitting departments, where she receives
the names of new patients. Here she waits while a nurse and clerk check the pa-
tient admitting cards at St. Vincent de Paul Hospital.

interest in all aspects of the patient's
well-being. She also determined if vol-
unteer groups visited the home to pro-
vide diversional therapy. One nursing
home, she discovered, was so beautiful
that elderly persons were reluctant to
go there. Patients want to feel at home,
she explains.

Choosing the best nursing home for
a particular patient is a decision that
often faces the patient services coor-
dinator. By listening carefully to the
patient and his family and considering
his medical, social, and financial situa-
tion, Mrs. Cole decides which nursing
home would best suit him. She makes
sure that the patient is satisfied with the
choice before he leaves hospital.

Before leaving a patient who has been
discharged from hospital, Mrs. Cole
makes sure he has her telephone num-
ber. She tries to visit a patient in a nurs-
ing home once during his first week or
two, and maintains close contact with
nursing home administrators.

Extended care

Sometimes a patient can return to the
community directly from active care in
hospital. But when a patient requires
a long period of hospitalization, Mrs.

Cole finds out if he needs active treat-
ment or if an application for transfer
to the Brockville General's extended
care unit can be made by the patient's
doctor. A 40-patient extended care unit
serves both Brockville General and St.
Vincent de Paul Hospitals.

A problem with the extended care
unit, Mrs. Cole says, is that hospital
staff and particularly patients and their
relatives think of it as the "last step be-
fore the grave." This creates a barrier
to the patient's transfer to this area. As
soon as she knows that a patient can be
moved to the extended care unit, she
visits him to talk about it and to explain
why he is going there. She hopes she
will soon have photographs of the unit
to show her patients.

Mrs. Cole talks enthusiastically about
the Brockville General's ADL unit,
where an occupational therapist teaches
convalescent patients "activities of daily
living." These activities might include
simplified techniques, such as tying
shoelaces with one hand. As the patient
improves, the occupational therapist
assesses the number of daily activities
the patient can perform for himself.
This ADL unit also serves both hospi-
tals in the Brockville area.

JULY 1970

Discussing the proi;rL\ys of' paitenis on ihc extended care unit at Brockville Gen-
eral Hospital involves all staff. Shown at a weekly staff conference are, left to
right, Ann Cole, patient services coordinator; a patient, relieved to hear that her
progress is encouraging; the head physiotherapist of the extended care unit; a
student nurse; the hospital nursing supervisor; the head nurse of the extended
care unit; a nursing assistant from this unit; and the occupational therapist.

Convalescent units, Mrs. Cole em-
phasizes, can make patients" lives much
more meaningful. She is concerned,
though, that these units are not staffed
as adequately as active wards. The rea-
son for this, in her opinion, is the mis-
conception that convalescent patients
do not require the same amount of care
as patients on active treatment wards.
At Brockville General, three physio-
therapists work part-time on the ex-
tended care unit.

With the assistance of the head nurse
and head physiotherapist of the extend-
ed care unit, Mrs. Cole has organized
an inservice program for nurses working
with convalescent patients. It consists
of a weekly conference attended by staff
nurses, the head nurse, and head phys-
iotherapist of the extended care unit,
and occupational therapist from the
ADL unit. In addition, head nurses from
other units are invited if patients on
their wards are waiting to be admitted
to the extended care unit. During the
conference everyone is encouraged to
contribute to the discussion of the pa-
tient's progress in the hospital.
JULY 1970

Before each conference, Mrs. Cole
reviews the background of each patient
on the extended care unit — his home,
financial, and medical situation. She
uses this information to keep the con-
ference participants aware of anything
that might further the patient's progress.
Sometimes a patient whose plan is being
discussed is asked to attend the confer-
ence and help with the planning.

Member of health team

While working with a patient, Mrs.
Cole keeps the doctor closely informed
about what she is doing. She keeps a
file for each patient, and on a card she
records the basic situation; information
from her interviews with the patient,
including her discussions with the doc-
tor; and notes on anything else she does.

Mrs. Cole recalls that when she first
became coordinator, nurses had diffi-
culty understanding her role on the
health team and did not know which
patients should be referred to her. To
explain her role, she first spoke to
nurses at an inservice program. Then
she talked to each head nurse and to as

many other nurses as possible, giving
them examples of what was happening
on other wards.

She has also participated in classes
for nursing students, who study a social
service situation and decide what agen-
cies should be involved. In the fall she
hopes to hold an inservice program for
nurses to give them a chance to express
their views on the effectiveness of the
coordinator's role.

Time to care

Since she does not work shifts or have
to follow ward routine, Mrs. Cole de-
termines her own work schedule. She
organizes her time to suit the situation.
This might involve talking with a pa-
tient and his family in the evening to
decide how he can best be cared for
after discharge from hospital. Or it
could mean being asked at any hour to
find a temporary home for children of
out-of-town accident victims.

For a long time, community services
have not been fully utilized, Mrs. Cole
says, partly because hospital staff lacked
time to work with them. As soon as she
sees a patient, Mrs. Cole tries to deter-
mine which agencies can help him and
makes sure their services are familiar
to him before he leaves hospital. By as-
sessing a patient's overall situation and
knowing the programs each agency of-
fers, she is usually able to direct him to
the most suitable agency.

From Ann Cole's obvious enthusiasm
for her work as patient services coor-
dinator, it is easy to see why she de-
scribes this position, with its limitless
potential, as fascinating. D

THE CANADIAN NURSE 35

Use of part-time teachers
benefits students and faculty

How one school of nursing uses part-time instructors to supplement its
regular teaching staff.

F. Joan McPhail

On December 6th, 1967, the school of
nursing at the Ottawa Civic Hospital
entered a new phase. On that day the
school became totally responsible for
the students' learn ing experiences during
the first two years of their three-year
program. No longer were the students
obliged to provide nursing service
during these two years.

At first, no one on the teaching staff
fully realized the implications of this
major decision. Later, we became aware
of certain problems: Who, for example,
was going to be responsible for the
student in the clinical area when the
teacher was ill, on leave of absence or
compassionate leave, or was at a con-
ference? It didn't take us long to decide
that we needed teachers who would be
willing to work on a part-time basis.

Two categories

We have two categories of part-time
teachers: those who relieve on a call
basis when the teacher is absent for
some reason; and those who are
employed on a regular part-time basis
for varying periods throughout the year
because of curriculum requirements.
Sometimes one teacher fits into both
categories.

The teachers who relieve on a call
basis may be used in any clinical area
in the hospital during any of the three
terms or the "skills practice" periods.
Naturally we try to select the teacher
who is best suited for the particular
clinical area in the hospital.

36 THE CANADIAN NURSE

Since September 1968, we have
employed a teacher on a regular part-
time basis in the pediatric unit to help
the 24 to 36 students who rotate through
this unit every six or seven weeks. This
teacher works three to four weeks out
of six or seven, beginning at the fourth
week of the students' experience. She
rotates during these four weeks with the
two permanent teachers through two
periods of duty, 7:45 a.m. to 4: 15 p.m.
or 12:00 noon to 8:00 p.m.

This year we hired two regular part-
time teachers in the nursing skills area.
The four permanent teachers indicated
they would be able to teach theory of
skills to the 170 beginning students,
but believed they needed help in both
the classroom and hospital settings.

One of these part-time teachers works
five half-days a week, usually in the
mornings. She assists with classroom
practice periods as required and is
responsible for these beginning students
on one of the hospital wards. The other
part-time instructor participates in the
students' hospital experience only,
which involves the morning hours every
second week from Tuesday to Friday
inclusive.

Last year, three part-time teachers
were assigned to help the first-year

Mrs. McPhail, a graduate of the Ottawa
Civic Hospital School of Nursing and the
University of Western Ontario's Certificate
Program in Teaching and Supervision, is
Administrative Assistant to the Principal
of the Ottawa Civic's School of Nursing.

Students with their more advanced
clinical experience. One teacher worked
full-time every day on a particular ward
for the entire term, and the other two
alternated on one ward for two-week
periods. This year we will be using four
of these teachers: two will alternate
with each other to cover one ward, and
two will cover a ward full-time.

In all, eight teachers are available
for relief teaching. Some indicate
inability to work certain days of the
week and some limit themselves to one
or two days weekly. This requires
careful scheduling. In budgeting for
teachers we plan for relief in case of
illness, attendance at conferences or
workshops, and of course for regular
part-time teaching.

Responsibilities and orientation

The part-time teachers' responsibil-
ities depend on the area in which they
are working, their previous experience
in that area, and their educational
qualifications. Generally, those on a
call basis are expected to do only inci-
dental teaching at the bedside and to
conduct pre- and post-care conferences.
Those involved on a full-time basis are
expected to participate more fully in the
program. They assist the student in
pre- and post-care conferences, mark
assignments for students for whom they
are responsible, help set examinations,
and assist with student evaluations.

An orientation program has been
set up for all part-time teachers. The

JULY 1970

Full-time and part-time teachers at their weekly planning meeting at the Ottawa Civic Hospital. Left to right: Sharon Thomp-
son, part-time teacher; Emily Reynolds; Jo Logan, part-time teacher; Joan Babcock, Diane Shaughnessy, and Alice Keiwan.

amount of orientation needed by each
teacher varies with her previous expe-
rience in the school and in the hospital.
Orientation includes an explanation of
the philosophy of the school, the overall
objectives of the program, and the
objectives of each term or practice
period.

The teacher is given a brief review
of the school's curriculum and learns
what to expect from various levels of
students for whom she will be res-
ponsible. She is oriented to her assigned
ward and is introduced to the ward staff
and other teachers. She is expected to
attend faculty meetings when possible.

Advantages of system

Use of part-time teachers has several
advantages. First, the system benefits
the permanent teachers as they have
time to attend conferences and work-
shops, to take a leave of absence if
necessary, and to work on committees.
For example, the school's curriculum
committee recently revised the curricu-
lum for the second term. This meant
that all members of this committee had
to be freed from their ward responsibil-
ities for a number of Fridays. To do

lULY 1970

this we used other faculty members for
relief purfX)ses and obtained the assist-
ance of three part-time teachers.

Faculty members also benefit from
working with the part-time teachers,
as ideas are shared. One of the regular
part-time teachers is presently doing
research for her master's degree. Both
our students and instructors are involved
in this research. Not only did this part-
time teacher benefit from the use of our
facilities, but our teachers found that
they learned a great deal by participat-
ing in her research.

Last, but not least, the students
benefit from this additional clinical
supervision. Part-time teachers are
generally well accepted by the students.
The teacher on a call basis may be
accepted with a little more reservation
because of her limited time with them.

Summary

As a result of changes in educational
programs for nurses, more use will
undoubtedly be made of part-time
teachers in the future. The Ottawa
Civic Hospital School of Nursing has
two categories of part-time teachers,
those who are available on a call basis

to relieve for illness or leave of absence,
and those employed on a regular part-
time basis because of curriculum re-
quirements.

Responsibilities given to these
teachers vary with their educational
qualifications and their previous ex-
perience. The choice and placement of
these part-time teachers is made with
care. Their special areas of skill are
weighed and the person called is the
one who best fills the need at the time.
Both the school and the faculty benefit
from a system of part-time teachers.

Certain things must be considered
when planning to use part-time teachers.
These include careful budgeting,
maintenance of records, a planned
orientation program, and faculty invol-
vement in deciding how and where these
teachers may be used. D

THE CANADIAN NURSfc 37

Hospital nursing

and the demand for change

Traditionally, the nursing profession has been conservative and passive when
faced with the need for change. If this passivity continues, nurses will
find themselves standing aside as others make decisions for them.

I. Ivan Williams, Ph.D.

The basic organizations of society are
currently being questioned and there are
increasing demands for change. Schools,
universities, churches, governments, the
family, the business world, as well as the
whole health care system are being re-
examined, and the question of priorities
is being raised.

By looking at the place of the hospital
in society, the emerging patterns of
health care, and the factors that influence
the growing demand for services, one can
determine why the hospitals are being
challenged and suggest what sort of
changes will be made. Since nurses are
central to the operation of hospitals, they
should play some role in making decisions
about these changes. To participate they
must understand the basic processes in-
volved.

Characteristics of organizations

Organizations are established so that
man may collectively solve problems that

Dr. Williams is Assistant Professor, Department
of Sociology and Community Medicine, The
University of Western Ontario, London, Ontar-
io. This article is a revised version of a paper
presented at the Seminar for Senior Nursing
Executives by the Faculty of Nursing at the
University of Western Ontario in June of 1969.
The writer is indebted to those nursing execu-
tives for their comments and suggestions. In
addition, the suggestions put forth by Dr. Amy
Griffin and Dr. Edward T. Pryor were most
useful in rewriting the paper.

38 THE CANADIAN NURSE

individuals alone cannot manage. There
are a number of organizations in our
society, each designed to meet particular
problems and accomplish certain goals.
The key characteristics of organizations
in Western societies include a highly
specified division of labor, written regula-
tions governing each position, employ-
ment of individuals according to technical
competence and professional training,
payment by salaries, and security and
promotion based on impersonal standards
of performance. 1

The primary consideration of an or-
ganization is whom it is designed to serve.
Peter Blau and W. Richard Scott have
developed a typology of organizations as
seen in Figure 1. ^

Mutual benefit associations as de-
scribed in Figure 1 exist only as long as
they meet the interests of their members.
Business concerns operate as long as
owners profit. If the clients do not seek
the services or are driven away, the
service organizations cannot render serv-
ice.

The elections in a democratic society
determine whether the public is served in
a satisfactory manner. The implicit
assumption is that organizations that
serve well survive, and those that fail to
serve, fail to survive.

Any organization that has "people as
products" has a whole set of peculiar
problems. The hospital is no exception to
this general rule.

lULY 1970

Type of Organization

Primary
Beneficiary

Examples

1. Mutual Benefit Associations

Members

CMA, CNA, CHA
Private Clubs

2. Business Concerns

Owners

GM, Ford, Labatts

3. Service Organizations

Clients

Schools, Churches,
Hospitals

4. Commonwealth Organizations

Public-at-large

Various governmental
bodies

Figure 1 - The Qui Bono Typology

First, only a limited range of means
are available as the individuals are viewed
as ends in themselves. Second, it is
difficult to demonstrate conclusively
which treatment procedures are most
effective and what constitutes good pa-
tient care. Third, people are self-
initiating; they can act as well as respond.
Nurses may become frustrated in their
appointed rounds because of patients
who refuse to conform.

Four, belief systems are important.
How persons are viewed is as important as
what is done; thus, mental hospitals
Ofjerate differently from general hospitals
because the patients are viewed differ-
ently.

Five, there is a continued surveillance
of the organizations on behalf of the
public. Hospitals must be accredited by
duly constituted bodies before they can
operate. 3

Given these perspectives on organiza-
tion, an analysis can be made of the
hospital in society, the relative position
of its professional workers, and the prob-
lems of the patients. Particular emphasis
is given in this paper to the nurse as the
person caught in the middle, between
doctor and patient.

The hospital

Hospitals were once under the jurisdic-
tion of the religious orders or were
charitable institutions. Most medical care
JULY 1970

was administered outside their walls.
Until the middle of this century, one-half
of all births and deaths occurred outside
the hospital. In this century, hospitals, as
complex medical and educational centers,
have become the key to medical care,
particularly in the urban and large metro-
politan areas and among low income
groups.

The two main goals of today's hospital
are to provide patient care, and to do so
in such a way as to serve the professional
values of the medical professions.^ As the
current hospital has emerged, one might
wonder whether it exists more for the
primary purpose of education, training,
and practice of the physicians and sec-
ondarily for patient care. 5, 6, 7

The problems

There are two basic sources of demand
for change in the present organization of
hospitals: tlie public, and the medical and
nursing professions. These are interrelat-
ed, and both directly affect the role of
the nurse and the nursing executive.

To understand the public demands,
the shift in fundamental assumptions
about health care must also be under-
stood. Since World War II, there has been
growing conviction in industrialized soci-
eties that health should be a guaranteed
right and that resources should be organ-
ized and expanded to assure this. In
Canada, voluntary private insurance and

later universal semi-voluntary government
insurance have attempted to guarantee
health care.

At the same time, health costs have
risen faster than the cost of living, hospi-
tal beds have become scarce, and doctors'
income has increased more rapidly than
most occupational groups. Even though
hospitals are better equipped and nurses
better educated, there are widespread
complaints about the quality of hospital
care. People are less willing to be treated
as "cases," and want to be cared for as
human beings.

Consequently, the whole medical care
system is coming more under public
scrutiny, from provincial to local levels.
The governments and citizen groups are
challenging the professions and their prac-
tices. In one city, where the board of
directors of a large hospital are elected in
a municipal election, candidates promise
that, if elected, they will find out what is
happening. Demands are made for public
board meetings; newspapers report inter-
nal organizational conflicts.

These demands probably affect the
nurses in three ways. First, the nursing
staff will come under public scrutiny; if
the doctors or patients complain about
nursing procedures, external pressure for
change will increase. On the bther hand,
as people become more aware of nursing
problems they will support attempts to
prepare more nurses and to provide better
pay and working conditions for nurses,
their assistants, and orderlies, all of whom
are underpaid according to accepted wage
levels for comparable positions. Third,
the public will probably be less tolerant
of strikes and work slowdowns as bargain-
ing devices.

In short, hospitals are more likely to
become "commonwealth organizations,"
serving the public-at-large. As a conse-
quence they will also come under more
public surveillance and the subsequent
demands for change. If participatory
democracy means the inclusion of as
many people as feasible in decision-
making bodies, then there probably will
be more demand#for participatory de-
mocracy in the operation of hospitals.

THE CANADIAN NURSE 39

The second problem arises for de-
mands for change within the hospital.
Hospital personnel consist of three
groups: physicians, nurses, and adminis-
trators. Rigid barriers separate these
groups and each group has its own hier-
archy. Cutting across these groups are the
various clinical departments that some-
times become autonomous medical em-
pires. The clinical departments involve
inservice wards and outpatient clinics.
The question arises, who actually benefits
from this type of organization?

In reality the key to the current
problems in hospitals is the physician.
Patients become cases to be treated and
to be used as heuristic devices for the
education and training of physicians in
the clinical specialty involved. Even
though the "cases" receive technically
competent care, the care is segmented,
fragmented, with little regard for the
social and emotional dimension of the
patient's illness. Not infrequently one
clinical department is unaware of what
other departments are doing for family
members and the patient himself.

A number of studies have demon-
strated the effects of hospitalism, where
the individual is reduced from an inde-
pendent, autonomous member of society
to a child dependent upon the expecta-
tions and demands of the physicians and
nurse. 8 The consequences of hospitalism,
particularly in chronic hospitals, may
offset the treatment process.

One of the advantages of treatment in
the home was that the patient was not
isolated from his normal social environ-
ment and received social and emotional
support from his family. He remained a
person rather than a case or product. The
old concept of bedside nursing implied
that one of the functions of nursing was
40 THE CANADIAN NURSE

to provide similar kinds of support. Now
such support appears to be missing.

The problem could be simplified if
physicians and nurses agreed on what
their roles should be. Clearly, the nursing
profession is in the midst of change.
There are three polarized continua that
serve as the axis for the conflict: the
professional versus the traditional models
of nursing; the university versus the hos-
pital programs; and the instrumental
versus the expressive functions of nursing.

Professional and Nightingale Models

The traditional model of discipline and
the religious model of service, purity, and
devotion to duty. The professional view
emphasizes education, leadership, re-
search, and participation in planning ther-
apeutic medical care. If the term bedside
nursing typifies the former, the team
approach signifies the professional work-
ing together with other professionals such
as doctors, dentists, and social
workers.9.10

University vs. Hospital Training

Of the 137,318 registered nurses in
Canada in 1969, only 6.2 percent had
baccalaureate degree or higher academic
degrees.'' ■• The Canadian Nurses' Associa-
tion has recommended that there be one
university-prepared nurse for every three
diploma nurses. Such statements are pred-
icated on the assumption that there are
differences between the abilities of the
graduates of the two programs.

Essentially the graduates of diploma
programs are viewed as technicians who
work with patients under the supervision
of a professional nurse. The professional
nurse is viewed as the university graduate
who selects appropriate nursing programs
for the patient in the hospital and com-

munity, works as a member of a health
team, evaluates and recommends changes
in the programs, works with members of
allied professions in solving community
health problems, provides personal pa-
tient counseling, and engages in adminis-
tration, teaching, consultation, and re-
search.''2 Some nurse educators believe
that administration, teaching, consulta-
tion, and research can be introduced in
baccalaureate programs, but that ade-
quate training for these areas should be at
the master's degree level.

If such differences are defined into
educational objectives for the respective
programs, the differences within the
ranks of nursing are more likely to widen.
This is particularly true as university
student nurses are more likely to be from
the upper middle classes, are more likely
to reflect the students' pressures for
general reform, and more likely to reflect
career and professional aspirations. The
diploma nursing students are more often
from the working classes, and probably
are more concerned about job security
and service; they are more likely to
leave the active profession for home
life. 13

The more professionally-oriented
nurses are challenging physicians. The
demand for the health-team approach
explicitly curtails the authority and
power of the physicians. These new
nurses are no longer intimidated by the
physician's prestige and knowledge.

Instrumental vs. Expressive Functions

An increasing variety of positions are
available to nurses in teaching, adminis-
tration, research, and clinical settings.
Within the clinical departments of a
hospital a nurse may serve in a number of
positions without being a bedside nurse.

lULY 1970

The instrumental function involves
making the organization operate and
planning and implementing programs.
The expressive function is more concern-
ed with meeting the patients' psycho-
social needs. The former implies patient
versus product; the latter implies patient
as person. ■•■*

The future

Generally, professional, university
graduate, and instrumental are seen as
one clear option in today's nursing. There
is a feeling among some administrators,
for example, that the talents of a
university-educated nurse should not be
wasted by having her engage in bedside
nursing. The traditional, hospital-trained,
and expressive nurse is seen as a blend of
nurse/nursing assistant. She is relegated to
carry out *he directions of others and is
left with Utue time for the patient.

This is not to say that such a dichot-
omy must arise from the three polarities.
There are at least eight possible combina-
tions, ranging from traditional, university,
and expressive, to professional, hospital-
trained, and instrumental.

People are demanding reforms, and
they do want quality health care for all.
They are no longer satisfied to be prod-
ucts, but demand to be treated as people
with real social and emotional concerns.
The health professions will have to reorgan-
ize themselves and provide this type of
individualized care or the public, via the
government, will delimit the areas of
authority and responsibility. As Blishen
stated:

Some nurses, however, seem unwiUing
to accept new responsibilities since it
means delegating to others old respon-
sibilities from which they gain emo-
tional satisfaction. This reluctance is
JULY 1970

evident in their opposition to reforms
in nursing education which attempt to
change traditional nursing values and
socialize students into a conception of
the new nursing role. For those who
support the reforms, these changes not
only bring nursing into touch with the
realities of twentieth-century medi-
cine, but they also mean a change of
status of the nurse. 1 5

Traditionally the nursing profession
has been conservative and passive in
the face of similar demands. The CNA
and its counterpart in the U.S.A., the
American Nurses' Association, have
been relatively weak professional
groups in terms of protecting the
interest of their members and shaping
the profession.

The profession is going to change.
If nurses decide to be passive, the
changes will be the result of external
pressures. If the nurses are active, they
may shape not only their own profes-
sion, but the health care dehvery
system as well. The challenge is now,
the response is yet to come.

References

1. Weber, Max. In From Max Weher: Es-
says in Sociology, edited and translated
by Hans H. Gerth and C. Wright Mills.
New York, Oxford Univ. Press. 1958.

2. Blau, Peter Michael and Scott, W. Rich-
ard. Formal Organizations: A Compar-
ative Approach. San Francisco, Chandler,
1962.

3. Street, David, Winter, Robert D. and
Perrow, Charles. Organization for Treat-
ment: A Comparative Study of Institu-
tions for Delinquents. New York, The
Free Press, 1966.

4. Goss, Mary E.W. "Patterns of Bureauc-
racy Among Hospital Staff-Physicians."
In Freidson, Eliot, ed. The Hospital in

Modern Society. London. The Free Press
ofGlencoe, 1963. pp. 170-194.

5. Sudnow. David. Passing On: The Social
Organization of Dying. Englewood
Cliffs, N.J., Prentice Hall. 1967.

6. Duff, Raymond S. and Hollingshead.
August B. Sickness and Society. New
York, Harper & Row. 1968.

7. Blishen, Bernard R. Doctors & Doctrine:
The Ideology of Medical Cure in Canada.
Toronto, Univ. of Toronto Press. 1969.
ch. 3.

8. Duff, op. c;7., ch. 10.

9. Olesen. Virginia and Whittaker, Elvi W.
The Silent Dialogue. San Francisco,
Jossey-Bass. 1968.

10. Davis, Fred, ed. The Nursing Profession:
Five Sociological Essays. New York,
Wiley, 1966.

11. Canadian Nurses" Association. Count-
down 1970. Ottawa, in process.

12. Mussallem, Helen K. Nursing Education
in Canada. Ottawa, Queen's Printer. 1964
(Royal Commission on Health Services
study).

13. Robson, A.H. Sociological Factors Af-
fecting Recruitment Into the Nursing
Profession. Ollawa.Queen'sPrinteT. 1964
(Royal Commission Health Services
Study).

14. Skipper, James K. The role of the hos-
pital nurse: is It instrumental or expres-
sive? Social Interaction and Patient Care.
J. Skipper and R.C. Leonard, eds. Phila-
delphia, Lippincott, 1965. pp.44-50.

15. Blishen, op.c(7., p.82. D

THE CANADIAN NURSE 41

research abstracts

The following are abstracts of studies
selected from the Canadian Nurses'
Association Repository Collection of
Nursing Studies. Abstract manuscripts
are prepared by the authors.

Muldoon, Sister Marie Barbara. The

teaching role of the staff nurse. Bos-
ton, Mass., 1963. Thesis (M.Sc.N.)
Boston University.

The purpose of this study was to iden-
tify the specific occasions in which the
staff nurse in a general hospital teaches
and the content of the teaching. The
study was conducted in a 185-bed gen-
eral hospital 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., 1 :00 to 2:30 p.m., and 4:00
to 6:30 p.m. for six days. The sample
consisted of 1 1 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 1 1 nurses.

Of the 234 teaching occasions in
which these nurses were observed, 150
were devoted to teaching physical care
of the patient, and most of this teaching
was directed to the nonprofessional
nursing personnel. On 127 occasions
aides 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
and 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 45
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. Q

Next Month

in

The

Canadian
Nurse

• CNA Convention Report

• Drug Misuse in Teenagers

• Body Image in Pregnancy

&

^^P

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. 1 1

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.

JULY 1970

On Death and Dying by Elisabeth
KiJbler-Ross. 260 pages. Toronto,
Collier-Macmillan Canada Ltd
1969.

Reviewed by Jeanne Quint Benoliei,
Associate 'Professor, School of
Nursing, University of California.
San Francisco, California.

Based on interviews 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 of the
book is the difficulties patients have in
communicating their needs during
serious and fatal illnesses.

One chapter is devoted to the
influence 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 conflicts 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, Saskatoon, 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 are merely
touched on. leaving the reader still
questioning the basis of some state-
ments. There is a tendency, particularly
in part I, to stereotype the nurse as a
slavish follower of rules. It would have
been valuable to 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 style
is quite different from medicare Cana-
dian style.

Despite these shortcomings, this is
a valuable book, particularly for nursing
administrative staff who are looking
critically 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 book 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.
Costello. 679 pages. Toronto,
John Wiley and Sons, 1970.
Reviewed by R. Barneti, Ph.D.,
Psychology Department. Carleton
University, Ottawa, Ontario.

Thomas Kuhn, author of The Structure
of Scientific Revolutions, suggested
that textbooks 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
will be of little use to the researcher
who demands more^han token summa-
ries of topic areas.
The book should find its major use
THE CANADIAN NURSE 43

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44 THE CANADIAN NURSE

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-
thology. 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-

lULY 1970d

velopment of the division of nursing
education at Teachers College, Col-
umbia University, from its inception in
1 899 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 leadershipcapacity 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 50 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.
lULY 1970

Persuasion, 2nd ed., by Marvin Karlins
and Herbert I. Abelson. 179 pages.
New York, Springer Publishing
Company, Inc.. 1970.
Reviewed hy D.G. Ogston, Faculty
of Arts and Science, The University
of Calgary, Calgary, Alberta.

In his 1969 presidential address to the
American Psychological Association,
Dr. George Miller 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. Miller's call, is a volume
that does much to open social psychol-
ogy to public view. The book is more
than two psychologists' review of
thoughts and theories on opinion and
attitude. It is a comprehensive collection
of the research and evidence that sup-
ports our contemporary understanding
of persuasion.

The authors view 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

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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 are 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 Living 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 "happiness"
is still an integral partof healthier living
in an all-consuming electronic age. n

AV aids

Medical film library

A catalogue of medical films is avail-
able without charge from the Ayerst
Medical Film Library, 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-tilm 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 1 958 of a cancer-
killing drug called VLB (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. Q

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.

lULY 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 any one time.

BOOKS AND DOCUMENTS

1 . L'uccorJ en framais moderne par Ri-
chard Bergeron 3. ed. rev. Montreal, Editions
Pedagogia. 1966. 124p.

2. The accreclikilion guide for extended
care facilities. Toronto, Canadian Council
on Hospital Accreditation. 1970. 3lp.

3. Attendrc tin enfant par Marianne Ro-
land Michel. Tournai Belgium. Casterman.
cl970. I7lp. (Collection "vie effectuelle et
sexuelle")

4. Birth: the story of how yon came to be
by Lionel Gendron. Translated by Alice Co-
wan. Montreal, Harvest House, 1970. 93p.

5. Brady's programmed introduction to mi-
crobiology. Washington, Brady, distributed
byj. B. Lippincott, Toronto, 1970. 174p.

6. Canadian Hospital Association office
and association directory March 1970. To-
ronto, Canadian Hospital Association, 1970.
60p.

7. Collection same et seciirite. Montreal,
Lidec Inc., 1967. I. Ton livre de sante, 2. Une
bonne journee, 3. Au grand air. 6. Pour votre
sante.

8. Continuing education for women in
Canada; trends and opportunities 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 Division of Nursing Education of
Teachers College, Columbia Universilv 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. I79p.

1 1 . L'ecoiier sa sante-son education par
Pierre Debray-Ritzen. Tournai, Belgium.
Casterman, 1970. 235p. (Collection "E ")

12. Emergency nursing by C. Luise Riehl.
Peoria III., Chas. A. Bennett, 1970. 286p.
"Suggested reading: p. 241-246"

13. L' enfant devant le film par Jean-Noel
Jacob. Montreal, Marcel Didier. 1969. 1 lOp.

14. Everyman's United Nations. 8th ed.
New York, United Nations. Office of Public
Information. 1968. 634p.

15. Family life education; community res-
ponsibility; report of symposium on sex edu-
cation for those involved in any aspect of
education. Don Mills. Ontario, Ortho Phar-
maceutical (Canada) Ltd.. 1967. 8 1 p.

1 6. The first day of life; principles of neo-
natal nursing by Helen R. McKilligin. New
York, Springer, 1970. 1 17p.

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 I970'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. Illness and health. Action for mental
health; final report of the Joint Commission
JULY 1970

on Mental lUnessand Health. 1 96 1 . New York.
Wiley. 1961. 338p. "Science editions"

20. Intervention in psychiatric nursing:
process in the one-to-one relationship Ijy
Joyce Travelbee. Philadelphia. Davis, 1969
280p.

21. /.v there a new design for the functions
of nursing services. 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. Neurological and neurosurgical nurs-
ing by Esta Carini and Guy Owens. 5lh 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 dying by Elisabeth Kii-
bler-Ross. Toronto. Collier-Macmillan, 1969.
260p.

25. Preparation for chiUlbearing. 3d. ed.
New York. Maternity Center Association.
1969. 47p.

26. Psychotherapie et relations hunuiines;
theorie et pratique de la therapie non-direc-
tive par Carl Rogers et G. Marian Kinget.
4e ed. Montreal. Institut de recherches psy-
chologiques. 1969. 2v. - Contents v.l Expose
general.- v. 2 La pratique.

27. The role of the nurse in the outpatient
department; a preliminary report by Warren
G. Bennis et al. New York. American Nurses
Foundation. 1961. 88p.

28. Social work in the hospital organiza-
tion by Margaret Gaughan Brock. Toronto.
Univ. of Toronto Press. 1969. 117p.

29. The unit management concept in lio.t-
pital patient care. St. Lou'is Mo.. 1969. 174p.

30. La vieillesse par Simone de Beauvoir.
Paris, Gallimard. 1970. 604p.

3 1 . Vocational and personal adjustments
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. Workbook for pediatric nurses by Nor-
ma J. Anderson. Saint Louis. Mosby, 1970.
159p.

PAMPHLETS

33. Annual report. Toronto University,
Faculty of Medicine, Behavioural Science
Department. 1968-1969. Toronto. 1969. pam.

34. Executive compensation in Canada.
Toronto. H. V. Chapman Associates, 1970.
pam.

35. Generic pharmaceuticals; the reasons
whv. Cleveland, Ohio, Strong Cobb Arner
Inc.. 1970. 13p.

36. Important things to consider and do
about family planning. Bramalea. Ont., G.D.
Searle and Company, n.d. pam.

37. NLN programs and Services 1969; a
report from Margaret E. Walsh, General
Director and Secretary. New York. National
League for Nursing. 1970. 8p.

38. Report of First National Conference
on Medical Malpractice, Feb.7-8, /970. 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
Workman's Compensation and Related Fields,
Toronto, Canada, Mar. 2-6, 1969. Ottawa.

When your day
starts at §S^
6 a.m... you're on
charge duty.,
you've skimped
on meals...

and on sleep. .^ p!
you haven't had^
time to hem
a dress. ..\

make an apple pie...
wash your hair...^,

evenpowder
yournose
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 seille down. Or it may need gentle help
from DOXIDAN.

use

DOXIDAN'

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 comfortable.

For detailed information consuli Vademecum
or Compendium.

HOECHST

PHARMACEUTICALS
3400 jcan talon w montreal 301
Division of cana oj a h hoechst limited

I PMAC I

THE CANADIAN NURSE 47

accession list

Dept. of Manpower and Immigration. 1970.
38p. (Rehabilitation in Canada Supp. no. 2)

40. 5/(;\'('V of Illinois iiuiclivc registered
nurses: a report to participants. Conducted
by Illinois Regional Medical Program in co-
operation u ith Illinois Nurses" Association.
Chicago. 1970. pam.

GOVERNMENT DOCUMENTS
Canada

41. Bureau of Statistics. Census of Canada,
1961: administrative report. Ottawa. Queen's
Printer. 1970. 371 p.

42. — .Census of Canada. 1966: Households
and families: household and family status of
individuals. Ottawa. Queen's Printer, 1970.
28p.

43. — .Mental health statistics, 1968. 19 Ip.

44. Dept. of Labour. Economics and Re-
search Branch. Strikes and lockouts in Can-
ada 1968. Ottawa, Queen's Printer, 1970.
92p.

45. — .Manafiement Consultation Branch.
Handhook for lahoiir-inanagement consulta-
tion committees. Ottawa, Queen's Printer,
1970. 16p.

46. Croupe de travail sur I'information
gouvernementale. Communiquer. Ottawa.
Imprimeur de la reine. 1968. 8 Ip.

47. Ministere de la Same Nationale at du
Bien-etre social. Manuel du consommateur
direction generale des aliments et drogues.
Ottawa. Imprimeur de la Reine. 1970. 22p.

48. Ministere des Finances. Propositions
de reforme fiscal par E. J. Benson. Ottawa,
Imprimeur de la reine, 1969. 107p.

49. Royal Commission on Bilingualism
and Biculturalism. Provincial autonomy mi-
nority rights and the compact theory, 1867-
1921 by Ramsay Co. Ottawa. Queen's Print-
er. 1969. 81 p.

fiQ. Task Force on Government Informa-
tion. To know and he known. Report of the
Task Force on Government Information. Ot-
tawa, Queen's Printer, 1969. 75p.
Onttuio

51. Council of Health. Report on the ac-
tivities of the Ontario Council of Health June
1966 to December 1969. Toronto, Ontario.
Department of Health 1970. 9v. Annexes. -
A Regional organization of health services. -
B Physical resources.- C Health manpower.-
D Education of the health disciplines.- E Li-
brary services.- F Health research.- G Health
statistics.- H Health care delivery systems.

52. Dept. of Labour. Research Branch. Ne-
gotiated wage rates in Ontario Hospitals. To-
ronto, 1970. 121 p.

Quebec

53. Comite superieur de nursing. Rapport,
premiere partie, a I'honorable ministre de la
sante de la province de Quebec. Quebec, P.Q.
1965? 27p.

U.S.A.

54. Dept. of Health Education and Wel-
fare. Public Health Service. Division of Nurs-
ing. Nurses in public health. Bethesda, Md.,
1969. 78p. (U.S. Public Health Service pub-
lication no. 785 rev.)

STUDIES DEPOSITED IN

CNA REPOSITORY COLLECTION

55. The collective bargaining experience

of Canadian registered nurses by Gerald W.
Cormick. Reprinted from Oct. 1969 issue of
Labor Law Journal. Chicago, Commerce
Clearing House, 1969. p.667-682.

56. Etude sur le personnel infirmier dans
les hopitaiix. Montreal. Association des In-
firmieres et des infirmiers de la Province de
Quebec. Comite Ad hoc sur les Besoins et les
Ressources en Soins Infirmiers, 1970. 35p.
(Rapport prepare par Barbara Kuhn) R

57. Falls in a general hospital by Annie
Elizabeth Clark. Seattle. Wash.. 1969. 54p.
(Thesis (MN)- Washington) R

58. Nursing study phase 2; a pilot study to
implement and evaluate the unit assignment
system. Saskatoon. Sask.. Saskatchewan Uni-
versity, Hospital Systems Study Group. 1969.
I83p. Project leader: K. Sjoberg. R

59. Rehabilitation nursing workshop;
course participants' altitudes toward certain
aspects of rehabilitation nursing by Dawn
Elizabeth Marshall. Boston, 1967. 135p.
(Thesis (M.Sc.N.) - Boston) R

60. Rehabilitation nursing; a review of the
literature by Beatrice Cole. Edmonton, 1970.
38p.

61. A 'study of the withdrawals of nursing
students at the Saskatoon City Hospital School
of Nursing, Saskatoon, Sask., from Sep. 1954
to Sep. 1960 by Linda Rose Long. Seattle,
Wash., 1962. (Thesis (MN) - Washington) R

62. Survey of nursing personnel in hospi-
tals. Montreal. Association of Nurses of the
Province of Quebec. Ad hoc Committee on
Nursing Needs and Resources, 1970. 34p.
(Report prepared by Barbara Kuhn) R

63. The teaching role of the staff nurses by
Sister Marie Barbara Muldoon. Boston, 1963.
50p. (Thesis (M.Sc.N) -Boston) R D

Request Form
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Requirements: R.N. and member of provincial nurses'
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48 THE CANADIAN NURSE

lULY 1970

August 1970

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The

Canadian

Nurse

convention report
my, you're getting big !
the Shouldice story

j0fi okay J^m ~
j(}fi r^ejefience X/^iefi

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 Brockman Keane, R.N., B.S., formerly of Athens (Go.)
Generol 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 con see the logic of each
problem. All problems ore 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, illustrated. 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 include core not
only at the site 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, illustrated. $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 illustrations. $17.30. February, 1970:

W.B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7

Please send on approval and bill me:

n Creighton: Law Every Nurse Should Know ($8.10)

□ Keane & Fletcher: Drugs and Solutions (about $4.00)

□ Flint & Coin: Emergency Treatment ($12.45)
n Smith: Patterns of Malformation ($17.30)

Nome

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The

Canadian
Nurse

^

^^p

A monthly journal for the nurses of Canada published

in English and French editions by the Canadian Nurses' Association

Volume 66, Number 8

August 1970

24 Convention Report

35 Auditors Report and CNA Financial Statement

40 My. You're Getting Big! E. Carty

44 The Shouldice Story M. Ferguson

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.

Editorial

4 Letters

16 New Products

2 1 Names

46 Books

47 Accession List

5 News

20 Dates

23 In a Capsule

47 AV Aids

64 Official Directory

Executive Director: Helen K. MossaUem • Ed-
itor: Virgiiua A. Lindaburj • Assistant Ed-
itor: Mona C. Rkks • Production Assist-
ant: Elizabeth A. Stanton • Circulation Man-
ager: Beryl Darling • Advertising Manager:
Rntli H. Baumel • Sabscription 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 Addreu:
Six weeks' notice; the old address as 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.

Manuscript InformadoB: 'The Canadian
Nurse" welcomes unsolicited articles. AH
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 right to make the usual editorial changes.
Photographs {glossy prints) ana graphs and
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. Permit No. 10,001.
50 The Driveway. OtUwa 4, Ontario.
O Canadian Nurses' Association 1970.

There was a strong feeling among CNA
members at the 35th general meeting
that the association must stop exam-
ining its own structure and get on with
the business that really matters, namely,
the provision of the best possible health
care for the people of Canada. There
was a strong demand that the national
association should take a firm stand on
social issues, such as pollution of the
environment, abortion, unemployment
insurance, and taxation.

The prospect of moving from an
introspective phase to one of social
action is exciting, and we hope all
CNA members — not just those who
attended the general meeting in Fred-
ericton — will find the excitement
contagious. There is no doubt that an
organization of 82.000 can move
mountains, if its members know what
they want, are determined to stand to-
gether to obtain it. and are not afraid to
speak out.

And how wonderful it would be if
the nursing profession were at long last
willing to shed its cloak of conserva-
tism and take some liberal, realistic
stands on issues that affect our society.
For example, although we're too late to
be the first health profession in Canada
to state that abortion should be a matter
that concerns only the patient and her
doctor — the Canadian Psychiatric
Association achieved that distinction in
June — we could be the runner-up.

Despite our enthusiasm about mem-
bership's desire to make CNA an
association of social significance, we
cannot but wonder just how this will
be accomplished. For without suffi-
cient funds, an association is limited in
what it can do.

We support the delegates' decision
on the payment of fees, realizing there
was no other alternative. But we also
see it as a "Band-Aid" approach, in
that it patches up the problem tempo-
rarily, but does not cure it. If CNA is
to accomplish all the things its mem-
bers demanded at the general meeting
in June, it cannot operate indefinitely
on the same buaget year after year. —

V^J..

AUGUST 1970

THE CANADIAN NURSE 3

letters {

Letters to the editor are welcome.

Only signed letters will be considered for publication, but

name ^11 be withheld at the writer's request.

Readers support permanent shifts

Congratulations on the overdue article
by Helen Saunders, "Let's Have Per-
manent Shifts" (June, 1970). Her rea-
soning is true and excellent! At last
someone is willing to admit that nurses
are human.

I, too, believe that the permanent
shift is the best answer for everyone.
Many hospitals put a nurse on a ward
that she dislikes and on a rotation that
allows almost no personal life. Since
this happens so often, many nurses hes-
itate to state a preference.

Married nurses with families make
up a large percentage of the hospital
staff. Rotating shifts usually mean seri-
ous difficulty for the nurse's family.
Household help is unavailable, and
children become the main victims. Hus-
bands carry an extra and unnecessary
responsibility every third or fourth
week. Is it any wonder that married
nurses are known as "until" workers?
They will go back to work until the
furniture is paid for, or until the hus-
band is over his illness.

Many of these married women enjoy
nursing, do an excellent job, and often
bring a more human touch to their
patients. Most would continue to work
on a permanent shift that would allow
them to make proper arrangements for
their children.

No good nurse can turn her back on
her first responsibility — her family.
Society should accept this fact. Single
nurses also have their own lives to live.
For many years a nurse's first and only
responsibility was supposedly her job.
— B.J. Buckman, Reg.N., Prince
George, British Columbia.

Blames nursing assistants

I have been a practicing registered nurse
since 1 94 1 . Although for many years I
have considered nursing to be one of the
most uplifting professions for women,
developments in the last few years have
forced me to think otherwise.

I now see our hospitals flooded with
nursing assistants and nurses' aides who
are receiving the same status and ap-
proval formerly accorded registered
nurses. Some may use the excuse that
there is a shortage of nurses, but this has
occurred only since the establishment of
schools for nursing assistants. Too many
nurses have used nursing assistants as an
excuse to get away from the bedside,
retreat behind a desk, and delegate
responsibilities that should never have
left the hands of qualified RNs.
4 THE CANADIAN NURSE

Who is responsible? I blame the pro-
vincial registered nurses' associations.
Although the result is not obvious now,
in 10 years the result will be chaos.

Today there is more need than ever
for good nurses. With the advance of
science and advanced surgical and med-
ical procedures, surely we cannot lessen
our requirements for meeting patient
needs, but rather increase them. This
can only be done by updating our im-
mediate contributions to patient wel-
fare.— Alfredo Ricketts, RN, Park-
dale, P.E.I.

Permanent shifts

The excellent review of the feasibility
of permanent shifts by Helen Saunders
(June, 1970) deserves careful attention
from all concerned nurses.

That such a skeleton in the cupboard
of nursing has been brought out for air-
ing is a credit to the author and to the
liberalism of The Canadian Nurse. —
N. Pamela Fairchild, R.N., Gabriola
Island, B.C.

Hospital routine necessary

I read with interest Pamela Poole's
article, "Nurse, Please Show Me That
You Care!" (Feb. 1970.) The type of
individualized nursing care advocated
by Miss Poole implies the need for an
intensive care unit or a private duty
nurse.

Attempting to cater to every patient's
habits and desires at all times would
create chaos. Many of these habits are
unnecessary while a patient is in hospi-
tal. At home a person is in charge of his
own affairs, but in the hospital he is
dependent on the staff for treatment.
Some kind of routine is always neces-
sary. I think a hospital routine is more
important than routine anywhere else;
it could be improved but never dropped.

Having been a patient many times,
I think that hospital routine is reassur-
ing to a sick person. A patient is confi-
dent when meals, baths, and medica-
tions are given at regular times. I was
never upset because a nurse awakened
me, as long as she was friendly and in-
terested. A cold, unfriendly nurse who
treats the patient like an ailing machine
does more harm to the patient's morale

Letters 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.

and wellbeing than any amount of rigid
routine.

Rather than making nurses more
concerned and understanding, dropping
routine would increase confusion and
make nurses irritable and inefficient.
Surely the nurse could treat the patient
kindly and intelligently while she does
her tasks at the usual time.

Can't common sense be combined
with routine? The patient could be asked
his opinion about maintaining or re-
laxing routine. I have often heard pa-
tients grumble about being disturbed]
constantly, yet it was a good-natured!
and even boastful complaint that im-
plied, "Look how important I am with
all these tests and doctors."

One example of what can happen
when hospital rules are relaxed can
be seen from the trend toward more
flexible visiting hours. The patient who
wants to rest is often forced to put up
with visitors for five or six hours.

Every nurse and doctor should be a
patient a few times to know what the
patient wants. — Betty Kowalchuk,
RN, Scarborough, Ontario.

Prenatal teaching in hospital

Congratulations for having the courage
to print "A Split in the Family" (April
1970). Seldom has an article in a
professional journal fired me with such
enthusiasm for my work.

The University of British Columbia
School of Nursing recently sponsored
a course on nursing care of the maternity
patient, which nurses and other per-
sonnel from hospitals and public health
agencies attended. During the discus-
sions nurses repeatedly expressed the
need for more continuity of teaching
and sharing of knowledge, and suggested
ways of achieving this need. Yet I left
feeling that little change would be
made, especially in hospitals. Maybe
part of the problem is that the indivi-
dual and her ideas get lost in the large
organization.

I recently talked with nurses from
maternity departments of several
hospitals about the opportunity for
prenatal teaching when a patient is
admitted during pregnancy. The
situation in most hospitals appears very
much as Mrs. Rose described. Several
nurses gave the reason that doctors do
not like them to say too much to the
patient. This is strange, when many
doctors encourage their patients to
attend prenatal classes in the community.
— Valerie Boyer, RN, B.C. D

AUGUST 1970

news

A Call To Action

An avid interest in the keynote address,
^iven at the CNA 35th biennial
meeting, continued after the conven-
tion's opening session. For those
members who were not there, here is a
synopsis of the highlights.

Nurses attending the Canadian Nurses'
Association convention last June in
Fredericton, New Brunswick, were told
two old-fashioned words, commitment
and dedication, were coming back into
use, and society in the 1970s may be
the better for them.

Verna M. Huffman, principal nursing
officer for the department of national
health and welfare, and keynote speaker
at the opening of the week-long conven-
tion, said other important words need
to be added to nursing today. She noted
four, outreach, involvement, and social
action. To each one, she said, it was
necessary to add new concepts.

Sp)eaking to a packed audience in
Fredericton's Playhouse, Miss Huff-
man reiterated the call of the nursing
profession, convened to discuss
"Continuing to Care in the 1970s,"
An end to differences in care for the
rich and the poor was one way in which
nursing could provide a vital link in
this theme, she said.

Commenting on three major profes-
sions meeting in conference during
June (Canadian Medical Association —
Winnipeg; Canadian Conference on
Social Welfare — Toronto; and the
Canadian Nurses' Association —
Fredericton), Miss Huffman said a
review of the doctors' and nurses'
programs showed that both professions
are concerned with the "Changing
patterns in health care in the 1970s,
and with their respective roles in rela-
tion to relevancy, practice, and quality
of care."

In contrast, the Canadian Conference
on Social Welfare focuses attention on
major national issues in health and
welfare.

Prevention and control of disease

Preventing and controlling chronic
disease will be the major health
challenge during the coming decade,
said Miss Huffman. Measures taken
will need to include the extension of
existing programs, and new ones added
to provide personal health services.
These will have to reach out into the
AUGUST 1970

Speaking on health and welfare services in Canada at the opening ceremonies
of the Canadian Nurses' Association 35th general meeting in Fredericton, New
Brunswick, Verna M. Huffman, principal nursing officer, department of national
health and welfare, told of government concern for public health needs. As
keynote speaker. Miss Huffman outlined positive approaches to nursing challenges
in the 1970s. She called on her nursing associates to clarify what is meant by
the extended role of the nurse, and asked that the CNA take a positive stand on
social issues. Seated behind Miss Huffman (right) Sister Mary Felicitas, outgoing
president, and The Honorable Wallace S. Bird, Lieutenant Governor of N.B.

homes of the community, making serv-
ices available to all.

Preoccupation with the treatment
of the acutely ill at the expense of
prevention and care of chronic disease,
should not cloud the prime concern —
without prevention, a healthy popula-
tion cannot be produced.

Pollution

Touching on the subject of pollution.
Miss Huffman said, "Prevention can
no longer be left as a concept. It must
be put to work in every avenue that
touches on the health of man.

"It is time for all Canadians to take
action and exert every conceivable
pressure to halt the pxiUuters in their
tracks."

Expressing the federal government's
concern on pollution control. Miss
Huffman said, "... we are striving to
increase the activities of the environ-
mental health division of the depart-
ment to bring a new code of clean air."
She felt there was also a great need for

the public, including professional
associations, to become active in the
drive toward pollutant control.

Social environment

Explaining why she felt major prob-
lems exist in our social environment
which touch the young and the old
directly, and many others indirectly,
Miss Huffman made it clear to her
audience that, in her estimation, "the
spread of alienation among young
people today is a phenomenon more
analyzed than acted on.

"Students are questioning the long-
held goals of their professions, or else
charging that their profession has
knowingly and willingly failed to
fulfill its expressed goals," she said.

Citing law, medicine, and nursing
as three professions affected by the
alienation of the young from established
practice. Miss Huffman termed student
viewpoint on the establishment as a
"sellout" to an exploitative, capitalist
system, "with a double standard of
THE CANADIAN NURSE 5

service for the privileged and the under-
privileged."

The young people today can give us
examples that show "inequality of rights
between the rich and the poor — even
the right to health care."

Continuingon the subject of equitable
health care, Miss Huffman mentioned
the health studies underway in Canada.
"We cannot deny the piles of studies
which demonstrate an inextricable link
between poverty and bad health. We
cannot claim that our health personnel
are distributed equitably according
to population or need. The only answer
is to reply to the challenge of the young
by accepting their outlook and mending
the gaps between theory and reality."
Faced by an audience of over 1 ,000
nurses, Miss Huffman turned her
comments directly to the CNA when
she asked the association to implement
its brief to the Senate Committee on
Poverty. She suggested the nursing
profession could experiment with new
models of community care and inter-
disciplinary community group prac-
tices.

"As a profession, we can shift the
priority and financial resources in our
education system over the public health
and community health care training,
seek closer working relationships with
social agencies and workers, and talk
to the self-organized low-income citizen
groups as equal partners in developing
better health and health education
programs."

Appealing to the nursing profession,
Miss Huffman said, " We can do these
thmgs if we care, but can we not care.
To go without care is an outright na-
tional shame in a country rich in health
personnel and facilities."

Calling for greater involvement in
the country's nursing facilities. Miss
Huffman described nursing conditions
in Canada's north, where many of the
nurses are foreign.

"Canada borrows nurses from
countries which have a desperate nurse
shortage, to fill the health needs in
outlying communities in the North,"
she said. This is because "our own girls
either cannot, or will not, take the
necessary training and face the social
challenge."

Health care for the aged also came
under Miss Huffman's penetrating gaze.
"It is true health care is provided for
most old people," she said, "... but
somefimes that care is neither within
their reach nor within their ken."

^ She charged there appeared to be
a "major breakdown in ourcommunica-
6 THE CANADIAN NURSE

tion with people about the resources
available. There is a great need for
Canadians to reexamine fundamental
values, with particular regard to the
aged."

According to Miss Huffman, nursing
in the 1970s is moving into one of the
most exciting periods in nursing history.
She described it as a "... time of great
change. A period requiring new sights,
new horizons, new roles, and new
relationships."

Referring to one new role that the
nurse may be filling in the early 1970s,
she agreed with the firm stand the
editorial in the June 1970 issue of The
Canadian Nurse, took on the doctor-
assistant issue. Quoting from the
editorial, she emphasized the need for
the CNA to back up its concern for
patient care by "taking a stand in this
issue, and quickly."

Health demands in the coming dec-
ade will see a need for nurses "with a
difference in preparation and perspec-
tive," according to Miss Huffman. She
saw these differences as a connecting
link between the patient, his family,
and the health services, and affecting
all areas of nursing as the role of the
nurse moved toward greater involve-
ment in health planning and care.

"There is already a need for the
nurse who is capable of looking at the
community as a whole, and capable of
moving with firm logic from health
needs to careful choices in the use of
available resources."

The need for nurses to accept other
nurses as colleagues was stressed on
several occasions. Respect for the
individual role and contributions not
only of other nursing disciplines, but
of working partners, became a theme
throughout Miss Huffman's speech.

During the past six months, discus-
sion on the appointment of a profes-
sional lobbyist for the Canadian
Nurses' Association has been given
frequent editorial coverage in the
journal and news media across the
country. Miss Huffman referred to
the lobbyist "as a legitimate role for
a responsible professional organ-
ization," but cautioned the association
when accepting this responsibility to,
"strive for a balance, one which seeks
to promote change while keeping in
mind the realities of the situation."

Questions asked

To an audience newly convened for
a week -long session on nursing policies
and nursing needs, the speaker posed
several questions. She prefaced her
remarks by stating that as a strong,
organized profession, nurses probably
have more experience with poverty
and its effects than any other segment
of the Canadian population. But, she
asked, as a responsible group in

numbers and weight of knowledge,
"whatsocial action has this organization
taken to combat poverty?"

Miss Huffman continued, "An
organization must have policy state-
ments on important national issues...
to initiate concrete action."

What," she asked, "is the stand of
this predominantly female association
in the national issue of abortion? What
is the stand on drug abuse?"

Applause almost drowned out her
questioning as she came back to her
listeners, asking if the association felt
there is an "artificial distinction
between legislation dealing with
harmful narcotics!"

She cited as examples marijuna,
which comes under the Narcotic
Control Act [ possession is an offense] ,
and amphetamines, considered equally
dangerous, but controlled under the
Food and Drug Act (possession is not
an offense ] .

" What is the association's stand on
these issues?" she demanded.

It was following her questions on
national issues and the stand taken by
the association on major social con-
cerns, that Miss Huffman detailed the
words and concepts she felt would help
the nurse in the 1970s identify her
changed role in Canada's health system.

CNF Members Recommend
Fee Increase Of $3

Fredericton, N.B. — Members of the
Canadian Nurses' Foundation attend-
ing the annual CNF meeting June 15,
expressed strong support for a mem-
bership fee increase. They voted una-
nimously to recommend to the board of
directors that the annual fee be raised
to $5 per regular member. The present
fee is $2.

Concern was expressed about CNF's
financial state. As of December 31,
1969, the surplus in the scholarship
fund was $37,4 1 9; in the research fund,
$1,917; and in the general fund,
$5,144. The secretary-treasurer of
CNF, Dr. Helen K. Mussallem, told
the members it costs at least $3 to
process each membership.

Several members said they were sure
that those who now support CNF would
be willing to pay the increased fee. One
member suggested that the 99 nurses
who have received CNF scholarships
should be taxed $ 1 00 annually. Another
suggestion was that CNF scholars should
think of ways to help publicize the
Foundation.

The president's address, presented
by the CNF vice-president Albert W.
Wedgery, pointed out that membership,
too, is low: 1 ,294 regular members as
of December 31, 1969; 16 sustaining
members; and 1 patron — a total of
1,31 1. This is a decrease of 183 mem-
bers from the previous year.

AUGUST 1970

In summarizing. Mr. Wedgery said,
"CNF needs members, convinced mem-
bers. Their enthusiasm can be the most
effective promotional factor for the
Foundation in defining its purpose,
interpreting its needs, explaining its
operation, and spurring donations, be-
quests, memorials .... The challenge
is to see the Foundation as an indepen-
dently established corporation by
1972," he continued. "Can it be done?
I think it could."

Report Urges Special Committee
On Nursing Research Be Set Up

Fiedericton, N.B. — Establishment of
a special 22-member committee on
nursing research was one of four
recommendations made by the ad hoc
committee on research of the Canadian
Nurses" Association, and reported to
membership at the 35th general meeting
June 19. The committee report is being
studied by provincial nurses" associa-
tions and will go to the CNA board of
directors when it meets in the Fall.

The other three recommendations,
made at an April meeting of the research
committee, are:

• CNA should accord high priority to
the need to allocate funds for research,
including $ 1 00,000 per year to prepare
nurses with the qualifications necessary
to participate in and direct research
projects.

• CNA should initiate discussions with
the Council of Canadian University
Schools of Nursing and with the depart-
ment of national health and welfare
for research in the field of nursing.

• CNA should adopt the complete
statement of policy on nursing research

Soon after president-elect E. Louise Miner (right) became president, following
the 35th biennial meeting of the Canadian Nurses' Association in Fredericton,
New Brunswick, she gathered her new executive together for the first official
picture. Left to right, 1st vice-president Kathleen G. DeMarsh, assistant
executive director. The Winnipeg General Hospital, Manitoba; 2nd vice-
president Huguette Labelle. director. Vanier School of Nursing, Ottawa; and
president-elect Marguerite E. Schumacher, director. Health and Social
Services, Red Deer College, Alta. Miss Miner is wearing her chain of office.

as recommended by the research com-
mittee.

In this statement the committee
said the role of CNA in relation to
research would be: to provide a com-

Dorothy J. Kergin, chairman of the CNA ad hoc committee on research, gives a
resume of her committee's recommendations on the national association s role in
research. Over 1,000 nurses attended the CNA general meeting in Fredericton.
AUGUST 1970

prehensive picture of the profession; to
encourage and infiuence the research
activities of individual practitioners
and of educational and service agencies;
and to serve as spokesman for the
profession in relation to research in
health services.

The committee report was discussed
at a special meeting of the CNA board
June 18 during the CNA general meet-
ing in Fredericton, N.B. Dr. Dorothy J.
Kergin, committee chairman, attended
to answer questions. She also presented
a resume of the report to the general
membership on June 19, for infor-
mation purposes.

During the session on June 19,
Verna Huffman, principal nursing
officer with the department of national
health, said a new committee on re-
search projects has been set up by the
department. It is headed by Dr. John
Evans, dean of medicine, McMaster
University, Hamilton; representing
nursing on the committee is Pamela
Poole, a nursing consultant with the
department.

Specialization Calls For
Nursing Changes

Interest sessions at the Canadian

Nurses' Associati^ 35th biennial

convention in Fredericton were attend-

(Continued on page 10)

THE CANADIAN NURSE 7

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(Continued from page 7)

ed by audiences eager to learn more
about specialization in nursing.

Speaking at The Playhouse, June 1 8,
on "The Expanded Role of the Nurse,"
three speakers expressed opinions,
showing that nurses have already
expanded their role into many areas of
medical service.

Opening the afternoon session, Dr.
F.B. Fallis of the department of family
and community medicine. University
of Toronto, said improved communi-
cations and a decrease in the cost of
health care through universal medical
coverage have "produced a strong new
boldness and demand by the public," for
more and better services.

Nurses and doctors should take
another look at the basic aspects of
their professional patterns. They should
begin by reexamining educational
preparation in all its phases.

Developing specific training for the
nurse's role by teacher identification
and well determined standards, he said
was one approach. Another, setting
standards for team skills and methods
in a community setting.

He felt it would be difficult to see,
"how the physician, with his extra
responsibility for diagnosis, and
medical and surgical therapeutics, was
not the senior member of the community
team."

"Featherbedding," he commented,
"is keeping up an outmoded style of
operations when a trade union insists on
it." When the same thing is done in
medicine, the explanation is "the
maintenance of established professional
values."

The problem of delegation must be
solved, he said, but a professional
relationship must also be maintained.
The family physician on the team "must
be able to assign those things which
the team nurse, in her extended role,
can do more effectively from a patient's
point-of-view.

Following Dr. Fallis, Rosemary
Coombs, clinical nurse specialist at
the Ottawa Civic Hospital, spoke on
the expanded role of the active-care
hospital nurse.

Mrs. Coombs told her audience that
to keep abreast of medical advances,
nursing specialization had become a
necessity. Because hospitals are being
divided into highly specialized units,
the role of the nurse has to take on
certain functions of the medical spe-
cialist.

Today's multi-disciplinary approach
to health care places the onus on nurses
10 THE CANADIAN NURSE

who "can and will... seek the knowledge
and clinical expertise to establish them-
selves as interdependent partners of
medical and paramedical personnel."
Speaking to fellow nurses who ap-
plauded her comments, Mrs. Coombs
said, "You know that the Canadian
public is concerned with the cost of
health care and is demanding more
accessible and more long-term care.

"What, then," she asked, "must
happen to the role of the nurse, if she
is to adapt to public, provincial, and
nafional demands."

Participation in specialization is the
answer, according to Mrs. Coombs,
and she explained why.

Three major trends in the active -care
hospital system are apparent: Medical
specialization — requiring specialty
units, nursing specialization, and
assumption by nurses of some medical
functions; Better utilization of nurses —
leading to patient-focused care, progres-
sive care, and patient-care classification
within a health region; Multi-discipli-
nary approach — requiring peer
relationships between all health pro-
fessionals.

What kind of nurse do we need to
answer the call medical change de-
mands? Nurses who are trained in
specialifies, with an ability to recom-
mend necessary change in medical
therapy, supported with scientific
reasons, said Mrs. Coombs.

To cope with the trend to a multi-
disciplinary approach to health care,
we need nurses who can and will "raise
their heads from their traditional,
dependent role and seek the knowledge
and clinical expertise to establish
themselves as interdependent partners
of medical and paramedical personnel."
Preparing nurses to function in a
changing health care pattern means,
qualified nurses must be sent to uni-
versities for graduate work in a clinical
specialty. These will become the
clinical nurse specialists, who will
demonstrate the expanded role of the
nurse, and assist other nurses to do
likewise.

Senior nurses should take short
courses to qualify as nurse clinicians,
and graduates from basic nursing
programs should be assisted to develop
clinical and technical expertise in the
specialities to become specialty nurses.
New graduates, general nurses, should

Notice

Changes of name and address that have
been forwarded by the Post Office to
the CNy 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.

be allowed easy mobility according to
their clinical expertise and scienfific
knowledge.

Mrs. Coombs said her description
of the extended role of the nurse is
suggested as one nursing answer to the
health delivery problems of Canada.

"If we [the nurses] want status, we
will find it not only in a university
degree, but if we function interdepen-
dently with all the health professions,"
she said.

Contributing her comments to the
expanded role of the nurse, Monica
M. Green, director of public health
nursing, department of health services
and hospital insurance, British Co-
lumbia, outlined the role of the public
health nurse in promoting health
service.

She said public health nurses have
unique role, their activities are con-
cerned with prevention, and with treat-
ment and care.

The basic philosophy, she felt,
would not change, but the delivery of
public health nursing will, as health
care needs in Canada change.

Prevention, including health pro-
motion, is the traditional role of the
public health nurse, said Mrs. Green.
Her effectiveness in all areas of
community nursing, including areas in
the North, has been felt. She cited
immunization procedures as one
example. Although practised by the
public health nurse for 25 years, it has
not been universal in all provinces,
said Mrs. Green. She quoted the federal
task force report as recommending
that immunization be done by the
public health nurse as one cost control
method.

Describing various trends in public
health nursing change, Mrs. Green
said organizational changes toward
having the nurse's services available
to physicians on a regional basis, or
attached entirely to a medical practice,
is one team concept of health care.

The role of the public health nurse
has expanded from that of referral
agent to active responsibility for
developing community health services,
she said.

Yet, few agencies provide the
opportunity for this expanded role.
"The public health nurse and agencies
are still reluctant to give up old routines
for new ones."

More opportunity to use her capabil-
ities is required, Mrs. Green told her
fellow nurses, rather than "expanded
education."

Spontaneity Is Key

To Helpfulness Of Psychodrama

Fredericton, N.B. — The key to the
helpfulness of psychodrama is its spon-
taneity of action, the director of nursing

AUGUST 1970

at the Clarke Institute of Psychiatry in
Toronto told an audience of over 400
on June 16.

Speaking at a special interest session
at the Canadian Nurses" Association's
35th general meeting, Dorothy Burwell,
who is also associate professor of psy-
chiatric nursing at the University of
Toronto, explained that psychodrama
is a "special case of encounter," where
patients are brought together on stage to
enact scenes that have bothered them.
"With spontaneity as the key, feelings
begin to emerge," Mrs. Burwell said.
"All the angry frustrations, fears, long-
ings, loneliness, and confusion become
shared with the group."

Mrs. Burwell then proceeded to de-
monstrate this spontaneity of action.
She had no trouble in rounding up eight
volunteers from her enthusiastic audi-
ence — four nursing students and four
"head nurses of World War II vintage."
Their assignment: to help each other
bridge the generation gap and to air the
misunderstandings that arise between
students and nursing staff.

"Tell these head nurses what you
don't like about them," Mrs. Burwell
directed the student actors. One student
reponded immediately: "We're sick
and tired of hearing how we have it so
easy, and how you head nurses had to
work 12-hour shifts when you were
students!"

The head nurses retaliated saying
that patient care wasn't as good as it
used to be, partly because students
weren't on the wards long enough to
learn the necessary skills, and seemed
reluctant to accept responsibility.

At this point, several students in the
audience, obviously annoyed at the
head nurses' comments, voiced objec-
tion.

Roles were then reversed: students
became head nurses, and head nurses
became students. This reversal of roles
seemed difficult for the actors, but they
gave the impression they had obtained
some insight into the other's problems.

At the end of the session, Mrs. Bur-
well received prolonged applause for
her lecture and demonstration.

Nursing Consultant Criticizes
Depersonalized Nursing Care

Fredericton, N.B. — Many of Cana-
da's hospitals have become so deper-
sonalized that there is almost more feel-
ing of welcome in a hotel, according to
Pamela Poole, nursing consultant with
the department of national health and
welfare.

Miss Poole showed this deperson-
alization and how it affects nursing care
during an interest session on June 18
at the 35th general meeting of the
Canadian Nurses' Association. She
gave two presentations, one in English
AUGUST 1970

Research Session Sparks Enthusiasm

Many nurses gave up their chance to sliop riuir^da\ night during the Canadian
Nurses' Association's 35th general meeting in Fredericton, to attend the 7:00
P.M. interest session on research. Their choice was a good one. The session,
chaired by Dr. Dorothy Kergin, right, director of McMaster University's school
of nursing, was interesting and lively, bringing an enthusiastic response from
the audience. The two RNs who presented research papers are, from left: Susan
E. Perry, lecturer. School for Graduate Nurses, McGill University; and Alice
J. Baumgart, associate professor. University of British Columbia.

and one in French, speaking to a full
house of some 400 nurses each time.
The audience reception was excellent.

Miss Poole told the terrifying story
of "Mr. Anybody" on his admittance to
hospital. "His experiences are a com-
posite of many patients" experiences,"
she explained. "Most of them happen
somewhere in Canada, to some patients,
every day."

In her presentation, Mr. Anybody's
problems started when he tried to find
the admitting office of the hospital. He
felt like a prisoner in his room, had great
difficulty getting any food, and was
worried about the strict visiting hours.

Miss Poole said the nurses caring
Mr. Anybody never took the time to
explain the routines they were perform-
ing: why he had to have his back rubbed
at 8:15 P.M. and his light out at 10:00
P.M.. his temperature taken at 5; 1 5 A.M.

The nurses would not explain why
Mr. Anybody had to take a certain pill,
or could not drink water one night. He
found them rigid about unimportant
things, such as washing from his own
metal basin rather than the sink, even
though the basin would not balance well.

Miss Poole showed that Mr. Any-
body was made to feel embarrassed —
by all the personal questions he was
asked, by being forced to use a wheel-
chair when he could walk. He also felt

isolated — he could not see his children
(they were too young to be allowed into
the hospital) and visiting hours were
short.

When he went for his operation, no-
thing was explained to Mr. Anybody,
and he was talked to like a child. Miss
Poole showed that his whole experience
of being in hospital was frightening and
uncomfortable. She said nursing cer-
tainly shared the blame for this deper-
sonalization of the hospital.

When a member of the audience
asked how to teach nursing students to
be perceptive and to care. Miss Poole
suggested apprenticing them to an ex-
pert practitioner who cares, rather than
to a hospital.

She questioned whether there would
be a registered nurse on the ward to
supervise nursing care 15 years from
now. The people who foot the bills have
not been convinced that professional
nurses make a difference, she added.
"The public can bring pressure, but will
do so only if they want you to give nurs-
ing care," said Miss Poole.

Highly Planned Patient Care
Essential, Nurses Told

Fredericton, A'.B. -•- Organized plan-
ning of patient care has many advan-
tages, mcluding individualized patient
THE CANADIAN NURSE 11

news

care and greater job satisfaction for
nurses, according to Myrna Sherrard,
nurse clinician, Moncton Hospital.
New Brunswick.

Proper planning also provides for
coordination of the efforts of all who
provide care, eliminates many routines
and ritualistic practices, and leads to
more effective utilization of nursing
care hours. Miss Sherrard told some
400 nurses attending the interest session
June 18 during the 35th biennial
convention of the Canadian Nurses'
Association.

Organized planning is based on
three well thought out steps, said Miss
Sherrard. Assessment is followed by
nursing intervention. "Perhaps one of
the most difficult tasks in this whole
process is to set for and with the patient
realistic goals or objectives," she added.

The final step is evaluation of
nursing action, probably the most
commonly overlooked part of the
process, said Miss Sherrard. "Nurses
must accept as their responsibility
providing the patient with the know-
ledge that will enable him to participate
effectively in his own plan of care,"
continued Miss Sherrard. "It is only
the patient who can evaluate the
effectiveness of some of our nursing
activities."

Huguette Labelle, director of the
Vanier School of Nursing, Ottawa,
presented the French-language interest
session on planning patient care. She
agreed with Miss Sherrard that an
organized nursing care plan is essential
for patient-centered care.

Mrs. Labelle also urged nurses to
look after their own profession before
others tell them what they should do.

Urgent Need Shown For
Nursing Textbooks In French

Fredericton, N.B. — An urgent need
for nursing textbooks in the French
language was expressed by over 130
nurses who attended a symposium held
June 15 during the 35th biennial
convention of the Canadian Nurses'
Association.

Those attending decided committees
should be formed within provincial
nurses' associations to find out exact
needs for French textbooks. These
committees could also ask for funds
from the health ministers of each
province, and encourage nurses to write
texts and help them get published.

The CNA general membership rein-
forced the findings of the symposium
12 THE CANADIAN NURSE

A lively symposium on the lack of nursing textbooks published in French, brought
an overflow audience to MacLaggan Hall, University of New Brunswick, during
the Canadian Nurses' Association convention last June. "There's no more room,"
was the repeated comment as those wishing to take part in the discussion made
every effort to find a seat. They packed the hall and stood in the corridor, a
steady two-way stream, in and out as they strove to take in the sessions.

on June 19, when it passed a resolution
asking the Board of Directors to con-
sider ways and means of producting
French-language textbooks.

At the symposium it was decided
that a basic health manual was a prior-
ity. All participants favored the original
production of texts in French, rather
than a translation.

Representatives from eight pub-
lishing companies attended the sympo-
sium and answered questions. They
pointed out the large cost of producing
a book, whether original or translated,
but said they were ready to help nurses
if given specific requests for books.

Legal Implications Of Nursing
Reviewed At Convention

Fredericton, N.B. — The health field
is changing so quickly that the law has
not caught up with it, Lome E. Rozov-
sky told some 400 nurses at an interest
session held during the 35th general
meeting of the Canadian Nurses'
Association June 14 to 19.

And Canadian nurses may be the
victims of more legal suits because
their relationships with doctors and
nursing assistants are not clearly enough
defined, said Mr. Rozovsky, solicitor
for the Nova Scotia Hospital Insurance
Commission.

The new legal specialty of health
law may assist nurses in definition of
their role, he added. However, since

this specialty is so new there are still
"large gaps of unanswered questions."

There are no longer "precise legal-
istic slogans governing the nurses'
minute-by-minute conduct," said Mr.
Rozovsky. And it is not true that so
long as a nurse is following a doctor's
orders, she will be protected from legal
suits.

"If a doctor gives an order which is
obviously wrong and which will or
could result in injury to the patient,
the nurse could well be held responsible
either in whole or in part if she carries
out the order," said Mr. Rozovsky. "If
the nurse observes that the doctor has
done something which is obviously
negligent, she must not assist in that
task."

She should obtain clarification of
the order and, if still not satisfied,
report the matter to her supervisor, he
added.

The nurse is in a difficult position,
said Mr. Rozovsky. because she may
not substitute a medical decision, but
she could be held liable if she followed
a decision she knew was wrong or
ambiguous.

"One has only the general legal
guidelines of the ordinary prudent
nurse to determine the role of the
nurse and her relationship with the
doctor," said Mr. Rozovsky.

The courts are guided as to proper
nursing conduct by the testimony of

AUGUST 1970

expert witnesses, he added, so "the
nursing profession sets its own legal
standards" to a large degree.

The nurse's responsibilities will
become greater as educational standards
are raised, said Mr. Rozovsky.

Nurses Told To Define Role,
Look For Change In Profession

Fredericton, N.B. — The proper "care
and feeding" by nurses of their profes-
sion will bring change, not comfort,
according to C.R. Brookbank, chair-
man, Dalhousie University department
of commerce, Halifax, Nova Scotia.

"If you avoid the crucial questions
and thus hope to avoid change," he
told some 1,000 nurses June 15 at the
35th biennial convention of the Cana-
dian Nurses" Association, "you will not
be comfortable because others will put
you in what they consider to be your
place, and continue to make inroads on
your territory."

The major dilemma of the nursing
profession today concerns the role of
the registered nurse, said Professor
Brookbank. He asked nurses to define
their primary functions, which no one
else can perform. "Which areas of
knowledge belong to you alone? Every
profession has them; if you do not, can
nursing truly be called a profession?"

If it is truly a profession, continued
Professor Brookbank, nursing must
have "a diagnostic function which de-
mands insight as well as technical
knowledge, analysis based on a perspec-
tive which 'belongs' to the discipline,
and responsibility backed by clear
authority for subsequent action."

Nursing must have some core func-
tions that cannot be performed by tech-
nicians or members of other professions,
said Professor Brookbank. Also, nurses
should not do jobs that lesser-trained
personnel can do.

Professor Brookbank said the long-
term success of all nurses' activities to
advance their profession will depend
on the valid answers they can provide
to these questions of their functions.

Some answers may be found in the
concept of team nursing, he said, es-
pecially if a registered nurse is the head
of the team in a professional sense.

One Million Children
Handicapped, Commission Finds

Ottawa — Twelve percent of all Cana-
dians up to age 19 — more than one
million children — need attention,
treatment, and care because of emo-
tional and learning disorders, but only
a quarter of them get adequate treat-
ment. This is the finding of the Com-
mission on Emotional and Learning
Disorders in Children, whose report
was released June 23.

The report, issued by CELDIC. a
non-government commission set up

AUGUST 1970

Professor C.R. Brookbank of Dalhousie University, Halifax, talks to over 1,000
nurses in Fredericton about the proper "care and feeding" of their profession.

four years ago by seven voluntary
agencies, severely criticizes aid
programs and calls for radical re-
organization of the helping services
throughout Canada. One hundred and
forty-four recommendations call for
sweeping changes in the organization
and delivery of services, in the training
of personnel and in the attitudes of
governments, the professions, and
society.

"In any other field a problem of this
magnitude would be heralded as an
acute epidemic or a national disaster,"
said R.H. Shannon, Commission
chairman. "The saddest and rankest
form of discrimination in our country
today is against these handicapped
children."

The Commission found that in most
circumstances present efforts to meet
the needs of these children are both
confusing and ineffective. As a result,
many thousands of children get no help
at all.

The report calls for an emphasis on
prevention and recommends that all
services be planned locally. It says
there must be a collaborative effort
between federal and provincial govern-
ments to look after the children; both
adequate funding and more permissive
legislation are needed.

The report indicated that non-
specialized professionals, such as
nurses, should be of more help to
handicapped children. For example, a
public health nurse should examine the

mental and the physical state of the
child.

The organizations that sponsored
the Commission are: Canadian Asso-
ciation for the Mentally Retarded;
Canadian Council on Children and
Youth; Canadian Education Associa-
tion; Canadian Mental Health Asso-
ciation; Canadian Rehabilitation
Council for the Disabled; and the
Canadian Welfare Council.

Progress Report Issued
On Implementation
Of Health Costs Report

Ottawa — Enough recommendations
of the task forces on the cost of health
services in Canada should be imple-
mented within three years to show an
annual saving of two hundred million
dollars, other costs being equal, accord-
ing to G.B. Rosenfeld, head of the
task forces secretariat.

He made this statement while in-
troducing a progress report of the
steering committee set up in March
1970 by the committee on the costs of
health services. This steering com-
mittee, headed by Mr. Rosenfeld, will
assess 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 tSbhniques for im-
plementation. It has also established a
program of activities that includes:
THE CANADIAN NURSE 13

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

Montreal — 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-
ple 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

It was breakfast at 7 a.m. under the treci ,.,. ..icse 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 1 970, 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 y^rA: — 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 EleanorSmith,
coordinator of the Sate Boards of Nurs-
ing Program of the American Nurses'
Association. "In some instances this

Nursing 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 CNJ.

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.B. - Nursing service
took the spotlight during February-April
in New Brunswick when a series of
workshops on planning patient care was
presented in 1 1 centers throughout the
province. Some 970 nurses from Mono-
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 applicable
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
guiae 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

Oiiawa — The Canadian Nurses"
Foundation has awarded a total of
S6I,237 to 19 Canadian nurses to
pursue graduate studies in the 1970-71
academic year.

They were selected for leadership
potential and scholastic ability. Indi-
vidual awards range from S 1.500 to
S4,500.

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. Saskatchewan; Janet
I. Ixitch. Winnipeg, Manitoba; Rita J.
Lussier, Latleche City, Quebec; Joce-
lyne Nielsen, Halifax, N.S.; Nora 1.
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, Ontario.

One hundred and twenty-nine awards
to 98 students have been made since
1962. Twenty-five students have
received more than one award from
CNF. CNF administers fellowships
provided by: W.B. Saunders Company
Canada Limited Nursing Fellowship;
White Sister Uniform Incorporated
Scholarship Award; Agnes Campbell
Neill Memorial Fellowship (provided
by the Nursing Sisters" Association of
Canada); and Dorothy MacRae Warner
Fellowship (provided by memorial
funds).

The Foundation was incorporated
to receive and administer funds for

AUGUST 1970

fellowships to prepare nurses for
leadership positions. It is dependent
upon gifts, donations, and bequests
from individual donors and organi-
zations.

CNA Wants Nurse On
Task Force Committee

Ottawa — Grave concern that no nurse
has been appointed to the steering
committee set up by the federal gov-
ernment to study implementation of
the Task Force Report, was expressed
by the Canadian Nurses" Association in
a letter to G.B. Rosenfeld, department
of national health and welfare.

The CNA"s executive director. Dr.
Helen K. Mussallem asked, "May we
anticipate that there will be nurses
appointed to the proposed sub-commit-
tees that will work with the steering
committee. I am confident that you are
aware of the significant contribution
that nurses can make in assisting the
committee to achieve its goals.""

She assured the department that CNA
is ready and willing to collaborate with
the department on every possible
occasion. Nursing is an essential
ingredient in medical services, said Dr.
Mussalem, and we want to get into
the act.

Published last November, the three-
volume report has 348 recommenda-
tions proposing changes in Canadian

Have you a Christmas
Story Or Message
To Share?

The

Canadian
Nurse

Invites readers to submit original articles
about Nursing at Christmas for possible
publication in the December 1970 issue.

Manuscripts should be typed dou-
j ble-space on one side of unruled paper,
leaving wide margins. The usual rate will
ibe paid for accepted material.

Suggested length: 1000-2500 words.

Deadline date: September 1, 1970.

Send manuscript to: Editor, The Cana-
dian Nurse, 50 The Driveway, Ottawa 4,
Ontario

health services. These affect the medical
profession, including nursing, said Dr.
Mussallem.

Announced in early July, the steering
committee to study implementation of
the report is made up of Dr. Graham
Simms, executive director. Nova Scotia
Hospital Insurance Commission; E.P.
McGavin, commissioner of finance,
Ontario Hospital Services Commission;
Jean-Paul Marcoux, director-general,
Quebec Hospital Insurance Services;
and federal representatives Dr. D.F.
Marcellus, J.E. Osborne, and Dr. R.W.
Tooley.

Chairman of the committee is G.B.
Rosenfeld, who headed the Task Force
secretariat. Representation from the
prairies has yet to be made.

CNA concern was reiterated in a
news report from the Canadian Medical
Association, which termed the CMA's
reaction as "unhappy." One CMA
member grumbled. "How would you
like it if a committee planning extensive
changes in the newspaper business
was composed entirely of social
workers?'"

None of the steering committee
members are practising physicians.

At Press Time...

Toronto. Out. — The Registered
Nurses" Association of Ontario grey-
listed the Pec! County Health Unit on
July 10.

Anne Gribben. director of RNAO's
employment relations department, told
The Canadian Nurse that negotiations
between the nurses employed by the
Unit and the Peel County board of
health are at a stalemate. "The nurses
offered to go to compulsory arbitration,
but the board of health turned this
offer down,"" she said.

Although the nurses voted in favor
of strike "action if the board refused
their request for arbitration, they have
not yet set a strike date.

According to the current issue of
RNAO News, present salaries for Peel
County public health nurses are:
minimum — $6,2.50 with four annual
increments of S350 to a maximum of
$7,450. The board of health offers a
1970 minimum of $6,687, and for the
second year of the contract, 1971, a
minimum of $7,155 with the same
annual increment of $300 for a maxi-
mum of $9,300.

In Ontario, hospital employees are
not allowed to strike, so disagreements
go to compulsory arbitration. As health
units have no such provision, strike
action is the only solution open to
nurses if the employer refuses to meet
their requests. D

THE CANADIAN NURSE 15

new products {

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

Infant Formula Systei

Infant Formula System

Mead Johnson Laboratories, Toronto,
has adopted a specially engineered
continuous thread cap and new glass
container for its Nursette disposable
infant formula system.

The new cap is a lithographed metal
closure with foamed plastisol lining and
cut rubber gasket. The closure contains
a vacuum detection panel for instant
detection of proper vacuum. When
opened, the cap makes an audible click,
indicating the bottle contents are satis-
factory for use. Discharge packs for new
mothers incorporate a handy carry-
home handle.

Nursette is sold through hospitals
and retail drug stores across Canada.

Drug for Asthmatics

A new drug to prevent asthma attacks
has been introduced by Fisons (Canada)
Limited. "Intal" (disodium cromogly-
cate), available by prescription only,
prevents the release of spasmogens from
the mast cell following antigen chal-
lenge.

Intal is not a bronchodilator, corti-
costeroid, nor antihistamine, but a new
agent with benefits for most asthmatics,
such as reduced frequency of attacks,
and reduced chest tightness, cough, and
16 THE CANAOrAN NURSE

wheeze. The drug comes in powder
form in cartridges. Administered by
the "Spinhaler," a Fison product, it is
delivered deep into the lungs by the
patient's inhalation.

Intal is packaged in dispensing bot-

tles of 30 cartridges, about one week's
supply for a patient at the usual dosage
of 4 cartridges a day. The Spinhaler is
packaged in individual units.

For more information, write to Fi-
sons (Canada) Limited, 26 Prince An-
drew Place, Don Mills, Ontario.

New Safety Chart

A wall-size chart, "Emergency Proce-
dures for Dangerous Materials," is
available for laboratories, classrooms,
and other locations. The chart gives
emergency procedures and hazardous
properties for dangerous chemicals.

All the hazard information is rated
on a scale of 0 to 5 in terms of its health,
flammability, and reactivity hazards, as
well as degree of danger associated with
eye contact, breathing, skin penetration,
skin irritation and swallowing. Precau-
tions that should be taken in storing,
handling, and disposing of these chem-
icals are included. General first aid pro-
cedures are given for handling emer-
gencies. In addition, a pressure sensi-
tive label is provided for local emer-
gency telephone numbers.

The chart is 35 x 45 inches, printed
in four colors on washable Texoprint,
and has metal mountings for hanging.
Large type and color-coded data gives
rapid access to safety information.

At a cost of $14.95, the chart is
available from Safety Supply Company,
214 King St. East, Toronto, Ontario.

Drug for Asthmatics

AUGUST 1970

Steri-Vac Gas Sterilizer

The 3M steri-vac brand gas sterilizer,
distributed by the J.F. Hartz Company,
is a new concept in the application of
gas sterilization. Completely automat-
ed the steri-vac is rapid and economi-
cal and requires no attention during
operation. Use of this sterilizer assures
complete elimination of viruses, fungi,
and bacteria.

The steri-vac is portable, and is
available in three models. Once it is
plugged in, a simple venting operation
makes it ready for use. Heat and mois-
ture sensitive articles, such as delicate
instruments, plastic and rubber goods
and books, can be sterilized without
damage, prolonging their life indef-
initely.

For further information, write to the
J.F. Hartz Company, 34 Metropolitan
Road, Scarborough, Ontario.

Urine Collector

In addition to being neat and easy to use,
this "large target" collection funnel pre-
vents contamination of the specimen con-
tainer. The plastic funnel is preconnected
to the threaded edge of the container and
protects it from contact contamination.
When an adequate amount of specimen
has been collected, the plastic funnel is
easily and aseptically removed and the
screw cap applied. No transfer of speci-
men is necessary.

The compact clean catch kit contains
everything needed for midstream speci-
men collection: collection funnel attach-
ed to a specimen container; three antisep-
tic towelettes; individually packaged
screw cap; and label.

This Macbick product is distributed in
Canada through the Stevens Companies in
Toronto, Calgary, Winnipeg, and Vancou-
ver. In Montreal, Compagnie Medicale &

Steri- Vac Gas Sterilizer

Scientifique Ltee, and Quebec Surgical
Company are the distributors.

Literature Available

A 12-page booklet, called Defense
Against Decubitus: The Conquest of
the Hidden Epidemic, is available free
of charge from Alcanox, Inc. The book-
let details the causes, symptoms, and
prevention of decubitus ulcers.

Elements of the preventive program
offered in this booklet include the use
of topical applications and pressure-
relieving materials. The relative merits
of aerosol spray versus synthetic fibers
as pressure-relieving materials are
covered.

A special appendix and a suggested
pocket-size directive manual for nurses

Urine Collector

AUGUST 1970

and aides, which outlines a seven-point
action program and features diagrams
showing the body's 10 pressure points
most prone to decubitus ulcers, are
included in the booklet.

For a copy of this booklet write to
Alcanox Inc., 215 Park Avenue South,
New York, N.Y. 10003. Up to six free
copies are available to any institution.

Gomco Surgical Manufacturing Corpo-
ration, Buffalo, New York, has issued
its 1970 catalogue of hospital, surgical,
and medical equipment. The 28-page
brochure illustrates and describes over
50 suction and pressure units and ac-
cesories offered by Gomco.

A selection guide and a repair and
replacement parts list are included in
this catalogue. A free copy of the cata-
logue, Gomco Hospital Equipment in
the '70's, is available from the Gomco
Surgical Manufacturing Corporation,
828 E. Ferry Street, Buffalo, N.Y.
14211.

The Pharmaceutical Manufacturers'
Association of Canada has published a
booklet. The Medicines Your Doctor
Prescribes, which gives the consumer
25 guidelines and safeguards for pur-
chasing and using prescription drugs.

According to an association spokes-
man, "The booklet is designed to com-
bat drug abuse from another angle: that
of ensuring that Rx drugs are respected
for their legitimate purposes, and that
they are properly used, not misused."

Although the booklet does not di-
rectly speak of drug abuse, it provides
information to guard against uninten-
tional abuse of medicines. Basic infor-
mation about the <fciig industry — its
accomplishments, research, quality
control and competition — is given.

THE CANADIAN NURSE 17

Whenyourday

starts at _
6 a.m. ..you re ofi
charge duty... ^
you've skimped
onmeals...^
and on sleep...
you haven't ha d^
time to hem
a dress...
makeana^pplepie...
washyourhair.
even powder is
your nose,
in comforts

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 OOXIDAN.

use

DOXIDAN*

most nurses do

OOXIDAN is an effective laxative for the gentle relief of
constipation without cramping. Because DOXIDAN con-
tains a dependable fecal softener and a mild peristaltic
siimOlant. evacuation is easy and comfortable.

For detailed information consult Vademecum
or Compendium.

M

HOECHST

PHARMACEUTICALS

3400 JE*N TALON W . MONTREAL 301
blVISION OF CANADIAN HOECHST LIMITED

new products

Small quantities of this easy-to-read
and attractive booklet are available free
of charge, or at a cost of $6 per hundred,
from PMAC, 141 Laurier Avenue
West, Ottawa 4, Ontario.

An educational portfolio on feminine
hygiene is available from Johnson «fe
Johnson Limited.

The material includes an instruction
guide for menstrual hygiene, a booklet
entitled It's Wonderful Being a Girl,
and a large illustrated chart showing
what happens during menstruation.

Copies of this portfolio can be obtain-
ed from Johnson & Johnson Limited,
2155 Boulevard Pie IX, Montreal 403.

Tpmac 1

18 THE CANADIAN NURSE

Adjustable Arthritic Crutches

Manufactured from aluminum alloy
and plated steel tubing, these arthritic
crutches are robust and dependable.
The troughs are shaped to allow the
weight of the body to be supported com-
pletely on the forearm, with the vertical
adjustment of the upright tube allowing
the crutch to be fitted to the patient.
Veico fastening is used to secure the
trough portion to the forearm, allowing
instant closure and release.

A comfortable ergonomic hand grip,
fitted to the adjustable horizontal tube,
affords a safe grip to patients severely
afflicted with arthritisin their hands.
Each crutch is supplied with an Everest
& Jennings Premier vacuum base, non-
slip crutch tip. A pair of crutches weighs
3 1/2 lbs.

For complete information, write to
Everest & Jennings Canadian Limited,
P.O. Box 9200, Downsview, Ontario.

Postoperative Knee Brace

A postoperative knee brace designed to
provide firm support following surgery
is now available from DePuy, Inc. Fea-
turing Velco fasteners and staves in the
back and both sides, this knee brace may
also be used to protect the knee follow-
ing sprains and ligament injuries.

The brace is made of washable felt
and comes in four sizes. It is priced at
$9.95.

For additional information write to
Guy Bernier, 862 Charles-Guimond,
Boucherville, Quebec, or to John Ken-
nedy. 2750 Slough Street, Maiton, Ont.

Oxygen Controller

This new instrument from Sinclair Scien-
tific makes possible automatic control of
oxygen concentration in any enclosure.
The controller is ideally suited for use
with incubators, oxygen tents, and infant
head enclosures.

The time-consuming and sometimes
dangerously inaccurate practice of manu-
al adjustment of flow rate and irregular
sampling of concentration is unnecessary.
Once the desired concentration is set, it is
automatically maintained - the Sinclair
Aerox controller does the rest. This saves
nursing time, as there is no need for
continual measurement and adjustment
of the oxygen supply.

This instrument is distributed in Cana-
da by Keith Ivey and Associates Ltd., 129
Carlingview Drive, Rexdale, Ontario.

AUGUST 1970

Next Month

in

The

Canadian
Nurse

• Maritimers Have a TV Nurse

• Ottawa's Distress Center

• Coffee Break With
a Difference

• Drug Abuse

^

^^P

Photo Credits for
August 1970

Harvey Studios, Fredericton,

N.B., pp. 5,7,11-14, 24-35

Tom Boschler Photography,
Hamilton, Ont . p. 21

Blood Warmer

A new and efficient method for warm-
ing blood prior to transfusion has been
developed by Fenwal Laboratories, a
division of Baxter Laboratories. De-
signed for use in hospital operating and
emergency rooms, Fenwal's unit warms
stored blood that has been refrigerated
at four to six degrees centigrade to the
normal body temperature of 37 degrees
centigrade during administration.

Fenwal's unit consists of two metal
plates — heated between 32 and 37
degrees centigrade — which surround
a maze of disposable tubing. The blood
passes from the storage bag through the
tubing and then enters the patient's
bloodstream.

A metal casing encloses the unit,
enabling it to be used safely near oxygen
equipment. To prevent the blood from
overheating, the unit automatically
shuts down at 37 degrees centigrade;
an alarm sounds should the temperature
increase to 39 degrees centigrade. In
addition, the danger of cross-contami-
nation is reduced because the dispos-
able tubing can be discarded and easily
replaced by fresh tubing tor each trans-
fusion. The unit automatically and in-
stantly adjusts to the flow of blood, so
it can be heated uniformly and trans-
fused at a constant temperature.

For more information about this
blood warmer, write to Baxter Labora-
tories of Canada, 6405 Northam Drive,
Malton, Ontario. U

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AUGUST 1970

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Pieeee anew suffiJtnt time for dell<rery.

THE CANADIAN NURSE

19

August 24-28, 1970

Workshop for library staff in nursing, hos-
pital, and medical libraries, sponsored by
the OMA, OHA, and RNAO, Wilson Hall,
New College, University of Toronto. Topics
to be discussed include administration of
a library, collection development, organi-
zation of library materials, and library serv-
ices. Applications are available from: Miss
S.C. Maxwell, Librarian, Ontario Medical
Association, 244 St. George Street, Toronto
5, Ontario.

September 1970

14th annual Registered Nurses' Association
of Ontario conference on personal growth
and group achievement. For further informa-
tion write to: Professional Development
Department, RNAO, 33 Price Street, Toron-
to 5, Ontario.

September 14-17, 1970

American Association of Nurse Anesthetists,
Shamrock Hilton Hotel, Houston, Texas.
For more information, write to the AANA,
3010 Prudential Plaza, 130 E. Randolph St.,
Chicago, Illinois 60601, U.S.A.

September 24-27, 1970

Meeting of the American Medical Writers'
Association, Waldorf-Astoria Hotel, New
York. For more information, write to the as-
sociation's executive secretary, Mr. W. Way-
ne Curtis, 420 Lexington Ave., New ITork,
N.Y., 10017.

September 26, 1970

The Nightingale School of Nursing in Toron-
to is marking its 10th anniversary with an
open house and reception for alumni and
invited guests. For further information,
write to The Nightingale School of Nursing,
2 Murray Street, Toronto 2B, Ontario.

September 28-October 9, 1970

Two-week symposium on the nurse's role
In prevention and treatment of acute and
chronic respiratory insufficiency, Manitoba
Rehabilitation Hospital, Winnipeg. Further
details are available from Miss ELM Thor-
pe, Consultant, Sanatorium Board of Ma-
nitoba, 800 Sherbrook Street, Winnipeg 2,
Manitoba.

October 1-2, 1970

Annual Convention, Catholic Hospital Con-
ference of Alberta. -Chateau Lacombe, Ed-
20 THE CANADIAN NURSE

monton, Alberta. For more information write
to: Reverend Sister John Marie, President,
Catholic Hospital Conference of Alberta,
Seton Hospital, Jaspar, Alberta.

October 5-6, 1970

Institute on operating room and central sup-
ply room procedures, auditorium, Calgary
General Hospital School of Nursing, Spon-
sored by the Alberta Association of Regis-
tered Nurses. For further details write to the
AARN, 10256—112 Street, Edmonton, Al-
berta.

October 5-30, 1970

Advanced program in health services orga-
nization and administration. The University
of Toronto School of Hygiene. The second
part of this program will be held March 1-26,
1971. Fee: $200 for each part. For further
Information, write to: Dr. R.D. Barron, Sec-
retary, School of Hygiene, University of
Toronto, Toronto 5, Ontario.

Institute of the Family, 170 Metcalfe Street,
Ottawa 4. Ontario.

October 7-10, 1970

Annual conference, Canadian Association
for the Mentally Retarded, Hotel Vancouver,
Vancouver, British Columbia. Special em-
phasis will be on the preschool child, resi-
dential services, and occupational- voca-
tional programs.

October 8-10, 1970

Workshop in Test Construction for Teachers
in Schools of Nursing to be held by the New
Brunswick Association of Registered Nurses
at Memramcook Institute, St. Joseph, N.B.
Conducted by Vivan Wood, Associate Pro-
fessor, Faculty of Nursing, The University
of Western Ontario, London, Ont.

October 17, 1970

14th Annual Symposium on Rehabilitation,
sponsored by the Rehabilitation Foundation
for the Disabled and the Ontario Society for
Crippled Children, Inn-on-the-Park, Don
Mills, Ontario. Write to Mrs. Betty McMur-
ray. Executive Director, Rehabilitation
Foundation for the Disabled, 12 Overlea
Boulevard, Toronto 354, Ontario.

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 information write to The Vanier

October 26-27, 1970

Nursing sessions at the Ontario Hospital
Association annual convention. Royal York
Hotel, Toronto. Write to the OHA, 24 Ferrand
Drive, Don Mills, Ontario.

October 26-28, 1970

Annual meeting of the Association of Regis-
tered Nurses of Newfoundland, St. John's.
Write to the AARN, 67 Le Marchant Rd.,
St. John's, Nfld.

October 26-28, 1970

Ontario Hospital Association annual con-
vention. Royal York Hotel, Toronto. Write to
the OHA, 25 Ferrand Dr., Don Mills, Ontario.

October 26-30, 1970

American Public Health Association, Civic
Auditorium, Houston, Texas. Write to the
APHA, 1740 Broadway, New York, NY.
10019, U.S.A.

November 9-13, 1970

Course in occupational health for profes-
sional registered nurses in industry, offered
by the department of environmental medici-
ne of New York University School of Medi-
cine, in cooperation with the American As-
sociation of Industrial Nurses. Limited to
nurses with five years or less experience
in occupational health. Tuition: $175. Spe-
cial emphasis will be given to interviewing
and counseling. For information and appli-
cations, write to the Office of the Recorder,
New York University Post-Graduate Medical
School, 550 First Avenue, New York. N.Y.
10016, U.S.A.

November 23-25, 1970

Conference for senior nurse administrators,
Westbury Hotel, Toronto. Sponsored by the
Ontario Hospital Association, 24 Ferrand
Drive, Don Mills, Ontario.

November 30-December 4, 1970

Conference for nurses in staff education
and staff development, Westbury Hotel, To-
ronto. Sponsored by the Registered Nurses'
Association of Ontario. Write to: Professio-
nal Development Department, RNAO. 33
Price Street, Toronto 5, Ontario. □

AUGUST 1970

names

The tragic air crash
near Toronto on Ju-
ly 5 took the life of
a well-known Cana-
dian nurse. Claire
Gagnon - Mailhiot,
director of Laval
University's School
of Nursing, was
killed with her hus-
band en route to Los Angeles. They had
been married one day.

A graduate of the Hotel-Dieu de
Sherbrooke School of Nursing, the
University of Montreal, and Teachers
College Columbia University in New
York, Mme Gagnon-Mailhiot was for
many years a head nurse and, later,
director of nursing at the Hotel-Dieu
de Sherbrooke. In 1965 she was ap-
pointed director of nursing service with
the Quebec Ministry of Health.

As director of Laval's School of
Nursing, Mme Gagnon-Mailhiot played
a leading role in its organization.
Through her work on various commit-
tees within the University, especially
the health sciences committee, she
succeeded in introducing an original
concept of the professional nurse's
future role — a concept that is now
being accepted in other schools of
nursing in the province.

Mme Gagnon-Mailhiot was active
in many professional associations. She
was a past president of the provincial
and national associations of the Catholic
Nurses' Association, and in 1958
represented the Catholic Nurses' Asso-
ciation of Canada at the first World
Catholic Health Conference in Brussels.
She also was co-convenor, nursing
service committee. Association of
Nurses of the Province of Quebec, and
a member of the Canadian Nurses"
Association's committee on nursing
service.

Nationally and internationally,
Claire Gagnon-Mailhiot will be missed.
She was a brilliant nurse educator, a
respected colleague, and an outstanding
person.

Effie Taylor , a Canadian-bom nurse
well-known internationally for her out-
standing contributions to nursing, died
in her native city of Hamilton, May 20.

As president of the International
Council of Nurses from 1937 to 1947,
Miss Taylor guided the council through
the critical war years. "That the ICN
had survived six years of war; that its
AUGUST 1970

Alma Reid Honored At Tea

A tea was held recently at McMaster University, Hamilton, for Alma Reid,
who retired after 2 1 years as director of the School of Nursing at McMaster.
Directors of nursing from hospitals and schools across Ontario attended the tea
for Miss Reid. Sister Mary Felicitas, past president of the Canadian Nurses'
Association, left, talks with Miss Reid, center, and Margaret Wiseman (back
to camera), a former teacher and teaching colleague of Miss Reid.

history was unbroken during this period,
and that it had retained its international
character and carried on with many of
its peacetime activities, is due in a large
part to the indomitable courage and de-
termination of Effie Taylor . . . ." This
tribute comes from A History of the
International Council of Nurses 1899-
1964 by Daisy C. Bridges.

After graduating from Johns Hop-
kins Hospital School of Nursing in Bal-
timore, Miss Taylor studied at Colum-
bia and Yale Universities. She worked
on the staff of the Phipps Psychiatric
Institute at Johns Hopkins. From 1926
to 1944, she was a professor of nursing
and dean of the Yale University School
of Nursing.

From 1923 to 1937, Miss Taylor
served as executive secretary and pres-
ident of the National League of Nursing
Education in the United States.

A memorial service will be held for
Miss Taylor at 2:30 P.M.. September
26 in Dwight Memorial Chapel, New
Haven, Connecticut. Anyone wishing
to attend is welcome.

An Effie Jane Taylor Memorial
Fund has been established at the Yale
School of Nursing, 38 South Street,
New Haven. In recognition of Miss
Taylor's contribution to ICN, the me-
morial will be used mainly to assist
international students studying at the
school. In lieu of flowers, donations
may be made to this fund.

Valerie Fournier,

public relations offi-
cer for the Canadian
Nurses' Association
since November
1967, left the staff at
the end of July. Mrs.
Fournier plans to
continue her career
in Europe, probably
Paris, where she and her husband
Pierre are moving in the fall.

With degrees in journalism and
honors history fromCarleton University
in Ottawa, Mrs. Fournier contributed
much to the CNA^She initiated and
chaired two public relation conferences,
THE CANADIAN NURSE 21

names

the first ever held by CNA, for her
provincial counterparts to prepare for
the Sasicatoon and Fredericton genera!
meetings and the ICN Congress in
Montreal. Mrs. Fournier kept members
informed of the Association's policies
and objectives through monthly news-
letters, and established regular com-
munication with representatives of the
press, radio, and television.

She also wrote news items for The
Canadian Nurse and is author of
several articles published in the journal.
Her most recent one is in the July
issue, "She's a Regular at the Race-
track."

Johanna Plummer

(S.R.N. , The West
Herts H., Hemel
Hemstead Herts,
United Kingdom;
C.M.B., The British
Hospital for Moth-
ers and Babies, Lon-
don; diploma, nurs-
ing administration,
U. of WesternOntario, London ;B.Sc.N.,
Lakehead U., Thunder Bay, Ont.) has
been appointed director of nursing serv-
ice at Owen Sound General and Marine
Hospital, Owen Sound, Ontario.

BeforecomingtoCanada,MissPlum-
mer was a head nurse at Miller General
Hospital in London, England. She has
held a variety of positions in hospitals
in Ontario: staff nurse at Dryden Gen-
eral Hospital, the General Hospitals in
Port Hope and Bowmanville, and Lit-
tlelong Lac Hospital in Geraldton; as-
sistant director at Littlelong Lac Hos-
pital ; director of nursing at Sioux Look -
out General Hospital; administrative
assistant, director of projects, and direc-
tor of nursing service at St. Joseph's
General Hospital in Thunder Bay.

Active in the Registered Nurses' As-
sociation of Ontario, Miss Plummer is
chairman of the chapter and regional
administrator committee.

Rita L. Rovere

(R.N., Misericordia
H., Edmonton) has
left Canada to serve
a two-year tour of
duty in Indonesia
with MEDICO, a ser-
vice of CARE. Miss
Rovere has been op-
erating room nurse

at Misericordia Hospital in Edmonton

since 1964.

22 THE CANADIAN NURSE

Miss Rovere will spend her first three
months in the Indonesian capital of
Djakarta, training local nurses in oper-
ating room procedures as part of the
MEDICOorthopedic program conduct-
ed there. She will then join a MEDICO
team of Canadians, stationed in Sura-
karta in the province of Central Java,
as operating room nurse with the team,
which includes a physician and a reg-
istered laboratory technologist. In ad-
dition to treating patients, the team,
which started work in January, is train-
ing medical personnel to staff the six
major regions of the province.

loan M. Dawes,

R.N., U. of Alberta
Hospital, Edmon-
ton, Alberta; Dipl.
in Teaching and Su-
pervision. School
of Nursing, U. of
Alberta.) former
director of nursing
at Prince George
Regional Hospital. Prince George,
B.C., has been appointed director of
nursing service for the B.C. Cancer
Institute in Vancouver. Miss Dawes
succeeds Miss Florence A. McDonald,
who has retired.

Miss Dawes graduated from the Uni-
versity of Alberta School of Nursing,
Edmonton, Alberta, in 1959, and

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received a diploma in teaching and
supervision there in 1962. She was
employed as a general duty nurse,
clinical instructor in pediatrics and as
nursing office supervisor at University
Hospital in Edmonton prior to be-
coming director of nursing at Prince
George Regional Hospital, in April,
1965.

Miss Dawes is a member of the
RNABC Committee on Nursing
Service and chairman of a task com-
mittee to review medical-nursing
procedures.

lacqueline Robertson (R.N., St. Boni-
face School of Nursing. Winnipeg;
B.S.C.N., Lakehead U., Port Arthur,
Ont.) has been named assistant director
of nursing service at St. Boniface
General Hospital in Winnipeg.

Miss Robertson has served as coor-
dinator of inservice education at Grace
Hospital in Winnipeg. She has held var-
ied positions at St. Boniface General:
general duty nurse and head nurse of a
surgical unit, coordinator of inservice
education, and director of nursing serv-
ice.

Sheila Ryan (R.N.,
Alfred H., Mel-
bourne, Australia;
B.Sc.N., U. of Alber-
ta) has been appoint-
ed associate director
of nursing at Univer-
sity of Alberta Hos-
pital in Edmonton.
Since 1958, Miss
Ryan has been a member of the nursing
staff of the University of Alberta Hospi-
tal, as a staff nurse, charge nurse, clinical
instructor, and clinical coordinator.

Miss Ryan was awarded a Canadian
Nurses' Foundation scholarship in 1969.
She is completing the master's program in
health services administration at the Uni-
versity of Alberta.

Elaine M. Sparks

(R.N., The Vancou-
ver General H.;
B.Sc.N., U. of Alber-
ta) has become di-
rector of nursing at
Prince George Re-

Vgional Hospital in
Prince George, Brit-
ish Columbia. Miss
Sparks has been assistant director of
nursing at the hospital since 1967.

As a general duty nurse, Miss Sparks
worked at Chilliwack General Hospital
and Penticton General Hospital in British
Columbia, and Rosetown Union Hospital,
Saskatchewan. She also became an oper-
ating room nurse and director of nursing
at Rosetown Union Hospital. D

AUGUST 1970

in a capsule

Murdering the menu

If you have ever experienced a sinking
feeling in an expensive restaurant when
you are unable to recognize anything on
the menu, you will understand the con-
fusion of hospitalized children when
they try to interpret their menu.

Hospital staff have not considered
the limitations of a child's vocabulary.
Thus, what should be one of the most
enjoyable times of the day becomes a
huge guessing game, often with disap-
pointing results for the young pediatric
patient. Faced with foreign-sounding
names, the child hesitates to order
something he does not recognize or un-
derstand. He may not be familiar with
the term frankfurter for hot dog or hot
vichysoisse for potato soup.

The Journal of the American Hospi-
tal Association had an article on pedia-
tric menu terminology in its May issue.
The author, Beatrice Bachrach, gave
some amusing examples of the child's
interpretations of menu items. For ex-
ample, "a heavenly fruit mold salad"
is moldy and no good; "consomme ju-
lienne" is a movie star; "hot vichy-
soisse" becomes a volcano; "molded
citrus salad" is cactus; and "creamed
eggs on dutch rusk" is egg pie.

We sympathize with the childrens"
difficulties and agree with Miss Bach-
rach's proposal to simplify menu ter-
minology and perhapsdraw illustrations
as well.

Nurses meet the Prince

Two members of the Victorian Order
of Nurses met a prince last July.
Prince Charles was guest at Govern-
ment House during his first visit to
Ottawa, July 2-4. Dawn Wigmore and
Patricia McBride were among a group
of young Canadians invited to a special
dance held in honor of Prince Charles
at Government House July 3. Miss
Wigmore is nurse-in-charge of the Red
Deer Alberta Branch of the VON, and
Miss McBride is nurse-in-charge of the
Medicine Hat and Redcliff branch in
Alberta.

What did they talk about when
introduced to the Prince? Full details
of the conversation aren't known, but
Prince Charles did express interest in
the VON and spoke of Lady Aberdeen,
the founder of the Order in 1 897.

Tomorrow's cop today

Where do police mix with demonstra-
tors like fish in water, pat 'em on the
back when they get too heated, and grab

AUGUST 1970

rocks and other missiles before they
start to fly? In Munich, Germany, the
police are working out a new approach
to crowd control, stressing psychology
over force.

Recently a police officer was seen
walking arm-in-arm with ranks of
long-haired demonstrators through the
city streets, much to the surprise of on-
lookers. The officer was guiding the
protestors from an important traffic ar-
tery to a more quiet section of town
where they could not do much harm.
According to a news item in German
Features in May, this new police tech-
nique has shown surprisingly good re-
sults. Street marches and demonstra-

tions usually disperse peacefully and
quickly, since there is nothing to resist.

The Munich police chief has employ-
ed a psychologist, has set up advanced
training courses for officers, and has
built new police dormitories that have
broken the old. military -style tradition.
The new police official will not just take
orders and carry them out; he will have
to think for himself and adjust to sud-
den changes in a situation. In addition
to learning technical language, tomor-
row's cop will need a thorough ground-
ing in psychology and sociology.

Will this positive approach spread
as quickly as violence does? Only time
and the mass media will tell! D

'I understand this operation is going to
be televised in living color." »

THE CANADIAN NMJRSE 23

If dissension, followed by agreement,
characterized the Canadian Nurses'
Association's general meeting in
Saskatoon two years ago, frustration,
followed by determination to make
the association a vital force in society,
best describes the Fredericton meeting
June 14 to 19.

The mood of the assembly of 1,283
seemed to change from day to day,
depending on the issue being discussed.
Even so, it was not difficult to grasp
some strong underlying feelings: an
impatience with the association's
continual concern about its own
structure, and a belief that CNA should
move from introspection to social
action; a demand that more specific
stands be taken by the national asso-
ciation on issues affecting health and
the practice of nursing; a desire for
each member to have a say in the poli-
cies and positions taken by CNA; and
a belief that the unique needs of each
member association must be con-
sidered if national unity of the profes-
sion is to be maintained.

There was unparalleled vitality at
this 35th general meeting. Members
showed they were no longer content
to sit on the sidelines and let others
make decisions for them. They packed
the business sessions — something
unusual for CNA conventions — and
made it clear they were interested in
what the elected officers and staff of
the association had said, spent, and
planned on their behalf

As further evidence of this increased
interest, 50 members gave up part of
24 THE CANADIAN NURSE

their "free day" Wednesday and met
to exchange views on issues such as
the physician's associate and the
practice of nursing. One motion the
group drafted — later approved by
membership — directed CNA to
provide facilities and program time at
future general meetings so that
members could meet informally to dis-
cuss current issues affecting the pro-
fession.

The resolutions approved by the
173 voting delegates on the final day
of the convention reflect this vitality.
They cover a wide range of issues,
from statements on the population
growth and pollution of the environ-
ment, to a resolution directing the
CNA board to consider as a priority,
ways and means of encouraging pub-
lication of textbooks in the French
language.

In retrospect, it was a week of
ebullience, with moments of drama,
tension, and occasional outbursts of
anger. It was also a week of achieve-
ment. From the frustration, evident at
the beginning of the week, came a
sense of purpose, solidarity — if not
unanimity — and determination. Mem-
bers demonstrated their belief that the
national association can and should be
a dynamic force in society.

Tone of meeting set early

The tone of the meeting was set by
Verna Huffman, principal nursing
officer, department of national health
and welfare, who gave the keynote
address at the official opening on

Sunday evening. Miss Huffman urged
members to focus their attention out-
ward, rather than inward, and to act
on important national issues.

Citing poverty as one example of
issues that should concern nurses. Miss
Huffman said, "Sheer weight of num-
bers, 82,000 nurse members, represents
a strong pressure group. In addition to
that, it represents a weight of expe-
rience with poverty." She then asked,
"As a responsible group having power
in numbers and weight of knowledge,
what social action has this organization
taken to combat poverty?

"An organization must have policy
statements on important national issues
and be prepared to take concrete action
on such issues," Miss Huffman con-
tinued. "What is the stand of this pre-
dominantly female association on the
national issue of abortion?" she asked.
"What is our stand on drug abuse?"

Miss Huffman said that commitment
and dedication are old-fashioned words
coming back into use. "To these we
must add new concepts — outreach,
involvement, social action. The degree
to which the nursing profession
embraces these concepts, lifting its
sights beyond the limits of its own
profession and its own place in society,
will determine the extent to which it
plays a meaningful and extended role
in the '70s," she concluded.

The same call for action and invol-
vement came from CNA president
Sister Mary Felicitas in her address
to the assembly Monday morning.
Sister Felicitas told members their

AUGUST 1970

decisions about CNA's objectives, role,
and fee structure would determine
the future of the national association.
"What role do you want it to assume?"
she asked. "Shall it be leadership,
forethought, prevision? Do you wish
it to be one of vigilence, guiding and
pointing the way to the twenty-first
century?"

The president urged members to be
objective, to discuss with open minds,
and to weigh the evidence in reaching
their conclusions. "There is no place
for preconceived ideas in a matter of
this importance," she said.

Reports discussed

In her report to membership. Dr.
Helen K. Mussallem, CNA executive
director, said membership increased by

almost 1 1 percent in the past biennium,
from 74,744 in 1967, to 82,826 in
1969. She said CNA, as the voice of
Canadian nursing, has grown in stature
and recognition and commands increas-
ing respect in the counsels of the allied
health professions.

Outlining highlights of the associa-
tion's activities during the biennium.
Dr. Mussallem listed the various briefs
submitted to government, CNA's
relations with other agencies, meetings
attended on behalf of membership, and
staff activities. She said CNA has
continued to press for representation
on the Canadian Council of Hospital
Accreditation, but was again turned
down in 1969.

An Ontario delegate asked what
nurses could do to convince CCHA that

CNA should be represented on its
council. A member of the board sug-
gested the matter be drafted as a reso-
lution and presented for delegate rati-
fication. On Friday, the final day of
the general meeting, a resolution was
passed, directing CNA to "press more
firmly for representation on the
CCHA," and to seek support from
other professional groups in obtaining
this recognition.

The value of having CCHA's nurse
surveyor on the hospital accreditation
team was mentioned by several dele-
gates. One said directors of nursing
service should demand that the nurse
surveyor be part of the team assigned
to accredit hospitals.

The reports of the standing com-
mittees on nursing service, education,
and social and economic welfare —
presented on the second day of the
convention — brought considerable
comment. On the whole, the committee
statements were well received, although
some delegates said they were too
general to be of use and should be
more specific.

A Quebec delegate questioned the
nursing service committee's recom-
mendation concerning the medical
assistant. She said the committee's
recommendation, to let the Canadian
Medical Associafion know "... we
would welcome the opportunity to have
dialogue" on this subject, was far too
weak. " We should do much more than
ask for dialogue," she said. " We must
approach them. We have as much to
say as the doctors about the gap that
exists in health care."

Replying to this comment, Margaret
D. McLean, chairman of the committee
on nursing service, said the recom-

( Report continued on page 28)

And the band played on — literally. These enthusiastic musicians were al Fredericlon. New Brunswick, airport to greet
jconventionists to the CNA 35th biennial. They played, but no plane arrived. Undismayed they blew harder, to the delight
of waiting travelers. Directed by Alex McCulloch, The Episilon Y's Mens Youths Band plays at many local OTfalrs.
AUGUST 1970 THE CANADIAN NURSE 25

Resolutions Passed at CNA 35th General Meeting

Whereas the needs of CNA member associations vary
in accordance with the size of the province or territory
and the number and geographic distribution of mem-
bers; and

Whereas mechanisms have been developed and imple-
mented to protect the voting rights of small member
associations; and

Whereas both large and small member associations
may have major problems associated with meeting the
needs of their members; and

Whereas social, economic, or political conditions in
any province or territory may alter needs of member
associations and result in conditions which are threat-
ening to the national unity of the profession; and
Whereas the viability of the CNA is dependent upon
the sensitivity of all member associations to each
other's unique needs and to changing social conditions
across the country; therefore be it
Resolved that the association membership fee shall
be $10 per member for associations whose mem-
bership is 20,000 or less, and $6.00 per member for
associations whose membership exceeds 20,000.

Whereas the recommended fee formula will result in
only slightly increased revenue for the CNA for the
coming biennium; and

Whereas the current trend across the nation is towards
tight budgeting; therefore be it
Renolved that the Board of Directors be authorized
and encouraged to examine alternative ways of meet-
ing membership needs such as will contain costs and
at the same time increase opportunities for member
association interaction.

Whereas members have indicated a desire for greater
understanding of the financing of the Association;
therefore be it

Resolved that the Board of Directors be requested to
examine the method of budget preparation of the
CNA with a view to making presentation of the budget
more meaningful to members.

Whereas the CNA is committed to the concept of
optimum health care for the people of Canada; and
Whereas the Task Force Report on the Costs of Health
Services in Canada emphasized coordinated planning
for delivery of health care; and
Whereas nursing departments in hospitals contribute
substantially to the delivery of health care; and
Whereas nurses comprise the largest single profes-
sional group, and nursing accounts for fifty percent
of the hospital budget; and

Whereas the department of nursing provides a twenty-
four-hour, seven-day-a-week service, thus placing
nurses in a unique position to assess the effect of
hospital organization on the patient and his family ; and
Whereas the CNA believes that knowledge of the
effect of hospital organization is essential for identifi-
cation of quality of patient care; and
Whereas the department of nursing is included in the
assessment of hospitals for accreditation; therefore
be it

Resolved
( 1 ) that the CNA press more firmly for representa-

tion on the Canadian Council on Hospital Accredit-
ation.

(2) That the CNA seek the support of other profes-
sional groups in this request.

Whereas the CNA recognizes the need to plan system-
atically to meet the health needs of the total Canadian
population; and

Whereas the CNA recognizes that significant gaps
exist in the delivery of health services to the Canadian
population; and

Whereas the recommendations of the Task Force
Reports on the Costs of Health Services in Canada
suggest the development of programs to expand the
nurse's role; and

Whereas the CNA recognizes the importance of work-
ing collaboratively to utilize the skills of medical and
nursing personnel; and

Whereas the CNA believes it is unwise for the health
professions to proceed unilaterally in the development
of new roles or the expansion of existing roles, i.e.,
clinical nurse specialist, physician's associate, medical
assistant, nurse practitioner; therefore be it
Resolved

( 1 ) that the CNA request the department of national
health and welfare to call a national conference prior
to the spring of 1971 to study health matters which
affect the total Canadian population;

(2) that this conference provide a forum for discus-
sion among the major purveyors (nursing and med-
icine) and the consumers of health services;

(3) that the discussion focus on more effective utili-
zation of medical and nursing manpower to fill the
unmet health needs of Canadians;

(4) that special emphasis be on the development of
complementary roles for nurses and physicians.

Whereas the CNA is a professional organization for
nursing; and

Whereas the CNA has responsibility to the public for
promoting the most effective utilization of nursing
manpower for nursing; therefore be it
Resolved that the CNA prepare a position paper on
the introduction of the new categories of workers into
the health field, namely those referred to as the phy-
sician's assistant and medical practitioner's associate.

Whereas textbooks in the French language for the
French-speaking students of Canada are practically
non-existent; and

Whereas the urgent need to publish textbooks in
French has been recognized during the Congress;
therefore be it

Resolved that the CNA Board of Directors consider
as a priority, ways and means of encouraging the pro-
duction of textbooks in the French language.

Whereas the Federal Government's White Paper on
taxation contains recommendations such as those
pertaining to deductions for child care and house-
keeping expenses; and

Whereas nursing is primarily a female occupation with
an increasingly larger proportion of married practi-
tioners with children; therefore be it

26 THE CANADIAN NURSE

AUGUST 1970

Members freely "spoke their piece" at the C NA 35ih general meeting before voting on business matters. Thomas Mekenna.
voting delegate from RNABC. and Helen Taylor, president. ANPQ. present their point-of-view prior to counting votes.

Resolved that the CNA make a presentation to the
Federal Minister of Finance on the White Paper on
taxation.

Whereas every member attending CNA conventions
is vitally concerned with issues being debated; there-
fore be it

Resolved that sufficient registration fee be charged
so that each registrant may receive the same folio of
information as provided for voting delegates.

Whereas every member of CNA has the right to assess
the information on the expenditure of funds; therefore
be it

Resolved that the audited financial report be printed
in The Canadian Nurse and L'infirmiere canadienne.

Whereas each voting delegate has both the right and
responsibility to cast a ballot for each elected position
on behalf on the provincial members he represents;
and

Whereas the members of this Association have desig-
nated a considerable amount of responsibility to each
elected officer; and

Whereas two separate vice-presidential positions must
be filled; and

Whereas under the present system each voting delegate
casts only one ballot for these two positions; therefore
be it

Resolved that voting delegates be granted the privilege
of voting for two nominees on the vice-presidential
ballot.

Whereas many issues presented in The Task Force
Reports on the Costs of Health Services in Canada
affect nurses in the areas of service, education, and
economic welfare; and

Whereas the Association should be prepared at all
times to act upon such issues; and
Whereas we believe it is the responsibility of Canadian
nurses to become increasingly involved at the decision-
making level of policies and legislation that affect the
social and economic welfare of nurses as members of
their professional organization and members of their
community; and

Whereas the Committee on Social and Economic Wel-
fare has recognized the need for a lobbyist; therefore
be it

Resolved that the Board of Directors give serious con-
sideration to the appointment of a well -qualified nurse
to assume the role of lobbyist for the CNA.

Whereas attendance at CNA general meetings affords
a valuable learning experience for nursing students;
and

Whereas basic nursing students now have the privi-
lege of attending these meetings at a reduced registra-
tion fee; and

Whereas there are other categories of full-time stu-
dents enrolled in nursing programs who do not now
have this privilege and who may also have limited
financial resources, therefore be it
Resolved that all nursing students enrolled full-time
in diploma or university programs be f>ermitted to
attend CNA general meetings at the reduced student
registration fee. The RNs so enrolled must provide
evidence of some form of current membership in their
provincial association.

Whereas there is a need for opportunities for members
of the Canadian Nurses' Association to discuss current
issues facing the profession; and
Whereas the full range of current issues affecting nurs-
ing may not be apparent to those who plan the pro-
gram; therefore be it
Resolved

( 1 ) that at future general meetings of the Canadian
Nurses" Association, program time and facilities be
provided so that nurses interested in discussing these
issues can meet to explore them in open forums.

(2) that these forums be unstructured with no pre-
announced topic unless it is one that grows out of the
preceding sessions.

(3) that they be held midway through the general
meeting, but prior to the deadline for submission of
resolutions.

Whereas the Canadian Nurses' Association is a profes-
sional organization concerned with the health of the
people of Canada; and

Whereas the present growth rate in population, pol-
lution of our environment, and depletion of natural
resources represent a serious and increasing threat
to health; therefore be it
Resolved

(1) that the Canadian Nurses' Association support
appropriate measures proposed for the control of the
aforementioned threats to the health of all Canadians.

(2) that each individual member of the Canadian
Nurses' Association be encouraged to become in-
formed to take such action as is possible in his/her
situation to assist in the solution of these grave
threats to life in the world today.

AUGUST 1970

THE CANADIAN IVURSE 27

mendation was made by her committee
early in the biennium. She explained
that since then the executive of the
CNA had met with CMA and discussed
the subject of the medical assistant.
"We didn't only initiate "dialogue," "'
she said, "we 'dialogued' with them."
Miss MacLean added that the topic was
also discussed at a meeting of the
CMA-CHA-CNA. "It is important that
we are for something, not against
something," she said. "We should come
out with a statement saying what we
can do to fill this gap."

On the final day of the meeting,
delegates approved a resolution
directing the association to prepare a
position paper on the introduction of
new categories of workers into the
health field, namely those referred to
as the physician's assistant and the
medical practitioner's associate. They
also directed CNA to request the
department of national health and
welfare to call a national conference,
where doctors, nurses, and consumers
of health services could examine more
effective use of medical and nursing
manpower and the development of
complementary roles for nurses and
physicians.

During the discussion of the nursing
education committee's report, a British
Columbia delegate questioned the
recommendation that CNA become
involved in research. Committee
chairman Kathleen Arpin said this
really means "when it is appropriate"
for CNA to become involved. "There
are times when an organization needs
to engage in research that is unpalatable
to other organizations," she explained.
Earlier in the meeting, an Ontario
delegate spoke of the urgent need to
get more funding for research. "Persons
outside of nursing get incredible sums
of money for outlandish projects," she
said. "Let's get money," she urged. "If
we have to hold bingo games to get it,
let's hold bingo games!"

The committee on social and eco-
nomic welfare was asked by a British
Columbia delegate if any thought had
been given to the submission of z.
brief on the federal government's
White Paper on Taxation. Committee
chairman M. Louise Tod said the
committee had not considered this.
On the final day of the meeting, dele-
gates approved a resolution directing
CNA to "make a presentation to the
federal minister of finance on the
White Paper on Taxation."

Delegates also acted on the social
and economic welfare committee's
28 THE CANADIAN NURSE

Statement that the national association
needs a lobbyist. They asked the board
of directors to give serious consideration
to the appointment of a well-qualified
nurse to assume the role of lobbyist
for the CNA.

Functions, relationships, fee structure

The report of the CNA ad hoc
committee on functions, relationships,
and fee structure (published in the
March 1970 issue of The Canadian
Nurse), was presented by committee
chairman Jeanie S. Tronningsdal on
the second day of the meeting. Only
two of the committee's recommenda-
tions brought much discussion, but one
of these, on fee structure, almost re-
sulted in chaos.

The debate started after Mrs. Tron-
ningsdal read aloud the committee's
recommendation that the association
be financed on a per capita fee basis,
the amount to be determined accord-
ing to the bylaws. A Quebec delegate,
Helen Taylor, proposed an alternative
method of financing, which had been
approved by ANPQ members at a
special general meeting in May: that
the fee to CNA be $ 10 per member for
the first 10,000 members, and $5 per
member for the remaining members
for all provinces, with a maximum of
$175,000.

In presenting the ANPQ proposal.
Miss Taylor said Quebec delegates
recognized CNA's need for sufficient
finances, but said the needs of a
bilingual provincial association such

as Quebec were also great. She spoke
of the high costs involved in duplicating
all ANPQ material in both languages,
and said the formula Quebec proposed
would actually give CNA a few thou-
sand dollars more and would enable
CNA to budget ahead.

Another Quebec delegate said Que-
bec was not asking for a gift, that other
provinces with a membership of over
10,000 would also benefit. The Quebec
membership of 28,000 is more than
double the size of any other provincial
association.

Several delegates replied, saying
they had a mandate from their member-
ship to approve the per capita fee, not
a sliding scale.

Tension was high as Alice Girard,
a past president of CNA, made an
emotional appeal to all delegates.
"Decisions such as this should not be
taken in this atmosphere of aggressive-
ness," she said. "Please let us not take
an action we might regret. Let's not
take a decision until we have had time
to consider."

A Manitoba delegate, Kathleen
DeMarsh, moved that an ad hoc
committee of delegates from each
province be set up to consider other
means of financing the association and
to examine the implicaUons of having
a ceiling, such as the $ 1 75,000 proposed
by ANPQ. The motion was approved,
and Sister Felicitas appointed the
CNA first vice-president. Marguerite
Schumacher, as committee chairman.
This committee, which dubbed itself

Gourmet taste buds went wild at the CNA 35th biennial in Fredericton. The province
of New Brunswick sponsored a banquet which featured local delicacies, including
fiddleheads and wine — enticing row after row of nurses to come back for more.

AUGUST 1970

the "night owl committee," reported
its recommendations to the assembly
on the final day of the general meeting.
(See resolutions 1, 2, and 3, page 00.)
The major recommendation was that
the association membership fee be $10
per member for associations whose
membership is 20,000 or less, and $6
per member for associations whose
membership exceeds 20,000. In other
words, the per capita fee basis of
payment would be maintained, and the
CNA would operate under the same
budget as it did in the 1968-1970
biennium.

Most delegates had reservations
about the recommendation, but empha-
sized it was designed to meet the
present situation. As a Saskatchewan
delegate said, " We are looking at the
situation today, not 10 years from
now." Several delegates mentioned
the importance of maintaining unity
of the profession. " We don't want to
jeopardize our opportunity to work
toward better solutions in nursing by
denying the national association its
unity." said one.

A delegate from Nova Scotia said
she hoped if a smaller province had
a problem, it would be given the same
consideration. Representing New
Brunswick, a delegate spoke of the
importance of interpreting CNA to
all members. "When members under-
stand what CNA does, they'll be willing
to pay more," she said. A BC delegate,
obviously disappointed about the
recommendation, said her delegation
could not accept this proposed fee
structure, that it did not represent
a reasonable compromise. An ANPQ
delegate said she believed a common
understanding had been generated at
the meeting.

The night owl committee's con-
troversial recommendation on fees was
approved by a majority vote.

Another recommendation of the ad-
hoc committee on functions, relation-
ships, and fee structure — 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
— was changed to read "at least one
senior member." A motion to designate
this person as associate executive
director of the association was defeated.

Bylaws approved

The ad hoc committee on legislation,
chaired by Jeanie S. Tronningsdal,
gave its report Thursday morning.
AUGUST 1970

".. .and we will give the nurses good salaries. "promised the Honorable Louis J. Robichaud.
premier of New Brunswick, as he encouraged nurses to locate in the province's hospitals.
The premier spoke at the provincial banquet honoring CNA convention members.

Before presenting the proposed bylaws
for membership approval, Mrs. Tron-
ningsdal briefly reviewed the back-
ground.

CNA functions under an Act of
Incorporation passed by Parliament in
1947 and revised in 1954, Mrs.
Tronningsdal explained. To obtain
desired amendments to its Charter,
CNA had to make application to come
under the Canada Corporations Act
Part II for Letters Patent, as Parliament
no longer deals with amendments to
private acts of this category.

In making application under the
Canada Corporation Act, bylaws of
the association have to be submitted.
To conform with the Act, additions had
to be made to CNA's bylaws to cover:
the holding of an annual meeting; the
withdrawal of members; and other,
more technical, matters.

The proposed bylaws were drawn
up to fulfil these requirements, Mrs.
Tronningsdal said. During the interval
between the circulation of the proposed
bylaws and the holding of a special
meeting of the association in November
1 969 to consider them, confusion arose
over the interpretation and implications
of the withdrawal bylaw. However,
the bylaws were approved without
amendment at the special meeting.

Following this meeting, confusion
still existed about the withdrawal
bylaw, Mrs. Tronningsdal said, and
certain provincial associations took
action that resulted in the board of
director's decision to withdraw the

application for Letters Patent. At
present, thedepartment of consumerand
corporate affairs is holding in abeyance
CNA's application for Letters Patent.

The bylaws proposed by the ad hoc
committee on legislation were passed
with few amendments. The controver-
sial bylaw on withdrawal, which, as
approved at the special meeting in
November would have allowed an
ordinary member to withdraw from
CNA, now reads: "any association
member may withdraw from the
association... ."

One bylaw amendment concerned
the chairmen of the three standing
committees: they will be elected, rather
than appointed.

The voting delegates then approved
a resolution authorizing CNA to apply
to the minister of consumer and
corporate affairs for Letters Patent.

The final day

Delegates were weary, yet enthu-
siastic, as they prepared to vote on the
resolutions. The satisfied feeling of,
" Well, we've finally tied up a lot of
loose, administrative strings, now we
can tackle the really important issues,"
could be sensed.

One important issue, research, had
been presented earlier in the day.
Business was adjourned for 20 minutes,
while the chairman of the ad hoc
committee on research, Dorothy J.
Kergin. gave a resume of her commit-
tee's recommendations on CNA's role

( RepoR lonliniicd on pane 34)
THE CANADIAN NURSE 29

^ai

V

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W

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Follow me
lassies
and lads

-*iwk..

Opening day and they came in droves! Over
1,000 nurses attended the 35th biennial
convention in Fredericton. N.B. / Jeanie
S. Tronningsdai introduced two reports. 2
The CN A staff tooic notes. 3 Flower power,
worn by the N.B. hospitality committee,
welcomed members. 4 Action all the way
was felt throughout the sessions. 5 The Hon.
Wallace S. Bird, Lieutenant Governor of
New Brunswick (second right) and (left to
right) Mayor J.W. Bird of Fredericton
and Capt. K.M. Jefferson talk to Louise
E. Miner, then CNA president-elect. 6 The
piper played and the CNA executive
followed. 7 They trod the red carpet from
the Lord Beaverbrook Hotel to the Play-
house. 8 A casualty, before the convention,
walking into the Playhouse. 9 And an
armed forces nurse made notes.

1.**

^^m

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^

They had fun ...

boating, fishing, and buggy riding in antique cars, three of
the many funtimes enjoyed by conventioneers at the CNA
general meeting in Fredericton, N.B. If you were not there,
these pictures will tell you... the weather was great and
New Brunswick hospitality the finest!

What a picnic!

The whirling skirts and gay shirts of the
Elm Tree Square Dance Club encouraged
nurses to dance under the stars at a barbeq
hosted by the city of Fredericton. Repairs
on the spot were necessary though. Oophs!
Was it a hole in her toe or her nylon?

Instantaneous translation was available
throughout the CNA 35th general meeting
in Fredericton, N.B. Seated in a box
overlooking the audience, three bilingual
translators relayed each speaker's com-
ments via portable transmitters.

in research. (Complete details in News,
page 7.)

Most resolutions were passed with-
out much comment, although two
sparked discussion. One, asking CNA
to urge the federal government to
remove the sections relating to abortion
from the Criminal Code, was referred
to the incoming board for further
study. Several delegates questioned
the legal implications of this resolution,
asking if illegal abortionists could still
be prosecuted if the abortion laws were
removed from the Criminal Code.

An Alberta member said CNA
"should go on record with intelligent
action" on the abortion issue. "The
association should have spoken two
years ago, as the law probably won't
be repealed for another two years at
least." she said. Delegates from several
of the provinces agreed it was time
for CNA to take a stand on abortion.
"We have to resolve our differences
among members, but not in small
gn>ups behind the scenes," a BC
delegate said.

The other resolution that brought
discussion, mostly of an explanatory
nature, was the one directing the CNA

board of directors to consider as a
priority, ways and meansof encouraging
the production of textbooks in the
French language. An Ontario delegate
pointed out there are only two books
in French for French-speaking nursing
students in Ouebec, New Brunswick,
Manitoba, and Ontario. In addition, a
Ouebec delegate said, the textbooks
from France are really not much help
to French-speaking nurses, as they do
not correspond to the philosophy of
nursing in Canada. The resolution was
approved.

Standing ovation for president

SisterMaryFelicitas,CN A president
since March 1 967, was given a standing
ovation for her contribution to the
association. "It has been a privilege to
serve you," Sister Felicitas said, "even
though at times it has been heavy."
The incoming president, E. Louise
Miner, presented Sister with an
engraved gavel as a memento of her
years as president.

Before the meeting adjourned, M.
Geneva Purcell, president of the
Alberta Association of Registered
Nurses, extended an invitation to all
CNA members to visit Edmonton,
Alberta, for the 36th general meeting
June 25 to 30, 1972. "And stay for the
Calgary Stampede and our celebrations
of the Klondike Days!" Miss Purcell
urged.

Summary

And now it has been told. The 35th
CNA general meeting was an outstand-
ing success. Attendance was high,
discussion stimulating, and members
seemed to know what they want and
how they are going to achieve it.

And it wasn't all work. The hos-
pitality and the efficient planning of
the hostess association, the New
Brunswick Association of Registered
Nurses, were enjoyed and appreciated
by all. The barbecue, sponsored by
the City of Fredericton; the banquet,
given by the province; the tours ar-
ranged by NBARN; the folk-singing
concert; and the many little things that
add to a conventioneer's pleasure — all
contributed in no small part to the
success of the meeting. D

34 THE CANADIAN NURSE

AUGUST 1970

AUDITORS' REPORT

January 21, 1970

To the Members of

CANADIAN NURSES' ASSOCIATION

We have examined the Balance Sheet of the Canadian Nurses' Association as
at December 31, 1969 and the Statements of Revenue and Expenditure and Surplus
and Reserve for I.C.N. Congress for the year then ended. Our examination included
a general review of the accounting procedures and such tests of accounting records
and other supporting evidence as we considered necessary in the circumstances.

In our opinion, these financial statements present fairly the financial position
of the Association as at December 31, 1969 and the results of its operations for the
year then ended, in accordance with generally accepted accounting principles ap-
plied on a basis consistent with that of the preceding year.

GEO. A. WELCH & COMPANY
CHARTERED ACCOUNTANTS

35

CANADIAN NURSES' ASSOCIATION

BALANCE SHEET

as at December 31, 1969

ASSETS

1969 1968

Current Assets

Cash $241,302 $136,267

Short term deposits — plus accrued interest 203,020 126,780

Accounts receivable 20 , 784 34 , 726

Membership fees receivable 33, 260 68 , 562

Prepaid expenses 10, 118 —

508,484 366,335

Sundry Assets

Marketable securities— at cost (Quoted value $12,205) 3,779 3,779

Loans to member nurses 17,565 13,365

Inventory of binders — 1 ,050

21,344 18,194

Fixed Assets

C.N. A. House — land and building — at cost less Accumulated depreciation

on building 679,268 711,135

Furniture and fixtures — at nominal value 1 1

679,269 711,136

1,209,097 1,095,665

Approved on behalf of the Board :

Sister Mary Felicitas President

Dr. Helen K. Mussallem Executive Director

36

CANADIAN NURSES' ASSOCIATION

BALANCE SHEET

as at December 31, 1969

LIABILITIES

Current Liabilities

Accounts payable and accrued liabilities $ 97,443 S 26 711

Unearned subscription revenue 24 750 21 300

122,193 48,011

Mortgage payable— 6^% due 1976 repayable in blended monthly instalments of $3,548

including principal and interest 428 , 001 441 , 590

Reserve for I.C.N. Congress — per statement — 123 327

Surplus 658,903 482,737

1,209,097 1,095,665

CANADIAN NURSES' ASSOCIATION

STATEMENT OF RESERVE FOR I. C. N. CONGRESS

for year ended December 31, 1969

Balance, December 31, 1968 $123,327

add:

Excess of Revenue over Expenditure for year 7 , 636

130,963
deduct:

Transfer to Surplus 1 30 , 963

Balance, December 31, 1969 NIL

Submitted with our report to the Members dated January 21, 1970.

GEO. A. WELCH & COMPANY
CHARTERED ACCOUNTANTS

37

CANADIAN NURSES' ASSOCIATION
STATEMENT OF REVENUE AND EXPENDITURE AND SURPLUS
for year ended December 31, 1969

1969 1968

Revenue :

Membership fees

Subscriptions

Advertising

Sundry revenue

Expenditure:

Operating expenses:

Salaries 384,534

Printing and publications 216,511

Postage on journal 79,304

Building services 72 , 930

Staff travel 9,684

Committee meetings 28,582

I.C.N, affiliation 31,214

Commission on advertising sales 18 , 261

Computer service 30, 775

Office expense 25 , 559

Legal and audit 4,750

Translation services 2 , 533

Consultant fees 9,322

Sundry 938

Furniture and fixtures 4,826

Landscaping and improvements 16, 157

Depreciation — C. N. A. House 31 , 867

967,747

Non -operating expenses:

LC.N. Congress —

1968 Biennial convention 145

Canadian Nurses' Foundation 3,131

3,276
Allocation to Reserve for LC.N. Congress

Excess of revenue over expenditure for year before
investment income

add:

Investment income

Excess of revenue over expenditure for year.

Surplus, December 31, 1968

Transfer from Reserve for LC.N. Congress..

Surplus, December 31, 1969

$697,754

$678,746

30,903

22,617

249,194

235,804

13,249

12,706

991,100

949,873

351,056

219,084

12,234

66,922

15,849

16,073

29,982

17,686

25,225

26,511

5,875

2,102

9,791

1,411

10,075

31,867

841,743

20,666

500

1,906

23,072

—

40,434

971,023

905,249

20,077

44,624

25,126

8,301

45 , 203

52,925

482,737

429,812

130,963

—

658,903

482,737

38

FINANCIAL REPORT

The financial results of the past biennium detailed
in the auditors' report (pp. 35-37) reflect the actions
taken by your Board of Directors in following the man-
date of the 34th General Meeting contained in the
following motion:

That for the 1968-70 biennium only, in member
associations whose membership exceeds 20,000
the full annual fee per member be $6.00 and in

member associations whose membership is 20,000
or less, the full annual fee per member be $10.00
and that the board of directors be empowered to
adjust the budget accordingly.

CARRIED

A comparison of actual revenue and expenditures to
budget is tabled below:

Revenue:

Fees

Expense:

Board and Committee Meetings

Research and Advisory

Affiliation and Sponsorship

Journals

Library and Archives

Public Relations

Budget

Actual

(Over)
Under

$1,494,880

SI

,376,500

8118,380

290,006

220,479

69,527

257,120

238,576

18,544

270,574

192,102

78,472

448,464

440,587

7,877

137,528

105,443

32,085

91,188

81,186

10,002

81,494,880

SJ_

,278,373

8216,507

It will be noted that expenditures in each category were
well below budget and that total net costs were appro-
ximately $100,000 less than revenue available through
fees. The latter was made possible principally through
the significant financial support received from the pro-
vincial associations for the ICN Congress, plus addi-
tional revenues accruing from interest on ICN Congress
funds.

Brief explanations of the means employed to hold net
costs to this level are noted below.

Board and Committee Meetings. Generally only those
meetings that were mandatory by by-law or resolu-
tion were held. For a major portion of the last half of
the biennium the Board and Committees operated
without support of four professional staff members,
the positions for which were unfilled.

Research and Advisory. Salaries related to unfilled
professional staff positions account for the total bud-
getary savings in this category.

Affiliation and Sponsorship. Included in this total is
$61,196 representing ICN affiliation fees forwarded
on behalf of the individual members. The remaining
$130,806 represents CNA's contribution to the ad-

ministration and operation of the CNF and the ICN
Congress. By virtue of good attendance and by fore-
going certain amenities, the ICN Congress was a
financial success producing a small profit of
$7,636.00.

The Journals. Included in net journal costs is an
unbudgeted amount of $66,400 caused by a postal
reclassification during the last eight months of the
biennium. This was more than offset by the introduc-
tion of cost reduction methods in the production pro-
cesses, by substantially increasing advertising and
subscription revenues, and by maintaining operating
costs at a minimum level.

Library and Archives. Major maintenance and oper-
ating expenses were deferred, acquisitions were held
to a minimum, and the filling of one additional au-
thorized staff position necessitated by increased vol-
ume was delayed until the last quarter of the bien-
nium.

Public Relations. The public relations activities were
concentrated primarily on the ICN Congress during
the biennium which necessitated the deferral of part
of normal CNA public relations programs.

39

Have you ever wondered how a pregnant woman reacts when a doctor or nurse
complacently pats her protruding abdomen, while commenting on its bigness? If not,
this understanding report will help explain why empathy is as important during
pregnancy as it is during any other period in the human life, and why acceptance
of changes in the body image during pregnancy is vital.

Elaine A. Carty, R.N., B.N., M.S.N., C.N.M.

When I was working in a prenatal clin-
ic, I frequently found myself patting a
pregnant woman on the abdomen and
saying, "My, you are getting big, aren't
you?" I also noted the reaction. More
often than not, this was a groan, accom-
panied by a pathetic facial expression.

This behavior made me think — per-
haps all mothers-to-be are not happy at
the sight of their enlarged abdomen dur-
ing pregnancy. On the other hand, I ar-
gued, some prospective mothers can
scarcely wait for their abdomen to give
visible evidence of advancing pregnan-
cy. These women show their maternal
pleasure by wearing maternity clothes
before they really need to, and walk with
shoulders well back so that their abdo-
men protrudes.

Noticing that attitudes toward the
figure-change during pregnancy differ,
I wondered why. How do women react
to the abdominal enlargement during
pregnancy, I asked? Whatever these
feelings are, do they present a problem?
What role might a nurse play in relation
to these feelings?

Body image

The more 1 thought about why many
health workers remark gently on the
fullness of a pregnant woman's abdo-
men, the more I thought — there must
be an answer to differing reactions!

Pursuing the subject, I found liter-
Mrs. Carty is a lecturer at the University
of New Brunswick, Fredericton, New Bruns-
wick. This article was based on her thesis,
"Women's Feelings About the Figure
Change in Pregnancy," Yale Univ. 1968.

40 THE CANADIAN NURSE

ature that provided an insight into the
way we view ourselves, and particularly
our bodies. "Individuals do have ideas
and attitudes concerning their bodies
and this concept is known as body im-
age."* These attitudes begin when an
infant girl discovers her fingers and
toes, and later, realizes something dif-
fers between herself and her mother.
The child's reaction to her body image
continues as she develops, and changes
as she learns more about herself and in-
teracts with others in her daily ex-
periences. Her popularity with her
peers, her achievements in her studies,
sports, or music, for example, all affect
how she sees herself and her body.

We all have some perception of our
body, and as a woman's figure changes
during pregnancy it would seem normal
that perception of her body image must
also change. The effect on a woman of
a change in body image may be signif-
icant, because, as Seymour Fisher points
out, "the female in her role as a woman
is more explicitly identified with her
body than is the male."^

Body identification is now inbuilt
in the American culture. Through the
medium of television, cosmetic adver-
tisements, and beauty magazines, an
ideal American girl has been established.
She is presented as pretty and slim, with
a curvy figure that makes her naturally
attractive to the male. Today's woman
is extremely body conscious.

Finding an answer

Hunches and feelings being all I had,
I proceeded to find explicit information

AUGUST 1970

on why pregnant women differ in their
reactions to their increasing girth. I
started by interviewing 40 women in
varying stages of pregnancy or in the
immediate postpartum period. Their
responses to my questions, and during
our general discussion, were rated as
positive or negative in relation to their
figure change. The number of positive
and negative responses were totaled, and
each woman was placed on a five-point
scale — ranging from complete satis-
faction to complete dissatisfaction with
the changes in her pregnant figure.

A woman was rated satisfied if all
her comments seemed to be completely
positive, and dissatisfied if all her com-
ments were rated as negative. A some-
what satisfied rating was given where
the majority of comments had a positive
tone and only a few negative comments.
The reverse was true of a somewhat dis-
satisfied rating. A neutral rating was
established for the same number of pos-
itive and negative comments, or when
the comments had a neutral tone and
expressed no particular feelings one way
or another. A nurse acted as a relia-
bility check for the classifications.

Ratings discussed

None of the women were completely
satisfied, 9 were somewhat satisfied, 10
were neutral, 1 7 were somewhat dissat-
isfied, and 4 were completely dissatis-
fied. The degree of dissatisfaction seem-
ed to increase as the pregnancy prog-
ressed.

My own reactions to these interviews?
If a woman views herself negatively
during her pregnancy, it may affect her
relationship with her husband and her
unborn child. Which made me conclude
— I see feelings about figure change as
a potential problem area.

Most of the women who were from
four to six months pregnant seemed un-
certain how they felt about their en-
larging abdomen. It was new to them,
for they were just beginning to "feel a
bulge." Some did express decided feel-
AUCUST 1970

ings. The primigravida at this time ap-
peared to be quite happy with and thrill-
ed about her enlarging figure, but the
multigravida was not. Reactions given
by some primigravidas made me think
that, perhaps for women who have not
had a baby before, the growth and
development of a baby within them-
selves seems unreal, almost mira-
culous. Then when they do
begin to bulge, there is real
evidence that a baby, their
baby, is growing within them

The women who were from
seven to eight months preg-
nant appeared to be some-
what more dissatisfied. They
felt those things that were
exciting in early pregnancy,
seemed to have lost enchant-
ment later. It was interesting
that many women in this
period expressed concern
not only about the increased
size of their abdomen but
also the stretch marks left after
the birth. Many women saw these as
increasing their unattractiveness.

This last reaction made me ponder
— perhaps the nursing profession takes
the stretch mark for granted, assuming
it to accompany pregnancy, forgetting
to tell the patient that stretch marks may
appear, where, and what they will look
like.

I also talked with 10 women who
were within one or two weeks of their
due date. Again, the amount of dissat-
isfaction with their enlarging figures
seemed to increase. These women re- i
ported they just wanted to get the preg-
nancy over, they felt uncomfortable and
unwieldy.

It was only in the postpartum group
that we rated anyone completely dis-
satisfied (there were four). These women
were prone to think that once the baby
was born, their nice, flat stomach would
soon come back. Dissatisfaction was
openly expressed when they found the
abdomen was still a little big and lacked

THE CANADIAN NURSE 41

muscle tone. I wondered if, as the baby
had been separated from their body,
perhaps they could easily express neg-
ative reactions without feeling they were
saying something against the baby.

Nurse's role

If the purpose of nursing is to assist
the individual, family, or group to adapt
to health care and/or health related
stressors,^ then it would be well to look
at what could affect the process of ad-
aptation. It could be that in pregnancy,
how a woman views herself could be a
factor which determines how she adapts
to her new role.

Certainly the pregnant woman has
many feelings, positive and negative.
The nurse's job is to support the positive
feelings and prevent, reduce, or, remove
the negative feelings. If a woman ex-
presses negative feelings, why is it im-
portant for the nurse to question these
feelings?

It seems to me that these feelings
could affect both the husband/wife re-
lationship, and the mother/child rela-
tionship. For example, if a woman feels
she is unattractive because of her preg-
nancy, it may strain her natural rela-
tionship with her husband and affect
the trust she has in him. She might
blame him for making her pregnant and
for making her "look this way." This
reaction could mean additional strain
on their relationship.

On the other hand, the husband/wife
relationship might be strengthened if
the wife is pleased with the way she
looks during pregnancy. She might ac-
cept her bulging abdomen, taking com-
fort in sharing her feelings with her hus-
band. She might even want him to feel
her abdomen, so that he can feel the
baby's movements and make a conjec-
ture on its position.

If the mother is dissatisfied with her
appearance, she might blame the baby,
and if this is allowed to continue she
might have difficulty developing a close
relationship with her infant. It would
42 THE CANADIAN NURSE

seem that the mother-to-be who is pleas-
ed and excited about her appearance,
is probably also pleased about the baby
within her, and is able to identify closely
with it. To me, the question seems to
be, "How can we help the mother who
is troubled by her, 'pregnant look?' "

Each nurse will have her own imag-
inative ideas on this subject. If accept-
able, I hope she puts them into practice.
Here are some of my ideas, particularly
on the importance of being aware that
different feelings exist among pregnant
women. It is important to determine
whether pregnancy was planned or not
planned. Teaching as it relates to ma-
ternity clothes is also important, as is
acquainting the husband with the stages
of pregnant body change, and post-
partum teaching on how to relate to
body change.

Helping the mother

During the rating interviews, two
questions seemed to detect whether the
mother's feelings could be categorized
as satisfied or dissatisfied. The first,
"What were some of your thoughts when
you first put on maternity clothes?"
brought various responses. One exam-
ple was, "Oh, I like maternity clothes,
they are comfortable and I look good in
them."

The following response rated as dis-
satisfied: "Well, here we go again! I
think of them as a uniform. You have
to wear them for your tour of duty.
They are all the same style, and no mat-
ter how hard you try to fix yourself up,
you can't."

The second question, "Some people
think women look their best when preg-
nant. What do you think?" brought re-
plies that seemed to be concerned with
how their husbands viewed their ap-
pearance, or how they thought he view-
ed their appearance. These two exam-
ples indicated the different opinions:
"No, I don't think so. I don't like my
husband to see me this way. He has
never said anything, but with this stom-

ach and being so awkward, I just can't
help but feel uncomfortable." "Well, I
look my best. I feel good and happy,
and my husband tells me I look grand
when I am pregnant."

If a nurse wants to find out how a
pregnant woman sees herself, one of the
above questions might be a useful ap-
proach. Perhaps the first step in help-
ing a mother is assuring her that feelings
of uncertainty or dissatisfaction with
the way she looks during pregnancy are
not abnormal. (This information could
be added to prenatal literature as anti-
cipatory guidance.) If a pregnant wo-
man knows that feeling unattractive is
nof unusual, she might be able to ex-
press her feelings on the subject easily
to the nurse and her husband.

Attitudes

The way a woman views her enlarged
abdomen may be indirectly related to
whether or not the pregnancy was plan-
ned. For example, perhaps the preg-
nancy was not planned because the
couple felt they could not then afford
another baby. By referring to a social
worker, help might be obtained through
extra funds.

Perhaps a pregnancy was not planned
because the wife felt she could not cope
with another child, or did not then have
the capacity to love another child. Neg-
ative feelings about the pregnancy
might be expressed as dissatisfaction
with the figure changes. Without inter-
pretation of her dissatisfaction, this
mother might not be able to love her
baby when it is born, and neglect or
abuse might result.

In the prenatal period the nurse can
help the mother identify with her baby.
She can encourage her to name the baby
and think of it as a person. She can help
the mother to be conscious of the baby's
movements and position. Postpartum,
the mother needs to claim her baby.
This can be best achieved by letting her
hold the baby as soon as possible after
delivery.

AUGUST 1970

My findings indicated that the way
a woman sees herself in maternity
clothes is a good clue to her satisfaction
or dissatisfaction with her figure
changes. The nurse might help by em-
phasizing the comfort of maternity
clothes, and discuss why they are nec-
essary for the enlarging uterus.

If the woman expresses feeling of
boredom with her maternity clothes, the
nurse could suggest inexpensive ways
to make her clothes different. Adding
a bow, a scarf, or a collar often en-
hances her appearance. The wo-
man could be helped to use her
own resources in many ways to
brighten her appearance, so that
she feels she looks nice in maternity
clothes.

To take the focus off the enlarged
abdomen, the nurse could comment on
how attractive the patient looks. Com-
pliment her dress or hairdo, or comment
on her clear skin and shining eyes. It
might also be helpful to encourage the
mother to think of the abdomen in terms
of the baby within it. One of the some-
what satisfied women I spoke to said,
"I ordinarily do not like a big tummy,
but a pregnant tummy is something
quite different and beautiful."

No one functions in a vacuum. Inter-
meshed with every woman's own personal
drama is another which is found in the reac-
tions she creates within her tiny segment of
society, her family. Her open or subtle indi-
cations of acceptance, ambivalence or rejec-
tions of her condition inevitably stir up re-
sponses and repercussions among her family
members. They in turn set up reactions in the
pregnant woman which are indeed conse-
quent to the reactions she perceives among
her key reference group members, in partic-
ular, her husband.^

Because of the increased emphasis
on beauty in our culture, the pregnant
woman wants to be attractive to her
husband most of all. But it seems a hus-
band often teases his wife about her
big tummy! This appeared to upset
some of the women with whom I spoke.
Perhaps men do not realize how sensi-
AUGUST 1970

tive a wife can be about her enlarged
abdomen.

Here the public health nurse might
be able to talk with the couple about
the teasing and reactions to it. Antici-
patory guidance could be given by in-
cluding this kind of information in pre-
natal classes. Nurses can also help men
realize that their wives want and need
to be complimented on their appearance
during pregnancy. The husband could
be encouraged to touch his wife's abdo-
men, feel the baby move, and accom-
pany her when she shops for maternity
clothes. This might help to involve him
totally in the childbearing process.

Conversely, the woman should also
be helped to understand that her hus-
band might be somewhat awed, confus-
ed, or even amazed at the physical ap-
pearance of pregnancy, and that his
teasing is done without really knowing
another way in which to respond to his
own feelings or reactions.

Postpartum idiosyncracies

During the interviews it seemed sev-
eral women were not realistic about
the way their figure would look post-
partum. Perhaps the medical profes-
sion should be more explicit in teaching
mothers about the weight distribution
in pregnancy. For instance, they should
know that the pregnancy itself accounts
for only 16 to 20 pounds, and that any-
thing over that becomes adipose tissue.
They also should learn about the rectus
abdominus muscle stretching during
pregnancy, and the resulting postpartum
flabbiness. Postpartum exercises should
be discussed and emphasized before
the pregnancy terminates.

It is also important for the woman
to understand why she must begin post-
partum muscle toners immediately
postpartum if her abdomen is to become
flat in a short while. The nurse should
begin working on exercises with the
mothers immediately postpartum. And
so get them into a daily exercising habit.

Purpose

Helping the nurse become aware of
the importance of body image in preg-
nancy has been the purpose of this ar-
ticle. I also wanted to share some of
my research findings, and to suggest
ways by which the nurse could support
positive feelings, and reduce or remove
negative feelings about figure changes
during pregnancy. Most certainly this
is only one small area in which the
nurse must be concerned during her care
of the childbearing woman. But the
nurse who is actively conscious of figure
change during pregnancy can contribute
to making pregnancy a healthy and
happy experience for all the family.

References

1. Arkoff, A. and Weaver. H.B. Body
image and body dissatisfaction in Japa-
nese Americans. J. Soc. Psychol. 37:4:323-
330. Apr. 1966.

2. Fisher, Seymour. Sex differences in body
perception. Psychological Monographs,
1964, p. 10, 71:10. 1964.

3. Calkin. Joy, and Carty. Elame. Curricu-
lum paper, Canadian Conference, Univer-
sity Schools of Nursing, Atlantic Region,
April, 1969.

4. Stone, Anthony R. Cues to interpersonal
distress due to pregnancy. Amer. J. Nurs.
65:11:88-91, Nov. 1965.

THE CANADIAN NURSE 43

The Shouldice Story

Crinolines were
hoisted and tuxedo
trousers dropped . .

Max Ferguson

Some future day, when the inevitable
emergence of a flourishing and dynamic
Canadian film industry will enable Can-
ada's story to be told to the world, I
certainly hope they won't overlook the
Shouldice Surgery. The very fact, gentle
reader, that your eye-brows are now
moving toward your hair-line and your
lips are silently forming the query
"What in Hell is the Shouldice Surgery?"
is eloquent proof of the crying need for
Canadians to cast off, at long last, this
stifling national winding sheet of ret-
icence, inhibition and self-depreciation
so that all the world may know of the
many things we do so well ... the things
which make this land of ours unique.

The Shouldice Surgery, occupying
the spacious grounds of a former pri-
vate estate and nestling in the pastoral
charm of farmland just north of Toron-
to, is devoted exclusively to the repair-
ing of hernias. Thanks to the develop-
ment of a new and infallible surgical
technique employing stainless steel
wire, it can now be said that no one
knocks in vain at the doors of the Shoul-
dice. Age is no deterrent. Shrivelled,
despairing men in their late eighties.

Max Ferguson, Arts '46. a noted Canadian
satirist, hosted a daily CBC radio program
for many years. He was awarded the Leacock
Medal in 1969 for his humorous writing.
Reprinted with permission. The University
of Western Ontario Alumni Gazelle, May
edition. 1970.

44 THE CANADIAN NURSE

whom no medical doctors would touch,
have shuffled to the Shouldice and been
made whole again, giving rise with am-
ple justification to the credo that no
doctor stands so tall as when he stoops
to fix an old hernia.

The philosophical modus operandi
at Shouldice seems to be an adaptation
of the old Biblical exhortation "Pick up
thy bed and walk." After the surgeon
has completed his work, the patient rises
from the operating table and walks back
to his room. Following a three-hour
rest period, he will be expected to make
his way to the main floor of the hos-
pital and participate in group therapy
which consists of five minutes of setting-
up exercices interspersed with five min-
utes of jogging on the double through
the labyrinth of main floor rooms. All
this is done under the supervision of a
hospital matron whose unfortunate
physical resemblance to Elsa Koch
sometimes makes the whiners and slack-
ers forget that there beats a motherly
heart of gold underneath.

After three brief days of this physio-
therapy, the patient is released to take
his place once again as a useful member
of society. With him, of course, go the
best wishes of the hospital staff and only
two minor stipulations. "Do not take a
bath for one week and try not to laugh."
I think any reasonable person can ap-
preciate the Shouldice insistence that
during the patient's sojourn there, the

AUGUST 1970

presence of liquor is prohibited. While
I was there, one of my fellow patients
— a mean, dour, bad-tempered Scot
of 83 years — had two bottles of con-
traband whiskey taken from him. He
had, of course, been in a nasty mood
from the very outset since he felt his own
son had betrayed him by suggesting an
innocuous Sunday drive in the country
and then whisking the stubborn, can-
tankerous old man into the Shouldice.
During his entire stay he assiduously
managed to overlook the fact that his
double hernia had been completely
cured for the first time in his life and
insisted on referring to the staff as
"heartless bastards, wi' nae a drap o'
human kindness."

Although the revolutionary surgical
techniques developed by the Shouldice
Surgery attract medical men from all
over the world as observers, it is not just
this physical aspect which astounds me
and evokes my most heart-felt praise.
Rather, it is the incredibly solicitous —
almost parental — concern which the
hospital shows for each member of its
graduating classes. And here I am not
thinking simply of the annual letter
which each ex-patient receives urging
him to return to the hospital, wherever
he may be, for a medical check-up. As
a former resident, 1 react to those siren
calls much in the way an exiled Scot
would react to the strains of "Will Ye
No Come Back Again?", but I can well
appreciate that a cynic might justifiably
view them as a standard, pragmatic pro-
cedure motivated only by the self-inter-
est of the hospital to verify the efficacy
of its surgical techniques. But how does
one explain all the other literature? The
considerate little reminders of social
evenings or the fact that my "year"
party is coming up on such and such a
date affording the chance to be with old
friends once again and re-live old and
happy memories. I'm well aware of the
old saying that "Familiarity breeds con-
tempt" and since the Shouldice Surgery
is situated right on Toronto's northern
doorstep 1 suppose it's only natural that
certain unthinking Torontonians, par-
AUCUST 1970

ticularly those who've never been there,
should refer to it glibly as "the Minit-
Wash Hernia". I only wish, however,
that such people could have been with
me on that April afternoon four years
ago when my phone rang at the CBC
and I picked it up to hear the warm
voice of Dr. Black ... the surgeon who
personally officiated at the healing of
my hernia. "I certainly hope, Mr. Fer-
guson, that we'll have the pleasure of
your company at our first annual ball
in the Royal York next month."
I suddenly found myself staring incred-
ulously into the ear-piece of the phone
as if searching for some visual proof of
what I was hearing. True, the hospital
had gone out of its way over the past
few years to preserve the bonds of
friendship that had sprung from my
hernia operation but — a personal in-
vitation to a Hernia Ball . . . especially
since my hernia had been so "run of the
mill" with not even a strangulation or
any other distinguishing complication
to raise it above the average. For a mo-
ment 1 gave way to a gnawing suspicion
that the voice on the phone might be
that of Allan McFee or some other
CBC announcer with a sick sense of hu-
mour and a rather off-color retort was
already forming on the tip of my tongue
but the warm, compelling sincerity soon
won me over as the voice continued.
"As a matter of fact, Mr. Ferguson, we
were hoping that you might even con-
sent to act as MC for the evening."
After accepting this additional honor
with a rush I asked just what my duties
would be. "Oh, there's really very little
involved ... a few words of welcome,
an introduction to one or two short
speeches and then at the conclusion of
the dinner a reminder that a live orches-
tra is standing by in the adjacent ball-
room awaiting the pleasure of those
guests who might wish to dance."

This certainly sounded like a simple
and pleasant assignment but just to be
sure I had it straight 1 enquired if my
services would only be required until
the end of the dinner. "Oh certainly Mr.
Ferguson because once the guests leave

the dining room and move into the ball-
room our own people will take over."
"Your own people will take over. Dr.
Black?" "Yes, we'll have two or three
of our staff people waiting in a small
anteroom which connects the dining
room with the ballroom. As the guests
move through to the dancing we'll be
able to give those hernias just a quick
check-up without really holding any-
body up or interfering with the evening's
fun. "I've always hated being a quitter
but the thought of luring all the beauty
and the chivalry of that evening into
that tiny room, the mental picture of all
those stunned expressions as crinolines
were hoisted and tuxedo trousers drop-
ped was just too much. If the sounds of
revelry by night were going to be con-
verted by probing thumbs into an an-
guished crescendo of coughs I didn't
want to be the Judas bull who led them,
all unaware, into such a thing. Though
I never did make the first annual Hernia
Ball at the Royal York I'm still stag-
gered by the brilliance of the imagina-
tive minds behind such a venture and,
as 1 mentioned at the outset, when an
emerging Canadian film industry begins
to tell Canada's story to the world, I
hope that somewhere up there alongside
Lloyds of London, Wells Fargo and the
other great milestones of cinematogra-
phy will be the story of . . . "Shouldice,
Mender of Men's Hernias." D

THE CANADIAN NURSE 45

Man, Medicine and Morality by A.E.

Clark-Kennedy. 214 pages. London,
Faber and Faber, 1969. Canadian
Agent; Queenswood House, To-
ronto, Ontario.

Reviewed by Eileen Healey, Asso-
ciate Professor, School of Nursing,
The University of Western Ontario,
London, Ontario.

This timely and thoughtful book dis-
cusses disease, the problems of medical
practice, and related moral, legal, and
financial questions. The author relates
these issues to the conflicting claims
of human experience as reflected by
religion and scientific interpretations of
the nature of man. Although the author
writes as a physician practicing under
the British Health Service, his discus-
sion of the problems of patient-doctor-
state interplay, modern therapeutics,
teaching, and research are relevant to
Canada.

The beginning chapters present the
essential facts of human growth and
development. Moral dilemmas facing
modern man are reconsidered in the
light of rapidly increasing knowledge
and avances in technology. The book is
relevant in its consideration of the eth-
ical problems or organ transplantations,
the definition of death, and related
medical-moral issues.

The author suggests that religion
changes and adapts with increasing
knowledge and human experience. The
question of the genesis of religion is
basic to subsequent considerations of
the relationship of science to religion,
and medical practice to human exist-
ence.

Today, science challenges the tra-
ditional assumptions regarding man
and his place in the universe. The
author proposes that chance determines
the direction of human evolution.
Chance determines one's parents, and
which of their gametes fuse to engen-
der their children's psychosomatic
development. Chance, as an alternative
to the concept of creation with purpose
and direction, must be considered as an
explanation of existence.

The first five chapters establish the
basis for the discussion of morality,
defined as "the right way of behaving
in situations demanding choice." The
basis for moral choice must be anchored
to something, and the author proposes
three possible anchors: the law of God,
the welfare of other people, and person-
46 THE CANADIAN NURSE

al integrity. Man is obliged to create an
environment beneficial to himself and
to others.

The author considers all kinds of
organ transplantations. The legal issue
of diagnosing death, the technical
problems of tissue typing, and the
functional deterioration of donor tissues
are discussed.

This book is important to nurses,
who are intimately involved with trans-
plant patients, parents of deformed
children, and dying patients. The author
illustrates his concern for the rights of
the individual under the British Health
Service and discusses these as they
contrast with physicians' moral and
legal obligations to the state. He has
written a sensitive and erudite account
of the moral issues involved in today's
health care service.

Modern Bedside Nursing by Vivian M.
Culver. 841 pages. Toronto, W.B.
Saunders Company Canada Ltd.,
1969.

Reviewed by Thelma Pelley, Director
of Nursing, Stratford General Hospital,
Stratford, Ontario.

Basic concepts, principles, and proce-
dures are presented in an organized,
comprehensive, interesting, and thought-
provoking way. Learning techniques are

B.OOO eosusH'Bcoi'^

used to clarify basic facts about the
science and art of nursing and to involve
the reader in a questioning analysis, evalu-
ation, and application of concepts, thus
promoting personal competence and
specific nursing skills.

In each chapter learning is directed
toward specific accomplishment through
suggested objectives of study, an intro-
duction and summary of content, practi-
cal guides for study and discussion,
provocative questions, and a suggested
application of content in actual situa-
tions.

The author uses a patient-centered
system approach. Emphasis is on observa-
tion and interpretation of signs and
symptoms to develop specific techniques
that meet particular human needs.

Units of study are presented in a
logical sequence, but can be studied
independently. Unit one orients the
reader to practical nursing, to an under-
standing of learning principles, and gives
an insight into understanding oneself and
others. Vital issues, such as legal and
ethical complications, are discussed.

Background theory of nursing practice
helps the student acquire knowledge of
the structure and function of the human
body in relation to the physiological
processes of specific systems and organs
and the processes of normal growth and
development.

The nurse is helped to ijiterpret her
role in relation to patient needs that arise
from basic nutritional requirements,
specific health problems, and drug
therapies. Special consideration is given
to maternal and child care and problems
arising from mental illness.

The appendices provide an excellent
reference source and include common
abbreviations, medical terminology,
procedural guidelines for specific nursing
techniques, and a glossary and index.

Orthopedic Nursing, 7th ed., by Car-
roll B. Larson and Marjorie Gould.
486 pages. Toronto, C.V. Mosby
Company, 1970.

Reviewed by Carole L. Martin, Mary
E. Brown, and Carol L. Jenkin, To-
ronto East General and Orthopaedic
Hospital, Toronto.

The chapters on introduction and gen-
eral features of this edition have been
greatly expanded and enlarged. In these
chapters the nurse will find the well-

AUCUST 1970

defined principles and basics of ortho-
pedic nursing. The areas of good body
alignment and positioning of the patient
are fundamental aspects of orthopedic
nursing and cannot be overemphasized.

The pages on traction are concise and
descriptive in outlining all methods of
application, with special reference to
prevention of pressure areas and the
importanceof exercise. Thenurseshould
understand the principles of traction
described in this chapter to enable her
to give effective patient care.

Inclusion of a chapter on rehabilita-
tion is an excellent addition. More and
more, the essential need for doctors,
nurses, physiotherapists, and social
workers to work together as a rehabili-
tation team to provide total patient care
is being recognized.

The detailed chapter on trauma is a
good reference. It emphasizes preven-
tion of injury and principles of first aid.
Anatomical diagrams of the injury are
clearly illustrated, with treatment and
nursing care outlined in detail.

In dealing with arthritis, further men-
tion about the recent trend of increasing
surgical intervention in the treatment
of this disease could have been made,
with discussion of relevant nursing care
and physiotherapy. The emotional sup-
port described in this chapter is an im-
portant adjunct in dealing with the ar-
thritic patient.

The remaining chapters, dealing with
cerebral palsy, bone tumors, congenital
deformities, infections, metabolic dis-
orders, and the special operative pro-
cedures are well described. The authors
have chosen the more prevalent diseases
and discussed these thoroughly.

This book is an important reference
on orthopedic nursing. The revised
edition has a much improved index,
facilitating quick reference. D

AV aids

Films on Food

Sets of 22 films dealing with food prep-
aration, kitchen safety, and food and
personnel sanitation have been dis-
tributed to the London, Hamilton,
Kingston, Toronto, and Northern On-
tario regional offices of the Ontario de-
partment of Health. These films are to
be distributed to public health person-
nel involved in food protection services
and programs for presentation to inter-
ested groups.

Each film is nine minutes in length
and is in color. The films are directed
to food handlers in institutions such as
mental hospitals, homes for special
AUGUST 1970

care, nursing homes, correctional in-
stitutions, summer camps, and some
educational institutions.

Address inquiries to the regional
medical officer at the regional public
health offices concerned.

New Films

The following films are new accessions
to the National Science Film Library
in Ottawa. All these films are available
on loan from the National Science Film
Library, 1762 Carling Avenue, Ottawa
13, Ontario, at a nominal fee.

• Congenital Dislocation of the Hip
in Saskatchewan Indians. Its Natural
History and Etiology. Canada, 1968.
16mm, color, sound, 25 minutes.

• The Endless War. Great Britain,

1967. 16mm, color, sound, 22 minutes.
This film covers William Harvey and
the circulation of the blood, Jenner and
vaccination, Alexander Fleming and
penicillin; present-day research into
producing more efficient drugs; and
trial testing on animals.

• Gift of Life! Right To Die. U.S.A.,

1968, 16mm, black and white, sound,
15 minutes. This film on medical ethics

MOVING?
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Be sure to notify us six weel^s in advance,
otherwise you will likely miss copies.

>

Attach the Label
From Your Last Issue

OR
Copy Address and Code
Numbers From It Here

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MAILTO:

The Canadian Nurse

50 The Driveway
OTTAWA 4, Canada

covers four types of debisions that in-
volve the question of life or death of a
terminally ill patient and one who is in
need of an organ transplant or emer-
gency treatment. The controversy on
this subject in the medical profession is
described as physicians and a nurse dis-
cuss the occasions when a decision must
be made to revive one patient rather
than another. Q

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 ins-
titutions. Reference items (theses, ar-
chive books and directories, almanacs
and similar 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 Li-
brary, Canadian Nurses' Association,
50, The Driveway, Ottawa 4, Ontario.

No more than ilirce titles should be
requested at any one time.

BOOKS AND DOCUMENTS

1. L'ABC dii BCG; pracliqiic de la vacci-
nalion par Armand Frappier, 3.ed. Montreal
L"Institut de Microbiologie et d'Hygiene de
I'Universite de Montreal, 1969. 45p.

2. L'alcool chez lesjeiines Quetyecois; mo-
deles de consommalion d'alcool chez tin
f>roupe de jeiines par Ezzal Abdel Fattah et
al Public pour Optat. Quebec. Presses de I'U-
niversite Laval. 1970. 102p.

3. Anesthesia, Montreal. Ayerst, Pharma-
ceutical Research Laboratories. 1970. 12 Ip.

4. Annual conference. Proceedings. 1965-
1969. Ottawa. Canadian Library Association.
5v.

5. Countdown: Canadian nursing statistics,

1969. Ottawa. Canadian Nurses' Association,

1970. I61p.

6. Dossiers de cinema, publies sous la di-
rection de Leo Bonneville. Montreal. Edi-
tions Fides, 1968. 15pts. in 1.

7. The dyslexic child by Macdonald Critch-
ley. London, Heineman. cl960. 137p.

8. L'etude et I'emploi du BCG au Canada
par Armand Frappier et Marcel Cantin. revu
et corrige novembre 1969. Montreal. Institut
de Microbiologie et d'Hygiene de L'Univer-
sitede Montreal. 1969. j8p.

9. Hospital career information. Toronto,

THE CANADIAN NURSE 47

accession list

(Continued from page 47)

Ontario Hospital Association, 1970. Iv.

10. Non-hook materials; the organization
of intergrated collections by Jean Riddle et
al. Prel. ed. Ottawa, Canadian Library Asso-
ciation, 1970. 58p.

11. Preliminary 8mm film project report
and listing of 8mm films. Omaha, Nebraska,
Nebraska University, College of Medicine,
Communications Division, 1969. Iv, (loose-
leaf)

12. Readings in development. Ottawa, Ca-
nadian University Service Overseas, 1970.
Iv.

13. Report of Seminar on Mental Health
in Developing Countries, Montreal, 11-13
November 1969. Toronto. Canadian Mental
Health Association, 1970 1 v. (various paging)
Seminar sponsored by World Federation for
Mental Health, Canadian International De-
velopment Agency, the Canadian Interna-
tional Development Agency and the Cana-
dian Mental Health Association.

14. Sources of medical information, edited
by Raphael Alexander. New York, Excep-
tional Books, 1970. 84p.

15. Structure and function in man by Stan-
ley W. Jacob and Clarice Ashworth Fran-
cone. 2d ed. Toronlo. Saunders. 1970. 59 1 p.

16. Structure and function in man, labora-
tory manual by Stanley W Jacob and Cla-
rice Ashworth 2d ed., Toronto. Saunders,
1970. 253p.

17. Tuberculosis and the general hospital.
New York, National Tuberculosis and Res-
piratory Disease Association, 1969. Iv. (var-
ious paging)

18. Tuberculosis eradication: policies and
program guides. New York, National Tu-
berculosis and Respiratory Disease Associa-
tion, 1970.

19. A validation study of the NLN pre-
nursin^ and guidance examination and related
studies emerging from data gathered for the
validation study. New York, National League
for Nursing, Measurement and Evaluation
Services, 1970. 58p.

PAMPHLETS

20. Communicating within the organiza-
tion by Leslie This. Washington, Leadership
Resources Inc., cl966. 28p. (Leadership Re-
sources Inc., Management series no. 2)

2 1 . Delegating and sharing y\orl< by David
S. Brown. Washington. Leadership Resources
Inc., cl966. 23p. (Leadership Resources Inc.,
Management series no. 4)

22. Developing personnel by Everett H.
Bellows. Washington, Leadership Resources
Inc., cl968. 24p. (Leadership Resources Inc.,
Management series no. 6)

23. Guide de morale medicale. 7. ed. Pre-
liminaire. Ottawa, Association des Hopitaux
catholiques du Canada, 1970. 5p.

24. International development and assist-
ance: an aid to study groups. Ottawa, Cana-
dian Institute of International Affairs, 1970.
26p.

25. Let's be practical about a nursing ca-
reer. New York, National League for Nurs-
ing, Dept. of Practical Nursing Programs,
1970. 42p.

26. Managing the changing organization
by Warren H. Schmidt and Gordon L. Lip-
pitt. Washington, Leadership Resources Inc.,
cl968. 24p.( Leadership Resources Inc.. Man-
agement series no. 7)

27. Masters education: route to opportu-
nities in modern nursing. New York, Na-
tional League for Nursing, Dept. of Bacca-
laureate and Higher Degree Programs, 1970.
15p. R

28. Medico-moral guide. 7th ed. Prelimi-
nary. Ottawa, Catholic Hospital Association
of Canada, 1970. 5p.

29. National survey of educational pro-
grammes to be conducted in 1970. Toronto,
Canadian Council on Hospital Accreditation.
1970. lip. R

30. Organizing the enterprise by Thomas
Q. Gilson. Washington. Leadership Resources
Inc., cl966 26p. (Leadership Resources Inc.,
Management series no. 5)

31. Planning for achieving goals by Lowell
H Hattery. Washington, Leadership Resour-
ces Inc., cl966. 24p. (Leadership Resources
Inc., Management series no. 3)

32. Understanding the management func-
tion by David S. Brown. Washington. Leader-

MY VERY OWN

STETHOSCOPE ?

— but of course!

ASSISTOSCOPE* was
designed with the
nurse in mind.

ASSISTOSCOPE* gives
you the acoustical
perfection of the
most expensive
stethoscopes.

ASSISTOSCOPE ^"^ is available with black or
hospital-white tubing and ear pieces with the slim-fit
sonic head which slips easily under blood pressure cuffs
or clothing.

Ordtr fromf

tCheck with your Director
of Nursini or P.A. today
on how you can buy
MSISTOSCOPE at
special group prices.

^■1^ M

WMLEYMORRIS COMPANY LTD.

UlteiCAL INSTRUMENTS DIVISION
MONTREAL 21 aUElEC

•TRADE MARK

48 THE CANADIAN NURSE

There's no waist with
KLING* conform bandages

KLING" Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes in bandaging areas that
are hard to bandage and hard to keep
bandaged.

KLING — the bandage that conformsl

MONTREAL*TORONTO - CANADA

'Trademark of Johnson & Johnson or affiliated companies

AUGUST 1970

accession list

ship Resources Inc., cl966. 28p. (Leadership
Resources Inc.. Management series no.l)

GOVERNMENT DOCUMENTS

Canada

33. Bureau of Statistics. Tuberculosis mor-
bidity and mortality, 1966. Ottawa, Queen's
Printer, 1970. 81 p.

34. Dept. of Labour. Economics and Re-
search Branch. Wages in Canada and the
United Stales; an analytical comparison pre-
pared in the Wages Research Division of the
Economics and Research Branch by Allan
A. Porter and others. Ottawa. 1969. I53p.

35. Dept. of National Health and welfare.
Film library catalogue. Ottawa, Queen's
Printer, 1970. 284p.

36. — Emergency Health Services Division.
Emergency blood Services. Ottawa, Queen's
Printer, 1970. 48p.

37. — Research and Statistics Directorate.
Survey of residential and in-patient treatment
centre for emothionally disturbed children.
Canada, 1968 and Directory of participating
treatment centres. Ottawa, 1970. 370p.
(Health care series no. 24)

38. Ministere de la Sante nationale et du
Bien-etre social. Manuel du consommateur

direction general des aliments et drogues.
Ottawa. Imprimeur de la Reine. 1970. 22p.

39. National Science Library. Union list
of scientific serials in Canadian libraries. 3d
ed. Ottawa. 1969. i066p. (NRC no. 10770) R

South Africa

40. Dept. of Information. Health and heal-
ing; hospital and medical services of South
Africa's developing nations. Pretoria, Gov't
Printer, 1969. 119p.

U.S.A.

41. Dept. of Health. Education and Wel-
fare. Public Health Service. Annotated bib-
liography on inservice training for allied
professionals and non professionals in com-
munity mental health. Washington, U.S.
Gov't. Print. Off. 1969. 3v. (U.S. Public
Health Service Publication no. 1900)

42. Dept. of Health, Education and Wel-
fare public Health Service. Training meth-
odolygy; an annotated bibliography. Wash-
ington U.S. Govt. Print. Off. 1969. 4v.

STUDIES DEPOSITED IN

CNA REPOSITORY COLLECTION

43. Attitude des infirmieres-hygienistes et
perception de leur role, face a I' aide a donner
aux meres au sujet de la planification des
naissances par Lisette Arcand. Montreal,
1968. 73p. (Thesis (M.Nurs.)-Montreal) R

44. Report of refresher programs in nurs-
ing pilot project for metropolitan Toronto
1968 co-sponsored by Ontario Hospital As-

sociation. Ontario Hospital Services Com-
mission and Registered Nurses Association
of Ontario by Margaret L. Peart. Toronto,
1970.101p. R

45. Level of preparation in maternity and
newborn nursing attained by senior nursing
personnel (Supervisors, head nurses and
charge nurses) employed by a sample of Ca-
nadian hospitals in maternity and newborn
services, survey report prepared by Ester Ro-
bertson for Subcommittee on Nursing, Ma-
ternal and Child Health Advisory Committee,
Dept. of National Health and Welfare, May
1969. Ottawa, Queen's Printer, 1970. 18p. R

RED CROSS

IS ALWAYS THERE
WITH YOUR HELP

MEMBER NEEDED FOR

TEST DEVELOPMENT TEAM

Applications are invited from university graduates with
a background in nursing education for a position with
the agency responsible tor the Canadian national nurse
registration examinations.

The successful applicant would assist in the develop-
ment of objective tests, with particular responsibilities
in the area of maternal and child care.

Qualifications: Several years experience in teaching
obstetric and/or pediatric nursing, this experience
to have includea the construction of objective type
examinations as part of student evaluation. Successful
completion of an introductory course in Tests and
Measurement.

Written applications should be addressed to:

Acting Director,
CNA Testing Service,
1867 AltaVista Drive,
Ottawa 8, Canada.

AUGUST 1970

Put your foot down. Insist on
KLING* conform bandages

KLING' Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes in bandaging areas that
are hard to bandage and hard to keep
bandaged.

KLING* — the bandage that conformsl

^tokwrtsnJijokvitrxsn

MONTREAL * TORONTO - CAI^OA

"Trademark of Johnson & Johnson or affiliated companies

THE CANADIAN NURSt 49

classified advertisements

ALBERTA

ALBERTA

MANITOBA

REGISTERED NURSES FOR GENERAL DUTY in 22-

bed hospital immediately for permanent or holiday
duty. Salary — $505.00 to $600.00. Residence avail-
able. Contact: Matron-Administrator. Consort Munic-
ipal Hospital. Consort. Alberta.

REGISTERED NURSES FOR GENERAL DUTY in a

34-bed hospital. Salary 1968, $405-$485. Experien-
ced recognized. Residence available. For particu-
lars contact: Director ot Nursing Service. White-
court General Hospital. Whitecourt. Alberta. Phone;
778-2285

BASSANO GENERAL HOSPITAL REQUIRES NURSES
FOR GENERAL DUTY. Active treatment 30-bed hos-
pital in the ranching area of southern Alberta. Town
on Number 1 Trans-Canada Highway mid-way between
the cities of Calgary and Medicine Hat. Nurses on
staff must be willing and able to take responsibility in
all departments of nursing, with the exception of the
Operating Room. Single rooms available m comforta-
ble residence on hospital grounds at a nominal rate.
Apply to: Mrs. M. Hislop. Administrator and Director
of Nursing, Bassano General Hospital. Bassano. Al-
berta.

GENERAL DUTY NURSES for active, accredited.

well-equipped 65-bed hospital in growing town, pop-
ulation 3.500. Salaries range from $490 — $610 com-
mensurate with experience, other benefits. Nurses'
residence. Excellent personnel policies and work-
ing conditions. New modern wing opened in 1967.
(iood communications to large nearby cities. Apply:
Director of Nursing. Brooks General Hospital. Brooks.
Alberta.

GENERAL DUTY NURSES (2) for small, modern hos-
pital on Highway no. 12. East Central Alberta. Salary

ADVERTISING
RATES

FOR ALL
CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additiorwl line

Rotes for display
advertisements on request

Closing dole for copy and cancellation is
6 weeks prior to 1st day of publication
month.

The Canadian Nurses' Association does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they ore interested
in working.

Address correspondence to:

The

Canadian
Nurse

50 THE DRIVEWAY
OTTAWA 4, ONTARIO.

range $477.50 to $567.50 including regional differen-
tial. Residence available. Personnel policies as per
AARN and AHA. Apply to: Director of Nursing. Co-
ronation Municipal Hospital, Coronation, Alberta.

GENERAL DUTY NURSES for 94-bed General Hospi-
tal located in Alberta's unique Badlands. $405 — $485
per month, approved AARN and AHA personnel poli-
cies. Apply to: Miss M. Hawkes, Director of Nursing,
Drumheller General Hospital, Drumheller, Alberta.

Inquiries are invited from GENERAL DUTY NURSES

for positions in a 330-bed active-treatment and aux-
iliary hospital complex. This is an ideal location in a
city of 27,000 with summer and winter sports facili-
ties nearby. 1970 salary schedules effective May 1,
1970, $490. — $610. Recognition given for previous
experience. For further information, please contact:
Personnel Officer. Red Deer General Hospital. Red
Deer, Alberta.

BRITISH COLUMBIA

HEAD NURSE required tor 30-bed hospital, B.C.

interior. New 41-bed hospital in late planning stage.
Salary and conditions of work in accordance with
RNABC Contract. Excellent accomodation available.
Community based on mining and ranching. Must
have or obtain B.C. registration. Demonstrated lead-
ership ability or capability required. Apply: Director
ot Nurses, Lady Minto Hospital, Box 488, Ashcroft,
B.C.

A HEAD NURSE and STAFF NURSES will be needed
lor Child Psychiatry. The Head Nurse will participate
in the clinical development and subsequent operat-
ion of the 20-bed unit anticipated for the Royal Jubi-
lee Hospital's Eric Martin Institute of Psychiatry. Cur-
rent registration with the Registered Nurses' Asso-
ciation of British Columbia is required. Enquiries
should include background and experience and be
made to the: Director of Nursing. Royal Jubilee Hos-
pital. 1900 Fort Street, Victoria, British Columbia,

NURSES registered in British Columbia with PSY-
CHIATRIC experience are needed for the newly opened
Eric Martin Institute of Psychiatry, When fully opened
this 170-bed facility is anticipated to have a Day Hos-
pital. 6 Acute Adult Psychiatric Units and a 20-bed
Children's Unit. Attractive salary scale and liberal
personnel policies. Apply to the: Director of Nursing,
Royal Jubilee Hospital. 1900 Fort Street. Victoria.
British Columbia.

REGISTERED NURSES FOR GENERAL STAFF requi-
red by TRAIL REGIONAL HOSPITAL. Trail has a
238-bed fully accredited regional referral hospital si-
tuated in the Columbia River Valley of southeastern
British Columbia. Salary $549 rising to $684. 38 3/4
hour week. Apply to: Director of Nursing. Trail Re-
gional Hospita, Trail, B.C.

GENERAL DUTY NURSES for modern 33-bed hospital
located on the Alaska Highway Salary and personnel
policies in accordance with RNABC. Accommodation
available in residence. Apply to: Director of Nursing,
General Hospital, Fort Nelson, B,C.

GENERAL DUTY NURSES for modern 3S-bed hospital
located in excellent recreational area. Salary and per-
sonnel policies in accordance with RNABC. Comfor-
table Nurses' home. Apply: Director of Nursing, Boun-
dary Hospita, Grand Forks, British Columbia.

OPERATING ROOM NURSES for modern 4S0-bed hos-
pital with School of Nursing. RNABC policies in ef-
fect. Credit for past experience and postgraduate
training. British Columbia registration is required.
For particulars write to: The Associate Director ot
Nursing, Sl.Joseph's Hospital, Victoria. British Co-
lumbia.

MANITOBA

REGISTERED NURSES required for 68-bed hospital,
modern, well-equipped. Starting salary $480-Septem-
ber $510. Residence accommodation available. Apply
to: Administrator, Ste. Rose General Hospital, Ste,
Rose du Lac, Manitoba.

GENERAL DUTY NURSES: Applications are invited
from REGISTERED NURSES for a 100-bed accredited
hospital fifty miles west of Winnipeg on Trans Canad:
Highway. Salary range $480/565 per month increasing
to $510/595 per month effective September 1st, 1970.
Excellent fringe benefits plus evening and night dif-
ferentials and academic attainment bonuses. Applica-
tions will be received by Director of Nursing, Portage
District General Hospital, Portage la Prairie, Manitoba.

NEWFOUNDLAND

WANTED: PUBLIC HEALTH NURSES (2) to work with
The Medical Services Division of the IJnited Church
of Canada, to cover coastal villages of the Bale Verte
peninsula on the north coast of Newfoundland. Please
contact: Dr. DP. Black. Superintendent, The United
Church Hospital, Bale Verte, Newfoundland.

NOVA SCOTIA

REGISTERED NURSES: Applications are invited from
Registered Nurses trained in psychiatry for the posi-
tion of DIRECTOR OF NURSING at the Halifax Coun-
ty Hospital, a 425-bed psychiatric hospital. Good
salary, working conditions and fringe benefits. Please
address applications to: Administrator, P.O. Box
1003, Halifax County Hospital, Dartmouth, N.S.

GENERAL DUTY NURSES applications are invited
for active treatment hospital caring for medium and
long term patients. Salary Range: $5,400, — $6,660.
Excellent Fringe benefits and working conditions.
Please apply to: Director of Nursing. Halifax Civic
Hospital. 5938 University Avenue, Halifax, N.S.

ONTARIO

50 THE CANADIAN NURSE

SUPERVISOR OF PUBLIC HEALTH NURSING, qual-
ified, required for Huron County Health Unit. Gen-
eralized public health nursing service with new pro-
grams being developed. Excellent working condi-
tions, salary minimum $9,000 per annum negotiable
on basis of experience. Main office in Goderich, a
pleasant town situated on Lake Huron. Vacancy im-
mediately. Applications should be directed to: Or. G.
P. A. Evans, Director and Medical Officer of Health,
Court House, Goderich, Ontario.

REGISTERED NURSES for 34-bed General Hospital.
Salary $525. per month to $625 plus experience al-
lowance. Residence accommodation available. Ex-
cellent personnel policies. Apply to: Superintendent,
Englehart & District Hospital Inc., Englehart, Ontario.

REGISTERED NURSES needed for 81-bed General
Hospital in bilingual community of Northern Ontario.
French language on asset, but not compulsory. Start-
ing salary $530. monthly with allowance for past ex-
perience, 4 weeks vacation after 1 year and 18 sick
leave days. Unused sick leave days paid at 100% eve-
ry year. Master rotation in effect. Rooming accom-
modation available in town. Excellent personnel pol-
icies. Apply to: Personnel Director, Notre-Dame Hos-
pital, P.O. Box 850, Hearst, Ont.

REGISTERED NURSES required for a 12-bed Inten-
sive Care-Coronary Care combined Unit. Post basic
preparation and/or suitable experience essential.
1970 salary range $535-645: generous fringe benefits.
Apply to: Director of Nursing, St. Mary s General Hos-
pital, 911B Queen's Blvd.. Kitchener, Ontario.

REGISTERED NURSES. Applications and enquiries
are invited for general duty positions on the staff of
the Manitouwadge General Hospital. Excellent salary
and fringe benefits. Liberal policies regarding ac-
commodation and vacation. Modern well-equipped
33-bed hospital in new mining town, about 250-mi.
east of Port Arthur and north-west of White River,
Ontario. Pop. 3.500. Nurses' residence comprises
individual self-contained apts. Apply, stating quali-
fications, experience, age, marital status, phone num-
ber, etc. to the Administrator, General Hospital, Ma-
nitouwadge. Ontario. Phone: 826-3251.

AUGUST 1970

September 1970

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Nurse

television brings nurse
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helps with problems

coffee break
answers questions

changing horizons

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THE CLINIC SHOEMAKERS • Dept. CN-9 7912 Bonhomme Ave. * St. Louis, Mo. 63105
2 THE CANADIAN NURSE SEPTEMBER 19701

The

Canadian
Nurse

A monthly journal for the nurses of Canada published

in English and French editions by the Canadian Nurses' Association

Volume 66, Number 9

September 1970

33 Maritimers Have a TV Nurse M.C. Ricks

37 Preventing Hearing Loss in Industry V. Hamilton

41 "Distress Center — May I Help You?' D.S. Starr

44 Discrimination — That's What I Call It! K.G. Roberts

46 Drug Misuse in Teenagers D. Lloyd

52 Idea Exchange

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

22 Names

26 New Products

56 Research Abstracts

60 Accession List

9 News

24 Dates

30 In a Capsule

57 Books

80 Official Directory

Editorial

Executive Director: Helen K. Mussallem • Ed-
itor: Virgiiiia A. Lindabury • Assistant Ed-
itor: Mona C. Ricks • Production Assist-
ant: Elizabeth A. Stanton • Circulation Man-
ager: Beryl Darling • Advertising Manager:
Roth H. Baiunel • 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-
ciation, where applicable. Not responsible for
journals lost in mail due to errors In address.

Manuscript Information: "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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
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. Permit No. 10,001.
50 The Driveway, Ottawa 4, Ontario.
© Canadian Nurses' Association 1970.

SEPTEMBER 1970

Canadian Press stories out of Toronto
during July, told of a wage disparity
in Ontario hospitals affecting reg-
istered nursing assistants. (See News,
page 9.)

Ihis category of worker, CP said,
is paid less than a male orderly, even
though her duties and educational
requirements demand more.

A court order, granting female
nursing aides at Toronto's Greenacres
Home for the Aged equal pay with
male orderlies, was cited as an attemp
to "broaden the interpretation of the
Ontario [equal pay] act."

What the stories failed to make clea
was that the court's application of the
Ontario labor statutory law at Green-
acres exposed the wage disparity.

Male orderlies in some Ontario
hospitals were on a higher wage scale
than nursing assistants prior to the
court order. By raising the wage level
of the nursing aide to that of the male
orderly, the anomaly was revealed.

The crux of the situation seems to
be the interpretation of the word
similar. Which in this case does not
mean identical.

According to an official of the
Ontario department of labor, job com-
parisons, under the province's equal
pay act, are made between jobs that ai
similar. Perhaps this is a clue for
nursing assistants when they begin to
bargain.

But, then, the department would asl
"Which hospital position do these
nurses claim as similar?"

Apparently the answer is none!

It seems some of the male orderly
duties are similar to those of the
nursing assistant — but not all!

What tops the argument is, the basi
educational and training requirements
for both positions differ widely. The
registered nursing assistant is way
ahead.

Perhaps this is where AI Hearn,
second vice-president of the Service
Employees International Union, and
M.E. Howard, director of the Ontario
employment standards branch, should
get together and spell out the interpn
tation of similar, as it applies to
hospital workers (professional and
service personnel).

A solution to the impasse might be
— take a looksee at the wage ladder
for all hospital personnel. By increasin
salaries at the top, leaway could be
given to lower paid groups —
including theccgistered nursing
assistant. — M.C.R.

THE CANADIAN 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.

Comment on poverty brief

It seems fitting to comment on the re-
port of the Canadian Nurses' Associa-
tion's brief to the Special Senate Com-
mittee on Poverty, in the July issue of
The Canadian Nurse. Congratulations
are in order to our association on the
preparation of this brief and particularly
to Trenna Hunter and her committee
who prepared a document of such high
caliber. The document presents the
nurse's role in undermining poverty in
Canada in a strong, straight-forward
manner. Its challenge is directed to
community health agencies in partic-
ular. The active nurse has a contribution
to make in her professional role, and the
inactive nurse has a contribution to
make as a citizen. From my observa-
tions, public health nurses have given
leadership in their communities and
have expressed their citizenship in many
ways, as active members of home and
school associations, or local councils
of women ratepayers associations. In
this way, they have been producers of
change.

I would urge nurses interested in this
problem to read the full report which
is available on loan from the Canadian
Nurses' Association library. The ten
recommendations now remain to be
implemented. — Isabel Black, Princi-
pal Nursing Consultant, Department of
Health, Toronto, Ontario.

Lack of nursing leadership

As a registered nurse in Ontario, I am
disgusted about the lack of nursing
leadership, that is, outspoken comment,
about hospital administration and
provincial government interference.

Every nurse should read the editorial
in the May issue of the American
Journal of Nursin^^. As the editorial
indicates, the credibility gap in nursing
is becoming disastrous. Staff nurses are
being shunted around, some as much as
six times a month. There are no public
outcries from our provincial associa-
tions unless collective bargaining is
involved. Moreover, the plan to reduce
nursing programs to two years is
ludicrous.

The dichotomy between diploma and
degree programs in the United States
has caused a civil war in nursing. Who
4 THE CANADIAN NURSE

is going to have the practical skills to
train these two-year nurses in any
specialty? Certainly not our degree
graduates, who now receive very little
practical experience.

Is it any wonder staff nurses are
examining their consciences about
continuing in a profession that has
no association to support them and no
leaders to speak for them? The leaders
in nursing seem intent on keeping their
own jobs by siding with government
attempts to cut the budget and obtain
a $3 million surplus.

Why doesn't The Canadian Nurse.
for example, sponsor a panel discussion
with some of our hospital consultants?
Are these people at all in touch with
nursing care?

I remember such articles as the one
on individualized nursing care ("Nurse,
Please Show Me That You Care!" Feb.
1970). Could the author of such an
article be aware of the nursing shortage
in some hospitals where there is one
nurse for fourteen patients? Does the
author know that in some so-called
specialty units, the patients aren't even
constantly observed by staff?

We will never attract young, intelli-
gent nurses to join any nursing asso-
ciation that continues to issue pro-
nouncements such as the Canadian
Nurses' Association's comment that
poverty causes ill health, which is surely
the picayune understatement of the
year. — R.N., Toronto, Ontario.

Permanent shifts

I was astonished to read the article by
Helen Saunders "Let's Have Permanent
Shifts" (June '70). In all the hospitals
I have worked in, the majority of nurses
prefer the day shift, but obviously,
everyone can't work this shift perma-
nently.

The article suggests that married
nurses should be able to work the shift
most convenient for babysitting ar-
rangements. I think the majority of these
nurses are on shifts best suited to their
family situation anyway, and usually
on a part-time basis.

Most hospitals are staffed with
young, unmarried nurses who would
prefer the day shift. I would refuse to
work in a hospital whose administration
told me that the only shift open was
evenings or nights. The waiting list for
permanent day duty would be endless.

The author of the article also suggests
that permanent shifts would benefit
patients. Does she not realize that per-
manent shift nurses have days off and
might find a change in patient assign-
ment on their return? Often a patient
and his nurse have a personality clash,
and it would be upsetting for him to
see this same nurse continually.

Permanent shifts sound good in the-
ory, but in all fairness to those doing
active bedside nursing, I don't believe
they would be practical. — Irene Hodg-
son, Reg. N., Sarnia, Ontario.

I was happy to read the article by Helen
Saunders, "Let's Have Permanent
Shifts" (June, '70). Having left general
duty nursing four years ago because of
weekly rotation, I have strong feelings
about permanent shifts.

I am now in charge of an 80-bed
special care home for the aged with a
small registered nurse staff. All my
nurses' aides are on a permanent shift
basis, and this has been successful.
There is little staff turnover because
personnel work the shift best suited to
their home and social situation, and the
patients benefit from a happy and satis-
fied staff. This plan could be used for
professional nurses in hospitals. — E.
Sanders, Reg. N., North Battleford,
Saskatchewan.

Part-time nurse disillusioned

I have thought of writing this letter for
a long time, and I wonder if there are
other nurses in my position who share
my anger and disillusionment.

I married just before graduating from
the Royal Victoria Hospital in Mon-
treal and worked as a staff nurse in sev-
eral hospitals until my son was born.
A year later I returned to nursing on a
part-time basis in one of Montreal's
large hospitals.

Working for one day a week, I am
placed on different wards, but my duties
are always the same. I am assigned tasks
that could easily be done by a nursing
assistant. The excellent training I have
is never called upon; my duties are re-
petitive, manual, and boring.

Why does a hospital employ a reg-
istered nurse if it doesn't make use of
her skills? Part-time nurses are left out
and ignored, and although staff nurses
are pleasant and polite, they exclude
SEPTEMBER 1970

Books for Inservice Training Programs

To help you prepare nurse's aides

by explaining basic nursing procedures

Jodais

Personal Care of Patients i

Here is an excellent basic text and reference that stresses the
"why" as well as the "how" of patient care. Special emphasis is
placed on how to work with people, on observation and reporting
as part of a team and on adaptation of skills for work in hospitals,
clinics, health agencies or nursing homes. You'll find valuable
information on; Personal care procedures ; observation proce-
dures : simple treatments ; care of the family ; conditions and
diseases. All are given in a well-written easy-to-read style.
Relevant anatomy and physiology are introduced where necessary
for comprehension of the procedures under discussion. Numerous
illustrations help familiarize the student with equipment she will
use.

By Janet Jodais. R.N., B.S.. M.S.. Coordinator, t^Jurses' Aide Training, Colorado
Associated Nursing Homes 292 pages. 206 Illustrations. Soft cover. $4.90 May
1970.

Mayes

Abdallah's Nurses Aide Study Manual

The Second Edition of this widely used handbook for nurse's
aides has been considerably expanded, with many new topics
added. Designed for use with inservice training programs, it is
equally valuable for individual use as a review guide. It starts with
the necessary orientation to the hospital and a summary of human
anatomy ; then it describes virtually every hospital procedure an
aide might be called upon to perform. This edition also covers
advanced procedures that aides sometime perform under super-
vision, such as tractieostomy care, cattieterization, and oxygen
therapy.

By Mary E. Mayes. R.N.. Si^pervislng Nurse. Emergency Room. Ventura County
General Hospital, Ventura, California. 239 pages. Illustrated, soft cover. $4.30.
Just ready.

I

f

Leake

Manual of Simple

Nursing Procedures

Explains basic procedures in
daily patient care.

By Mary J. Leake. 192 pages, illustrated.
S3. 55 Fourth Edition. January 1966.

Anderson's
Programmed Texts

mmtmm^m^^^A. Basic
Patient Care

step-by-step presentation of
nursing fundamentals for the
first half of the standard basic
nursing course.

By Maja 0. Anderson. B.A., M.N. 234
pages, illustrated. Soft cover. $4 60.
February 1965.

■■iHH2. Basic Nursing
Techniques

Introduces more advanced topics
and further procedures in patient
care for the second half of the
basic nursing course.
By Maja C. Anderson

pages, illustrated
Marcti 1968.

B.A . M.N. 305
Soft cover. $5.15.

norland's Pocket Medical Dictionary

699 pages, 16 pages of plates in full color Thumb indexed. $6 75 21st Ed.. April 1968.

W. B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7

Please send me the following books

Zone

SEPTEMBER 1970

Province

CN9-70

THE CANADIAN NURSE 5

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THE CANADIAN NURSE

(continued from puf>c 4)
the part-time nurse from duties that
would test her knowledge or judgement.
I have often wanted to get involved in
decision-making and the planning of
patient care, but when 1 offer sugges-
tions or another perspective on how
things might be done, I am not treated
as part of the team and, having little
status, I am politely ignored.

Could this be part of the reason why
married nurses prefer to stay at home,
rather than seek work? Have they felt
as lonely and left-out as 1 have? Each
week I hope for greater involvement
and for greater demands being made of
me, but 1 wonder if 1 will ever feel use-
ful and challenged again.

Although my main function is that
of homemakcr and mother, I am still a
well-qualified registered nurse. Why
can't hospitals utilize their part-time
RNs more effectively? Then, at the end
of the day, we might feel more produc-
tive and less like manual laborers. —
R.N., Quebec.

Visitors express appreciation

In the fall semester of 1969 I corre-
sponded with the directors of integrated
baccalaureate nursing programs in Can-
ada, and during the past January and
early February I had the opportunity
to visit 1 5 of the schools to learn more
about their programs.

I wish to acknowledge through The
Canadian Nurse, my appreciation for
the way in which I was received at each
of these Canadian universities. The
many personal courtesies extended to
me by directors and faculty remain in
my memory of you as a truly gracious
people.

Even though I have expressed my
gratitude along the way, I salute each
of you for the professional leadership
you have given and continue to give in
your country and ultimately to all
nurses. — Sister Mary Beata Buaman,
Dean, School of Nursing, University
of San Francisco, California.

I was delighted to receive a copy of the
June issue of The Canadian Nurse. The
editorial on doctor-assistants and var-
ious other articles were almost follow-
up information on subjects I had dis-
cussed with nurses while in Canada.

I have requested that our department
of health arrange for me to receive
The Canadian Nurse regularly. —
Winnifred M. Ride. Melbourne,
Australia. D

SEPTEMBER 1970

We want

of

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-
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.
Write: The Director
of Recruiting and
Selection, Canadian
Forces Headquarters,
Ottawa 4, Ontario.

^ ^

kind

^■■t'-i.t

THE CAIMADIAIM ARMED FORCES ^

SEPTEMBER 1970

VB2102A

THE CANADIAN NURSE

'"»*nr?r?i

Johnson & Johnson's newly developed SURGINE Face
Mask — six years in the designing — is so extra-
ordinarily comfortable you'll be almost as unaware of
it as you are of your own skin.

The fact that the SURGINE mask fits so well is part of the
reason it does such a superior job of bacterial filtration.
Cheek and chin leaks are eliminated. But the main

reason for SURGINE's efficiency is a new, specially
developed filter medium. In vivo tests show an extra-
ordinary average filtration efficiency of 97% .
For free samples of the new SURGINE Face Mask, con-
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•Trademark of Johnson & Johnson or affiliated companies.

SURGINE

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MONTREAL4TORONTO- CANADA

8 THE CANADIAN NURSE

SEPTEMBER 1970

news

Salary Levels Of

Ontario Hospital Workers

Under Fire

Ottawa — Application of the Ontario
equal pay act in a recent Toronto court
case has disclosed wage differences be-
tween two groups of hospital workers
in the province.

Registered nursing assistants are paid
an average of $50 a month less than
male orderlies, whose job requires less
training and responsibility.

Al Hearn, second vice-president of
the Service Employees International
Union, said his understanding of the
problem was mainly a lack of organized
bargaining.

Disclaiming a Canadian Press story
which quoted him as exhorting nurses
to, "get out and fight for higher wages,"
Mr. Hearn said, "Nurses should col-
lectively bargain through their provin-
cial registered nurses associations,
similarly to what is being done by bar-
gaining units in some provincial hos-
pitals in Ontario."

The wage situation was brought to
light following a court order which
granted female nursing aides at Toron-
to's Greenacres Home for the Aged
equal pay with male orderlies. Grounds
for the decision were based on require-
ments for both jobs involving the same
skill, effort, and responsibility, even
though not identical. The equal pay
increase brought female nursing aides
above the registered nursing assistants.

Speaking for workers in about 80 of
the provinces unionized hospitals, Al
Hearn said the SEIU is working hard
to eliminate wage disparities. He was
concerned that wages of registered
nurses, the highest paid female hospital
employee, remained low, eliminating
the possibility of raising workers on
lower rungs of the wage scale.

By asking hospitals to increase sala-
ries of registered nursing assistants, to
at least the same level as male orderlies,
SEPTEMBER 1970

we invite an argument from hospitals,"
said Mr. Hearn.

According to the union official, hos-
pitals say they can hire a registered
nurse for the same price as a male or-
derly. (The minimum salary for be-
ginning R.N.s is often within the range
of the maximum salary for an orderly.)

Duties of the nursing assistant and
the male orderly differ in responsibility,
educational requirements, and training.

The nursing assistant takes a 35 week
course approved by the College of
Nurses, and in Ontario is required to
have a minimum grade 10 education.
An orderly is trained on the job, and
must have a minimum grade 9.

Bedside care, involving lifting and
clothing patients is part of each job, but
the duties of the registered nursing as-
sistant call for more nursing skills, such
as changing dressings and reporting
observations to the RN regarding a
change in the patient's condition.

As Ontario's equal pay for equal work
act requires job comparisons to be based
on similar work, the registered nursing
assistant is in a dilemma, says John
Scott, an administrator in the provincial
employment standards branch.

Since the two jobs are only partially
similar, and there is no other hospital
position with which to make a compar-
ison, little can be done under the act to
regulate the pay inequality.

The CP story cites M.E. Howard,
director of the Ontario employment
standards branch, as saying " . . .there
is no legal way the province can force
the hospitals to give this group of wom-
en workers equal pay."

Although Mr. Howard was not avail-
able when The Canadian Nurse con-
tacted his office, an official said it was
quite true — until a similar job compar-
ison can be made, the registered nursing
assistant wage disparity would remain
unsolved.

NBARN Bargaining Council
Acts For Hospital Nurses

Fredericton — Approximately 2,300
nurses employed in New Brunswick
public hospitals now have the right to
negotiate wage demands and working
conditions. They have decided to fight
for employment changes through the
NBARN Provincial Collective Bargain-
ing Council.

The council applied for certification
to the Public Service Labor Relations
Board last February and was accepted
as the nurses' official agent in June.
Certification came after agreement on
the exclusion of 85 persons employed
in managerial and confidential positions
— directors of nursing and associate
directors of nursing.

Notice to bargain for the hospital
nurses' 1 970 contract was served to the
provincial treasury board June 25. Both
parties met for the first time at the bar-
gaining table on August 1 1 . At press
time. The Canadian Nurse had not re-
ceived notification of any progress;
but the discussions were expected to
cover several areas of work conditions.

The NBARN Provincial Collective
Bargaining Council won the right to
represent another group of nurses last
May. Contract proposals to be worked
out for these 150 nurses, employed in
civil service positions, were presented
to the provincial treasury board July 9.
A representative of NBARN reported
that a second meeting, scheduled for
July 3 1 , would bring out the board's
counter-proposals. Results from this
meeting had not been released at press
time.

In a CBC labor talk last July, Dick
Wilbur of Halifax, Nova Scotia, aired
his views on the New Brunswick labor
situation, citing nurses in that province
as an example of new-found bargaining
freedom.

His opening comments depicted the
apparent tranquil laoor scene in New
THE CANADIAN NURSE 9

news

Brunswick as " a serious and at times an
angry struggle," and compared it witii
the national postal tug-of-war. "All
that's lacking," he complained of the
New Brunswick labor situation, "is the
publicity."

"Throughout New Brunswick's grow-
ing army of public employees, an all-
out effort is being made to win the right
to bargain for various groups."

He referred to the New Brunswick
nurses as in an advanced stage of nego-
tiations with the provincial treasury
board. But did not state what the nurses
were seeking in new contracts.

New Brunswick nurses won Mr. Wil-
bur's admiration for stepping out on
their own and appointing the NBARN
Provincial Collective Bargaining Coun-
cil as their certified bargaining agent.
He "heartily endorsed" the nurses' ac-
tion. "It indicates that at long last nurses
are determined to improve their own
lot themselves — to fight doctors and
hospital administrators for decent work-
ing conditions in keeping with their
professional status."

Expressing his disapproval of oppo-
sition from the combined forces of hos-
pital administrators and provincial
treasury board officials, Mr. Wilbur
said the nurses face an "even greater
hurdle." He referred to a "mental rigid-
ity, almost a knowledge vacuum, on
the part of management and most gov-
ernment negotiators."

Slamming the government of Premier
Louis Robichaud for not adhering to a
"much heralded equal opportunity slo-
gan," Mr. Wilbur compared wages of
liquor store warehousemen with a temp-
orary consultant for the provincial wel-
fare department. He cited the consult-
ant's wage as $120 a day and the top
wage for warehousemen as $330. a
month.

According to Dick Wilbur, it will be
many years before the salary gap among
government employees in New Bruns-
wick is narrowed.

The labor-scene broadcaster did
hand Premier Robichaud one bouquet
— "the government took one giant step
10 THE CANADIAN NURSE

Two well-known nurses in Prince Edward Island were given honorary membership in
the provincial association during the 49th annual meeting of the ANPEI. (Lcfi to
right) Mary Bradshaw read the citation honoring Fidessa Reeves 23 years as staff nurse
and supervisor at the Prince County Hospital. Summerside. Katharine MacLennan.
director of nursing at the provincial sanatorium, and psychiatric nursing at Hillsbo-
rough Hospital was introduced by Laura Kitchen.

forward when it passed its Labor Rela-
tions Act." But he took some of the
glorified perfume from the bouquet
when he added, "... in the meantime,
the government side of the bargaining
table, composed mostly of well-paid
lawyers with little experience in collec-
tive bargaining, is learning what labor
relations are all about."

Study Issues, ANPEI President
Asks Members

Charlottetown, P.E.I. — Nurses attend-
ing the 49th annual meeting of the
Association of Nurses of Prince Edward
Island, last May, were asked by Presi-
dent Bernice Rowland to form their
own opinions on news items.

Miss Rowland spoke to the 118
nurses and 55 student nurses on a one-
word theme Contradictions. "With the
apparent contradictory statements being
issued regarding news items, it is essen-
tial for people to study thoughtfully
issues in any organization... to reach the
goals set by the particular group," she
said.

In a report to the general member-
ship, executive secretary, Helen C.
Bolger, spoke of the progressive edu-

cational program planned by the direc-
tor and faculty of the new Prince Ed-
ward Island School of Nursing. She
expressed concern that many qualified
candidates for schools of nursing cannot
be accommodated on the island.

"The new school admits about the
same number of students as the three
island schools combined... but still
many young aspirants are turned away.
We are hopeful that facilities will be
made available in the near future to
meet the needs of young people on the
island in the educational field of their
choice," she said.

Associate Executive Director of the
Canadian Nurses' Association, Lillian
E. Pettigrew, spoke at a luncheon meet-
ing on the philosophy and role of a pro-
fessional association.

"By public acclaim and by the efforts
of practitioners, nursing has become a
profession in modern society," Miss
Pettigrew told her audience.

The eternal thrust of the nursing
association must be toward "improved
competence in the delivery of nursing
care," she said.

Miss Pettigrew said her concept of
the word profession is anchored to the

(continiu'cl on piif^c 12)

SEPTEMBER 1970

t:t»i

ahead
soften

With

dermassage,
you'll rub
every
patient the
right way.

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 ^y^^^
your patients against linens, >J£k
helping to prevent sheet
burns and irritation.

Just think of the
welcome comfort a
Dermassage rub can be f*-"^"
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.

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'Trade mark

news

(Continued from page 10)

exercised by the professional person
cannot be standardized, she said, and
cannot be regulated effectively by an
authority outside of the person. To this
comment she added,"... herein lies the
word judgment. The kind of judgment

ultimate responsibility of the real pro-
fessional."

Two well-known nurses on the island
were presented with honorary member-
ships. Katherine MacLennan is direc-
tor of nursing at the provincial sanato-
rium, and nursing education m' psy-
chiatric nursing at Hillsborough Hospi-
tal. Fidessa Reeves has served as staff
nurse and supervisor for 23 years at the
Prince County Hospital, Summerside.

Two of the principal resolutions

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a

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12 THE CANADIAN NURSE

presented by Margaret Aiken, chairman
of the committee on resolutions, present-
ed the members" feelings on psychia-
tric nursing.

The first asked that, "Psychiatric
nursing be included as an area of in-
struction and experience for all students
of nursing, effective September 1970."
The second covered registration exami-
nations asking that, "Psychiatric nursing
be a required registration examination
for all candidates, ...effective January 1
1972".

Another resolution supported the
Canadian Nurses" Foundation by a
voluntary donation of one dollar for
each member annually; and others ask-
ed that new members of the ANPEI
council be given orientation sessions
on the functions and activities of the
association; that emphasis is given to
improving communication between the
provincial association and district
branches; that new members from other
provinces are welcomed to the P.E.I,
association by nurses in the community
and invited to meetings; and that dis-
trict presidents be invited to council
meetings as observers.

New officers were announced:
Constance Corbett, president; Ella
MacLeod, president-elect; Beth Robin-
son, vice-president, and Flora Dick-
inson, Sylvia Mulligan, Mary Graham,
Marion Chapman, and Norma Bow-
ness, council members.

British RCN Requests
Review Of Abortion Act

The new abortion act in Britain is caus-
ing nurses concern. They charge the
increase in abortions in some British
hospital has added pressure to an al-
ready short-staffed nursing service and
has delayed admitting seriously ill
patients needing immediate treatment.

According to a recent news release
from the Royal College of Nursing in
London, the added work pressure has
had "adverse effect on staff morale."

In a letter to Sir Keith Joseph, secre-
tary of state for social services, the RCN
made an urgent request for a "review
of the workings of the abortion act, and,
in particular, the manner in which it is
being interpreted."

The release states British nurses have
expressed unhappiness about the in-

SEPTEMBER 1970

crease in abortions carried out in some
hospitals.

General secretary of the RCN, Cath-
erine M. Hall, stated that"... if this
situation continues it could have an
effect not only on the willingness of
nurses to take appointments in operating
theatres where large numbers of abor-
tions are performed and in gynecolo-
gical wards in which these patients are
nursed, but in the long term recruitment
to the nursing profession."

Serious concern for the interpreta-
tion of the abortion act, which was ef-
fective in 1968, was shown by the RCN
a year ago, when a representative body
carried a resolution calling for an en-
quiry. Action was deferred because facts
and figures supporting the RCN beliefs
were not available. Consultation with
the British Medical Association and
findings of an enquiry by the Royal
College of Obstetricians and Gynecol-
ogists, later supported the RCN cause.

The release states that the RCN
would support a nurse who decides to
"opt out" of nursing duties authorized
by the act to which she has a conscien-
tious objection.

But the RCN made it quite clear that
this support would only be given if the
nurse acted "responsibly and gave ade-
quate notice to her matron, so that other
arrangements could be made for staf-
fing the operating theaters."

A conscience clause in the act frees
a person from any duty to participate
in treatment authorized by the act to
which he has a conscientious objection.
But as a safeguard for the public, the
clause cannot relieve a person from
"any duty to participate in treatment
which is necessary to save life or to pre-
vent grave permanent injury to the phy-
sical or mental health of a pregnant
woman."

Alluding to publicity given to the
actions of theater nurses in one hospi-
tal, the release states it would "be wrong
to think that the actions of these nurses
represent an isolated situation." An
explanation of the nurses' action is not
given, but an extract from the RCN
letter to the secretary of state for social
SEPTEMBER 1970

services, gives some enlightment: "The
findings of the Royal College of Obste-
tricians and Gynaecologists bear out
the growing unhappiness of nurses
about the extent to which abortions are
being carried out in some places."

Reaction by the British government
to the RCN letter is not stated in the
release.

Lack Of Health Manpower Acute
In Developing Countries

Geneva, Switzerland — Delegates from
a number of African countries speaking
last May at the 23rd World Health As-
sembly, commented on a common
chronic shortage of health personnel.

The representative from Rwanda
spoke of the need to adapt all health
plans and educational programs to the
particular problems of these countries
concerned. Rwanda, with a population
of 3.5 million, had only 20 native born
physicians educated in the country by
1969.

The Cameroon delegate stressed his
government's desire to discard old-fash-
ioned university programs that are
unsuited to developing countries and
to Africa in particular; where general
practitioners and a form of health serv-
ices are needed, if they are to meet the
growing demand for them. African
doctors should be trained in Africa, the
speaker said.

The delegate from Malawi pointed
out the serious medical manpower
shortage in his country, which is en-
tirely agricultural. For a population of
over 4 million, there is only one doctor
for 58,000 people.

Expensive medical treatment absorbs
a large part of Gabon's available means,
profiting only a limited number of peo-
ple, to the disadvantage of preventive
services that benefit the majority of the
population, said the Gabon delegate.
He listed the first needs as research on
questions of fertility, health education,
and teaching elementary medicine with-
in the framework of maternal and child
health. Later it would be necessary to
strike a balance between preventive and
curative medicine, he added.

According to the speaker, preventive
medicine should be equipped to deal
with endemic diseases such as malaria,
parasitic diseases, tuberculosis, and
leprosy.

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k^--

THE CANADIAN NURSE 13

a show of hands.

'^j/"

proves its smoothness

NEW FORMULA ALCOJEL, with
added lubricant and emollient, will
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or yours!

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14 THE CANADIAN NURSE

(Continued from page U)

The delegate for Chad pointed out
the severe lack of qualified health work-
ers in his country: 60 physicians for a
population of 4 million. Of these 60,
three were native born, he said.

Federal Team Studies
Nursing In The North

Ottawa — A study of the clinical train-
ing needs for nurses in the North is
underway.

Two teams of medical and nursing
experts flew north July 29, announced
national health and welfare minister,
John Munro. The doctor-nurse teams
examined problems which occur when
nurses have to take on responsibilities
ordinarily borne by doctors.

According to a departmental news
release, the teams will act as an advi-
sory committee, to design a clinical pro-
gram for departmental nurses working
with Indians and Eskimos in isolated
areas of Canada. The group will "pre-
pare a report and recommendations for
establishing a new kind of formal train-
ing program to qualify nurses in certain
kinds of clinical work to meet the med-
ical needs of their communities."

The department is responsible for
144 nursing positions and 194 health
positions at stations scattered through-
out the North and in the Territories.

Dr. Dorothy J. Kergin, director of
McMaster University's school of nurs-
ing, and chairman of the Canadian
Nurses' Association ad hoc committee;
Anne Wieler, department of national
health and welfare; Dr. K. O. Wylie,
University of Manitoba; and Dr. W.D.
Dauphinee, Royal Victoria Hospital,
Montreal, visited northern Manitoba
stations, going into areas such as Nor-
way House and Nelson House, and the
Territories.

The other team toured northern Que-
bec communities, going also into Cape
Dorset and Frobisher Bay. In this team
were : Huguette Labelle, director, Va-
nier School of Nursing and 2nd vice-
president of the CNA; Pauline Laurier,
department of national health and wel-
fare; Dr. Fernand Hould, Laval Uni-
SEPTEMBER 1970

versity, Quebec; and Dr. James J.
Wiley, University of Ottawa.

Final report of the committee's find-
ings and recommendations is expected
to be submitted to the minister by the
end of October.

Federal Grant Aids
Nursing Practice Research

Ottawa — Financial support by the
federal government will aid a national
conference on research in nursing prac-
tice.

Announcement of the $4,700 grant
to the University of British Columbia
was approved by national health and
welfare minister, John Munro, last July.

Tentative dates for the conference,
to be held in Ottawa, have been set as
February 16-18, 1971. Project director
will be Dr. Floris E. King, associate
professor and coordinator of the grad-
uate program at the school of nursing.
University of British Columbia.

Goals for the meeting are the estab-
lishment of a coordinated program of

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studies, and improved channels of com-
munication to provide new and bettei
use of nursing manpower.

St. John's Bursaries
Awarded To Nurses

Ottawa — Fourteen 1970 nursing

awards from two St. John Ambulance

Bursaries were announced recently by

national headquarters.

Established 10 years ago in memory

of Lady Mountbatten, Superintendent-

in-Chief of the Commonwealth St. John

Ambulance Brigade, 1941-1960, the

Countess of Mountbatten Bursary Fund

granted awards to finance post-basic,

student, and continuing aid for nursing

studies.

The memory of Margaret MacLaren.
Superintendent-in-Chief, St. John Am-
bulance Brigade in Canada, 1 946- 1 963,
is honored in a bursary fund established
under her name in 1964. Two awards
for master's degrees were made from
the Margaret MacLaren bursary.

Both funds have a similar aim : to
provide financial assistance to Cana-
dians entering or advancing in the nurs-
ing profession.

Financial support is drawn from
members and friends of the brigade
in Canada.

Countess Mountbatten Bursary (post-
basic : Barbara Ann Wilson, Camrose,
Alberta, bachelor of science, nursing.
University of Alberta; Lorraine Lucas,
Montreal, Quebec, bachelor of nursing,
McGill University.

Countess Mountbatten Bursary (stu-
dent) : Ruth Rogers, Moncton, New
Brunswick, St. John Brigade Crusader,
bachelor of nursing. University of New
Brunswick, Fredericton, New Bruns-
wick; Ruth Matheson, Sydney, Nova
Scotia, St. John Brigade Crusader, 2-
year course, Victoria General Hospital,
Halifax, Nova Scotia; Nicole Legault,
Ottawa, Ontario, St. John Brigade
Crusader, Ottawa Civic Hospital, stu-
dent nurse, Ottawa, Ontario; Gertrude
E.A. Erickson, Saskatoon, Saskat-
chewan, St. John Brigade Crusader,
University of Saskatchewan, bachelor
of nursing science; Denise Lapensee,
Ottawa, Ontario, St. John Brigade
Crusader, Ottawa Civic Hospital,
student nurse, Ottawa, Ontario; Eileen
Neighbour, Clarkson, Ontario, Quo

SEPTEMBER 1970

This hand

was bandaged

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with

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THE CANADIAN NURSE 15

A friendly exchange of ideas at a seminar for directors of nursing service, held by national health and welfare, division of hospital
insurance. (Left to right) Dr. R.A. Armstrong, director, division of medical care, health insurance and resources branch: Margaret
D. McLean, senior consultant, hospital insurance and diagnostic services; Huguette Lahelle, director of nursing education,
Vanier School of Nursing, Ottawa; and Dr. R.B. Goyette, director of hospital insurance and diagnostic services.

Vadis School of Nursing, New Toronto,
2-year training program; Julia Gordon,
Ottawa, Ontario, baciielor of science,
nursing. University of Ottawa; Sadie E.
Barkhouse, Birch Cove, Halifax, Nova
Scotia, Dalhousie school of nursing,
bachelor of nursing.

Countess Mountbatten Bursary (con-
tinuing aid) : Heather Lewis, Pointe-
Claire, Quebec, bachelor of nursing,
psydiatric nursing, McGill University,
Montreal, Quebec; Brenda Hunter,
Winnipeg, Manitoba, St. John Brigade
Crusader, student nurse, Winnipeg
General Hospital, Winnipeg, Manitoba.

Margaret MacLaren Bursary : Mona
Margaret Williams, Toronto, Ontario,
master's degree, nursing education,
University of Western Ontario, London,
Ontario; Patricia Marilyn Hay, St.
John, New Brunswick, master's degree,
nursing administration, of Alberta.
16 THE CANADIAN NURSE

ANPO Sets Up

Claire Gagnon Foundation

Ottawa — Nurses from district nine.
Association of Nurses of the Province
of Quebec, have organized a fund-
raising project to honor the memory
of Claire Gagnon-Mailhot, killed in
the July 5 air crash outside Toronto.

Known as the Claire Gagnon Foun-
dation, the fund has collected to date
$8,000 to be used in nursing schol-
arships.

Contributions may be sent to District
nine, Association of Nurses of the
Province of Quebec, Box 92, Haute-
Ville, Quebec 4.

Internal Contraceptive Proves
Successful In US Study

Chicago — Clinical data, reported at

the American Medical Association Con-

vention last June, showed the effec-
tiveness of SAF-T-Coil, an intrauterine
device. Its safety rating was stated as
being unparalleled by any other con-
traceptive means — mechanical or
biological.

The data summarized studies of 3,640
patients whose pregnancy prevention
rates were as high as 99.7 percent, with
removals of the intrauterine device for
serious complications or infection,
amounting to 0.2 percent.

New Nurse Member Makes
CNF Donation

Ottawa — Following the 35th general
meeting of the Canadian Nurses' Asso-
ciation in Fredericton last June, an
anonymous member of the CNF made
a $200 donation accompanied by this
message : "I read with great interest the
SEPTEMBER 1970

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 in 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.

Five Peel- Pack Sets

To accommodate patients of various 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 1 6-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 sterile "peel-
pack" envelopes. Just peel the envelope
apart. Drop the set onto a sterile tray—
It's ready for use in any sterile area. Your
Abbott Man will gladly give you
material for evaluation. Or
write to Abbott Laboratories,
Box 61 50, Montreal, Quebec.

Abbott's Butterfly

Infusion Set

SEPTEMBER 1970

^ 435Y

THE CANADIAN NURSE 17

(continued from page 16)

detailed reports of the activities of tiie
Canadian Nurses" Foundation.

"Knowing that the two dollar annual
membership fee is too little to enable the
foundation to reach its commendable
goals, I enclose this cheque... . I know it
is not very much but I hope it will
encourage others to make the same
gesture."

Quebec Inservice Education Seminar
Assists Nursing Care

Montreal — The committee on nursing
service. Association of Nurses of the
Province of Quebec, chose Mont Ga-
briel in the Laurentian Hills just north
of Montreal as the setting for a three-
day workshop last March.

Improving nursing care through
inservice education was the theme,
planned to provide a strong program
on education. Resource people, led by
Dr. Malcolm Knowles, professor of
education, Boston University, were
Mary Buzzell, assistant professor.

school of nursing, Western University;
Mona Callin, lecturer in nursing, school
for graduate nurses, McGill University;
and Eileen Strike, associate director of
nursing service, The Montreal General
Hospital, co-chairman of the committee
on nursing service. Miss Strike and
Margaret Wheeler, assistant secretary,
ANPQ, committee on nursing service,
were the organizers of the three-day
session.

Ninety nurses attended from all levels
of the profession. From staff nurses to
directors of nursing, and from inservice
departments, the VON, and UNM, and
one male nurse.

Dr. Knowles spoke on pedagogy and
andragogy, presenting several concepts
concerning adult education. Androgogy,
derived from the Greek stem andr
meaning man or grownup, formed the
basis for the sessions.

"Adults learn differently from chil-
dren,'" said Dr. Knowles. "'Adults have
a strong concept of self-direction, they
desire to learn to satisfy immediate
needs, whereas children learn for the
future. The self-concept of the adult as
an independent person causes him to
resent ideas being imposed on him."

The doctor felt, "...the climate of

V-l VADEMECUM INTERNATIONAL V-l

Pharmaceutical Specialties and Biologicals

During the past years we have received many orders from Registered Nurses for VADEMECUM
INTERNATIONAL. We have not been able to fill some of these orders due to the limited
number of books ovoilobie. If you would like a copy of the 1971 edition, please order it
mmediotely to enable us to order an adequate supply from our printer to insure delivery
of your copy. There will be no other solicitation for your order. November delivery.

I 1

J. Morgan Jones Publications, Ltd.
6300 Park Avenue,
Montreal 155, P.O.

V-l 1971

Enclosed you will find my check or postal money order at the special R.N. rate of
$5.00. Please send to me the 1971 n English or □ French (check language choice)
edition of VADEMECUM INTERNATIONAL as soon as printed.

NAME

ADDRESS

CITY PROV.

18 THE CANADIAN NURSE

most learning situations is an adult one,
where the learner participates in diag-
nosing his own needs and is involved
in the planning process of learning."

"Adults have also accumulated more
experience than children. This affects
the learning process and is the richest
resource of the adult learner."

Dr. Knowles proposed changes that
must take place in adult education. The
Mont Gabriel workshop, he said, is an
illustration of the techniques of andra-
gogy, flourished by the enthusiasm of
those present.

Participation was the keynote of the
sessions. Although the basic topic was
set and outlines of the program for the
first day prepared, the structure of the
workshop for the remaining two days
emanated from the participants and
resource persons. It was a "get-together"
of ideas in a "fun"' manner.

Different techniques of adult learning
were demonstrated in the discussion
groups : xfishbowl technique. iWustrat-
ing group dynamics; role-playing; lis-
tening exercices; and a three-way inter-
view with one person acting as an
observer of the interviewer. Small
group projects were also helpful.

An evaluation followed the work-
shop. It revealed appreciation for and
an understanding of andragogy, and
its difference from pedagogy and the
realization of the need to use this new
technology as part of education. Parti-
cular mention was made by the dele-
gates of the climate setting, group
dynamics, communication skills, and
feedback.

Many of those attending the seminar
felt a benefit when they returned to
work. They mentioned a more flexible
attitude, a new self-confidence, and an
increased trust in the individual as a
contributing member of the group.
Many used techniques they experienced
at the workshop.

Future workshops suggested includ-

(conlinned on page 20)

Notice

Changes of name and address that have
been forwarded by the Post Office to
the CW 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.

SEPTEMBER 1970

Build Your Students' Knowledge
of Nursing Concepts

Choose These Timely
MOSBY Texts
For Your Classes . . .

New 5th Edition! PSYCHIATRIC
NURSING. By Ruth V. Matheney.
R.N., Ed.D., and Mary Topalis. R.N..
Ed.D. Consistently popular text on
modern psychiatric nursing care
stresses development of interpersonal
skills for tiie nurse. Timely sections
focus on crisis intervention, drug ad-
diction, psychopathology, chemo-
therapy, and children's emotional
problems. Primarily a guide to care of
the hospitalized mentally ill, it also
depicts care of patients in varied
psychiatric settings. Helpful glossary,
appendix and updated bibliography
are valuable student aids. March, 1970.
359 pages, 33 illustrations. S6.90.

New 5th Edition! NEUROLOGICAL
AND NEUROSURGICAL NURSING.

By Esta Carini, R.N.. Ph.D.; and Guy
Owens, M.D. This is the most fre-
quently used text in this challenging
field. It clearly presents scientific
principles and special nursing pro-
cedures, stressing the need for indi-
vidualized care. Helpful guidelines ex-
plain how to alleviate patient fears.
Contents include timely data on the
blood-brain barrier, brain scan, stereo-
taxic surgery, botulism, rabies and
tetanus. January, 1970. 398 pages,
122 illustrations. $10.85.

New 7th Edition! ORTHOPEDIC
NURSING. By Carroll B. Urson,
M.D., F.A.C.S., and Marjorie Gould,
R.N., B.S., M.S. Give your students a
comprehensive knowledge of ortho-
pedic care with the most widely used
text in this field! Helpful sections
outline effective methods of care for
the cast patient, traction patient, and
orthopedic surgery patient. Fresh facts
on rehabilitative care include strokes,
body mechanics and range of motion,
bed positioning and prevention of de-
formities. February, 1970. 486 pages,
377 illustrations. $10.45.

A New Book! ORTHOPEDIC
NURSING: A Programmed Approach.
By Nancy A. Brunner, R.N., B.Sc.
Self-help manual emphasizes care of
surgical orthopedic patient, yet in-
cludes material on non-surgical care.
Helpful sections outline indications for
treatment, current methods, and ex-
pected patient responses. Students
learn the need for traction and its
basic forms; also how to adapt their
knowledge of body mechanics to or-
thopedic care. An excellent self-
teaching aid; a lucid supplement to
larger, more detailed texts. September,
1970. 181 pages, 126 illustrations.
About $6.35.

MOSBY

TIMES MIRROR

New 4th Edition! PRACTICAL
NURSING: A Textbook for Students
and Graduates. By Dorothy Rapier,
R.N., B.S., M.S.:Marianm Koch. R.N.,
B.S.: Lois Mora n, A.B.;J. R. Geronsin,
R.N.; and Geraldine Phelps, A. A.,
R.N., B.S., M.S. Comprehensive new
edition of this widely adopted text
encompasses all material the LPN must
master to function effectively.
Opening sections discuss her ex-
panding role in hospital, clinic and
home care, and offer helpful chapters
on legal problems and vocational as-
pects. Revisions include new illus-
trations, new procedures, new drugs!
September, 1970. Approx. 640 pages,
197 illustrations. About S8.80.

New 3rd Edition! INTEGRATED
BASIC SCIENCE. By Stewart M.
Brooks, M.S. Unique timesaving text
integrates physics, chemistry, micro-
biology, anatomy and physiology.
Fundamental concepts, laws and theo-
ries are presented first; discussions of
the various body systems then apply
these principles to practice. This
edition features a new chapter on
genetics, 316 lucid illustrations. Italics
spotlight key terms. April, 1970. 522
pages, 316 illustrations. $11.00.

THE C.V. MOSBY COMPANY. LTD. • 86 NORTHLINE ROAD • TORONTO 374, ONTARIO. CANADA

SEPTEMBER 1970

THE CANADIAN NURSE 19

When your day

starts at __
6 a.m... you're on
chargeduty..
you've skimped
on meals. ..^^
and on sleep... ^
you haven't had^
time to hem
a dress...
make an apple pie...
wash your hair.,
evenpowder 4s<
your nose,
in comfort."^

it's time for a change. Irregular hours and meals on-the-
run won't last. But your personal irregularity is another
itiatter. It may settle down. Or it may need gentle help
from DOXIDAN.

use

DOXIDAN*

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 comfortable.

For detailed information consult Vademecum
or Compendium.

HOECHST

PHARMACEUTICALS

3400 JEAN TALON W.. MONTREAL 301
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L ^^ S

Congrandutions. and the flowers are lovely!

The new president of the Canadian

Nurses' Association. Louise E. Miner, wearing

her chain of office, greets Marguerite

E. Schumacher, president-elect, following the
in Fredericton, New Brunswick, last June.

sessions at the 35th general meeting

20 THE CANADIAN NURSE

ed : practice in techniques of andragogy;
team nursing; interdepartmental woric-
shop on the technology of andragogy;
evaluation of the relationship between
inservice education and the quality of
patient-care; and an evaluation process.

Newfoundland Nurses Reject
Government Wage offer

Ottawa — An across-the-board offer
of a $45 monthly salary increase was
rejected by the Association of Reg-
istered Nurses' of Newfoundland last
May. In a Canadian Press story at that
time, the association was reported to
have reaffirmed its demand for $100 a
month.

Nurses in Newfoundland now earn
a maximum of $420 a month. They
asked for a $100 increase last January.

Association lawyer, Robert Wells
of St. John's, told the association that
provincial health minister, Ed Roberts,
had agreed to discuss overtime pay and
fringe benefits when the nurses appoint-
ed an official body to represent them in
negotiations. A resolution passed in
May appointed the association as the
negotiating body, representing the
nurses on wage demands.

As part of a pay offer to Newfound-
land government employees, the pro-
posed salary increase was accepted by
non -professional hospital employees
in western and central Newfoundland
last May. The employees had threatened
strike action to back up their wage
demands.

No further news at press time had
been received by The Canadian Nurse
on labor demands by the nurses.

SEPTEMBER 1970

news

Summer Help For
Nurses in the North

Ottawa — The University of Alberta
School of Nursing extended its contract
with the department of national health
and welfare this year to include nursing
students in a health program provided
for northern regions of Canada.

Nine nurses from the school of nurs-
ing, University of Alberta, spent three
to four months in nursing stations or
hospitals in the North. Five of the nur-
ses were graduates of the four-year
degree program. The other four are
enrolled in the post-basicdegree program
for registered nurses.

The number of registered nurses
selected for northern duties is deter-
mined by the federal department, and
depends on the number of replacements
required for the summer.

An evaluation of the northern nursing
program will be made following this

first experience for summer replace-
ments.

Seven of the nurses came from
western Canada, one from England, and
another from New Zealand.

Joan F. Aman, Diane E. Grout,
Diane B. Hicks, Patricia A. Porterfield,
all from Edmonton, were posted to
Gjoa Haven Nursing Station, Copper
Mine and Cambridge Bay, Igvolik and
Frobisher Bay, and Inuvick respective-
ly; Maureen Butler, from York, Eng-
land, went to Tuktoyaktuk; Isabell A.
Dixon, from Calgary, was posted to
Inuvik; Mary P. McGee, from Jarvie,
Alberta to Rankin Inlet; Mary A.
McLees, from New Zealand to Brough-
ton Island and Cape Dorset; and Lor-
raine E. Warwick, from Oyen, Alberta,
to Inuvik.

Some of the nurses did general nurs-
ing on wards in hospitals, and those
with public health training and/or
experience were posted to nursing
stations where they did clinical nurs-
ing, public health nursing, and treat-
ment; their experience included treat-
ment clinics of various types. For more
serious cases they were in telephone

or radio communication with doctors
on the "outside". They also assisted
the regular department of national
health and welfare nurses.

J^um)

TRY AS WE MAY WE CAN'T
GET BLOOD OUT OF A HAT.
WE NEED BLOOD DONORS
. . . PEOPLE . . . YOU. MAKE
A DATE TODAY TO
GIVE THROUGH
YOUR RED CROSS.

+

has received

URGENT

requests for

NURSES

to work in

INDIA

and

COLOMBIA

SEPTEMBER 1970

CUSO health department has high priority requests
for as many as 30 nurses for postings in India and
Colombia. A few RNs with only one year's
experience can be placed, but the real need is for
nurses with at least two years' experience. Following
are typical positions available for BScNs, BNs, RNs
with post-basic diplomas and RNs with experience:

Public Health nursing / teaching in schools for
nursing auxiliaries / teaching at both diploma and
baccalaureate level / ward administration and
clinical instruction in various specialties /
operating-room nursing / family planning

TERMS OF SERVICE: In addition to the
professional qualifications a CUSO assignment calls
for such personal qualities as maturity, initiative,
common sense, adaptability and sensitivity.

All assignments are for two years. Most salaries are
paid at approximately local rate by the overseas
employer. CUSO provides training, return
transportation, medical and life insurance.

Next training course begins early August. For further
information write NOW to: CUSO Health
Department. 151 Slater Street, Ottawa 4, Ontario.

THE CANADIAN NURSE 21

names

Eleanor S. Graham

(R.N., Vancouver
General H. School
of Nursing, Van-
couver; B.A. Sc. in
public health nurs-
ing, U. of British
Columbia; M.Sc, in
supervision and ad-
ministration, public
health nursing, U. of Chicago, Illinois)
retired in August from her position as
executive director of the Registered
Nurses' Association of British Colum-
bia.

Miss Graham has had a wide and var-
ied career in Canada and Asia. She was
supervisor of the Cowichan health unit;
senior nurse. Prince Rupert health unit;
nurse-in-charge of the Powell River
health unit, all in British Columbia; sec-
ond assistant superintendent, Victorian
Order of Nurses for Canada; health in-
structor for the Metropolitan School of
Nursing, Windsor, Ontario; director of
nursing. Royal Columbian Hospital,
New Westminster, B.C.; and regional
nursing advisor for the World Health
Organization South East Asia region,
New Delhi, India.

Miss Graham has been with RNABC
for 1 1 years. She began as assistant ex-
ecutive secretary, later becoming ex-
ecutive secretary. Her title was changed
to executive director at the 1969 an-
nual meeting of the association.

Margaret F. Myles, a leading author-
ity on midwifery is giving 20 talks on
midwifery, including pre- and postnatal
care, during her visit to Canada in Sep-
tember and October.

Mrs. Myles left her home in Aber-
deen, Scotland, June 5, on a world
lecture tour that has included South
Africa, Australia, New Zealand, Fiji,
Honolulu, and San Francisco.

She arrives in Vancouver on Septem-
ber 16, and following a private visit to
Victoria, Mrs. Myles will return to Van-
couver on September 20 for two speak-
ing engagements. She will visit Creston,
British Columbia, September 23-26, and
on 27, leave for Whitehorse, Inuvik,
and Yellowknife, where she will stay
until October 10.

Mrs. Myles concludes her tour with
a visit to students in the advanced
practical obstetrics program at the Uni-
versity of Alberta School of Nursing,
Edmonton, October 10-14.

22 THE CANADIAN NURSE

Mrs. Myles is a graduate of York-
ton Hospital School of Nursing in Sas-
katchewan, and has held several nursing
and teaching posts in Canada and the
United States. She was principal mid-
wife tutor for 14 years at the Simpson
Memorial Maternity Pavilion, Royal
Infirmary, Edinburgh, Scotland, and
retired in 1952. Mrs. Myles established
the first school of midwifery in Ethiopia
and visited that country's hospitals for
the World Health Organization in 1959.

She is author of the well-known
book. Textbook for Midwives, which
is to be published in its seventh edition.

McMaster University, Hamilton, On-
tario, has announced four appointments
to its school of nursing. Myrtle A. Kut-

schke (Reg.N., Vic-
toria H. School of
Nursing, London,
Ontario; B.Sc. N.,
U. of Western On-
tario; M.S., Boston
U . , Boston ) has been
appointed associate
director of the
school of nursing.
A 1964-65 Canadian Nurses Founda-
tion scholar. Miss Kutschke began her
teaching career as an instructor at the
Calgary General Hospital, Calgary,
Alberta. She was also assistant professor
at the University of Toronto School of
Nursing. Miss Kutschke's two previous
appointments at McMaster were as a
lecturer and an assistant professor.

Shirley Smale

(Reg.N., Belleville
General H., Belle-
ville, Ontario;
B.Sc.N., Case West-
ern Reserve U.,
Cleveland, Ohio:
M.P.H.,U. of Mich-
igan) has been ap-
pointed an assistant
professor at McMaster School of Nurs-
ing. Miss Smale will be responsible for
teaching public health nursing.

Prior to this appointment Miss Smale
was a nurse practitioner with the Mc-
Master University department of family
medicine, and a clinical associate on the
school of nursing faculty. She was ma-
ternal-child health nursing consultant
with the Wisconsin Division of Health
in 1967-68, and supervisor of public
health nursing, Yakima County Health
District, Washington State, 1964-67.

Susan E. Perry

(R.N., Victoria Pub-
lic H., Halifax, Nova
Scotia; B.N. ,McGill
U., Montreal; M.S.,
Boston U., Boston)
has been appointed
\i ^ ' an assistant profes-

.-^ X. Jlk ^°'"' *'^^ responsi-

tUt^ .^mm^m^K bilitiesinpsychiatric

nursing and the integration of mental

health concepts in all four years of the

bachelor of nursing science program.

Miss Perry has been a staff and a
head nurse at the Victoria General Hos-
pital, Halifax; a clinical instructor at
Allan Memorial Institute, Montreal;
and a lecturer in psychiatric nursing,
McGill School for Graduate Nurses.

Dorothy McClure
(Reg.N., Victoria
H. School of Nurs-
ing, London, On-
tario; B.Sc.N., U.
of Western Ontario;
M.S., Boston U.,
Boston) has been
appointed an assist-
ant professor at the
school of nursing. She will be respon-
sible for supervision of the medical-
surgical program.

Miss McClure's nursing experience
includes: seven years as a general staff
nurse at the Victoria Hospital, London,
Ontario, Sunnybrook Hospital, Toronto,
and Westminster Hospital, London,
Ontario: and two years as a staff nurse
with the North Atlantic Treaty Organ-
ization/Royal Canadian Air Force in
France. She was a public health nurse
for four years and a teacher at the Ham-
Iton Civic Hospitals School of Nursing.

Esther A.D. Janzow (Reg.N., Royal
Columbian H., New Westminster, B.C.;
dipl. in teaching and supervision, U. of
B.C.; B.Sc.N., U. of B.C.; M.A., U.
of Washington, Seattle) has been ap-
pointed director of nurses' training at
Vancouver City College, Vancouver,
British Columbia.

Miss Janzow served as a general duty
nurse at the Vernon Jubilee Hospital,
Vernon, B.C., and as a ward supervisor
and acting matron at the same hospital.
She was an operating room nurse at the
Medicine Hat General Hospital, Med-
icine Hat, Alberta, and assistant direc-
tor of nursing at the Royal Columbian
Hospital, New Westminster, B.C. After

SEPTEMBER 1970

names

profession in 1934 and is former di-
rector of nursing at the Hotel Dieu Hos-
pital in Chatham, New Brunswick.

a year of private duty nursing in Vic-
toria, B.C., Miss Janzow joined the Vic-
torian Order of Nurses as a staff nurse
and later as a rehabilitation consultant
in Victoria. She was rehabilitation con-
sultant to the Greater Toronto Branch,
Victorian Order of Nurses until 1 968.

E. Marie Sewell

(Reg.N., Wellesley
School of Nursing,
Toronto, Ontario;
B.N., School for
Graduate Nurses,
McGill U., Mont-
real, Quebec) has
been appointed di-
rector of nursing.
New Mount Sinai Hospital, Toronto.
Previous to this appointment, she was
assistant director, nursing education
from 1955-1970.

A past president of the Registered
Nurses' Association of Ontario, Miss
Sewell also served on the Ad Hoc
Committee on Legislation and on the
Ad Hoc Committee to study function,
structure, and relationship of the Ca-
nadian Nurses' Association. She was a
short-term consultant to South East Asia
region for the World Health Organiza-
tion in 1967.

Dorothy M. Morgan (Reg.N., Victoria
H. School of Nursing, London, Ontario;
B.A., U. of Western, London, Ont.;
B.S., McGill U., Montreal; M.B.A., U.
of Chicago) has retired after four years
of service as director of nursing, Vic-
toria Hospital, London, Ontario.

Miss Morgan began her career at the
Kingston General Hospital as assistant
superintendent of nursing. She went on
to serve in various administrative
positions at St. Barnabas Hospital, Min-
neapolis, Minnesota, University of Chi-
cago Hospitals, Chicago, Illinois, and
University of Pittsburgh Medical
Center, Pittsburgh, Pennsylvania.

She is succeeded by Davis W. Corder,
a graduate of the Stracathro Hospital
and School of Nursing, Angus, Scotland,
and of the University of Toronto course
in hospital administration.

Sister Mary Winslow was made a life
member ot the New Brunswick Associa-
tion of Registered Nurses' at the 54th
annual meeting. Life memberships are
awarded for outstanding contributions
to nursing development in the province.
Sister Winslow entered the nursing
SEPTEMBER 1970

Alice J. Baiimgan

Irene M. Biuhaii

The chairmen of three standing com-
mittees of the Canadian Nurses' Asso-
ciation, have been annonced.
Alice J. Baumgart (B.S.N., of Brit-
ish Columbia; M.A.Sc, McGill U..
Montreal) has been appointed chairman
of the committee on nursing education.
A Canadian Nurses" Foundation scholar.
Miss Baumgart is associate professor
at the University of British Columbia
School of Nursing. She is a contributor
to The Canadian Nurse and has worked
on various committees for the Regis-
tered Nurses' Association of British
Columbia.

Irene M. Buchan (R.N., Gait School
of Nursing, Lethbridge, Alberta; B.N.,
McGill U., Montreal) has been appoint-
ed chairman of the committee on nurs-
ing service, she is nursing consultant to
the health insurance and resources
branch, department of national health
and welfare.

Miss Buchan is a 1965 Canadian
Nurses' Foundation scholar and was the
assistant director of a CNA project to
evaluate the quality of nursing service.
Marilyn Brewer (R.N., B.Sc.N., U.
of Toronto School of Nursing, Toronto)
has been appointed chairman of the
committee on social and economic wel-
fare. Mrs. Brewer has been a general
staff nurse at the New Mount Sinai Hos-
pital, Toronto, and a clinical instructor
of surgical nursing at the same hospital.
She was a public health nurse with the
New Brunswick department of health,
and editor of the New Brunswick As-
sociation of Registered Nurses news
bulletin.

Helen Sundstrom (B.A., Brandon U.,
Brandon, Manitoba; B.Sc.N., U. of Sas-
katchewan, Saskatoon, Sask.) has been
appointed coordinator of continuing
education for the Manitoba Association
of Registered Nurses.

Mrs. Sundstrom is coordinator of the
two-year program at Victoria General
Hospital, Winnipeg, Manitoba, and was
an instructor at the Children's Hospital
of Winnipeg.

Elsbeth G e i g e r

(R.N., Royal Victo-
ria H., Montreal,
Quebec; B.N., Mc
Gill U., Montreal;
M.A., Columbia
Teachers' College,
New York) has been
appointed chief of
nursing of the Hos-
pital for Sick Children, Toronto, Onta-
rio. As chief of nursing. Miss Geiger is
responsible for some 1,000 nurses.

She was president of the Registered
Nurses' Association of Ontario in
1966-67, and is now president of the
College of Nurses of Ontario. Miss
Geiger is also a member of the test serv-
ice board of the new Canadian Nurses'
Association testing service which sets
the examinations for nurses in schools
across Canada.

Miss Geiger's appointment to the new
position, chief of nursing, marks an ad-
ministrative reorganization.

Alma Ferrier was named Alberta's nurse
of the year at the 54th annual dinner of
the Alberta Association of Registered
Nurses. As nurse in the community of
Blueberry Mountain, Miss Ferrier par-
ticipated in a number of activities and
contributed much to this isolated com-
munity.

Miss Ferrier, who has retired to Rut-
land, British Columbia, was born in
Scotland and received her education
there.

Dr. J. Douglas Wal-
lace has been ap-
pointed executive
director of the
22000-member Ca-
nadian Medical As-
sociation. He suc-
ceeds Dr. Arthur F.
W. Peart, who re-
signed for health
reasons last March after four years in
office.

Dr. Wallace received his medical
training at the University of Alberta,
Edmonton. Following service in the
RCAF medical service during World
War H, he did private practice for 13
years in his hometown of Wainwright,
Alberta. His first administrative position
was as director of the Alberta Hospital
Plan. In 1969. Dr. Wallace served as
chairman of the federal-provincial cost
of health services task force on salaries
and wages.

Dr. Wallace is executive director of
the Toronto General Hospital. He is
also president. Ontario Council of Ad-
ministrators of Teaching Hospitals, and
past president, Ass(fciation of Canadian
Teaching Hospitals. D

THE CANADIAN NURSE 23

September 11-13

Clinical Cardiovascular Nursing — 1971,
sponsored by the American Heart Asso-
ciation, Council on Cardiovascular
Nursing, Georgetown University Medical
Center, Washington, D.C. Address in-
quiries to the Canadian Heart Founda-
tion, 270 Laurier Ave. West, Ottawa,
Ontario.

September 14-17

American Association of Nurse Anesthetists,
Shamrock Hilton Hotel, Houston, Texas.
For more information, write to the AANA,
3010 Prudential Plaza,'130 E. Randolph St.,
Chicago, Illinois 60601 , U.S.A.

September 19-20

Third national congress on medical
ethics, sponsored by the Judicial Com-
mittee, of the American Medical Asso-
ciation, to be held at the Ambassador
Hotel, Chicago, Illinois. For more infor-
mation write to E.G. Shelley, M.D.,
Chairman, Judicial Council, American
Medical Association, 535 North Dearborn
Street, Chicago, Illinois 60610.

September 24-27

Meeting of the American Medical Writers'
Association, Waldorf-Astoria Hotel, New
York. For more information, write to the as-
sociation's executive secretary, Mr. W. Way-
ne Curtis, 420 Lexington Ave., New York,
N.Y., 10017.

September 26

The Nightingale School of Nursing in Toron-
to is marking its 10th anniversary with an
open house and reception for alumni and
invited guests. For further information,
write to The Nightingale School of Nursing,
2 Murray Street, Toronto 2B, Ontario.

September 28-October 9

Two-week symposium on the nurse's role
in prevention and treatment of acute and
chronic respiratory insufficiency, Manitoba
Rehabilitation Hospital, Winnipeg. Further
details are available from Miss E.L.M. Thor-
pe, Consultant, Sanatorium Board of Ma-
nitoba, 800 Sherbrook Street, Winnipeg 2,
Manitoba.

October 1-2

Annual Convention, Catholic Hospital Con-
ference of Alberta, -Chateau Lacombe, Ed-
monton, Alberta. For more information write

24 THE CANADIAN NURSE

to: Reverend Sister John Marie, President,
Catholic Hospital Conference of Alberta,
Seton Hospital, Jaspar, Alberta.

October 5-6

Institute on operating room and central sup-
ply room procedures, auditorium, Calgary
General Hospital School of Nursing. Spon-
sored by the Alberta Association of Regis-
tered Nurses. For further details write to the
AARN, 10256—112 Street, Edmonton, Al-
berta.

October 5-30

Advanced program in health services orga-
nization and administration. The University
of Toronto School of Hygiene. The second
part of this program will be held March 1-26,
1971. Fee: $200 for each part. For further
information, write to: Dr. R.D. Barron, Sec-
retary, School of Hygiene, University of
Toronto, Toronto 5, Ontario.

October 7-10

Annual conference, Canadian Association
for the Mentally Retarded, Hotel Vancouver,
Vancouver, British Columbia. Special em-
phasis will be on the preschool child, resi-
dential services, and occupational- voca-
tional programs.

October 8-10

Workshop on Test Construction for 35
teachers from schools of nursing and the
provincial hospitals, sponsored by the New
Brunswick Association of Registered
Nurses, in Memramcook, New Brunswick.
The workshop will be conducted by Vivian
Wood, Assistant Professor, Faculty of Nurs-
ing, University of Western Ontario. For more
information write to Mary Russell, R.N.,
NBARN staff. Secretary to Nursing Educa-
tion, 231 Saunders Street, Fredericton, N.B.

October 17

14th Annual Symposium on Rehabilitation,
sponsored by the Rehabilitation Foundation
for the Disabled and the Ontario Society for
Crippled Children, Inn-on-the-Park, Don
Mills, Ontario. Write to Mrs. Betty McMur-
ray, Executive Director, Rehabilitation
Foundation for the Disabled, 12 Overlea
Boulevard, Toronto 354, Ontario.

October 25-29

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 information write to The Vanier
Institute of the Family, 170 Metcalfe Street,
Ottawa 4, Ontario.

October 26-27

Nursing sessions at the Ontario Hospital
Association annual convention. Royal York
Hotel, Toronto. Write to the OHA, 24 Ferrand
Drive, Don Mills, Ontario.

October 26-28

Annual meeting of the Association of Regis-
tered Nurses of Newfoundland, St. John's.
Write to the AARN, 67 Le Marchant Rd.,
St. John's, Nfld.

October 29-31

Second annual symposium of the Institute
of Community and Family Psychiatry, Jew-
ish General Hospital, Montreal, Que-
bec, on techniques in family therapy
and the future of the family. Simulta-
neous translation is available in French.
For more information and advance reg-
istration, contact: Philip Beck, M.D.,
registration chairman. Symposium, In-
stitute of Community and Family Psy-
chiatry, 4333 Cote St. Catherine Road,
Montreal 249, Quebec.

Nov. 4-6, 1970 and Feb. 24-25, 1971

A continuing education course called Nurs-
ing Service Objectives is being sponsored
by the University of Toronto School of Nurs-
ing. For more information write to: Conti-
nuing Education Program for Nurses, Uni-
versity of Toronto School of Nursing, 47
Queen's Park Crescent, Toronto 5, Ontario.

November 30-December 4

Conference for nurses in staff education
and staff development, Westbury Hotel, To-
ronto. Sponsored by the Registered Nurses'
Association of Ontario. Write to: Professio-
nal Development Department, RNAO, 33
Price Street, Toronto 5, Ontario.

February 16-18, 1971

A national conference on research in
nursing practice will be held in Ottawa.
For more details write to Dr. Floris E.
King, Associate professor and coordi-
nator of the graduate program, University
of British Columbia School of Nursing. Ll
SEPTEMBER 1970

L<l

no OThi€l< BAG PeRPORW UK€ m.

My safety chamber
really slops retro-
grade infection.
There's simply no way
for the bugs to back
up and go where they
don't belong. And by
tucking the BAC-
STOP chamber in-'
side the bag, it can't
be kinked acciden-
tally to stop the flow.

I'm clear-faced and
easy to read. My white
back makes my mark-
ings stand out unique-
ly, whether you look
at my backbone scale,
or tilt me diagonally \
to read small amounts j
with the corner cali-
brations.

Cystoflo

yr«uiy Butiini '«y

My hanger is the
hanger that works
well all the time. Hang
it on a bed rail or a
belt, it is always se-
cure and comfortable.
I'm always on the
level with this hanger,
whether my patient is
lying, sitting, or walk-
ing around.

I have the only shortie
drainage tube around,
and lis miles belter
than any other
you've ever used. It's
easier lo handle, and it
won't drag on Ihcfloor.
even with the new low
beds. So out goes one
more path lo possible
contamination.

I'm le new CYSTOFLO dtainar,

trut' od to nurses, physicians and

Why don t we gel acquainted?

BAXTER LABORATORIES OF CANADA

new products {

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

Saneen Infant Wipes

Facelle Company Ltd., Toronto, has
introduced Saneen Infant Wipes, a spe-
cially processed two-ply tissue, rein-
forced with nylon threads to give excep-
tional strength when wet.

Made with facial quality cellulose
tissue, they provide both softness, for
the delicate skin of newborn infants,
and high absorbency.

Saneen Infant Wipes measure 8
inches by 1 2 inches. They are packaged
in polyproplene units of 50 for clean-
liness, easy stock control and storage,
and are delivered in cases of 2,000.

In addition to baby care, Infant
Wipes may be used in the hospital where
a strong, soft, absorbent and lint-free
wipe or washcloth is required.

For further information write: Facelle
Company Ltd., 1350 Jane Street, To-
ronto 335, Ontario.

I.V. Metering Device

Inexpensive and disposable, this device
permits an immediate reading of solu-
tion flow rates, thereby controlling ac-
curacy and improving patient care. De-
signed with adaptations to fit all I.V.
bottles, the I.V. metering device mini-
mizes setup time and provides greater
infusion control.

Component parts include a bottle-
to-device connector; a micro-drop or
standard-drop meter which monitors
drops per minute and ml. per hour on
a slide indicator; a clamp and connect-
ing tubes with needle adapter.

For further information write: I.V.
Ometer, P.O. Box 1219, Santa Cruz,
California 95060, United States.

Teflon-Coated Catheter
C.R. Bard, Inc., has introduced the
Bardex coated Foley catheter with
Teflon. The new catheter has been pro-
duced by bonding a specially-developed
coating that contains Teflon on the in-
side and outside layers of the Bard cath-
eter. This new coating facilitates cath-
eter insertion, and will not peel or crack
when the balloon is inflated. The slick
surfaces reduce calcification formation
on the outer and inner surfaces of the
catheter. The incidence of urethral
strictures following extended use is re-
duced, with minimal urethral dis-
charge even after prolonged catheter
drainage.

For more details write to C.R. Bard
Canada Ltd., 22 Torlake Crescent,
Toronto, 18, Ontario.
26 THE CANADIAN NURSE

Infant Wipes

Cardioscope

A new nme-mch, four-channel cardio-
scope, specially designed to permit
simple service and repairs by hospital
personnel, has been introduced by Dal-
lons Instruments.

Designated type CM-9, the new mon-
itor permits simultaneous display of
four cardiac signals, with controls to
provide independent positioning and
amplification of each signal.

The machine is serviced by placing
all the electrical parts on four plug-in
circuit boards, any of which can be
easily removed and replaced.

All circuits are protected against
damage.

Preamplifiers are available for ECG.
EEC, DC (blood pressure), and strain

gage. Each preamplifier contains one
printed circuit board which is easily
removable from its plug-in connector.
Dallons is represented in Canada
by Bionetics Ltd., 6420 Victoria Ave-
nue, Montreal 252, Quebec.

Disposable OR Draping

Kimberly-Clark of Canada Limited has
introduced a new disposable draping
system. A variety of obstetric and oper-
ating room packs are available to fill
every draping requirement. Individual
components are also available to sup-
plement the draping packs.

The basic draping material is made
from a new fabric, Kaycel. This mate-
rial has many advantages over the tra-
ditional linen. Standard linens, when
wet, encourage bacteria migration.
Kaycel moisture-inhibiting fabric eli-
minates this cross contamination. The
components are light-weight, yet strong
to eliminate tearing. All sheets, towels,
and covers are lint and dust free. The
soft pliable fabric is more easily draped
over the patient than linen.

Each kit and individual supplemen-
tary pieces are double packed and guar-
anteed sterile. The sheets are function-
ally folded, sequence packed, and iden-
tified for easy use. This new disposable

(conliniu'd on page 28)
SEPTEMBER 197»

This decongestant tablet contends that a
cold is not as simple as it seems on television

Coricidin* "D" 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 "D"
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?

Coricidin "D"

comprehensive relief

of cold symptoms

DESCRIPTION: Each CORICIDIN
D" tablet contains 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 to exceed 4
tablets in 24 hours. Children (10-
14 years): Vi the adult dose.
Children under 10 years: as di-
rected by the physician

SIDE EFFECTS: Adverse reac-
tions ordinarily associated with
antihistamines, such as drowsi-
ness, nausea and dizziness occur
infrequently with Coricidin "D"
when administration does not
exceed recommended dosage,
PRECAUTIONS: May be injurious
if taken in large doses or tor a
long time. Additional clinical
data available on request.

■reg. Trade Mark,

24TMlfT5

"ixAe^una

Corporation Limited
Pointe Claire 730, P.Q,

®

For colds of all ages:
Coricidin tablets,
Coricidin with Codeine.
Coriforte' for severe colds,
Nasal Mist, Medllets
and Coricidin ■D" (VIedilets
for children,
Pediatric Drops,
Cough Mixture %
and Lozenges.

new products

(iontiniu'il from page 26)

draping system reduces storage, hand-
ling time, and laundry problems.

For further information, write to:
Kimberly-Clark of Canada Limited,
Medical Products Division, 2 Carlton
Street, Toronto 2, Ontario.

Unit Dose Injectable Drugs

Moore -Thompson-Clinger Pharmaceu-
ticals of Hamilton, Ontario, a subsidiary
of Canada Packers Limited, has an-
nounced it is beginning to market a new
line of unit dose injectable drugs to
hospitals and institutions in Canada.

The first drug of the new line will be
unit-dose sodium heparin injection,
marketed under the brand name of
Hepalean.

The primary use of Heparin is in the
treatment of cardiovascular diseases
due to blood clotting and agglutination.

It is used extensively in open-heart
surgery, kidney transplants, and artifi-
cial kidney treatments.

The drug is packaged in 1 ml. unit-
dose ampuls, and 5 ml. and 10 ml. vials,
in concentrations of 1,000, 10,000, and
20,000 units per ml. The vials and
ampuls are color coded according to
concentration. This enables medical
personnel to readily identify the correct
strength and dosage of the drug, which
can be critical to the life of the patient,
and where rapid treatment is imper-
ative.

For more information write: Moore-
Thompson-Clinger Ltd., 1890 Bramp-
ton Street, Hamilton, Ontario.

Extra-light Stethoscope

The Soloscope, a new stethoscope that
weighs 1 1/4 ounces and offers a high
volume of sound transmission, is a new
product from DePuy, Inc. Made of a
flexible plastic, that makes it easy to
handle and clean, the Soloscope is reus-
able.

Despite its durability, its price is

Uiiil DoM' Injciitihlc Dnt/is

28 THE CANADIAN NURSE

economical. As a disposable product,
it is ideal for use in isolation or infec-
tious disease wards.

Each Soloscope, individually pack-
aged, costs $3.90 but must be purchased
in minimum quantities of one carton
which contains six Soloscopes.

For further information, write to :
Guy Bernier, 862 Charles-Guimond,
Boucherville, Quebec, or John Ken-
nedy, 2750 Slough Street, Malton, Ont.

Indocid

Merck Sharp & Dohme Canada Ltd.
has made available a new dosage form
of Indocid (indomethacin, MSD Std.)
in 50 mg. capsules. Indocid is an anti-
inflammatory agent with concomitant
analgesic and antipyretic activities.

The addition of the 50 mg. capsules
to the 25 mg. dosage form provides
convenience, economy, and dosage
flexibility for patients who need a high-
er dosage of Indocin.

The 50 mg. capsules are opaque,
blue and white, imprinted with the po-
tency level and the MSD trademark,
and are available in bottles of 50 and
250.

For further information write: Merck
Sharp & Dohme Canada Ltd., Kirkland,
Quebec.

Quadruped Walking Aid

Designed to give maximum mobility
and stability to handicapped users, this
walking aid can be used singly or in
pairs. The lightweight, die cast, alu-
minum hand piece is fitted with a
nontoxic ergonomic hand grip, and the
strong stable base has four non-slip,
non-marking, grey rubber tips.

Instant height adjustment is achiev-
ed by means of stainless steel spring
buttons, fitting into precision-punched
holes with 3/4-inch graduations. There
are two models to choose from.

For further information, write to
Everest & Jennings Canadian Limited,
P.O. Box 9200, Downsview, Ontario.

Tiltable Infant Bed

A Tiltable Infant Bed has been intro-
duced by Bourns, Inc., Life Systems.
The bed is designed to provide control-
led positioning of the newborn during
mtensive care. It can be tilted from
side to side to help prevent tissue dam-
age of the infant resulting from prolong-
ed pressures.

Obtaining arterial blood samples and
suctioning are greatly facilitated by the
bed. A removable panel in the bottom
of the bed permits chest X-rays to be
taken without disturbing the infant.

For further information write:
Bourns, Inc., Life Systems, 6135 Mag-
nolia Avenue, Riverside, California,
92506, United States. D

SEPTEMBER 1970

NOWAY!

There's no way airborne contaminants can accidentally get into
viAFLEX plastic containers unless you inject them. Unlike gfass
bottles, the VIAFLEX container has no vent — room air is kept out.
it's the only completely closed I.V. system; airborne contami-
nants are locked out, and the system remains sterile throughout
the procedure. Even when the spike of the set is inserted, air
cannot get in — because the spike completely occludes the port

opening before it punctures the internal safety seal. A self-
sealing latex cap on the second port is provided for adding
supplemental medication, viaflex is the first and
only plastic container for intravenous solutions.
To assure your patient the safety of a completely
closed system, it's the first and only container
you should consider. ^Hb'

BAXTER LABORATORIES OF CANADA

DIVISION Of TRAVENOL LABORATORIES INC

6405 Northam Drive. Malton, Ontario

Viaflex

in a capsule

The word is communication!

Communicating in another language
can be difficult, and when a word is
used incorrectly, there may be some
embarrassment. A much-traveled nurse
tells of this amusing experience.

It was a wet and windy day when she
arrived in Zurich by plane. A customs
official asked if she had anything to de-
clare; it was then she remembered her
new Parisian wig tucked in its glam-
orous box, still sitting in the plane.
"Mon poupon, mon poupon est sur le
plane!" she cried.

The Zurich officials looked at the
excited woman in disbelief. But, if what
she said were true, then they must waste
no time! She was immediately whisked

off to the waiting plane in an open car.

When she had recovered her precious
wig, she attempted to thank the man
for his trouble, but he interrupted,
"Votre poupon! Votre poupon?"

Blushing with embarrassment, our
nurse friend realized the word she
should have used was "ma perruque"
for wig, not "mon poupon" for baby!

Perhaps the moral of the story is,
when in doubt, try, try, again.

Hospital ombudsman

Who speaks for the patient? Doctors,
nurses, and administrators have their
professional associations. But who
really knows what non-medical aid the
patient requires?

30 THE CANADIAN NURSE

These questions were posed by
Richard Cavalier in an article called
"Ombudsman is Middle Man Between
Clinic Patients and Hospital" in the
January issue of Modern Hospital.
The article describes the efforts of the
ombudsman — actually one man and
one woman — to act as patient spokes-
man at Michael Reese Hospital in
Chicago. The program, started in
1969, has resulted in smoother com-
munications and easing of tensions
between patients and staff.

In a sense related to the Scandanavian
ombudsman, who investigates com-
plaints of citizens against government,
the ombudsman at Michael Reese
Hospital interprets prescription orders
for the patient, and explains hospital
procedure to him. He may also call
attention to a patient who has come to
the emergency room on a routine visit
but who is in pain.

By gaining the trust and confidence
of the patients, and the acceptance of
the hospital staff, the ombudsman has
shown that there is a need for service
of this kind and for more patient
advocates.

Chewing gum discovery

What is better than a toothbrush when
it comes to keeping teeth clean and
healthy? A special chewing gum, reports
Dr. Karl Otto Heede of Goettingen,
West Germany, in German Features.

After experimenting on a special
chewing gum for 14 years, Dr. Heede
says that his gum, which is a mixture of
natural resins, chemically basic min-
erals, volatile oils, trace elements,
herbs, and vitamins, successfully fights
dental disorders such as cavities and
periodontal disease. He hopes this gum
will be on the market soon.

Dr. Heede claims that his invention
fights decay actively through the in-
gredients, which restore the acid-base
balance in the saliva. The substance has
been tested by a clinic in Dusseldorf,
which reported that a person's teeth are
completely cleaned after chewing the
gum for 1 5 minutes. The clinic says that
not even a toothbrush can match this
achievement.

The inventor gives a friend credit for
the idea of the gum. After Dr. Heede's
friend returned from a trip to Africa,
he recounted that he had met some na-
tives who had very white, healthy teeth,
apparently because they often chewed
certain tree resins. D

SEPTEMBER 1970

Fleet

ends ordeal by

Enema

for you and
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.

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
administration. Repeated administration
at short intervals should be avoided.

Full inlormation on request.

•Kehlmann, W. H.: Mod. Hosp. 84:104, 1955

FLEET ENEMA® — single-dose disposable unit

It^ CkMha£.3>ioMt &Ca

DMOMTNIVJOWMOA

SEPTEMBER 1970

THE CANADIAN NURSE 31

Lippincott

Film 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 'how it was done.''

T>VO NE^V SERIES-NO>V 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 Patient 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 Patient— Transfer
from Bed to Stretcher and Return

Price for 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: Reusable, Open Technique

• Gown, Gloves, Mask: Single Use, Discard 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 Technique

Price for each film: $23.75
32 THE CANADIAN NURSE

Also Available:

Bedmaking

Making an Unoccupied Bed (Parts I, II) .... $47.50

Making an Occupied Bed (Parts I, II) $47.50

Manipulation of Linen (Parts I, II) $47.50

Hygiene

Giving a Bed Bath (Parts I, II) $47.50

Giving a Back Rub $23.75

Positioning and Exercise

Prevention of External Rotation

(Trochanter Roll) $23.75

Prevention of Drop Foot (Part 1, II) $47.50

Injection Technique

Preparation of an Injection from a Vial .... $23.75
Preparation of an Injection from an Ampule . . $23.75
Preparation of an Injection from a Tablet . . . $23.75

Subcutaneous Injection:

Site Selection and Administration $23.75

Selection of a Site for Intramuscular Injection:

Deltoid $23.75

Selection of a Site for Intramuscular Injection:

Lateral Thigh $23.75

Selection of a Site for Intramuscular Injection:

Ventrogluteal $23.75

Selection of a Site for Intramuscular Injection:

Dorsogluteal $23.75

Administration of an Intramuscular Injection. . $23.75

• Write for descriptive material on new film loops,
or for complete film loop catalog.

J. B. LIPPINCOTT COMPANY OF CANADA LTD.
60 FRONT STREET WEST
TORONTO 1, ONTARIO

SEPTEMBER 1970

Maritimers have a
TV nurse

Education, whether for the young or not so young, is a demand never completely
satisfied. Medical and nursing education is one of these ongoing needs. TV Nurse,
a public service program produced in the CHSJ-TV studios. Saint John, New
Brunswick, reaches out into the community to assist in educating the public on health
procedures. Hostess Elaine Hazen is convinced the public welcomes information on
health, particularly preventive measures. Here is a glimpse of her program and how
it originated.

Mona C. Ricks

Answering nursing questions, and trying
to help educate the public in health
matters, has been the dedicated role of
a petite, blonde nurse in Saint John,
New Brunswick, for nine years.

Elaine Hazen hosts a unique, weekly
television show, telling viewers, in her
own way, why preventive medicine is
the key to better health. She radiates
this philosophy the moment her Sunday
program opens, and continues as she
questions guests on medicine and
nursing.

"If only the public would realize
that a moment taken to visit a doctor,
could mean many years of well life,"
says Mrs. Hazen. "Then these programs
would be abundantly repaid."

"This is TV Nurse, with Elaine
Hazen," says an announcer, as the
camera swings full view to a diminutive
nurse in white uniform. The opening
line of another informative half-hour
begins, commented on later by a faithful
audience.

Measured by the letters and telephone
calls after each show, Mrs. Hazen feels
TV Nurse has become an institution in
the Maritimes. If the program has
a motto it could be, health education
without fear; an honest attempt to
inform the public on health issues and
medical advances.

Mona Ricks was recently appointed assistant
editor of Tin- Cmuitlidii Nurse.

SEPTEMBER 1970

Reaching out to a possible viewing
audience of 600,000, it has brought the
medical profession and the public health
nurse closer to the Maritimer — in fact
right into the community.

Beamed from CHSJ-TV. Saint John,
and CHM-TV, Moncton, New Bruns-
wick, it spans city and rural areas in
three Canadian provinces. Prince
Edward Island, Nova Scotia, and New
Brunswick. And in Maine. U.S., another
avid audience waits each week.
How did the program come about?
Mrs. Hazen won't admit directly to
this, but in conversation you'll find she
frequently refers to the continuing
expansion in medical knowledge, and
the demand for medical communica-
tion.

And this is precisely what inspired
her initial request for television time.
It has held her interest through nine
years of planning an exacting weekly
show.

The lack of nursing help, and the
need forgreatercommunication between
physician and public became evident
when her husband, the late Dr. Frank
Hazen, was medical health officer for
Saint John and two nearby counties,
Albert and Charlotte.

"My husband often mentioned the
need for more nurses. His was, and
still is, a very busy district."

After his sudden death, Mrs. Hazen

thought more and more of her husband's

THE CANADIAN NURSE 33

cry for additional nursing staff to reach
the people.

Loneliness can be the reason for
lethargy or activity — for Mrs. Hazen
it was an awakening to nursing needs.

"I lay awake many nights wondering
how 1 could answer my husband's call,"
she said.

Then the idea of a televised medical
program began to form. "It seemed the
logical medium to reach the public and
to educate the people on the essentials
of public health."

But an idea in thought is one thing,
activating the idea is another. Especially
one as wide open as public health.

Fortunately, Mrs. Hazen is a reg-
istered nurse, trained in public health,
and with an educated knowledge of the
medical profession.

She discussed her idea with William
Stewart, program director at CHSJ-TV,
Saint John. Within weeks a receptive
director and an eager nurse had
produced the first live TV Nurse
program.

"it was a great success," says Mrs.
Hazen. "1 was overwhelmed at the

on" to listen to medical and nursing
news each week.

A remarkable array of medical spe-
cialists have followed each other across
the TV Nurse screen. And thousands of
letters and telephone messages tell of
its educational value in the community.

"Since the first program, when I was
a greenhorn, in fact I still am," ack-
nowledged Mrs. Hazen, "specialists
from most medical disciplines have told
of their work."

Illustrious names, such as Dr. Heinz
Lehman of the Douglas Hospital,
Verdun, Quebec and Dr. Robert Jones,
Dalhousie University, both represented
psychiatry. Pediatric specialists. Dr.
Richard Goldbloom, also of Dalhousie
University, and Dr. Leo Stern, Mont-
real Children's Hospital, told of their
experiences in child care. Dr. Andre
Barbeau from the University of Mont-
real and Dr. J.B.R. Cosgrove, McGiil
University, answered questions on
neurology.

Dr. Robert Kinch from The Montreal
General Hospital discussed social
problems affecting the unwed mother.

Tlie first giu'.sr TV Nurse. Elaine Hazen. interviewed on iter popular weelily sitow out
of Saint John. New Brunswick, was Dr. Stephen Weyinan. At tliat time the doctor
was provincial minister of health: he is now a practisinf> pediatrician in the area.

number of congratulatory letters."

And that was nine years ago!

Shown every Tuesday at 6 P.M.. the
program continued in the same slot for
six years. "It seemed a good time to
reach the people, especially those in
rural areas."

But audience reaction showed an-
other time was wanted. As one farmer
firmly pointed out. "If you'll discuss
my particular problem, I'll even give up
milking the cows to listen."

The program did change viewing
time — to 12:30 P.M. on Sunday. And
this is when Maritimers still "switch

34 THE CANADIAN NURSE

and Dr. Pierre Grondin, the well-known
heart surgeon, told of his work in
cardiac surgery.

Two former ministers of health also
contributed to the program. One, Dr.
Stephen Weyman, now a practising
pediatrician in Saint John, was the first
guest interviewed.

Searching for up-to-date medical
news has garnered specialists from
many countries outside North America.
Britain, Belgium, and Switzerland
among them.

Controversial subjects, such as
pollution, LSD, and venereal disease
SEPTEMBER 1970

have brought yea's and nay's from an
audience deeply involved in the vagaries
of a technical age.

After seeing the program on the
unwed mother, Dr. J.R. Cameron,
director of the Atlantic health unit,
Dartmouth, Nova Scotia, wrote, "Your
program takes a positive approach. It
generates faith and every attempt is
made to counteract unwarranted fear."

Of greatest interest to viewers is a
small word with a large meaning —
obesity. Asked why, Mrs. Hazen said
she felt obesity is one health problem
affecting the majority — and not just
older persons.

People are anxious to know how to
"slim the bulge." They've tried dieting,
and listened to friends divulge their own
slimming secrets — but they never
work.

Often letters from heavyweights are
filled with appeals for medical help.
But, they don't want to see a doctor.
They are too embarrassed.

TV Nurse brings the doctor to them
via the television screen. Questions,
gleaned from letters, are answered as

sensitive skin problems — she wanted
to learn all she could about allergies.

Multiple sclerosis and heart disease
also bring a share of questions. On
these problems, and many others, local
and provincial organizations come into
the picture.

Working with health associations in
Saint John and other maritime areas,
has given the health worker and the
public an opportunity to get together.
The team spirit is evident.

Health associations want to know
public needs, and each individual in
the community needs to know what
services are available.

Getting to know, and telling the
public, is an important part of the
service TV Nurse contributes to the
community.

Norman H. MacBeth, president of
the Canadian Heart Foundation in New
Brunswick, is always eager to help with
information on cardiac questions. When
Dr. Pierre Grondin told of his work in
heart surgery, letters poured in asking
for a repeat show.

The viewing public want to know

As a community service. TV Nurse relays information on medical questions and
scientific data. Here Mrs. Hazen disctis.ses the CNA prior to the 35th convention. (Left
to right) Mona C. Ricks, assistant editor. The Canadian Nurse: Louise E. Miner. CNA
president: Elaine Hazen: Catherine Bannister. N BARN: and Marf>aret D. McLean,
senior nursing consultant, department of national health and welfare.

factually as possible. And so some
overweight fears are allayed.

But, says Mrs. Hazen, we do not
give TV medication — we try to al-
leviate concern by advising viewers to
see a doctor. On one point she is ada-
mant, "We never diagnose on the
program. "

Next to obesity, questions on skin
diseases bring in many letters. One
recently begged Mrs. Hazen for news
on allergies. The writer had missed a
show on the subject — and could she
have some information, please.

Withfourchildren — all with hyper-

SEPTEMBER 1970

more and more about the preventive
measures taken by medical specialists,
says Mrs. Hazen. They need to know
what is being done in research on their
behalf. They want to be involved, right
in their homes, with advances in
medical application. TV Nurse aims to
do thisi

Since her first program. Mrs. Hazen
admits she has learned a lot about
asking the right question to bring out
the information needed by letter
writers. "I learned the hard way, right
before the cameras," she will tell you.

Bui according tether producer. Joe
THE CANADIAN NURSE 35

McVicar, she is still the best person
to host the special program TV Nurse
has become.

He readily admits Mrs. Hazen is a
neophyte in the subtleties of television
knowhow. "And I hope she stays that
way. It makes the show spontaneous."
Producing the program is a unique
experience for Joe McVicar. He feels
it keeps going because of the deep
sincerity generated by its hostess.

"She brings medicine to the people
in a way they can understand. She helps
them overcome fear of medicine and
the doctor."

He describes her audience appeal
as honest, "...coming from a person
who has a deep appreciation of human
needs. She is never too busy to person-
ally answer the letters which come in
after every show."

Answering mail often means research
far into the night to find the correct
reply. Or calling a busy doctor to
acquaint him with a health problem.

Programmed six weeks in advance to
give guests an opportunity to schedule
time and prepare scientific data, the
show uses every medium available to
back up medical information.

Visual aids, demonstrations, and
discussions make up the bulk of the
program; often staged to coincide with
a provincial or national medical event.

While the Canadian Nurses' Asso-
ciation was holding its 35th biennial
in Fredericton, New Brunswick, last
June, two board members and a repre-
sentative from the New Brunswick
Association of Registered Nurses, met
before the TV Nurse mike.

With Mrs. Hazen and one of The
Canadian Nurse editorial staff, they
relayed information on the association
and answered questions about the
convention.

After nine years finding answers to
complex medical questions, and listen-
ing to community problems, what does
Mrs. Hazen foresee is the future for
TV Nurse?

"To keep the service going," is her
direct reply.

Has the program taken over any
duties of the general physician, espec-
36 THE CANADIAN NURSE

iaily in the rural areas? Does the pro-
gram fill in gaps between the delivery
of community nursing service and the
medical practitioner?

To these questions Mrs. Hazen
answers, "NO! It isn't the prerogative
of a television program to fill in medical
gaps, or override nursing service."

But, she will also tell you that some
problems which plagued people in
rural areas have been alleviated. Not
because TV Nurse diagnosed the
problem — but because the television
screen is a responsive listener, inviting
calls for knowledge. Those requiring
help know they can ask for it.

"People seem to have a greater
awareness of their health needs since
we offered this service," says Mrs.
Hazen. By acquainting them with early
symptomsof a disease, and encouraging
them to seek professional help,
prevention has become their own
special therapy.

"Have you brought the patient closer
to the doctor?" Mrs. Hazen was asked
during a press interview.

She smiled. "If it was needed, then
I would like to think I have."

Perhaps one of the most revealing
aspects of the service given by TV
Nurse is Mrs. Hazen's reaction to what
seems a strange question.

"Do you think folklore, attributed to
medicine in some rural communities,
has been dispelled by the revealing
eye of TV Nurse?"

"I think doctors in both urban and
rural areas would agree it has. People
don't go to a doctor with oldtime
apprehensions anymore. Call it what
you like — folklore, or just lack of
health knowledge — they certainly are
able to relate with less fear than
before our program was established.

"They know more about heart
disease and its causes. They are aware
of the ravages obesity can cause. They
are concerned with the social implica-
tions of increased drug addiction."

Because health education in Canada
is under review, cameras in the Saint
John studio continue to scan a wider
and wider horizon for medical news.
Programs tailored for teenagers are

built into the content. Educational
authorities in the area assist.

One of the most popular TV Nurse
programs is an interview with the
school nurse. Sometimes this reveals
another side of the nurse. Students
know the nurse is there to care for cuts
and bruises. Through television, they
learn the nurse will also discuss their
personal health problems and show
how they can be attacked.

How does Mrs. Hazen keep the
program going single-handed?

"I get out of breath sometimes, and
wonder whether I should hand over the
reins. At the end of the fourth year
I did sign off the show with a farewell.

"The calls which followed kept me
busy on the telephone for over an hour.
So, I gave in. And here I am going into
the tenth year."

Watching Mrs. Hazen as she talks
about her show is like listening to the
voice of reason. Everything she says
about education, communication, and
preventive medicine spills over into a
desire to tell the public "what it's all
about." Whether it's sex education, drug
control measures, or world pollution.

And it does make sense!

The window to Mrs. Hazen's living-
room looks out to a protected cove in a
secluded corner of Saint John. Her show
looks out to a world craving for the
word knowledge — unleavened. d

SEPTEMBER 1970

Preventing hearing loss
in industry

Intense noise for prolonged periods can produce hearing loss. In employment
situations where noise is a factor, programs to test hearing and prescribe
aids to prevent loss or further loss are essential.

Vera Hamilton

Of every 100 newly-hired workers in
industry, about 20 to 27 are found to
have hearing loss.^-^ Frequently, the
person is unaware of his hearing disa-
bility, and, by the time it is discovered,
irreparable damage has been done.

All too often, the person's hearing
loss has been caused by intense, pro-
longed noise in his work environment.
To prevent this, hearing conservation
programs are being established by
employers to help their workers assess
and protect their hearing. In most of
these programs, occupational health
nurses or public health nurses are very
much involved.

Anatomy of sound

Sound waves travel through air at
approximately 1,130 feet-per-second.
If their intensity and frequency are
within certain ranges, they produce
the sensation of hearing.

Sound has two fundamental charac-
teristics: frequency (which the ear
receives as pitch) or number of sound

Miss Hamilton graduated from the Sol-
dier's Memorial Hospital. Campbellton,
New Brunswick, and has a diploma in
public health nursing from Dalhousie
University, Halifax, Nova Scotia. She was
employed as district nurse with the New
Brunswick International Paper Company
for six years before becoming in-plani
occupational health nurse in 1962.

SEPTEMBER 1970

waves per second; and intensity {which
relates to loudness and pressure) or
the amplitude of the sound wave.

Sound may consist of a single fre-
quency (pure tone), such as that pro-
duced by a tuning fork or audiometer,
or of a combination of many frequen-
cies, such as those that make up
industrial noises.

The human ear responds to frequen-
cies ranging from about 16 to 16,000
cycles-per-second. The higher the
frequency, the higher pitched the
sound.-' Middle C on the piano is about
250 cycles-per-second; the top note on
the piano keyboard, about 4,000 cycles-
per-second.

Sound intensity is measured in
decibels (dB). Zero decibels represent
roughly the weakest sound a person of
good hearing can hear in a quiet place.
A whisper registers about 20 decibels;
a power lawn mower, 100-1 10; and a
jet engine, 140-160.

A sound wave, carried through the
air, reaches the outer ear and enters
the auditory canal where it strikes the
ear drum. This moves the ossicles,
which carry the wave through the
space of the middle ear to the oval
window. The vibrations of the stapes
against the oval window move the fluid
in the inner ear, which, in turn, stimu-
lates certain sensory nerve endings.

These nerve fit^es, depending on

the type of sound, transmit the sound

THE CANADIAN NURSE 37

Author Vera Hamilton talks to employees in the shipping department of the New Brunswick International Paper Company.
Dalhousie, New Brunswick. She always wears a hard hat when touring the plant.

via the cranial nerve to the brain. If
hearing is perfect, ail this takes place in
less than 1/1 ,000 of a second.

Tones of different frequencies stimu-
late the nerve endings in hair cells in
different regions along the inner ear
membrane. Failure of this nerve mech-
anism to register and transmit sounds
to the brain is called sensorineural
deafness. Noise-induced deafness is
an example of this. So far, it cannot be
helped by medicine or surgery.^

Deafness

There are two basic types of deaf-
ness: conductive and sensorineural.

In conductive hearing loss, the
damage is found in the external ear
canal, the middle ear, or the Eustachian
tube. Possible causes of this damage
are: impacted wax; foreign body or
cyst in the ear canal; infection or
ruptured ear drum; and congenital
malformations.

In sensorineural hearing loss, the
damage is to the inner ear or auditory
nerve. Some causes are head injury,
certain drugs, and exposure to intense
noise.

The onset of hearing loss from noise
exposure is insidious. First signs usually
appear in the hair cells responding
to 4,000 cycles. Continued exposure
lowing initial damage in the 4,000-
cycle range may gradually spread into
areas responding to lower frequencies.
38 THE CANADIAN NURSE

Not until these lower ranges are reached
does the individual begin to experience
some difficulty in hearing speech.

There is little evidence that low
noise levels cause hearing damage, but
where noise levels are high, steps must
be taken to reduce noise and conserve
hearing through ear protection.

Testing programs

When a hearing conservation pro-
gram is considered, two things are
basic: a person trained in audiometry
to run the program, and a proper
testing environment.

Valid measures of hearing acuity
cannot be obtained unless sound levels
in the examining room are low enough
to avoid interference with pure tones
used in the tests. Many centers have
soundproof booths, but this is not
always necessary.

If a soundproof booth is not available
and the noise level in the room is
excessive, steps can be taken to reduce
it. These include: making sure there
is a tight-fitting door at the entrance;
having acoustic tiles placed on door,
walls, and ceiling; and seeing that the
floor covering is soft. Attention
should be paid to light fixtures, as
some produce a loud hum.

The most important piece of equip-
ment for testing is the audiometer,
which produces pure tones at various
frequencies and intensities for measur-

ing hearing acuity. It is a delicate
instrument and must be handled with
care. Rough handling, overheating,
and exposure to dust will cause the
audiometer to lose its calibration.

The nurse should periodically check
the threshold hearings of at least two
control subjects. If the instrument is
used daily, a calibration check should
be made at the beginning and end of
the day. The nurse herself can be one
of the control subjects. A record is kept
of all calibration checks.

Before starting audiometric testing,
sound level readings should be taken
in all the work areas in the plant.
Management can obtain the services
of an industrial hygiene engineer from
the department of national health and
welfare, to carry out this study.

The engineer will make noise meas-
urements throughout the entire mill
with a sound level meter and octave
band analyzer. He also can compile a
comprehensive report of these findings,
along with a list of the permissible
maximum duration (minutes) of expo-
sure for each shift in each area.

This report will assist the nurse by
showing her at a glance where each
employee is working, what the noise
level is, and if hearing protection should
be recommended. It also ends many
arguments as to whether an area is
noisy or not. It is not uncommon for
an employee to tell you an area is not
SEPTEMBER 1970<

Those who work in lu^li-noisc areas oj tin- plant liave an audiogram every eight months to a year. Miss Hamilton, who has
special training in audiometry, tests the hearing of one of the company's employees.

really noisy at all — simply because
he has become accustomed to the noise
or because he already has a severe
hearing impairment.

Getting started

The New Brunswick International
Paper Company began its program for
hearing testing in 1968. Before be-
ginning, a letter was given to each
employee along with his pay cheque,
telling him he would have the oppor-
tunity during the next few months to
have his hearing checked.

The test was not compulsory, but
employees were advised to take
advantage of the opportunity.

Letters were also sent to doctors in
in the area informing them of our
plans. We proposed a two-pronged
program: testing and education. Doctors
were advised that this audiometric
testing was not diagnostic, but screen-
ing, in nature. Persons showing hearing
loss would be referred to their own
doctor.

Meetings were held with supervisory
staff and with representatives of local
labor unions. At these meetings, the
nurse explained the program and
discussed ear anatomy, effects of high
noise levels, the kind of information
required for records, the importance of
seeking professional advice for hearing
impairment, and the use of hearing
protection. A film, entitled How We
SEPTEMBER 1970

Hear, available from the Audiovisual
Services, New Brunswick Department
of Education, was used as well.

The first persons tested were man-
agement, supervisory foremen, and
local union officers. Then we started
in the various departments.

A hearing conservation program in
its first stages is time consuming. Our
management employed a second nurse
to handle the industrial plant nursing
work, so I could work almost exclu-
sively on the hearing program. I also
went to Colby College in Waterville,
Maine, for a short course in audio-
metry.

of sound, audiometric testing, record
keeping, ear protective devices, inter-
pretation of audiograms, and legal
aspects. At the end, nurses are certified
as competent to perform pure tone air
conduction audiometry.

Records must be kept of all tests.
The audiometric record we use is a
serial type record on which the results
of many audiograms can be entered. A
glance at the record shows if any change
has occurred since the previous audio-
gram was taken.

The pre-employment audiogram
record may be important at some future
date in compensation claims. It may
reveal a claim is legitimate, or it may
be a defence against false claims.

The employee is usually interested
in his record. It can be used as a moti-

vating tool to convince him of the
importance of wearing ear protectors,
especially if we find he has a high-
frequency hearing loss that was pre-
viously unknown.

The first audiogram takes approx-
imately one-half hour. This includes
explaining the procedure; taking a
brief history; recording the results;
discussing hearing protection with those
who work in areas with high noise
levels; discussing the results of the
audiogram; and, if necessary, recom-
mending that the individual visit his
own doctor.

Repeat audiograms lake less time,
but the testing routine follows the
same procedure each time so that com-
parisons of results are valid.

We try to test the entire work force
on a revolving basis, which can take up
to two years. Those working in high-
noise areas have audiograms more
frequently — every eight months to
a year.

Hearing protection

There are two main types of hearing
protection used in our plant: ear muffs
and ear plugs. In some industries, where
higher noise levels occur, employees
wear a helmet-type protector that
completely covers the cranium.

i,ar muffs cover the whole ear;
fitting is not a pipblem as they are
easily adjusted and offer good atten-
THE CANADIAN NURSE 39

B ANATOMY OF THE HUMAN EAR

1 '

An assortment of hearing protectors worn by employees in high noise areas. In some industries, where extremely high noise
levels prevail, a helmet-type protector (not shown) is used by the employees.

uation. The disadvantage to muffs is
that workers complain of discomfort
when woricing in warm areas. Since
many areas in our mill are warm, the
muff-type protector is not popular.

Ear plugs are available in many
types and in a variety of materials
(rubber, neoprene, plastics). They must
be fitted properly, but this is not dif-
ficult as a wide variety of sizes is
available.

Plugs are the preferred protection in
our plant. The disadvantages are that
they require proper insertion daily by
the employee for maximum comfort
and effectiveness.

We have found disposable plugs
work well, and use both the waxed
cotton and Swedish wool (fine fiber-
glass down) types. They are popular
even with employees who complain of
discomfort with standard plugs. As
they must be disposed of after a single
use, the cost is slightly higher.

One type of plug will not prove
satisfactory for all workers, mainly
because ear canals vary in size and
shape.

There seems to be more resistance
to the use of hearing protectors than
to other types of personal protective
devices, such as hard hats or safety
shoes. The two most common reasons
given are that employees find hearing
protectors uncomfortable, and that
40 THE CANADIAN NURSE

they are not convinced of the need to
wear them.

Frequently, employees accept noise
as a normal part of the occupation and
do not worry about something that
may not take place for several years.
Older employees who have hearing
loss need to be convinced that the
wearing of protective devices will
preserve their remaining hearing.

Our records show that those who
have been wearing their plugs while
working in noisy areas are the ones
with the good hearing.

The educational program regarding
hearing protection seems never ending,
but it is a challenging and interesting
part of my occupational health nursing.

One employee comes in for a hearing
test and announces emphatically that
he's against ear plugs "because they
are no good anyway." He may go out
still against ear plugs, despite all our
efforts.

He may be followed by another
employee who is afraid that his walk
from the entrance to the nurse's office,
without hearing protection, may have
damaged his hearing. This employee
prefers to wear a helmet protector all
the time.

Fortunately, the majority of workers
are somewhere between the two views.
So we don't give up hope. Our aim is
to see that, in future, all our workers

will reach retirement age still able to
hear all the sounds that are meant to be
heard.

References

l.Maas, Roger B. Hearing Conservation
Industry. Employees Mutual of Wausau,
Wisconsin.

2. Sataloff. Joseph. Hearing Loss. Toronto.
J.B. LippincoU Co.. 1966, p. 3.'59.

3. Guide for Industrial Aiidiomelric Tech-
nicians, Wausau, Wise, Employees In-
surance of Wausau, 1967, p.4.

4. //)/(/., p.8. n

SEPTEMBER 1970

//

Distress Center — may I help you?

ff

At the Ottawa Distress Center, volunteers sUnd by to help telephone callers who are
in need of reassurance, companionship, or simply a sympathetic ear. This type of service
is providing valuable assistance to hundreds of depressed persons.

Dorothy S. Starr, B.A., M.N.

"This is the Distress Center. Dorothy
speaking. May I help you?"

The person on the other end of the
telephone may be shy and hesitant, or
so sleepy with drugs taken in an attempt
to end life, that the Distress Center
volunteer leans into the telephone,
trying to catch every word. Or the
caller may come on booming — indig-
nant, hostile, frustrated with the cir-
cumstances of his life.

Another caller will speak with a
burst of sound, releasing pent-up
emotion in speech so rapid and slurred
that only when the torrent has subsided
can the volunteer ask a few questions to
understand the caller's basic problem.

An organization of listeners

The Distress Center is a community
service, operated by volunteers who
answer the telephone and talk with
individuals who are disturbed. It is not
a professional counseling service, but
an organization of friendly listeners.

The need for a Distress Center arises
from the anonymity of life in a city,
where individuals may not know anyone
well enough to talk over their problems
as they would with a friend or family

Mrs. Starr, a graduate of Yale University
School of Nursing, New Haven, Connecticut,
is Assistant Professor of Nursing at the
University of Ottawa School of Nursing.
SEPTEMBER 1970

THE CANADIAN NURSt 41

member. Several Canadian cities offer
this telephone service: in Vancouver,
it's called the "Crisis Center"; in
Toronto, the "Distress Center"; in
London, "Contact"; and in Montreal,
the service is called "The People's
Center."

Background of Ottawa center

A variety of people and concerns
were responsible for the establishment
of the Ottawa Distress Center. A young
couple moved to Ottawa from England,
where they had been active in The
Samaritans — a telephone service
started in 1953. At the same time, a
social action committee of churches in
downtown Ottawa was considering the
need for a telephone service for troubled
people, and wrote for advice to the
Toronto Distress Center. The Toronto
Center referred the Ottawa committee
to the newly-arrived English couple.

After contact was made with the
Social Planning Council of Ottawa,
family service agencies, and the Cana-
dian Mental Health Association, to
determine the need for this telephone
service, a steering committee of vol-
unteers was formed. A year of organ-
izing, recruiting, and training vol-
unteers followed. When the Ottawa
Distress Center was opened on March
17, 1969, 90 volunteers were trained
and ready to man the telephones from
9:00 A.M. to 1 1:00 p.m.

The Ottawa center is financed by
local service clubs, a grant from the
Alcoholism and Drug Addiction Re-
search Foundation, a grant from the
regional municipality, individual dona-
tions, and fund-raising projects.

Volunteers well qualified

The volunteers who answer the
Distress Center's two phone lines come
from many walks of life; a significant
proportion are nurses, both those
actively engaged in professional prac-
tice and those who are full-time home-
makers.
42 THE CANADIAN NURSE

An initial six-week training course,
consisting of a two-hour session each
week, follows the acceptance of an
applicant as a volunteer-in-training.
During this course, the volunteer
receives information about community
resources, role-plays telephone calls,
and discusses ways in which the Cen-
ter's purpose of friendly listening or
referral to professional agencies are
carried out.

The leader of the training program
— a professional with background in
counseling and a knowledge of com-
munity resources — screens volunteers
during the training course. Those who
are accepted for service are placed on
the duty schedule and are again screened
in action.

Volunteers usually work in pairs,
manning the two telephones for the day
and evening shifts. When possible, a
male and a female volunteer are teamed
to meet the caller's preference to talk
to a man or a woman.

In May 1970, volunteers numbered
about 150, with a waiting list for the
fall training courses. Whereas volun-
teers were at first recruited by word-of-
mouth and by announcements made in
churches, they now respond mainly to
advertisements in newspapers and to
radio and television publicity.

Sample calls

Who calls the Distress Center? Here
are examples of the type of conversa-
tions 1 have received.

"May I help you?" is answered by
the trembling voice of a young woman
who says, "Talk to me!"

What have we here? A would-be
suicide who has changed her mind?
Someone who is mentally ill? A drug-
taker who wants to keep in touch with
reality? Find out a little more; try the
echo: "Talk to you?"

The young woman continues: "I'm
so lonesome for the sound of a human
voice. My husband is away all week
driving a transport truck and the chil-

dren have gone to bed. Just talk to me."

"Certainly. What would you like to
talk about?"

The caller, whose name is Mary,
really means: "Please, listen to me."
So I listen, asking an occasional ques-
tion as Mary tells me what she's been
planting in her garden, about her chil-
dren, and also about her loneliness and
feelings of isolation.

During the conversation 1 find out
what triggered the call. If Mary is
willing, we can then talk about what
she would like to do to lessen her
isolation. I may be able to suggest the
"Y" program for mothers and pre-
schoolers, or a nearby church group
of young mothers. Mary may be so
lonesome that she just hasn't been
able to think of these things.

Another caller is an elderly man,
crippled with arthritis, living alone
"because my children don't want me,"
and bitter at the world. He sounds
disagreeable. As he complains about
the various social and medical agencies
in town, I can imagine that he must
have sorely tried the patience of the
various professionals with whom he has
come in contact.

It's much easier for me to talk with
him on the phone, without any goal but
to listen and be friendly, than it would
be to meet him in my professional
capacity. So I listen and make no
comment on his vilification of the
agencies and the workers who have
tried to help him. Nobody is any good.
Nobody cares about him. The doctors
are all quacks, the nurses are all rough,
and the social workers are all snoopy.
I feel a kinship with the social welfare
workers and the public health nurse,
and hope his call to the Distress Center
may have relieved the pressure a little
so that his next contact with these health
workers may be more productive.

A 1 3-year-old girl calls to say her

parents disapprove of her friends and

won't let her stay out past 10:00 P.M.,

even on weekends. We discuss how she

SEPTEMBER 1970

might arrange for her parents to meet
her friends. I curb my temptation to
share with her my feelings for her
parents, and try to let her see for herself
how she feels about them and how she
perceives their feelings about her.

Our talk ends with. "Well, I guess I
could talk it over with mother. Maybe
she'd let me ask some of the kids over
to dance in the rec room, so she and
dad could meet them." She thanks me
warmly, and I wish her success with the
proposed party.

The next call is trying: the caller is
a patient in a psychiatric day hospital,
who has been referred by the hospital
to the Distress Center as an additional
resource in the evenings. She is anxious
and fearful, and wants reassurance that
a Distress Center volunteer is willing
to talk to her. I am unable to get a clear
picture of any particular problem at the
moment, but follow her lead for a
rambling 20 minutes. I remind her that
she may call us anytime. She seems
more composed as she says "good-bye,"
but I find I need a cup of coffee.

I'm glad I had that coffee when 1 talk
with the next caller. "May 1 help you?"
is greeted by a belligerent male who
snarls, "No, I don't think so, but try,
just try to give me one good reason not

to leave this world." The

adjectives preceding "world" are not
complimentary to the cosmos.

1 don't take the bait, but instead try
to find out what's bothering him right
now. The picture that emerges gradu-
ally, between milder bursts of profane
anger, is a grim one; out of work, a
drinking problem, his wife left him six
months ago and took their three children
to her parental home.

The final straw that led to the call
to the Distress Center is almost comic
relief: last night he put his foot through
the television set when he had been
drinking, and just now realized he
wouldn't be able to watch the hockey
game. He has no money to get the TV
repaired, and no money for a beer so
SEPTEMBER 1970

he can watch the game at a nearby bar.
I try to find out what he would like to
do about the present situation. What
emerges would require a magic wand
— which the Distress Center does not
include in its shabby office furnishings.
The caller would like a lot of money,
his TV fixed, and his wife and children
home.

1 enquire whether he has discussed
his problems with anyone. He says he
hasn't, but when I suggest a social work
agency, he turns it down with an oath.
So, we aren't going to get anywhere at
the present time with a referral. Some
of the steam seems to be drained from
his anger; he sounds sad and depressed.

How serious was his implied threat
of suicide? He says he hasn't decided on
the method of suicide, so it seems less
imminent. I ask whether he would like
to talk over his problems with a Distress
Center leader. Sometimes we can get a
counseling process started in this way.
He willingly gives me his name and
telephone number so the leader can call
him the next morning.

!f I had sensed that he planned to
commit suicide, or if he had already
taken action to end his life, the proce-
dure would be to have the other vol-
unteer use the "hot line" to call the
leader and, if necessary, the telephone
company, to trace the location of the
caller. The fastest way to get resusci-
tation and transportation to an indivi-
dual whose life is in danger is through
the police, whom we would notify
when we had a name and address. This
kind of action is rarely necessary, but
a leader — who is on call for each
24-hour period — is notified to share
responsibility with the volunteer.

Advantages to volunteers

As a professional nurse, volunteer
work at the Distress Center has enriched
my ability to practice nursing and to
teach nursing in several ways know-
ledge about our society and the prob-
lems people encounter is supplemented

with actual experience; consumer re-
action to health care is available in more
direct, less censored, tbrm than is pro-
vided to a person identified as a nurse:
listening skill grows when one concen-
trates attention on this sense alone; ap-
preciation of the helping ability of lay-
men (other volunteers) curbs any ten-
dency to a professional "God complex.'

The personal growth and develop-
ment of each volunteer can be measured
only by the individual, but I believe
it must be a growing, learning ex-
perience for most. An ability to lessen
another's distress satisfies personal
needs and is reflected in performance
of work activities and relationships
with others.

Distress Centers are meeting a real
need in Canadian communities, as
evidenced by the use made of their
services. If there is a Distress Center in
your town, you might like to consider
being a volunteer. If there is not, you
might work with other citizens to
establish one.

However it is phrased, "May I help
you?" is an answer to a cry for help. □

THE CANADIAN NURSE 43

Call it what you will, discrimination, unfair practice, or another attack on sex
equality, the situation described below surely calls for consideration!

Discrimination
that's what I call it!

Kay G. Roberts

It'sgross, unjustifiable, unconstitutional
discrimination against women. Besides,
it's not fair!

I mean to say, we don't want to die
a miserable death from lung cancer any
more than the men do. Yet they have
their cake and eat it too, and we can't.
Those crazy social customs — estab-
lished by men and condoned by women
— are denying women the right to live
and smoke.

Look at it this way. When a man
smokes a pack of cigarettes a day, he
is in for trouble. He is 10 times more
likely to die of lung cancer than his
friend who doesn't smoke. He's loading
the dice against himself for a coronary,
for bronchitis, for emphysema, and a
mess of other nasty diseases. But he has
an out! He can stop smoking cigarettes
and switch to a pipe or a cigar. From
the statistics available, these don't
seem to undermine his health. He can
puff away on his beastly old briar, or
chew up to five fat cigars a day without
detriment to his health. But can we
women? Oh, no!

We have to remain sane on our own
particular diet of cigarettes, or suffer
the agonies of withdrawal with a stoical
smile. We're not allowed an occasional
stogey, or a pipe full of our favorite
English blend, to calm our nerves during
coffee break or at the coffee clutch in
suburbia. Women frown on it because
men frown on it because their mothers
would have frowned on it.
44 THE CANADIAN NURSE

In short, we female smokers can
either take our chances of dying a
premature death, induced by cigarette
smoking, or live as neurotics, twitching
with desire for just one more fag.

The answer, of course, lies in our-
selves. We have to change the national
mores. We have to change the customs
so that we, too, can puff a cheroot
delicately in public, or pull a pipe and
tobacco pouch from our purse (in any
social situation), and join the men who
quit the butts for a briar or a Havana.

But right now the equipment for this
is wrong. What we need is a designer
of smoking utensils who will make the
pipe and cigar feminine and socially
acceptable.

What we need are the tools for the
vice. We can't go around with a dirty
old briar clamped between our teeth. It
would look too disgustingly masculine.
So why doesn't someone design for
women a delicate, floral bowl in china,
or one with classical figures in Wedge-
wood blue and white. We could pull
SEPTEMBER 1970

1

out our rhinestone pouch of baccy, load
up with the men, puff away serenely,
and still look feminine.

When it comes to cigars, we don't
need to haul out a Churchillian monster.
Why not slim cheroots, rolled specially
for women? And we could draw the
soothing smoke through elegant holders
in silver, jade, or amber. After all,
manufacturers have produced cigarette
lighters and cases for ladies, and in one
epoch, ladies snuffboxes. It's a question
of fashion really, and social acceptance.
SEPTEMBER 1970

Which brings up another matter.
Perhaps a female V.I. P. might be per-
suaded to popularize the habit on TV.
The girls on Front Page Challenge, for
instance, could be invited to smoke a
cheroot or puff on a pipe.

Can't you just see a blonde in a
TV spot ad selecting a long, thin stogey?
Then beating off the men who rushed
to light it! And can't you see the girls
in suburbia comparing their latest
pipes and pouches over coffee, and
discussing their favorite blend of

tobacco? With a well-planned cam-
paign I can see a new industry rising
from the ashes of the cigarette trade.
What does a pipe or a cigar taste like?
Hmmmmmm ... that's your problem.
I'm talking about women's rights. D

The auihor of this coniroversUil outcry is
the editor of a national magazine.

THE CANADIAN NURSt 45

Drug Misuse in
Teenagers

David Lloyd, M.D.

One of the important problems among
today's adolescents is the misuse of
drugs. At The Hospital for Sick Chil-
dren in Toronto there is an increasing
need to understand more about the
problem because, first, there has been
some extension of drug misuse into
younger age groups and second the Hos-
pital recently extended the age limit for
its patients upward from 16 to 19 years.

This is a very rapidly changing field
and, for this reason, there are all too
few people who can be called experts.
Nevertheless, over a period of months,
some penetration was achieved into the
world of the teenage drug misuser and
much current information elicited.

Any discussion of drug misuse must
take place within the context of soci-
ety's current views and practices with
respect to all the substances that affect
a person's mood and behavior. Choice
of any particular drug by any one seg-

Dr. Lloyd is a Resident at The Hospital for
Sick Children. Toronto, in the Adolescent
Clinic. He is also a physician at the Toronto
Free Clinic, Toronto, Ontario.

Reprinted, with permission, from Applied
Theriipeulics, Vol. 12, No. 3, March 1970.
Although this article is directed to doctors,
the editors of The Canadian Nurse believe
it will be of interest to many registered
nurses in this country.

46 THE CANADIAN NURSE

ment of the population at one time is
generally less significant than the under-
lying personal and social reasons for the
use or misuse of drugs.

Cannabis sativa

More commonly called "grass" in
Toronto "on the street," Cannabis
sativa (marijuana), presents a paradox
in that it seems to be the cause for major
concern despite indications in the most
recent pharmacological literature that
it is relatively harmless.-^ In our society
the misuse of alcohol and other drugs,
such as the barbiturates, poses a far
greater problem than Cannabis in terms
of habituation, functional and organic
damage in the habitual user, as well as
morbidity generally.

Slang terms for Cannabis are multiple
and vary according to geographic re-
gions as well as popularity of current
jargon. Marijuana, grass, pot, mary jane
are all popular in the North American
idiom. In Jamaica the word is Ganja
(meaning "the weed"), in India, Cha-
gras; Acapulco Gold is a very potent
form of Cannabis originating in Mexico.

The active ingredients in Cannabis
are tetrahydrocannabinoids (THC's)
obtained from the flowering tops and
upper leaves of the unpollinated female
Cannabis plant. The male plant has lit-
tle or no pharmacological effect but,
when harvested, is almost indistin-
SEPTEMBER 1970

Cunnabis saliva

guishable from the female plant, making
it a good control in any study of this
compound's effects.

Hashish, also obtained from the can-
nabis sativa plant, has a higher percent-
age of cannabinoids. It is obtained from
the resinous material exuded from
the flower tops and leaves. Cannabis is
similar to dry, crushed parsley in ap-
pearance— greyish-green to greyish-
brown in color. Usually, the seeds and
stems have been screened out.

Marijuana can be smoked in a thin,
hand-rolled cigarette ("joint") or in
a pipe. It can also be brewed in tea or
baked in cakes, such as brownies.
Hashish is sold in solid cakes or blocks.
It ranges in color from light brown to
black, and its consistency may be
crumbly or hard and resinous.

Much has been written recently in
SEPTEMBER 1970

the daily tabloids about the effects of
Cannabis. A lot of this information is
irrelevant, based on emotional appeal
rather than scientific fact. The effect of
any psychogenic drug will always vary
with three factors: the user, the dose,
and the circumstances in which the drug
is taken. Marijuana and hashish (which
have similar effects) are no exceptions.
Common effects are a sense of ex-
hilaration and alertness, feelings of per-
ceptiveness and self-confidence, talk-
ativeness with outbursts of laughter.
Appetite is stimulated and there is a
slight rise in pulse rate and blood pres-
sure. Conjunctival congestion and dry
mouth may occur. In higher doses, hal-
lucinations and perceptual distortions
may be experienced.

In 100 subjects accustomed to Can-
nabis and given a fixed dose, exhilara-
tion, talkativeness, lessening of fatigue
and increased appetite were the most
commonly reported effects.' Depression
and mental fatigue were reported least.
Inexperienced users generally reported
fewer and less intense effects. Panic
reactions occasionally occurred, partic-
ularly if the subjects were inexperienced
and apprehensive at the time of intake.
The only literature on the long-term
effects of Cannabis comes from coun-
tries where malnutrition and poor liv-
ing conditions are rampant. From such
studies it is difficult to distinguish
whether any of the effects described are
due to the Cannabis per se or the poor
socio-economic conditions in the coun-
tries where the drug is popular.

It is uncommon to treat anyone tak-
ing pure Cannabis. Panic reactions that
occur in inexperienced users can usual-
ly be handled by talking to the patient
in a calm and understanding manner.
Valium (Hoffmann-La Roche Limited)
is used in the rare case where panic and
agitation are extreme.

LSD 25

d-lysergic acid diethylamide

This drug is an example of those
which have a hallucinogenic effect.
"Acid," as it is called on the street, is
related in structure to other hallucino-
gens such as psilocybin, psilobin and
mescaline. All these compounds contain
an indole ring as part of their structure.

Other hallucinogenic compounds
include FUK (a phosgene derivative),
which appeared in 1968. Its use, for-
tunately, was limited, following several
deaths reported on the West coast. An-
other hallucinogen is DOM (2, 5 di-

methyl-4-methoxy-amphetamine) re-
ferred to by its users as STP — serenity,
tranquility and peace. Of these drugs,
LSD25 is more commonly used.

LSD25 is a synthetic chemical obtain-
ed from a fungus belonging to the ergot
family that grows on rye plants.

On the street, LSD25 appears in var-
ious forms — colored capsules or tablets
in doses of 250 to 1 800 micrograms. At
the present time, it is usually combined
with a stimulant.

The effects of the drug are influenced
by the same variables that were dis-
cussed with regard to Cannabis — sub-
ject, dose and circumstances. Previous
experience with LSD25 may also influ-
ence the effects.

Visual effects, such as perception of
intensified colors, distorted shapes and
sizes, as well as movement of station-
ary objects, may be experienced. Au-
ditory distortions may also occur, as
well as disorientation. Emotional re-
actions are varied but increased self-
awareness and dissociation of mind from
body are reported. Negative emotional
reactions are experienced, and these
are very common when the pre-intake
personality is disturbed in some way.
The same user may have good "trips,"
or experiences, or bad "trips" on dif-
ferent occasions.

It is the bad experience or trip that
presents a problem in management.
When first seen, the patient is in a state
of acute anxiety, but with a relatively
clear sensorium. Visual and tactile hal-

Table 1

Summary of reactions of 100 subjects ac-
customed to cannabis smoking, after admin-
istration of V2 g to 2 g of ganja or charas
through a pipe

Effects

Number

1. Euphoria and feeling of exhilarafion..7£

2. Depression 12

3. Increased energy, desire and
capacity for work 39

4. More talkative 60

5. Mental activity and efficiency

increased 30

6. Mental activity and efficiency

decreased 10

7. Sharpening of appetite .58

8. Diminution of appetite 30

9. Appetite not affected 12

10. Feeling of constriction in the throat.. .40

1 1 . Reaction to work as regards fatigue:

(a) Less fatigue BO

(b) Sense of fatigue enhanced 20

(c) No effect 20

•

THE CANADIAN NURSE 47

Laid out on a towel ready for use are these typical items used by drug abusers in To-
ronto. The three needles at left and top right are typical of those used to iniect meth-
amphetamines. The ampoule is of a type similar to those containing amphetamines.
The eyedropper at right was converted to a hypodermic by taping a needle to it.

lucinations often accompanied by syn-
esthesias are common. Such a person
may be sensitive even to minor environ-
mental stimuli and his focus of attention
may shift quickly and frequently.

Paranoid suspicions and autistic
withdrawal may occur in the same hour
— in fact, the mental state may vary
considerably. Thus, periods of apparent
lucidity and normality tend to give way
to abrupt recurrences of the bizarre,
fearful state.

The principles in managing a bad
LSD trip are: reassurance, reduction of
threatening, external stimuli, and relief
of panic with chemotherapy.

The treatment personnel are of the
utmost importance in the successful
management of a bad trip. In mild cases
of anxiety and agitation, their sympa-
thetic attitude toward the patient, com-
bined with an understanding of his fear
of loss of control over his environment,
are all that is necessary for successful
treatment. In anything but mild cases,
however, the trip should be aborted
chemically and as rapidly as possible.
This seems to reduce the likelihood of
so-called LSD flashes (recurrences) in
the future. It is also not practical to
have such a patient tear up an emer-
gency ward. Within reason, start chemo-
therapy as soon as possible, before the
patient harms himself or someone else.
48 THE CANADIAN NURSE

Any person dealing with a "freaked-
out acidhead" should avoid threatening
legal or moral judgments and try to sup-
press any exhibition of hostility. Angry
value judgments reinforce the patient's
mistrust of treatment institutions and
medical personnel. This widens the
credibility gap that pre-exists in such
a situation and lessens the chances of
a patient or his friend returning to an
institution where proper medical treat-
ment can be given.

A simple attempt with a nasogastric
tube can lead to a disastrous situation,
as it can be interpreted as a very threat-
ening move. Lavage is to be discouraged.
It is a useless procedure where in most
cases drugs have been ingested an ap-
preciable period of time previously.

Most bad LSD trips are treated chem-
ically and hospitalization is often ad-
visable following this treatment as the
patient tends to require such large doses
of drugs in therapy that he may require
monitoring of his vital signs. Whenever
practical, however, the patient should
not be admitted against his will.

When LSD25 made its first appear-
ance in the drug sub-culture, chlorpro-
mazine was used to decrease anxiety and
psychiatric symptoms of a bad trip dur-
ing the acute phase of agitation, which
lasted anywhere from 8 to 24 hours.

Today, pure "acid" is rarely found m

the streets and combinations of LSD
are most common under such names as
the "Peace Pill" (LSD, cocaine and
mescaline), "LBJ Stayaway" (LSD, bel-
ladonna and atropine) and, more com-
monly, LSD and methamphetamine.
The latter prolongs the LSD effects.

Atropine compounds enhance the
hypotensive effect of chlorpromazine in
a synergistic but non-dose-related man-
ner. Too often, the administration of
chlorpromazine to a patient who sup-
posedly has taken LSD, has resulted
in a cardiovascular collapse, cardiac
arrest and even death. A similar picture
results when chlorpromazine is given to
"freaked-out" STP users.

In the initial assessment, any signs
of atropine poisoning or a history of
what was ingested can be helpful. But
most of the time this is not available
and, since all the underground pills re-
semble each other, it is best to treat in
a manner which is likely to do least
harm. Therefore, the use of chlorprom-
azine is discouraged. In the present
treatment of bad trips, Valium is the
most popular drug in Toronto and other
major centres in North America.

In a Toronto series of 69 patients
with acute hallucinogenic psychoses re-
ported by Solursh and Clement,^ 67
cases responded favorably to diazepam
(Valium). The two patients who failed
to respond had pre-existing psychiatric
disorders (indigenous depression and
paranoid schizophrenia) and required
further chemotherapy.

Methamphetamine HCL

The third and last group of com-
pounds abused by adolescents are the
amphetamines, a group of synthetic,
sympathomimetic stimulants, with a
basic phenylethylamine structure. The
proper medical use is limited to the
treatment of narcolepsy and hyperki-
netic behavior in children.

Unfortunately, amphetamines are
very much abused. Thousands of house-
wives ingest them as a panacea for that
terrible trio: obesity, fatigue and depres-
sion. Students use them to keep awake
while cramming for examinations.

Although the present discussion re-
lates to high-dose amphetamine abuse,
the previously mentioned examples of
low-dose abuse are relevant because
they indicate that drug abuse is not
confined to the sub-culture drug user.
If you understand the relative ease
with which the low-dose abuse evolves,
it is easier to comprehend how high-
SEPTEMBER 1970

J

dose abuse can become such a problem
among adolescents.

Amphetamines are the cheapest, least
legally risky drug available. Possession
is not against the law. Trafficking is
illegal, but large quantities usually must
be found by police before trafficking
is considered to be present. Today, it
is much easier to obtain amphetamines
in Toronto than some other drugs, such
as marijuana.

Methamphetamine, referred to as
speed, meth or crystal, is the most com-
mon amphetamine in street use. It is
manufactured illicitly by underground
chemists using facilities where they
work or their own small labs set up
wherever feasible. The chemists are u-
sually heavy users and generally have
a sponsor with the necessary funds to
set up the operation. The sponsor may
be a loan-shark or an active partner.

A chemist can produce methamphe-
tamine for about three dollars an ounce
and will sell it for roughly nine dollars
an ounce to a distributor. The distrib-
utor, rarely a heavy drug user himself,
will dilute the product (one part drug
to four of bulk materials) to increase
the volume. He will sell this diluted
product at $80 an ounce to "quantity
dealers" on the street.

These latter individuals usually deal
in a variety of drugs. Depending on the
market, they sell to "street dealers"
who may be high schoolers, motorcycle
gangs, or similar people, and who are
usually heavy users themselves. The
street dealer will sell to the ultimate
consumer for prices up to $100 an
ounce. Almost all users deal some of the
time, but not as consistently as the street
dealers.

Amphetamines are sold in two forms,
as solids in a white powder or tablets
or capsules; or in solution ready for in-
jection. Since the price of tablets is
about 50 percent to 70 percent less than
the injectable ampoules, the user often
buys the solid form and turns it into so-
lution for himself. Usually the solution
is hot water from the nearest tap, "ster-
ilized" in a spoon and injected intra-
venously.

The effects of amphetamines are
predominantly on the central nervous
system and include arousal, wakeful-
ness, lessening of fatigue, a sense of in-
creased energy and self-confidence,
euphoria and, to a lesser extent, nerv-
ousness, insomnia and appetite reduc-
tion, with excessive motor activity.

Physically, the action of the amphe-
SEPTEMBER 1970

tamines is close to that of adrenalin.
There is an increase in heart rate and
blood pressure; widely dilated pupils;
dry mouth; sparse, thick saliva; relax-
ation of the gastrointestinal and minor
smooth muscle; with diarrhea and dif-
ficulty in micturition.

For the speed freak (chronic amphe-
tamine abuser), high-dose intravenous
amphetamine abuse occurs in cycles,
with periods of wakefulness lasting from
two to five days and maintained by re-
peated injections, followed by 36 to
48 hours of sleep.

Injections produce an immediate re-
sult which has been described as a "to-
tal body orgasm." Initially, activity is

purposeful, with marked loquaciousness
(little useful being said and little re-
memberd by the speaker from one mi-
nute to the next). Yet the speaker has a
sense of crystal-clear thinking and com-
petence. As the amphetamine "run"
proceeds, activity becomes less organ-
ized and initial relief of anxiety is re-
placed by self-consciousness and sus-
piciousness of others.

If the user injects more drug as he
feels himself "running down." he will
suffer increased agitation and suspicion.
There is marked over-reaction to slight
movements in the peripheral field of vi-
sion and, frequently, visual and auditory
hallucinations appear. After several

Cannabis sativa — mood elevator

slang — marijuana,

grass, pot, mary jane

active ingredient:

tetrahydrocannabinols

source:

composed of the flowering tops and upper leaves of
the unpollinated female Cannabis plant.

intake:

smoked, ingested (tea, brownies)

effects:

short term — varies with the dose, user and setting.

physical:

increased heart rate, increased blood pressure,
redness of the eyes

mental:

sense of exhilaration, talkativeness, increased
appetite.

treatment:

seldom required.

Lysergic Acid Diethylamide — hallucinogen

slang:

acid "A"

active ingredient:

synthetic chemical

source:

chemical derived from a fungus (ergot) that grows
on rye.

effects:

vary with user, dose and setting

physical:

tremors, numbness, chills, nausea, weakness, cold
sweaty palms, "goosepimpled" skin, loss of
appetite, hyperventilation, increased blood pressure
and pulse, dilated pupils.

mental:

visual effects, auditory effects, disorientation

combinations:

"LBJ," "Peace Pill"

treatment:

iDon't use chlorpromazme ^

THE CANADIAN NURSE 49

months of intravenous amphetamines,
the user develops fairly well-organized
delusions of persecution and personal
ideations, though this is seldom a prob-
lem during early oral use.

The active phase may be terminated
in two ways, by a psychotic reaction,
or break-down, or because the patient
is so exhausted, he may sleep for 24 to
48 hours. On awakening, he experi-
ences a profound depression and is
ravenously hungry. This depression is
often so severe and intolerable that he
may start another speed binge. The
"speeder" who begins as a tyro with
20 to 40 mg. per shot, may work up to
as much as six to seven grams per injec-
tion or even higher.

The therapeutic problems posed by
the high-dose amphetamine user arc.
first, the exhaustion reaction. This is
fairly simple and requires, mainly, sup-
portive therapy. Second, the physical
withdrawal reaction, in which severe de-
pression, altered sleep patterns, diffi-
culty in micturition, dry mouth and
thirst may create a severe problem in
treatment. Withdrawal initially may ap-
pear as paranoid schizophrenic psy-
chosis in some persons and convulsions
in others.

A third problem likely to be found in
any emergency ward is the speed freak
in an acute anxiety or full-blown psy-
chotic reaction. These situations can
sometimes be handled by calming the
patient by the use of moderate drug
therapy and non-threatening techniques
on the part of the nursing staff. It is no
affront to the nurses" ability if this fails.
It would be a gross understatement to
say that it is extremely difficult to be
nonchalant and to stop yourself ex-
pressing hostility toward an aggravated,
hostile paranoid "meth freak" who is
tearing apart your emergency ward,
striking the nursing staff and generally
creating a chaotic situation.

The drug of choice in this situation
is Valium or Haldol (McNeil Labora-
tories (Canada) Limited) (haloperidol)
or more recently Tarasan. (Hoffmann-
La Roche Limited). The latter two drugs
are safe if you are sure no combined
LSD or STP mixtures have been used.
Barbiturates and morphine are also
used in such centers as Los Angeles
and New York.

The patient is hospitalized and ob-
served for suicidal tendencies or con-
vulsions. Eventually, if the patient ac-
ceps treatment, he is placed on Haldol
as required, with Disipal (Riker Phar-
50 THE CANADIAN NURSE

Methamphetamine HCI — stimulant

slang:

speed, meth, crystal

active ingredient:

sympathomimetic, methamphetamine

sources:

synthetic

effects:

vary with dose, user and setting

low dose abuse

high dose abuse

short term

long term

direct — enzyme damage

indirect — health problems

characteristic speed freak

chronic depressive

treatment:

Valium ®, Haldol ®, Tofranil®, Elavil ® •

maceutical Company Ltd.) to counter-
act the extrapyramidal side effects.

Tofranil (Geigy Pharmaceuticals)
and Elavil (Merck. Sharp & Dohme of
Canada Limited) are added if depres-
sion is a major factor, as is so often the
case with speed freaks. Vitamins are
also added. The patient is given sup-
portive psychotherapy through the
withdrawal phase, with social assess-
ment as the long-term basis through
the support of various suitable social
agencies.

Some chronic amphetamine abusers
are like alcoholic derelicts, and tend to
return time and again to the emergency
department. This frequently results in
social and therapeutic mutual rejection
by treatment centre staff and patient.

The indirect results of chronic am-
phetamine abuse have been thought un-
til very recently to be the major cause
of death in speed freaks. Research as
recently as one month ago concluded
that, besides causing morbidity in hy-
pertension, phlebitis, hepatitis, chronic
infections, septicemia, lung granuloma-
ta, cerebral vascular accidents, malnu-
trition and vitamin deficiency syndro-
mes, high doses of intravenous amphe-
tamines over a prolonged period act on
body cells, and may cause enzyme dam-
age in all the organs of the body. Thus,
the amphetamines would be extremely
dangerous, even without their indirect
side effects.

What characteristics do chronic am-
phetamine abusers possess? There is
some evidence that they tend to be pas-
sively dependent and chronically de-
pressed, but much more research is

needed in this whole area. What is the
sociological significance of the existence
of the chronic amphetamine abuser in
the drug sub-culture'.' Currently studies
arc underway at our institution to elu-
cidate this latter problem.

In conclusion 1 would like to offer
some suggestions. When dealing in an
office practice with a boy or girl mis-
using drugs:

1 . Be knowledgeable about drugs and
their effects. Stick to facts and avoid
generalities. Kids are fairly knowledge-
able themselves and know when you are
putting one over on them.

2. If you find yourself hostile, refer the
patient to someone more likely to prove
understanding.

3. Build up the patient's confidence by
dealing with his or her other health prob-
lems correctly.

Summary

1 . Helping the teenage drug misuser is
an important part of medical practice
in many centers but it is far from easy.

2. Three of the common drug types is
use by teenagers in Toronto are repre-
sented by Cannabis sativa (marijuana),
LSD25 and similar hallucinogens, and the
amphetamines.

3. Marijuana appears relatively harm-
less, seldom needs treatment. LSD25 is
usually found now in combination with
other drugs and, for this reason, chlor-
promazine, once a treatment of choice,
is specifically warned against. Valium
is the drug of choice today. Recent re-
search has shown the amphetamines to
be dangerous in their direct effects on
body cells and not simply in their indi-

SEPTEMBER 1970

rect influence on disease processes.
4. Personnel treatingdrugabusers should
be particularly careful to avoid revealing
hostility. Admittedly, this is sometimes
difficult but it is important to show un-
derstanding and avoid judging the pa-
tient if he is to come back to the insti-
tution which can help him most.

Appendix

It is easier to bridge the communica-
tion gap with a drug misuser if you know
the jargon he is likely to use. Here are
some common terms;
Acid: — LSD.

Acidhead: — a person who regularly
uses LSD.

Bad trip: — an unpleasant experience
with a drug — usually LSD.
(to) Ball: — to have sexual intercourse
with.

(to) Blow one's mind; — to break with
one"s personal reality,
(a) Bummer: — an unpleasant drug ex-
perience.

(a) Burn: — purchasing or using an inef-
fective drug.

"C" — candy, snow or coke; — co-
caine.

Candyman: — cocaine dealer.
Cap: — No. 5 gelatin capsule.
Cool: — trust.

(to) Cop; — to purchase or acquire.
Coke freak: — a person who regularly
uses cocaine.

(to) Crank, to shoot up. to hit: — to
inject a drug intravenously.
Cunt; — an area or vein favored for
injection.

Dime bag: — $10 worth of Cannabis
— about an ounce.

Ditch: — the cubital fossa, a favored
site for injection,
(to) Do: — to take (a drug),
(to) Do one's thing: — to perform a
usual task.

(to) Do up: — to take mind-elevating
drugs.

(a) Down (goofers, goof balls): — sed-
ative or tranquilizers, usually barbitu-
rates.

(to) Drop: — to inject,
(a) Fix: — an intravenous injection
usually heroin or morphine.
Flash (rush): — an intense orgasm —
like euphoria experienced immediately
after an intravenous injection.
Flashing; — a periodic illusory percep-
tion of visual light flashes often a sequel
of an LSD bad trip.

(to) Freak: — to hallucinate (not nec-
essarily an unpleasant or undesirable
experience).
SEPTEMBER 1970

(to) Freak out; — to feel loss of control
over thought processes and have an un-
favorable hallucinogenic drug experi-
ence.

Fuzz (the man, the pigs): — the police.
Grass (marijuana, pot, rope, Mary
Jane); — Cannabis sativa.
Hang-up: — physical or emotional
problems, usually associated with ex-
ternal society.
Hash: — hashish.

(to) Have one's head in a good space;
— to be in agreement with another in-
dividual's ideas, to have insight into a
problem.

Into (a drug); — to take a drug.
Joint; — a Cannabis cigarette.
Juice; — alcoholic beverage,
(to) Lay it on: — to give something (an
object or words).

LBJ Stayaway; — a combination pill
popular in Toronto during the summer
of 1968, containing LSD. belladonna
and strychnine, and having a duration
of action of about three days.
Narcos (narks); — narcotic agents,
R.C.M.P.

Needle freak: — a person who gets a
thrill out of using a needle.
Nickel bag; — $5 worth of Cannabis.
Peace Pill: — a combination pill con-
taining mescaline, cocaine and LSD.
Pipe: — a large vein.
Pothead; — a person who regularly uses
Cannabis.

Rig (point): — needle and syringe,
(to) Rip off: — to steal.
Schmeck (smack, horse, "H". junk):
heroin (diacetylmorphine).
Scriptwriter: — a sympathetic MD, eas-
ily duped into writing prescriptions for
drugs, one who forges prescriptions.
Shit: — commonly used to denote her-
oin, but more recently methampheta-
mine.

(to) Smoke: — to smoke Cannabis,
(a) Snow freak; — a person who reg-
ularly uses c(x;aine.

Speed (meth., crystal): — any stimulant
but usually methamphetamine.
Speeders; — people who regularly use
stimulants.
Snow: — cocaine.

Straight: — someone who does not seek
to understand the drug sub-culture but
instead rejects it without careful thought.
That's where he's at; — that's what he
thinks.

(a) Trip; — a drug experience,
(to) Turn on; — to become involved
with.
Wired; — addicted.

Author's note

This glossary is meant as an aid to
understanding the history as given by
the patient. Use of such jargon by the
doctor will likely appear to the patient
as a sign of dishonesty and falseness,
and should be discouraged as being un-
professional.

References

1. R. N. Chopra and G. S. Chopra: The
Present Position of Hemp Drug Addiction
in India. Indian Med, Research Memoirs,
3 I. July 1939.

2. L. P. Solursh and W. R. Clement: The
Use of Diazepam in Hallucinogenic

Drug Crises. JAMA, 20.'i: 644. 1968.

3. W. R. Clement and L. P. Solursh:
Hallucinogenic Drug Abuse: Mani-
festations and Management. C.M.A.J.
98:407. 1968. (Vocabulary.)

4. W. R. Clement. L. P. Solursh and W.
Van Ast: Amphetamine Abuse. Unpub-
lished data. December. 1969.

."i. A. T. Weil. N. E. Zinberg and J. M.
Nelson: The Clinical and Psychological
Effects of Marijuana in Man. Science
162: 1234. 1968.

6. D. E. Smith. J. Fort and D, L, Craton:
Psycho-active drugs: A reference for
staff at the Haight-Ashbury Medical
Clinic. San Francisco. 1967. (Vocab-
ulary.)

7. A report on the Increasing Use of Meth-
amphetamine (Speed) among Young
People in Toronto; Prepared by the
"Trailer Project"' of the Jewish Family
and Child Service of Metropolitan To-
ronto. November 1969.

THE CANADIAN NURSE 51

The

Canadian
Nurse

50 The Driveway, Ottawa 4, Canada

^^P

Information for Authors

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The Canadian Nurse and L'infirniiere ccmadienne welcome
original manuscripts that pertain to nursing, nurses, or
related subjects.

All solicited and unsolicited manuscripts are reviewed
by the editorial staff before being accepted for publication.
Criteria for selection include : originality; value of informa-
tion to readers; and presentation. A manuscript accepted
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References, Footnotes, and
Bibliography

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Bibliography listings should be unnumbered and placed
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52 THE CANADIAN NURSE

SEPTEMBER 1970

idea
exchange

A. Operative field slwwing position of pocket hag and suction tip

B. Nurse applies pocket bag to Velcro surface on drape

C. Pocket bag and suction tip in position

Protecting OR Drapes

Numerous patches around the aperture
and at one end of the laparotomy drapes
used at our hospital convinced us that we
had to find a way to save the drapes from
further damage. In discussing the problem
with the operating room personnel, we
learned that the holes were probably
caused by towel clips used t" tasten the
abdominal suction or cautery tips within
easy reach of the surgeon, or to fasten the
head end of the drape around intravenous
poles, used as the anesthetic screen.
SEPTEMBER 1970

To prevent this damage, we now use
Velcro instant zipper material, a sewing
accessory available in retail stores.

A four-inch strip of Velcro, sewn on
one side at the open end of a 4-inch x
8-inch cloth bag, provides a safe pocket
that the scrub nurse can attach firmly to
another piece of Velcro sewn near the
aperture on the drape. This pocket pre-
vents the abdominal suction tip or the
cautery tip from slipping off the sterile
field, and avoids the holes made by towel
clips.

Two more sets of Velcro material,
each about 4 inches long, are sewn to the

head end of the drape, two feel on either
side of the center. The drape can then be
fastened around the intravenous poles
without tearing the sheet.

The addition of the "pocket bag" to
our lapartomy bundle s;ives the drapes,
improves technique by keeping items in
place on the sterile field, and saves time
that would be needed to resterili/.e or
replace a tin that falls from the sterile
field. Joyce Fredin. Iicad nurse. Cen-
tral Supply Room. Prince George Region-
al Hospital. Prince George. B.C.

THE CANADIAN NUKSb

D

53

idea
exchange

Coffee hour at the University of Alberta Hospital, h'dinontoii, is an informal affair, when parents of hospitalized children meet
to talk over problems and share opinions. The Rev. R. K. Doiigan and Anne Toupin. (standing) supervisor of the hospital's
pediatric unit, are two staff members who have taken part in most of the coffee hour session.

Coffee Break
With A Difference

She watches a nurse feed a small pa-
tient, looks down to the child held close
in her arms, and her face mirrors the
reaction within her. The unknown, the
lonely wait, add up to apprehension,
fear.

Mrs. Bennett is sitting in the pediatric
ward, patiently waiting for her child to
be taken to the operating room. She has
seen nurses at work, has wondered how
her child will accept new surroundings
— changed suddenly from familiar
home life to a hospital.

The child stirs, disturbed by the
54 THE CANADIAN NURSE

strange activities. A nearby door opens
and an operating room attendant walks
toward Mrs. Bennett. The child is taken
from her arms, placed on a stretcher,
and another stage of fitting into hospital
routine begins for this small patient.

Mrs. Bennett continues to watch as
her child is carried farther down the
corridor. She picks up a crumpled blan-
ket, wrapped moments ago around the
infant, and goes to the waiting room to
smoke a cigarette and wait, alone.

Elsewhere in the pediatric unit at the
University of Alberta Hospital, Edmon-
ton, Alberta, preparations are being
made for the weekly parents' coffee
hour. A brain-child of the hospital's

pediatric core committee, the coffee
hour gives parents of hospitalized chil-
dren an opportunity to relax with a cup
of coffee. With encouragement from
the hospital chaplain and a nurse from
one of the five pediatric wards, parents
talk about their apprehensions, register
complaints, and share opinions with
each other on a variety of subjects.

A nurse's invitation relieves Mrs.
Bennett of her lonely vigil and she joins
other parents for coffee. The chaplain
welcomes the parents and explains the
purpose of the social hour. In the
friendly atmosphere, Mrs. Bennett re-
laxes and joins in serious discussions of
mutual concern.

SEPTEMBER 1970

"Nurse, I wonder if I should be com-
ing to see my son as often as I do? He is
so upset when I leave. Sometimes I have
a feeling I am in the way."

Other mothers listen for the nurse's
reply.

"We realize hospitalization is hard
on you and your boy, and we will try to
make a strange situation less difficult
for him. But the staff feel your presence
in the hospital is important to him, and
encourage you to visit him as often as
you can. Because visiting hours are un-
restricted, you may spend as much time
with your son as you wish. Let me as-
sure you, the staff appreciate the value
of your visits, and we certainly don't
consider you 'in the way.""

The hospital chaplain is listening. He
agrees, says it is quite normal for a
young child to protest his mother's de-
parture. "With the mother's reassur-
ance that she intends to return, the
child usually accepts the situation, and
settles down to play activities in the
ward, the chaplain explains.

The discussion continues for an
hour. Subjects vary from the weather
to hospital diets, and to ointments for
diaper rash. Mrs. Bennett sits quietly,
listening. Frequently she glances into
the hall for signs of the stretcher bear-
ing her child back to the ward.

As the children's rest period ends,
the mothers finish their coffee and re-
turn to the wards. An invitation to join
in another parents' coffee hour is quick-
ly accepted.

After the parents have left, the nurse
and the chaplain review the verbal and
emotional content of the coffee hour.
Many worthwhile suggestions have been
made and they want to determine if
any can be adopted by the hospital.

An idea for changing hospital diets
for toddlers is gleaned from one mother's
comments. A misunderstanding of hos-
pital policy by some parents indicates
effective communication is needed
between hospital personnel and parents.
Mrs. Bennett's anxiety is noted and it is
decided to consult the charge nurse of
SEPTEMBER 1970

her child's ward regarding follow-up

care.

The coffee hour at the University of
Alberta Hospital began in February
1969 as a tryout. Parents and staff par-
ticipants were asked to evaluate the ef-
fectiveness of the program by complet-
ing forms designed for this purpose. The
result? An overwhelming vote in favor
of continuing the coffee hour.

Parent evaluations showed some re-
vealing reactions: "I feel these sessions
were definitely helpful, particularly for
parents who are new to the hospital sit-
uation."

"It was very gratifying to be able to
air my feelings about the care given to
the children, and to share the opinions
of other parents in a group discussion."

"I feel the pediatric department cares
and shows interest in patients by this
coffee hour. It is a wonderful help for
parents to know staff are willing to lis-
ten and try to better the care. I feel the
coffee hour should be continued."

Comments by nurses participating in
the program are also positive. "These
meetings are an excellent idea. They
give us a chance to inform parents
about hospital procedure, to settle mis-
understandings, and to health teach."

"I feel, by attending these social
hours, the parents are made to feel part
of the pediatric team."

Although the parents' coffee hour has
run fairly smoothly and has received
positive support from parents and staff,
it has not been completely free from
problems. Parents seem reluctant to
voice negative views on the kind of care
given their children. This is often con-
trary to the troubled attitude they dis-
play while on the ward. Sometimes,
when the group consists of 10 to 15
people, one or two parents tend to dom-
inate the conversation. Others may wish
to participate, but find the size of the
group inhibiting. When this situation
occurs, the staff participants try to draw
silent members into the conversation.

Parents are sometimes hesitant to
discuss particular concerns in a group.

It has been observed, however, that par-
ents who are silent during the coffee
hour, or contribute to the discussion
only on "safe" subjects, will later ap-
proach the chaplain or nursing staff for
assistance.

Since the coffee hour takes place after
lunch, it is not surprising that more
mothers find it convenient to attend
than fathers. And because of its success
in promoting communication, some
pediatric staff feel the coffee hour
should be expanded. They suggest an
evening session, so that husbands and
wives can attend together.

Efforts are being made to include
this change in routine. Its solution will
undoubtedly increase the effectiveness
of the parents' coffee hour.

A philosophy of pediatric nursing
sees optimum parental involvement as
an important goal in the care of the hos-
pitalized child. For its achievement,
however, there needs to be trust in the
pediatric ward. Trust seems to develop
most readily when there is effective and
meaningful communication among phy-
sicians, nurses, parents, and children.
The parents' coffee hour at our hospital
has stimulated the growth of good
parent-staff communication. This is
surely a concrete example of greater
parental involvement in patient care.
— Diane MacTavish. charge nurse, pe-
diatric unit, and Rev. R.K. Dougan,
director, department ofchaplaincy serv-
ices. University of Alberta Hospital,
Edmonton. □

THE CANADIAN NURSE 55

research abstracts

The following are abstracts of studies
selected from the Canadian Nurses'
Association Repository Collection of
Nursing Studies. Abstract manuscripts
are prepared by the authors.

Roach, Sister Marie Simone. Toward
a value oriented curriculum with
implications for nursing education.
Washington, D.C., 1970. Thesis
(Ph.D.) The Catholic University of
America.

This study was initiated because of a
concern for the widening gap between
what is proposed as a Christian phil-
osophy of nursing education and the
implementation of this philosophy in
a given nursing curriculum. The study
is related specifically to values inherent
in a Christian philosophy of nursing
education and the possibility of directly
confronting these values in a given
curriculum through the medium of
experiential learning.

The study rests on certain assump-
tions: 1 . that there is a contemporary
value crisis that has a bearing on
education, and which, according to
the writer, appears to be related to
certain movements or trends — natur-
alism, modern atheism, and humanism;
2. that a Christian philosophy of
education encompasses certain values
that need to be identified, and if
sufficiently concretized, can be taught,
provided appropriate teaching-learning
strategies are used.

Using an exploratory approach, a
major purpose of the study was to
provide a background for future cur-
riculum planning in one undergraduate
nursing program by drawing from
philosophy a Christian perspective on
value theory, and, from education
sources insights into teaching and
learning values.

An attempt was made to show what
consequences a Christian theory of
value, as presented in the study, would
have for a curriculum that identifies
human health as its central core concept.
Since, in the study, human health was
considered as ultimate harmony and
integration transcending death itself,
it was necessary to use theological
insights to account for the paradox that
constitutes an experiential reality for
the nurse, namely, the problem of
pain, suffering, and death.
56 THE CANADIAN NURSE

The conclusion of this study is that
values are objective and can and should
be taught. Further attention needs to
be directed to the process by which
values are internalized, as well as to the
methodologies that facilitate this
process. Since man is central to the
educative process and the central value
in education, the character and direction
of the curriculum will be related to the
philosophy of man on which the curri-
culum rests. If a nursing curriculum is
supported on a theocentric humanism,
it would seem that Christian philosophy
of man and theology are essential core
courses.

The writer believes that a value-
oriented curriculum is a possibility.
The actual implementation, however,
presupposes a greater refinement of
the answer to the question, "What
values?" Philosophical and theological
foundations of the nursing curriculum
need to be explored, and greater
expertise in the selection and integration
of content in these areas demonstrated.

Wadsworth, Patricia Mary./1 study of the
perception of the nurse and the
patient in identifying his learning
needs. Vancouver, 1970. Thesis
(M.A.) The University of British
Columbia.

The purpose of this study was to com-
pare the perception of the nurse and
the perception of the patient in iden-
tifying priorities for the patient's
learning needs with respect to his
medical condition and hospital environ-
ment. A Q-sort of statements related
to these two learning needs was de-
veloped and used to test the nurse's
perception and the patient's perception
of these learning needs. The diabetic
patient was selected for study because

Nursing 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 CNJ.

his learning needs with respect to his
condition are well documented, and the
general staff nurse was selected because
she is responsible for direct patient
care.

To test the hypotheses, the Q-sort
was administered to 50 newly-hospital-
ized diabetic patients, to 50 general
staff nurses directly responsible for the
care of these patients, and to 50 general
staff nurses having no contact with a
patient or no direct responsibility for
his care. The study was conducted in a
large hospital in Vancouver, British
Columbia. The hypotheses assumed
that the two groups of nurses and the
patients would assign different prior-
ities to the patient's learning needs. The
.05 level of significance was used in
this study.

An analysis of selected personal
characteristics of the patients provided
a description of the patient population.
The findings showed that all but one
patient had been in hospital before, and
that only three patients were newly
diagnosed diabetics. An analysis of
selected personal characteristics of the
nurses indicated that there was no
significant difference between the two
groups. Thus, any differences in per-
ception could not be attributed to these
characteristics.

The Q-sort scores of all three groups
were examined for differences in
perception, and the selected personal
characteristics were tested with respect
to these scores. The results indicated
that the patients and both groups of
nurses assigned a greater degree of
importance to the patient's learning
needs related to his diabetic condition
than those related to the hospital
environment. Although the nurses
attached a greater degree of importance
to the former needs than did the
patients, the difference was not signi-
ficant.

The results of the study have dem-
onstrated the value of the Q-sort
technique as a procedure for acquiring
data on the learning needs of the pa-
tient. The analysis of the data of the
nurses and patients under their care
provided a measurement of the quality
of patient care. In addition, the analysis
of the data of the patients provided a
guide for the establishment of a desir-
able learning sequence for the indi-
vidual patient. D
SEPTEMBER 1970

The Professional Nurse by Kathleen
K. Guinee. 177 pages. London, The
Macmillan Company. Canadian
Agent: Collier-Macmillan Canada,
Ltd., Don Mills, Ontario, 1970.
Reviewed by Dorothy J. Kergin,
Director, School of Nursing, Mc-
Master University, Hamilton, Out.

The jacket description of this book
states that Professor Guinee "...seeks
to develop in the beginning student of
nursing an awareness of the many dif-
ferent roles and responsibilities of the
professional nurse. She attempts to
prepare the future nurse for the increas-
ing complexity of the nursing profession
and the constantly changing needs of
the community."

Aside from the chapters on nursing
education programs in the United States
and on the purposes and activities of
professional nursing organizations in
that country, the text should be of use
to nursing student in Canada. It is dif-
ficult to assess the level of student in-
tended by the author, as part one has
more substance and validity than part
two.

Part One "Foundations of Profes-
sional Behavior," includes material
on nursing, societal change, the profes-
sions, professional ethics, and teaching
nursing. It also includes topics aimed
at the beginning student in a basic
nursing program. Following each
chapter are bibliographies and seminar
topics, including questions for discus-
sion and projects for research.

Part two, "Development of Profes-
sional behavior," includes description
of nurse behavior with patients.
Although families are seldom men-
tioned, the focus is on the patient's
perceptions. The level of content seems
appropriate for only the most unso-
phisticated of beginning students, and
one finds unsupported and imprecise
generalizations, such as, "It is well
known that patients feel better in the
presence of a nurse."

The descriptions of the responsi-
bilities of various levels of nursing and
related personnel in hospitals and com-
munity agencies would serve as a useful
review for students as they begin clin-
ical practice. Part two would be of
greatest value as a reference for sec-
ondary school students who wish to
SEPTEMBER 1970

gain information on the opportunities
available in nursing.

Any teacher of nursing is advised
to assess carefully how well the text
will contribute to the achievement of
course objectives before considering
its adoption.

Structure and Function in Man, 2nd

ed. by Stanley W. Jacob and Clarice
Ashworth Francone. 591 pages. To-
ronto, W.B. Saunders Company,
1970.

Reviewed by Mary J. Ross, Director
of Nursing, Aberdeen Hospital, New
Glasgow, Nova Scotia.

This book is designed for use by the
first year nursing student. It looks at
the human body as a whole and goes on
to deal with its specific parts. Anatomy

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OTTAWA 4, Canada

and physiology have been integrated
throughout the text in the hope that the
student would more readily understand
life as an integrated process.

The subject is presented under four
units which discuss normal functioning
of the body, and deviations from the
normal. In each chapter, the author
presents a comprehensive summary of
the topic discussed, and study questions
for the purposes of review.

The section on bones, muscles, and
articulations, is well illustrated and
the diagrams are excellent. A separate
chapter on skin and various abnor-
malities ofthe skin, along with diagrams
is included to make the text more mean-
ingful to the student.

The major asset of this text is its
presentation of the subject matter. The
book is written clearly, concisely, and
in a logical sequence. It provides a
valuable teaching and reference source
for the first year student.

Arrows of Mercy by Philip Smith. 244
pages. Doubleday & Company, Gar-
den City, New York, 1969. Canadian
Agent : Doubleday Publishers, To-
ronto, Ontario.

This author tells the absorbing story
of the development of curare for use
in clinical anesthesiology. In describing
how curare came to be used so widely
for muscular relaxation during general
anesthesia, he has also summarized the
history of attempts from early times to
the present to provide pain relief and
unconsciousness for the performance
of surgical operations. Philip Smith has
captured the fundamental skills of the
anesthesiologist, who is part physician,
physicist, pharmacologist, diagnosti-
cian, and specialist in respiratory con-
trol. He has also placed in perspective
the development of anesthesia and the
development of curare. Descriptions
in the book range from the frock coat
surgeon of the pre-antiseptic era. to the
modern transplant of a heart and other
organs. It is interesting too for both the
lay reader and the professional.

Part One gives a general history of
research in surgery. In a colorful ac-
count, we learn of the groping toward
medical knowledge, when the cavemen
opened each other's ^ull. The operation
is known today as trepanning.

THE CANADIAN NURSE 57

Next Month
in

The

Canadian
Nurse

• Hospital Nurse Expands Role

• Epidurals and Childbirth

• Computer Aids Psychiatry

• Your Will Is important

=&

"^^

Photo Credits for
September 1970

Association of Nurses of Prince
Edward Island, Charlottetown,
P.E.I. , p. 10

Dept. National Health & Welfare,
Ottawa, p. 16

Dickie Photo Ltd., Harvey Studio,
Campbellton, N.B.. pp. 20. 38.
39,40

Ron Kenyon, Willowdale. Ont..
pp. 46, 48

Prince George Regional Hospital,
Prince George, B.C.. p. 53

University of Alberta Hospital,
Edmonton, Alta., p. 54

The Rennaissance brought with it
new medical advances which showed
later in the work of Thomas Morton
and Horace Wells, who successfully
made use of ether to rid man of surgical
pain.

Part Two discusses in depth the dis-
covery and use of the drug curare.

Part Three summarizes the advances
of anesthesiology in the nineteenth and
twentieth centuries. It takes us from the
natives of the Amazon to cardiac sur-
gery by Dr. Christiaan Barnard and his
first human heart transplant.

This is a fascinating and detailed
account of the progress of medicine.
It shows an unbelievable advance in
medical technology in the twentieth
century.

Readers who are excited by the ro-
mance of progress in medicine, who
appreciate a lively storyteller, and the
professional who enjoys medical folk-
lore will find this book more than a
textbook approach to medical history.

Human Nutrition and Dietetics, 4th ed..
by Sir Stanley Davidson and R. Pass-
more. 899 pages. London, E. & S.
Livingstone Ltd.. 1969, Canadian
Agent: Macmillan Company of
Canada Limited, Toronto.
Reviewed by Lillian C. Sharp, Teach-
ing Dietitian, University of Alberta
Hospital, Edmonton.

This new edition of a well-known Brit-
ish text displays extensive knowledge
and interest in human nutrition. The
topics are well documented and com-
ments are made on current research.
The book follows the same organ-
izational pattern as previous editions.
It is divided into six parts : Part I gives
an account of the physiology of nutri-
tion; Part II gives a general descrip-
tion of the chemical and nutritive prop-
erties of foods commonly used by man.
Effects of food processing and a brief
account of various forms of food poi-
soning are also included; Part III de-
scribes diseases caused by faulty nu-
trition; Part IV deals with defective
diets as they contribute to general
disease patterns and an account is giv-
en of treatment in which proper diet is
necessary; Part V is concerned with
nutrition in public health, emergency
feeding, and outlines the work of the
Food and Agriculture Organization
of the United Nations; Part VI deals
with special diets in pregnancy and
lactation, athletic training, and ex-
tremes of climate.

58 THE CANADIAN NURSt

Illuminating tables and charts are
included throughout the text. These are
for the most part, identical to the pre-
vious editions and whole paragraphs,
even whole chapters, are transposed
from the old text to the new. There are,
however, some changes in terminology
and word usage. For example the term
retinol replaces vitamin A, and chol-
ecalciferol is introduced as an alterna-
tive name for vitamin D3.

An interesting item under new and
improved foods suggests that the pro-
duction of protein concentrates from
yeasts, using petroleum oils as sub-
strates, already useful in the feeding of
animals, may benefit humans.

The reports on cyclamates, listing
benefits and risks, are already outdated.
Although sodium glutamate is men-
tioned, latest theories and findings
about this flavor enhancer are not in-
cluded. Similarly, although mention is
made of the accumulation of DDT in
fatty tissues, the latest decision to ban
its use as an insecticide has not been
mentioned.

A new section on hospital food dis-
cusses the wastage and the poor qual-
ity of the food, particularly in larger
hospitals, comments on nurses being
poorly informed about nutrition should
raise a few hackles.

Modern contraceptive techniques
are described as a method of voluntary
control of the population explosion.
Some methods of family planning in
various countries are outlined, and the
problems and difficulties which have
yet to be overcome are noted.

The diets mentioned in the appendix
are based on British products and Brit-
ish food habits and may not be readily
understood by Canadians. However,
these diets are quite usable and can
easily be altered to suit any circum-
stance.

The book contains a vast amount of
information and could be used as a
reference text, especially in institutions
conducting teaching programs. All
members of the medical team will find
it a valuable asset.

A Happier Life, by Alfred E. Eyres
and Charles T. Pearson. 270 pages.
Durham. North Carolina, Moore
Publishing Company, 1969.
Reviewed by Carol Kotlarsky, for-
merly Editorial Assistant. The Ca-
nadian Ntirse.

There is no magic formula for living a
happier life, says the author of this book,
but you may be able to help yourself
overcome emotional difficulties. This
well-organized book was written to
provide psychiatric self-help, and cov-

(Ciiiiliiuu'il on pciin' 60)
SEPTEMBER 1970

\

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Soothing, cooling TUCKS provide
greater patient comfort, greater
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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
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in both pre-and post-operative
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Specify the FULLER SHIELD<» as a protective
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(continued from page 58)

ers topics such as learning to budget
your worries, training yourself to relax,
and knowing if psychoanalysis can
help you.

You don't have to be in the medical
profession to understand what the au-
thor is saying, because all psychiatric
terms are clearly explained and case
histories give added meaning to words
like paranoia, paradoxical intention,
and schizophrenia. The book takes a
realistic and practical approach to
preventing emotional difficulties, and
advises that one of the ways to main-
tain an emotional balance is through
proper eating habits.

The highlights are listed at the end
of each chapter, making an effective
summary of the material covered. D

accession list

60 THE CANADIAN NURSE

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 in-
stitutions. Reference items (theses,
archive books and directories, almanacs
and similar 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 any one time.

BOOKS AND DOCUMENTS

1. The (in of tianslalion by Theodore
Savory. Boston, The Writer, 1968. 191p.

2. Behavioral concepts & nursing inter-
vention coordinated by Carolyn E. Carlson.
Toronto. Lippincott, 1970. 341 p.

3. Canadian hooks in print edited by
Gerald Simoneau. Toronto, Canadian Books
in Print Committee, 1969. 764p.

4. Coronary care units in small hospitals
— the Stanclish I Michigan) experience by
Eric H. Halt et al. Battle Creek, Mich.. W.K.
Kellogg Foundation, 1970. 99p.

5. A doctor discusses narcotics and drug
addiction by Louis Relin. Chicago, Budlong
Press, 1969. 90p.

6. L'ediicalion des enfants el des adoles-

SEPTEMBER 1970

cents handicapes. Tome I Lex hiitulicapes
moleiirs par Lucien Lefevre et al. Paris,
Sociales Fran^aises. 1969. 245p.

7. Education in the health-related pro-
fessions. Consulting editors Joseph G. Benton
and Richard S. Gubner. New York. New
York Academy of Sciences. 1969. p.821-
1058. (New York. New York Academy of
Sciences. Annals, v. 166 art. 3)

Partial contents. — The feldsher in the

USSR by Victor Sidel. p.957-966. Nurse

midwifery by Louis Hillman. p. 896-902.

The pediatric nurse practitioner and the child
health associate: new types of health pro-
fessionals by Henry K. Silver, p. 927-933.

The physician's assistant in the community
hospital and in office practice by Hu C.
Myers. p.91 l-91S._The physician's as-
sistant in the university center by E. Harvey
Estes. p.903-910. — Trends in nursing
education by Joan Hartigan. p. 1045- 1049.

8. Enrolment in educational institutions
by province 1951-52 to 1980-81 by Z.E.
Zsigmond and CJ. Wenaas. Ottawa.
Economic Council of Canada. 1970. 306p.
(Economic Council of Canada staff study
no. 20)

9. Family by Margaret Mead and Ken
Heyman. Toronto. Collier-Macmillan. 1965.
208p.

10. Guide to the use of hooks and
libraries. 2d ed. by Jean Key Gates. Toronto.
McGraw-Hill. 1969. 273p.

11. Healthier living. 3d ed. by Justus J.
Schifferes. with a foreward by William
Hammond. Toronto. John Wiley & Sons.
1970. 578p.

12. Hygiene et prophylaxie par G. Vi-
guier. Paris. Librairie Maloine. 1970. 364p.

13. An illustrated guide to medical
terminology by Helen R. Strand. Baltimore.
Williams &Wilkins. 1968. 1 lOp.

14. Is your child on drugs by Ralph E.
Wendeborn. Lorrie McLaughlin and Michael
E. Palko. Toronto. Mil-Mac Publications.
1970. 2 lOp.

15. Medical librarian examination review
hook. Vol. 1 : 1500 multiple choice questions
and referenced answers compiled by Jane
M. Fulcher. Flushing, Medical Examination
Publishing Co., 1970. 186p.

16. Medicine in the university and com-
munity of the future: Proceedings of the
scientific sessions marking the centennial of
the Faculty of Medicine. Dalhousie Uni-
versity. Sep. 11-13. 1968. Edited by LE.
Purkis and U.F. Matthews. Halifax, Faculty
of Medicine, Dalhousie University. 1969.
241 p.

17. Men money and medicine by Eli
Ginzberg with Miriam Ostow. New York.
Columbia University Press. 1969. 291 p.

18. Nursing examination review hook;
1600 tnultiple choice questions and referenced
answers edited by Martha M. Borlick et al.
Flushing. Medical Examination Publishing.

1969. 255p. (Nursing examination review
book no. 9)

1 9. L'opere abdominal; les suites normales
et compliquees de la chirurgie abdominale
par Philippe Detrie. Paris. Masson & Cie.

1970, 653p.

SEPTEMBER 1970

20. Orthopedic nursing by Carroll B.
Larson and Marjorie Gould. 7th ed. St.
Louis. Mo.. Mosby. 1970. 486p.

21. Pharmacology and patient care by
Solomon Garb. Betty Jean Crim and Garf
Thomas. 3d. ed. New York, Springer. 1970
597p.

22. The professional nurse; orientation,
roles, and responsibilities by Kathleen K.
Guinee. Toronto. Collier-Macmillan, 1970

I77p.

■ 23. Promotion of physical comfort and
safety by Valentina G. Fischer and Arlene
F. Connolly. Dubuque. Iowa. Wm. C.
Brown. 1970. 94p. (Foundations of nursing
series)

24. Propedeutique obstetricale: a I'usage
des candidates au diplome d'etat d'infirmiere
ou d'assistante sociale par Robert Lyonnet.
2d. ed. Editions Doin, 1969. 309p.

25. Psychology for a changing world by
Idella M. Evans and Patricia A. Smith.
Toronto, Wiley, 1970. 444p.

26. Psychologic et education par Joseph
Leif et Jean Delay. Montreal, Fides. 1965-
1968. 2v. Contents. - t.l L'enfant. - t.2 L'A-
dolescent.

27. Qui conteste qui? La contestation et
la sante mentale. conference tenue a Mont-
real du 4 au 8 mai 1969 organisee par
I'Association canadienne pour la Sante
Mentale. Division du Quebec. Montreal.
Association canadienne pour la Sante
Mentale, 1969. 21 3p.

28. Relaxation by Josephine L. Rathbone.
Philadelphia, Lea & Febiger, 1969. 17 1 p.

29. The role and preparation of the
outpost nurse by Ruth E. May. {In
Medicine in the university and community
of the future... Halifax, Faculty of Medicine,
Dalhousie University. 1969. p.59-61.)

30. Rides of order by Henry M. Robert;
a new and enlarged edition by Sarah Corbin
Robert. Glenview. III.. Scott. Foresman.
1970. 594p.

3 1 . Sample catalogue cards exemplify-
ing the Anglo-American cataloging rules.
Compiled by K.L. Ball et al. 3d ed. Toronto.
University of Toronto Press: for School of
Library Science, 1969. 150p.

32. Sources of medical information; a
guide to organizations and government
agencies which are .sources of information
in fields of medicine, health, disease, drugs,
mental health and related areas, and to
currently available pamphlets, reprints and
selected scientific papers arranged by
subject, edited by Raphael Alexander. New
York, Exceptional Books, 1969. 84p.

33. Special libraries: development of the
concept, their organizations, and their
.services by Ada Winifred Johns. Metuchen.
N.J.. Scarecrow Press, 1968. 245p.

34. The speech writing guide; profes-
sional techniques for regular and tKcasional
.speakers by James J. Welsh. New York, John
Wiley & Sons. 1968. 128p.

35. State approved .schools of professioiuil
nursing 1970. New York. National League
for Nursing. 1970. I I6p.

36. State-approved .schools of nursing

Largest selling among nurses ! Superb lifetime quality . . ,
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E*ch band 20' long, pre^ut to pop-
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V4" (8 per box). %' (6 per boiO. I'
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Remove and refasten cap bant) instantly
for launflefing ant) replacement' Tiny
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Choose Black. Blue. WMte or Crystal
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hard-fired enamel on gold plate Dime-smd; pm-bKk
Specify RH, LPN. PN, LVN, NA. or Rf»ti oo coupon.
N«. 205 Enameled Pin 1.6S ea. ppd.

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ings fted-tipped sweep secofKl hand, chrome stamiess
case Stainless eipansion band plus FREE biKk leithtr
strap 1 yr guarantee
No. 06-923 1630 ea. ppd.

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Protects against stains and wear Hubit white
plastic with gold stamped caduceus Two com-
partments for pens, shears, etc Ideal token gifts
or favors

No. 210E ( 6 for 1.75. 10 for 2.70
Savers ) 25 or more ^5 M., all ppd.

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No. 1000 Shears [no initials) 2.75 u. ppd.

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THE CANADIAN NURSE 61

accession list

meeting minimum requirements set by law
and board rules in the various jurisdictions,
1970. New York, National League for Nurs-
ing, 1970. 80p.

37. Slatislics: the essentials for research
by Henry E. Klugh. Toronto, John Wiley
&Sons, 1970. 368p.

38. Student's guide for writing college
papers- by Kate L. Turabian. 2d. ed., rev.
Chicago. University of Chicago Press, 1969.
205p.

39. Textbook of medical-surgical nursing.
2d. ed. by Lillian Sholtis Brunner et al.
Toronto, Lippincott, 1970. 103 Ip.

40. Training in indexing: a course of the
Society of Indexers edited by G. Norman
Knight. Cambridge, Mass. M.LT. Press,
1969. 2 19p.

41. What is protest in Quebec: mental
health in conflict; a conference held in
Montreal, May 4-8. 1969, organized by The
Canadian Mental Health Association,
Quebec division. Montreal, Canadian
Mental Health Association. Quebec Division,
1969. 2 lOp.

42. Woman; a biological study of the
female role in twentieth century society by
Philip Rhodes. London, Transworld
Publishers. 19^9. 19lp.

PAMPHLETS

43. Associate degree education for nurs-
ing. New York, National League for Nursing.
Dept. of Associate Degree Programs, 1970.
27p.R

44. Belleville General Hospital, School of
Nursing, 1893-1970: historical information.
Belleville, 1970. 5p. R

45. Extending the boundaries of nursing
education; the preparation and roles of the
functional specialist. Papers presented at the
fifth conference of the Council of Bac-
calaureate and Higher Degree Programs,
Denver, Colorado, Nov. 12-14, 1969. New
York, National League for Nursing. Dept. of
Baccalaureate and Higher Degree Programs,
1970. 39p.

46. Guide to development of patient care
policies in extended care facilities by Rowena
E. Rogers. New York. Systems Educators.
1970. 39p.

47. Guidelines for the purchase of ser-
vices. A report on the Canadian Welfare
Council's task force on purchase of service
agreements between non-governmental
agencies and provincial and municipal
government agencies, under the Canada
Assistance Plan. Ottawa. Canadian Welfare
Council. 1969. 21 p.

48. Public Affairs Committee. Pamphlets.
New York.

No. 436 What about marijuana by Jules
Saltman. 1970. 2 Ip.

No. 438 Parent-teen-ager communication;
bridging the generation gap by Millard J.
Bienvenu. 1970. 20p.

No. 440 The unmarried mother by Alice
Shiller. 1969. 2lp.

No. 441 When your child is sick by Jacque-
line Seaver. 1969. 24p.

No. 442 Wanted: medical technologists by
Elizabeth Ogg. 1969. 20p.

49. Statement in nursing education,
nursing practice and service and the social
and economic welfare of nurses. Geneva,
International Council of Nurses. 1969. I Op.

GOVERNMENT DOCUMENTS
Canada

50. Bureau of Statistics. Mental health
statistics. 1967. Ottawa, Queen's Printer,
1970. I96p.

5 1 . — . Survey of vocational education
and training, 1967-68. Ottawa, Queen's
Printer, 1970. 98p.

52. Dept. of Labour. Legislation Branch.
Labour relations legislation in Canada.
Ottawa, Queen's Printer, 1970. 180p.

53. Dept. of Manpower and Immigration.
University, college and technological
institute; guide: graduations, enrolments,
salaries. Prepared by... the Professional and
technical Occupations Section, Manpower
Information and Analysis Branch. Program
Development Service. Ottawa, 1968. 45p.

54. Department of National Health and

You're ahead with
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KLING* Conform Bandage — the unique
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that specializes in bandaging areas that
are hard to bandage and hard to keep
bandaged.

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62 THE CANADIAN NURSE

Don't stick your neck out. Stick
with KLING* confornn bandages.

KLING' Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes in bandaging areas that
are hard to bandage and hard to keep
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SEPTEMBER 197M

Welfare. Canada health manpower studies.
Ottawa, 1970. 6pts in 1.

55. — . Research and Statistics Director-
ate Hospital morbidity statistics. Based on
the experience of provincial hospital in-
surance plans in Canada. January 1 - De-
cember 31. 1966. Ottawa. 1970. 277p.

56. Public Service Staff Relations Board.
Second annual report 1968-69. Ottawa.
Queens Printer, 1969. 113p.

Great Britain

57. Central Office of Information. Refer-
ence Division. Social security in Britain.
Prepared for British Information Services,
Canada. London. 1970. 42p.

58. — . Social .services in Britain. Pre-
pared for British Information Services,
Canada. Rev. London. 1969. 1 17p.
Ontario

59. Committee on the Healing Arts.
Report. Toronto. Queen's Printer 1970. 4v.

60. — . Studies. Toronto, Queen's Printer
1970.11V.

61. Dentistry in Ontario by R.K. House
1970. 274p.

62. A legal history of health professions
in Ontario by Elizabeth MacNab. 1970
152p.

63. Mental health in Ontario by C. Hanly
1970, 436p.

64. Nursing in Ontario by V.V. Murray
1970. 284p.

65. Organized medicine in Ontario by
J.W. Grove. 1969. 327p.

66. The paramedical occupations in
Ontario by Oswald Hall. 1970. 140p.

67. Private clinical laboratories in
Ontario by Chemical Engineering Research
Consultants Limited. 1969. 76p.

68. Sectarian healers and hypnotherapy
by John A. Lee. 1970. 173p.

69. Selected economic aspects of the health
care sector in Ontario by R.D Eraser 1970
479p.

70. Social Work in Ontario by Michael
Landauver. 1970. 89p.

Saskatchewan

71. Dept. of Public Health. Criteria for
levels of care for the province of Saskatche-
wan. Regina. 1969. 1 Ip.

United States

72. Dept. Health, Education and Welfare.
Regulations, standards, and guides pertaining

to medical and dental radiation protection

an annotated bibliography. Washington,
U.S. Government Printing Office, 1969. 73p.
(U.S. Public Health Service Publication no.
999-RH-37)

73. National Institute of Neurological
Diseases and Stroke. Cerebral palsy: hope
through research. Washington, U.S. Govt
Print. Off., 1969. 7p. (U.S. Public Health
Service publication no. 7 13 rev.)

74. National Institute of Neurological
Diseases and Blindness. Mental retardation,
its biological factors: hope through research.
Washington, U.S. Govt. Print. Off., 1968.

23p. (U.S. Public Health Service publication
no. 1 152 rev.)

STUDIES DEPOSITED IN

CN.\ REPOSITORY COLLECTION

75. The male patient — an opportunity
and a challenge by Albert W. Wedgery.
London, Ont., 1960. 62p. R

76. Nursing education in a changing
society. Published on the occasion of the
fiftieth anniversary of the University of
Toronto. School of Nursing, edited by Mary
Q. Innis. Toronto, Univ. of Toronto Press
1970. 240p. R

77. A study of the relationship between
self-acceptance and acceptance of parents in
a selected group of nurses working in child
psychiatry by Sheila W. Mackey. Seattle,
Wash., 1968. 77p. R

78. A study of the use of consultation by
occupational health nurses in two Canadian
provinces by Dorothy Kergin. Ann Arbor,
Mich., 1962. 57p. /{

AUDIO-VISUAL AIDS

79. The nursing audit. Prepared by Helen
W. Dunn. New 'Vork, National League for
Nursing, 1970. 2 tapes (NLN Nursing
service cassettes)

80. Staff development. Prepared by
Myrtle Kitchell Aydeoltte. New York,
National League for Nursing, 1970. 4 tapes
(NLN Nursing services cassettes) O

Request Form for "Accession List"
CANADIAN NURSES' ASSOCIATION LIBRARY

Sen(d 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

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SEPTEMBER 1970

THE CANADIAN NURSE 63

classified advertisements

ALBERTA

ALBERTA

NEW BRUNSWICK

HEAD NURSE required for 15-bed hospital. 105 miles
East of Edmonton. Leadership, Pharmacy and Sup-
plies control, needed. Pleasant staff residence in
lovely country with many recreational facilities. Al-
berta Hospital Association salary schedule. Apply
Administrator. Mannville Municipal Hospital. Mann-
ville. Alberta. 763-3621.

REGISTERED NURSES FOR GENERAL DUTY in a

34-bed hospital. Salary 1968, $405-$485. Experien-
ced recognized. Residence available. For particu-
lars contact: Director of Nursing Service. White-
court General Hospital, Whitecourt, Alberta. Phone:
778-2285.

GENERAL DUTY NURSES for active, accredited,
well-equipped 65-bed hospital in growing town, pop-
ulation 3,500. Salaries range from $490 — $610 com-
mensurate with experience, other benefits. Nurses
residence. Excellent personnel policies and work-
ing conditions. New modern wing opened in 1967.
(jood communications to large nearby cities. Apply:
Director of Nursing, Brooks General Hospital. Brooks.
Alberta.

GENERAL DUTY NURSES (2) for small, modern hos-
pital on Highway no. 12, East Central Alberta. Salary
range $477.50 to $567.50 including regional differen-
tial. Residence available. Personnel policies as per
AARN and A.H.A. Apply to: Director of Nursing, Co-
ronation Municipal Hospital, Coronation, Alberta.

GENERAL DUTY NURSES for 94-bed General Hospi-
tal located in Alberta's unique Badlands. $405 — $485
per month, approved AARN and AHA personnel poli-
cies. Apply to: Miss M. Hawkes, Director of Nursing,
Drumheller General Hospital, Drumheller, Alberta.

ADVERTISING
RATES

FOR ALL

CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additionol line

Rotes for display
advertisements on request

Closing date for copy and cancellation is
6 weeks prior to 1st day of publication
month.

The Canadian Nurses' Associotion does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For outhentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they are interested
in working.

Address correspondence to;

The

Canadian t^
Nurse ^

50 THE DRIVEWAY
OTTAWA 4, ONTARIO.

Inquiries are invited from GENERAL DUTY NURSES

for Dositions in a 330-bed active-treatment and aux-
iliary hospital complex. This is an ideal location in a
city of 27.000 with summer and winter sports facili-
ties nearby. 1970 salary schedules effective l^ay 1,
1970, $490. — $610. Recognition given lor previous
experience. For further information, please contact;
Personnel Officer, Red Deer General Hospital, Red
Deer, Alberta.

PUBLIC HEALTH SENIOR NURSE with DP H.N (min-
imum) or baccalaureate degree, and supervision ex-
perience preferred, required for Minburn-Vermilion
Health Unit. Good personnel policies. Salary range
$7.552-$9,512. Apply: Dr. F.J. Covill, Director and
MO.H., Minburn-Vermilion Health Unit, Vermilion,
Alberta.

BRITISH COLUMBIA

A HEAD NURSE and STAFF NURSES will be needed
tor Child Psychiatry. The Head Nurse will participate
in the clinical development and subsequent operat-
ion of the 20-bed unit anticipated for the Royal Jubi-
lee Hospital's Eric Ivlartin Institute of Psychiatry. Cur-
rent registration with the Registered Nurses' Asso-
ciation of British Columbia is required. Enquiries
should include background and experience and be
made to the; Director of Nursing, Royal Jubilee Hos-
pital, 1900 Fort Street, Victoria, British Columbia.

NURSES registered in British Columbia with PSY-
CHIATRIC experience are needed for the newly opened
Eric t^artin Institute of Psychiatry. When fully opened
this 170-bed facility is anticipated to have a Day Hos-
pital, 6 Acute Adult Psychiatric Units and a 20-bed
unildren's Unit. Attractive salary scale and liberal
personnel policies. Apply to the: Director of Nursing,
Royal Jubilee Hospital. 1900 Fort Street, Victoria,
British Columbia.

REGISTERED NURSES, G. NURSES and all Hospital
personnell are available: Contact: PHILCAN PER-
SONNEL SERVICE, 5022 Victoria Drive, Vancouver
16, British Columbia. Ph: 327-9631.

GENERAL DUTY NURSES tor modern 33-bed hospital
located on the Alaska Highway. Salary and personnel
policies in accordance with RNABC. Accommodation
available in residence. Apply to: Director of Nursing,
General Hospital, Fort Nelson, B,C.

GENERAL DUTY NURSES for modern 35-bed hospital
located in excellent recreational area. Salary and per-
sonnel policies in accordance with RNABC. Comfor-
table Nurses' home. Apply: Director of Nursing, Boun-
dary Hospital, Grand Forks, British Columbia.

OPERATING ROOM NURSES for modern 450-bed hos-
pital with School of Nursing. RNABC policies in ef-
fect. Credit for past experience and postgraduate
training, British Columbia registration is required.
For particulars write to: The Associate Director of
Nursing, St.Joseph's Hospital, Victoria, British Co-
lumbia.

NURSES' COME TO THE PACIFIC NORTHWEST —

Gateway to Alaska. Friendly community, enjoyable
Nurses' Residence accommodation at minimal cost.
1970 RNABC contract salaries in effect. Registered
$549-$684. Non registered $522. Northern Differential
$15 a month. Travel allowance up to $60 refundable
after 12 months service. Apply to; Director of Nurs-
ing. Prince Rupert General Hospital, 551 5lh Avenue
East, Prince Rupert, British Columbia.

MANITOBA

GENERAL DUTY NURSES: Applications are invitea
from Registered Nurses for a 100-bed accredited
hospital 50, miles west of Winnipeg on Trans Canada
Highway. Salary range $510/ $595 per month
effective September Isl, 1970. Excellent fringe
benefits plus evening and night differentials and
academic attainment bonuses. Applications will be
received by: Director of Nursing, Portage District
General Hospital, Portage la Prairie, Manitoba.

DIRECTOR OF NURSING required for 56-bed acute
General Hospital. Salary commensurate with
education and experience. Apply to: Administrator,
Sackville Memorial Hospital. Sackville, New Bruns-
wick.

NOVA SCOTIA

REGISTERED NURSES: Applications are invited from
Registered Nurses trained in psychiatry for the posi-
tion of DIRECTOR OF NURSING at the Halifax Coun-
ty Hospital, a 425-bed psychiatric hospital. Good
salary, working conditions and fringe benefits. Please
address applications to: Administrator, P.O. Box
1003, Halifax County Hospital, Dartmouth, N.S.

REGISTERED NURSES 'for active accredited llt-bed
maternity hospital. Positions available in labor and
delivery, antenatal and nursery departments. Please
apply to Director of Nursing, Grace Maternity Hos-
pital, Halifax, Nova Scotia.

GENERAL DUTY NURSES applications are invited
for active treatment hospital caring for medium and
long term patients. Salary Range; $5,400. — $6,660.
Excellent Fringe benefits and working conditions.
Please apply to: Director of Nursing. Halifax Civic
Hospital. 5938 University Avenue, Halifax, N.S.

ONTARIO

NURSING PROGRAMME CO-ORDINATOR: To assist
with implementation, co-ordination and interpretation
of Nursing Programme, and evaluate and supervise
Nursing Staff. Public Health degree and Supervision
required. Good personnel policies. Apply to: Dr. A.E.
Thoms. Medical Officer of Health, Leeds, Grenville
and Lanark District Health Unit, 70 Charles Street,
Brockville, Ontario.

REGISTERED NURSES for 34-bed General Hospital.
Salary $525. per month to $625 plus experience al-
lowance. Residence accommodation available. Ex-
cellent personnel policies. Apply to: Superintendent,
Englehart & District Hospital Inc., Englehart, Ontario,

REGISTERED NURSES needed for 81-bed General
Hospital in bilingual community of Northern Ontario.
French language on asset, but not compulsory. Start-
ing salary $530. monthly with allowance for past ex-
perience, 4 weeks vacation after 1 year and 18 sick
leave days, Unused sick leave days paid at 100% eve-
ry year. Master rotation in effect. Rooming accom-
modation available in town. Excellent personnel pol-
icies. Apply to; Personnel Director, Notre-Dame Hos-
pital, P.O. Box 850, Hearst, Ont.

REGISTERED NURSES required for a 12-bed Inten-
sive Care-Coronary Care combined Unit. Post basic
preparation and/or suitable experience essential,
1970 salary range $535-645; generous fringe benefits.
Apply to: Director of Nursing, St. Mary's General Hos-
pital, 911B Queen's Blvd., Kitchener, Ontario.

REGISTERED NURSES. Applications and enquiries
are invited for general duty positions on the staff of
the Manitouwadge General Hospital. Excellent salary
and fringe benefits. Liberal policies regarding ac-
commodation and vacation. Modern well-equipped
33-bed hospital in new mining town, about 250-mi.
east of Port Arthur and north-west of White River,
Ontario. Pop. 3,500. Nurses' residence comprises
individual self-contained apts. Apply, stating quali-
fications, experience, age, marital status, phone num-
ber, etc. to the Administrator, General Hospital, Ma-
nitouwadge, Ontario. Phone: 826-3251.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS. Our 75-bed modern, progressive Hos-
pital invites you to make application. Salaries
$510.00 and $357,00 with yearly increments and ex-
perience benefits. We are located in the Vacationland
of the North, midway between Winnipeg and Thunder
Bay. Write or phone: The Director of Nursing, Dry-
den District General Hospital, Dryden, Ontario.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS tor 45-bed hospital. R.N.'s salary $525
to $600 with experience allowance and 4 semi-annu-
al increments. t^Jurses' residence — private rooms
with bath — $30 per month. R.N.A.'s salary $350 to
$425. Apply to; The Director of Nursing, Geraldton
District Hospital, Geraldton, Ont.

64 THE CANADIAN NURSE

SEPTEMBER 197(

'i

October 1970

HISS MTM MORRIS

290 NELSCN ST APT 812
OTTAWA 2 ONT 00005784

The

Canadian
Nurse

the hospital nurse
expands her role

"epidurals" are here to stay

what is your will?

home care of children
with metabolic disorders

changing horizons

f

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The

Canadian
Nurse

^

^^p

A monthly journal for the nurses of Canada published

in English and French editions by the Canadian Nurses' Association

Volume 66, Number 10

October 1970

23 Active-Care Hospital Nurse Expands Her Role R. Coombs

30 What Is Your Will? R.J. Green

34 "Epidurals" Are Here to Stay E.L. Rosen, A.M. Dillabough

38 Information for Authors

39 Idea Exchange

41 Home Care of Children with Inborn

Errors of Metabolism T. Reade, C. Clow

The views expressed in the various articles are the views of tht authors and do not
necessarily represent the policies or views of the Canadian Nurses' Association.

4 Letters

17 Names

20 New Products

46 Books

48 Accession List

7 News

19 Dates

44 Research Abstracts

47 AV Aids

64 Official Directory

Executive Director: Hden K. Mnssallem • Ed-
itor: Virgiiiia A. Lindabury • Assistant Ed-
itor: Mona C. Ricks • Production Assist-
ant: EIizal>eth A. Stanton • Circulation Man-
ager: Berjl 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-
ciation, where applicable. Not responsible for
journals lost in mail due to errors in address.

Manuscript Information: "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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
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. Permit No. 10,001.
50 The Driveway, Ottawa 4, Ontario.
O Canadian Nurses' Association 1970.

OCTOBER 1970

Editorial

At the Canadian Nurses' Association's
general meeting last June, delegates
approved a resolution directing CNA
to ask the federal department of health
and welfare to call a national conference
to study health matters affecting Cana-
dians. The resolution stated that this
conference should provide a forum foi
discussion among the major purveyors
(nursing and medicine) and the con-
sumers of health services, and that spe-
cial emphasis be on the development
of complementary roles for nurses anc
physicians.

CNA received an encouraging re
ply from the deputy minister of nationa
health in July, stating he supports the
rationale of the resolution. He added
however, "The resolution itself ... is
another matter. It seems to me there
are a number of steps to be taken be
fore such action could be productive.'

Probably one step to which the dep
uty minister refers would involve ob
taining data on programs where nurses
have already demonstrated their abil
ity to assume additional responsibility
This seems logical before embarking
on a national conference, and woulc
help set the stage for action, rather thar
mere rhetoric.

Nurses are expanding their tradi
tional roles in many settings, anc
articles published in previous issues
of The Canadian Nurse attest to this

We are convinced, however, tha
change has occurred in other areas ir
nursing, but is not being reported
Whether this reticence by nurses tc
publicize their expanding roles anc
functions stems from a fear of criticisn
by physicians, or merely from self
modesty — we do not know. We d(
know, however, that unless nurses give
a clear picture of what they are doinj
to fill the gap between the physicians
role and their own, the demand made
by a few influential physicians for i
new category of worker — the phy
sicians' assistant — stands a gooc
chance of being met.

This month we feature an article
by a clinical nurse specialist describing
how the role of the active-care hospita
nurse in one center is expanding; ar
article slated for November will show
how occupational health nurses in one
industry are successfully assuming
responsibilities once considered fai
beyond the competence of a nurse. Whc
knows, perhaps we will eventually be
able to publish an article explaining
how nurse midwives across Canad£
are helping to reduce the high incidence
of maternal aMd mortality rates in this
country! — V^.l

THE CANADIAN 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.

Weight gain inaccurate?

It was rather astounding to read the
statement in the article "My You're
Getting Big" (August 1970), advising
that pregnant women should limit
their weight gain to about 16-20
pounds, when from press reports, the
public is warned that "the current
medical practice of restricting pregnant
women to a weight gain of only 10
to 14 pounds may be contributing to
the high infant mortality rate in the
United States," by a United States
Committee of the National Research
Council. Further, a gain of around
24 pounds was being recommended,
according to various reports.

Interested nurses are advised to
read research reports, such as the
American Journal of Public Health.
Part 2, April 1970, and Dr. Charles
Lowe's testimony before the Senate
Select Committee on Nutrition and
Related Human Needs, especially on
new findings regarding protein syn-
thesis by the brain, in utero, and in
infancy. Dr. Joaquim Cravioto, the
noted Mexican nutrition expert, gave
additional information at the 12th
annual meeting of the Canadian Fed-
eration of Biological Sciences in Mont-
real this June. Nutrition Today (USA)
is another source of newer thinking
available to nurses.

Perhaps it would be wise to delete
dogmatic statements about the Cana-
dian situation until all findings are
in from the coming Canadian federal
nutrition survey. Possibly our esti-
mates of protein requirements will
be raised considerably by this study
and from some preliminary soundings.
— A. Cecilia Pope, R.N., M.R.S.H.,
Toronto, Ontario.

The author replies:

Nowhere in my article was 16 to 20
pounds given as the recommended
weight gain in pregnancy. The point was
that the pregnancy weight itself ac-
counted for 16 to 20 pounds, that is,
uterus 2 to 3 pounds, placenta 1 pound,
etcetera, and that the mother should be
aware of this so she will not expect to be
exactly the same weight and size
postpartum as she was before she be-
came pregnant. The point made was to
emphasize the need for anticipatory
teaching.

The additional information Miss
Pope provides is certainly of interest

4 THE CANADIAN NURSE

and could be used in teaching mothers
so they will be still more accepting of
their "tiabbiness" postpartum. — Elai-
ne Carty, R.N., Kingston, Ontario.

Timely and revealing

I feel strongly about the excellent
article "Negligence in the Recovery
Room" (July 1970). It is a timely and
revealing piece of information.

The nurses involved and, sadly,
the patient, were sacrified to prevent
a similar situation from occurring in
high risk areas. When this disaster
was made public, there was a province-
wide reaction, and staffing in most
hospitals was under close scrutiny by
administration and nursing service.

The events that led to this tragedy
were precipitated by the much malig-
ned coffee break. It was suggested
that a coffee break should be taken
at the beginning of the shift. This is

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OTTAWA 4, Canada

ridiculous. A break was designed to
increase efficiency and to relieve ten-
sion or even monotony, if present in
a working day. All of us have missed
coffee and lunch breaks during peak
periods, but how well and accurately
were our duties carried out?

My point is that few have come to
the defence of the nurses involved.
The picture is quite clearly one of
communication breakdown due to a
tight budget and lack of foresight.
Head nurses, supervisors, and nursing
administrators are all involved and
responsible for staffing during break
periods. Our profession has condemn-
ed those responsible in this hospital,
but it is time for provincial associations
to evaluate staffing, make recommen-
dations to employers, and provide
support when these recommendations
are not met.

Other professions stand behind)
their numbers as well as discipline
them. Why can't we? Is it because we
are predominantly a female profession?

Two excellent nurses have had theit
lives permanently scarred. I submit!
that the hospital staffing pattern ia
responsible for the circumstance, no«
the nurses involved. — B. Hudson .
R.N., Surrey, British Columbia.

Comments on abortion

"Abortion," you say, "should be a
matter that concerns the patient and
her doctor," (editorial, August 1970)
Aren't you forgetting somebody? Wha '
about the tiny bit of life that exists ir i
the mother's womb? Who is goinj,;
to fight for and protect him?

Physicians, biologists, philosophers
and theologians do not know wher
a fertilized ovum becomes a person
Are we, as nurses, so certain of tht
time when humanity begins, that wr
will advocate the abortion of an or
ganism? Is there any differenca
between aborting a fetus and murderinjn
a newborn baby? If you answer yes
then let me hear your arguments. Provic
to me that a fertilized ovum is not n
human being.

In my graduation pledge, I promisee
to respect human life as sacred. Eacl'i
patient is treated as a valuable, indi
vidual human being. Furthermore
my students are taught to do the same
Now, you are asking me to belon;i
to a professional association that denie i
OCTOBER 1971

the value of human life. Where do you
draw the line? Am I to return to my
patients and students and say, "Yes,
human life is valuable, but not the
life that is unborn"? Do you expect
anyone to believe me?

If the Canadian Nurses' Asso-
ciation advocates legalizing abortion,
I will dissociate myself from it, and
urge my fellow nurses to do the same.
I will not practice and teach the value
of life, and at the same time ignore it.

You will argue that legal abortions
are more humane than those performed
by back-alley abortionists, but the
more fundamental question is, "Arc
we responsible for our actions?" We
must accept the consequences of
what we do, be they minor ones,
like cystitis, or more serious, such
as venereal disease or pregnancy.
The treatment of the former conse-
quences, however, does not involve
the sacrifice of an innocent life. If we,
as a professional association, advocate
legal abortion, we are saying that
people are no longer responsible for
their actions. I am not willing to do
this. Are you? — Mary Ann Cons-
tantln Morgan, R.N., B.N. Montreal,
Quebec.

Editor's Note: The Canadian Nurse'
Association has not taken a stand on
the matter of termination of pregnancy.
Tire ideas expressed in the editorial are
the editor's opinions.

Permanent shifts

1 wish to congratulate Helen Saunders
on speaking out in her article "Lets'
Have Permanent Shifts" (June 1970).
In the past, nurses have been required
to sacrifice their personal needs. Let's
be a little more human.

When a nurse feels happy and se-
cure in her work, she will give better
service to her employer and to her
patients. If an employer wants the re-
spect of her staff, then she must fol-
low one policy for all. No employer
should tell some nurses that they have
to rotate shifts, while others are per-
mitted to work on a permanent shift
basis. Staff will be more cooperative,
will follow hospital policies, and econ-
omize willingly if there is no discrim-
ination and everyone is treated alike
with respect to shifts. — Hazel J.
McLaughlin, R.N., Port Credit, On-
tario.

lournal not educational

While browsing through files of The
Canadian Nurse, I realized what a
great journal we used to have. These
issues were truly educational, to a
degree not found in our present pub-
lications.

One example, the March 1964
OCTOBER 1970

journal, really made the point! It
featured a complete cardiovascular
series and included all the peripheral
vascular diseases, excellent descrip-
tions of anatomy and physiology,
with open heart and catheterization
procedures. If we could do this in
1964, think what we could offer
today's subscriber.

Our journal should revert to being
an educational series, with accurate
medical terminology rather than the
current lay terms now used. The latest
August issue had not one article in-
volving basic medical knowledge.

I would like to see less social news
and more articles on continuing edu-
cation.— Doreen J. Stewart, R.N.,
Edmonton, Alberta.

No unemployment protection

I have recently learned that thousands
of nurses in Canada are completely un-
protected against unemployment. Is
there a valid reasion for some nurses to
be ruled ineligible for unemployment
insurance?

Hospitals usually have their own un-
employment insurance schemes. Nurs-
ing homes of any size now must include
their nursing staffs in unemployment
insurance contributions. But what hap-
pens to the many not-so-young nurses
who are finding it almost impossible
to get work? They have made no contri-
butions and are thus ineligible for un-
employment benefits. In many cases
they cannot afford to keep paying for
hospital and health insurance.

Cannot the provincial nurses' asso-
ciations take the first step in looking at
the reasons why nurses are a race apart?
— R.N., Ottawa.

Time for rededication

1 enjoyed reading the August issue,
especially the editorial and the CNA
resolutions. It is refreshing to hear
talk of throwing off the "cloak of
conservatism," although it is a long
time coming. I support your ideas
on abortion reform support, and on
the problem of CNA fees. Payment
of such fees ought to be manditory,
despite the shrieks of protest this is
bound to bring.

I also fully support the idea that
we must begin to ensure that people
everywhere in Canada be given the
best possible health care. Thinking
nurses have been afraid to speak
out for better care for far too long,
and sometimes have been unable to
give better care due to other restraints,
some of which have even come from
other nurses. It is time for rededica-
tion. Let us tune in to the challenges
of the seventies! — Georgina Kish
B.N., Montreal, Quebec. §

*->

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THE CANADIAN NUKSE

NEWBORN REGULAR

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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-)infection.
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 leRlchc Bacteriology Study— 1963

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news

French Nurses Not Being Recruited
As Physicians' Assistants

Ottawa — France has a shortage of
doctors, but to date there is no talk of
nurses being recruited as physicians'
assistants, according to two French
nurses who visited Ottawa on a private
study tour August 3 1 to September 4.
Marie-Claire Portehaut and Janine
Prevot, postgraduate students at the
International School of Higher Nursing
Education in Lyons, explained that
third-year medical students who had
not qualified for a medical degree
were used this past summer as an exper-
iment to help fill the gap between the
doctor-nurse services.

Although the two French nurses had
not been in Canada long enough to
make many comparisons between nurs-
ing in the two countries, they did note
that the organized profession here is
stronger than in France. One reason,
they said, was because there are four
nursing associations in their country,
and not every nurse belongs to the
national association. In France, many
of the decisions affecting nursing are
made by the department of health,
rather than by the nurses' association.

When asked why the length of nurs-
ing education programs in France was
being increased from two to three years
in 1971, Miss Portehaut said the aim
vyas to give students a broader educa-
tion and include more of the behavioral
sciences in the curriculum. This could
be done only by extending the length
of the program.

Most schools of nursing in France
are affiliated with hospitals, Miss
Prevot said, and as yet there are no
university schools of nursing. "'Our
emphasis now is on raising the stand-
ards of admission to schools," she
explained. "We are trying to convince
government authorities that higher
standards of admission, better salaries
for nurses, and a more interesting
curriculum would attract more people
to the profession."

Miss Portehaut and Miss Prevot
said they were particularly interested
in learning about nursing education
in Canada; the administration of nurs-
ing care and the kind of care being
planned to meet the total needs of the
patient; and the organization of the
national association. During their
OCTOBER 1970

Two postgraduate students from the International School of Higher Nursing
Education in Lyons, France, visited the Canadian Nurses' Association in
August. Mane-Claire Portehaut, left, and Janine Prevot, right, talk with Doris
Crowe, CNA's recently appointed public relations officer.

week in Ottawa, they visited the Cana-
dian Nurses' Association, the depart-
ment of national health and welfare,
the National Defence Medical Centre,
and the Vanier School of Nursing.
Their remaining six weeks will be spent
in the province of Quebec, as guests of
the Association of Nurses of the Prov-
ince of Quebec, and they will return
to France in mid-October.

CNA Ad Hoc Committee Meets
For Final Discussion

Ottawa. — The final meeting of the
Canadian Nurses" Association's ad hoc
committee to study recommendations
of the task force reports on the cost of
health services in Canada, was held at
CNA House August 24-27. The first
meeting was held in April, and results
of that meeting were presented to the
CNA board of directors for discussion
and approval at the June general meet-
ing in Fredericton.

Committee chairman Lois Graham-
Cumming. head of CNA's research and
advisory services, said 59 recommen-

dations were discussed at the August
meeting, and one of the main issues was
that of the nurse practitioner. The 14-
member committee included chairman
of the three standing committees: nurs-
ing education; nursing service; and
social and economic welfare. Provin-
cial associations were represented by
an appointed member. Members were
sent a detailed questionnaire and work-
ing papers to prepare for the meeting.

A final report will be submitted to the
CNA board of directors meeting this
month. The board is expected to take a
stand on the nurse practitioner issue at
this time.

Nursing Legislation Discussed
At International Seminar

Geneva, Switzerland — Nurses repre-
senting 23 national nurses' associations
met in Warsaw, Poland, from July 6 to
16 to discuss legislation affecting the
nursing profession. Conducted in
English and French, the seminar was
organized by the Intefciational Council
of Nurses, with funds from the Florence
THE CANADIAN NURSE 7

Nightingale International Foundation.
The Polish Nurses' Association was
host, and organized a varied program of
social and professional activities.

All participants at the seminar were
nurses who are in a position to promote
nursing legislation in their own
countries. The Canadian Nurses" As-
sociation was represented by Helen M.
Sabin, executive secretary of the Alberta
Association of Registered Nurses.

Seminar participants looked at nurs-
ing legislation in relation to nursing
education, nursing practice, social and
economic welfare of nurses, and the
role of auxiliary nursing personnel. The
recognition and licensing of foreign
qualifications, a code of ethics and
standards for practice, and the role of
the national nurses' association in
nursing legislation were studied.
Throughout the seminar, discussions
were based on the publication Principles
of Legislation for Nursing Education
and Practice — A Guide to Assist
National Nurses' Associations. It is the
published result of the first stage of
the FNIF project, which was the calling
ofan expert group on nursing legislation
in 1968.

Those attending the nine-day seminar
in Warsaw had the added responsibility
of evaluating the meeting; their judg-
ments will affect the planning of future
legislation seminars. This first FNIF
international seminar on nursing legis-
lation will, ICN believes, meet the need
voiced by member associations for
assistance in formulating or reassessing
the laws relating to nursing in their own
countries.

Speakers at the seminar presented
their own points of view, which were
as varied as the countries they rep-
resented and did not necessarily reflect
ICN's official position. Although the
speakers emphasized that the legislative
needs of a country can relate only to
that country, they agreed that the same
basic principle applies everywhere:
nursing legislation must safeguard the
care provided to the community, the
education of the nurse, and the quality
of her practice. The responsibility rests
with nurses to assume leadership in
promoting appropriate nursing leg-
islation to meet the needs of their
respective countries.

Seminar participants said the prime
purpose of nursing legislation is to
secure for society the benefits that
come from the services of highly skilled
nursing personnel. With the present
mobility of people, every country must
8 THE CANADIAN NURSE

Animals And Fish Admitted To HSC

The admission procedure isn't too formal, there are no elaborate tests needed,
and no medical history to be taken. In fact, the only criterion for admission
is that you be an attractive bird, an exotic fish, or a non-snapping turtle.
And your only role while in Toronto's Hospital for Sick Children is to please
hospitalized young fry — a rather easy task. Your home will be in the small
zoo on the 1 1th floor playroom at HSC, and you are guaranteed much at-
tention and affection. If you are a turtle, you'll find boys like Peter Burry,
top, left, ready to play with you all day; or, if you're a fish, there will always
be children such as David Maloney, being pushed in his wheelchair by Marcello
Molinaro, fascinated with your aquatic acrobatics. And if you're lucky enough
to be a guinea pig, you'll find yourself being cuddled and pampered by young
gentlemen such as Rubin Zak, left, and Brian Smith. What more!

consider provisions for the licensing of
nurses from other countries. Regardless
of the approach taken, the minimum
standard to be met must be comparable
to the standard set for graduates of the
country. Reciprocity of laws and agree-
ments made between registration bodies
safeguard a minimum standard of
education and practice. In the develop-
ment of this legislation, the professional
association must participate so it can
reflect the profession's viewpoint and
uphold nursing standards.

The three consultants for the FNIF
seminar were Mary Henry, registrar
of the General Nursing Council for
England and Wales; Dr. L. Krotiewska,
director of the legal department, min-
istry of health and social welfare and
lecturer at the postbasic medical center,
Poland; and Julie Symes, registrar of

the Nursing Council of Jamaica.

The list of speakers included Mrs.
Sabin, Canada; Maja Foget, director,
nursing education, national health
service of Denmark; A. Bailey, registrar
of the Nursing Council of Nigeria; M.
Oostinga, administrative secretary of
the National Nurses' Association of the
Netherlands; Margaret Darby, hospital
matron. North Canterbury Hospital
Board, New Zealand; Anny Pfirter,
head of the medical personnel section.
International Committee of the Red
Cross; and Margaret Pickard, ICN
nurse adviser.

Jadwiga Izycka, member of the
Board of ICN and of the Polish Nurses'
Association, extended greetings to the
participants on behalf of ICN's board
of directors.

{Continued on piif-e 1 1 )
OCTOBER 1970

*:*A

^I«?.^

Successful ELASE treatment often depends on proper application.
These four steps will help prevent an unsatisfactory or delayed
response:

1. Clean wound with water, peroxide, or normal saline ... and dry
area gently.

2. Apply a thin layer of ELASE Ointment.

3. Cover with petrolatum gauze or other nonadhering dressing.

4. Change dressing and repeat the above procedure at least once
a day . . . preferably twice a day.

Enzymatic debridement with ELASE facilitates healing in topical
ulcers, burns, infected wounds and other fibro-purulent lesions.
By helping remove necrotic debris and purulent exudates, ELASE
Ointment creates a better environment for healing.

ELASE-CHLOROMYCETIN " Ointment provides effective enzymatic
debridement plus direct antibacterial action to assist healing of
seriously infected surface lesions when the organisms are suscep-
tible to chloramphenicol.

This enzyme combination is supplied in three forms; ELASE (a lyophilized powder), ELASE Ointment, and ELASECHLOROiVIYCETIN Ointment. Each gram of ointment
contains 1 unit (Loomis) of fibrinoiysin and 666 units of desoxyribonuclease. Each vial of ELASE for solution contains 25 units (Loomis) of fibrinolysin and 15,000 units of
desoxyribonuclease. ELASECHLOROIVIYCETIN Ointment contains 1% Chloromycetin (chloramphenicol, Parke-Davis) in combination v»ith ELASE Ointment.

Elase'

[fibrinolysin and desoxyribonuclease, combined (bovine), Parke-Davis]

ELASE (powder for solution) ELASE Ointment
ELASE-CHLOROMYCETIN ° Ointment

INDICATIONS: ELASE is indicated for topical
use as a debriding agent in a variety of inflamma-
tory and infected lesions. These include general
surgical wounds; ulcerative lesions, abscesses,
fistulae, sinus tracts; second- and third-degree
burns; hematoma; cervicitis; vaginitis; circum-
cision and episiotomy; otorhinolaryngologic
wounds. ELASE-CHLOROMYCETIN Ointment
may be useful in the topical treatment of seriously
infected burns, ulcers, wounds, cervicitis and
vaginitis when the organisms are susceptible to
chloramphenicol and utilize a process of fibrin
deposition as a protective device. APPLICATION;
General Topical Use— repeat local application of
ointment or solution as indicated as long as
enzymatic action is desired, since enzymatic
activity becomes progressively less after applica-

tion, and Is probably exhausted for practical pur-
poses at the end of 24 hours. Remove necrotic
debris between applications. Intra-vaginal Use-
In mild to moderate vaginitis and cervicitis, 5 cc.
of ELASE Ointment should be deposited deep in
the vagina once nightly at bedtime for approx-
imately 5 applications; reexamine to determine
possible need for further therapy. PRECAU-
TIONS; Observe usual precautions against aller-
gic reactions, particularly in persons sensitive to
materials of bovine origin, antibiotics or thime-
rosal (a preservative). ELASE-CHLOROMYCETIN
Ointment should be used only for serious infec-
tions caused by organisms which are susceptible
to the antibacterial action of chloramphenicol.
WARNINGS: ELASE should not be used paren-
terally. ELASE-CHLOROMYCETIN Ointment

should not be used as a prophylactic agent. Chlor-
amphenicol when absorbed systemically from
topical application may have toxic effects on the
hemopoietic system. Prolonged use may lead to
an overgrowth of non-susceptible organisms in-
cluding fungi. ADVERSE REACTIONS: Although
deleterious side effects have not been a problem,
local hyperemia has been observed. IF ELASE-
CHLOROMYCETIN Ointment is used, allergy to
the chloramphenicol portion of the preparation
may show itself as angioneurotic edema or vesicu-
lar and maculopapular types of dermatitis.
SUPPLY; ELASE Ointment in 30-gram and 10-
gram tubes; ELASE-CHLOROMYCETIN Ointment
in 30-gram tubes; V-Applicators (disposable
vaginal applicators), in packages of 6, for use with
rO-gram tubes; ELASE is supplied dried in
3ubber-diaphragm-capped vials of 30 cc.

Detailed information available on request.

PARKE-iJAViS

PARKE. DAVIS ( COMPANY. LTD.. MONTIIEAL iJi

This decongestant tablet contends that a
cold is not as simple as it seems on television

Coricidin* "D" 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 "D"
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?

Coricidin "D"

comprehensive relief

of cold symptoms

DESCRIPTION: Each CORICIDIN
■ D" tablet contains 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 to exceed 4
tablets in 24 hours. Children (10-
14 years): V2 the adult dose.
Children under 10 years: as di-
rected by the physician.

SIDE EFFECTS; Adverse reac-
tions ordinarily associated with
antihistamines, such as drovirsi-
ness, nausea and dizziness occur
infrequently with Coricidin D "
vi/hen administration does not
exceed recommended dosage
PRECAUTIONS: IVIay be injurious
if taken in large doses or for a
long time. Additional clinical
data available on request.

■ rag Trade tVlark.

24T*»irrs

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Corporation Limited
Pointe Claire 730, P.Q.

®

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.

news

(Continued from page 8)

CNF Membership Rising Slowly

Ottawa — Only 78 new members
have joined the Canadian Nurses"
Foundation in the six-month period
from February to August, 1970.

The interim membership of the
CNF indicates a total of 1.389. Pro-
vincial membership is shown below:

Canadian Nurses' Foundation Mem-
bership as of] August, J 970

Province

Membership

British Columbia

371

Alberta

106

Saskatchewan

104

Manitoba

48

Ontario

317

Quebec

78

New Brunswick

212

Nova Scotia

90

Prince Edward Island

13

Newfoundland

14

Outside Canada

18

Total

1,371

Sustaining

17

Patron

1

Grand Total

1.389

Greylisting of Muskoka-Parry Sound
And Peel County Health Units Ended

Toronto. Ont. — The Registered
Nurses Association of Ontario has lifted
the graylisting of both Muskoka-Parry
Sound and Peel County health units.

On strike since May 18. the nurses
at the Muskoka-Parry Sound health
unit returned to work August 10. The
new contract is retroactive to January
1 . 1 970. and provides salaries of S6,550
to $8,050 as of January I, 1970; $7,000
to $8,500 as of August 10. 1970; and
$7,500 to $9,000 as of July 1. 1971.
Other improvements gained by Musko-
ka-Parry Sound nurses include incre-
ments for registered nurses not previ-
ously paid. The contract expires De-
cember 31. 1972.

Peel County nurses requested and
received a greylisting of their Board of
Health by RNAO on July 14. A strike
vote was taken, but not acted upon,
when settlement was reached. The
contract is retroactive to January 1
1970 and expires June 30. 1972. Sal-
aries are as follows: $6,700 to $8,200
as of January 1, 1970; $7,000 to $8,200
as of August 1. 1970; and $7,500 to
$9,000 as of July 1, 1971. Peel County
nurses will receive five annual incre-
ments in place of four, and holidays
have also been negotiated. By 1972
nurses will be entitled to four weeks
holidays after three years. In the previ-
OCTOBER 1970

ous contract, only nurses with seven
years of service were entitled to a four-
week holiday.

Salary Increase Awarded
To Nova Scotia Nurses

Halifax. M.S. — An arbitration board
awarded salaries of $5,700 to $6,840 in
August to nurses employed by the Nova
Scotia Civil Service Commission. The
department of public health and four
provincial hospitals, the Victoria
General, the Nova Scotia (psychiatric)
hospital, the Nova Scotia sanatorium,
and the Point Edward sanatorium, are
affected by this award.

In Nova Scotia, the Civil Service Act
provides for a joint council to consider
matters regarding employment for civil
servants. Through their Civil Service
Association, the nurses had requested a
basic salary of $6,000. The council
offered them a starting salary of $5,520.
This offer was rejected and the dispute
was brought to an arbitration board.
Hearings held in June and July brought
out discussions on: the comparative
wage levels in other institutions of the
same kind; the comparative wage levels
of persons doing similar jobs in indus-
try; the trends in wage increases, par-
(Continued on page 14)

, If you
cloiit do il,

it wmk
^doiie.

GIVE THE IMTTED WW

THE CANADIAN NURSE 11

Our best sponge ever is of course our
popular TOPPER* Sponge. The
TOPPER* Sponge owes its long-stand-
ing popularity to its all-round efficiency
and economy. The outer gauze cover
of this sponge encloses a layer of ab-
sorbent surgical viscose filmation of
longer staple and greater purity than
ordinary cotton filler, and a centre web
of cellulose which serves to diffuse
drainage laterally.thus assuring full use
of the entire absorbent capacity of the
sponge. Because ofthis unique design,
TOPPER* Sponges retain up to 20%

more fluid. In other words, they're just
that much more sponge for the money!
TOPPER* Sponges are available in
various sizes in either bulk or Patient-
Ready* form.

'Trademark of Johnson & Johnson or affiliated companies

TOPPER

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BEST EVER FROM

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^

12 THE CANADIAN NURSE

OCTOBER 1970

just try
our best
sponge yet!

Our best sponge yet is our new
TOPPER* SPONGE WITH SOFNET*
GAUZE. This remarkable new sponge
has a number of major advantages over
ordinary sponges. It is up to 25% more
absorbent than ordinary sponges, mak-
ing for not only convenience but econ-
omy, since less sponges will be needed.
Too, it boasts virtually no wound ad-
herence, to both facilitate removal and
speed healing. It is extra soft and com-
fortable, cushioning the wound better
and adding to patient comfort. The
SOFNET* gauze cover makes this
sponge uniquely easy to handle.

'Trademark of Johnson & Johnson or affiliated companies

TOPPER* SPONGES WITH SOFNET*
GAUZE are also available in various
sizes in either Patient-Ready or bulk
form.

TOPPER*

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WITH

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BEST YET FROM

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OCTOBER 1970

THE CANADIAN NURSE 13

(Continued from page II)

ticularly in local areas; concepts of what
is just, fair, or reasonable; and the cost
of living.

The raise will be retroactive to
January 1, 1970, and one increment of
$240, and three of $300 were also
granted.

New Diploma Program

For New Brunswick Students

Fredericton. N.B. — Official approv-
al has been granted by the New Bruns-
wick Association of Registered Nurse
to the new Saint John School of Nurs-
ing, scheduled to open its doors this
fall. The school, directed by Anne
Thorne, will be the first of its kind
in New Brunswick, and represents a
totally new philosophy in the education
of nurses.

Students will learn the practice of
nursing through an educationally-
controlled program of studies, rather
than the traditional service -oriented
approach. They will pay a tuition fee
for their course and will not be re-
quired to live in residence.

The concept of the Saint John School
of Nursing emerged as individuals
involved in nursing education became
interested in modernizing education
for nursing in the Saint John area.
Essential ideas relating to nursing
education at the diploma level, incor-
porated by the Saint John School of
Nursing, appear in such writings as
A Path To Quality, by Dr. Helen K.
Mussallem, and Portrait of Nursing,
by the late Dr. Katherine MacLaggan.
Support for the concept that nursing
education can best be accomplished
in an institution whose primary pur-
pose is education, has also been ex-
pressed and reiterated by the NBARN
for many years.

The program of the Saint John
School of Nursing will be approxi-
mately two years in length. By the fall
of 1970, with the admission of students
to the new school, both local hospital
schools of nursing will begin to phase
out their present programs.

Included in the curriculum are gen-
eral education courses and nursing
courses. Facilities for nursing practice
will include the Saint John General
Hospital, St. Joseph's Hospital, and
other health-directed agencies in Saint
John. Graduates will receive a diploma
in nursing.

The new program is supported by
the Hospital Services Division of the
New Brunswick department of health
and welfare, and has its own board
14 THE CANADIAN NURSE

of directors, under the chairmanship
of Dr. R.M. Pendrigh. Applications
for admission are now being accepted.
Further information may be ob-
tained from Anne Thorne, Director,
Saint John School of Nursing, Bruns-
wick House, Coburg Street, Saint John,
New Brunswick.

New Coronary Teaching Aid
Purchased By SRNA

Saskatchewan nurses had the opportun-
ity to test their new $7,000 multi-
media instructional system in coronary
care (see AV aids. The Canadian Nurse,
June 1 970) this summer at two, five-day
institutes held in Saskatoon and Regina.

The system is the first of its kind in
Canada and was purchased from
Rocom, through the new health educa-
tion and information division of Hoff-
man-LaRoche Inc. of Montreal. A
variety of educational techniques are
involved in this system, including
motion pictures, sound filmstrips, and
texts, as well as lectures, demon-
strations, discussions, case history
presentations, clinical experience, and
problem solving.

The purpose of the cardiopulmonary
resuscitation and emergency care in-
stitutes was to improve a nurse's effec-
tiveness in caring for patients with
cardiopulmonary emergencies.

The multimedia instructional system
expands and updates the basic course
content of intensive coronary care — A
Manual for Nurses by Meltzer, Pinneo,
and Kitchell.

The SRNA has set certain policies
to govern the use of the Rocom system.
It will be loaned only on written request
at least a month in advance. A nurse
must sign for it and be responsible for
accepting and returning the unit. The
maximum period of the loan will be
two weeks, and cost of shipment must
be paid by the borrower.

Grant For University of Manitoba
To Study Geriatric Hospital Care

Ottawa — A $12,520 federal govern-
ment grant to the University of Mani-
toba to study the role of day hospitals
in home care programs for elderly per-
sons has been approved by the depart-
ment of national health and welfare.

The demonstration project will be
conducted by the Victorian Order of
Nurses at the Deer Lodge Hospital and
Winnipeg General Hospital.

The VON has been designated by the
social service in Winnipeg as a coor-
dinating agency for future developments
in home care.

The three objectives of the project
are: to demonstrate the feasibility of
having a voluntary agency supervise
a hospital-based activity and therapeu-
tic program in a day hospital; to deter-

mine the management and operative
aspects of such a day hospital operation;
and to demonstrate the role of an inte-
grated support program for geriatric
patients in maintaining them in the
community by providing social relief,
the stimulus for continuing activity
and continuity of care. This portion of
the project will be carried out by com-
parison on a paired patient basis be-
tween the Deer Lodge Hospital, which
has a day hospital component, and the
Winnipeg General Hospital, which does
not.

The project stems from a recom-
mendation concerning the requirements
of geriatric health care contained in
the report of the task force on health
services in Canada.

NB Committee Set Up

To Study Nursing Education

Fredericton, N.B. — A committee to
study and make recommendations on
nursing education for the province of
New Brunswick has been established.
The announcement was made July 24
by the provincial health and welfare
minister, Norbert Theriault.

The committee will include repre-
sentation from nursing education, nurs-
ing service, the medical profession,
hospital administration, the public,
and the provincial departments of health
and welfare and education. Chairman
of the committee is Chaiker Abbis,
Q.C., of Edmundston.

Among the topics to be studied by
the committee are: the types and levels
of nursing education; the number of
nurses that must be educated to meet
the anticipated need in nursing service,
and the process of standard-setting,
inspection, and enforcement of stand-
ards in nursing education.

The committee began work in Sep-
tember, and is expected to submit its
final report by the end of this year.

CMAJ Editorial Says Abortion
Should Be Patient s Choice

Ottawa — Doctors should not be oblig-
ed to assume the function of gatekeepers
to decide which unwanted children
should be allowed into this overpopulat-
ed world and which ones should not,
says an editorial in the August 1 issue
of The Canadian Medical Association
Journal. "The moral aspect of this
question should reside solely with the
patient and not with the physician."

The editorial questions the present
law in Canada that requires a hospital
abortion committee of at least three
physicians to review applications from
physicians on behalf of their patients
seeking abortion. Few of the applicants
for termination of pregnancy are seen
by the committees, the editorial says,
thereby violating one of the most cher-
OCTOBER 1970

ished principles of medicine, namely,
that one does not make medical deci-
sions without at least seeing the patient.
"If the hospital abortion committee
is really a Judicial tribunal." the editori-
al continues, "society should be aware
that it is made up of people who have
no training in using the law to see that
justice is done. Further, the women on
whose fate the tribunal is deliberating
has none of the legal rights and safe-
guards she would have if she were on
trial in a court of law, namely the right
of counsel and the right of appeal from
the decision."

The CMAJ editorial says the present
law is open to wide variation of inter-
pretation and, as a result, inequities
abound. Some committees are made
up of physicians who hold a conserva-
tive view, and in such a hospital few
applications are approved: physicians
trying to get help for their patients
become discouraged and turn to a hos-
pital where the committee takes a more
liberal view. "The latter facility soon
becomes overwhelmed, while the former
hospital is able to insist that it has an
active abortion committee as the law
demands but that few applications are
received."

The editorial emphasizes that in all
countries with a committee-type screen-
ing procedure, illegal abortions remain
a serious public health hazard.

Most of the opposition to a truly
liberal abortion law has to do with the
rights of the fetus, CMAJ says. "The
proponents of this argument must show
an equal concern that the rights of the
unwanted child are respected and guar-
anteed after it is born," it adds.

The CMAJ editorial says that the
recent stand taken by the Canadian
Phychiatric Association on the abor-
tion issue, namely that the termination
of pregnancy should be removed from
the Criminal Code and should become
strictly a medical procedure to be decid-
ed by the woman and husband, if she
has one, will likely encourage other
medical bodies and individual physi-
cians to declare themselves openly on
the subject.

Federal Grant For Symposium
On Drug Users

Ottawa. — A $15,000 federal gov-
ernment grant has been awarded to
the Canadian Hospital Association to
support a national symposium on
hospital handling of drug users.

National health and welfare min-
ister, John Munro, said he hopes "...
the symposium will try to examine the
problems of drug users within the total
context of the situation, and that health
agencies outside the hospital field be
invited to participate in the program."

•V

\^ a show of hands...

^y/

proves its smoothness

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.

^efresh-.og-^""''"©.

ALCOJEL

Send for a free sample

through your hospital pharmacist.

l^leilied^

RUBBING
ALCOHOL

WTTH

ADDED

UJBRICANTanil

JMOUJENT^^

f*II«H DRUG HOUSES

THE BRITISH DRUG HOUSES (CANADA) LTD.

Barclay Ave., Toronto 18, Ontario _

OCTOBER 1970

THE CANADIAN NURSE 15

6

8
9

10
11

12
13

ELASTOPLAST
elastic adhesive
bandages

give strong support, allow air to
reach the skin and moisture to
evaporate to promote rapid
healing.

GYPSONA

Bandages and Slabs are available
In 4 types for casts of great
strength, minimum weight, and
fine porcelain-like finish.

JELONET

Paraffin Gauze Dressings are
non-adherent and open-meshed.
Now available in individual
sterile unit 'peel-apart' envelopes.

ELASTOPLAST
dressing strips

are continuous elastic adhesive
porous dressings. Strips are cut
to fit the wound.

ELASTOCREPE

I Cotton Crepe Bandage is a
smooth surface non-adhesive
bandage with unique properties
of stretch and regain.

NIVEACREME

is beneficial in a wide variety of
skin conditions after deep
x-ray therapy, plastic surgery,
chafing, and as a lubricant.

SUPER-CRINX

Softstretch Bandages conform
to difficult body contours. It's
unique weave of cotton and nylon
assures sustained tension.

PLASTAZOTE

Polyethylene Foam Splinting
Material is light yet strong enough
to form a variety of splints,
supports, and prostheses.

ELASTOPLAST
'airstrip' ward
dressings

for the care of post-operative
wounds-air-permeable yet water-
proof to permit healing under
ideally dry conditions.

DISPOSABLE

gowns, masks, caps, sheets, bed
pan and urinal covers are for low-
cost sanitary use in the hospital.

CELLOLITE

All-Cotton Thermal Blankets
give maximum warmth and
comfort with minimum weight
and withstand the strain of
repeated laundering.

ELASTOPLAST
skin traction kits

are ready-to-use and
provide the most efficient
method of skin traction.

ELASTOPLAST
anchor dressings

feature a porous elastic
adhesive fabric— H-shaped
to give firm anchorage on
hard-to-dress areas.

10

si

C

SMITH S NEPHEW LTD.

2100-52nd Avenue, Lachine, Quebec

the best dressed patient

names

Liv-Ellen Locke-
berg (R.N., Royal
Victoria Hospital,
Montreal; Diploma
P.H.,U.ofToronto,
Toronto; B.A., Car-
leton University,
Ottawa) has been
appointed assistant
editor of The Cana-
dian Nurse. For the past five years she
has been with the research development
section of the department of national
health and welfare, where her adminis-
trative duties centered around the public
health research grant.

Miss Lockeberg has had 15 years of
active nursing, including: Victorian
Order Nurse in Ontario's Porcupine
area; public health nurse in Deep
River, townsite for the atomic energy
plant at Chalk River. Ontario; and
visiting nurse in the outlying counties
served by the Ontario Hospital. Lon-
don. She later joined the scribes in the
Prime Minister's Office, remaining
there during the tenure of Mr. Diefen-
baker and Mr. Pearson.

Miss Lockeberg has a keen interest
in people, outdoor activities, and the
creative arts.

Jean Audrey Lister

(R.N., St. Boniface
School of Nursing.
St. Boniface, Mani-
toba; Dipl. nursing
service administra-
tion, U. of Western
Ontario, London,
Ontario; B.N. Lake-
head U., Thunder
Bay. Ontario.) has been appointed co-
ordinator of inservice education at St.
Boniface General Hospital.

Mrs. Lister obtained all of her nurs-
ing experience in Ontario. At McKellar
General Hospital, Thunder Bay, Onta-
rio, she held positions as general duty
nurse, assistant head nurse, head nurse,
and supervisor of inservice education.
Following her hospital experience Mrs.
Lister was appointed lecturer in nursing
at Lakehead University, Thunder Bay.

Clare Chuchia (R.N.. bachelor of
science in nursing education, Gonzaga
U. school of nursing, Spokane. Wash-
ington) has been appointed assistant
director of nursing education at the

OCTOBER 1970

Nurse Honored at Convocation

Dr. Virginia Henderson, a nurse widely renowned for her work, writings,
and research, was granted the honorary degree of Doctor of Laws, honoris
causa, at the spring convocation of the University of Western Ontario. She
is author of several books, including The Nature of Nursing and ICN Basic
Principles of Nursing Care. Miss Henderson is presently working on the
Nursing Studies lnde.x from 1900 to 1957. Standing behind Miss Henderson
IS Dean Catherine Aiken of the University of Western Ontario School of
Nursing. Dr. D.C. Williams, president and vice-chancellor of Western, read
the citation that described Miss Henderson as "Leader, scholar, and author,
whose devotion to the profession of nursing has elevated and distinguished it
and whose personal charm is such that the prospect of having her care for
one is the only argument known in favor of being sick."

Clarke Institute of Psychiatry, Toronto.
Miss Chuchia has had wide expe-
rience in psychiatric nursing education.
She completed an eight-month intern-
ship at the Alberta Guidance Clinic in
Calgary, Alberta — a provincial diag-
nostic and treatment service for children
and young adults. Her most recent ap-
pointment was as instructor at the
Mount Royal Junior College in Calgary.
Earlier teaching positions were with the
department of nursing education for
mental health services in British Colum-
bia; the school of nursing. University of
Ottawa; the Jewish General Hospital

school of nursing, Montreal; the Ed-
monton General Hospital and the Royal
Alexandria Hospital, Edmonton.

Lynda Lafoley (R.N., St. Michael's
Hospital School of Nursing, Toronto)
has arrived in Honduras to serve a two-
year tour of duty with MEDICO, a service
of CARE.

She will join a MKDlCO team sta-
tioned at Hospital de Occidents in
Santa Rosa, a rural town in the west-
ern part of the couigry. The team is
working to expand and upgrade med-
THE CANADIAN NURSE 17

names

ical treatment in the area and to train
counterpart personnel.

Miss Lafoiey will teach in the school
for auxiliary nurses and supervise local
nursing personnel in the wards. Previ-
ously she worked at the Ottawa General
Hospital, and also served with the
Canadian University Services Overseas
in Ghana. West Africa.

Josephine DeBrincat {R.N., Winnipeg
General Hospital School of Nursing,
Winnipeg, Manitoba; Dipl. public
health, U. of Toronto.) has been granted
honorary life membership in the Cana-
dian Public Health Association.

Miss DeBrincat, who retired in 1965,
has been active in public health nursing.
She was industrial nursing consultant
in the Manitoba provincial department
of health and public welfare; public
health supervisor of the United Nations
Rehabilitation and Relief Administra-
tion in Italy; and industrial nursing
consultant, public health nursing con-
sultant, and civil defence consultant to
the department of health and public
welfare, all in Manitoba.

She is an active member of the
Manitoba Association of Registered
Nurses and was secretary of the Mani-
toba Public Health Association. Miss
DeBrincat was granted honorary life
membership in the MPHA and was
also made honorary life member of
the Canadian Institute of Public Health
Inspectors.

Lorette Morel (Reg.
N., U. of Ottawa
School of Nursing;
Certificate public
health, U. of Otta-
wa; B.Sc.N., U. of
Ottawa; M.Ed., U.
of Ottawa.) has been
appointed health
education and nurs-
ing consultant, Canadian Tuberculosis
and Respiratory Disease Association.

Miss Morel is an active member of
the Registered Nurses Association of
Ontario, the Canadian Public Health
Association, and the Canadian Health
Education Specialists Society. She has
worked as general staff nurse in her
home town of Mattawa, Ontario, and
public health nurse in: the Timiskaming
Health Unit, Kirkland Lake, Ontario;
the Northern Ontario public health
service. North Bay, Ontario; the city of
Ottawa health department; and the city
of Calgary health department, Calgary.
18 THE CANADIAN NURSE

Ginette Fallu-Treyvaud, right, and
Monlque Charron, left, staff nurses at
the out-patient clinic of the Sacred
Heart Hospital in Hull, Ouebec, were
among 20 Ouebec nurses selected to
participate in a seminar on the nursing
profession and the public health fields
in France in August.

Participants were chosen by the office
of the France-Ouebec exchange pro-
gram, and were requested to submit a
paper stating their conception of the
nursing profession in Quebec for the
next 15 years. Mrs. Treyvaud sees the
nurse closely related to the computer
world, acting as a physician's associate
and assuming some of his present res-
ponsibilities. Miss Charron believes the
nurse will eventually replace the family
doctor and will aim toward public health
and preventive medicine.

The Ouebec nurses met medical and
paramedical authorities of the French
national public health and social secu-
rity departments, and public health
directors in Paris. They also visited
French hospitals and held discussions
with directors of nursing and leaders of
the professional associations in France.

Miss Morel was also supervisor of
public health, city of Ottawa health
department.

Heather B. Dawkins received a schol-
arship for excellence in psychiatric
nursing at Ryerson Polytechnical In-
stitute, Toronto, Ontario.

Miss Dawson plans to continue her
studies in the nursing field with empha-
sis on psychiatry, educational psychol-
ogy, sociology, and psychodrama.

Olivette G a r e a u

(R.N.. Hopilal Ste.
Justine, Montreal;
Dipl. P.H.. U. of
Montreal; B.Sc.N.,
and M.Sc.A.). direc-
tor of nursing of the
public health divi-
sion. Ouebec depart-
ment of health, has
been chosen by the World Health Or-
ganization to work withamulti-disciplin-
ary team to evaluate the public health
service in Thailand.

The team members will meet in New
Delhi for a brief period of orientation
and study of the situation before return-
ing to their place of work. Miss Gareau
will conduct an on-the-spot study and
will hold interviews with persons re-
sponsible for academic preparation of
nurses and with government authorities.

F.A. (Nan) Kennedy

(R.N., Vancouver
General Hospital
School of Nursing;
Dipl. P.H.. U. of
British Columbia;
B.Sc.N., U. of Brit-
ishColunibia;M.A..
U. of Washington,
Seattle. Washing-
ton.) has been appointed interim execu-
tive director of the Registered Nurses
Association of British Columbia. She
will fill the vacancy created by the
resignation of Eleanor S. Graham, in
an acting capacity from August 3 1 to
December 31,1 970.

Miss Kennedy joined the RNABC
provincial staff in 1959 as director of
education services. Her varied nursing
career includes four years with the
World Health Organization, first as a
tutor in public health nursing in East
Pakistan, and as a public health nursing
consultant in Iran.

K. Marion Smith

(B.S.N. , U. of Brit-
ish Columbia; M. A.,
McGill U., Mont-
real) has been ap-
pointed assistant
director of nursing
at the Surrey Me-
morial Hospital,
Surrey, B.C. She was
executive assistant and assistant director
of nursing at Vancouver General Hos-
pital, prior to her new appointment.

Miss Smith served with the Victor-
ian Order of Nurses for two years before
becoming a nursing sister in the Royal
Canadian Air Force in 1958. She is an
active member of the Registered
Nurses" Association of British Colum-
bia and was honorary secretary from
1967-69. *

OCTOBER 1970

October 14-17

Joint annual meetings and scientific ses-
sions of the Canadian Heart Foundation
and Canadian Cardiovascular Society,
to be held in the Chateau Laurier, Ottawa.
For further information write to Mr. E.
McDonald, Canadian Heart Foundation,
270 Laurier Avenue West, Ottawa 4.

October 16

The School for Graduate Nurses, McGill
University, is celebrating its 50th anni-
versary in conjunction with the McGill
Homecoming, 1970. Dr. Sheldon Schiff,
University of Chicago, will be guest speak-
er at a seminar, "The University and Pro-
fessional Education." A wine and cheese
party will also be held. For further infor-
mation write to Miss Phoebe Stanley,
School for Graduate Nurses, 3506 Uni-
versity Street, Montreal 112, Quebec.

October 17

14th Annual Symposium on Rehabilitation,
sponsored by the Rehabilitation Foundation
for the Disabled and the Ontario Society for
Crippled Children. Inn-on-the-Park. Don
Mills. Ontario, Write to Mrs. Betty McMur-
ray. Executive Director, Rehabilitation
Foundation for the Disabled, 12 Overlea
Boulevard. Toronto 354, Ontario.

October 26-27

Nursing sessions at the Ontario Hospital
Association annual convention. Royal York
Hotel, Toronto. Write to the OHA, 24 Ferrand
Drive, Don Mills, Ontario.

October 26-28

Annual Meeting of the Association of
Registered Nurses of Newfoundland at
the Holiday Inn, St. John's Newfoundland.
For further information write to Executive
Secretary, Association of Registered
Nurses of Newfoundland, 67 LeMarchant
Road, St. John's Newfoundland.

October 26-28

Annual meeting of the Association of Regis-
tered Nurses of Newfoundland. St. John's.
Write to the AARN, 67 Le Marchant Rd ,
St Johns, Nfid

October 28-31

American Association of Medical Assist-
ants' 14th Annual convention to be held
OCTOBER 1970

in Des Moines, Iowa. For further infor-
mation write to Secretary, American Asso-
ciation of Medical Assistants, 200 East
Ohio Street, Chicago, Illinois, 6061.

October 29-31

Second annual symposium of the Institute
of Community and Family Psychiatry, Jew-
ish General Hospital. Montreal. Que-
bec, on techniques in family therapy
and the future of the family. Simulta-
neous translation is available in French.
For more information and advance reg-
istration, contact: Philip Beck. M.D.,
registration chairman. Symposium, In-
stitute of Community and Family Psy-
chiatry, 4333 Cote St Catherine Road.
Montreal 249. Quebec.

Nov. 4-6, 1970 and Feb. 24-25, 1971

A continuing education course called Nurs-
ing Service Objectives is being sponsored
by the University of Toronto School of Nurs-

WORK AND PLAY
IN SWINGING SUNNY

CALIFORNIA

Staff Nurie minimum $715/month plus
$100 differential. Other positions pay
according to experience and education.
Select from 35 major hospitals, any shift
or department. Will ossist in U.S. working
permit Of immigrotioo visa, housing ac-
commodation and California license.
Nothing to poy . . . FREE PLACEMENT.

TRANS U.S. INC.

(Authorized Representative of Hospitals)

1316 Wilshira Blvd.

Les AngelM, California 90017

U.$.A.

Tel.: (313) 4ai.0««6

WITHOUT OBLIGATION

Please send me more information about

working in Colifornio:

NAME

ADDRESS:

Ta.:

Specialty:

Licenses:

ing. For more information write to: Conti-
nuing Education Program for Nurses, Uni-
versity of Toronto School of Nursing, 47
Queen's Park Crescent. Toronto 5. Ontario.

November 9-13, 1970

Course in occupational health for profes-
sional registered nurses in industry, offered
by the department of environmental medici-
ne of New York University School of Medi-
cine, in cooperation with the American As-
sociation of Industrial Nurses. Limited to
nurses with five years or less experience
in occupational health. Tuition: $175. Spe-
cial emphasis will be given to interviewing
and counseling For information and appli-
cations, write to the Office of the Recorder,
New York University Post-Graduate Medical
School. 550 First Avenue, New York, NY.

November 30-December 4

Conference for nurses in staff education
and staff development, Westbury Hotel, To-
ronto. Sponsored by the Registered Nurses'
Association of Ontario Write to: Professio-
nal Development Department. RNAO. 33
Price Street. Toronto 5, Ontario.

February 15, 1971

Six-week coronary course offered to nurses
currently working on coronary care units.
Enrollment is limited to six nurses, and
total sponsorship by present employee
is required. Registration fee is $75.

For further information write to the
Course Coordinator, Intensive Care Nurs-
ing H601, Winnipeg General Hospital,
700 William Avenue, Winnipeg 3. Man-
itoba.

Feb. 15-19, 1971

Five-day course m occupational health
nursing for registered nurses who have
five or more years experience in occupa-
tional health nursing, and who work alone
or with one other nurse. For further infor-
mation write to: Continuing Education
Program for Nurses, University of Toronto,
47 Queen's Park Crescent, Toronto 5,
Ontario.

February 16-18, 1971

A national conference on research in
nursing practice will be held in Ottawa.
For more details write to Dr. Floris E.
King, Associate professor and coordi-
nator of the graduate iprogram. University
of British Columbia School of Nursing. ^
THE CANADIAN NURSE 19

new products

Descriptions are based on information
supplied by the manufacturer. No
endorsement Is intended.

Bucket-type Enema System

Hj

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^1

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B ®l!l

i;P!l

^m

HHI

^Bl ^

^

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^^^IK'B'

li

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If

Ol

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■

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Bag- Type Enema System

20 THE CANADIAN NURSE

Disposable enema systems

Convenience and fast administration
are features of two new disposable
enema systems available from Davol
Inc. One system offers a 1600 cc.
enema bag, and the other, a 1500 cc.
bucket. All other accessories needed
for routine administration, including
prelubricated tip, are included with
each.

One new Davol feature is a method
of sheating the lubricated tip. A loose
fitting plastic sheath leaves the lubri-
cant essentially undisturbed on its
removal.

The new Davol enema bag uses a
self-sealing valve that opens easily
for filling, yet retains the contents if
the bag is laid on its side. A specially
designed ouMet eliminates the possi-
bility of constriction at the point where
the tube joins the bag.

Other features of the bag and bucket
are a short, broad design that minimizes
height requirements during admin-
istration, and a special slip clamp design
that provides fast, effortless, on-off
control. Each Davol unit is supplied
with 48-inch tube with prelubricated
tip and slipclamp, waterproof underpad,
and a 2/3 oz. package of enema soap.

Davol products are available through
Canada from leading surgical supply
dealers.

Literature Available

The Council on Drug Abuse will dis-
tribute eight different pamphlets on
drugs to more than 600 pharmacies
across Ontario, with national distribu-
tion being planned. As part of its public
information program, the CODA has
made available pamphlets discussing
stimulants, solvents, narcotics, and a
drug reference chart.

Literature on depressants, drugs and
the law, and hallucinogens will be dis-
tributed shortly to drug stores and drug
sections of department stores, where
they may be picked up free of charge.

General Electric Company has pub-
lished a 12-page, color, brochure, that
describes its Monitrol-series of diag-
nostic x-ray tables.

For a copy of this brochure. No.
4243, write to the General Electric
Medical Systems Ltd., 3311 Bayview
Avenue, Toronto, Ontario.

OCTOBER 1970

An eight-page, color brochure de-
scribing Trainex audiovisual pro-
grams for the health care field, is
available from Trinex Corporation,
a subsidiary of Simplicity Pattern
Co., Inc.

The brochure also lists available
audiovisual projection equipment for
group or individual instruction.

For a free copy of this brochure,
write to Trinex Corporation, P.O.
Box 116, Garden Grove, California
92642.

A 16-page catalog on industrial skin
protection called. Ply... The Answer
to Industrial Dermatitis, is available
from Safety Supply Company. The
booklet lists common industrial skin
irritants and the PLY counteragent
most effective to combat them. A four-
step hand care program is also included
in the booklet. For a free copy, write
to Safety Supply Co., 214 King St.,
East, Toronto, Ontario.

Therapeutic Whirlpool Center

Jacuzzi research Inc., now offers a
complete line of water massage units
for hospital physical therapists. A
fiberglass hip tank includes a self-
contained unit with contoured seat
to permit complete immersion. The
moving parts and electrical compo-
nents of the unit are concealed. An
optional 2,000 watt heater maintains
desired water temperature automat-
ically.

The Portable Jacuzzi Whirlpool

Bath may be used in therapy tank or
bathtub, and requires no special plumb-
ing or electrical hookups.

The Jacuzzi distributor in Canada
is Ramsley, Inc., 3856 Notre-Dame
Street, Chomedey, Laval, Quebec.

Saneen Medical
Towels Polywrapped

Facelle Company Limited's Saneen
single-use medical towels are now poly-
wrapped in units of 50 for cleanliness,
easy storage, and stock control. The
packages are wrapped in polypropylene
to withstand autoclaving, yet are easily
opened by a perforated band. The tow-
els come in three convenient sizes and
are suitable for many sterile, as well as
non-sterile, procedures.

For further information, write to Fa-
celle Company Limited, 1350 Jane
Street, Toronto 335, Ontario.

Knee Straps

The Posey Company has introduced
knee straps that provides a simple solu-
tion for patients who often slide forward
in wheelchairs. A broad nylon strap
attaches to the wheelchair frame and
passes in front of the patient's knees.
The belt stops the person from sliding,
with no discomfort or restraint of free-
dom.

This knee strap, easy to use with any
wheelchair and patient, costs $6.30. It
is available from Enns & Gilmore, Ltd.,
1033 Rangeview Road, Port Credit,
Ontario.

Therapeutic Whirlpool Center

Whenyourday
starts at ^^
6 a.m... you're on
charge duty.,
you ye skimped
onmeals...^^^
and on sleep...
you haven't had^
time to hem
a dress... ^
mal<e an apple pie...
wash your hair.,
even powder 4m
your nose
in comfort.^

It's time for a change. Irregular hours and meals on-lhe-
run won't last. But your personal irregularity is another
matter. It may settle liown. Or it may need gentle help
from DOXIOAN.

use

DOXIDAN"

most nurses do

DOXIOAN is an effective laxative for the gentle relief of
constipation without cramping. Because OOXIOAN con-
tains 3 dependable fecal softener and a mild peristaltic
stimulant, evacuatiort is easy and comfortable.

For derailed information consult Vademecum
or Compendium.

HOECHST

PHARMACEUTICALS

3400 JEAN TALON W., MONTREAL 301
DIVISION Of CANADIAN HOCCHST LIMITED

i'"*"!

OCTOBER 1970

THE CANADIAN NURSE 21

BE PREPARED ... to meet the challenges of today's

nursing practice with these up-to-date guides

THE NURSING CLINICS
OF NORTH AMERICA

September Issue:

CARE OF THE INFANT AND

YOUNG CHILD

E. Cleves Rotbrock, Guest Editor

PATIENTS WITH SENSORY

DEFECTS

Elizabetb Wesseling, Guest Editor

The valuable September number of
Tbe Nursing Clinics provides prac-
tical help in a series of pertinent
articles in two areas of growing con-
cern. The first. Care of tbe Infant
and Young Cbild, focuses on specific
challenges to the nurse's ability
and compassion. Discussions range
from a delineation of nursing re-
sponsibilities in postoperative care
following open heart surgery to a
sensitively written article that shows
how the nurse can best respond to
the needs of the dying child and his
parents. The second symposium. Pa-
tients witb Sensory Defects, offers
practical guidance in the nursing of
patients who have these problems by
demonstrating proven nursing care
measures used at leading medical
centers.

Published quarterly. Ayerages 185 pp. per
issue. Hardbound. Illustd. No advertising.
By yearly subscription only. $13.

Keane & Fletcher:

DRUGS AND SOLUTIONS

New 2nd Edition

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 conver-
sion of dosages and calculation 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 proportion,
without confusing formulas. At the
end of each section is a post-test,
presented as an actual nursing situa-
tion. The answers are given at the
end of the book, as is a final ex-
amination that reviews and reinforces
the entire book.

By Claire B. Keane. R.N., B.S. and Sybil M.
Fletcher, R.N. About 180 pp. Illustd. About
U.OO. Just Ready.

22 THE CANADIAN NURSE

Creighton: New 2nd Edition

LAW EVERY NURSE SHOULD KNOW

The long-awaited revision of this classic book
is now in print. Written by a woman who is a
nurse, educator and 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 obliga-
tions as an employee to her responsibilities
in witnessing a will. Also included is a chap-
ter on Canadian law. The new edition is
substantially enlarged with added coverage
of such topics as "good samaritan" laws,
child abuse, telephone orders, supervision of
paramedical personnel, sterilization, and
organ transplantation.

By Helen Creighton, R.N., J.D. 246 pp. $8.10. June, 1970.

LeMaitre & Finnegan:
THE PATIENT
IN SURGERY

New Second Edition

The new Second Edition of this
well known text is designed for the
advanced nursing student and the
nurse in service. The book clearly
guides the student through the
preoperative, operative, and post-
operative phases of patient care
and explains her role and respon-
sibilities. Noteworthy additions to
the revised edition include new
chapters on: Wounds and Wound
Healing — Vascular Surgery —
Open and Closed Heart Surgery —
Craniotomy. Study questions at
the end of each chapter enable
the student to check her retention
and comprehension of material.

By George D. LeMaitre, M.D., F.A.C.S.
and Janet A. Finnegan, R.N., M.S. About
530 pp. About 110 illust. About $6.50.
Just ready.

Freeman:

COAAMUNITY HEALTH
NURSING PRACTICE

New

Designed as a text for advanced
nursing students and as a guide for
teachers of LPN's and health aides,
this new book introduces modern con-
cepts of community health nursing
as a dynamic and societally-oriented
discipline. Dr. Freeman bases her pre-
sentation on two fundamental con-
cepts: the family as the unit of ser-
vice, and "community diagnosis" (as-
sessment of community health needs)
as the keystone of public health prac-
tice. She devotes special attention to
such problems of current concern as
poverty, family planning, and mental
health. Recent research is incorpor-
ated throughout the book, and ex-
tensive lists of up-to-date readings
are recommended.

By Ruth B. Freeman, R.N., Ed.D. About 440
pp. Illustd. About $9.75. Just Ready.

W. B. SAUNDERS COMPANY CANADA LTD.
1 835 Yonge Street, Toronto 7
Please send on approval and bill me:

Author

Title

Author

Title

n Please enter my subscrption to THE NURSING CLINICS, starting
with the September 1970 issue. $13.00 per year.

Name

Address .

Prov..

CN 10-70

OCTOBER 1970

Active-care hospital nurse
expands her role

Expand, extend, change — nurses are told from day to day. Can the role of the
nurse be expanded, extended, or changed? Do we really need doctors' assistants?
This article reveals that nurses in one unit in an active-treatment hospital are
responding to the demand for change and still retaining the concept and the
role of the nurse.

Rosemary Prince Coombs, B.Sc.N., M.N.

With almost monthly regularity, nursing
journals in North America remind us
that the role of the nurse must be ex-
panded, extended, or changed, i In
addition, three national and provincial
reports recently recommended changes
in the nursing role of Canada's health
delivery systems. 2 Adding pressure
is a Canadian public concerned about
the cost of health care and demanding
greater access to health care and more
long-term care.

What, then, are the changes required
in the hospital nurse's role to respond
to modern health care needs? What
changes in health care delivery systems
must the nurse adapt to?

Basis for expanding nursing role

Answers to these questions can only
be made by considering three major
indications for change in the active-care
hospital system. These indications for
change are basic to the expanded role
of the nurse.

First, medical specialization is an
accomplished fact, and the division of

The author, a graduate of the University
of Toronto School of Nursing and the
University of Washington School of
Nursing. Seattle, is Clinical Nurse
Specialist at the Ottawa Civic Hospital.
Mrs. Coombs was a Canadian Nurses'
Foundation Scholar in 1963.

OCTOBER 1970

hospitals into highly specialized units
or services is becoming an accomplished
fact. Nursing specialization is necessary
to keep abreast of medical advances
and the effect on patient care. At the
same time, there is a mismatching of
doctor and nurse skills with the tasks
they perform. With medical specialists
attempting to cope with a wide spectrum
of specialized and general care, nurses
will have to assume some of the medical
specialist's functions.

Second, nursing manpower must be
better utilized. Nursing care must be
planned and performed according to the
needs of the patient and not based on
ritual and tradition. Nursing care will
have to take place in a progressive sense
within a patient-care classification in a
regional health system. Different nurs-
ing units will have to be populated by
different care categories of patients
requiring different levels of care. Non-
nursing responsibilities will have to be
eliminated as nursing functions.

Third, the multi-disciplinary ap-
proach to health care must be utilized
for all the care categories of patients.
This will necessitate all health profes-
sionals working in peer relationships.

Consideration should also be given
to three worries that are a major concern
to hospital nurses: we are losing contact
with the patient, who is the reason for
our existence; our ba|ic nursing knowl-
edge is woefully inadequate to cope
THE CANADIAN NURSE 23

24 THE CANADIAN NURSE

A — Two hours after open-heart surgery (double valve implant), and the patient is
awake and responding in the recovery ward of the Ottawa Civic Hospital. A team of
three nurses receive the patient from the O.R.. connect the equipment, and check the
apparatus. Left to right: Rosemary Coombs, clinical nurse specialist; Pat Giffen.
cardiac nurse; and Joan Lyon, nurse clinician.

B — A dangerous arrhythmia sequence on the heart monitor is noted by the clinical
nurse specialist. Rosemary Coombs, to cardiac nurse. Pat Giffen.

C — Doctor W.J. Keon. chief, cardio-thoracic surgery, and Rosemary Coombs check
postoperative, open-heart surgery patient in recovery ward. Civic Hospital.

OCTOBER 1970

D — Teamwork in cardiac nursing continues in the intensive care unit. Left. Pat
Chapman, cardiac nurse, and Joan Lyon, nurse clinician, compare stethoscope findings
of an open-heart surgery patient.

E — Checicing patient charts to assess immediate postoperative condition of open-
heart surgery patient in the Civic recovery ward. Left. Rosemary Coombs double
checks notations of cardiac nurses Pat Giffen and Heather Dowell, as Dr W.J. Keon
asks questions. Each outgoing shift reports verbally to takeover shift.
F — Discussing electrocardiogram patterns of an open-heart surgery patient (coronary
artery, bypass graft, and double implant) in the intensive care cardiac unit. Civic
Hospital. Instructor is Rosemary Coombs, watched by Kathy Licari. center, and Judy
Doraty. cardiac nurses.

G — "Take care" is the advice given by Rosemary Coombs to well patient Rev.
H. Donald Joyce. It's three months since his open-heart surgery (bypass graft and
double implant), and there are rehabilitation plans to discuss. Nurse Coombs contends
that ongoing nursing care is essential for patients. She invites them to return for a
chat. Problems may be averted this way, she feels.

OCTOBER 1970

THE CANADIAN NURSE 25

with medical and technological ad-
vances; and if we don't fill the gap
between the patient and the doctor,
someone or something else will.

Finally, recognition of the two unique
positions occupied by the hospital
nurse is also basic to the expanded
nursing role. Patients are admitted to
hospital because they need 24-hour
observation, and the hospital nurse is
the only health professional who main-
tains full-time observation of the pa-
tient. The hospital nurse has contact
with every health discipline involved
in direct patient care.

Nursing role expanded

To cope with medical specialization,
we need nurses who can and will learn
to nurse in cardiac surgery, coronary
care, intensive care, neurosurgery,
neurology, paraplegia, hemodialysis,
burns, hyperbaric, respiratory, peri-
natal, gastrointestinal, renal transplan-
tation, ophthalmology, otolaryngology,
maternity, and pediatric units.

Nurses are needed who can and will
teach patients and their families what
they want and need to know about their
specialized therapy; work purposefully
and safely with specialized equipment;
observe all parameters of the patient's
condition and report significant alter-
ations to the medical specialist; under-
stand the significance of abnormal
laboratory reports; judge scientifically
the necessity for medical observation
and intervention; use a stethoscope to
determine needed respiratory care, a
cardiac irregularity, or the presence of
bowel sounds.

We need nurses who can and will
recommend necessary change in medi-
cal therapy and support the recom-
mendation with scientific reasons; know
the expected response of the patient's
condition to medical therapy; use a
cardiac monitor as a tool to prevent
dangerous arrythmias, rather than to
portray fatal arrythmias; remember to
talk to, feed, cleanse, exercise, assist
elimination, and provide rest and sleep
for the acutely ill patient.

To develop better utilization of
nurses, nurses are needed who can and
will state when patients need intensive,
moderate, or minimal nursing care,
based on an admission and daily assess-
ment of the patient's personal and ill-
ness problems; arrange physical ward
layouts and staffing patterns so that
24-hour observation is a fact, and TV
screens, monitors, and call systems do
not come between the nurse and the
patient.
26 THE CANADIAN NURSE

We need nurses who can and will
view each patient's hospital experience
as part of a continuum: learn about the
patient as he was before hospitalization;
follow him through the stages of illness;
and refer for necessary follow-up when
he returns to the community.

Nurses are needed who can and will:
activate changes, supported by scientific
rationale, in care practices and organi-
zational procedures to provide for and
protect the patient; integrate the pa-
tient's family into the patient's pattern
of care; teach the patient how to handle
the drugs he takes at home (show him
what they look like, draw up a drug-
taking schedule); institute nursing
procedures in accordance with the
patient's condition and/or his drug
therapy (for example, if a patient is
receiving a diuretic, the nurse would
order measurement of fluid intake and
output and daily weight); arrange for a
diagnostic test (such as an ECG or a
blood test) to document findings of
change in a patient's condition; teach
other nurses how to nurse in intensive,
moderate, or minimal care situations;
and anticipate a patient's potential
problems, and write preventive sugges-
tions for on-coming nursing staff.

To join in the multi-disciplinary
approach to health care, nurses are
needed who can and will raise their
heads from the traditional dependent
role and seek knowledge and clinical
expertise to establish themselves as
interdependent partners of medical and
paramedical personnel; discuss the
patient's medical and paramedical
problems with the appropriate person-
nel; understand and use the correct
medical and paramedical terminol-
ogy; refer patients who need a certain
paramedical service; and seek methods
to relay the information each health
team member needs to know before he
goes to the patient.

Finally, we need: nurses who will
demand the education required to fill
the role described; nursing adminis-
trators who will encourage clinical
nursing functions and limit non-nursing
functions; and medical and paramedical
personnel who will share their special-
ized knowledge to help achieve these
clinical standards.

Preparation for the expanded role

The Canadian Nurses' Association
has endorsed two levels of professional
nurses, distinguished by educational
preparation at the baccalaureate and
the diploma level. Issue must be taken
with this differentiation for several

reasons: The educationally-prepared
nurses are not available, or are not
attracted to the active-care hospitals
of today. Also, upward mobility is
denied to nurses with clinical experience
and demonstrated clinical expertise.

Following are four categories of
nurses. In three categories the educa-
tional qualifications are less rigid than
those specified by CNA, so that those
nurses available will be used, and some
of the problems of 1970, solved.

Clinical Nurse Specialists
To encourage nurses into this cate-
gory, interested and qualified nurses
should be sent to universities that offer
a graduate degree program with a major
in a clinical specialty. These are the
nurses who can demonstrate the ex-
panded role of the nurse, and assist
other nurses to expand their patient-care
functions.

Nurse Clinicians
Interested and capable senior nurses,
who have good clinical experience,
knowledge of hospital functions, and
demonstrated expertise, should be taken
away from the present-day supervisor
and head nurse roles, and their non-
nursing duties eliminated. Nurses and
doctors should be found who will teach
the senior nurses what they need to know
to cope with medical science advances.
These nurses should be sent on short
courses that include content in the
clinical specialties and functions of the
multi-discipline health team. These are
the nurses who would become nurse
clinicians.

Specialty Nurses
Graduates from basic nursing pro-
grams with six months to two years
general nursing experience should be
assisted to develop clinical and techni-
cal expertise in the specialties. These
nurses could be prepared to function in
the intensive care specialties by inserv-
ice teaching, and whenever possible, by
attending short specialty courses. They
would become specialty nurses.

General Staff Nurses
New graduates from basic nursing
programs should be allowed mobility,
according to their clinical expertise
and scientific knowledge, up through
the levels of patient care. These nurses
would gain experience in patient care,
knowledge of hospital functions, and
the nursing maturity to move into the
three other positions. They are the
general staff nurses.

OCTOBER 1970

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masters courses to update
theory

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scientific specialized nurs-
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Collaborates with medical
and paramedical personnel
Concentrates all functions
on the patient

Selects case load of pa-
tients; moves from patient
to patient wherever they
are located; nurses patients
whose problems fall in
range of specialized know-
ledge - 15-60 patients de-
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27

These four categories of nurses are
concerned with clinical patient care.
None of them would carry out either
the major or minor administrative tasks
presently assigned to clinical nursing,
such as submitting budgets, developing
master rotations, ordering supplies and
drugs, telephoning for relief nurses.
They would perform only administrative
or clerical tasks that directly affect
patient care, such as assignment of
nurses to patients, evaluation of a
nurse's clinical abilities, speaking by
telephone or in person to the patient's
family, training relief nurses, evaluating
new equipment, and notifying nurses
of changes in medical or nursing
procedures.

Attached to each nursing unit would
be a well-trained clerk, who would
assume the clerical and administrative
tasks associated with managing a group
of health personnel and the service they
provide.

The clinical nurse specialist has a
staff position in which she can work
with all levels of clinical nurses and all
patients in her specialty. The nurse
clinician has a line position in which
she reports to an associate director of
nursing service, and functions on a peer
level with all health professionals. Both
these nurses would be responsible for
the selection of general staff nurses for
the specialty nurse position. Both these
nurses would orientate and evaluate the
new specialty nurse after a trial period
and recommend her for a permanent
position as a specialty nurse.

Table 1, page 27, gives a description
of the four nurse categories.

Four nurse categories at Ottawa Civic

The four previously detailed cate-
gories of nurses are being demonstrated
in the cardiac surgery unit of the Ottawa
Civic Hospital.

The number of clinical nursing per-
sonnel required to staff a unit is difficult
to predict. It must be estimated by the
clinical nurse specialist and the nurse
clinician, considering the physical
layout of their unit, the particular needs
of their patients, and the level of
nursing care required. These nurses
must also choose the number and
placement of nursing assistant person-
nel in each unit.

In the Ottawa Civic Hospital cardiac
surgery unit, there is a clinical nurse
specialist and a nurse clinician (present-
ly titled head nurse); 17 full-time
specialty nurses (known as cardiac
nurses, receiving the same salary scale
as a general staff nurse); 4 to 6 part-time
28 THE CANADIAN NURSE

TABLE TWO
Three Levels of Hospital Patients

Level

Care Category

Nursing

Nurse Category

I

Investigative

Simple physical and

General staff nurse

convalescent

psychological

Registered nursing assistants
Clinical nurse specialist or
Specialty nurse

n

Intermediate

More complex physical

General staff nurse

extended

and psychological care

Specialty nurse

(long-term)

Clinical nurse specialist or
Nurse clinician

III

Acute

Highly complex physical

Clinical nurse specialist

intensive

and psychological care.

Nurse clinician

Performs some medical

Specialty nurse

functions

General staff nurse

general staff nurses (trained on the job
and never given all the responsibilities of
a specialty nurse); but no registered
nursing assistants (these are considered
to have insufficient knowledge for any
nursing in the acute care setting). These
23 to 25 nurses care for two patients in
the cardiac surgery recovery room, and
four patients in cardiac surgery inten-
sive care.

The specialty nurses work in a master
rotation, which allows the same number
of nurses on day, evening, and night
shifts. The surgical schedule and the
nursing rotation are planned together,
so that four major cardiac-surgical
cases are scheduled and can be nursed
each week. The rotation is planned so
that the specialty nurses never leave the
patients alone for longer than three
minutes.

On every shift, seven days a week,
one specialty nurse or a general staff
nurse who has had some orientation to
the unit, floats between the recovery
room and the intensive care unit,
providing meal and break relief and
helping with acutely ill patients.

The specialty nurses care for the
patients on a one-to-one ratio for the
first 48 postoperative hours, and a
one-to-two ratio for the next 48 post-
operative hours. When possible, each
specialty nurse has the same patient
for at least three days.

The clinical nurse specialist and the
nurse clinician move freely between
the cardiac surgery recovery room and
the intensive care unit (these two areas
are at opposite ends of the hospital),
and between the two or three surgical
preoperative and postoperative conva-
lescent wards. The two nurses divide
the number of patients between them,
each usually selecting every other

patient scheduled for surgery. They
follow the patient from his admission
to his discharge from hospital, and
spend several hours with him doing
preoperative teaching.

Both nurses, along with a specialty
nurse, receive every patient from the
operating room into the recovery room.
Later, the clinical nurse specialist and
the nurse clinician visit acutely ill
patients several times each day, and
make daily nursing rounds to all conva-
lescent patients. The two nurses are in
charge of the 17-member specialty
(cardiac) nurse team.

From March 1969, when the cardiac
surgery unit opened, until September
1970, there have been 14 class days for
specialty nurses, and the nurse clinician
has been to a six-week course in coro-
nary care nursing. Each specialty nurse
receives a month's orientation to the
unit. During this time she is never left
alone with a patient.

Medical and paramedical
communication

In the setting described above,
medical and paramedical communica-
tion is informal and formal. The clinical
nurse specialist and the nurse clinician
communicate informally with the
specialty nurse, the surgeon, and the
anesthetist.

The clinical nurse specialist and the
nurse clinician meet three times a week
with the surgeons, cardiologists, and
surgical resident staff for one "sit-
down" and two "walk-around" rounds.
These two nurses meet once weekly
with the social worker, the physio-
therapist, and a public health nurse to
review each patient and discuss perti-
nent problems. Meetings with inhalation
therapists, the pharmacy clinical coor-
OCTOBER 1970

dinator, and dietitians take place as
necessary.

Patient care classification

Table II shows the placement of the
four nurse categories within a patient-
care classification system, adapted from
Murray 3 and MacDonnell."

The description of the extended role
of the nurse as utilized ir the Ottawa
Civic Hospital is suggested as one
nursing answer to the health delivery
problems of Canada. The four nurse
categories are open for experimenta-
tion, particularly those of the clinical
nurse specialist and the nurse clinician.
But experimentation must be carefully
done. Nurses chosen for the new roles
must have flexible and creative person-
alities, and they must have or they must
seek theoretical knowledge in the
clinical specialties.

Doctor-assistant — what for?

None of the previously named four
nurse categories represents the equiva-
lent of the proposed new paramedical
role — the doctor assistant. I contend
that, // nursing can expand the role of
the nurse, the health care system of
Canada does not need doctors' assist-
ants.

If the doctor-assistant role is allowed
to develop, there is great danger that we
will lose the title, the concept, and the
very existence of a nurse.

If we allow some new category of
medical workers to develop, we are
admitting that nursing cannot keep up
with the demands of modern health
care. If we allow some new worker to
"inject new life into the medical care
team," 5 we are admitting that nursing
cannot communicate with medicine
to solve the problems of modern health
care. If we allow nurses to take doctor-
assistant apprenticeship-type courses,
with a minimum of bookwork and
examinations, we will never increase
our basic nursing knowledge.

This article exemplifies an acute-care
nursing program. I maintain the same
nurse categories are readily adaptable
to any extended health care setting.^
Certainly, these categories show that
nursing has the ability to achieve in-
creased status, and the right to higher
salaries.

Our patients have the right to assist
us in stating our case. The following is
the reaction of a patient who has
experienced the expanded role of the
nurse.

"This cardiac experience was the
first time I had met a supervising nurse
OCTOBER 1970

technician. [She was a clinical nurse
specialist.] I cannot speak too highly
of her part both before and after sur-
gery. She came to see me three times on
the day before the operation, each
time giving me information and guidance
about the procedure to be followed and
the kind of support which would be
around me in the coming days. Because
I w as knowledgeable about some aspects
of surgery, she gave me as much detailed
information as I was willing or able to
absorb. She arranged for me to meet
most of the people who would be
ministering to me — the special nurses,
respiratory technicians, and physio-
therapists. She gave my wife informa-
tion about where and when she might
see me after the operation, and gave
both of us wise and kindly counsel
based on her own long experience.
Perhaps most of all, she related to me
as a compassionate human being,
recognizing natural fears and anxieties,
and meeting them with reassurance and
with nothing of shallowness or senti-
mentality. In brief, she translated the
skill and efficiency of a highly dedicated
team of specialists into the warm
humanism which is so necessary if the
patient is to cooperate even in the
twilight of returning consciousness.

"In the days following, she main-
tained daily visits, and despite a
rigorous schedule, was ready to inter-
pret and explain as a direct liaison
between myself and the surgeon. As a
highly skilled nurse and a specialist in
cardiac work, she filled a vital role in
my need for understanding and personal
support. Once the clinical condition
of the patient is assured, I am convinced
that such a nurse is as important as the
doctor in the total wellbeing of the
convalescent. It means a great deal to
me to know that any day during the
coming months, I, or my family, can
contact such a nurse by telephone,
either to clarify some situation or to
interpret it to the doctors."

Perhaps all that has been said on the
expanded nurse role can be summarized
in this way: If we wani status as nurses,
we will find it, not only in a university
degree, but by functioning interdepen-
dently with all health professions; if we
nant an independent nurse function, we
will get it by maintaining our 24-hour
observation of the patient, and by
coordinating the health professionals
who are in contact with the patient; if
we want to prove our role as nurses can
change and is changing, then we need
not resort to the title doctor-assistant,

nor do we have to remain physicians'
handmaidens.

In relating to all health professionals,
we are, or we should be, associates in
providing the best quality care that
medical science and individual effort
can offer.

References

1. Hacker. Carlotta L. A new category of
health worker for Canada. Canad.
Nurse. 65;38. 1969. Levine. Eugene.
Nurse manpower — yesterday, today,
and tomorrow. Amer. J. Niirs. 69:290,
1969. Mereness. Dorothy. Recent trends
in expanding roles of the nurse. Nurs.
Outlook. 18:30. 1970. Mussaliem.
Helen K. The changing role of the
nurse. Amer. J. Nurs. 69:.^I4. 1969.
Souze, Laurence E. (ed.) Symposium on
new ways of providing nursing service.
N.C.N. A. 4:488. 1960. Wilburg,
Dwight L. Total manpower needs and
resources — medicine and nursing.
Nurs. Outlook. 17:32. 1969.

2. Department of National Health and
Welfare. Tusk Force Reports on the
Cost of Health Services in Canada, vols.
I. 2. 3. Ottawa. Queen"s Printer for
Canada. 1970. Ontario Department of
Health. Report of the Ontario Council
of Health. Communications Branch,
Ontario Department of Health. Toron-
to. 1970. Murray, V.V. Nur.\ing In
Ontario — A Study for the Committee
on the Healing Arts. Toronto, Queen's
Printer. 1970.

3. Murray. V.V. Nursing in Ontario — A
Study [for the Committee on the Heal-
ing Arts. Toronto. Queen's Printer.
1970.

4. MacDonnell. Department of National
Health and Welfare. Task Force
Reports on the Cost of Health Services
in Canada, vol. 2. Ottawa. Queen's
Printer for Canada. 1970.

5. Stokes. J. Physicians' assistants. Amer.
J. N//rv. 67:1442. July 1967.

6. Aradine, Carolyn R. and Hansen. Marc
F. Nursing in a primary health care
setting. Af//r.v. 0((f/oo*. 18:45, 1970. ^

THE CANADIAN NURSE 29

What is your will?

Perhaps you thought a will was for anyone but you to worry about. Your
will is your concern. According to the author of this introduction
to will-making — you should make your will NOW.

Robert J. Green, B.A., LL.B., C.A., Barrister-at-law

Do I really need a will?

You might reply, "Oh. I don't need a
will, I haven't any property."

This is seldom the case.

Do you have a bank account? Do
you own a car, a house? Is there a chance
you might receive an inheritance? To
what pension would a surviving rela-
tive be entitled? Do you own stocks or
bonds? Do you own furniture, jewelry,
life insurance?

Your affirmative answer to any of
these questions indicates you do possess
property, substantial or small. Undoubt-
edly you will want to pass on this prop-
erty to chosen people and not just to
anyone. To do this you need a will. For
if you have not made a will, your prop-
erty will be disposed of at your death
as the law directs, and this may not be
as you wanted.

As far as I am aware, a nurse, in
carrying out her normal duties, incurs
no greater risk of sudden demise than
incurred by any other person. However,
there is still the possibility of an acci-

Mr. Green is associated with the law
firm of Gowling, MacTavish, Osborne
& Henderson, in Ottawa. He is also a
member of The Institute of Chartered
Accountants of Ontario, and he is a
graduate of Queen's University. Kingston.

30 THE CANADIAN NURSE

dent or a sudden fatal disease. Thus a
nurse should make a will now!

No will

To know why a nurse should make a
will now, consider what could happen
when a person dies without a will. Take
the case of an unmarried nurse, Jane
Roe (name fictitious), who died intes-
tate — that is without a will.

Because nurse Roe died without
a will, her property would go only to
those whom the law directs. Generally,
if Miss Roe is survived by one or more
parents, brothers, or sisters, all her
property (after payment of debts and
taxes) will be divided equally among
her immediate relatives. If she is with-
out family survivors, her property would
pass to her next closest living relative.

An exception might occur if Jane
had a joint bank account with a friend;
this account could become the prop-
erty of the friend, depending upon the
circumstances. However, before the
friend could obtain complete possession
of the joint bank account, certain legal
requirements would have to be met, such
as obtaining permission of the admin-
istrator of Jane Roe's estate. Also, be-
fore possession of the estate, in part or
whole, is granted, Letters of Admin-
istration must be granted to the admin-
istrator.

OCTOBER 1970

A person usually wants to benetit
members of her family. Sometimes,
though, we may want to give a memen-
to to a friend, or donate to a particular
charity. Without a will this cannot be
done.

As a nurse, Jane Roe might have
wished to leave money to assist nurses
or nursing, aid a named hospital, or
to further medical research in an area
of special interest to herself. To do this
she needed a will!

To avoid Jane's mistake, and to
make sure your own special wishes are
OCTOBER 1970

carried out, asceriam if there is an
organization which takes care of such
donations. You can direct your lawyer
to specify in your will that so much
of your money is to be donated to such
and such charitable organization or
foundation. Of course you can also state
how you want your money used.

If there isn't an organization able
to handle your wishes, you can set up
a trust fund through your will. But
you would have to name a person or
agency to act as trustee to carry out
your wishes after your death.

Now consider the case of a married
nurse. Our example deals with the
husband, as statistics show it is mostly
the husband who predeceases his
wife. (A wife dying without a will
presents practically the same situation.)
John Doe dies intestate leaving a
wife and two children under 21 years.
He owns a home, a car. stocks and
bonds, and a bank account, all reg-
istered solely in his name.

Immediately upon John Doe's
death his wife will experience difficul-
ty dealing with the property registered
in her husband's name. She will not
be able to take any money out of the
bank account beyond $2,500, and she
will not be able to sell the stocks or
the bonds. Until the estate is settled,
she may even have to borrow money
tor food, clothing, and the mortgage
ox rent payments.

In Ontario (as in most provinces),
tor John Doe's wife to obtain posses-
sion of the property she must apply
tor Letters of Administration from
the proper court. Letters of Adminis-
tration appoint the wife personal rep-
resentative of the deceased, with power
to deal with her late husband's estate.
Her actions will be governed by various
laws, including those laws governing
to whom the property is to be distrib-
uted.

The person applying for Letters of
Administration must post a bond — a
guarantee from persons or a bonding
company guaranteeing proper admin-
istration of the estate.

Should the administrator not properly
distribute the property of the deceased,
there will be funds available to satisfy
any resulting claims. A bond is normally
obtained from an insurance company,
and a fee charged, varying according to
the value of the estate.

Legislation in most provinces spells
out how the deceaseds property is to
be distributed when a person dies with-
out a will. If the deceased is survived
by a wife and or ch^dren, the property
is divided among them. Funeral ex-
THE CANADIAN NURSE 31

penses, debts, and taxes of the deceased
have first claim on the assets of the
estate, and must be paid.

After Mrs. Doe has been appointed
administratrix, she may decide she
could better support her family if she
sold their home. To do this she might
have to obtain permission of the court,
and, in Ontario, might also have to
obtain permission of a government
agency known as The Official Guard-
ian's Office. This agency protects the
interests of children in the estate. It
necessitates additional expenditure.

If the house is sold, then part of the
proceeds might have to be paid into
court when there are children involved
in the estate. Money paid into court
for a child would remain there until
the child reaches 21 years, when his
share is paid to him. At that time he
is free to do what he wishes with the
money.

Should the wife of the late John
Doe need any of the money paid into
court from the sale of the house for
the education or maintenance of her
children, then she must once again
obtain permission of the court (and
in Ontario permission of The Official
Guardian), before withdrawing the
money. She can only use it for the di-
rect benefit of her children, and not
for her own use, even though by spend-
ing it for her own use she may be im-
proving the lot of her children. Once
again expense and delay can be incur-
red.

If John Doe had been single and
died without a will, his property would
have been distributed in equal shares
to his next of kin.

It is to avoid situations such as those
described, and to ensure our property
goes to whom we choose, that we should
draw up a will.

The only answer to the question,
"Do I really need a will?" is "Yes!"

Making a will

A will is a document in writing by
which the testator — person making
32 THE CANADIAN NURSE

the will — directs how his property
is to be disposed of at his death. It is
prepared in accordance with the law
governing wills. A will does not take
effect until the death of the person
(testator) who makes the will. At any
time prior to his death the testator
may revoke the will or dispose of his
property.

Normally, a person who wishes to
have a will prepared appoints a law-
yer qualified to draw up the will to
comply with all legal requirements.
Any person authorized to practice as
a lawyer in your province should be
qualified to assist you in the prepa-
ration of your will. There is provincial
legislation dealing with wills, including
the proper manner for drawing up a
will and signing it.

As a general rule, a will must be
signed at the end by the testator in the
presence of two witnesses, who must
both be present at the same time, and
who must both see the will signed by
the testator. After the testator has signed
the will, the witnesses, each in the
presence of the other and of the tes-
tator, must then sign.

Care must be taken to make sure
that a person signing as a witness is
not named in the will as a beneficiary
or is not the husband or wife of a per-
son named in the will as a beneficiary.
Were this to happen, the person enti-
tled to benefit loses his right. This
does not mean the complete will is
void, only that portion which desig-
ates the signee as a beneficiary.

Another rule : anyone under the age
of 21 years cannot make a valid will.
There are some minor exceptions to
this rule. In New Brunswick and Sas-
katchewan, a married minor can dis-
pose of his property by will, but in
Alberta, a married person must be
over 19 years to make a valid will.
There have been recent moves in the
provinces to reduce the voting age to
18 or 19 years; perhaps the age at
which a valid will can be made will
also be reduced. Until this is law, the

general rule is — at least 2 1 years.

Also as a general rule, your will
becomes automatically invalid if you
marry after making it. One exception
is a will made in contemplation of
marriage to a named person.

The type of will discussed so far
is sometimes referred to as an English
will. That is, it is the type of will that
came to us through the law of England.
However, another will is valid in six
Canadian provinces (Alberta, Saskat-
chewan, Manitoba, Quebec. New
Brunswick, and Newfoundland). This
is a holograph will, and does not need
witnesses. It can be signed by the
testator without any witnesses being
present or signing the document.

In the province of Quebec commu-
nity of property must be considered
when drawing up a will. As a general
rule, under community of property a
wife is entitled upon the death of her
husband to 50 percent of his prop-
erty, provided at the time of the mar-
riage the husband was living in the
province of Quebec. If, at the time
of your marriage, your husband lived
in Quebec, then you should tell this
to the person drawing up your husband's
will. This problem can be circumvented
by a marriage contract.

Sometime you may want to change
all or part of your will. You can do
this by using a codicil. The rules ap-
plied to other wills and previously
discussed, also apply to a codicil.
Often, a codicil is used when the change
is minor. If the contemplated change
is major, then it is better to draw up
a new will. Signing the new will effects
the revoking of an older will; a codicil
does not do this.

Contents of a will

Property of the deceased must first
pass through the hands of a personal
representative of the deceased before
it reaches those named in the will. The
personal representative is in a posi-
tion of trust, and is often referred to
as a trustee. If the personal represen-

OCTOBER 1970

lative is named by the deceased in his
will, he is called an executor, (executrix
if female). If the deceased did not name
an executor or executrix as his personal
representative. In this case the per-
married, a relative) can apply to the
court to be appointed the personal
representative. In this case the per-
sonal representative is called an
administrator (administratrix for
female).

In addition to distributing the
assets of the deceased, the personal
representative is responsible for pay-
ing out of the estate assets, any debts
of the deceased, including taxes. This
duty can involve a great deal of re-
sponsibility, particularly if part of
the deceased's estate will not be dis-
tributed for several years.

This type of situation often arises
when there are minor children, or
where the spouse is given the right
to the income of the estate and the
children the right to the capital on
the death of the surviving spouse.
Thus, the position of executor should
be carefully considered.

Any individual or trust company
can be appointed executor. However,
it is wise to obtain permission of
the appointee, to be sure he would be
willing to act. Even if named in the
will as executor, he is under no obli-
gation to act.

When discussing a will, taxes must
also be considered. The federal gov-
ernment taxes estates under what is
called the Estate Tax Act. Under its
provisionspropertypassingdirectlyfrom
one spouse to the other, or property
to which the surviving spouse has the
sole use during his or her lifetime,
passes free of tax. Also under the Estate
Tax Act, you can leave each of your
children up to $10,000 before it is
subject to taxation.

In addition, for those living in British
Columbia, Ontario, and Quebec, there
are provincial taxes called succession
duties. This means that when drafting
your will you must take into considera-
OCTOBER 1970

tion the tax payable on your estate.
Often this influences the disposition of
property.

The main problem with which the
testator is concerned is the disposition
of his property. This is a personal
decision which varies from person to
person. You should consider the nature
of your property, the ongoing needs
of your family, friends, charitable and
religious organizations, and the effect
of taxation.

If the person named in your will
predeceases you, the bequest lapses.
That is, it ceases to take effect and
the property named in that bequest
passes to those to whom you have left
the residue of your estate. The residue,
simply means the balance of your
estate remaining after all your debts,
funeral, and testamentary expenses
have been paid, and specific bequests
have been made.

The expression "brothers and sisters"
or "children" is often used in a will,
rather than specifically naming each
one. At the time you draw up your will
you cannot be sure how many members
of your family will be alive at your
death. There may be more children born
or some may have died prior to your
own death. If you only want to benefit
certain brothers or sisters, or children,
then you must name these people or
else all those considered by law as in
the same "class" will benefit.

General

There is one piece of property
over which no one has control, not
even the spouse of the deceased (un-
less she is the executrix), and that is
your body. It has long been established
law that there is no property in a body,
although it is the responsibility of the
executor to arrange for burial of the
body. This point is mentioned because
many people want their bodies, or
parts thereof, used for medical pur-
poses, such as transplants.

The province of Ontario passed an
act called The Human Tissue Act

1962-63, which recognized this prob-
lem. Under this act a person can, in
writing at any time or orally in the
presence of at least two witnesses
during his last illness, request that his
body or specified parts thereof be used
after his death for medical purposes.
Once a body is buried it cannot be used
for medical purposes. Therefore, if you
wish your body or parts thereof
to be used for medical purposes, you
should so advise your family and
executor.

Although this article has only
covered a few matters related to wills,
I hope it has made you aware of the
need for a will and the need for careful
preparation of a will.

If you do not mind to whom your
property passes on your death, then
you don't need a will. If you wish to
put your relatives to a great deal of
trouble and cause unnecessary expense
and delay in the administration and
distribution of your property, then
you don't need a will.

if, however, you do care what hap-
pens to your property after your
death, and you wish to minimize the
effort needed to administer and dis-
tribute your property — then you
should make your will now!

Once you have had a will prepared,
you should review it periodically,
checking that it is suitable to meet
changed circumstances. ^

THE CANADIAN NURSE 33

//

Epidurals'' are here to stay

• • • particularly in obstetrics, where this method of analgesia is used frequently during labor.

Andrea M. Dillabough, B.Sc.N., and
Ellen L. Rosen, B.Sc.N.

There have always been special prob-
lems associated with obstetrical anal-
gesia and anesthesia. Probably the
greatest problem is that there are two
patients to consider, one of whom can-
not be observed. As a result, many
types of analgesia have been used, var-
ious combinations of drugs have been
given, and several methods of "verbal
preparation" have been tried.

One method that is becoming in-
creasingly popular is continuous epi-
dural analgesia and anesthesia. Its use
has brought changes in the parturient's
outlook on labor, in the climate of the
labor room, and in the nursing care
given.

As long ago as the 1 800s, physicians
attempted to use this form of anesthesia
for gynecological and urological sur-
gery. It was successful in relieving dis-
comfort, but lacked the most important
component — safety. It was not until
1930, with the introduction of new
agents, that epidural anesthesia was

Andrea M. Dillabough is an instructor m
maternal health nursing at St. Joseph's
Regional School of Nursing, London.
Ontario. She is a graduate of Hamilton
Civic Hospitals, Hamilton, and the Uni-
versity of Western Ontario. London. El-
len L. Rosen, a graduate of the basic
degree program, McGill University.
Montreal, teaches maternal health nursing
at St. Joseph's Regional School of Nurs-
ing. London, Ontario.

34 THE CANADIAN NURSE

employed more frequently. In several
institutions, epidural anesthesia was
given for the relief of pain in the second
stage of labor; until recently, however,
no one attempted to use it for contin-
uous relief throughout labor.

In 1960, a study was undertaken by
the anesthesia department of the Uni-
versity of Western Ontario to assess
the effect of continuous epidural anal-
gesia. The procedure, which involved
the intermittent injection of a local
anesthetic through a plastic catheter
into the epidural space, was started
when patient's cervix reached four to
five centimeters dilatation.

During the course of the study, the
use of this form of analgesia increased
from five to fifty percent. At present,
St. Joseph's Hospital and the Victoria
Hospital in London, Ontario, use
continuous lumbar epidural analgesia
almost without exception for patients
in labor.

Method of administration

Lumbar epidural block is a form of
extradural analgesia produced by in-
jecting a local anesthetic into the per-
idural space in the lumbar region. The
epidural space is a potential space that
extends from the foramen magnum
to the sacrococcygeal junction. The
inner wall constitutes the dura; the
outer wall consists of the periosteum
and the supportive ligaments of the
OCTOBER 1970

LUMBAR VERTEBRAE

SUBARACHNOID SPACE
EPIDURAL SPACE

SACRUM

COCCYX

J

CAUDAL CANAL

The second, third, or fourth lumbar Interspace Is used when
injecting the anesthetic for a lumbar epidural block.

vertebrae. The space is filled with adi-
pose tissue, spina! nerves, lymph, and
blood supply. When injecting the anes-
thetic, the second, third, or fourth lum-
bar interspace is used.

For insertion of the epidural catheter,
the patient lies on her side with her legs
and neck well flexed. The area is pre-
pared with antiseptic solution and
draped, using aseptic technique. A
skin wheal is made over the entry site
with a local anesthetic, then a 17-gauge
Tuohy needle is inserted until it im-
pinges on the ligamentum flavum. The
stylet is removed from the needle, and
a syringe with 2 cc of the anesthetic
agent (Carbocaine or Xylocaine) is
attached.

Firm pressure is applied to the nee-
dle to penetrate the ligament, which
yields with a snap; the solution is then
injected. A polyethylene catheter is
threaded through the needle into the
epidural space, the needle is removed,
OCTOBER 1970

and the catheter secured with gauze
and tape. If the patient has no side
effects from the injection, she is posi-
tioned on her back and an additional
4 to 5 cc of anesthetic is injected.

Following injection of the anesthetic,
the patient's blood pressure and the
fetal heart rate are checked; these pro-
cedures are repeated in 15 minutes.
Analgesia should be established within
10 to 20 minutes, and usually lasts
60 to 90 minutes.

If the patient's vital signs are stable,
the nurse administers the hourly 6 to
7 cc dose of the anesthetic. When the
patient is ready for delivery, the head
of the table is raised and the anesthetist
injects the final dose of 10 to 15 cc.
This achieves anesthesia of the lower
part of the uterus and the perineal area.

Effects of epidural anesthesia

The anesthetic acts on the sensory
supply to the uterus and does not affect

the motor nerves. It eliminates dis-
comfort, but does not change the rate
or force of the contractions. During
the first stage of labor, the block that
causes anesthesia at the T-1 1, T-12
levels relieves the discomfort of uterine
contractions without affecting the effi-
ciency.

In the second stage, the block can
be extented to provide perineal anes-
thesia by injecting a larger dose. Al-
though the anesthetic does not interfere
with the mechanism of labor, it does
eliminate the sensation of "bearing
down." This is of no consequence, as
the nurse can interpret this to the pa-
tient and help her to bear down as
required.

The advantages of this type of anes-
thesia are many. The most important
is that it is the least toxic to both mother
and baby. Other advantages are :

1 . Very few babies are flaccid at
birth from analgesic effects.

2. Maternal glycogen stores, required
to provide energy for each contraction,
are not depleted. As a result, the baby
does not have to endure the force of
the contractions with a diminished
amount of glucose.

3. Relaxation enhances uterine
contractility and assists labor.

4. Pain and anxiety are eliminated.
As a result, the motor nerves function
efficiently without having to compete
with the effects of the adrenalin that
is released during anxiety.

5. There is no danger of maternal
aspiration during anesthesia.

6. A more controlled delivery is
achieved when "bearing down" sensa-
tions are absent.

Patients comment favorably on this
method of anesthesia. They are able to
understand labor and appreciate their
increased freedom to participate in
and to watch the birth of their child.
The recovery time following this type
of labor is faster, and the mother ad-
justs quickly to her new role.

The experience Ik more enjoyable
for the father, too. He can sit with his
THE CANADIAN NURSE 35

wife during labor without worrying
about the discomfort she is experienc-
ing. This does not malce him any less
devoted or less awestruck by what his
wife is accomplishing, but it does
relieve much of his apprehension, and
increases his enjoyment and acceptance
of the baby.

Toxic reaction

Side effects of epidural anesthesia
are minimal. When they do occur, they
are easily overcome. As some patients
experience toxic reactions to the anes-
thetic, and initial test dose is given.

Toxic reactions range from drow-
siness, to slight tremors, to convulsions.
The latter are extremely rare. A minor
drop in blood pressure may occur fol-
lowing administration of a dose of the
drug, and this is overcome by turning
the patient on her left side to relieve
the pressure of the uterus on the great
vessels. Checking blood pressure and
pulse immediately after an injection
and again in 15 minutes allows the
nurse to detect hypotension. If posi-
tioning of the patient is not effective
in returning the blood pressure to nor-
mal, intravenous infusions and oxygen
therapy may be initiated. These latter
measures are not usually required.

Other complications include tissue
trauma, possible infection, and trauma
to the spinal nerves — problems
that have never occurred in our insti-
tution. Occasionally systemic anes-
thesia may occur if the agent enters
the blood stream. This is characterized
by ringing in the ears, circumoral
paresthesia, syncope, or ineffectual
analgesia.

The nurse or anesthetist may note
the presence of blood in the epidural
tubing. If the tip of the tubing is out-
side the intervertebral space, the pa-
tient will experience one-sided anal-
gesia. Treatment consists of slight
withdrawal of the catheter by the anes-
thetist. If this action is not effective,
the anesthesia is repeated, using a
different intervertebral space.
36 THE CANADIAN NURSE

Another complication has been
mentioned in medical literature. It
occurs when the solution is injected
too rapidly or when it is given during
a contraction. Because of the limited
size of the epidural space, the solution
may be forced upward, causing anes-
thesia of the higher thoracic nerves
with resultant respiratory difficulties.
This is a rare occurrence, but must be
promptly rectified by the anesthetist.

As a general precaution, whenever
epidural anesthesia is being performed,
all staff must be aware of the measures
used to avert a crisis. Although only
rarely required, these measures must
be put into effect immediately.

The only contraindications to this
form of anesthesia are : any form of
neurological disease except epilepsy;
chronic back conditions; hypotension
resulting from untreated antenatal
hemorrhage; skin infections; and sen-
sitivity to local anesthetic agents.

Patient orientation

When a patient arrives in our labor
room, she is given a general orientation
to the department. The nurse explains
the epidural anesthesia, if this is the
method of choice, even though the
patient's doctor may have discussed it
with her during the antenatal period.
The patient and her husband are told :

• When the epidural will be started.

• Time required for the insertion.

• Effect of the epidural. Initially, the
mother will feel numbness, tingling,
warmth and heaviness, starting in the
feet and moving up the legs to the um-
bilicus. The epidural relieves the dis-
comfort of the contractions by acting on
the sensory nerve supply to the uterus,
but does not deaden the skin, nor
eliminate the sensations of heat, cold,
or pressure.

If the patient is not properly in-
formed, she will complain each time
she feels any one of these sensations.

The husband is also given an appor-
tunity to ask questions. The nurse ex-
plains that he will be required to leave

the room while the epidural is inserted,
but he may remain with his wife for
the entire labor if he desires.

Effects on nursing care

How have epidurals changed ob-
stetrical nursing? Almost all branches
of nursing have experienced rapid
change in response to technological
advances. Obstetrical nursing, however,
has appeared to be at a standstill. Until
now, nurses in the labor room depended
largely on their senses and observa-
tional skills to judge the mother's prog-
ress. Only on rare occasions were nurses
allowed to examine patients, and then
they were restricted to rectal examina-
tions.

Nurses with extensive experience
were usually capable of accurate judg-
ment. However, a certain number of
deliveries occurred before the patient
reached the delivery room or before
the doctor reached the patient. The
nurse had to be observent during her
first contact with the patient, as this
gave her an indication of the patient's
behavior to use for later comparison.
These observations were important
for, as labor progressed, the mother's
personality and behavior changed.

In the early stages of labor, most
women are quite communicative and
aware of their surroundings. They
are interested in what is happening
and accept any health teaching offered.
Later, there may be a "turning inward"
of feelings as the mother focuses her
efforts and energy on her contractions.
She cannot discriminate between dif-
ferent nurses and really does not care.
She makes overt behavioral responses
to the stress of labor. Between contrac-
tions she usually sleeps or rests. Sudden
changes in behavior and her degree of
discomfort indicate her progress.

Now, with continuous epidural anal-
gesia, nursing care and methods of
observation must be reassessed. Be-
cause the patient is unaware of her
contractions, she requires special atten-
tion. She does not need to have her
OCTOBER 1970

hand held, her brow wiped, or be re-
minded of her breathing for each
contraction. She and her husband
require a different type of support.
They are interested in the type of work
being accomplished by the uterus, and
in the baby's condition. They want
information that will help them to ac-
cept the newborn and their new role.

The nurse sits with her patient for
longer periods, noting the length,
frequency, and quality of the contrac-
tions. During this time, she keeps the
couple informed of the progress in
labor, and explains the mechanism of
labor. This usually stimulates the par-
ents to talk about the baby and the
mother's hospitalization, and encourages
them to air their anxieties.

The nurse still looks for the cues she
needs to assess her patient's progress.
While these are less obvious in patients
receiving epidural anesthesia, they are
still present in a more subtle manner.
The patient whose epidural has been
effective may suddenly begin to expe-
rience rectal pressure and discomfort.
There may also be a sudden onset of
nausea. These symptoms usually
indicate transition into the second
stage of labor.

Vaginal exammation is the preferred
method of assessing cervical dilatation,
effacement, and station. Rectal exam-
ination is considered to be too uncom-
fortable and inaccurate. The labor
nurses in our center have been taught
to perform vaginal examinations under
sterile conditions. Findings indicate
there is a greater degree of accuracy,
with no increase in infection.

What are the implications for nurs-
ing? Nursing education must change
so that students are taught to understand
their new role in obstetrics. Since not
all Canadian hospitals use this type
of anesthesia, inservice education must

* Rubin. Rena. Puerenal Change. Mater-
nal Health Nursing. N. Lytle. ed.,
Wm. C. Brown Co., Iowa. pp. 127-
133. 1967.

OCTOBER 1970

assume the responsibility for teaching
registered nurses the knowledge and
the skills they need to provide adequate
care for these patients.

The nurse assists the anesthetist
in the insertion of the epidural; she
administers the hourly dose of anes-
thetic solution; and, with the anesthetist,
she is responsible for its effects. She
must know what precautions are nec-
essary during administration of the
anesthetic, and what action is indicated
if untoward effects occur.

Nurses must also understand how
the care they give after delivery is
affected. Patients recover much faster
following delivery under epidural anes-
thesia. They tend to have a very short
"taking-in" phase, as Rubin describes
it.* The "taking-hold" phase occurs
sometimes as early as two days post-
partum, and the new mothers have a
tremendous need to regain complete
control of bodily function so they can
begin the tasks of "mothering."

Conclusion

The obstetrical patients at our center
look forward to childbirth, and we try
to make their experience as enjoyable
as possible. Any hospital that intends
to use this type of obstetrical analgesia
and anesthesia must have a compre-
hensive inservice program to educate
the staff and establish nursing responsi-
bilities. This is extremely important
to the smooth functioning of the de-
partment, and very necessary if epidural
anesthesia is to be used to its fullest
advantage.

Bibliography

Filler. W.W., Hall. W.C. and Filler. N.
W. Analgesia in obstetrics. Amer. J.
Ohsiet. Gynec. 98:832. July 1967.

Henry. J.S.. Kingston. M.B., and Maug-
han. G.B. The effect of epidural anes-
thesia on Oxytocin induced labor.
Amer. J. Obstet. Gynec. 97:350. Feb.
1967.

Hingson, R.A. Continuous peridural anal-
gesia and anesthesia for obstetric
delivery and cesarean section Int.
Anesth. Clin.. 2:517. May 1964.

Kandel. P.F.. Spoerel. W.E.. and Kinch.
R.A.H. Continuous epidural analgesia
for labor and delivery Canad. Med.
Ass. J.. 95:947. Nov. 1966.

Lund. P.C. Complications of peridural
anesthesia. Int. Anesth. Clin.. 2:'S65.
May 1964.

Lund. P.C. The history of peridural anes-
thesia. //;;. Anesth. Clin.. 2:471, May
1964.

Lund. P.C. Elementary considerations in
peridural anesthesia. Int. Anesth. Clin.,
2:477. May 1964.

Reeder, S. Becoming a mother — nurs-
ing implications in a problem of role
transition. A.N. A. Clinical Sessions.
1967.

Thompson. H.G.. Johnson. K.R., and
O'Connor. J.J. Epidural anesthesia in
obstetrics Ohstet. and Gvnec. 29:682
May 1967.

Tryon. P. A. Assessing the progress of
labor through observation of patients
behavior. The Nursing Clinics of North
America. 3:2:3 1 5. iune 1968.

Wendl. H.K. Peridural anesthesia tech-
niques and local anesthetic agents.
Int. Anesth. Clin.. 2:487. .May 1964.

Willocks. J., and Moir, P.D. Epidural
analgesia in the management of hyper-
tension in labor. J. of Obstet. and
Gynec. of Brit. Comm., 75:225. Feb
1968.

. Regional anesthesia in obstetrics.

Ross Laboratory Nursing Education
Service, No. 17. ^

THE CANADIAN NURSfc 37

The

Canadian
Nurse

50 The Driveway, Ottawa 4, Canada

^^P

Information for Authors

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The Canadian Nurse

OFFICIAL JOURNAL OF THE CANADIAN NURSES' ASSOCIATION

idea
exchange

Computer in Psychiatry

In some Canadian hospitals the com-
puter is used to facilitate phases of med-
ical work, such as recording patient
admissions and ordering supplies. In
May last year, the nursing service de-
partment at the Foothills Hospital,
Calgary, Alberta, undertook a research
project, computerizing nursing notes of
psychiatric patients.

The aim of the project was to develop
the notes into a checklist of adjectives
which described patient behavior and
progress, and could be computer tabu-
lated. The assumption was that a well
designed and usable computerized
checklist would result in accurate,
standardized records ; prov ide gu idel i nes
for nursing students learning to observe
and assess patient behavior: reduce the
amount of clinical time spent by nurses
in record-keeping; and provide a con-
densed, permanent store of readily
available data for future psychiatric
research.

OCTOBER 1970

The department of psychiatry, where
the research took place, opened in
1966. There is an active-treatment
center of two inpatient units (each con-
taining 35 beds and facilities for milieu
therapy). A day-care program is also in
operation. Geared to accommodate all
types of psychiatric patients, the depart-
ment serves the city of Calgary, and
accepts referrals from southern Alberta.

After a preliminary survey of current
research on computerized psychiatric
nursing notes, it was found the usage
and meaning of psychiatric terminology
varied from region to region. This
meant a specific form was required to
incorporate most used terms. The form
was called Observation Checklist.

To determine what terminology
nurses at the Foothills Hospital used
to describe a patient's condition and
behavior, nursing notes from some 350
patient files were reviewed. Expressions
derived from this source described:
sleeping habits, activity involvement,
socialization, and other behavioral

aspects. It was noted the nurse's
notes reflected her training to observe
and report, but not to diagnose. Many
comments on the patient's condition
were modified by, "seems, appears,
looks, complains, expresses." However,
traces of originality appeared from
time to time in the comments, "patient
behaving like a wet-weed" or "patient
using poetic language, given reality
therapy."

From the nursing notes, major cate-
gories, with an average of 75 adjectives,
were set up. The range of verbalization,
exclusive of the speech content, included
description of type, speed, manner,
quality, quantity, amplification, absence
of speech, impediment, tone and pitch.
Terms used by nursing personnel to
designate a patient's speech included:
abusive, aphasic, superficial, inappro-
priate, strained, slurred, slowed, flip-
pant, babbling, moaning, muttering,
spontaneous, and inconsequential. The
final checklist was cdnstructed by delet-
ing all unusual or seldomly used expres-
THE CANADIAN NURSE 39

sions, and combining or summarizing
all synonymous terms under one adjec-
tive to determine the broadest meaning.

To measure degrees of behavior,
words were selected which provided the
extent and intensity of a patient's action
or reaction. For example, mood was
designated under three adjectives, bor-
ed, apathetic, flat, intended to convey
emotional detachment ranging from
mild or moderate to severe. Under the
heading cognition, a section dealing
with a patient's intellectual ability,
descriptions such as alert, logical, and
organized, decreased interest, forgetful,
flight of ideas, and autistic were used to
assist in differentiating between unim-
paired thinking, mildly disturbed think-
ing, and thinking that indicates severe
impairment.

An accompanying glossary defined
the meaning of terms. Frequently, the
definition assigned a term was the
adaptation of several descriptions taken
from nursing notes and combined. For
example, if a patient was shown as
demonstrating an attitude designated
as self-centered, he might be described
as "primarily concerned with his own
desires, needs, interests, and problems,
and indifferent to those of others; tend-
ing to be narcissistic and to resent or
display jealousy of attention shown to
others; selfish and often given to self-
indulgence and self-pity."

As the planned activity program is
an integral part of the psychiatric pa-
tient's therapy, provision was made in
the Observation Checklist to record
the extent and quality of his participa-
tion in the activities. A list, with a sim-
ple six-point grading scale for measur-
ing the patient's degree and quality of
participation in activities was set up.

Participation was designated by the
words, "refused, attended, participated,
satisfactory contribution, dominated,
disrupted." These terms were intended
to indicate : does not participate ; passive
participation; minimal, not particularly
40 THE CANADIAN NURSE

significant; satisfactory contribution;
dominates, monopolizes or tries to
control the activity; disturbs; is a nega-
tive member of the group or activity.

Included in the checklist was a section
describing symptoms. The somatic
problems listed {e.g., vomiting, con-
vulsions, diarrhea) referred to the
manifestation of physical symptoms
and disturbances whether organic or
psychosomatic. The checklist was also
designed to assist the doctor when diag-
nosing disease, drug effects, and other
conditions.

To evaluate the new checklist as a
patient progress record, it was used for
two months on preliminary trial. A
decision to continue with the standard
nursing notes was made at the end of the
trial period, and to use the new, com-
puterized checklist in conjunction with
these notes for the first two days follow-
ing the patient's hospital admission, and
weekly thereafter to evaluate the pa-
tient's behavior and progress.

As the checklist is composed of ter-
minology used and understood by nurs-
ing staff, it was decided to use it in its
newly computerized form, to replace
the Whittenborn Psychiatric Rating
Scale. The checklist form has been used
in this way since last January, and has
proved to be a worthwhile means of
recording and assessing patient prog-
ress.

A weekly computerized summary of
the form provides a concise reference
when comparing a patient's progress
week by week. It also produces recording
uniformity. The checklist and accom-
panying glossary has also proved help-
ful for orienting new staff, students,
and interns.

Information from the Observation
Checklist is keypunched on 80 column
computer cards. These are sent to the
University of Calgary Data Centre and
batch-processed. The printout is deliv-
ered to the hospital the next day. An
improvement of the processing opera-

tion will cut approximately two hours
from the present schedule. Under the
new system, the computer cards will be
entered via a remote card reader/printer
on location — Margaret Osborne is
psychiatric nursing coordinator at
Foothills Hospital, Calgary, Alberta.
She received her bachelor of nursing
from McGill University, and has exper-
ience in nursing education and nursing
service in psychiatry. Gerald ine Fordyce
has been employed as a social worker
with the city of Calgary social service
department for several years. She is
working toward a master's degree in
social work. ^

OCTOBER 1970

Home care of children with
inborn errors of metabolism

A description of a metabolic disease unit that carries health services into 60
patients' homes. Although the unit does not provide general health care, it does
undertake the consultative care of certain hereditary metabolic diseases, and
the problems related to the primary disease.

Terry Reade and Caroline Clow

The hereditary metabolic disease unit
at the Montreal Children's Hospital
was established three years ago to pro-
vide constant monitoring of patients
with inborn errors in metabolism, at the
lowest possible cost to the community.
If these patients had been treated by
repeated visits to a physician or to an
outpatient clinic, or by hospitalization
at intermittent intervals, the cost would
have been prohibitive and the frequency
of supervision, insufficient. As it is,
almost 90 percent of patient care is
provided by two members of the unit,
and home supervision of each patient
is given at a cost of approximately two
dollars per day.

Patients are referred to the unit by
their physicians, or their disease is de-
tected by the newborn screening pro-
gram.i If the unit had to care for all
these patients in the Montreal area,
there would be about 26 new patients

The authors, staff members of the heredi-
tary metabolic disease unit at the Mont-
real Children's Hospital, provide the day-
to-day care for 60 families in which there
are one or more children with metabolic
disorders. Mrs Reade is a graduate of the
Hospital for Sick Children in Toronto.
Mrs Clow, co-director of the unit, was
trained for her role in the deBelle I.abora-
tory for Biochemical Genetics, and is now a
research associate with the Faculty of
Medicine. McGill University.

TABLE 1

Hereditary Metabolic

Diseases

Treated By Home Care

Program

No. of

Disease

patients

Phenylketonuria

25

Hyperphenyialaninemia

5

Hereditary Tyrosinemia

1

Homocystinuria

2

Cystathioninuria

2

Cystinuria

3

Cystinosis

6

Fanconi Syndrome

2

X-linked Hypophos. Ric

kets 8

Vitamin D. dependency

5

Miscellaneous

5

Total

64

OCTOBER 1970

each year requiring medical supervi-
sion. The total number would accumu-
late annually, as many patients require
long-term or permanent treatment.
Fortunately, the Quebec government
started a program similar to the Mont-
real Children's Hospital in October
1969.

Treatment

Hereditary metabolic disorders are
gene-dependent traits that modify or
impair the normal metabolism of a
particular substance. The unit treats
these conditions by various forms of
"environmental engineering. "^ The
THE CANADIAN NURSE 41

patients' biochemical values are mon-
itored, and the various amino acids
and minerals affected by the disease
are kept within the proper limits by
adjusting the intake of the substances
through diet and medication.

This treatment may range from strict
diet control to reduce the intake of
phenylalanine in the phenylketonuric
patients, to the administration of mas-
sive doses of phosphorus by mouth for
X-linked hypophosphatemic rickets
patients. In all cases, samples of blood
and urine are analyzed and the results
recorded. Metabolic charts are kept to
record the progress of each patient.

Treatment requires close coopera-
tion between the unit and the patients'
parents. The parents have an important
function because they are responsible,
with the unit's supervision,for managing
the diet, administering the medications
and, in some cases, collecting capillary
blood and urine samples. This close
cooperation reduces the claim on the
physician's time. Physicians review the
charts regularly, but are otherwise called
on only when some unexplained situa-
tion arises, or when a change in treat-
ment seems necessary.

Without treatment, most of the inborn
errors of metabolism have serious ef-
fects on the patient. Phenylketonuric
patients can become seriously retarded
if the phenylalanine levels in their blood
are elevated for long periods after birth.
Hereditary rickets can cause crippling
deformities and short stature. Although
the genetic defect can never be cured,
its effect on the patient can be min-
imized, and damage to the patients
avoided.

Much of the work of the unit involves
counseling the parents, both in their
homes and on the telephone. Chronic
illness in general, and hereditary disease
in particular, impose added pressures
on family life; these pressures can be
relieved by sympathetic understanding
and advice on specific problems as they
arise. Since these disorders are heredi-
42 THE CANADIAN NURSE

tary. parents will benefit from genetic
counseling and family planning.

The unit words as an integral part of
the deBelle Laboratory at the Montreal
Children's Hospital, and the laborato-
ry's full range of analytical equipment
is available for monitoring the patient's
biochemical values. A few of the non-
routine tests are sent to other laborato-
ries in the hospital for completion.
Close liaison is kept with the radiology
department because of the many x-rays
required for the patients with hereditary
rickets. Part-time services of a social
worker and a dietitian are also used.

Much of the treatment for the amino
acid disorders is handled in the labora-
tory. Parents of phenylketonuric pa-
tients are shown how to use a lancet
andcapillary tubes tocollectheparinized
blood samples. These samples are sent
to the laboratory at regular intervals
for one-way partition chromatography
testing. If the phenylalanine levels are
elevated, the parents are telephoned
and the diet is adjusted.

Parents are encouraged to call the
unit to discuss health and family prob-
lems related to their children's disor-
ders. We have one phenylketonuric
patient living 1,000 miles away, who
has been successfully monitored by
mail and telephone.

Home visits

Most home visits by the team nurse

are made to patients with hereditary
rickets. Calls are made regularly on a
predetermined schedule in the greater
Montreal area (approximately 200
square miles), with occasional home
visits to patients in outlying areas. An
analysis of home visits is shown in
Figure I .

Many parents find it difficult to make
regular visits to an outpatient clinic,
particularly if they have younger chil-
dren to care for and no extra money
for baby-sitting or transportation. A
child with rickets may be in a cast,
requiring transportation by ambulance
— a further financial burden. Experi-
ence has shown that attendance at in-
hospital clinics cannot be depended on.
The vital need for regular monitoring
of these patients makes it more econom-
ical to bring the medical services to
them, rather than bring them to the
central hospital clinic.

Home visits bring closer contact
with the parents, and demonstrate to
them that someone is interested in their
plight. Many parents have guilt feelings
about passing on a hereditary weakness
to their children, and these feelings can
be discussed better in the security of
their own homes. Although there is
nothing that can be done about the pri-
mary genetic disorder, something can
be done about the way in which the
disorder affects the child and his family.

Special family problems can be de-

HOME VISITS (Ar«a=200 sq. miUs)

visits per patient in disease

disease ^

> 1

2

3 4

group

5

X-linked rickets

vitamin D depend.

■■

■

HBi

number
of visits

Fanconi syndrome

^M

E

5 etc.
actua

1 1-

hyperphe'emia

^9

pku

■I

cystathioninuria

cystinosis

homocystinurio

■f4
■ l

|3

0 1 2 3 4 5

Fig. 1 An analysis of home visits made by the team nurse.

= 809mins/mo.

=677mins/mo.

_ in home time
_ travel time

OCTOBER 1970

content

TELEPHONE CALLS

% of total calls
5 10 15 20

health matters
lab. results
treatment: non diet
treatmentidiet
miscellaneous
supplies
appointments
finances

direction:
ln=82%

Out=18%

handled by:

R.T. R.N

0 5 10 IS 20

Fig. 2. A breakdown of the telephone calls made to patients.

tected and corrected in the home visits
before they disturb the treatment rou-
tine. For example, one child with X-
linked rickets lived with her mother in
a small apartment belonging to the
grandmother. The grandmother retired
early in the evening and demanded that
the others comply with her wishes, with
no disturbances during the night. As
a result, the child was not getting her
nightly doses of phosphorus, and her
blood levels of the mineral were too
low. The hospital arranged for a social
worker to counsel the mother, and the
mother and her child were helped to
move into an apartment so the child
could receive medication on schedule.

Medications are supplied by the
hospital pharmacy, and the cost is
charged to our research grant. This
allows us to calculate a true cost basis
for the treatment of each disease. A
running record is kept on the supply
each patient has on hand. When the
supply is low, a new supply is delivered
on the next home visit. Samples of
blood and urine are also collected during
these visits, and records are kept of the
height, weight, general health, and
blood pressure, if required.

Parents of children with amino acid
disorders play an important role in
the treatment. To give them a forum
OCTOBER 1970

in which they could air their problems,
a parents" group was formed. This
group meets once monthly, except
during the summer months, to discuss
mutual problems and to exchange ideas
on how these problems are being hand-
led. The subjects for discussion range
from new recipes for their children's
diet, to the moral problem of sterilizing
-retarded teenage girls. Nurses in the
unit attend these sessions to provide
leadership and medical knowledge.

Conclusion

Proper support is important to par-
ents of children with chronic disorders.
They have to know that someone else
other than themselves cares about what
happens to them and their children.
They can become easily discouraged
with the prospect of years of treatment
ahead, and need to talk to someone
who can reassure them that all their
efforts are worthwhile.

But it is not only the parents who
need the support. A young patient with
rickets, who has endured previous
osteotomies, needs personal support
and encouragement when told that
another operation is needed.

Close liaison with families in which
there are one or more children with
inborn errors of metabolism is proving

successful. As evidence of success,
there are now phenylketonuric pa-
tients with normal intelligence quo-
tients, and X-linked hypophosphate-
mic rickets patients with normal
growth rates and healed bones. Pa-
tients with other hereditary diseases
treated in the Montreal Children's
Hospital have also responded well,
although not always in such a dra-
matic way.

References

1. Clow. C, Scriver, C.R., Davies E.
Results of mass screening for hyper-
aminoacidemias in the newborn
infant. Amer. J. Dis. Child. 1 17:48.
1969

2. Scriver, C.R. Treatment of inherited
disease : realized and potential.
Med. Clinics of N. Amer. 53 :941-
963, 1969

The authors express their apprccialion to
Dr. C.R. Scriver. Director of the deBelle
Laboratory for Biochemical Genetics at
the Montreal Children's Hospital, for
his advice and encouragement, and to
Drs. D.T. Whelan. H. Goldman. F. Glo-
rieux. and K. Baerlocher. for their medical
assistance. This study is supported by
Dominion-Provincial Grant 6-4-7-64\
(N.H.&VV.. Canada). ^

THE CANADIAN NURSE 43

research abstracts

The following are abstracts of studies
selected from the Canadian Nurses'
Association Repository Collection of
Nursing Studies. Abstract manuscripts
are prepared by the authors.

Roach, Sister Marie SImone. The

development of an instrument to
measure selected affective outcomes
of a diploma program in nursing
from verbal responses of nurses on
completion of tlw program. Boston,
1967. Thesis (M.Sc.N.) Boston
University.

The problem of the study was the de-
velopment of an instrument to measure
selected affective outcomes of a diploma
program in nursing. The instrument
was administered in a pilot study one
month before graduation to one-third
of the senior class of the cooperating
agency, an independent school of nurs-
ing in Boston, Massachusetts.

A selection of nine objectives, used
as a basis for the instrument, was made
from data obtained through the assist-
ance of 72 percent of the faculty of the
agency. Test items were designed to
measure selected behaviors of each of
the nine objectives.

The instrument was organized into
four parts, with each part employing
a different measurement technique.
One standardized test, the Study of
Values (G.W. Allport et al, Boston,
1960) was used to obtain information
on more complex value patterns.

Reliability estimates for internal
consistency, using the Hoyt procedure,
ranged from a .08 to a .94 coefficient.
No tests of validity were applied, but
at various stages of the study the
faculty reviewed objectives, behaviors,
and test items.

Mean scores for the Study of Values
were compared with national norms
and with one recent nursing study, as
well as with responses of students to
selected items of the instrument.

A major limitation of the study was
the fact that the instrument was based
on a limited sample of objectives and
selected behaviors. Furthermore, the
measurements were based on verbal
responses only. No provision was made
for follow-up performance.

The study provided evidence that
affective outcomes of learning can be
identified and appraised. The construc-

44 THE CANADIAN NURSE

tion of the instrument allowed for an
opportunity to experiment with the
taxonomy of affective objectives and
to discover the usefulness of this
classification of behavioral terms for
identifying levels of behavior and
preparing test items.

A major insight gained at the con-
clusion of the study was a realization
of the relevancy and urgency for
further research, not only to identify
and appraise affective outcomes of
nursing education programs, but to
consider ways of providing learning
experiences so that students can develop
the interests, attitudes, appreciations
and values essential for the nursing
practitioner. In light of the pressing
need to increase the nation's comple-
ment of nurses and reduce the number
of rejects and withdrawals from nursing
programs, the study concluded that the
problem justified further research.

Creeggan, Sheila Moreen. Factors
affecting faculty attitudes toward
curriculum change in selected diplo-
ma schools of nursing. London 1970.
Thesis (M.Sc.N.) U. of Western
Ontario.

This project was an attempt to explore
factors affecting faculty attitudes toward
current curriculum trends in nursing
education in Ontario. Attitudes were
evidenced by the degree of personal
involvement in curriculum planning
and expressed feelings toward the pres-
ent trends in nursing education. Varia-
bles considered included personality
characteristics, educational preparation,
and age.

The investigator obtained informa-
tion from nursing teachers in six hospi-
tal-based diploma schools of nursing.
The instrument used for collection of
data was an attitude measure consisting
of 32 controversial statements, 16 ori-
ented to change and 16 traditional.
The participants were asked to score
these statements on a nine-point scale
from very strongly agree to very strong-
ly disagree. These data were coupled
with information on general personality
traits obtained by using a standardized
personality inventory (Jackson Person-
ality Inventory) and general information
relating to age, educational prepara-
tion, nursing and teaching experience.

Mass data processmg was used to

facilitate analysis and the Pearson Prod-
uct Moment Correlation Coefficient
was the statistic computed to show
the significance of the relationship
between expressed attitudes to current
curriculum trends and the other varia-
bles being considered.

The 98 teachers who completed the
attitude measure appeared to be oriented
to change, rather than holding to tradi-
tional attitudes. The correlations showed
a significant relationship at the 1 per-
cent level for six of the seven selected
personality traits (tolerance, breadth
of interest, complexity, value ortfio-
doxy, risk-taking, and innovation) with
scores on the attitude measure. The
correlation analysis showed that there
was no significant relationship between
involvement in curriculum planning
and scores on the attitude measure.
The percentage of high scores on the
attitude measure was shown to be higher
for teachers with a baccalaureate degree
than for those with less academic prepa-
ration. Attitude scores decreased as
school size decreased. A correlation
coefficient significant at the 2 percent
level was obtained between attitude
scores and year of graduation from a
basic nursing program. The findings
indicated that young teachers were less
bound by conventional standards.

Long, Linda. A study of the withdrawal
of nursing students at the Saskatoon
City Hospital School of Nursing,
Saskatoon, Saskatchewan, from Sep-
tember 1954 to September 1960.
Seattle, 1962. Thesis (M.N.) U. of
Washington.

This study was planned to determine
the number of students who withdrew
from the Saskatoon City Hospital
School ofNursing from September 1954
to September 1960 and the analysis of
the reasons for withdrawal.

The main problem was that although
the large number of qualified student
applicants to the school of nursing al-
lowed for better selection, and although
involuntary withdrawal lessened, stu-
dent withdrawal still occurred.

The descriptive survey method was
used. Data were collected by the review
of school records and content analysis.
The classes of nursing students selected
for the study were those admitted to the
school of nursing from 1954 to 1960,
OCTOBER 1970

a period of acute competition with the
University Hospital's three-year dip-
loma nursing program.

Of 463 students enrolled in the
school of nursing from 1954 to 1960,
82 students withdrew, 33 voluntarily
and 49 by request of the school. Of these
withdrawals, 68 left during the first
year of the program : 35 of these stu-
dents were in the centralized teaching
program. Only five students with-
drew during the third year.

The greatest number of withdrawals
were from the 1956 and 1957 classes.
Of the five major reasons for with-
drawal, academic failure represented
4 1 percent of the total withdrawals. The
other major reasons — pending mar-
riage, dissatisfaction with the program,
dissatisfaction with nursing, and health
— accounted for a student withdrawal
of 9 to 1 1 percent.

All reasons for withdrawal appeared
during the first year of the nursing pro-
gram. Only marriage and "breach of
conduct" were reasons for withdrawal
in the students" third year. Nearly all
students who withdrew for marriage
indicated a desire to continue in nurs-
ing. The greatest number of student
withdrawals had an academic average
on admission of 60 to 64 percent. Of
all the reasons for withdrawal, academic
failure accounted for the majority of
students with the lowest admission av-
erage — 55 to 64 percent. One student
of the Jehovah Witness religion with-
drew because of religious conflict with
medical practice.

Nearly three-fourths of student with-
drawals were 1 8 years of age on admis-
sion to the school. A high school prin-
cipal's reference, which was a stated
school requirement, was available for
only 10 student withdrawals, and these
references were inadequate in content.
Past employment was indicated for 1 5
student withdrawals.

No standard pattern of interviewing
candidates for the school of nursing was
apparent from the records. Pre-admis-
sion interviews — a stated requirement
of the school — were recorded for 1 5
students. Content of these interviews
was limited and descriptions of student
behavior was too generalized in most
cases. No student record presented the
total information desired for the investi-
gation.

The findings of the study indicated
several suggestions for student selec-
tion as a means of approaching the
withdrawal problem : a minimum
admission academic average should be
maintained, with consideration given
to establishing a minimum average of
65 percent; and a pre-admission inter-
view guide and form should be prepared
by the school of nursing, and filed with
the permanent record of each student
withdrawal. ^

OCTOBER 1970

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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
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in both pre-and post-operative
conditions. TUCKS are soft
flannel pads soaked in witch hazel
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TUCKS — the valuable nur-
sing aid, the valuable patient
comforter.

Specify the FULLER SHIELD^ as a protective
postsurgical dressing. Holds anal, perianal or
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yVA MONTHtAL CANADA

TUCKS is a trademark of the Fuller Laboratories Inc.

THE CANADIAN NUKSt 45

Behavioral Concepts & Nursing Inter-
vention, coordinated by Carolyn
E. Carlson. 341 pages. Toronto,
J.B. Lippincott Co. of Canada,
1970.

Reviewed by M.A. Beswetherick,
Assistant Professor, School of Nurs-
ing. The University of Alherta,
Edmonton, Alberta.

This book is a collection of articles
written by 1 6 different nurse educators.
The authors attempt to identify, exam-
ine, and demonstrate social -behavioral
and mental health concepts in a nurs-
ing context.

The content is broad and could be
applied in nursing situations to identify
patient problems and develop areas
of research. Topics include: denial
of illness; empathy; the professional
nurse and body image; shame; grief
and mourning; trust in the nurse-
patient relationship; humor in nurs-
ing; listening; ambivalence; transac-
tional analysis or communication and
nursing; privacy; stigma; development
of awareness of self for the professional
nursing student; the process of role
change; and relationship control.

Varied philosophical approaches
are used throughout the text. For ex-
emple, the one on stigma takes a so-
ciological view of the problem, while
those on shame and privacy are a
combination of sociological, psycho-
logical, and psychiatric approaches.
The discussion on the professional
nurse and body image reflects the
view of medicine and natural science.

Each article is related to the other
and provides insight into the emotional
complexities experienced by the patient.
Because the topics or chapters are
complete in themselves, it is unnec-
essary to read them in sequence.

A reference and bibliography are
included with each article. This feature
alone adds to the book's value as a
teaching tool.

Texfbook of Medical-Surgical Nursing,

2nd ed., by Lillian S. Brunner et al.
1031 pages. Toronto, J.B. l.ippincott
Co. of Canada, 1970.
Reviewed by Charlotte Hardy,
Assistant Director of Nursing Serv-
ice, Ottawa Civic Hospital, Ottawa.

The purpose of the text, to conduct an
in-depth discussion of the clinical

46 THE CANADIAN NURSE

conditions and problems most frequent-
ly seen in nursing practice, is outlined
in the first paragraph of the preface.
The book achieves its purpose and, at
the same time, shows a humanistic and
compassionate understanding of the
patient's problems, needs, and nursing
care. In each section, the significance
of the nurse's role m buildmg the
confidence of the patient is stressed.

Units and chapters divide the book
in a logical sequence, beginning with
assessment of the patient in unit one,
cause and prevention of disease in unit
two, and discussion of specific condi-
tions of illness in later units. Illustra-
tions and diagrams are precise and
accurate, and effectively explain appro-
priate nursing procedures.

One of the highlights of this excellent
teaching and reference text includes
unit four, which gives a brief history of
surgery. It also describes preoperative,
intraoperative, and postoperat'ive nurs-

NURSING
EDUCATION
IN A

CHANGING
SOCIETY

EDITED BY MARY Q. INNIS

Rapid social change and advances in
health care have greatly changed the
function of the nurse. In this volume,
published to celebrate the fiftieth an-
niversary of the University of To-
ronto School of Nursing, doctors and
nurses from many branches of their
professions present their experiences,
views, and prophecies. Combined they
express a wide range of opinion on
the controversial subject of nursing
education in a changing society.

$2.50 ($8.50 cloth)

at your bookseller

UNIVERSITY OF TORONTO PRESS

ing care. Charts and diagrams are used
extensively in unit four. Chapters in
unit nine cover vascular disorders and
discuss the common pathological condi-
tions affecting the venus, arterial, and
lymphatic systems. A section on pa-
tients with conditions involving the
kidneys, the urinary tract, and the re-
productive system is informative and
uses illustrations to assist in explaining
nursing care procedures.

Emergency and disaster nursing are
covered in the last unit. Specific emer-
gency situations are discussed, and
treatment is listed step by step in order
of priority.

This is an informative, clear, and
stimulating text. It presents both basic
and specific material required by every
nurse.

Law Every Nurse Should Know by

Helen Creighton. 245 pages. Toron-
to, W.B. Saunders Company, 1970.
Reviewed by Eileen C. Flanagan,
co-chairman, legislation committee.
Association of Nurses of the Province
of Quebec.

The need for this book is shown by the
extensive number of samples given of
cases taken to law courts involving
nurses either individually, or in con-
junction with hospitals and with mem-
bers of the medical profession. This
may be an indication that we are failing
in our duty to student nurses by not
giving them the type of instruction
needed to prevent the occurrences that
result in so many court actions.

This book, which is concisely writ-
ten, should assist teachers to improve
instruction in this difficult subject, not
only at the undergraduate level, but also
in graduate schools. It will also serve
as an excellent reference source for
nurses in hospital administration, in
public health organizations, and in
private duty. Secretaries of State, pro-
vincial nurses' associations, and chair-
men and members of legislation com-
mittees will find this book helpful in
conducting their affairs.

The material on licensing, with clear
explanations of the difference between
permissive and mandatory laws, and
the history of the struggle for licensing
on the part of groups of sincere, ener-
getic, public-spirited members of the
nursing profession in many lands, with
OCTOBER 1970

its great influence on the status of
nurses, are very important facts that all
nurses should know.

Court actions relating to negligence
and malpractice are becoming increas-
ingly common, and the nurse today must
be keenly aware of these hazards in her
role, as the book illustrates in its many
examples. Today's nurse must also
work with many others on the health
team — nursing assistants, technicians,
aides, orderlies, and clerical workers —
on whom she has to exercise a certain
amount of supervision and assume some
responsibility. This subject is discussed
with good reason since the nurse can be
legally involved in these relationships.
However, the trend is to hold nursing
assistants responsible for their own acts.
For this reason, the material should
assist nurses who teach nursing assist-
ants.

The material dealing with new legis-
lation in the health fields, the newer role
of the nurse in the areas of chest, kidney
and heart surgery, transplantation of
organs, sterilization, resuscitation, and
narcotics is most valuable. In the chap-
ter on Canadian Law, it is pointed out
that while nine provinces are under
English Common Law, Quebec is
governed by French Civil Law (except
in the case of Criminal Law), and there-
fore it is important to know which law
operates in your province. Quebec,
Prince Edward Island, and Newfound-
land have mandatory nursing acts.

In conclusion, the large number of
examples of cases in which nurses have
been involved in situations of negli-
gence, should stimulate all nurse edu-
cators and nurse practitioners to apply
themselves to the task of preventing such
incidents. A serious use and study of
this book will be a great asset in this
endeavor.

Emergency Nursing by C. Louise Riehl.
286 pages. Peoria, Illinois, Chas. A.
Bennett Co. Inc., 1970.
Reviewed by Major Margaret H.
Hunter, Chief Nursing Officer, St.
John Ambulance in Canada, Ottawa,
Ontario.

The author has attempted to cover too
many subjects in one book, resulting
in briefness and simplicity of style.
Perhaps it was intended as a quick
reference book.

Descriptions in the text deal briefly
with a hospital's emergency department
and its administration, planning, per-
sonnel, physical layout, equipment,
supplies, and legal matters involving
the hospital.

Following chapters discuss such
emergencies as respiratory resuscita-
tion, cardiac massage, and injuries of
the head, chest, abdomen, and bones.

OCTOBER 1970

Infections, antibiotic therapy, burns
and shock, medical emergencies, and
emotional aspects of injury are also
covered.

The concluding chapter presents
guidelines for training ambulance per-
sonnel. By including this subject the
author has touched on a weak area in
the health field. Certain provinces in
Canada have taken definite steps to
train ambulance personnel to care for
patients at the scene of the mishap and
during transit to hospital. Although
the program is not functioning in all
areas, nurses realize that this is an
important field. It is an area that needs
to be coordinated and developed to
maximum efficiency.

The author takes only a brief look at
emergencies. Unfortunately, those
emergency problems that dominate our
present-day society, that is, drug addic-
tion, psychiatry, and disaster nursing,
have been omitted.

The content is over-simplified to
the extent where I would question its
value as an in-depth study text. It ap-
pears to be geared to the non-profes-
sional worker. Today's nurse must as-
sume responsible functions, and needs
much more knowledge than this book
offers.

Most illustrations are not effective
from an educational point of view, and
therefore do not serve any useful pur-
pose.

But, the author has done an excellent
job in pointing out to nurses the impor-
tance of being aware of the patients and
the family's deepest needs. In a busy
and short-staffed emergency depart-
ment, this aspect of nursing is often
depersonalized and neglected. '^

AV aids

Films

Scott Paper Limited has introduced a
complete teaching program on the
subject of menstruation. The program
centers around a 20-minute, color
film. World of a Girl, which includes
teenagers discussing their own feelings
on the subject. The menstrual cycle is
explained on film by a teacher talking
to a live class and using illustrations.

A Teacher's Guide provides material
for classroom discussion following the
film. Each student receives a 16-page,
illustrated booklet World of a Girl.

The film is available on loan free of
charge by writing to World of a Girl,
Modern Talking Picture Service, Inc.,

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Sel-Fix NURSE CAP BAND '

Black velvet banij material Self-ad-
hesive: presses on, pulls off: no sewing
or pinning. Reusable several times.
Each band 20"' long, pre-cut to pop-
ular widths: V*' 112 per plastic boi).
H" (8 pet bo»). y*' (6 per twi), 1'
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THE CANADIAN NURSE 47

Next Month

in

The

Canadian
Nurse

• Continuing to Care
— in the Air

• Preplacement Health Screen-
ing by Nurses in Industry

• Are We Really Meeting
Our Patients' Needs?

• The Autistic Child

&

^^P

Photo Credits for
October 1970

Crombie McNeill Photography,
Ottawa, pp. 7, 24, 25

Julien LeBourdais, Toronto, p. 8

Studio C. Marcil, Ottawa, p. 18

Montreal Children's Hospital,
pp. 42,43

AV aids

1943 Leslie Street, Don Mills, Ontario.
Details needed are the name of the
teacher, name and address of school,
preferred showing dates, and an
estimate of the number of participating
students.

A Hospital Is . . .

The Canadian Hospital Association has
made a 30-minute, color film on the
day-to-day routine of a large city
hospital. The film, entitled, A Hospital
Is..., was produced by Crawley films,
and was shown on CBC television
August 28.

Directed to lay audiences, the film
effectively portrays all aspects of
hospital life in a fast-moving and real-
istic fashion. According to the film, a
hospital is: the people who work in it;
a community business; a beginning; a
community health center; expansion;
a factory for people; education; and,
finally, change.

The birth of a baby and an operation
on a sebaceous cyst are two scenes from
the film. The CHA film offers lay
audiences an insight into a hospital's
operation. Nurses will notice, however,
that although the film discusses the
changing role of the nurse, she is shown
in only traditional roles.

For more information, write to the
Canadian Hospital Association, 25
Imperial Avenue, Toronto, Ontario.

Drugs

The following films are available from
Educational Film Distributors Limited:
Monday is a 12 1/2 minute, black
and white, film that looks at the world
through the eyes of a young man using
hard drugs. It has no dialogue, and
apart from the main character, all
actors were filmed on the spot, in a
true-to-life style. Cost of this Canadian-
produced film is $ 1 10.

Drugs and the Nervous System is an
animated film that discusses the ef-
fects of drugs on organs and body sys-
tems. It explains the serious disruption
of the nervous system caused by nar-
cotics. This color, 16-minute film
costs $215.

For further information write to
Educational Film Distributors Ltd.,
191 Eglinton Avenue E., Toronto
315, Ontario.

Films dealing with food preparation,
kitchen safety, and food and personnel
sanitation have been distributed to
five regional health offices of the On-

tario Department of Health. These
sets of 22 films each have been sent
to offices in London, Hamilton, Kings-
ton, Toronto, and Northern Ontario,
and will be presented to interested
groups under public health personnel
supervision. These color films are 9
minutes in length. Distribution is re-
stricted to health personnel involved
in food protection services and pro-
grams. For further information write
to the Regional Medical Officer at
the regional public health offices in
your district. ■§■

accession list

•)

48 THE CANADIAN NURSE

BOOKS AND DOCUMENTS

1. Tlw Anwriciiii alnuiiuic: the U.S. book
of facts, statistics, and information. New
York, Grosset iV: Dunlap. 1970. Iv. R

2. Anniuil report. Ottawa. Order of the
Hospital of St. John of Jerusalem. 1969. 60p.

3. Ctinadian hospital directory. Toronto,
Canadian Hospital Association, 1970. 336p.

4. Cartridged film-loops. Science catalogue
for colleges and universities. Dorval. Ealing
Scientific Limited, 1969. 168p. R

5. Chunking society: perspectives on
coinmiinicution. New York. National Public
Relations Council of Health and Welfare
Services. National Public Relations Institute,
1969. 63p.

6. Constitution and by-laws as amended

1969. Geneva, International Council of
Nurses, 1970. 63p.

7. Contemporary nursing practice: a guide
for the returning nurse by Signe Skott Coop-
er. Toronto. McGraw-Hill. 1970. 348p.

8. The day care of children: an annotated
bibliography. Rev. edition. Ottawa. Canadian
Welfare Council. Research Branch. 1969.
68p.

9. Dictionnaire (dphahetique and analogi-
qiie de la langiie fran^-aise par Paul Robert.
Paris, Societe du Nouveau Littre. 1967.
1969p. R

10. The drug the nurse the patient by
Mary W. Falconer et al, 4th ed. Toronto,
Saunders, 1970. 566p.

1 1. Educational technology and the teach-
ing-learning process; a selected bibliography,
prepared by Jeanne Saylor Berthold et al.
Rev. 1969. Bethesda. Md. U.S. Public Health
Service, Division of Nursing, 1970. 56p.

12. Focus on the future: proceedings of
the 14th quadrennial congress of the Inter-
national Council of Nurses, Montreal (Can-
ada). June 22-28. 1969. Basel. S. Karger.

1970. 447p.

13. From dependency lo dignity: individ-
ual and social consequences of a neighbor-
hood house by Louis A. Zurcher et al. New
York. Behavioral Publications, 1969. lOOp.

14. Group practice in Canada. Report of

OCTOBER 1970

Canadian Medical .Association. Special
Committee on Group Practice with addi-
tional guest articles. Toronto. Ryerson Press
for Canadian Medical Association. 1970.
129p.

15. Health instruction: saggestions for
teachers, rev. ed. Columbus. Ohio. American
School Health Association Study. Commit-
tees on Pre-School. Elementary School, and
Secondary School Health Education. 1969.
90p.

16. Health planning: notes on comprehen-
sive planning for health by Henrik L. Blum
and associates. Berkely. Calif. Comprehen-
sive Health Planning Unit School of Public
Health, Univ. of California in cooperation
with . . . Western Regional Office. American
Public Health Association. San Francisco.

1969. Iv.

17. Influencing attitudes and changing
behavior: a basic introduction to relevant
methodology, theory, and applications by
Philip Zimbarbs and Ebbe B. Ebbesen. Don
.Mills. Ont.. Addison- Wesley. 1969. 148p.

18. Law every nurse should knoiv by
Helen Creighton. 2d. Toronto. Saunders.

1970. 246p.

19. Man and the luitural world: an intro-
duction to life scierue by Coleman J. Goin
and Olive B. Goin. Toronto. Collier-Mac-
millan. 1970. 643p.

90. Means and ends in education: com-
ments on living and learning edited by Brian
Crittenden. Toronto. Ontario Institute for

Studies in Education. 1969. 128p. (Occasion-
al papers 2)

2 1 . Medical advice for the traveler, 1st ed.
by Kevin M. Cahill. New York. Holt. Rine-
hart and Winston. 1970. 79p. R

22. Nursing home .standards: a tragic
dilemma: an analysis of slate of nursing home
standards under federal medicare and state
licensure programs by Jorden Braverman.
Washingon. DC. American Pharmaceutical
Association. 1969. T.'ip.

23. Persoiud care of patients: a te.xi for
health assistants by Janet Jodais. Toronto,
Sauders. 1970. 292p.

24. Personal, impersonal, and interper-
sonal relations: a guide for nurse by Gene-
vieve Burton. 3d ed. New York. Springer,
1970.292p.

25. Physicians panel on Canadian medical
history: an informal round-table discussion
on the highlights of Canadian medical history
held in Lac Beaupori. October 7. 1966.
Presented by Schering as a Centennial Proj-
ect in collaboration with the Canadian Med-
ical Association. Pointe Claire. P.Q.. Scher-
ing Corp., 1967. Iv.

26. Practical nurses five years after gradu-
ation nurse career-pattern study by Lucille
Knopf. Barbara L. Tate and Sarah Patrylaw.
New York. National League for Nursing.
1970.76p.

27. Problem-solving in nursing practice
by Mae M. Johnson, Mary Lou C. Davis, and
Mary Jo Bilitch. Dubuque, Iowa. Wm C.

Brown, 1970. 102p. (Foundations of nursing
series)

28. Proceedings of Nursing Theory Con-
ference, First. University of Kansas Medical
Center, Dept. Nursing Education, March 20-
21, 1969. edited by Catherine M. Norris.
Lawrence. Kansas. 1970. 126p.

29. Professumal nursing: foundations,
perspectives and relationships by Eugenia
Kennedy Spalding and Lucille E. Notter.
8th ed. Toronto. Lippincott, 1970. 677p.

30. Programmed instruction in arithmetic,
dosages, and solutions by Dolores F. Saxton
and John F. Walter. 2d ed. Saint Louis.
Mosby, 1970. 60p.

3 1 . Rapport du Comite d'etiide des relations
entre I'universite Laval, la faculte de mede-
cine et les hopetuu.x d'enseignement dans les
secteurs des diverses sciences de la same
autres. 349p.

32. Records system guide for a community
health service. New York, National League
for Nursing. Dept. of Public Health Nursing,
1970. 53p.

33. Report of RNAO regional conferences
on the use of audio-visual aids in nursing.
Toronto, Registered Nurses Association of
Ontario. 1970. 163p.

34. Report to the Minister of National
Health and Welfare on the Recommendations
of the Task Forces on the Cost of Health
Services in Caiuida. Ottawa. Canadian Hos-
pital Association, 1970. Iv. R

35. Roll of the order in Canada. Ottawa.

Put your foot down. Insist on
KLING* conform bandages

KLING* Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes in bandaging areas that
are hard to bandage and hard to keep
bandaged.

KLING — the bandage that conformsl

MONT REAL A TORONTO- CANADA

'Trademark of Johnson & Johnson or affiliated companies

OCTOBER 1970

There's no waist with
KLING* conform bandages

KLING' Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes in bandaging areas that
are hard to bandage and hard to keep
bandaged.

KLING — the bandage that conformsl

^o4nirona(lclMiton

MONTREAL 4 TORONTO - CANADA

*Trademarl( of Johnson & Johnson or affiliated c<m>panies

THE CANADIAN NURSE 49

accession list

Order of the Hospital of St. John of Jerusa-
lem. 1970. 58p. R

36. The story of niirsinf> by Desiree Ed-
wards-Rees. Don Mills. Longmans, 1965.
96p.

37. Toward llicrapeiitic care: a guide for
those who work with the mentally ill by
Group for the Advancement of Psychiatry,
Committee on Therapeutic Care, 2d. ed.
New York. Springer. 1970. 125p.

38. The use of managerial tools in evaluat-
ing and improving the quality of nursing
care; a survey of selected hospitals in New
Jersey by Donald Orleans. New York. Na-
tional League for Nursing. 1970. 50p.
(League exchange no. 92)

39. What every supervisor should know,
edited by Lester R. Bittel. Toronto. McGraw-
Hill. 1968. 536p.

40 Writing a technical paper by Donald
H. Menzel et al. Toronto. McGraw-Hill.
1961. 132p.

PAMPHLETS

4 1 . Brief presented by Canadian Medical
Association to the Special Senate Committee
on Poverty. Ottawa. 1970. I5p.

42. Brief to the Commission of Inquiry
into the Non-Medical Use of Drugs. May 15,
1970. Hamilton. Ont. Ottawa. Pharmaceuti-
cal Manufacturers" Association of Canada.
1970. I4p.

43. A brief to the special senate committee
on poverty. Ottawa. Victorian Order of
Nurses for Canada, 1970. 27p.

44. Continuing education of professionals.
Report of a workshop, June 4, 1969. Algon-
quin College of Applied Arts and Technol
ogy. Ottawa. Toronto. Canadian Association
for Adult Education. 1969. 20p.

45. Ui Croix-Roiige et les .loins infirmiers.
Geneve. Ligue des Societes de la Croix-
Rouge. 1969. 23p.

46. Defense against decubitus ulcers: the
conquest of the hidden epidemic. New
York. Alconox Inc.. 1970. 9p.

47. Executive compensation in Canada,
June 1970. Toronto. H. V. Chapman Asso-
ciates, 1970. I5p.

48. Guidelines for coronary and intensive
care, based on a report of the College of
Physicians and Surgeons: as approved by
Joint Committee on Nursing. Medical and
Hospital Services, the Sask. Registered
Nurses" Association, the Sask. College of
Physicians and Surgeons and the Sask. Hos-
pital Association. Regina. 1969. 6p.

49. L.P.N, to R.N. the as.wciate degree
way, 1970 edition. New York. National
League for Nursing, 1970. Iv. R

50. On record; statements approved 1970.
Ottawa, Canadian Nurses' Association, 1970.
7p.

5 I . Operation retrieval; list of physicians
and biomedical .scientists training or working

50 THE CANADIAN NURSE

abroad and available for employment in
Canada. 1970. Ottawa. Association of Cana-
dian Medical Colleges, 1970. 19p.

52. Quarante-cinqiiieme rapport annuel.
Ottawa. Le Conseil canadien du Bien-etre.
1965. 12p.

53. Report, 1969170. Toronto, Canadian
Public Health Association. 1970. 32p.

54. Report of the committee on the philos-
ophy, structure and operation of the Canadian
Association for Adult Education. Toronto.
Canadian Association for Adult Education.
1969. 33p.

55. Report on organization study. Seattle.
Washington State Nurses Association. 1969.
42p.

56. Scientific and technical communica-
tion; a pressing national problem and recom-
mendations for its .solution. A synopsis.
Washington. National Academy of Sciences.
1969. 30p.

57. Some statistics on baccalaureate and
higher degree programs in nursing 1969.
New York. National League for Nursing.
Dept. of Baccalaureate and Higher Degree
Programs. 1970. I4p.

58. Submission to Minister of Finance,
Government of Canada, 14 July 1970. Otta-
wa. Canadian Nurses Association. 1970.
lOp. R

59. Submission to the Special Senate
Committee on Poverty. Ottawa. Canadian
Nurses Association. 1970. 29p. R

GOVERNMENT DOCUMENTS

60. Bureau of Statistics. Annual report of
notifiable diseases, 1969. Ottawa. Queen's
Printer. 1970. 77p.

61. — .Federal government employment in
metropolitan areas 1968. Ottawa. Queen's
Printer. 1970. 22p.

62. — .Income distribution and poverty in
Canada. Preliminary estimates. 1967. Otta-
wa, Queen's Printer. 1969. I5p.

63. — .Hospital statistics 1968: vol. I.
Hospital beds. Ottawa. Queen's Printer,
1970. 94p.

64. — .vol. 4. Balance sheets. Ottawa,
Queen's Printer. 1970. 51 p.

65. — .vol. 5. Hospital revenues. Ottawa.
Queen's Printer 1970. 40p.

66. — . vol. 6. Hospital expenditures. Otta-
wa. Queen's Printer. 1970. 91 p.

67. — . vol. 7. Hospital indicators. Ottawa.
Queen's Printer. 1970. I54p.

68. — . Tuberculosis statistics 1968 vol. I.
Tuberculosis morbidity and mortality. Otta-
wa. Queen's Printer. 1970. 80p.

69. — . vol. 2. Institutional facilities, serv-
ices and finances. Ottawa. Queen's Printer.
1970. 54p.

70. Commission royale denquete sur
Bilingualisme et le Biculturalisme. L'histoire
du Canada. Enquete sur les manuels par
Marcel Trudel et Genevieve Join. Ottawa.
Imprimeur de la reine. 1969. I29p. (Canada
Commission royale d'enquete sur le bilin-

guisme et le biculturalisme. Etude no. 5)

71. Dept. of Indian Affairs and Northern
Development. Report, 1968169. Ottawa,
Queen"s Printer. 1970. Iv.

72. Dept. of Labour. Industrial relations
research in Canada. Ottawa. Queen"s. Printer.
1970. 56p.

73. Dept. of Manpower and Immigra-
tion. Immigration statistics, 1968. Ottawa.
Queen's Printer, 1969. 25p.

74. — . Manpower in Canada; 1931 to
1961; historical statistics of the Canadian
labour force by Noah M. Meltz. Ottawa.
Queen"s Printer, 1968. 288p.

72. — .Requirements and average starting
salaries: community college graduates. Pre-
pared by the Professional and technical
Occupations Section. Manpower and Infor-
mation and Analysis Branch. Program Devel-
opment Service. Ottawa. 1969. Iv.

73. — .University and community college
guide to graduations and average starting
salaries. Prepared by . . . the Professional
and technical Occupations Section. Manpow-
er and Information and Analysis Branch.
Program Development Service. Ottawa.
1969. Iv.

74. Dept. of National Health and Welfare.
Canada health manpower projections 1970.
Ottawa. 1970. 7pts in 1

75. — .Guide for imported drugs manufac-
turing facilities and controls. Ottawa. 1969.
I6p.

76. — .Social security in Canada, 1969.
Ottawa. 1969. 84p.

77. — .Therapeutic diets. Ottawa. 1970. 9p.

78. Dept. of Regional Economic Expan-
sion. Female participation in the Canada
newstart program by Eva Kassirer. Ottawa.
Queen's Printer. 1970. 26p.

79. Ministere de la Main d'Oeuvre et de
rimmigration. La main-d'oeuvre au Canada
1931 a 1961 ; statist iqiie historique de la po-
pulation active au Canada par Noah M.
Meltz. Ottawa, de rimmigration. 1969. 290p.

80. Ministere de la Sante nationale et du
Bien-etre social. Direction des Aliments et
Drogues. Guide des importaleurs des drogues
installations et controles de fabrication.
Ottawa. 1969. 16p.

81. Ministere du travail. Greves et lock-
out au Canada, 1968. Ottawa. Imprimeur
de la Reine. 1970. I04p.

82. — .Les salaires au Canada et aii.x Elats-
Unis; line analyse comparee preparee par la
Division des recherches sur les salaires de la
Direction de I'economique et des recherches
par Allan A. Porter et autres. Ottawa. Minis-
tere du Travail. 1970. I56p.

83. National Research Council of Can-
ada. Report. 1969-70. Ottawa. Queen"s
Printer. 1970. 80p.

84. Parliament. House of Commons.
Standing Committee on Health, Welfare
and Social Affaires. Report on tobacco and
cigarette smoking, presented by chairman.
M. Gaston Isabelle. session 1969-1970. Otta-
wa, Queen's Printer, 1969. 53p.

OCTOBER 1970

85. Parliament. Senate. Special Committee
on Poverty. Procccdintis. iu>.47. Thursday
Jane 1970. Ottawa. Queens Printer. 1970.
49p.

86. Royal Commission on Bilingualism
and Biculturalism. Conference inrerpreralion
in Canada by Therese Nilski. Ottawa.
Queens Printer. 1969. l$p. (Canada Royal
Commission on Bilingualism and Bicultural-
ism Documents no. 2)

87. — .The culuirtil contrihiiiion of the
other ethnic i;roiips. Ottawa. Queen's Printer.
1969. 35 Ip.

88. — .The Department of E.xlernal Affairs
and hiciiltiiralism. Ottawa. Queen's Printer.
1969. 210p. (Canada. Royal Commission on
Bilingualism and Biculturalism. Studies no. 3)

89. Science Council of Canada. Tech-
niques and sources. Scientific and technical
information in Canada, pt.2 ch.5 Tech-
niques and sources. Ottawa. Queen's Printer.
1969. 99p. (Science Council of Canada.
Special study no.8)

90. Task Force on Labour Relations.
Adaptation and innovation in wage payment
systems in Canada by Jack Chernick. Ottawa.
Queens Printer. 1968. I30p. (Its Study no. 5)

91. — Compalsory arbitration in Australia
by J. E. Isaac. Ottawa. Queen's Printer.
1968. 84p. (Its Study no.4)

92. — .Labour arbitration and industrial
change by Paul C. Weiler. Ottawa, Queen's
Printer, 1969. 146p. (Its Study no.6)

93. — .Professional Workers and collective
bargaining by Shirley B. Goldenberg. Otta-

wa, Queen's Printer. 1968. 298p. (Its Study

no.2)

Ontario

94. Committee on the Healing Arts.
Highlights of the Report of the Committee
on the Healing Arts. Toronto. Dept. of
Health. 1970. 28p.

95. Dept. of Health Research and Planning
Branch. Infant, neonatal and perinatal mor-
tality and still births. Ontario. 1925-1967.
Toronto, 1969. 23p. (Its Vital and health
statistics special report no. 43)

United States

96. Environmental Control Administra-
tion. Bulletin of courses. July J969-December
1970. Washington. U.S. Dept. of Health.
Education and Welfare. 1969. 68p.

97. Office of Education. Teacher educa-
tion institute for new health tKcupations
education teachers. Final report by Lewis D.
Holloway. Washington, Govt. Print Off..

1969. 83p.

98. Public Health Service. Biological,
psychological (unl sociological aspects of
aging. Washington. U.S. Gov't Print. Office.

1970. 51p. (Its publication no. 1459)

STUDIES DEPOSITED IN

CNA REPOSITORY COLLECTION

99. Addendum no. 2 to liulex of Canadian
Nursing studies compiled by CNA Library.
Ottawa. Canadian Nurses' Association, 1970.
Iv. R

100. Cognitive functioning of patients
iiiuler stresses of impeiuling and recent

surgery by Carolyn Pepler. Detroit. Mich..
1967. 48p. (Thesis(M.Sc.N.)-Wayne State) R

101. The development of (m instrument
to measure selected affective outcomes of a
diploma program in nursing from verbal
responses of nurses on completion of the
program by Marie Simone Roach, Sister.
Boston, 1967. I08p. (Thesis CM.Sc.N.)-
Boston) R

102. H(md and arm motor behaviour in
laboring patients by Elisabeth Ann Walton.
New Haven, Conn., 1967. 77p. (Theses(M.
Sc.N.)-Yale)/?

103. Historical study of the voluntary
tuberculosis community health program in
Canada with projective emphasis by Floris
Ethia King. Chapel Hill. N.C.. 1967. 564p.
(Thesis - North Carolina) R

104. Public health nursing pilot project
report August 25 to September 12. 1969
experience by O. Bieber and J. Innes (Cop-
pock), Saskatoon. University of Saskatcha-
wan. School of Nursing, 1969. 6p. R

105. Report of a study on group nursing
practice sponsored by Victorian Order of
Nurses for Canada and conducted by four
Victorian Order of Nurses branches in three
provinces, Jan. 1. 1968 to Dec. 31. 1968.
Ottawa. Victorian Order of Nurses for Can-
ada. 1970. 105p. R

106. Toward a value oriented curriculum
with implications for nursing education by
Mary Simone Roach. Sister. Washington,
D.C., 1970. 152p. (Thesis - Catholic Univer-
sity of America) R ^

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 Author Short title (for identification)

No.

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

Prepare for
a rewarding
career in
foreign lands ^^

Take our special course in tropical diseases and
related subjects This equip>s you when applying
for overseas positions to en)oy special status.
gain valuable experience and serve where the
needts great

Open to graduate nurses, nursing assistants and
paramedical personnel Comprehensive 19-
week course commences in September and Feb-
ruary Train in modern, fully-equipped centre
with attractive accommodation for living in. lo-
cated in Metropolitan Toronto.

For more information write to

Coordinator, Health Service Course

intemational
heatth institute

4000 LesUe Street, TOUowdale,
Ontario, Canada.

OCTOBER 1970

THE CANADIAN NURSE 51

classified advertisements

ALBERTA

BRITISH COLUMBIA

ONTARIO

ASSISTANT DIRECTOR OF NURSING (wanted >m.
mediately) for a small hospital in Central Alberta.
Experience in OR.. O.B. and in Nursing Administra-
tion is essential. Nurses' residence available. Apply
to: Mr. P.O. Matriew. R.N., Administrator, Bentley
General Hospital. Bentley. Alberta.

REGISTERED NURSES FOR GENERAL DUTY for a

37-bed General Hospital. Salary $490 to $595 per
montti. Train fare from any point in Canada will be
refunded after one year employment. Hospital
located m a town of 1100 population, 90 miles from
Capital City on a paved tiighway. For full particulars
apply to: Two Hills Municipal Hospital, Two Hills,
Alta,

REGISTERED NURSES FOR GENERAL DUTY in a

34-bed tiospital. Salary 1968, $405-$485. Experien-
ced recognized. Residence available. For particu-
lars contact: Director of Nursing Service, While-
court General Hospital, Whitecourt, Alberta, Phone:
778-2285.

GENERAL DUTY NURSES for 94-bed General Hospi-
tal located in Alberta's unique Badlands. $405 — $485
per month, approved AARN and AHA personnel poli-
cies. Apply to: Miss M. Hawkes, Director of Nursing,
Drumheller General Hospital, Drumheller, Alberla,

BRITISH COLUMBIA

A HEAD NURSE and STAFF NURSES will be needed
for Child Psychiatry. The Head Nurse will participate
in the clinical development and subsequent operat-

ADVERTISING
RATES

FOR ALL
CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additional line

Rotes for display
advertisements on request

Closing dote for copy and cancellation is
6 weeks prior to 1st day of publication
month.

The Canadian Nurses' Association does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they ore interested
in working.

Address correspondence to:

The

Canadian c^

NIukI
urse ^

50 THE DRIVEWAY
OTTAWA 4, ONTARIO.

ion of the 20-bed unit anticipated for tf^e Royal Jubi-
lee Hospital's Eric f^artln Institute of Psychiatry. Cur-
rent registration with the Registered Nurses' Asso-
ciation of British Columbia is required. Enquiries
should include background and experience and be
made to the; Director of Nursing, Royal Jubilee Hos-
pital. 1900 Fort Street, Victoria. British Columbia.

NURSES registered in British Columbia with PSY-
CHIATRIC experience are needed for Ihe newly opened
Eric Martin Institute of Psychiatry. When fully opened
this '.""O-bed facility is anticipated to have a Day Hos-
pital 6 Acute Adult Psychiatric Units and a 20-bed
Chiioren s Unit, Attractive salary scale and liberal
personnel policies. Apply to the; Director of Nursing.
Royal Jubilee Hospital, 1900 Fort Street. Victoria,
British Columbia.

GENERAL DUTY NURSES for modern 33-bed hospital
located on the Alaska Highway. Salary and personnel
policies in accordance with RNABC. Accommodation
available in residence. Apply to: Director of Nursing,
General Hospital, Fort Nelson, B.C.

GENERAL DUTY NURSES for modern 35-bed hospital
located in excellent recreational area. Salary and per-
sonnel policies in accordance with RNABC. Comfor-
table Nurses' home. Apply: Director of Nursing, Boun-
dary Hospital. Grand Forks. British Columbia.

OPERATING ROOM NURSES for modern 450-bed hos-
pital with School of Nursing. RNABC policies in ef-
fect. Credit for past experience and postgraduate
training. British Columbia registration is required.
For particulars write to: The Associate Director of
Nursing. St.Joseph s Hospital, Victoria. British Co-
lumbia.

NURSES' COME TO THE PACIFIC NORTHWEST —

Gateway to Alaska. Friendly community, enjoyable
Nurses Residence accommodation at minimal cost.
1970 RNABC contract salaries in effect. Registered
$549-$684, Non registered $522. Northern Differential
$15 a month. Travel allowance up to $60 refundable
after 12 months service. Apply to: Director of Nurs-
ing. Prince Rupert General Hospital, 551 5th Avenue
East. Prince Rupert, British Columbia.

UNDER B.C.H.I.S. STAFF NURSES with leadership
qualities to help initiate and promote quality care
for the long term patient. Salary — under RNABC
contract. Write Nursing Director. St. (Gary's Priory
Hospital. 567 Coldstream Avenue, Victoria, British
Columbia.

MANITOBA

GENERAL DUTY NURSES; Applications are invited
from Registered Nurses for a 100-bed accredited
hospital 50 miles west of Winnipeg on Trans Canada
Highway. Salary range $510/5595 per month
effective September 1st. 1970. Excellent fringe
benefits plus evening and night differentials and
academic attainment bonuses. Applications will be
received by Director of Nursing. Portage District
General Hospital. Portage la Prairie, Manitoba.

NEW BRUNSWICK

DIRECTOR OF NURSING required for 56-bed acute
General Hospital. Salary commensurate with
education and experience. Apply to: Administrator.
Sackville Memorial Hospital. Sackville, New Bruns-
wick.

NOVA SCOTIA

GENERAL DUTY NURSES applications are invited
for active treatment hospital caring for medium and
long term patients. Salary Range; $5,400. — $6,660.
Excellent Fringe benefits and working conditions.
Please apply to: Director of Nursing. Halifax Civic
Hospital. 5938 University Avenue, Halifax. N.S.

52 THE CANADIAN NURSE

ROTATING SUPERVISORS required for 180-bed
General Hospital situated at St. Anthony. Newfound-
land. Excellent personnel policies, fringe benefits.
Residence accommodation available. Apply: Mrs.
Ellen E. McDonald. International Grenfell Association,
Room 701, 88 Metcalfe Street, Ottawa 4, Ontario,

PUBLIC HEALTH NURSING SUPERVISOR with
preparation in advanced Public Health Nursing or
Baccalaureate degree with Administration and Super-
vision, required for Hastings and Prince Edward
Counties Health Unit. Shopping Plaza, 470 Dundas
Street East, Belleville, Ontario. Good personnel
policies. Apply to: Dr. C.R. Lenk. Director, Medical
Officer of Health, Hastings and Prince Edward
Counties Health Unit, Shopping Plaza. 470 Dundas
Street East. Belleville. Ontario.

REGISTERED NURSES for 34-bed General Hospital.
Salary $525. per month to $625 plus experience al-
lowance. Residence accommodation available. Ex-
cellent personnel policies. Apply to; Superintendent,
Englehart & District Hospital Inc.. Englehart, Ontario.

REGISTERED NURSES needed for 81-bed General
Hospital in bilingual community of Northern Ontario.
French language on asset, but not compulsory. Start-
ing salary $530. monthly with allowance for past ex-
perience, 4 weeks vacation after 1 year and 18 sick
leave days, Unused sick leave days paid at 100% eve-
ry year. Master rotation in effect. Rooming accom-
modation available in town. Excellent personnel pol-
icies. Apply to: Personnel Director, Notre-Dame Hos-
pital, P.O. Box 850, Hearst, Ont.

REGISTERED NURSES required for a 12-bed Inten-
sive Care-Coronary Care combined Unit. Post basic
preparation and/or suitable experience essential.
1970 salary range $535-645; generous fringe benefits.
Apply to: Director of Nursing. St. Marys General Hos-
pital, 911B Queens Blvd., Kitchener. Ontario.

REGISTERED NURSES. Applications and enquiries
are invited for general duty positions on the staff of
the Manitouwadge General Hospital. Excellent salary
and fringe benefits. Liberal policies regarding ac-
commodation and vacation. Modern weil-equipped
33-bed hospital in new mining town, about 250-mi.
east of Port Arthur and north-west of White River.
Ontario. Pop. 3,500. Nurses' residence comprises
individual self-contained apts. Apply, stating quali-
fications, experience, age, marital status, phone num-
ber, etc. to the Administrator, General Hospital. Ma-
nitouwadge, Ontario. Phone: 826-3251.

REGISTERED NURSES (2) Night Duty, small 18-bed
Chronic Hospital. Salary $495 to start, meals includ-
ed, annual increments, fringe benefits, 8 statutory
holidays. Apply Superintendent. Beverley Private
Hospital. 230 Beverley Street. Toronto 130, Ontario.

REGISTERED NURSES AND REGISTERED NURSING

ASSISTANTS. Our 75-bed modern, progressive Hos-
pital invites you to make application. Salaries
$510.00 and $357,00 with yearly increments and ex-
perience benefits. We are located in the Vacationland
of the North, midway between Winnipeg and Thunder
Bay. Write or phone: The Director of Nursing, Dry-
den District General Hospital, Dryden. Ontario.

REGISTERED NURSES AND REGISTERED NURSING

ASSISTANTS for 45-bed hospital. R.N.s salary $525
to $600 with experience allowance and 4 semi-annu-
al increments. Nurses' residence — private rooms
with bath — $30 per month. R.N.A.s salary $350 to
$425. Apply to: The Director of Nursing, Geraldton
District Hospital, Geraldton, Ont.

REGISTERED NURSES AND REGISTERED NURSING

ASSISTANTS, looking for an opportunity wo work in
a patient Centered Nursing Service, are required by
a modern well-equipped hospital. Situated in a pro-
gressive Community in South Western Ontario. Ex-
cellent employee benefits and working conditions.
Write for further information to Director of Nursing:
Leamington District Memorial Hospital: Leamington.
Ontario.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS for 36-bed General Hospital in Mining
and Resort town of 5,000 people. Beautifully located
on Wawa Lake, 140 miles north of Sault Ste. Marie.
Ontario. Wide variety of summer and winter sports
including swimming, boating, fishing, golfing, skating,
curling, bowling, etc. Six churches of different
faiths. Salaries comparable with most northern
hospitals. Excellent personnel policies, pleasant
working conditions. Apply to: Director of Nursing.
The Lady Dunn General Hospital. Box 179, Wawa.
Ontario.

OCTOBER 1970

November 1970

MISS MTM MORRXS

290 NELSON St APT 812
OTTAWA 2 ONT O000578A

The

Canadian

Nurse

continuing to care
— even in the air

preplacement health screening
by nurses in industry

are we really meeting
our patients' needs?

Changing Horizons

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For the Nurse
who cares
enough
to be
involved . . .

CARE of the ADULT PATIENT:

Medical-Surgical Nursing
2nd Edition

By Dorothy W. Smith, R.N., Ed.D.,
and Claudia D. dps, R.N., Ed.D.

A patient-centered text that takes a broad, total look
at the needs of medical and surgical patients and
the nurse's role in caring for them. How to administer
this care intelligently in terms of both physical and
psychological considerations is explained. Included
are recently-adopted principles and practices brought
about by advances in medical and nursing know-
ledge.

1206 Pages 406 Illustrations 2nd Edition, 1966

$12.75

New

THE NURSE and the CANCER PATIENT:

A Programmed Textbook

By Josephine K. Craytor, R.N., M.S.,

and Margot L. Fass, B.A. Programming Associate

A definitive text, structured for rapid assimilation,
that deals in depth with psychological and physical
care of cancer patients of all types and every age.
The emphasis is on nursing attitudes and how the
nurse can improve the quality of life for her cancer
patients. The chapter on care of the terminal pa-
tient applies to all seriously-ill patients and should
be read by every student and practicing nurse. With
review questions by chapters and an Appendix with
answers.

260 Pages

1970

Paperbound, $5.50

New

BEHAVORIAL CONCEPTS and

NURSING INTERVENTION

By Carolyn E. Carlson, R.N., M.S., Coordinator.
With Sixteen Contributors.

This is the first book to identify and examine in depth
relevant concepts from the behavorial sciences and
to demonstrate their application to nursing. The ma-
terial in this pioneering book is fresh, original and
practical. Content provides valuable insight into the
emotional problems of illness and hospitalization and
their influence on the patient. Chapter subjects range
from denial of illness, empathy, and body image
through ambivalence, shame, grief, hostility, and con-
trol of the nurse-patient relationship.
341 Pages 1970 Paperbound, $5.50

Clothbound, $7.75

J. B. LIPPINCOTT COMPANY OF CANADA LTD.

60 FRONT ST. WEST
TORONTO 1, ONT.

Please send me the following books:

D CARE OF THE ADULT PATIENT 2nd Edition

D THE NURSE AND THE CANCER PATIENT

Lippincott

$12.75
5.50

n BEHAVORIAL CONCEPTS AND NURSING INTERVENTION D Pap«rbound, $5.50

D Clothbound, 7.75

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n Payment enclosed D Charge and bill me

Lippincott books may be returned within 30 days if you

ore not fully satisfied.

CN ■ n-70

THE CANADIAN NURSE

NOVEMBER 1970

The

Canadian
Nurse

&

^^p

A monthly journal for the nurses of Canada published

in English and French editions by the Canadian Nurses' Association

Volume 66, Number 11

November 1970

29 Preplacement Health Screening By Nurses L.B. Munro

33 Continuing to Care — Even in the Air M.C. Ricks

39 Are We Really Meeting Our Patients' Needs? .. N. Du Mouchel

44 The Autistic Child V. Whitlam

48 Winter Isn't So Very Far Away! B. Williams

51 Information for Authors

TTie 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

19 Names

24 New Products

52 Research Abstracts

56 Accession List

7 News

23 Dates

26 In a Capsule

55 Books

72 Index to Advertisers

Executive Director: Helen K. Mussallem • Ed-
itor: Virginia A. Lindaburv • Assistant Ed-
itors: Liv-EUen Lockeberg, Mona C. Riclis •
Production Assistant: Elizalieth A. Stanton •
Circulation Manager: Beryl Darling • Adver-
tising Manager: Ruth H. Baumel • Subscrip-
tion Rates: Canada: 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. • Cliange of
Address: Six weeks" notice; the old address as
well as the new are necessary, together with
registration number in a provincial nurses'
association, where applicable. Not responsible
for journals lost in mail due to errors in
address.

.Manuscript Information: "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 reserves
the right to make the usual editorial changes.
Photographs (glossy prints) and graphs and
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. Permit No. 10,001.
50 The Driveway, Ottawa 4, Ontario.
C Canadian Nurses' Association 1970.

NOVEMBER 1970

Editorial

In the past few months, the Canadia
Nurses" Association has been besiege
by telephone calls from the news medi
asking the national voice of nursing i
identify its stand on abortion reforr
CNA staff cringe when these calls con
in, as they can say only that CNA h;
taken no stand on the issue, althoug
the implications of removing abortic
from the Criminal Code are beir
studied by the association's board (
directors.

On October 8 — the same day tf
Speech from the Throne informe
Parliament that the federal governmei
will set aside time for special debate c
abortion — the CNA board discusse
the abortion issue, and passed a resoli
tion stating that CNA "... reiterate i
belief that every Canadian woman wh
has decided to secure an abortion he
the opportunity of availing herself (
the best health care possible." (New
page 7.)

Between now and the next boar
meeting in March 1971. the 10 pre
vincial nurses' associations will stud
the abortion issue further and repo
their findings. Then, the Canadia
Nurses' Association — the large:
group of health workers in this countr
— will undoubtedly take a stand on th
vital issue and make every effort t
promote its beliefs.

We believe CNA should take th
following position, already adopted b
the Canadian Psychiatric Associatior
abortion laws should be removed fror
the Criminal Code and become a medi
cal procedure to be decided by th
woman and her husband, along with th
physician. To this we would add: n
nurse should be asked to abandon he
beliefs and be required to help carr
out an abortion; by the same token, n-
nurse who opposes '"abortion on de
mand" should be able to impose he
beliefs on those who favor it.

Naturally, prevention of conceptioi
is preferable to the termination of ai
unwanted pregnancy, and more in
formation on this subject must be givei
to Canadians through sex education ii
schools, family planning centers
etcetera. But no matter how compre
hensive the information given. n<
matter how sophisticated the method
of contraception used, unwanted preg
nancies will occur.

An article on abortion in the Augus
1965 issue of the Atlantic Monthl]
poses this question to those who favo'
only preventive measures: "'If it is mora
to prevent conception, is it immora
to interrupt angll-advised pregnancy?"

— V.A.L

THE CANADIAN 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.

information on Velcro

As exclusive distributor for the product
Velcro since its inception in the health
field, I was most interested in the Idea
Exchange published on page 53 of the
September 1 970 issue of The Canadian
Nurse.

Miss Fredin's suggestions, although
not new, are most interesting. However,
I believe one of her comments could
be confusing to many potential users:
". . . we now use Velcro instant zipper
material, a sewing accessory available
in retail stores." (Italics mine.)

The fact is that Velcro is available,
in limited widths, colors, etc., in very
few retail stores, at prices much in
excess of the established wholesale
prices at which institutions can buy.
For example: 1" Velcro per yard retail,
costs approximately $2.80; however,
1" Velcro per yard wholesale, costs
approximately $ 1 .60.

As a Canadian and a tax payer, I am
naturally concerned that institutions
buy from the proper source and at
the best possible price. — B.C. Hol-
lingshead, B.C. Hollingshead Limited,
64 Gerrard Street East, Toronto 2,
Ontario.

Defends registered nursing assistants

I am writing to defend myself and all
registered nursing assistants against
the insinuations made by Alfreda Rick-
etts (Letters, August 1970).

I, too, consider nursing one of the
most uplifting professions for women,
otherwise I would never have entered
it; however, 1 was unable to afford the
time and financial burden that a three-
year program would have placed on
me and my family.

RNAs are not on a plateau with reg-
istered nurses and never will be. We
are trained to do specific types of nurs-
ing care and to do them well. We will
never take on the more important tasks
that someone else is better trained to
carry out, although we will be asked to
do so by some RNs. We are not trained
to do procedures that require aseptic
technique, nor to give some of the more
complicated treatments that so many
RNs expect us to do.

In many hospitals it is not the RNA
who is taking over, but rather the RNs
and the hospital administrators who
are pushing the additional load on us
by instructing us to do things that are
not included m our original training.

From a medico-legal and moral point
4 THE CANADIAN NURSE

of view, I am concerned about the added
load being forced on us. Who will stand
behind us if we make an error? Who
will commend us for refusing to perform
a duty that is not within our area? Rath-
er, we are condemned for not carrying
out an order when we refuse. The soon-
er members of the health team realize
what our limitations are and abide by
them, the sooner the friction between
RNs and RNAs will stop.

I am trained to give basic patient
care including simple procedures and
treatments and I do them well. But
please don't ask me to do procedures
that I was not trained or licensed to
do. Instead, maintain your superiority
as an RN, and keep the more important
aspects of nursing for yourself.

Why should RNAs, for $350.00 per
month or less, depending on the loca-
tion, take on the responsibilities of
the RN and let her take home the big
money? We are happy as we are, other-
wise we would not be working as reg-
istered nursing assistants. — Louella
Cassell, RNA, Kitchener, Ont.

Well, Shades of Florence Nightingale!
In this day of enlightened nursing care
and progressive functioning of team
nursing, Alfreda Ricketts, a registered
nurse from Prince Edward Island takes
us back 25 years in nursing care atti-
tudes (Letters, August 1970).

Team nursing utilizes each member
of the nursing team to the optimum
of her ability, and within the limits
of her classification. Nursing assistants
were developed to do routine nursing
care, thereby allowing the registered
nurse sufficient time to carry out intri-

USE CHRISTMAS SEALS.

IT'S A MATTER
OF LIFE AND BREATH.

cate duties that require more skill and
judgment. Registered nursing assistants
are trained in government-approved
schools in most provinces, and pass
qualifying examinations through the
provincial nursing associations. The
role of the nursing assistant on the
team is clearly defined in the hospital
policies and job description.

The shortage of RNs was a recognized
problem long before the establishment
of schools for RNAs. The problem has
increased with the growing population
and the need for medical services.

I ask — who is to blame? I disagree
with the writer when she states the
provincial nursing associations are to
blame — they are a standard-controll-
ing influence.

If the RN is taken away from the
bedside, she can blame no one but
herself. True, increased paper work
keeps her at the desk; but if she wants
bedside nursing, she can take advantage
of every opportunity to give good bed-
side care. By delegating the correct
amount of responsibility to the RNA,
she is free to assume her own duties.

An intelligent RNA works within the
limits of her classification and under
the supervision of the RN. We should
remember that the aim of team nursing
is the optimum care and rehabilitation
of each patient, with each team member
cooperating to the fullest. — Susan
Higgins, RNA, Toronto, Ontario.

Resigned, not retired

The September 1970 issue of The
Canadian Nurse contained a pleasing
and excellent write-up on Eleanor S.
Graham, former executive director of
the Registered Nurses' Association of
British Columbia. However, the term
"retired" was incorrect, and should have
read "resigned" — a term that carries
quite a different connotation.

Continuity of administration is the
keystone of the RNABC structure, and
the key person who carries the respon-
sibility of this continuity is the executive
director, in this instance Eleanor S.
Graham.

Miss Graham, with her outstanding
integrity and keen sense of responsibility
for her position, made a great contri-
bution to the growth and ethical
advancement of the RNABC. Her
resignation is indeed a serious loss to
the association.

It is to be hoped that, after a vaca-
tion, Miss Graham will again share her
NOVEMBER 1970

knowledge and experience by becoming
active in the nursing profession of
Canada. — Janie E. Jamieson, RN,
Victoria, B.C.

Wage disparity

Having been an orderly for the past
eight years, I was interested to read
the editorial on the wage disparity
between orderlies and registered nurs-
ing assistants. (September 1970.)

1 had the good fortune to receive
a 24-month orderly training program
at St. Joseph's Hospital in Victoria,
B.C. Grade 10 education was required
for this course, which included: basic
nursing arts, urology, orthopedics,
oxygen therapy, and central supply
Service. An advanced course was also
available for those interested in be-
coming operating-room technicians.

We were taught postoperative
nursing care of urologic and orthopedic
patients, including the shortening of
drains and the removal of sutures. We
were also taught to give doctors
assistance in setting up various tractions,
or to do it ourselves when necessary;
to apply and remove plaster of Paris
casts, when requested by the physician;
and to help with minor surgery in the
emergency room.

More power to the nursing assistants
if they can get more money, but I do
not believe they should use the order-
ly's salary as a basis. If there is a
registered nursing assistant in Ontario
who has had a better training than I
had, 1 would like to hear about it.
— Nursing Orderly, Brampton, Ont.

Can one day a week be challenging?

In answer to the letter "Part-time
nurse disillusioned" in September.

This part-time nurse would be sur-
prised at the number of nurses who are
looking for the type of nursing she
finds unchallenging. She feels left
out of the team? How would a football
player coming to the field every ninth
or tenth game be received by the team?
Any nurse can tell us it takes a few
hours to get back "into the stream"
after an absence of two or more days.
How can the nurse who comes into the
inner circle only eight hours every six
or seven days expect to have a chal-
lenging job?

As an employer of part-time nurses
in an active general hospital, I try to
appreciate their problems. Whatever
their reasons for part-time work, their
needs and the hospitals' needs must
meet somewhere along the way. The
best utilization of their services can
be rewarding for both parties.

First, a personal interview is man-
datory. I explain what we require and
how it can be fulfilled. Sometimes
concessions have to be made on both
sides, but never at the expense of "less
than best" nursing care. The regular
NOVEMBER 1970

Staff nurses must never suffer from
the awkward schedules of part-time
nurses. Adjustments, yes; but unhap-
piness, no.

Second, all our nurses, full- or part-
time, must undergo an orientation of
at least two weeks in the day-time
hours. Our greatest need for part-time
nurses is in the evenings, nights, and
on week-ends and statutory holidays.
At these times the part-time nurses
take charge of a unit or of a special
unusual situation.

Nurses are never employed as an
"extra pair of hands" or to do "leg
work," and never for one day a week.
Sometimes an adaptable nurse who
knows the hospital well may be called
in at the last minute for one day. After
the orientation, the part-time nurse
is assigned to a unit where her time
is scheduled, along with the other
nurses, one month ahead.

I have not heard of part-time nurses
leaving us because of boredom. Per-
sonally, 1 wonder what kind of work
could be challenging one day a week.
In the helping professions I fail to see
it, but then I do have fxjor eyesight.
— V.A.A.R., Montreal.

Peaceful coexistence

Due to the technological advances
in medicine and the monetary control
of health resources, the workload of
the nurse has increased almost beyond
her capacity to function safely and
efficiently within the allotted time
element. To compensate for this,
improvements within the physical and
financial setting have been introduced
by the registered nurses' associations.

But what of the interpersonal rela-
tionships between administrative and
nursing personnel? This remains a
sterile field, and the nurse has become
a number to be appropriately or inap-
propriately slotted.

This situation affects the level and
efficiency of patient care. The efficient
functioning a department demands
that the right person be in the right
place at the right time — the reverse
is chaosi In such a situation, those
who try to make improvements create
waves, resulting in discriminatory
reaction to them.

A peaceful coexistence between
employer and employee must be main-
tained, but not at the price of conform-
ity to the past. It is time for the pro-
vincial associations to give judicial
support to the internal problems that
arise between employer and nurse-
employee. Standards should be set
for evaluation and placement of nurses,
and associations should supervise the
level of qualifications and competency
of nursing administration. — Jean E.
Nicholson, S.R.N. , S.C.M., Victoria,
British Columbia. ^

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THE CANADIAN NURSE

Fleet

ends ordeal by

Enema

for you and
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.

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
administration. Repeated administration
at short intsrvals should be avoided.

Full information on request.

•Kehlmann, W. H.: Mod. Hosp. 84:104, 1955

FLEET ENEMA® — single-dose disposable unit

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THE CANADIAN NURSE

NOVEMBER 1970

news

CNA Board Discusses Abortion

Ottawa — When the Canadian Nurses
Association is asiced to state its views
on the abortion controversy, the reply
will reiterate the association's belief that
every Canadian woman has the right to
the best possible health care after an
abortion.

The matter first came up at the 35th
general meeting last June and was re-
ferred to the board. CNA directors were
asked to study legal implications of the
resolution that requested the national
association to urge the federal govern-
ment to remove from the Criminal Code
those sections relating to abortion.

Some nurses at the June biennial
reasoned they were aware of the often
tragic results of criminal abortions; that
the question of an abortion should be a
medical matter, nat legal; and that the
decision for an abortion should be
reached by the woman and her doctor.

A cursory explanation of the impli-
cat-'- 's involved in the resolution was
givvii by a lawyer at the Fredericton
meeting, but was insufficient for the
nurses to feel qualified to vote.

Following a lengthy discussion on
what stand, if at all, the association
should take on abortion, the board
issued a resolution to clarify the situa-
tion.

CNA Board Takes Stand
On The Physician's Assistant

Ottawa — The Canadian Nurses' Asso-
ciation board of directors, at its meeting
October 7-9, spent considerable time
discussing the question of the proposed
physician's assistant. On the final day
of the meeting, the board took a stand
on the issue, which will be referred to
the minister of national health and
welfare, the provincial minister of
health, and the Canadian Medical
Association.

CNA's stand on the physician's
assistant reads:

"The CNA views with grave concern a
proposal to fill gaps in health services
by introducing a new category of
worker, namely the physician's as-
sistant or associate.

"The CNA firmly believes that the
health needs of the Canadian people
can more effectively and economically
be served by expanding the role of the
nurse.

NOVEMBER 1970

Late News

MESSAGE OF SYMPATHY

SENT TO PREMIER ROBERT BOURASSA

FROM CNA PRESIDENT

On behalf of the 82,000 members of the Canadian Nurses' Association, I
express my profound grief and extend my deepest sympathy to you, the
Governemnt of Quebec, and to the citizens of the province on the tragic
death of the Minister of Labour, Manpower and Immigration, Monsieur Pierre
Laporte. Monsieur Laporte's dedication to his people and to the unity of
Canada will long be remembered by the citizens of this country. — E. Louise
Miner. President, Canadian Nurses' Association.

The CNA President also sent a telegram of condolence to Madame Laporte
and her family.

"The CNA sees at least four areas in
which immediate action could be taken
to utilize nurses fully:

1. primary care for ambulatory patients;

2. continuing care for convalescent and
long term patients;

3. preventive care to preserve health;

4. care for patients requiring specialized
services.

"The CNA takes this position for the
following reasons:

1 . In general, the preparation and
potential of the nurse is not now
being utilized to its fullest capacity
In particular, a large number of
nurses prepared in University Schools
of Nursing at the baccalaureate level
do not realize their full potential in
the present health care delivery sys-
tem.

2. Nurses constitute a large and ready
pool of workers who with little or no
added training could move in to
assume greater responsibilities in
relation to primary, continuing, pre-

ventive and specialized care.

3. Public health nurses already partici-
pate to a significant degree in the
delivery of these services.

4. There are currently unemployed
nurses in a number of Canadian cities
who could quickly be available if new
roles existed.

5. It would be less costly to provide
short courses for nurses when neces-
sary, than to fund entirely new
programs for the preparation of a
totally new category.

"The CNA, therefore, believes that the
physician's assistant should not be
introduced and urges that a fair trial be
given to expanding the role of the nurse.
"The CNA believes that experimenta-
tion with various patterns of delivery of
health care utilizing the nurse in an
extended and more independent role is
urgently needed. However, the CNA
emphasizes the importance of proceed-
ing jointly with the medical profession
in these endeavors."

Abortion Resolution

WHEREAS the decision of the Board of Directors to accept as one of its

priorities for the 1970-72 biennium the matter of position papers on social

issues, and

WHEREAS the quality of health care of Canadian women who have decided

to avail themselves of whatever facilities are available in order to secure

abortions is very much a social issue, and

WHEREAS the CNA has already gone on record as stating its belief that

all Canadians requiring health care have the right to the quality and quantity

of nursing care that is at a level appropriate to their needs.

BE IT RESOLVED that when questions concerning the stand of the CNA

on the issue of abortion are raised, the CNA takes the opportunity to

reiterate its belief that every Canadian woman who has decided to secure an

abortion has the opportunity of availing herself of the ^est health care

possible.

%

THE CANADIAN NURSE

Canada And Britain

To Exchange Nursing Personnel

Ottawa — Nurses in the Canadian
Armed Forces and their counterparts in
the British Army Nursing Service will
soon have an opportunity to exchange
know-how on nursing care and service.
Brigadier Barbara Gordon, matron-
in-chief and director. Army Nursing
Service, Britain, and Lieutenant Col-
onel Joan Fitzgerald, Director of Nurs-
ing, Canadian Medical Armed Forces,
met recently to discuss the exchange of
forces nursing personnel.

Brigadier Gordon said details and
implementation of the program would
be determined during her stay in Ot-
tawa. Similar discussions were held in
Washington.

Asked if she felt there were notice-
able differences in nursing care between
the two countries" armed forces, Brig-
adier Gordon said, "Not major differ-
ences. In fact British and Canadian
practices are similar. Even more so than
I was led to believe."

Explaining that nursing education in
Britain is primarily practical. Brig-
adier Gordon said she regretted the
strong demand for nurses to have a
diploma or baccalaureate. 1 wish there
were more of the old school practical
nurses," she said.

As in Canada, continuing to care is
a nursing theme in Britain, although
we extend our care, said the senior
matron. Nursing care in British military
hospitals continues on through conva-
lescence. The Canadian practice is to
discharge service personnel to conva-
lesce at home.

After touring a Canadian service
hospital, Britain's chief military matron
said she was surprised not to see women
and children as patients. Military hos-
pitals in Britain also care for service
personnel dependents.

To the question, "is the austere
matron image still prevalent in Britain?"
Brigadier Gordon answered, "The ma-
tron today is much younger, there's
none of the old-time 'Carry on, matron"
atmosphere."

Questions on drugs and the new
abortion law in England, were parried
with restrained replies.

Drug use by service personnel is not
a grave concern, neither is there a
noticeable increase in requests for
abortions in military hospitals.

She admitted the image of the service
is still important, especially to parents,
and that the military nursing personnel
always kept this in mind.
8 THE CANADIAN NURSE

Canadian Nurses' Association
1970-72 Biennium

COAL

To influence nursing practice in a changing health care delivery system through
an informed membership and relevant policy statements.

Priorities

1 . Position papers and plan of action in relation to the expanded role of the
nurse to include:

(a) the physician's associate or assistant;*

(b) specialization in nursing on both a vertical and horizontal direction;*

(c) the proliferation of workers (technicians) involved in the allied health
field;-

* (All of these have educational, legal, and financial implications that need
to be explored.)

2. Nursini^ Research:

• the need for nurse researchers
(preparation and financial assistance needed)

• the need to make decisions and take action on the report from the Ad Hoc
Committee on Research.

3. Position papers on social issues, white papers, and reports of commissions
that have relevance to nurses and nursing.

4. Decisions and plan of action in relation to the problem of the publication of
French books for education purposes.

"We don't want our girls going to '.he
back streets of Singapore to get help,"
said the brigadier. For this reason we
have reviewed the content of our
training courses dealing with contra-
ceptives and abortion."

Promotion of a book on the wartime
experiences of Dame Margot Turner.

Brigadier Gordon's predecessor, was a
topic during a press interview.

Brigadier Gordon said she encour-
aged Dame Margot to tell her story.
"She was a courageous nursing sister —
her story exemplifies the life of many
of our nurses.""

(Coniiiiiicd on ptiiic 12)

'Welcome" — Harriet Sloan, nursing coordinator, Canadian /V/(«v.v' Association,
extends greetings to Brigadier Barbara Gordon, matron-in-cliief and director of
Britain's Army Nursing Service. Accompanied by Lieutenant Colonel Joan Fitzgerald,
director of nursing. Canadian Medical Forces. Brigadier Gordon toured national
headquarters during her visit to Ottawa. Discussion on an exchange program for British
and Canadian forces nursing personnel was the focal point of the brigadier's talks at
national defence. A similar exchange was discussed with army authorities in Washington

NOVEMBER 1970

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10 THE CANADIAN NURSE

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THE CANADIAN NURSE 11

ICoiuliiiicd from pauc 8}

RNs Participate

In Nutrition Canada Project

Ottawa — Three registered nurses
have been selected by the department
of national health and welfare as team
members for Nutrition Canada, a food
and drug directorate project to provide
basic information on the nutritional
well-being of Canadians. The nurses
are: Lenora Kane, Susan Theobald,
and Barbara Howelett — all public
health nurses. French-speaking nurses
will be selected later, as the team to
survey French-speaking Canadians is
not scheduled to start work before
February 1971.

The survey started in Ottawa Satur-
day October 3, after the nurses had
completed an intensive training pro-
gram to help them identify symptoms
of malnutrition and do cursory physical
examinations. Physicians will perform
the cardiovascular, respiratory, and
abdominal examinations, and dietitians,
a lab technician, and a dental hygienist
will complete the other aspects of the
survey. The investigators will also de-
termine the quantity of food additives,
non-nourishing foods, and insecticides
being absorbed by Canadians.

Twenty-one thousand persons will

Inclusion of Canadian nurses in a government operated unemployment plan
has been accepted by the Canadian Nurses' Association. In a brief to the House
of Commons standing committee on labor, manpower, and immigration last
October, President E. Louise Miner (left) and executive director Dr. Helen K.
Mussaliem (center) said the association saw no reason why the plan s!iould
not benefit nurses. Speaking to committee chairman David Weathcrhead
(right). Miss Miner asked if, under the white paper's proposals, unen.pioyed
nurses might be referred to other government agencies to be elif.ible for
benefits, and so retrained out of the nursing profession. The associition was
assured this would not happen, even if there were an oversupply of nurses.

Susan Theobald, one of three RNs on the
Nutrition Canada team, eheeks measure-
ments of "patient" Stephany Blackstone.
coordinator of puiylic relations for ilie
project.

12 THE CANADIAN NURSE

be interviewed and examined at clinics
across the country. Those selected have
been determined by the dominion bu-
reau of statistics, according to geo-
graphical location, type of community,
age, sex, and income level.

Plans for Nutrition Canada were
announced in the fall of 1969 by the
minister of national health and welfare,
John Munro. who reported that medical
literature had cast considerable doubt
that Canadians were as well fed as had
been assumed, and that there were
clear indications of malnutrition in
certain segments of the Canadian pop-
ulation. Mr. Munro added there was
growing concern about the use of food
additives and pesticides in food sup-
plies, and that the data indicated an
urgent need for a comprehensive study
of the food intake and nutritional status
of Canadians.

Final results of the study are expect-
ed to be released in 1973.

Health Care Costs
Need Closer Look

Ottawa — Soaring health care costs,
"one of the largest and fastest-growing
activities in the economy," was pin-
pointed as a major concern by the
Economic Council of Canada in its

seventh annual review released in
September.

Urging careful attention to the
economic aspects o." health care, the
council foretold rapid increases in
expenditure for the 1970s, and warned
that the public should be asking ques-
tions about the effective use of such
resources.

Reflecting federal and provincial
concern on the rising costs of health
services, the council, however, dealt
mainly with "getting more and better
health care."

This was interpreted as including an
equitable distribution of health care
across the country, between rural and
urban communities, and among the
poor and minority groups. The report
described the goal of health care as
adequate, timely, efficient, and humane
— for all Canadians.

Calling for improved productivity
in the health care "industry," the report
emphasized the need for public educa-
tion on the effective use of the "in-
dustry." Preventive measures, including
greater attention to good nutrition,
pollution abatement, recreation, and
safety programs, were mentioned.

Supplying health care personnel did

not give the council concern. It found,

"the lead time in training more workers

is fairly short (two or three years for a

NOVEMBER 1970

registered nurse; shorter still for some
others), so that the supply of such
personnel can be adjusted fairly flexibly
in response to increased needs."

The increase in quantity and quality
of services was given as two causes for
rising costs. Intensive training of
doctors, nurses, and other personnel, a
wider range of diagnostic tests and other
services, and the declining incidence
of communicable diseases were cited as
indicators.

To avoid unnecessary demands on
the health system, the council suggested
deterrent fees in the form of a "util-
ization" charge. This would have to
include adequate safeguards for families
and individuals in the low income
bracket.

In the section dealing with economic
aspects of health care, the report noted,
"the most important proposal for
economizing on limited resources is
avoiding wasteful use of highly trained
professionals." This could be overcome
by "shifting tasks to less costly person-
nel."

The team approach in nursing was
advocated, even though it meant greater
specialization, increased delegation,
and more group responsibility.

Stepped up training techniques in
the team approach were suggested to
facilitate the wide use of trained per-
sonnel.

If, said the report, changes were made
in licensing laws, enabling paramedical
personnel to do routine procedures
iinder supervision, then another effec-
tive use of health care resources would
be made available.

Turning to the administration of
health care, the report urged a "more
deliberate and concerted approach."
It recommended better management of:
work studies; staffing according to
workloads and patient needs; scheduling
diagnostic services; improved hospital
design; computerized records; and
other administrative concerns.

Long-term planning by government
health agencies and private institutions,
was given the bite by the council. Five-
year budgeting should be a normal
practice, rather than a rarity — as it
now is.

Nurses Told Militancy Is Answer
To Labor Problems

Hespeler, Ontario — "You're being
whipped to death with your own pro-
fessionalism," Donald O. Hersey, law-
yer for the Registered Nurses' Asso-
ciation of Ontario, told a collective
bargaining workshop here.

Organized by RNAO for nurses in
the Gueiph area, the workshop drew a
responsive reaction to labor and legal
representatives.

Counseling a liberal, as opposed to
a legalistic approach to collective
NOVEMBER 1970

bargaining, Mr. Hersey said, "In an
environment where you do not have
the right to strike, where you will al-
ways be faced with an arbitration
procedure, it makes more sense to be
cooperative." He advised his audience
to "achieve a working relationship with
your employer... don't create a standoff
situation."

The tough attitude of labor consul-
tant Drummond Wren received ap-
plause from the group of 40 nurses. He
told them management has retained
those rights the employee hasn't taken
away through bargaining, and described
a labor agreement as "a document

whereby you have taken away from the
employer some of the dictatorial
rights employers have had for years."

He said management is trained in
and committed to the adversary system
— without militancy and agressiveness
you'll get nowhere.

Speaking with conviction, Mr. Wren
called for action from the nursing
profession, "The quicker you get some
militancy, the quicker youMI get what
you organized for."

Three executives of local association
chapters gave advice on what to expect
in employer-employee relations.

Communication between association

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THE CANADIAN NURSE 13

{Continued from page 13)

members and the employer was des-
cribed by Pat Pettibone, nurses" asso-
ciation, Yoric-Oshawa District, as
probably the most important task of
an association president.

"Good internal communication can
often head off the formal filing of a
grievance," she said. "But go in pre-
pared."

She advised nurses to get guidance
from provincial associations — es-
pecially if they felt insecure.

Mrs. Pettibone stressed objectivity
when handling grievances, recalling the
days when management decided what
was best for "its girls." She likened this
type of relationship as the "old parent-
child" attitude.

Nurses now regard this as an attack
on their emotional maturity, she said.
"In those days a pliant, appealing,
dependent attitude aroused father-
protector emotions in the employer.
This type of girl got a good salary —
the militant type got a lower salary and

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was still expected to offer dedicated
service."

Mardi Bullivant, nurses' association,
Hamilton Civic Hospitals, told of a
treasurer's job in a large hospital asso-
ciation with considerable funds to
administer.

"Get things done properly from the
start," she advised, "such as hiring an
accountant, having a yearly audit, and
keeping duplicate records."

Her own association's tactic in
Hamilton was to "pick the brains of
established large local unions."

A representative from the nurses'
association, Queensway General Hos-
pital, Toronto, stressed the opportunity
for personal growth in association
activity.

"It's been the greatest experience
since my training days," Margaret
Harris said.

"A good association member earns
the respect of hospital management."

Student Nurses
Enjoy Royal Visit

Winnipeg — During the royal visit to
Winnipeg, July 15, 21 student nurses
from five Winnipeg hospitals were
guests at a dinner dance at the Interna-
tional Inn, Winnipeg, honoring their
Royal Highnesses, Prince Charles and
Princess Anne.

Nine students from Winnipeg Gen-
eral Hospital attended: Susan Kent,
Theresa Ruth Tyler, Linda Louise
David, Susan Jan McCallum, Shelley
Bernice Isenberg, Tannis Joan Grant,
Karen Joan Stavenjord, Janet Louise
Bell, and Barbara Ann McClymont.
Misericordia General Hospital was rep-
resented by Edward Oakly; Joan Ran-
kin; Cecilia Li; and Melvin Dahl. From
St. Boniface General Hospital, Patricia
Semcow, Fay Charko, Caroline Shep-
herd, and Beverly Nield attended. Grace
General Hospital sent two representa-
tives, Edith Kliever and Clara Roy.
And from Victoria General Hospital,
Cheryl Dowd and Donna Braun also
attended.

Health Care Explored
At McMaster Seminar

Hamilton — Understanding attitudes
and feelings surrounding the human
experience of birth was the basis of a
recent health care conference sponsored
by McMaster University.

Two hundred nurses at the four-day
seminar on Birth and the Family, were
told by Karen von Schilling, McMaster
nursing professor, that emotional and
physical crises, if dealt with by untrain-
ed hospital personnel, can result in
permanent emotional scarriig. Miss
von Schilling referred to an ai. normal
birth as such a crisis. Expressioi.s and
attitudes of delivery room staff tell a

NOVEMBER 1970

Next Month
in

The

Canadian
Nurse

Nurses' Involvement

in Student Drug Problems

Monitoring the Mother and
Fetus During Labor

Chemotherapy in
Hemodialysis

"^7

Photo Credits for
November 1970

Crombie McNeill, Ottawa,
pp.8, 17 (left), 31,32

Photo Features, Ottawa,
p. 12 (top)

Studio C. Marcil, p. 12 (bottom)

John Evans Photography Ltd.,
Ottawa, p. 1 5

Canadian Forces Photos,
W/O W. Cardiff, cover,
pp. 33, 34, 35

National Film Board,
Peter Phillips, p. 49

CMA House Officially Opened

The new headquarters of the Canadian Medical Association, located in the
nation's capital, was officially opened October 2 by Dr. D.A. Graham, the
oldest living past-president of the association. Designed by the architectural
firm of Webb, Zerafa and Menkes, of Toronto, the two-story structure provides
over 43.000 square feet of floor space. It presently houses several tenants,
including the Canadian Nurses" Association Testing Service, the Academy of
Medicine, the Canadian Medical Protective Association, the Medical Council
of Canada, and the Canadian Association of Prosthetists and Orthotists.

mother that something is wrong. Wiih-
out explanation, she is left to imagine
the worst.

Miss von Schilling said nurses avoid
answering a mother's request for infor-
mation until she has talked to her doc-
tor. This kind of treatment gives the
mother a feeling she will be avoided,
because of an imperfect birth.

Referring to a study of families fol-
lowing abnormal births. Miss von
Schilling told the nurses medical per-
sonnel have little knowledge of the
kinds of help parents need at such
times.

In an overview of life continuum
from conception through pregnancy,
birth, infancy, and on to adolescence,
marriage and again pregnancy, factors
relevant to the nature and nurture of
human life were discussed.

What are the values and attitudes
of professional health workers toward
nature versus nurture, and how do they
influence human life experiences? were
two questions put to the nurses.

Health care, and the role of pro-
fessional health workers, was a major
topic during seminar sessions. Examples
of professional collaboration on health
care issues was given by physicians and
nurses.

NOVEMBER 1970

Speaking after the conference. Miss
von Schilling said, "It is hoped each
group of nurses in health units will
continue, or learn, to work with physi-
cians and other health professionals
in the community. This will enable
health workers to communicate and
coordinate efforts, providing effective
family health care. Only by combining
and coordinating services can optimal
public health be provided."

Health Facilities
Receive Federal Grants

Ottawa — Four provinces have recent-
ly received federal grants toward health
facilities amounting to $1.75 million.

Training facilities for nurses in Thun-
der Bay and Fort Frances, Ontario,
will benefit by $653,784. The largest
slice will aid construction of a new
building for the Lakehead regional
school of nursing. Thunder Bay. De-
signed to accommodate 300 students,
it will be completed by July 1 97 1 .

In Fort Frances, the registerecl
nurses" assistants school. La Verendrye
Hospital, has received a grant toward
a one-storey unit, completed in 1969.
The school provid^ training for 20
students.

THE CANADIAN NURSE 15

The community and health center of
the Toronto student health organization
has also received a grant. The center
was created as a community-oriented
approach to comprehensive health care.
Teaching experience for health science
students is provided by the center.

Accreditation of Manitoba's hospi-

tals will be assisted by a $ 1 3,000 grant.
The project entails a detailed study
of requirements to bring the province's
hospitals in line with the Canadian
Council on Hospital Accreditation
standards.

Immunization data processing in a
Saskatchewan health department is
expected to be simplified after a study
to reduce clerical work has been com-
pleted. The project was granted
$15,060.

Two contributions amounting to
$462,750 were approved by the federal
government for the health sciences

your
waiting room

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A sound that echoes around all the doctors' waiting rooms

from September until Spring is the sound of coughing.
Now Parke-Davis introduces an additional formula for your

coughing patients: BENYLIN® DM cough syrup.

This is a specifically antitussive formula designed to control

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BENYLIN DM offers the powerful antitussive qualities of

Dextromethorphan together with the antihistamine

BENADRYL® which also has antispasmodic action

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engage In other activities requiring keen Menthol 1 mg.

response while using this preparation.

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16 THE CANADIAN NURSE

center and library at Memorial Uni-
versity, St. John's. Newfoundland.

Letters Patent Granted CNA

Ottawa — After four years discussing
formalities required to amend its
charter, the Canadian Nurses' Associa-
tion has been granted Letters Patent
under the Canada Corporation Act
Part II.

Issued by the department of con-
sumer and corporate affairs, July 15,
Letters Patent enables the CNA to
operate under new bylaws passed at the
association's 35th biennial meeting in
Fredericton, New Brunswick, last June.

Associate executive director, Lillian
E. Pettigrew. said the association's
1966-68 rules and procedures will be
revised to conform with current bylaw
one, and renamed Rules and Regula-
tions.

The Letters Patent under which CNA
will operate, the bylaw, and the rules
and procedures are to be published as
one document, and will be available
to CNA members early in 1 97 1 .

Nursing Practice
Subject of Seminar

Ottawa — A four-pronged approach to
research in nursing practice will be
the main objective of a conference to
be held in Ottawa, February 16-18,
1971. Identifying needs for research,
exploring methodology, determining
means of exchanging information about
nursing studies, and coordinating re-
search in Canada, will be discussed.

Dr. Floris E. King, associate profes-
sor and coordinator of the graduate
program, University of British Colum-
bia, Vancouver, has been named proj-
ect director. A federal government
grant has been made to aid the confer-
ence.

Screening Newborns

Assists Disease Prevention Programs

Quebec — Studying the characteristics
of a newborn to assist prevention of
disease, is part of a screening program
undertaken by the hereditary metabolic
disease unit of the Quebec department
of health.

In collaboration with other Canadian
universities, the department has set
up a preventive system, making it possi-
ble to study genes of newborns.

A minute amount of blood from the
baby's heel, and a sample of urine,
taken between the fifth and seventh
day after birth, fortn the basis of the
study. Parents are informed of the test
results three weeks later.

NOVEMBER 1970

On With New, Out With The Old

It's goodbye to the old and on with the new. Neither midi or mini, the new
Canadian Forces uniform for women personnel (including nursing sisters) sets
its own fashion swing — elegant comfort. Compared with the outmoded, tailored
silhouette, the new, free-style suit considers the whims of women's fashions and
excludes the military look. During the last 20 years, nursing sisters and women
personnel in Canada's army, navy, and airforce have worn similar fitted uniforms
with a stiff collar and necktie, and shirt and insignia of each service. Now in
1970, and under a new title, Ccmadicm Forces, women personnel (nursing sisters
included) are issued fashion-oriented uniforms. It's the suave dark green look, a
loose boxlike jacket to the hips, straight skirt to mid-knee, and light green, round
neck blouse. Three gold buttons, scaled-down versions of the serviceman's size,
and gold rank braid, complement the suit. Simplicity, and a nod to current
fashion, are also seen in the dark green felt hat. The rounded crown and softly
molded brim is standard for all ranks. Taupe stockings are worn with black
pumps. All other accessories are also black. And for the ultra fashion-conscious
armed forces miss — there's a black umbrella to keep off the raindrops. Talking
to a Chelsea Pensioner during a visit to Queen Alexandra Hospital, London,
England, is CNA nursing coordinator. Harriet Sloan. Miss Sloan retired from
the Canadian Forces medical services in 1968. As matron-in-chief. Lt. Colonel
Sloan wore the old-style uniform and was succeeded by Lt. Colonel Joan
Fitzgerald, who wears the new issue and is known as Director of Nursing. Whether
old or new style, both uniforms proudly bear the royal cypher, proclaiming the
wearer as an honorary nursing sister to Her Majesty, Queen Elizabeth 11. As
director of Canadian Forces nursing personnel, Lt. Colonel Fitzgerald will retain
the honor until she leaves her post. Located on each epaulettc^he cypher is
recognized by the initials ER.

17

Johnson & Johnson's newly developed SURGINE Face
Mask — six years in the designing — is so extra-
ordinarily comfortable you'll be almost as unaware of
it as you are of your own skin.

The fact that the SURGINE mask fits so well is part of the
reason it does such a superior job of bacterial filtration.
Cheek and chin leaks are eliminated. But the main

reason for SURGINE's efficiency is a new, specially
developed filter medium. In vivo tests show an extra-
ordinary average filtration efficiency of 97% .
For free samples of the new SURGINE Face Mask, con-
tact your Johnson & Johnson representative. Or write to
Mr. Mark Murphy, Product Director, Johnson & Johnson
Ltd., 2155 Blvd. Pie IX, Montreal 403, Quebec.

'Trademark of Johnson & Johnson or affiliated companies.

SURGINE

the comfortable face mask

MONTREAL4TORONTO- CANADA

18 THE CANADIAN NURSE

NOVEMBER 1970

names

Margaret Mar>' Street spent a week in
September at CNA House in con-
nection with her forthcoming biography
of Dr. Ethel Johns, whose distinguished
career included many years as the first
full-time editor of The Canadian Nurse.

Miss Street (R.N., Royal Victoria
Hospital, Montreal: M.S., Nursing
Service Administration, Boston Univer-
sity, Boston) is associate professor.
School of Nursing, University of British
Columbia, Vancouver. She has been
awarded two Canada Council grants to
make the work on this biography fin-
ancially possible, and has been granted
a sabbatical year from her professorship
to devote full time to this monumental
task.

Miss Street's aim is to present Ethel
Johns, w horn she knew both as a nursing
leader and as a person, within the per-
spective of the historical era her life
work spanned. As a true biographer.
Miss Street subdues her own personal-
ity while speaking in glowing terms of
the complex woman whose influence in
nursing circles was apparent for nearly
60 years — years of great change within
the profession.

Ethel Johns was a pioneer. Her life
pattern was set when, as a little girl,
she and her younger brother were left
in boarding schools in Wales while
their father was becoming established
as missionary and teacher on the Ojib-
way Indian Reserve at Wabigoon Lake
in Northwestern Ontario, and when, as
a "teenager" she lived on the reserve
with her family and had as tutor her
erudite father. Little wonder then, that
she had such a serious dedication to
work. However, her writings when off
duty displayed a delightful humor and
a keen insight into a world that encom-
passed much more than her profession.

Miss Johns graduated from the Win-
nipeg General Hospital School of Nurs-
ing in 1902 and studied public health
and teaching methods at Teachers Col-
lege, Columbia University, in 1915.
She held senior positions in several hos-
pitals in Ontario and Manitoba before
her dual appointment in 1919 as direc-
tor of the nursing school of The Van-
couver General Hospital and first nurse
director of the baccalaureate program
for nurses at the University of British
Columbia. Between 1925 and 1929,
as field director for the Rockefeller
Foundation in their European office in
Paris, Miss Johns helped to develop
nursing schools affiliated with universi-
NOVEMBER 1970

Nursing Leaders Honored By Ottawa Friends

Royal Victoria Hospital (Montreal) graduates living in Ottawa had tea with
Margaret E. Kerr, former editor of The Canadian Nurse, and Winnifred
MacLean, formerly on the administrative staff of the RVH and then circulation
manager of The Canadian Nurse, during their September visit to Ontario
and Quebec. Seen above, left to right, are Irene Kierstead Brown, the hostess,
and Liv-Ellen Lockeberg, assistant editor of The Canadian Nurse, greeting
the guests of honor. Miss MacLean and Miss Kerr.

ties both in Hungary and Rumania.
Then followed eleven years with The
Canadian Nurse.

In 1948, four years after her active
career had ended. Mount Allison Uni-
versity honored Ethel Johns by confer-
ring on her a Doctor of Laws degree.
During her quiet life of retirement in a
little house in Vancouver, Dr. Johns
continued to share her rich experience
and wide knowledge by writing. "Just
Plain Nursing" became a vehicle for her
commonsense approach to the field,
and her contributions to a history of
the Winnipeg General Hospital and

to a history of the Johns Hopkins
School of Nursing were considerable.

Miss Street came to know this re-
markable woman well during her de-
clining years prior to her death in 1968,
and believes that she can enrich the leg-
acy of Dr. Ethel Johns by writing her
biography.

Margaret Street would not wish to
accept all the credit for her endeavor,
for throughout any discussion on the
subject of her biography she is full of
praise for those who have so generously
aided her in col^cting biographical
material and little known personal
THE CANADIAN NURSE 19

names

information. She expressed particularly
warm thanks and appreciation to Mar-
garet Paricin for maicing available the
resources of the CNA library and to
Dr. Dorothy Percy of Ottawa, Kathleen
Ruane of Winnipeg, and Miss Edna
Rossiter of Vancouver for their special
contributions to the ultimate success of
this work.

Nine committees of the Manitoba
Association of Registered Nurses
announced new chairmen early this
fall: nursing service, Jacqueline Robert-
son; nursing education, Joy Winkler;
social and economic welfare, Shirley
Paine; education fund, Marie Kullberg;
accrediting, IVlarjorie Jackson; legisla-
tion, Mary Wilson; credentials, Mar-
garet McCrady; careers, Grace Davis;
board of examiners, Elva Cranna.

The association announced that two
other committees, house and finance,
have been disbanded.

t Sister Mary Felici-
tas, immediate past
president of the
Canadian Nurses"
Association, was
honored this month
by her alma mater.
The Catholic Uni-
versity of America.
On November 7,
Sister Felicitas received the University's
1970 Annual Alumni Achievement
Award in the field of nursing, at a
homecoming banquet in Washington,
D.C. The award was given "to provide
public recognition of the distinction[she
has] achieved in her life work."

Sister Felicitas is director of the
school of nursing at St. Mary's Hospital
in Montreal. A graduate of Providence
Hospital, Moose Jaw. Saskatchewan,
and the University of Ottawa, she
obtained a master's degree from The
Catholic University of America, where
her high standard of scholarship won
her Phi Beta Kappa recognition.

An active member of the Association
of Nurses of the Province of Quebec,
Sister was vice-president of that asso-
ciation at two different periods, as well
as honorary treasurer and chairman of
District 1 1, English chapter. She served
on the CNA board for many years
before becoming president in March
1967.

Sister is also a member and past
chairman of the Canadian Conference
of Catholic Schools of Nursing. She was
elected to membership in the Honor
societies of Sigma Theta Tau (U.S.
20 THE CANADIAN NURSE

Nursing Leaders Meet

Three nurses on World Health Organization fellowships are spending four
months in Eastern Canada and the United States to study nursing service and
nursing education. While in Ottawa, they were received by Verna Huffman,
principal nursing officer, office of the deputy minister, and other nursing
consultants at the Brooke Claxton Building, head office of the Department of
National Health and Welfare. They are shown above admiring a photograph
of the Department's head office. From left to right: Miss Huffman; Mary Clara
Xavier, assistant superintendent of nursing, Uttar Pradesh, India; Louise
Miner, president of the Canadian Nurses' Association; Kanchan Surendra
Shah, assistant superintendent of nursing, Gujarat, India; Dr. Helen K. Mus-
salem, executive director of the Canadian Nurses' Association; and Mrs.
O.A. Adewole, senior matron of the Ministry of Health, Nigeria.

National Honor Society of Nursing)
and Pi Gamma Mu (U.S. National
Social Science Honor Society.)

Hisako R. I m a i

(B.N., McGill U.,
Montreal; M.P.H.,
Johns Hopkins U.,
Baltimore) is the
new research officer
at the Canadian
Nurses' Association,
J , Ottawa. A Canadian

• '^ f Nurses' Foundation

scholar, she recently completed her
master's degree in public health. Born
in New Westminster, British Columbia,
Miss Imai graduated from Moose Jaw
Union Hospital, Moose Jaw, Sask., and
obtained a diploma in operating room
management and technique at The
Montreal General Hospital, Montreal.
During her work in Japan and Oki-
nawa for the United Church of Canada,
she developed an interest in public
health, and returned to Canada to obtain
a degree in this field. She was appointed
a public health nurse with the Toronto
department of health, and taught for one

year at the School for Graduate Nurses,
McGill University. Her studies at Johns
Hopkins included projects in mental
hygiene, in the behavioral sciences,
and in medical care.

Dr. Amy Griffin,

professor and assis-
tant dean (academ-
ic). Faculty of Nurs-
ing, the University
of Western Ontario,
has been elected
chairman of the ed-
ucational commit-
tee, R N A O. Dr.
Griffin received her doctoral degree at
Teachers College, Columbia University.

Honorary memberships in the Saskat-
chewan Registered Nurses' Association
have been awarded to three long-time
members of the nursing profession.

Hazel B. Keeler (R.N., The Vancou-
ver General H.; dipl. in teaching and
supervision. School for Graduate
Nurses, McGill U.; B.A., U. of Sas-
katchewan; M.A., Teachers College,
Columbia U.), was director, school of
NOVEMBER 1970

nursing at the University Hospital
before her retirement in 1969.

Grace Motta {R.N., 'Winnipeg Gen-
eral H., dipl. in teaching and supervi-
sion, U. of Toronto) retired in 1969
after i 3 years as registrar of SRNA.

Laura Reynolds, a native of Mani-
toba, graduated from the Saskatoon Citv
Hospital school of nursing. She was a
private duty nurse prior to her appoint-
ment as school nurse for the Saskatoon
public school board. Miss Reynolds
joined the Saskatoon city public health
department when the city took over
school public health.

Madge McKillop

^w*! i^b^a ^^^ reelected presi-
■V jMI ^^"' "f th^ Saskat-

pr __j^^^ chewan. Registered
iJp^ ^'"'V^HI Nurses' Association
P' ^^K at its 53rd annual

— |/ I meeting. Miss Mc-

flg|— ^^ Killop made partic-
■ "^ ^^^^^^L ular note of two
^* achievements in Sas-
katchewan nursing circles, made
possible largely through the efforts of
the SRNA: the first group of students
had graduated from the school of
diploma nursing at the Saskatchewan
Institute of Applied Arts and Sciences
in Saskatoon; and the first salary con-
tract between the Saskatchewan Hos-
pital Association and the SRNA had
been negotiated and signed.

Yvonne Chapman is

the new employment
relations officer for
the Alberta Associa-
tion of Registered
_^ Nurses. She replaces

4 JZl-^^ Louise Tod, who is
^^__ S studying for her
^P^ 9 master's degree at
the University of
Colorado, Denver, Colorado.

Miss Chapman received her nursing
diploma at the Victoria General Hos-
pital, Halifax, and a diploma in nursing
service administration from the Univer-
sity of Saskatchewan. Saskatoon. She
graduated from McGili University,
Montreal, with a bachelor of nursing
degree in 1967.

a^

tal, Montreal. He
taken at Institut
Montreal.
NOVEMBER 1970

Rachelle Marquis

has joined a team of
CARE-MEDICO .per-
sonnel in Tunisia,
on a two-year tour
of duty. Miss Mar-
quis had worked as
an x-ray technician
at Sacred Heart of
Cartierville Hospi-
r x-ray studies were
de Technologic in

Eight new appointments to the school
of nursing faculty have been announced
by the University of Calgary. Seven
are assistant professors: Sar'la Setht
(B.Sc.N., Delhi U.. New Delhi; M.A.
in psychology. Dunjab U., New Delhi;
M.A. in public health teaching. New
York U.) was previously assistant
professor at Laurentian University,
Sudbury. Ontario. Margaret J. Mon-
crieff (dipl.. Royal Jubilee H.. Victoria.
B.C.; dipl.. O.R. Tech.. sup. & man..
The Vancouver General H.; dipl.,
teaching and supervision. McGill U.;
B.S.. U. of Washington. Seattle;
M.Sc.N., U. of Western Ontario, Lon-

don) was assistant professor at the
University of Western Ontario. Diana

D. Pechiulis (R.N., Holy Cross H.,
Calgary; dipl., teaching and supervi-
sion, U. of Alberta, Edmonton; B.Sc.N.,
U. of Colorado, Denver) was assistant
professor, medical^surgical nursing at
the Universitv of Calgary, Alberta:
Marj A, -Wise, (B.N., Ellis H. School
of Nursing, Schenectady, N.Y.; BS
Columbia U.. N.Y.; M.S.. U. of Chi-
cago. 111.) was assistant professor at the
University of Calgary. Alberta; Annie

E. Clark (R.N.. Calgarv General H.,
dipl., public health, and B.Sc.N.. U. of
Alberta; M.N., U. of Washington).

Who Prefers

explosion-proof suction
units? "We do,"
say most O.R. nurses.

Here's why: Gomco Explosion -Proof
Suction Pumps are ready for life-
protecting service because of their
dependable, quiet operating pump,
precision regulating valve and gauge,
explosion-proof, heavy-duty motor
and sealed-in switch. Cabinet,

portable, and stand-mounted units.

Are your operating rooms prop-
erly equipped with Gomco? For
latest catalog, see your dealer
or write: GOMCO SURGICAL
MANUFACTURING CORP., 828
E. Ferry St., Buffalo, N.Y. 14211

THE CANADIAN NUKSE 21

Whenyourday

starts at

6 a.m... you're on
charge duty.,
you've skimped
onmeals...^^
and or] sleep...
you haven't had^
time to hem
a dress... ^
make an apple pie.,
wash your hair.,
evenpowder to
your nose
in comfort!^

il's time for a change. Irregular hours and meals on-lhe-
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 comfortable.

For detailed information consult Vademecum
or Compendium.

HOECHST

PHARIVIACEUTICALS

3400 JEAN TALON W . MONTREAL 301
blVISION OF CANADIAN HOECHST LIMITED

22 THE CANADIAN NURSE

Life Membership For Dr. Gladys Sharpe

The South African Nursing Association conferred honorary life membership
on Dr. Gladys J. Sharpe during her recent visit to the association in Pretoria,
South Africa. Dr. Sharpe (left) accepted her certificate from associate president
P.H. Harrison.

Outstanding contributions to the nursing profession by Dr. Sharpe have been
numerous through her long and active career. As a nurse educator, she was
well-known as the founder and first director of McMaster school of nursing.
She retired in 1969 as senior nursing consultant, Ontario Hospital Services
Commission. Dr. Sharpe is a past president of the Canadian Nurses' Association
and the Registered Nurses" Association of Ontario.

Mary V. Peever (dipl.. Royal Victoria
H., Montreal; dipl., public health and
B.N., U. of Manitoba; M.Sc.N., U. of
Colorado) was a teacher at the Mount
Royal College, Calgary. Janet C. Kerr
(B.Sc.N., U. of Toronto; M.S., U. of
Wisconsin) was director of inservice
education at the Washington General
Hospital, Fayetteville, Arkansa: Jac-
quelyn Peitchinis (Reg.N., Hamilton
General H., Ontario; cert, nursing
instructor and B.Sc.N., U. of Western
Ontario, London; M.Phil., U. of Lon-
don) is a part-time lecturer at the uni-
versity. She had been an associate
professor at the University of Western
Ontario.

Two appointments to the Toronto
Department of Health, although made
during the fall of last year, are of inter-
est to journal readers: Madeleine C.
Smillie, is the department's assistant
director, nursing division. Miss Smillie
graduated from the school of nursing.
University of Toronto in 1943 and
returned to complete her bachelor of
science in nursing degree in 1954. The
department has been her only em-
ployer.

Muriel H. Davidson is the new

director of health services. Miss David-
son obtained a certificate in public
health nursing from the University of
Toronto, and became staff nurse in the
department. She graduated in 1968
with a bachelor of science in nursing
degree.

S. June Agnew

(Reg. N., Peterbor-
ough Civic Hosp.,
Ont.; D.P.H.N. and
B.Sc.N.. U. of West-
ern Ont.; M.P.H.,
U. of Michigan) has
been appointed lec-
turer at the school of
nursing. Memorial

University of Newfoundland.

Miss Agnew had been a staff nurse

in the Peterborough, Ontario, health

unit.

Eileen Healey, assistant professor,
faculty of nursing. University of Western
Ontario, has been elected president of
the Ontario Region, Canadian Confer-
ence of University Schools of Nursing.
NOVEMBER 1970

Nov. 4-6, 1970 and Feb. 24-25, 1971

A continuing education course called Nurs-
ing Service Objectives is being sponsored
by the University of Toronto School of Nurs-
ing, For more information write to: Conti-
nuing Education Program for Nurses, Uni-
versity of Toronto School of Nursing, 47
Queen's Park Crescent, Toronto 5, Ontario,

November 9-13, 1970

Course in occupational health for profes-
sional registered nurses in industry, offered
by the department of environmental medici-
ne of New York University School of Medi-
cine, in cooperation with the American As-
sociation of Industrial Nurses. Limited to
nurses with five years or less experience
in occupational health Tuition: S175. Spe-
cial emphasis will be given to interviewing
and counseling For information and appli-
cations, write to the Office of the Recorder,
New York University Post-Graduate Medica>
School. 550 First Avenue New York N,

November 30-December 4

Conference for nurses in staff educatfcn
and staff development, Westbury Hotel,
ronto. Sponsored by the Registered Nursed
Association of Ontario Write to: Professio-
nal Development Department. RNAO. ,?3
Price Street, Toronto 5, Ontario,

November 30-December 11, 1970

First of two sessions in comprehensive
health planning concepts and skills, Uni-
versity of Cincinnati, Ohio. Information
from: Frank Heck, Public Information Offi-
cer, University of Cincinnati, Cincinnati,
Ohio, U.S.A.

February-June

Continuing nursing education, non-credit
courses, at the University of British Colum-
bia have been scheduled for the first six
months of next year. For further information
write: The University of British Columbia,
Health Science Centre, School of Nursing,
Vancouver, Britlsfi Columbia.

February 15, 1971

Six-week coronary course offered to nurses
currently working on coronary care units.
Enrollment is limited to six nurses, and
total sponsorship by present employee
is required. Registration fee is $75.

For further information write to the
Course Coordinator, Intensive Care Nurs-
ing H601, Winnipeg General Hospital,
700 William Avenue, Winnipeg 3, Man-
itoba.

NOVEMBER 1970

Feb. 15-19, 1971

Five-day course in occupational health
nursing for registered nurses who have
five or more years experience in occupa-
tional health nursing, and who work alone
or with one other nurse. For further infor-
mation write to: Continuing Education
Program for Nurses, University of Toronto,
47 Queens Park Crescent, Toronto 5,
Ontario.

February 16-18, 1971

A national conference on research in
nursing practice will be held in Ottawa.
For more details write to Dr. Floris E.
King, Associate professor and coordi-
nator of the graduate program. University

of British Columbia Sr.hnQ| nf Niiroirrg

*fch29-April2, 1971

third international congress of psycho-
somatic medicine in obstetrics and gynecol-
ogy will be held at the Bloomsbury Centre
Hotel, London, W.C.I. Scheduled conference
theme is "Womanhood and Parenthood. "
Write for information to: Kurt Fleishmann
and Associates, Chesham House, 136 Re-
gent Street, London, W.I,, England.

14, iwr

The 6th International Hospital Exhibition
(Interhospital 71), held every three years,
is to be held in Stuttgart, Germany. Exhibi-
tors and visitors to previous exhibitions
were world-wide. Information can be obtain-
ed from: R.F. Haussmann, 130 Willowdale
Avenue, Suite 3, Willowdale, Ontario.

May 19-21,1971

A nursing committee and the annual meet-
ing, Catholic Hospital Conference of Ontar-
io, will be held at the King Edward Hotel
in Toronto, Ontario. Information can be
obtained from: Sister Raymond Marie,
Secretary Treasurer, Catholic Hospital
Conference of Ontario, St. Mary's of the
Lake Hospital, 355 King Street West, Kings-
ton, Ontario.

May 26-29, 1971

Reunion of the Montreal General Hospital
School of Nursing graduates to celebrate
the hospital's 150th anniversary. Graduates
should send addresses to: Miss Phyllis
Walker, The Montreal General Hospital
(Dept. of nursing), Montreal 109, P.Q.

May 30, 31 and June 1, 1971

The three-day annual meeting of the Mani-
toba Association of Registered Nurses
will be held in Dauphin, Manitoba. '6'

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Sel-Fix NURSE CAP BAND

Black velvet band material Self-ad-
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or pinning. Reusable several times
Each band 20" long, pre-cut to pop-
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ings Red-lipped sweep second hand, chrome stjinlett
case Stainless eipansion band plus FREE black leather
strap 1 yr guarantee
No. 06-929 16.50 ea. ppd.

Uniform POCKET PALS

Protects against slams and wear Pliable white
plastic with gold stamped caduceus Tviro com
partments for pens, shears, etc Ideal token gifts
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THE CANADIAN NURSE 23

new products {

Descriptions are based on information
supplied by the manufacturer. No
endorsement is intended.

RADIAL HEAD

CARPAL LUNATF

TRAPEZIUM

ULNAR HEAD

Implants for Arthritic |oints

Dow Corning Silicones Medical Prod-
ucts Division has recently introduced
five new products designed to restore
normal function in joints affected by
arthritic conditions.

Radial Head Prosihesis: A pliable,
one-piece intrameduUary-stemmed

prosthesis designed to help restore
articulation following radial head
resection for rheumatoid, degenerative
or traumatic arthritis, and to prevent
migration of the radius on the ulna.

24 THE CANADIAN NURSE

Trapezium Prosthesis: Designed to
help restore function of thumbs dis-
abled by rheumatoid arthritis, degener-
ative arthritis or trauma, and to main-
tain motion at the base of the thumb
without loss of stability. Available in
five sizes.

Carpal Scaphoid Prosthesis: Designed
to preserve normal joint space relation-
ship and to restore articulation follow-
ing excision of the carpal scaphoid,
without loss of stability. Available in

three sizes for both right and left wrists.

Ulnar Head Prosthesis: Designed to
help restore function following ulnar
head resection and to help maintain
physiological length of the ulna, thus
preventing ulnar drift of the wrist when
too much bone is removed. Available
in three sizes.

Carpal Lunate Prosthesis: Designed
to preserve a normal joint space and
articulation following excision of the
carpal lunate.

Made of pliable Silastic brand
medical-grade silicone elastomer, these
implants are non-reactive to bone and
surrounding tissue. Permanent fixation
is not required. Radiopaqueness allows
x-ray evaluation.

For further information write to
Dow Corning Silicones. Medical Prod-
ucts. 1 Tippet Road, Downsview, Ont.

Teslac

Teslac (Squibb Testolactone), a chemo-
therapeutic agent in the palliative
management of advanced or disseminat-
ed mammary cancer, is now available
from E.R. Squibb & Sons, Inc. as tablets
for oral administration.

A lactone derivative of the andro-
genic hormone, testosterone, Teslac is
the first steroid for advanced breast
cancer that separates the wanted anti-
neoplastic action of testosterone from
that hormone's unwanted biological
activity of masculinization.

Teslac has been found to be effective
in approximately 15 percent of patients
treated, according to the following
criteria: those with a measurable de-
crease in size of all demonstrable tumor
masses; those in whom more than 50
percent of nonosseous lesions decreased
in size although all bone lesions remain-
ed static; and those in whom more
than 50 percent of total lesions im-
proved while the remainder were static.

As an oral dose, Teslac is a more
acceptable form of treatment by the
patient and the preferred administration
by the physician. It is significantly free
of uterotrophic, progrestional, gluco-
corticoid, gonadotrophiclike anti-
progestational, antiuterotrophic, anti-
estrogenic, or cholesterol-altering ac-
tivity.

Teslac is recommended in the pal-
liative treatment of advanced or dis-
seminated breast cancer in postmeno-
pausal women when normal therapy is
indicated. It may also be used in women
NOVEMBER 1970

who were diagnosed as having had
disseminated breast cancer when pre-
menopausal and in whom ovarian
function has been subsequently ter-
minated.

Further information may be obtained
from E.R. Squibb & Sons Limited.
2365 Cote de Liesse Road, Ville St.
Laurent, Montreal, Quebec.

Disposable Needles

Total destructibility and safe, easy
disposal are major features of all
hypodermic needles and syringes used
in the new Sterimedic system developed
by Sterilon Corporation. Rigid poly-
propylene sheaths, color coded to assist
in needle gauge identification, shield
the needle from damage before and
after use and protect hospital personnel
from accidental injury. The sheath is
also used, following injection, to snap
the needle at its mid-point and to break
the luer tip from the syringe to prohibit
reuse. The shipping carton doubles as
a disposal receptacle: used needles and
syringes are pushed through a sunburst
opening and the carton is taped shut.
These safety measures are designed to
reduce injury and infection within the
hospital and to prevent the reuse of
discarded syringes and needles by
drug addicts and other unauthorized
users.

The Sterilon Corporation's Canadian
outlets are situated in St. John's, Nfld.,
Quebec City, Montreal, Toronto, Lon-
don, Winnipeg, Calgary, and Van-
couver, B.C.

• Tomorrow she will get soap so she can wash her hair.
And everyone in her family will have soap, too.

• Within a month she will have a dress that is not torn.

• She and her family will get regular dental and medical
attention.

• Soon she and her brothers and sisters will have shoes to
wear to school.

• For the first time Rosalba will know what it's like to eat at
least one wholesome meal, what it's like to fall asleep without
gnawing hunger keeping her awake.

Most of all, she'll understand that someone somewhere
cares. Someone thoughtful and loving enough to give $17 a
month to Foster Parents Plan.

PLAN operates in Bolivia, Brazil, Colombia, Ecuador, Peru,
Indonesia, Korea, the Philippines, and South Viet Nam. PLAN
is a non-political, non-profit, non-sectarian, government-ap-
proved, independent relief organization. Financial statements
are filed with the Montreal Department of Social Welfare and
other similar bodies.

Approved by Department of Revenue, Ottawa

Foster Parents Plan of Canada
Plan de Parrainage du Canada

FOSTER PARENTS PLAN, Dept. CN 11-1-70
153 St. Clair Avenue West, Toronto 7, Ont. Can.

A.I wish to become a Foster Porenf of a needy child for one year. If potsi-

ble, sex age nationality

I will pay *17 a month for one year or more ($204 per year). Payments
will be made monthly D , quarterly □ , semiKinnoally □ . onnoolly Q .
I enclose herewith my first payment $

B. I cannot "adopt" a child, but I would like to help o child by
contributing $

Name

Address

City

Prov.

Dote Contributions Income Tax ^Deductible I

NOVEMBER 1970

THE CANADIAN NURSE 25

in a capsule

Time-study results surprise VON

"Clock-watching" is usually abhorred
by employees and supervisors (depend-
ing on who is doing the watching), but
a time-study carried out now and then
in any organized activity can turn up
some rather interesting information.
According to a recent issue of News
from National Office, a newsletter of
the Victorian Order of Nurses for
Canada, VON branches have used
time studies regularly as a means of
evaluating work patterns and improv-
ing service. Last year, the VON decided
to have the time study carried out
at approximately the same time in all
branches, and to have the results for-

warded to the national office in Ottawa.
From analysis of the overall statistics,
the Order hoped to develop a better
idea of what was reasonable or average
for the time spent in the VON's three
major activities: home visiting, office
work, and travel.

The result was surprising: on a
national average, only 55 percent of
the nurses' total time on duty was
actually spent in the home, even though,
as a visiting nurse organization, the
home is its prime focus for service.
Time spent in the office was 1 8 percent,
which appeared high, as administrative
and supervisory time was not included
in the statistics.

26 THE CANADIAN NURSE

There are pills and pills!

So British Columbia would like the
federal government to hand over an-
other $500 million!

Tis said the reason is — B.C.'s
population grows faster than anywhere
in the country.

George Bain, Toronto Globe and
Mail, advises the prime minister to
"... give him [Premier Bennett] a
giftwrapped case of birth-control pills,
and offer to undertake a joint federal-
provincial program to install cold show-
ers." Fine, George, but what about those
deserving gals in the rest of Canada?
Would they have to "makedo" if Brit-
ish Columbia had the lions share of
contraceptive goodies?

Living longer

The world's first patient to be fitted
with a new type of heart pacemaker
was discharged from London's National
Heart Hospital in July, eight days after
her operation. Powered by a nuclear
battery, the pacemaker was designed
to maintain the heartbeat of sufferers
from heartblock for at least 10 years
before an implant is needed. Power
source is a tiny quantity of plutonium
238 sealed in a capsule. (From British
Information Service. )

How much will they need?

Even though the tale of the Loch Ness
monster is "old hat," it provides end-
less copy for members of the fourth
estate.

Reuters, in the Scotsman, reported,
"An American bid to entice the Loch
Ness monster from its depths with 'sex
essences' is doomed to failure because
the old girl is past her prime."

The Scotsman says a scientific team
from the U.S. will try to lure the mon-
ster to the surface with sex essence
from eels, sea cows, sea lions, and other
creatures of the deep.

Sounds great! But what if Nessie
doesn't like the flavor of sex essences
from eels, sea cows, and sea lions?
What's the next medical step?

Midi or pantsuit?

Dramatic or traumatic! There's been
some mighty big changes in nurses'
uniforms over the years. And now
they're wearing pantsuits — and with
permission, thank you! Is the midi
contemplated? Or did it ever leave
the nursing scene? ^

NOVEMBER 197(

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-

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

(Selenium Sulfide Detergent Suspension il.T.P.)

A PRODUCT OF ABBOTT LABORATORIES, LIMITED

U.*P

•twe nevv text >^ P -^^g, Fo\ o ^^^k-
rlassrooni 3"" tbe autV^or resents tf ess,

cuss>ons caf^ the P^e' ^, exP^^.'" ^ .w^s-

^Pro9ra"«"^°N^atet•>a^

, ,„..u,Wco"«'rp""P-»°le„,,c...e

dU>or^s-6V A73pa9«|6p36.

the /^P*^^* a students

demonstra^ ,V>es. R^P .^.uat^ons, ' and

„, age ofO^^^ u\ustfate ^^^,09- '^. ' vuctor^

° Jv 9r°"Jeatw« P^°^ouT charge to "^foBOt,
encourage ^^^^^.^,ed;v>thout^^^^^G^S^^Q

Gu'-d^/VtU 9-f -pAULeTTE ^^V pages.

B.N., ^j! Oecen^ber.^^ About S6.^
B.^-^Il; AAU\ostrat>ons.

TORONTO 3^ ■

Preplacement health screening
by nurses in industry

In industry, too, the nurses' role is being expanded. At Bell Canada, the
occupational health nurses are responsible for carrying out preplacement health
assessments and for advising the employer whether prospective employees meet
the health requirements for the job.

Changing concepts in recent years about
preplacement assessments, and the
conviction of our medical director that
nurses in industry should be used ef-
fectively, have added new scope and a
challenging role for occupational nurses
at Bell Canada. Since 1*963, our nurses
have assessed the health of more than
55,000 applicants and accepted the
responsibility of advising management
as to whether prospective employees
meet the health requirements for the
job.

Background of program

Bell Canada provides telephone
service in the provinces of Ontario and
Quebec, and has approximately 40,000
employees — 55 percent females and
45 percent males. About 80 percent are
located in 9 major cities and have
available to them occupational health
services, staffed by 9 full-time and 16
part-time physicians, 45 full-time
nurses, and several full-time clerical
staff.

Another 17 percent of Bell's em-
ployees are located in smaller cities or
towns where district nursing services
are provided on a regular scheduled
basis. In these areas medical examiners
are appointed by the company to do
examinations on a fee-for-service basis.

At present 97 percent of the em-
ployees have access to company health
services; the remaining 3 percent are
NOVEMBER 1970

Lillian B. Munro

scattered throughout company territory
in small numbers, and are not provided
with company health services.

Throughout our health program the
overall emphasis is on prevention and
health maintenance. An assessment
of health is required for all new em-
ployees, one reason being to establish a
basis for future health follow-up. Over
the past 20 years this area of our pro-
gram has undergone many changes.

Prior to 1963, the nurse's role in the
preplacement examination was to
complete the health questionnaire with
the new employee and do the labora-
tory, vision and hearing testing: in each
instance the doctor was required to
examine the applicant, assign the final
health category, and complete the
report that goes to the employing
official.

Two main reasons, however, led to
the transition from the doctor-oriented
examination to the present screening
procedure, known as the Initial Health
Review (IHR), by health nurses.

First, available doctor-time in the
company is always limited, and there
is an ever-increasing need to assign

Miss Munro is Nursing Supervisor. Cen-
tral Area. Bell Canada. A graduate of The
Montreal General Hospital School of
Nursing, she has a diploma in teaching
and supervision in psychiatric nursing
from McGill University, Montreal.

more of this time to periodic health
examinations.

Second, detailed analysis of results
of the medical department program over
the years showed: (a) there is consis-
tently a low rejection rate of applicants
for medical reasons (-1%); and (b) al-
though a large number of health prob-
lems were identified, they were usually
picked up by the nurses while doing the
questionnaire or test procedures.

Nurses screen applicants

The IHR. a fully nurse-oriented
screening prtKcdure for female appli-
cants, was introduced throughout the
company in 1963. All nurses were
given additional training for the new
prtx;cdure and received adequate help
and support from the medical staff for
their new responsibilities. Meetings
were held with management, employing
officials, and union representatives to
inform them of the change in the
procedure and to gain their acceptance.

Over a tlve-year period, the results
of the new program for female appli-
cants were favorable. Certain factors
had to be considered, however, before
changing to a similar screening exam-
ination for men.

For example, there was some con-
cern as to whether company manage-
ment and the applicants would accept
nurses carrying out tne total procedure:
also, some supervisory personnel
THE CANADIAN NURSE 29

wondered about undue risks for the
company, and questioned whether a
nurse is capable of assessing backs and
knees of male applicants. This latter
concern is realistic, as many of our
male employees are required to climb
ladders and telephone poles.

However, for several years now, as
part of our preplacement examination,
company nurses have been trained to
observe carefully each applicant as he
or she carries out a set of exercises
specially designed to assess the range
of movement of all the important joints
in the body. (Fiiiiirc I ). These exercises
take approximately three minutes to
complete. When limitations of move-
ment or deviations from normal occur,
the nurse refers the applicant to a
company physician for further assess-
ment. This, of course, is standard
practice when the nurse detects any
problem beyond her scope.

Early in 1968, after minor revision
of the questionnaire and careful review
of all factors involved, a decision was
made to extend the use of the IHR by
nurses to include male applicants.

Our departmental statistics now show
that 95 percent of all male and female
applicants are given the complete IHR
by nurses. The remaining five percent
are required to see a company physician
for advice on some health problem (such
as hypertension, back conditions, history
of rheumatic fever, or history of psycho-
sis), which has been identified by the
nurse during the Review.

IHR Procedure

The Initial Health Review consists
of a health questionnaire, a series of
tests, the assignment of a medical
category, and the written recommenda-
tion to the hiring official.* As this
assessment forms the basis for the

EVALUATION OF MUSCULO-SKELETAL SYSTEM
MALE & FEMALE INITIAL HEALTH REVIEWS

1. Applicant stands facing examiner, forearms flexed on
arms, hands in supination.

2. Applicant spreads fingers apart and brings them to-
gether, closes fists, opens fists, apposes tips of thumbs
to little fingers, pronates, and again supinates.

3. Flex forearms acutely until fingers touch shoulders. Raise
elbows anteriorly as high as possible.

4. Abduct both arms in this position and rotate shoulders.

5. Applicant in erect position — nurse back of patient notes
any postural deformity, scoliosis, kyphosis, lordosis. If
noted, ask whether congenital, acquired, or due to
injury.

6. Raise hands straight up above head as high as possible.
Bend over touching ground — with knees straight.
Report distances — finger tips miss floor— if restricted.

7. Resume erect position.

8. Squat on heels and rise to original position.

9. Abduct first one leg and then the other.
10. Rotate the head from side to side.

If these exercises are gone through rapidly, they can be
accomplished in about three minutes, and every important
joint in the body will have been tested.

If any deviations from normal appear, consult a company
doctor or medical examiner.

Figure 7. Nurses at Bell Canada use these exercises during the Initial
Health Reviews to assess an applicant's musculoskeletal system.

30 THE CANADIAN NURSE

employee's medical file, the nurse
must obtain a complete and accurate
health history.

The questionnaire is intentionally a
departure from the traditiona' "Yes-
No" answers opposite a list of illnesses.
Instead, the questions are designed to
be used with other questions by the
nurse to obtain a concise, yet meaning-
ful, summary of the applicant's past and
present health history. All positive
history and findings are recorded, along
with any pertinent information on
family history, nutrition, exercise, use
of drugs, and smoking and drinking
habits.

Immunization history and dates are
also noted. The menstrual history of
each female applicant is carefully
reviewed, and data pertaining to the
cycle and date of last menstrual period
are recorded. Throughout the interview
the nurse has an excellent opportunity
at this initial stage to help guide the
applicant's thinking toward improving
present health habits or toward main-
taining good overall health practices.

All company nurses are trained to
check visual acuity and color vision by
means of an Ortho-Rater, and to do
hearing tests using audiometers. In
addition, they check and record the
applicant's height, weight, pulse, and
blood pressure; inspect his oral
hygiene, throat, scalp, ear canals, and
skin; and assess his musculoskeletal
system, using the exercises previously
mentioned.

The applicant's urine is checked for
albumin and sugar, and a hemoglobin
reading, determined. Each applicant is
required to have a chest x-ray.

Throughout the Review, the nurse
closely observes actions, mannerisms,
and responses so she can make a real-
istic assessment of the applicant's
emotional health. Our inservice program
for staff nurses provides considerable
training on the various aspects of men-
tal health — a valuable aid in the early
recognition and evaluation of common
emotional problems.

A summary of the positive findings
from the health history and test proce-
dures is recorded, and the results are
readily evaluated from the standards

'-'' Samples of the questionnaire used for the
Initial Health Review can be obtained by
writing to the author at Bell Canada. 161
Laurier Avenue West. Ottawa.

NOVEMBER 1970

I he tiiuhor. Lillian Munro. about to check an appln'aiir\ I'ur aiiuil.

for various job requirements as set up
by our medical department.

A follow-up date is noted according
to the findings, and a medical category
— A, B, C, or D — is assigned for con-
fidential use in the medical department.
Class A indicates that the applicant
meets all health requirements for the
job. Class B applicants are recommend-
ed for employment only in specified
jobs. These individuals may have non-
correctable conditions, such as mono-
cular vision, an artificial limb, or a
chronic condition, such as epilepsy or
diabetes. They are required to be
reviewed in the medical department
prior to a transfer to another job that
involves different physical qualifica-
tions.

Class C applicants are recommended
NOVEMBER 1970

for employment after correction of
specific health problems, such as severe
dental caries involving extractions, or
refractive conditions of the eye. Class
D applicants do not meet medical
standards for employment in any capa-
city in the company, and are not re-
commended for employment.

The final part of the IHR procedure
is the written recommendation to the
hiring official. When an explanatory
note is required on this form, care is
taken to keep confidential information
within the medical department. Only
general, constructive data are released
to the supervisor or hiring official.

The IHR procedure has proved to be
an interesting and challenging part of
our nursing program. All district
nurses and nurses in the main health
centers use identical equipment to carry
out the Review. District nurses work
out of large centers to a number of
smaller centers on a scheduled basis,
and bring the overall nursing program
to the employees in the various areas
of the company territory.

Rapport established

The initial rapport established be-
tween the nurse and the new employee
at the time of the IHR proves invaluable
for future contacts in following up
health problems and when doing health
counseling and periodic health evalua-
tions. Besides continuity in relationship,
a better understanding of the preventive
role of the medical department and its
objective is established early with the
employee.

Problems most commonly identified

All Bell Canada nurses are trained to ckeck

an applicant's oral hygiene and throat.

THE CANADIAN NURSE 31

As pan of the health review, a nurse observes each applicant as he performs exercises to evaluate his nuisculo-skeletal sysleiii.

during the IHR are dental caries, re-
fractive errors, obesity, and dysmen-
orrhea. Our experience shows that most
new employees make a real effort to
try to correct their individual health
problems within the time specified for
the follow-up visit. In many instances,
however, further follow-up may be
required over a number of months.

Since the change-over to a nurse-
oriented procedure, our industry has
realized a substantial economic advan-
tage. In a five-year period, the expense
of pre-employment health assessments
has been reduced by one-third. This is
equivalent to $150,000 in company
savings. Further statistics show that in
addition to the financial saving, some
1 ,500 hours of doctor time per year are
now released for other areas of our
program that specifically require the
skills of well-qualified physicians.

It is recognized that minimal risks
may be involved, as each new employee
does not receive a complete medical
examination. We also realize that the
IHR procedure might not be acceptable
to every industry. However, our medi-
cal director, who gives us full support,
is convinced of the value of the program
and is able to reassure management
personnel that the present type of
assessment being carried out by well-
trained nurses gives an adequate, over-
32 THE CANADIAN NURSE

all health evaluation, and is presently
meeting the needs in our company
better than ever before.

Summary

Occupational health nurses can
effectively carry out comprehensive
preplacement screening evaluation,
provided they have added training,
keen interest, and the full support of a
continuing program of health super-
vision.

Initial Health Reviews by nurses at
Bell Canada have been carried out on
all female applicants since 1963, and
on all male applicants since 1968.
Ninety-five percent of all applicants are
evaluated totally by nurses and con-
sidered for employment on their recom-
mendations; the remaining five per-
cent are referred to company physicians
about findings indentified by the nurse
during the Review.

The IHR procedure adds varied
content to the overall nursing program,
and staff nurses derive greater work
satisfaction with the assurance they are
making good use of their nursing capa-
bilities.

The early relationship established
between the nurse and the applicant at
the time of the Review promotes better
opportunity for follow-up on health
problems, and better understanding on

the part of the new employee regarding
the preventive role of the medical
department.

Occupational nurses will continue
to experience a challenging role as long
as they are encouraged and permitted to
utilize fully their nursing skills.

Bibliography

Bcws. DC. and Baillie. J.H. Preplace-
ment Health screening by nurses. Amer.
J. Public Health 59; 1 2;2 1 78-2 1 84. Dec.
1969. ■&

NOVEMBER 1970

Continuing to care
— even in the air

Continuing to care is a special medication prescribed by nursing personnel.
Canada's armed forces demonstrates its own brand of nursing care in this report
of a medical air evacuation. Heightened by a strong sense of esprit de corps,
nursing personnel, air and ground crews, work as a synchronized team
throughout each flight, returning patients and dependents to Canada.

The big bird flew low. touched ground,
and moved along the flight path. Under
neon-lit skies ground crews, ambu-
lances, and a fire truck — waited.
Another medical air evacuation had
crossed the Atlantic, and eight patients
showed relief.

It all seemed simple as the cargo
door to "old faithful" slid open. With
synchronized precision. 437 Transport
Squadron. Canadian Armed Forces,
moved to the next step — unloading
patients and gear from the Yukon.

Simple, yes, because medical per-
sonnel, aircrew, and ground staff had
worked "airevacs" many times. Simple,
also, because they worked as a team.

I'd heard of an aire vac long before
I was invited to cover an "op," and had
taken for granted patients crossing the
Atlantic on regular bi-weekly runs
from the armed forces base at Lahr,
West Germany. But I was not aware of
the vast communication system, trained
personnel, and knowhow required to
NOVEMBER 1970

Mona C. Ricks

transport a patient from base A in Eu-
rope to destination Z in Canada.

Nor was I aware of the extensive
training undergone by the nursing
personnel.

My trip revealed all this!

On the way

We left Canadian Armed Forces
Base, Trenton, on a regular service
passenger flight, Boeing 707, Sunday,
August 16, enroute to pick up eight
patients.

We. meaning two armed forces
nursing sisters, a medical assistant, an
administration clerk, a photographer,
and myself, plus a full passager list of
armed forces personnel and dependents.

Destination'.'

Lahr, West Germany — seven hours
away!

Mona Ricks is assistant editor. The Cana-
clian Nurse. Ottawa. Ontario.

procedures mandatory for all airevacs:
nature of patient illness, medical
facilities required, and typeof aircraft —
but no indication of the intricate paper-
work already completed to facilitate
safe and easy delivery of the patients.

Moving my watch forward five hours
meant a short night's rest. No time to
think of baggy eyes. The first leg of the
airevac had started minutes before we
landed in Lahr.

Two hours later I was back on the
flight path with photographer. Warrant
Officer Bill Cardiff, waiting for a
Hercules to deliver seven patients from
Dusseldorf. It was Monday afternoon.

Pictures of frontline hospitals and
films dcKumenting war carnage have
become a regular sight on television.
But, as an armchair spectator, there's
no involvement!

I realized this watching the first litter
patient leave the Hercules — plastic
I V bottle held aloft bv a watchful flight

nurse.

THE CANADIAN NURSE 33

In the air they care

A. Preparing to load patients into the Yukon aircraft. The hoist
acts as a conveyor belt, lifting litter patients through the cargo
door. B. Unloading at Trenton, Canadian Forces Bases, enroute to
final destination. C. Teamwork is vital for a successful airevac.
This includes the aircrew. Capt. John Sled commanded the flight
described in this story. D.The flight nurse's constant companion
— a tlying pharmacy. Used frequently, it contains a variety of
medication and nursing necessities. E. Correct loading and unloading
of patients is watched by the flight nurse. F. Turbulence sends
the nursing team to litter patients, and belts are fastened for
the patients' safety. G.French-speaking nurses are in demand
for rescue flights of skiers in France. Capt. (N/S) Gertrude Dorais
was flight nurse on the trip from Dusseldorf. H. Checking litter
placement in the aircraft before takeoff.

Three litter patients and four mobile
patients entered waiting ambulances.
Warrant Officer Cardiff's camera
clicked. I watched. We had become
part of the airevac team.

Part of the team

In the nearby Canadian Forces
Europe, medical center, the staff took
over. Usually airevac patients are
brought to the Lahr medical center at
least one day before the ongoing flight
to Canada. Enough time to assess
patient medical and personal needs,
and to determine if able to travel on a
12-hour flight.

While this was happening, I met the
hospital commanding officer. Colonel
Ross Irwin is also Surgeon, Canadian
Forces Europe.

I wanted to know the how and n7;v
of a medical air evacuation, especially
the nursing involvement.

Questions and answers

Colonel Irwin's answers to my ques-
ti is told me.

(?.What is the responsibility of the
Canadian Armed Forces Europe in
an airevac?

A.Tq coordinate all requirements
involved in transporting patients and
dependents to Canada. This entails
collecting patients by road or air from
all parts of Europe, including Eng-
land, also Cyprus.

2- How does a request for help come?

A. By telephone or wire message, usu-
ally from embassies. The message,
in code, tells the patient's condition,
where to be evacuated from and
destination, whether service person-
nel or civilian, and if dependents are
to travel with the patient. Lahr
medical center assesses the require-
ments and double checks: is the
patient postoperative? are there
complications which might preclude
travel by air? The information is
recorded and sent onto Canada. The
message traffic on each patient is
considerable. A format is followed,
cutting time to a minimum, but still
every piece of information on the
patient is requested before transport-
ing, to ensure safe delivery and
correct medication on the way.

(2- How long does it take to set up an
an airevac for one litter patient?

/I. Quickly — within 24 hours notice
our nursing staff in Lahr can pick

36 THE CANADIAN NURSE

up a patient as far away as England
and meet a flight onto Canada the
next day. We never have problems
servicing emergency flights; these
patients are usually kept in the Lahr
medical center.

^.What is the procedure for accepting
patients at Lahr before going onto
Canada?

A. The Lahr service doctors check pa-
tient documents, perhaps reexamine
the patient to ensure if able to travel
on. Medication is checked and as-
sembled for each patient, sufficient
for the flight. A list of 26 items is
checked for every patient. Such
things as: international vaccination
certificate (is it updated? if not, the
center gets this done); has the patient
Canadian funds? if not, deutsche
marks are changed; custom clearance
arranged; family notified; traveling
dependents made comfortable.

Q.Do you use a doctor on airevacs?

A. On each leg of the airevac medical
personnel decide if a doctor is neces-
sary. Otherwise a flight nurse and a
medical assistant carry patient care
responsibility.

^. If a doctor is not on board, who is

in charge of medical personnel?
/(.Senior flight nurse.

Q.The nurse, then, takes on the doctor's

role?
/(.That is correct.

5. Would you describe the senior
nursing role? You say she is working
as a doctor — what is expected of
her?

/I. We expect her to care for a patient
as she would were she in a hospital
ward. Occasionally she has to do
things she would not be expected
to do on a ward. She must meet
emergencies as they arise. If we can
predict a situation will occur, then a
doctor is detailed for the flight. How-
ever, the flight nurse has considerable
responsibility on the 12-hour trip
across the Atlantic.

2. Would you say the nurse today is no
longer a bedpan carrier? That she
has taken on wider medical respon-
sibilities?

/I. Yes, this is certainly true. I think
there is a considerable amount of
medical responsibility on the aire-
vacs. Our service nurses readily

volunteer to go on the flights, often
at considerable inconvenience to
themselves. All have taken the
medical air evacuation course in
Trenton.

A well-used hospital

It seemed we'd talked for hours.
Colonel Irwin's explanation had in fact
taken one hour. There was time to look
over the medical center before dinner.

Familiar faces in wards off a wide
corridor reminded me of the airevac
from Dusseldorf. The seven patients
rested.

To describe the center as modern
would be like glamorizing a comfort-
able, but well used hotel. The slate grey,
one-level building is "functional," and
provides all the conveniences needed
to handle mostly transit patients en-
route to Canada. Seventy-five beds in
bright, immaculate wards, staffed by
highly trained workers, a well equipped
kitchen, and administration offices are
fitted into a small area.

The center is furnished to care for
most emergency cases, and has a mater-
nity unit. Neuro- and vascular surgery
is usually done at the United States
forces base in nearby Landstuhl.

You couldn't come away after peering
into wards and administration offices
without visiting the library. Canada's
armed forces medical personnel in Lahr
are avid readers — the up-to-date
library included The Canadian Nurse.

I thought I'd ferreted out most in-
formation on the medical center and
airevac personnel by this time — but
I'd forgotten the B and B reporti The
hospital staff in Lahr is bilingual, even
trilingual. French speaking flight
nurses work the airevacs. They are
particularly needed for rescue flights
evacuating injured skiers in France.
Captain (N/S) Gertrude Dorais, a
French Canadian, was flight nurse on
the Dusseldorf airevac. She told me how
pleased she was to work in Europe —
even though her parents in Ouebec had
shown concern for her "soul."

Briefing time

Tuesday, August 18, 10:30 a.m.
We're back at the medical center. It's
briefing time. Airevac personnel meet
the first ward nurse, an RN. She holds
a pile of tags (base evacuation tags). I'm
told these are vital papers and carry
information on each patient from point
of pickup to final destination.

Captain (N/S) Marj Whinfield,

senior flight nurse on the airevac, is

NOVEMBER 1970

AEROMEDICAL EVACUATION COURSE YUKON LOAD PLAN

A
B
C
D

E

LITTER PLACEMENT OF CONTAGIOUS PATIENTS

LITTER PLACEMENT OF PATIENTS WITH LEG AND BACK INJURY

WORK TABLE AND SEATS FOR NURSING PERSONNEL

PASSENGER SEATS

OXYGEN TANK

briefed on patient diagnosis, treatment
on tlight. and foreseen problems. She
meets each patient, describes flight
preparations, discusses personal prob-
lems, and answers questions.

For those going on by air from
Trenton, Captain Whinfield assures
each patient he will be made comfort-
able at the base hospital overnight, and
so will traveling dependents.

And now the airevac medical team
get together. They've seen the patients,
know their ailments and prescribed
flight treatment — how they are to be
placed on the aircraft is the next deci-
sion.

Corporal William Gunn, medical
assistant, and Captain Whinfield plan
configuration of the aircraft (load plan).
Seven patients are listed as litter cases,
three of these designated infectious and
must be separated from other patients
and traveling dependents, three have
leg injuries, and one a spinal injury.
The eighth patient, a psychiatric case,
is mobile.

Placement of gear, oxygen tank,
bedding, medical supplies, seating, and
luggage must also be planned. Easy
access to patients for treatment and
traveling comfort is the prime concern.

Oxygen, important to the patients
with tuberculosis, must be placed near
them ready for emergency. Flying at a
high altitude, even though the cabin is
pressurized, the oxygen content of the
air is still less than at sea level: turbu-
lence could mean an oxygen need.

Configuration is an important part
of the medical assistant's duties. 1 asked
Corporal Gunn to explain configuration
of a patient with a broken right leg.
Where would he be placed in the air-
craft?

Limb care is the deciding factor. If
there is a double-tier of litters (two
tiers side by side), and if the nurse is
average height, the patient would be
placed with his injured leg toward the
outside of the litter, on a middle or
lower berth.

Fortunately, both Captain Whinfield
and Corporal Gunn are tall and can
tend to patients in higher berths.

Because we were carrying infectious
cases, arrangements for decontamina-
tion of the aircraft in Trenton had to be
made before we left Lahr.

On this trip the flight nurse was in
charge. To me this meant she was acting
on a medical doctor's level.

I asked Captain Whinfield if this

were so. Her modist answer is typical

of the ego restraint I have become

THE CANADIAN NURSE 37

accustomed to in the nursing profession.

"True to a certain extent. However,
there are certain things a nurse cannot
fill in tor a medical officer — that's for
sure!""

"'But, supposing there was an emer-
gency enroute'.'" I asked.

"We would deal with it to the best
of our ability. We are trained to act
with precaution."

"You, as an RN in charge of an
airevac. work as a doctor then?"

"Well, yes. I suppose you could say
that."

Captain Whinfield was insistent on
one nursing practice necessary for every
airevac — teamwork. She stressed
the importance ofthe medical assistant's
role (always a male), which compares
with a civilian registered nursing assis-
tant.
The airevac is on!

It was airevac day! Wednesday,
August 19. Takeoff time 1028 hours
Trenton time, 1528 hours Lahr time.

Custom officials cleared us at the
medical center, medication on the
airevac tags was completed and signed
by the duty doctor, ambulances waited.
The Yukon, its huge belly fitted as a
flying hospital, also waited.

Captain (N/S) Marg Antwis, detailed
to accompany me, and I board the air-
craft. Patients, placed in positions al-
ready planned in the configuration, are
strapped into litters, dependents' seat
Jjelts checked, luggage and gear strapped
to the floor, and Captain John Sled,
aircraft commander, signals "closeup."

We are airborne! But only after a
long, slow takeoff. Restrictions on
acceleration and deceleration are strin-
gent. Again, for the safety and comfort
of patients.

A passenger bulletin gave flight
speed as 365 miles an hour, altitude
20,000 feet — the beginning of a
3,920-miie journey.

Now began the test of the nursing
team in flight. Litter patients required
constant attention. Turbulence could
mean oxygen for anyone. Almost always
a paper bag was at the ready. Individual
medications must be carefully timed
and recorded on the evactags.

Captain Whinfield works on GMT
when timing medication. For her this is
the only way to be sure treatment is on
time during Atlantic time changes.

Two hours later, and all is quiet.
Patients and passengers sleep.

A rough air spot and the nursing
team straps patients to litters again, and
mobile passengers to seats.
38 THE CANADIAN NURSE

One question asked by a patient is
answered soon after we are airborne.
Litter patients are given individual
privacy. Curtains separate each litter
tier, and continue round the patient if
treatment calls for constant privacy, or
left open if the nurse orders.

Inventive skill must be part of
the airomedical evacuation course.
Throughout the flight t!ie nursing
team, backed by loadmaster Corporal
Aubrey Delong. improvised. Gear
boxes made fine table tops, and the
flight nurse's kit made a handy tray rest,
a patient seat for changing bandages,
or a footrest. Fitted with trays, the black
box is a flying pharmacy. Emergency
drugs, adrenalin, coramine, and ergo-
metrine are carried. Aspirin, codeine,
gravol, bandages, dressings, and sterile
instruments, thermometers, torch, tour-
niquet, safery pins, syringes, tracheoto-
my tubes — and other medical needs
are always ready.

The kit was used frequently.

We arrive in Canada

It is 2210 hours. The Yukon has
landed at Trenton. Patients are ready
for unloading. Bedding, medical sup-
plies, and gear are packed. The cargo
door swings open. Ambulances stationed
off the flight path move to the loading
ramp, armed forces personnel board —
one, two, three litter patients are carried
to an ambulance. Three patients, listed
as infectious, are unloaded after all
others, masks across mouth and nose.

The Yukon's belly is emptied; pa-
tients are in Trenton base hospital,
admitted and assessed by a forces doc-
tor; traveling dependents are cared for;
gear unloaded, aircrew debriefed. The
nursing team also heads for the hospital.
They check patients before turning in
for the night.

All so simple — but the airevac is
not completed.

Some patients are to travel on the
next day. Another aircraft must be
configurated, another nursing team and
aircrew briefed. In Lahr, more patients
are being collected for the next airevac
— and in Trenton preparation for the
fall aeromedical evacuation course is
underway.

Thursday, August 20. I wake to
marching feet and drum rolls. I am still
at Trenton. There is more airevac
information to come.

Communication! Who takes care of
the paperwork? What training do flight
nursing personnel take?

Colonel J.R.W. Wynne, Command
Surgeon, Aeromedical Evacuation
Control Centre, Trenton, answered
question one.

Messages received from Lahr medi-
cal center, are relayed to the Trenton
control center. Arrangements for air-
craft and the base designated to supply
a medical team are determined and
coordinated by the center — a year-
round administrative concern.

Question two is the responsibility
of Captain Antwis, chief flight nurse
instructor of the aeromedical evacuation
course.

Captain Antwis received her nursing
education in England and is a registered
nurse in Newfoundland. She described
the 18 working-day course as rugged,
covering six main training units: air-
manship, administration and dcx;u-
mentation, unloading and loading
patients (configuration), equipment,
nursing (enroute care and treatment),
and flight training. The first five units
are covered during 1 5 days of ground
school training, the sixth, practical
training, during three days flying.

Only armed forces personnel can
request the course or be selected.
Nurses must be registered in Canada,
and medical assistants must be in an
advanced stage of trade progression.

In operation since 1963, the school
runs six or seven courses each year.
During seven years, 240 flight nurses
and 320 medical assistants have been
trained.

The first course was set up and
conducted by Squadron Leader Ella
Mannix.

Now late Thursday afternoon, surely
all questions are answered. No, one
more! What is the basic cost of an
airevac (aircraft, crew, and fuel) from
Lahr to Trenton? I'm told approxi-
mately $7,200 for a 12-hour flight.

It's five days since I left for West
Germany. I'm heading back to Ottawa,
leaving behind nurses, doctors, and
other armed forces personnel to plan
anil carry out another airevac. ■§■

NOVEMBER 1970

Are we really meeting
our patients' needs?

The author criticizes the present organization of nursing services, and suggests
some ways to upgrade nursing care. Nurses should stop thinking in terms of
illness, she says, and think more of people, patients, and health.

Nicole Du Mouchel, R.N., M.N.

Our patient is a complex human being,
accustomed to living in highly-organized
social groups. Each group he belongs
to in the community is organized to
meet its members" needs to the fullest
extent possible. To this end. the group
has its own language and its own char-
acteristic functions. Within this secon-
dary group of an ethnic society, our
patient has been influenced by several
other secondary and primary groups
and his socialization affected by a set
of circumstances and by his personal
experiences.

Man lives all his life in various
groups, both inside and outside his
family, at work, in his neighborhood,
and in his recreational and religious
activities. Life in the group is important
to him, and his behavior is influenced
by the different groups to which he
belongs. Koos explains. '•Social inter-
action can be thought of as a continuum
ranging from one extreme to another.
At one end of this continuum is com-
plete adjustment; at the other end is
outright conflict. Man is always at one
point OT the other on this continuum
as he interacts with others. ""'

The author is Consultant. Canadian Coun-
cil on Hospital Accreditation. She present-
ed this paper last April at a seminar for
nursing directors of Canada, sponsored
by the Department of National Health
and Welfare, Ottawa.

NOVEMBER 1970

Man also has to earn his living, and
his work has a great influence on the
way he adapts to the various circum-
stances of life.

The patient and his fears

The patient who comes to us arrives
at the hospital at a certain level of
maturity and at a certain point on the
social interaction continuum; he is
also strongly influenced by his knowl-
edge, beliefs, and prejudices. He is a
person who cannot resolve his health
problems and who is asking our assist-
ance to restore him to a state of equi-
librium.

The balance has been destroyed and
our patient is worried: he is afraid of
pain, and of leaving our hospital as
something less then when he came in.
He does not wish to be among us. He
wants to be with his family, to work,
and to go about his normal daily activ-
ities. A few days ago he made plans
for the future; today, he finds himself
in an unknown world, a world to which
he attempts to adapt himself. He is
afraid of losing his identity, of not
being treated as a father, an industri-
alist, or a farmer, but rather as an inter-
esting case of jaundice, a strange clini-
cal development, or a troublesome
kidney.

The nurse is ca^ed on to help all

kinds of people; the unconscious pa-

THE CANADIAN NURSE 39

tient admitted to the intensive care unit;
the young mother having her first baby:
the child hospitalized as a result of an
accident or who is suffering from dia-
betes: the mother suffering fron. a
terminal disease: the businessman,
accustomed to the activity involved
in directing his company, who has to
remain at complete rest: the ageci per-
son, overcome by feelings of useless-
ness, who is waiting to be placed in a
home: the patient with a physical hand-
icap who requires rehabilitation. All
these people need our help to restore
them to balanced health, and our task
is often difficult.

Psychiatry, medicine, surgery, car-
diology, pediatrics — each specialty
involves specific patient nejds to be
met in different ways, according to the
disease in question. There are as many
individual reactions to illness as there
are persons in any given uepartment.

Certain health units specialize in
a particular type of patient care. Others
cover all or several medical specialties.
The more specialties there are in a
given center, the more complicated it
becomes to organize our nursing care
in terms of the individual patient.
Whatever the situation, all nursing
directors must undertake a serious
study of the patients under their care
to ascertain their needs and establish
policies geared to them as members of
family groups in the community.

Individual human needs

As hospital services should be organ-
ized in terms of patient needs, a review
of the theories on fundamental human
needs seems appropriate.

Satisfied needs, whether conscious
or not, enable man to fulfil himself.
Fundamental needs are hierarchical.
As one category of needs is satisfied,
there is an evolution to a higher level
and a new need arises. ^

The first human needs requiring
satisfaction are the physiological needs,
such as the need to breathe, eat, drink,
and sleep. A patient who is unconscious
or critically ill will want these needs
satisfied before thinking what he will
do if he remains ill for a long time.
Only when the critical stage has passed
will the psychological needs emerge.
40 THE CANADIAN NURSE

The efforts of the nurse at this stage
will therefore be concentrated mainly
on the satisfaction of physiological
needs, although she must always remain
on the lookout for the first signs of
unsatisfied higher needs.

However, we have specified that our
patient lives in society and is a member
of a family, which will also have acute
fundamental needs to satisfy during
this period of the patient's hospitaliza-
tion. The nursing staff has to be able
to identify these needs, because they
will be on a different level from those
of the patient hospitalized in the inten-
sive care unit, when physiological needs
predominate until they are satisfied
and channel all the body's resources as
efficiently as possible to that end.

The need for security, predominant
in the sick person, is well illustrated in
the behavior of children. In the pam-
phlet. Who Am I? I Am Your Patienl....
published by the Ontario Hospital
Association, this need for security is
explained in these terms: "1 appear
normal but I have left my equilibrium
at your door. Although 1 am mature,
I have suddenly become a child who
is afraid of the long black nights.""

Maslow describes certain behavioral
patterns which may indicate that this
need for security is unsatisfied: ". . . an
individual may attempt to maintain his
security by adopting an overbearing
and superior attitude. He would not
have taken this attitude unless he felt
rejected and disliked. However, this
very attitude makes people dislike him
even more, which in turn reinforces in
him the necessity for this overbearing
attitude."" ^

If the physiological needs and the
need for security are sufficiently satis-
fied, the needs for affection and a sense
of belonging will emerge. The patient
may feel isolated, may miss his friends,
his wife, and his children. He will hun-
ger for close relations with other peo-
ple, especially to affirm his place in the
group, and he will expend intense ef-
forts attempting to satisfy this need.

Following very closely on the need
to belong, comes the need to love and
respect oneself. Maslow explains that
everyone in our society has a need or
desire to hold both himself and others

in high esteem.'* There are two aspects
of this need; first, the desire to be
strong, to succeed, to be equal to the
situation, to have confidence in society,
and to possess independence and liber-
ty; second, the desire to protect ones
reputation, to attain prestige, and to
have status. The satisfaction of self-
love leads to feelings of confidence in
oneself, and gives one the impression
of being useful and necessary to society.
However, neglect of these needs pro-
duces feelings of inferiority, weakness
and inadequacy.

The need to belong to a group, which
is strong in the adolescent, is further
amplified, if. as a result of a chronic
ailment such as diabetes, the adolescent
fears he will no longer be able to remain
with his group. The need for self-love
will be threatened in a person disfigured
by an accident or who has undergone
surgery, such as mastectomy, amputa-
tion, colostomy, which has made him
in some way incomplete.

And what about the need for self-
esteem in the aged person, who has lost
his sense of usefulness and who feels
himself rejected by the family group?
If we reduce our care because his is not
an interesting case; if we do everything
for him because he is too slow; if we
make him feel, through our system,
that there is no place for him in our
health center, giving him — a person
who has always worked and been active
— nothing at all to do, then we are
doing all we can to prevent his need
for self-esteem from being satisfied.

When there is a lengthy period of
convalescence, there is a strong chance
that once the condition of the patient
has improved he may fall prey to feel-
ings of discontent and restlessness
because he cannot resume his customary
activities. This is particularly apparent
in the case of a physically-handicapped
person who has to undergo a long period
of rehabilitation and be retrained for
another type of work and a different
way of life. Does our hospital system
enable us to help this patient satisfy his
need for self-fulfillment by adapting
our routines to prepare him for his
return to his family and his community'.'

The more information the public has

about health problems and hospital

NOVEMBER 1970

life through the media, the more it needs
to know and understand. This is a need
that raises many problems for the nurs-
ing staff. The patient needs to know
that postoperative depression is a nor-
mal state; he needs to know that he can
care for himself when his condition
improves. He needs to understand our
work methods and know his nurse; and,
he needs to be taught how to continue
his own care when he returns home.
The new mother must be trained in the
care her child requires, and the business
man must learn and understand that he
must lead a more balanced life.

Verbal indications of certain needs
may often be signs of other unconscious
and unspoken needs. The patient who
tells us his coffee is cold, is perhaps
trying to inform us that hot coffee
symbolizes the security of home, where-
as cold coffee signifies a strange envi-
ronment. He may complain about the
indifference of the nursing staff; per-
haps he is trying to tell us that he feels
lonely and neglected. Has the nurse
been trained to identify, through the
various spoken or unspoken communi-
cations of the patient, the deeper funda-
mental needs? Does she have the time
for this? Are our methods of assigning
staff designed with the patient in mind,
or do they merely serve traditional
routine?

This subject is certainly not new.
We have heard it time and again. But
how often do we think of the patients
and their needs when we establish our
policies and when we experiment with
new work methods in our nursing
services?

Present situation of nursing services

Does the care given m our health
centers really meet the needs of the
patient? Let us take an honest look at
the present situation.

Maslow gives the conditions required
for the satisfaction of needs: "Such
conditionsare freedom tospeak, freedom
to do what one wishes as long as no harm
is done to others, freedom to express
oneself, freedom to investigate and
seek information, freedom to defend
oneself, justice, fairness, honesty, order-
liness in the group . . .These conditions
are defended because without them the
NOVEMBER 1970

basic satisfactions are quite impossible,
or least severely endangered." 5

Do we give thought to the needs of
our patients when drawing up policies
to govern our nursing services, or do we
think more of having beautiful writings
to impress our visitors? It is easy to
evaluate the policies and practices
simply by looking at what goes on in
each unit, by stopping and speaking to
the staff, by listening to them and
assessing their attitudes and their ap-
proach to the patient. It is easy to see
whether the established policies are
constantly being renewed and really
implemented, or whether they are
merely on paper for display.

When a director studies the distribu-
tion of her personnel, does she consider
the general needs of the patients in each
clinical specialty, or is she simply
concerned with filling positions that
have been determined by tradition,
without analyzing each situation and
seeking the best distribution for each
unit? When the time comes for the
annual budget and staffing assessment,
is the director concerned with meeting
the needs of administrators, doctors,
unions, and financiers, instead of basing
her decisions on a serious and docu-
mented analysis of the various needs
of the patients?

Do we meet the needs of the patient
when we blindly accept ready-made
solutions dictated by tradition and
unproven by scientific research? Cer-
tainly it is easier to accept unquestion-
ingly the policy that four or five hours
of care in medicine or surgery is requir-
ed, together with a certain proportion
of professional staff, than to undertake
experiments to advance the profession.

Do we meet the needs of the patient
when we establish the same rigid poli-
cies for all the units without exception?
Do we sacrifice the patient's need to
efficiency? Abdellah states correctly
that unless each practice and policy
can be measured in terms of the pa-
tient's needs, there can be no justifica-
tion in perpetuating them.^

Can we really be concerned about-
the patient's needs when we are igno-
rant of research in nursing care or,
what is worse, when we do not collabo-
rate in research studies initiated in

other health fields to improve patient
care? Is it traditionalism or lack of
initiative and preparation that slows
down the efforts of nursing personnel
studying the improvement of patient
care? In certain health centers, the
nurses not only dislike the studies un-
dertaken in health fields, but even
condemn or oppose them.

How can we meet the needs of our
patients if senior staff members never
visit them? In many health centers, the
management of the nursing services is
too far removed from the patient and
from the activities of the hospital. There
are still some directors who have never
seen their hospital in operation in the
evening or at night!

When you read the minutes of the
various nursing service committees,
you soon realize that the nursing staff,
is preoccupied with the needs of all
the other services in the hospital, but
very little with nursing itself. The pa-
tient is almost never referred to, nor is
there any mention of nursing methods
and practice and their evaluation. There
is talk of equipment, interdepartmental
relations, dripping taps, lights, labora-
tories, leaves and wages, but never of
the patient — the justification for our
existence in the health field.

Evaluation of nursing services

The patient's pnysiological needs
ought to be the easiest to satisfy, but
look what happens. The patient needs
sleep, yet, we bring him his breakfast
early in the morning, meeting a need he
does not have. Also he must feel this
need for food at the proper hours,
otherwise he will have to wait for the
next meal to satisfy his hunger. The
patient needs to breathe, yet we never
think of opening a window in the eve-
ning.

Do we meet the patient's need for
security when we neglect to prepare
him for discharge? How can the patient
feel secure if he has to leave the hospital
abruptly, where everything has been
done for him, and get along by himself
at home. The nurse has the best oppor-
tunities to give such instruction while
she is carrying out the daily care of the
patient. How often«ioes she profit by
this opportunity? Too often she is so
THE CANADIAN NURSE 41

preoccupied by the task to be accom-
plished, that she forgets to start instruct-
ing the patient.

Of course there is the form request-
ing visits by a nurse, but since every-
thing is decided at the last minute, full
information is not given to the visiting
nurses. This means they have to start
from scratch to obtain the details they
require. How can the patient feel secure
when he suddenly learns he is being
sent to a extended care center, and
when, in addition, the hospital has not
contacted the nurse in this center to
give her information about him? When
are we going to have a system for con-
veying nursing care information to the
various health services?

At some point during his hospitali-
zation, the patient may feel the need for
social contact, for communication with
other people. Are these needs met? No.
We continue to leave him in his room,
—we do not make it possible for him to
have his meal with other patients in
the day-room. If he has to be hospital-
ized for a long period and requires
help in adapting to life in society, do
we ever think of putting him in contact
with people in the community, or of
taking him to the cafeteria or the gift
shop'

Returning to the elderly patient we
considered earlier, let us remember he
may have been in the habit of going to
bed at 7:00 p.m. and getting up at 5:00
A.M. He must now adapt to our routine
and go to bed at 9:00 or 10:00 p.m. and
sleep until 6:00 a.m. His need for sleep
has diminished with age, and at 4:00
AM he is up and strolling around the
ward. In so doing, he disturbs our
beloved routine and is classified as
a ""difficult case." To reestablish order,
he is given a sleeping pill; in the morn-
ing he is confused, which does nothing
to help him achieve the status of "'model
patient." Has anyone ever considered
that, without disturbing the whole ward,
he could be made happy by being allow-
ed to smoke his pipe, chat, enjoy a
warm drink, or do a simple job for
someone?

Young paraplegics have a strong
need to belong to a group, but their
rehabilitation and retraining often
require lengthy hospitalization in ex-
42 THE CANADIAN NURSE

tended care centers where the average
age of the patients is 80. Do we cater
to their needs by drawing up a special
program for them? Do we provide them
with a place where they can go and act
their age, a place they can fix up accord-
ing to their own tastes?

How can we say that nursing care
meets the patient's needs, when nurses
take no active part in the work of the
health team, are not informed of every
detail of the treatment program, and
do not contribute by reporting what
they know of the patient and his prob-
lems?

There are treatment plans, but try
to find a report on the patient's needs,
or a care program drawn up by the
nursing staff! You will find the medical
aspect is well protected, but the nursing
aspect is ignored. How can the night
staff help to satisfy the patient's needs
if it does not know what approach was
used by the day staff.' This lack of
information about the patient's reaction
to his illness and the educational aspect
of his treatment program can completely
destroy the progress accomplished over
several weeks of work.

We established the team system
throughout hospitals without examining
whether it was necessary or preferable
for all units. Do we recognize that,
because of the lack of preparation of
senior nurses, the information given at
team conferences is not even listened to?
The basic concern is to check whether
assignments have been carried out!

Meeting the patients' needs

I have painted a black portrait of our
nursing care, based on first-hand obser-
vation of nursing facilities throughout
the country. However, 1 assure you that
nursing care can be organized to meet
the needs of the patient, and that a
number of encouraging experiments are
currently underway. Not every need
can be met and every frustration elimi-
nated, but a good many needs can be
met, and nursing care can be improved
if we keep the patient in mind when
establishing nursing procedures and
policies.

Even if the physical facilities do not
allow all the necessary flexibility to
meet the various needs of patients in

each unit, some adaptation is possible.
For example, a bed or bedside table
can be moved to allow the patient to
enjoy a different arrangement from
time to time.

When the nursing director partici-
pates from the outset in the preparation
of the plans for a new hospital, she is
able to design the various units to meet
the particular needs of each group of
patients, keeping in mind that efficiency
requires a certain degree of uniformity.
There will be an obvious difference
between the pediatric unit with its
playroom; the extended care unit with
its dining room, lounge and larger
cupboards for the patients' belongings;
and the medical ward. A few Canadian
hospitals have benefited from knowl-
edge acquired in thorough preliminary
studies and from significant participa-
tion by the nursing staff in the planning
stages.

Nursing care will suit the needs of
the individual patient if the nursing
director, when deploying her staff,
makes a thorough study of: the popula-
tion served by the hospital; the physical
facilities; the treatment programs; the
established policies; the approved meth-
ods of assigning staff; and the categories
of patient requiring care and the specific
needs of each.

Lambertsen has stated that improved
use of nurses is an excellent thing in so
far as its aim is to provide better patient
care. 7 In support of this statement, she
cites the example of a decision made at
Brooklyn Methodist Hospital to reduce
the anxiety of pediatric patients. Earlier
research had clearly demonstrated the
importance of a continuous personal
relationship in child care and the extent
to which this was helpful in reducing
stress in the hospitalized child. The
staff therefore decided that meals would
be served by the nursing staff in the
pediatric ward. In all other units, meals
would be the responsibility of the
dietary service. This is an example of
an administrative decision to which
nurses contributed.
— There is a greater likelihood that
nursing care will meet patient needs if
the nurses are involved in the life of the
community and familiar with the pa-
tient's way of life. They should not.
NOVEMBER 1970

therefore, shut themselves away in an
ivory tower and forget that other health
facilities exist outside the hospital.

Hospital nurses must have frequent
communication with nurses in other
health services in the community to
make them aware of their capabilities
and limitations. Hospital staff will thus
be led to think of medical care in broad-
er terms, and to prepare patients to
move from one treatment sector to
another with minimum disruption. It
will then be as natural for a nurse to
refer her patient to another source of
nursing care as it is for a doctor to refer
his patients to a colleague.

Lydia Hall maintains that if the
patient's needs are to be met, he must
be attended exclusively by professional
nurses.8 The Loeb Center in New York,
where everything has been arranged
with the patient's needs in mind, offers
concrete evidence of her views. In the
belief that fragmentary treatment is to
be avoided, she deployed her staff to
provide total care. She felt that profes-
sional nursing care was not only essen-
tial, but should at times predominate
in the provision of an integrated health
service for the hospitalized patient. If
we really believe in this approach, our
use of nursing staff will be influenced
accordingly.
— Treatment will meet individual needs
when nurses providing direct patient
care make a systematic examination
of the patient's needs, and determine
priorities for the care program by
observing psychological symptoms in
the patient and by listening to his com-
ments. The standard of care will im-
prove when nurses know how to ques-
tion patients to obtain the information
required. The ideal will be reached
when the care program becomes a real
working tool that provides information
for the entire nursing staff.

We will thus achieve a uniform
approach by the nursing staff and con-
tinuity in the care provided. When the
care program follows the patient when
he leaves the hospital to return home
or for admission to another treatment
facility, we shall be able to say that our
nursing care really meets the basic needs
of our patients.

If the patient is able to take part in
NOVEMBER 1970

social interaction within the treatment
unit, he will be happier and his recovery
facilitated. He will thus be restored
to health more quickly. Brown tells us
there are a number of ways to involve
the patient, which will remind him of
his normal life, thus helping to reduce
boredom and to give him back his
independence. ^ Patient participation
must take place largely within the
treatment unit and must be planned,
supervised, and stimulated by the nurs-
ing staff.

The care we provide is likely to be
better adapted to the constantly chang-
ing needs of the people we serve if the
nursing care methods and practices are
subjected to regular assessment at all
levels. An overall approach must be
adopted, embracing procedures in
general, staff, methods, and patient
records. This assessment should be
decentralized and carried out at the
ward level.

The care is more patient-centered in
establishments where administrative
committees set aside some of their time
to discuss treatment, practices, and new
methods and discoveries in the various
fields of health care. If this is done at
the health-team level, the attention of
the nursing staff will be directed more
toward the total treatment concept.

None of these approved methods can
begin to succeed unless the nursing
director exercises firm leadership in
providing individual nursing care. This
will be reflected in her management
techniques. She is responsible for the
continuous training of her staff in this
field, and must encourage them to adopt
a broader and more creative approach
to the daily care of the patient.

The nursing director must convince
her staff that the encouragement of the
patient to undertake psychologically-
beneficial activities is the very essence
of nursing. All the lectures in the world
will fall on deaf ears if the nursing staff
do not realize the importance of these
activities.

It is f 14 tile to believe that the nursing
staff will be attentive to the needs of
the patient if their own needs are not
considered. On this point, Donovan
states that our own needs and short-

comings are reflected in the manner
we adopt toward patients and their
visitors.^ 0 j^g best demonstration a
nursing director can give of the impor-
tance she attaches to the consideration
of basic human needs is the example
she gives in working with her staff.
She wants her staff to evaluate the needs
of the various patients for whom they
are responsible. She will therefore have
to set an example by evaluating the
needs of the members of her nursing
staff, without forgetting the evening and
night staff.

I have touched briefly on a number
of requirements that must be fulfilled
if the nursing care we provide is to meet
the needs of the patient. This care will
be satisfactory if we keep the patient
in mind in everything we do as profes-
sional nurses. The more we work with
the patient — and not against him —
the more success we will have.

References

1. Koos. Earl. L. Tlie Sociology of the
Patient. Toronto, McGraw-Hill.
1959. p.95.

2. Maslow, A.H. Motivation and Per-
sonality. New York. Harper & Row.
1954. pp. 80-106.

3. lbid.,p.iS.

4. Ibid.. p.90

5. Ibid., p.92

6. Abdellah, Fayc G. Applications o\
patient-centered approaches to nurs-
ing services. Patient-Centered Ap-
proaches to Nursing. New York.
MacMillan. I960, pp. 39-68

7. Lambertsen, Eleanor. When you
change routines be sure you improve
the care. Mod. Ho.sp. 109: 140. Ocl.
1967.

8. Hall. Lydia. Another View of Nurs-
ing Care and Quality. New York.
Loeb Center. 1965.

9. Brown. Esther Lucile. The use of the
physical and social environment ol
the general hospital lor therapeutic
purposes. Newer Dimensions of Pa-
tient Care. Pan I . New York. Russell
Sage. 1961.

10. Donovan, Helen M. Determining
priorities on nursing care. Nurs.
Outlook 11: 1:44-45. Jan. 1963. $■

THE CANADIAN NURSE 43

The Autistic Child

Have you ever wondered how you would recognize an autistic child and how you
could help him? The author describes the major signs of this syndrome and
the nursing measures used when caring for a child with this illness.

Autism is confusing in many ways. For
example, tine term "autism" may be used
as a diagnosis or as an adjective describ-
ing behavior. Also, in diagnosing
children, it is difficult to differentiate
between autism, mental retardation,
brain dysfunction, schizophrenia, and
other psychoses. (Table A.) The symp-
toms overlap considerably, and some
children have more than one of these
problems. Once diagnosed, there is
controversy over what methods of
treatment are most helpful.

Major signs of autism

Several authorities have described
the major signs of autism, and these
signs are found in most autistic chil-
dren. 1.2

Autistic children do not relate to
people in the usual way, beginning at
birth or sometime before the age of two.
They tend to be unresponsive and do
not cuddle when being carried. They
seldom make eye contact, do not seem
to like being around others, and often
treat people as objects.

Annette, a four-year-old on our unit,
showed this indifference. She appeared
to look right through us, and would
walk into us if we were in her way. She
appeared neither concerned nor happy
when told it hurt.

Although these children neither relate
to people nor appear to notice them,
they sometimes are aware and will
44 THE CANADIAN NURSE

Valerie Whitlam, B.Sc.N.

recall apparently unnoticed incidents.
For example, Bobby, an eight-year-old
blind boy on our unit, would curl up on
the floor with only his back exposed to
view, and did not seem to notice those
around him. Months later, he recited
the names of people with whom he had
only brief contact and asked where they
were. Staff and parents must keep this
awareness in mind and refrain from
discussing the autistic child as though
he were not present.

Some autistic children have no
speech, while others are able to talk,
but seldom communicate verbally. When
they do talk, their tone is wooden and
not reinforced by gestures. Their speech
lacks questions and is often echolalic.
For example, the child will repeat,
parrot-like, the question "Do you want
a candy?" rather than answering it. Or
he will suddenly say something com-
pletely out of the blue, such as, "He's
been blind since birth." Many will
repeat from memory lists of names,
nursery rhymes, and songs. This may
.show intellectual potential, and will help

Miss Whitlam. a graduate of the Univer-
sity of British Columbia's basic degree
program, is Clinical Instructor on the
Children's Unit at the Clarke Institute of
Psychiatry. This is a small, residential
unit that functions as a setting for assess-
ment and short-term treatment of emo-
tionally-disturbed children.

to differentiate autism from simple
retardation.

The autistic child's speech is also
characterized by a lack of pronouns.
He will say, for example, "Want
candy," instead of "I want a candy."
He reverses pronouns, when he does
use them, and will say "Pick you up,"
for "Pick me up." His vocabulary lacks
words; "Go walk" is used instead of
"1 want to go for a walk."

Another sign of autism is the child's
obsessive need to have things the same.
He may not want the furniture moved;
he may not want to leave the house; he
carries out certain rituals at special
times. Young Annette would not start a
meal without being told to do so. Until
we said, "Eat your soup," she would
look intently at us and repeat in a pres-
sured tone, "Eat your soup," or what-
ever she wished us to say. Going home
Friday and returning on Sunday upset
her. Each Friday she handled this by
taking her mother's purse to the play-
room, muttering phrases as if she were
her mother, and waiting there until her
parents had talked to staff and were
ready to go. All week she would repeat
•'Home Friday, hospital Sunday."

Although autistic children do not
seem interested in people, they are often
fascinated with objects and handle them
skillfully. Sometimes this leads to a high
level of excitement. For example,
Jerry, age four, could spin almost any-
NOVEMBER 1970

Intellectual function

Tests that help decide
Speech

TABLE A
Ways to Differentiate Autism From
Organic or Genetic Difficulties

Autism

Motor Coordination

Physical appearance

Perceptions

Behavior

Ego functions

Usually functions below
age level in all areas, but
performance levels are
inconsistent. May show
potential in good memory.

Hard to test.

Lack of speech, echolalia.
Wooden, flat speech, pause
in phrases and sentences.

Usually good.

Healthy, often intelligent
looking.

Often use only one sense
for recognizing objects.

Withdrawn, ritualistic.

Severely impaired. Lack
of reality testing,
preoccupied.

Mental Retardation

Deficit levels are uniform
and consistent — level
depends on degree of
of retardation.

IQ test.

Delayed development,
degree depending on
degree of retardation.

Poor in both gross and
fine motor, related to
degree of retardation.

Physically underdeveloped,
delayed mile-stones, such
as walking.

Impaired in severely
retarded.

Normal to sluggish, de-
pending on degree of
retardation. Possibly
aggressive outbursts.

Fairly normal, but low
frustration tolerance.

Brain Dysfunction

Wide range, but generally
normal potential.

EEG, psychology, Ritalin.

Normal for age — there may
be articulation difficulties.

Poor in both gross and fine
motor.

Usually normal.

Higher sensory CNS functions,
such as auditory discrimina-
tion, are affected.

Hyperactive, aggressive, low
attention span. Responds well
to medication, especially to
the amphetamines.

Low frustration tolerance.

thing — dice on their corners or flat
discs on their edges — and would get
many objects spinning at once. He
watched them as if in a trance, jumping
up and down and laughing and quiver-
ing with excitement.

Many autistic children will hold a
small bright object in hand, and then
rapidly flick their wrists back and forth,
either staring in fascination or paying
no attention. Often these children open
and close doors endlessly, or turn the
lights off and on.

There is some controversy about the
autistic child's intellectual potential in
some areas (for example, memory),
while he is functioning below his age
level in other areas. It is extremely
difficult to assess his intellectual abil-
ities because of his lack of speech or his
unusual use of it, and his resistance to
testing. However, these children usually
have islands of intellectual ability, and
if there is some meaningful speech by
the age of five, they may be able to learn
adequately in most areas. Even so.
NOVEMBER 1970

areas concerning people and commu-
nication tend to lag.

Other features

In addition to the major symptoms,
we have seen other characteristic be-
havior in our autistic children. They
often walk shoeless and on their toes,
rock and twirl a great deal, use odd hand
gestures, and enjoy rhythmic music. In
addition, they frequently have sudden,
unprovoked anxiety responses, and
may appear frightened for no apparent
reason. Their perceptions seem unusual.
For example, the child may show no
response to pain, but be very sensitive
to sounds.

An all too common feature of autistic
children is their habit of slapping,
pinching, biting, or hurting themselves
in some way. There are many theories
about why they do this. Some psychia-
trists believe the child is turning inward
his anger and frustrations, and, having
done this, discovers this behavior elicits
a strong response from his environment.

Others believe this self-abuse helps the
child know where he "ends," and there-
fore may help him realize he exists.

Theories about autism

The autistic child seems to have
difficulty from the beginning of life.
Normally an infant is one with his
environment, especially with his moth-
er; she seems like part of him, and he,
part of her. This continues until around
six to nine months, when the child
begins to become a person in his own
right. However, autistic children seem
unable to allow this very necessary first
step of fusion.

What leads to this difficulty? There
are various ideas. A widely-accepted
theory is that the child has some
genetic defect. This would play an
important part in etiology, but would
not rule out the importance of the
environment. Generally, the parents of
an autistic child are intelligent, obses-
sive, and emotiona% cold. It should be
remembered, however, that the autistic
THE CANADIAN NURSE 45

child's unresponsiveness would effect
even the warmest parents and lead to
their emotional withdrawal.

When treating these children, some
therapists (known as "learning theo-
rists") are particularly concerned with
the child's small repertoire of behaviors,
much of which is maladaptive. Treat-
ment programs attempt to increase new
adaptive behavior such as speech with
rewards, and decrease maladaptive
behavior with punishment.

Nursing approaches

In caring for these children, we have
attempted to adapt theories of develop-
ment, learning, and interaction.

First, one nurse is assigned to the
child to allow a caring, continuing
relationship to develop. Naturally,
others care for the chiid, but we attempt
to keep the same people and limit the
number of persons who come in close
contact with him.

The nurse's first approach to the child
is designed so each can get to know the
other. To do this she has to find ways
of communicating with him. This may
involve imitating his sounds and ac-
tions; sharing anything he enjoys, such
as tickling, and music; being with him;
and commenting on his action. The
approach has to be gentle, supportive,
and patient, otherwise it may cause
further withdrawal.

To satisfy the child's need for same-
ness and routine, we try to have a
regular daily program so that changes
become predictable, thus minimizing
the child's anxiety. We may warn him a
few minutes before an activity changes.

Because these children like to be
alone, we allow this at certain times
each day; gradually the time can be
decreased. At first the autistic children
do not tolerate other children near
them, but gradually they can be in a
room with others and will show interest
in playing with another child.

If we are sensitive to the child's
communications, we can discover what
he needs most.

For example, when staff or children
left the unit permanently, Bobby would
talk about ambulances and fire engines.
After a few months he started to void
on the floor when this occurred. We
realized he needed help to deal with his
feelings of separation. We started by
commenting, "You wet your pants." He
would grin gleefully. "You must be
pretty upset about something," we'd
add. We did not push him to talk, but
suggested, "I don't like it when my
friends leave." A week later he said,
46 THE CANADIAN NURSE

"It's happy to say hello." We com-
mented that we got sad and mad when
people left us. "What do you do?" he
asked. One nurse said, "Oh I might
stamp my foot" (a common response of
Bobby's), "or I might say I'm mad."
Bobby then asked, "Do you swear?"
Soon he was saying "Damn it!" and
gradually got to "I don't want you to
leave, it makes me sad." This change
took a year.

Some autistic children react to stress
by beginning or increasing enuresis,
having physical complaints, or becom-
ing resistant to everything by with-
drawing. It is difficult to discover the
source of stress, but if discovered and
eased, symptoms often decrease. Bobby,
for example, was being encouraged to
learn new concepts, to run and jump, to
talk in a normal voice that he seldom
used, and to taste all food at meals. Talk
and play about fire engines increased,
he took longer to dress, spent an hour on
the toilet (thus missing gym period) and
was less spontaneous. We then decided
that only his special nurses would
encourage the food tasting and the use
of his normal voice, but the other pres-
sures would continue. This helped, and
his progress resumed.

Besides setting up a relationship of
caring and letting the child know it is
safe and even fun to interact with
others, we use a structured learning
program. Our goals are to help the child
learn new concepts, communicate
meaningfully and spontaneously, and
get used to sitting and working so his
attention span will increase and he can
adapt to a classroom setting.

We find it helpful to have half-hour
school periods each day, the number
depending on the child's stress tolerance
and his other activities. At first we keep
the child alone, but later may bring in
another child to increase his ability to
share and interact with his peers.

During these school periods, concepts
of "yes-no," colors, shapes, numbers,
body image, and "I-you" are learned,
and the child has an opportunity to use
his different senses.

Anne, a nine-year-old blind girl, used
only her sense of hearing. We asked her
to smell jars of jams, fruits, honey, and
sugar, and to identify them. Then we
asked her if she would like a taste,
giving her a sample when she responded
"yes." Her nurses encouraged her to
use her new classroom learning on the
ward. When she knew shapes and
directions, we put her in a box-on-
wheels, which had a triangle, circle,
and square cut out of its sides. She

was to identify the shape in front, in
back, and on her left. A correct answer
meant a ride; an incorrect answer meant
she would have to try again or get
another child to guess.

Our third approach involves working
with the parents, especially the mother.
We have found that early contact is
helpful. On the child's admission to our
unit, his nurse takes a home history to
get information about him and a feeling
about the parent-child relationship. We
explain our program and routines and
try to be open with them.

Parents often feel we are judging
them, blaming them for their child's
difficulties. Although they hope we can
help, they often fear our success in
reaching and handling their child, as
it seems to confirm their incompetence.
This feeling is often revealed when the
parents concentrate on the physical care
of their child. If he is messy, hair
disheveled, has new scrapes and bruises,
and looks sloppy, they feel we are not
caring for him.

We explain that we believe in good
hygiene and safety, but that it is also
important for the child to play and try
new activities. If the parents continue
to worry about our care of the child, we
have a meeting with them and encourage
them to voice their feelings. This usually
improves the nurse-parent relations and
the child's progress.

Annette is an example of the im-
portance of such a meeting. She was
making progress in our terms, and
was exerting her will, becoming resis-
tive, and negativistic. Although she
was expressing anger directly, she
started to have temper tantrums and
developed enuresis. Her parents were
concerned that we had undone their
accomplishments. Meeting with us, they
expressed these feelings and stated they
felt we were not concerned about the
child's behavioral change. We explained
why we saw the general trend as prog-
ress, and said we, too, were concerned
about the bed wetting and were counting
the number of times it occurred. The
enuresis decreased drastically the next
week. Perhaps the sense of cooperation
eased the tension around Annette and
she no longer needed to wet the bed.

Another difficulty parents voice is
that, when their child shows progress,
they feel replaced in his life and thus
feel even more inadequate. To count-
eract this, we have them visit the ward
for half days or for full days to observe,
participate in the program, and plan
the next steps with us. We emphasize
they are the most important people in
NOVEMBER 1970

the child's life, and that we can only
help, not replace, them.

As yet, we have done little home
visiting, but believe this would be
helpful, as we could see their situation
on their home territory and give con-
tinued support after the child returns
home.

References

l.Beck. Samual (chairman). Childhood
schizophrenia symposium 1955. Amer.

J. Onhopsychiai. 26:497-566. Julv
1966.
2. Polan. Spencer. A checklist of symp-
toms of autism of early life. The West
Virginia Medical Journal. June 1959,
pp. 198-204.

Bibliography

Christ. A. and Griffiths. R. Parent-nurse
therapeutic contact on a child psy-
chiatric unit. Amer. J. Orlhopsycliiat.
vol. 35, no. 3, April, 1965.

Kanner. L. Child Psychiatry. 3d. ed.

Springfield III., Charles C. Thomas,

1957. pp. 730-748.
Spurgeon. R. Nursing the autistic child.

Amer. J. Niirs. 67:7:1416. July 1967.
Wilkes. J. Involving parents in children's

treatment. Canada's Mental Health

18:l;IO-l4.Jan.-Feb., 1970. i?

Take a Child...

Take a child, disturbed

Lost.

Hold him close

For he's very frightened

And his fear is twice his size.

Take a child, disturbed
Angry.

Hold him tight.
He has the right to his anger.
The world has hit him hard
Again and
* Again

Beat him into the ground

k.

And battered his body
With fists of hell
Show him it's 0. K.
To want to hit back

Take a child, disturbed

Burning with madness.

Hold him secure.

Teach him to turn his hell

Outward

Not inward

To self-destruction.

Take a child, disturbed
Protect him.
Soothe his wounds.
Caress his scars.

BY TERRY LYNN CARTER

Build on the tissue

That has been destroyed.

Teach him

That good exists

And although he has three strikes

Against him.

He's in

Not out.

Take a child, disturbed

Emotionally.

Grow him straight

Although he's bent.

Grow him tall

Although he's small.

Pick him up

When he falls

And make him try again.

Take a child, disturbed
And chart his course.
He has the right to live.
The right to dream.
The right to achieve.
The right to hate.
The right to love.

Take a child, disturbed

In so many ways.

Walk his hell

With him

In his world of black.

Show him what's wrong.

Show him what's right

And in the depth of his hell

In the depth of his night.

Your gift to him

Is a patch of light.

NOVEMBER 1970

THE CANADIAN NURSE 47

Winter isn't so very far away!

Before you head for the ski slopes . . . here are some safety rules to help lessen
your chances of an accident. If you are an experienced skier, already aware of
accident possibilities, the excitement of this winter sport is wide open. For the
less experienced skier, these few tips by a nurse, who is a member of the
Canadian Ski Patrol, can alert you to ski dangers.

Barbara Williams, B.Sc.N.

Author Barbara Williams and her
husband pose before the first-day run.
Warm clothing, and proper equipment
checked for use, is a must for all skiers,
they say.

Mrs Williams, a graduate of St. Joseph's
Hospital School of Nursing. London.
Ontario, and the University of Western
Ontario, is presently Assistant Director
of Woodstock General Hospital School
of Nursing.

48 THE CANADIAN NURSE

When a nurse expounds on the benefits
of physical fitness to a patient, it would
seen' essential that the nurse is physi-
cally fit herself. I have found a sport
that bolsters my physical fitness theory

— skiing! This is one activity that
quickly burns unwanted calories,
heightens the color in your cheeks,
strengthens muscles, and almost makes
you wish winter lasted the year round.
When you are in good physical condi-
tion, the chance of catching a cold is
lessened, and you look what you feel

— healthy!

For the nurse, this can mean less
fatigue on ward duty.

You may assume you get adequate
exercise stomping the wards — enough
to prepare you for the ski slopes any-
way. Not so! You should begin early
in the fall to strengthen your arm, leg,
and chest muscles, and to improve your
general coordination. Ski exercises
can be fun, especially when practiced
in a group. From books and magazines,
newspaper articles, or from your local
ski store, you can find the best type
of exercises for each set of muscles.
If you faithfully maintain a good exer-
cise program, you will ski better and
for longer.

' Proper equipment Important

The type of ski equipment you use

can add to or detract from your skiing

enjoyment. A reputable sports store

NOVEMBER 1970

When mechanical failure puts a chairlift out ofsen'ice, the ski pat roller lowers himself from the chairlift by using a self-
evacuation kit. Skiers are evacuated by slides or other means of evacuation. These two illustrations were taken during a
rescue demonstration, prior to the ski season opening.

can advise you on the ski that is best
suited to your skiing ability. Whatever
ski you choose, make sure it has a metal
edge that can be repaired and sharpened
easily.

of binding to have mounted on your
ski, if the bindings are adjusted properly
for your weight and type of skiing. They
are made to release your foot easily
from the ski when you fall, lessening
the chances of breaking a leg. Release
bindings should be checked for correct
adjustment before the first run. This
check is important. Bindings can be
changed by vibrations, which occur
when carried, or by overnight weather
changes.

A satisfactory method of testing
the binding release mechanism is to
stand with a ski securely attached to
a foot, and with the other foot, kick
the side of the ski boot sharply, just
behind the toe. Your toe binding should
release.

To test the heel release, lean forward
at a 45-degree angle with both skis on.
If your heel releases are properly ad-
justed, they will not release at this angle
unless you jump forward.

It is absolutely necessary to buy
strong and preferably two-point safety
straps that attach boot to ski. Other-
wise there is nothing to prevent a ski
from becoming detached, sliding
NOVEMBER 1970

downhill, and possibly injuring some-
one.

The proper type of clothing is also
necessary if you are going to enjoy this
sport. Long underwear is a must, pref-
erably the kind that can absorb perspir-
ation without remaining damp. A two-
layer wool and cotton type is satisfac-
tory. Two pairs of socks are best, but
they must fit well. Socks should be
worn under ski pants; if worn outside,
they trap snow.

Ski pants are fashionable but expen-
sive, and not necessary if you have
pants that allow ample movement and
shed the snow. On extremely cold days,
it is a good idea to wear a shirt under
your sweater, plus a warm, windproof
jacket. Leather gloves, or mitts, keep
your hands much warmer if they overlap
the cuffs on your jacket, and it is wise to
protect your ears from frostbite. With
all this wearing apparel, you may think
you are warm enough for skiing, but
beware — the ride on the tow can be
cold!

Start the day right

Limber up at the beginning of your
ski day by climbing a hill several times.
Be sure to keep to the sides of the hill,
away from skiers. Although you may
find the hill-climbing tiring until you
become accustomed to the added exer-

cise, you will feel warmer and relaxed.

Ski areas have a map showing which
hills are best suited to the novice, inter-
mediate, or expert skier. Before starting
out. study this map to be sure you do
not ski into an area you are unable to
handle with confidence. But be honest
with yourself. Do not consider that you
are a better skier than you really are.
It's much more fun to ski on a hill where
you are relaxed and confident, rather
than being overconfident, trying to ski
on a hill that is beyond your scope.
You will only become tense and nerv-
ous. If you think you are in a situation
you cannot handle, ask a ski patroller
for assistance. He is there for your
safety and service.

You may have already discovered
that it is more fun skiing with a com-
panion. It is also safer! If you injure
yourself, your partner can go for help or
can assist you until a ski patroller
arrives.

Learn basic rules

Ski lifts are a problem for some
people. Unfortunately, bad lift accidents
do occur. If you dont know how to use
a lift, ask the operator for instructions,
or ask a ski patroller to ride with you.

When you ride the lift your ski pole

straps should be offfcyour wrists and

the poles held so they don't drag in the

THE CANADIAN NURSE 49

5C

p^

ji

^

^^"^^^

U-^

^

Rescuing an accident victim and preparing him for transport downhill on a
toboggan to an ambulance are other facets of ski patrol duties.

snow. Poles can get caught on chunks
of snow or branches and pull you off
the tow. Loose clothing can catch in
the tow equipment, resulting in personal
injury or damage to your equipment.

Sometimes skiers ski from the top to
the bottom of the hill completely out of
control. A skier can be held liable if he
runs into another downhill skier, even
if the other person is out of control.
You must be able to turn and stop at all
times.

If you find yourself in a situation
you can't control, put your knees and
skis together and sit down, leaning
back and to one side. If you are relaxed
when you fall, you won't hurt yourself
or anyone else.

After you have fallen, remember to
fill in any holes you have made in the
snow. Another skier may not see this
danger and get his skis caught in your
"sitz mark." causing a serious fall.

If you find you are falling too often,
you may need to take a coffee break
and give yourself time to relax; or, you
may need to take lessons from a quali-
fied instructor. Statistics show that
the chance of ski accidents are reduced
by fifty percent when skiers take pro-
fessional lessons. These may seem ex-
pensive, but the enjoyment you receive
from skiing well is worth every cent.
After all, professional instruction is
50 THE CANADIAN NURSE

less expensive than mending a broken
leg. Most large resorts have ski-weeks,
which include lessons at reduced cost.

Safety on the slopes

The Canadian Ski Patrol System,
a national volunteer organization devot-
ed to promoting safety in ski areas,
gives first aid to accident victims, and
tries to prevent accidents. PatroUers,
who must be highly qualified in first
aid, are assigned an area to ski two or
three nights a week. They watch for
people who may require assistance.

Most accidents treated by the ski
patrol involve the legs, especially from
the knee down. The majority of these
accidents are caused by those who ski
beyond their ability. The first thing a
patroller does at an accident is to in-
struct the person to lie still while be
examines him for injuries. Extra patrol-
lers and a transport toboggan can be
summoned by using whistle signals.
The toboggan carries a supply of card-
board splints, which can be used to
immobilize an injured limb. PatroUers
carry packs containing triangular
bandages, sterile pads, safety pins,
scissors, tongue depressors, and various
other items needed for an emergency.
After the splint is secured with triangu-
lar bandages, the victim is transported
by toboggan to a car or ambulance.

In areas serviced by chairlifts,
patroUers are required to learn proper
chairlift evacuation procedures. Some
are taught to lower themselves from
the chair, by using self-evacuation kit,
then evacuate the skier by slides.

There are many more tips for better
skiing. I have given only those that are
essential. If you want to know more
about the Canadian Ski Patrol, write
to the Western Zone, Ontario Division,
Box 242, Burlington, Ontario. If you
live outside this division, your request
will be forwarded to the proper address.

Even though the sight of snow-clad
hills seems months away — it's never
too early for those limbering-up exer-
cises.

Try a few each day. One, two, three
— bend and stretch. ^

NOVEMBER 1970

The

Canadian
Nurse

50 The Driveway, Ottawa 4, Canada

Information for Authors

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Bibliography

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NOVEMBER 1970

to a reasonable number as determined by the content of the
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The Canadian Nurse

OFFICIAL JOURNAL OF THE CANADIAN NURSES' ASSOCIATION

THE CANADIAN NURSE 51

research abstracts

The following are abstracts of studies
selected from the Canadian Nurses"
Association Repository Collection of
Nursing Studies. Abstract manuscripts
are prepared by the authors.

Miller, Kathleen Ruth. A study in the
use of role playing with a select
population. New Haven, Connecticut,
1970. Thesis (M.Sc.N. Yale Uni-
versity.

The purpose of this study was to dem-
onstrate the use of role playing in as-
sisting low income, female, post-
hospital, mentally ill clinic patients
to improve their functioning in every-
day life. Participants were subjected
to role playing or group discussion,
or to no intervention by the researcher.
The inconclusive results seen after
comparing the functioning of the three
groups were attributed to the small
sample of patients and to insufficient
exposure to the independant variables.
Although her belief that the role
playing group would show the most
improvement was borne out only to a
limited extent, the author remains
convinced that role playing is an ef-
fective, but little-used method by which
nurses can treat large numbers of low
income patients in a form that does
not symbolize less status. An addi-
tional finding of the study was that
professional nurses and low-income
patients differed as to how they per-
ceived the problem of daily living
experienced by the patient group.

Pepler, Carolyn Joan. Cognitive func-
tioning of patients under stressors
of impending and recent surgery.
Detroit, Mich., 1967. Thesis
(M.S.N.) Wayne State University.

A field study was carried out to inves-
tigate changes in cognitive function-
ing shown by patients before and after
surgery. The main hypothesis was that
patients undergoing scheduled abdom-
inal surgery would have their poorest
cognitive functioning one day preop-
eratively, a moderate performance
three days postoperatively, and their
best performance one month postop-
eratively. The second hypothesis stated
that patients in the higher mental abil-
ity group would show more variation
in performance than those in the lower
group, it was also hypothesized that,
52 THE CANADIAN NURSE

when compared with the lower mental
ability group, the higher group would
show more change in conceptual abil-
ity than in perceptual ability.

To test the hypotheses, one test of
perceptual ability (Embedded Figures
Test) and one test of conceptual abil-
ity (Word-Sorting Test) were given to
13 female patients the evening before
abdominal surgery, three days postop-
eratively, and approximately one month
postoperatively. Subjects were divided
into two mental ability groups on the
basis of performance on the Wonderlic
Personnel Test.

Analysis of variance and a test of
differences between pairs of means
were shown to analyze the data. The
hypothesis was not confirmed. Anal-
ysis showed that there was no signif-
icant difference between performances
on the perceptual task in the three
stressor situations. There was a signif-
icant decrement in ability in conceptual
functioning on the third postoperative
day, but there was no significant var-

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iation between the preoperative per-
formance and the performance one
month postoperatively. This was not
the hypothesized pattern of change.
Concerning the second and third
hypothesis, the effect of interaction
between mental ability and the stressor
situations was not a significant source
of variation.

Possible explanations as to the lack
of support of the hypotheses include
the combined effect of physiological
and psychological stressors, different
levels of motivation in the three testing
situations, unanticipated stressors
during the testing one month postop-
eratively, and the small population
studied.

Riley, Marion Smith. The effect of
working conditions on nursing care
in eight hospitals as perceived by
general staff nurses and patients.
London 1970. Thesis (M.Sc.N.)
U. of Western Ontario.

This study was undertaken to determine
the areas of nursing care perceived as
most satisfactory and those perceived
as least satisfactory by general staff
nurses and patients, and to determine
their perceptions of the effects of work-
ing conditions on the provision of nurs-
ing care. Questionnaires were complet-
ed by 96 patients and 70 general staff
nurses on medical and surgical units
in eight general hospitals in southwest-
ern Ontario.

A validated tool, developed by Dr.
Faye Abdellah and Dr. Eugene Levine
in 1956, was used to measure the pa-
tients' levels of satisfaction and dissat-
isfaction with nursing care, and an
open-ended questionnaire was used to
obtain the perceptions of the nurses.

The nurses perceived the physical
aspects of nursing care and delegated
medical tasks as the areas ot nursmg
care being given most satisfactorily.
They perceived emotional or psycho-
logical support of the patient, and pa-
tient teaching and rehabilitation, as
the areas needing the most improve-
ment. The highest levels of dissatis-
faction among patients were in the
categories of rest and relaxation, die-
tary needs, and contact with nurses.
The areas of least dissatisfaction were
personal hygiene and supportive care,
reaction to therapy, and elimination.

Factors in the hospital environment

perceived by the nurses as the most

NOVEMBER 1970

helpful in the provision of nursing care
were their working relationships with
co-workers, with head nurses, and with
physicians, and also the availability of
adequate physical facilities. Factors
perceived as a hindrance were insuffi-
cient staff, inadequate physical facili-
ties, and some hospital policies.

The patients perceived inadequate
physical facilities and the nurse not
being available because she was too
busy, as the major deterrents to satisfac-
tory care.

Lindstrom, Myrna. Nursing problems
of the paraplegic patient as seen by
the nurse. Vancouver 1970. Thesis
(M.Sc.N.) U. of British Columbia.

A body of nursing knowledge in rehabil-
itation cannot be attained until the
specific problems nurses encounter in
their work are identified. The purpose
of this study was to identify some of
the specific nursing problems in relation
to the paraplegic.

This study included interviews with
1 7 nurses caring for paraplegics during
the three stages of their rehabilitation:
the acute stage; the time of intensive
rehabilitation; and after returning to
the community. A basically unstructured
interview method was used, permitting
the nurses a wide scope in identifying
nursing problems they had encountered.
The specific nursing problems were
summarized within components of a
typology developed during the study.

Sixty-eight different, specific nursing
problems were identified a total of 247
times. Fourteen different specific nurs-
ing problems were within the compo-
nent of the typology of psychological-
emotional problems. The psychological-
emotional problem identified most
frequently. 12 times, was that of trying
to help the paraplegic face the future
as a disabled person. The largest per-
cent of the total number of nursing
problems identified, 35.22 percent,
were within the component ot the typol-
ogy of physical problems. The three
most frequently identified nursing
problems were within this component.
These were: maintaining the bowel and
bladder function. 3 1 times; maintaining
the integrity of the skin, 20 times; and
being alert for complications, 16 times.

The largest number of different nurs-
ing problems, 30, and the greatest per-
cent of the total number of nursing
problems. 63.56 percent, concerned
the paraplegic himself. Seventeen dif-
ferent nursing problems (19.84 per-
cent of the total iiumber of nursing
problems identified) concerned the
paraplegic's relationship to those out-
side of the health care system. There
were 16 different nursing problems,
(12.96 percent of the total number of
nursing problems) concerned with the
NOVEMBER 1970

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THE CANADIAN NURSE 53

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research abstracts

54 THE CANADIAN NURSE

paraplegic's relationship to the health
care system. The remaining 3.64 per-
cent of the total number of nursing
problems, five different ones, concerned
the paraplegic's inanimate surround-
ings.

Research should be done to discover
the best way of solving the specific
nursing problems identified in this
study. Many of them are currently
being dealt with by intuition or by trial
and error; others are being ignored. It
would be advisable to discover what
identifiable needs or problems para-
plegics have as they move through the
various stages of the rehabilitation
program. Nurses involved in helping
the paraplegic accomplish his goals
should be alert to what he regards as
his problems and help him arrive at a
satisfactory solution to them.

Taylor, Elizabeth Ann. A study of
selected factors affecting the commu-
nication process employed by general
staff nurses in eight hospitals in
referring patients with a long-term
illness to the community setting.
Vancouver, 1970. Thesis (M.Sc.N.)
U. of British Columbia.

This study was prompted by concern
for the method of promoting continuity
of care for persons discharged from
hospital. Descriptive in design, the
purpose of the study was to examine
selected factors affecting the communi-
cation process employed between gen-
eral staff nurses in hospitals and per-
sonnel in community agencies with
regard to the referral of patients with
a long-term illness from the hospital
to the community setting.

The data were gathered by means
of a self-administered questionnaire,
designed to seek information related
to each of the study's three hypotheses.
It was completed by 57 general staff
nurses on selected nursing units of
eight general hospitals in and near
Vancouver, British Columbia. The units
were chosen on the basis of the average
number of patients with a long-term
illness usually present in the unit.

From analysis of the data the follow-
ing conclusions were drawn. Although
general staff nurses who participated
in this study could recognize needs in
patients which indicate the necessity
for referral to community resources,
they did not appear to have an adequate
knowledge of available community
agencies. When these nurses made
referrals, the lines of communication
used were frequently indirect. ^

NOVEMBER 1970

You Are Barbara lordan. 72 pages.
Hospital Research and Educational
Trust, 840 North Lake Shore Drive,
Chicago, Illinois, 6061 1. 1970.

The in-basket exercise You Are Barbara
Jordan, a unique training program for
developing administrative knowledge
and skills in nurses, was prepared to
provide an actual learning experience
to help nurses recognize the need to
establish priorities; evaluate their
ability to delegate authority; practice
reading and writing communications;
perceive relationships between problem
situations; develop sensitivity to atti-
tudes of co-workers; and analyze the
factors that affect the decision-making
process.

Participants in the program play the
role of Barbara Jordan, director of
nursing in a 205-bed, short-term
general hospital. They must appraise
and act on 24 items of written commu-
nications, ranging from routine to
emergency, which are in Barbara Jor-
dan's in-basket.

The You Are Barbara Jordan exer-
cise was tested with nursing supervisors
in a hospital setting, with directors of
nursing at an American Hospital Asso-
ciation institute, and with students at
the department of nursing education.
Teachers College, Columbia University.

Materials for each participant are
in a workbook that contains background
information on Barbara Jordan's hos-
pital and her department, and 24 tear-
out messages that she must answer. A
9" X 12" cardboard in-basket is
packaged with the workbook to give
realism to the teaching. An instructor's
guide explains how to conduct the
simulation exercise and gives sugges-
tions for leading follow-up discussions.

Cardio-Vascular Surgery for Nurses
and Students by W.H. Bain and J.
K. Watt. 174 pages. London, E.
& S. Livingstone. Canadian dis-
tributor: The Macmillan Co. of Can-
ada, Ltd., Toronto, 1970.
Reviewed by J. David, Supervisor,
Surgical Services, The Vancouver
General Hospital, Vancouver, B.C.

The authors have explained in simple
terms the basic knowledge and tech-
niques of cardiovascular surgery. Com-
prised of 20 chapters, the first 9 deal
with the heart. Following a brief review
of the normal anatomy and psysiology
NOVEMBER 1970

of the heart, the hemodynamic conse-
quences of heart disease are explained,
along with the presenting signs and
symptoms.

An explanation of techniques used
in cardiac surgery encompasses the
closed and open heart surgical methods.
A description of the lesion and the
surgical treatment is clearly outlined
for: 1 . chronic rheumatic disease of
the heart valves; 2. congenital defects;
and 3. occlusive disease of the coronary
arteries.

The chapter on postoperative care
deals primarily with the procedural
responsibilities of the nursing team
in the immediate care of the patient
who has undergone cardiac surgery.
Steps to be followed in the preliminary
preparation of the care area are fol-
lowed by an ordered description of
the procedures to be undertaken when
the patient is admitted to the area.
Vital functions are clearly outlined
with specific reference to changes that

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50 The Driveway
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can occur and the significance of these
changes.

The latter portion of the book gives
a comprehensive coverage of periph-
eral-vascular disease and related sur-
gical treatment.

The format for the remaining chap-
ters is similar, covering the artery or
system of arteries affected by disease;
investigative techniques; preoperative
management of the patient; operative
steps; postoperative care; complica-
tions; and the final results of surgery.
The use of anatomical sketches, dia-
grams, and photographs throughout
the book assist the authors in present-
ing a clear, concise picture of the
cardiovascular system, and make the
corrective surgical techniques mean-
ingful.

This book would be a useful adjunct
to the library of those wishing to ac-
quire a basic knowledge of the tech-
niques of cardiovascular surgery, and
for the staff nurse who wished to ex-
pand her knowledge in this particular
branch of surgery. Although brief
mention is made of the patients" psy-
chological needs, the reader should not
expect to find guidance for a compre-
hensive approach to nursing the car-
diovascular patient. More detail in the
table of contents would have been
helpful.

Contemporary Nursing Practice; A
guide for the returning nurse by

Signe Skott Cooper. 348 pages.
Scarborough, Ont., McGraw-Hill
Company of Canada Ltd., 1970.
Reviewed by D. O'Donovan, Head
Nurse, Pediatric Unit, Western
Memorial Hospital, Corner Brook.
Newfoundland.

This book meets its objective, and
should be of interest to nurses hoping
to return to active practice. Also, it
would be an excellent review for all
nurses, especially for those working in
specialized areas, whose thoughts and
reading may be limited to the latest
developments in their own area of
interest.

The author's approach to the subject
shows an understanding of the needs of
both the returning nurses and the active,
1970-oriented nurses. In her tlrst
chapter, she issues a wise warning: "It
is imperative that the returning nurse
keep an open mindtend avoid saying.
"That's not the way I was taught..."

THE CANADIAN NURSE 55

Divided into four sections and 19
chapters, the text is clearly presented
and well illustrated. Each chapter
concludes with references and suggested
activities.

The topics include: hospital facilities;
community resources; current health
problems, including drug addiction;
and responsibilities and opportunities
for the professional nurse. There is a
good chapter on the legal aspects of
nursing.

In summary, this book would be a
useful addition to any nursing library,
and should prove valuable to nurses
involved in planning refresher courses.

accession list

Publications on this list have been
received recently in the CN.A 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.

archive books and directories, almanacs
and similar 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.
>0 Ihc Driveway. Ottawa 4. Ontario.

No more than three titles should be
requested at any one time.

BOOKS AND DOCUMENTS

1 . Advances in public licciltli nursing selected
by the editors from recent issues of Nursing
Outlook. New York. American Journal of
Nursing Company. 1969. 72p.

2. Annual report, 1969. Toronto. Canadian
Kcd ( ross .Society. Ontario Division. 1970.
(iSp.

3. Annual report. NSNA convention.
1969170. New York. National Student
Nurses" Association. Inc., 1970. Iv.

4. Aventure en psychiatric: evolution so-
ciologiqiie d'lin liopital psychiatriqiic par
Denis v. Martin. Paris. Editions du Scarabee.
1969. 223p.

5. Behavioral components of patient cure
by John V. Gorton. Toronto. Collier-Mac-
milian, 1970. 241p.

6. Book list on Latin America for Canadians
edited by Kurt L. Levy. Ottawa. Canadian
Commission for Unesco. 1969. 5 Ip.

7. Care of the patient with common med-
ical-surgical disorders: a textbook for nurses

by Maureen McCutcheon. Toronto. McGraw-
Hill, 1970. I490p.

8. Essais sur I'udministration hospitaliere
par Gilbert Blain. Montreal. Les Editions
de Recherches Administratives. 1969. 13 Ip.

9. The evaluation of nursing education:
report on a Working Group convened World
Health Organization. Regional Office for
Europe. Copenhagen. 11-13 Dec. 1968.
Copenhagen. 1969. 97p.

10. Folio of reports and proceedings, 56
annual meeting. Winnipeg, Manitoba
Association of Registered Nurses. 1970. 48p.

1 1 . Folio of reports, 1970. Halifax. Registered
Nurses" Association of Nova Scotia. 1970
65p.

12. Handbook of medical library practice.
3d. ed. edited by Gertrude L. Annan and
Jacqueline W. Felter. Chicago. Medical
Library Association. 1970. 41 Ip.

13. A happier life: psychiatric self help by
Alfred E. Eyres and Charles T. Pearson.
Durham. N.C.. Moore. 1969. 270p.

14. Manual for librarians in small hospitals
by Lois Ann Colaianni and Phyllis S.
Mirsky. Los Angeles. 1970. 74p.

15. Manual of clinical laboratory procedures
2d. ed. edited by Willard R. Faulkner and
John W. King. Cleveland. Ohio. Chemical
Rubber Co.. 1970. I54p.

16. Matters of life and death by Francis
Camps et al. London. Darton. Longman &
Todd. 1970. 60p.

17. New methods in nursing service lulmin-
istration and nursing education selected

You're ahead with
KLING^ conform bandages

KLING* Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes in bandaging areas that
are hard to bandage and hard to keep
bandaged.

KLING* — the bandage that conforms!

MONTREAL 4 TORONTO - CANADA

'Trademark of Johnson & Johnson or affiliated companies

56 THE CANADIAN NURSE

Don't stick your neck out. Stick
with KLING* conform bandages.

KLING' Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes in bandaging areas that
are hard to bandage and hard to keep
bandaged.

KLING* — the bandage that conformsl

(tiAmrcrn c^fltAn«^n

MONTREAL4TORONTO CANADA

'Trademark, ot Johnson & Johnson or affiliated companies

NOVEMBER 1970

CREIGHTON: By Helen Creighton, R.N., B.S.N., A.B., A.M., M.S.N. , J.D.

Law Every Nurse

Should Know

2nd Edition

Here are the legal facts that every nurse should know. Written by a nurse who
is also a lawyer, this book 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. The first edition became a standard reference and helped
thousands of nurses avoid legal entanglements. This new edition is
substantially larger, including such topics as "good Samaritan" laws, child
abuse, telephone orders, sterilization, and organ transplantation.

246 pages. $8.10. Published June 1970.

COLE:

By frank Cole, M.D.

THg Doctor'^ ^'^'^ "®^ manual is a handy guide to medical abbreviations, notations, and

symbols. Nurses will find it indispensable in reading medical records and
Qi ,1 J orders. Nearly 6,000 entries are included; a special section depicts and defines

tjUOrtUSIlU. symbols used in medicine.

About 288 pages. Soft cover. About $5.40. Just ready.

r

mgety)

- .tin'

LE MAITRE & FINNEGAN:

The Patient

in Surgery

2nd Edition

VOEKS:

On Becoming

An Educated Person

3rd Edition

By George D. Le Maitre, M.D., F.A.C.S., and Janet A. Finnegan, R.N., M.S.

This excellent textbook clearly guides the student through the preoperative,
operative, and postoperative phases of patient care, explaining the nurse's role
and responsibilities as part of the health team. Some of the new topics
discussed in this edition ore: wounds and wound healing, vascular surgery,
open and closed heart surgery, craniotomy.

About 479 pages. About 113 figures. About $6.50. Just ready.

By Virginia Voeks, Ph.D., San Diego State College

This little book has helped thousands of students learn how to learn. In
practical, down-to-earth language, the author tells how to study most
effectively, how to take notes, how to develop greater powers of
concentration, how to profit more fully from lectures. She includes new material
on teaching machines, programmed texts, and new methods of learning
foreign languages.

278 pages. Soft cover. $3.25. Published June 1970.

W.B. SAUNDERS COMPANY CANADA LTD., 1835 Yonge Street, Toronto 7

Please send on approval and bill me:

Q Creighton: Law Every Nurse Should Know, 2nd Edition ($8.10)

□ Cole: The Doctor's Shorthand (About $5.40)

□ Le Maitre & Finnegan: The Patient in Surgery, 2nd Edition (About $6.50)

□ Voeks: On Becoming An Educated Person, 3rd Edition ($3.25)

Nome
Address

City Zone

Province

NOVEMBER I97U

CN n-70
THE CANADIAN NURSE 57

accession list

by the editors from recent issues of Niirsinf;
Outlook. New York, American Journal of
Nursing Co., 1969. 72p.

18. Tlic nurse and llw cancer paiicni: a
programmed textbook by Josephine K.
Craytor and Margot L. Fass. Toronto,
Lippincott. 1970. 260p.

19. Nurse's aide study maniud by Mary E.
Mayes. 2d. ed. Toronto. Saunders. 1970.
239p.

20. Nursing reconsidered; a study of change.
Part 1. The professional role in institutional
nursing by Esther Lucile Brown. Toronto.
Lippincott. 1970. 2 18p.

2 1 . Pediatrics for practical nurses by Eleanor
Dumont Thompson. 2d. ed. Toronto. Saunders.
1970. 348p.

22. Ui presenlalion des theses el des rap-
ports scientifiques: normes et e.xemples
par Adrien Pinard et al. 2. ed. Montreal.
Institut de Psychologie, Universite de Mont-
real. 196.'^. 1 16p.

2.''. La prevention du suicide. Geneve.
Organisation mondiale de la sante, 1969.
90p. (Les Cahiers de sante publique no. i5)
24. Projet de reforme de renseignenieiit dans
la province de Quebec; memoire presente
ail Ministere de Peducation. Montreal.

Association des Infirmieres de la Province
du Quebec. 1965. 61 p.

25. A projection of manpower requirements
by occupation in 1975 by B. Ahamad.
Ottawa. Research Branch. Program Devel-
opment Service. Dept. of Manpower and
Immigration. 1969. 315p.

26. Report 1968169. London. General
Nursing Council for England and Wales,

1969. 72p.

27. Reports to House of Delegates 1968170.
New York, American Nurses' Association.

1970. 145p.

28. Sanity, madness, and the family; fam-
ilies of schizophrenics by R. D. Laing and
A. Esterson. Baltimore. Maryland. Penguin
Books. 1970. 281 p.

29. Study of health facilities in the province
of New Brunswick. Ottawa, Llewelyn-Davies
Weeks. Forestier-Walker & Bor. 1970. Iv.

30. La traduction scientifique et technique
par Jean Maillot. Paris, Eyrolles. 1970. 233p.

31. The undergraduate library by Irene A.
Braden. Chicago. American Library Asso-
ciation. 1970. 158p. (ACRL Monograph 31)

32. Une experience d' education sexuelle
par Henry Tavoillot. Paris. Montaigne.
1969. 226p. (L'enfant et lavenir)

33. Wrigley's hotel directory; official
directory of Hotel Association of Canada.
Vancouver. Wrigley Directories Ltd.. 1970.
413p. R

PAMPHLETS

34. Annual meeting. Committee reports.

1970. Toronto. Canadian Hospital Asso-
ciation. 1970. Iv.

35. Consulting; establishing and maintain-
ing (Ui independant practice by Richard A.
Stemm. Los Angeles. Calif.. Stemm"s In-
formation Systems t*;; Indexes. 1970. 29p.

36. How to get better results front a con-
ference by James M. Dysart. Florida. Univ.
of Palm Beach. 1970. 15p.

37. Maps indicating distribution of popu-
lation tiiul health services in 21 countries.
Washington. World Health Organization.
Pan American Health Organization. 1967. Iv.

38. Provincial association reports 1970.
Toronto. Canadian Hospital Association.
1970.lv.

39. The Red Cross and nursing. Geneva.
League of Red Cross Societies. 1969. 23p.

40. Report. Toronto. Canadian Hospital
Association. 1969. 47p.

41. Report, 1969. London. Council for the
Training of Health Visitors. 1969. Iv.

GOVERN MIENT DOCUMENTS
Cathula

42. Bureau of Statistics. Hospital statistics,
vol. 3. Hospital personnel 1968. Ottawa.
Queens Printer, 1970. 89p.

43. — .Hospital statistics, vol. 2. Hospital
services 1968. Ottawa. Queen's Printer.
1970. 80p.

44. — .Tuberculosis statistics. vol. I.
Tuberculosis morbidity and mortality. 1969.
Ottawa. Queens Printer. 1970. 81p.

Prepare for
a rewarding
career in
foreign lands ^^

^

Take our special course in tropical diseases and
related subjects This equips you when applying
for overseas positions to enjoy special status,
gam valuable experience and serve where the
need is great

Open to graduate nurses, nursing assistants and
paramedical personnel Comprehensive 19-
week course commences in September and Feb-
ruary Train in modern, fully-equipped centre
with attractive accommodation for living in. lo-
cated in Metropolitan Toronto.

For more information write to:

Coordinator. Health Service Course

irrtemational
health institute

4000 LesUe Street, WUowdale,

Ontario, Canada

DIRECTOR

THE

NIGHTINGALE

SCHOOL
OF NURSING

The school offers a two year programme leading to
o diploma in Nursing. It has residential accommoda-
tion for 130 students.

The position involves the direction, leadership and
administration of the school.

The position requires the applicant to be a registered
nurse, v^/ith five years experience in nursing and
holding a university degree in Nursing.

Date of appointment: July 1, 1971

For further information and application — write to:

Chairman, Board of Trustees

NIGHTINGALE SCHOOL OF NURSING

2 Murray St.
Toronto 130, Ontario

58 THE CANADIAN NURSE

NOVEMBER 1970

accession list

45. Commission on Emotional and Learn-
ing Disorders in Children. One million
children. Toronto. Leonard Crainford.
1970. 521 p.

46. Department of Labour. Women's Bu-
reau. Workinf! mothers and their child-cure
arrangements. Ottawa. Queen's Printer.
1970. 58p.

47. Dept. of National Health and Welfare.
Commission of Inquiry into the Non-Med-
ical Use of Drugs. Interim report. Ottawa,
Queen's Printer. 1970. 557p.

48. — .Research and Statistics Directorate.
Hospital morbidity statistics. Based on the
experience of provincial hospital insurance
plans in Canada, January I -December 31,
1965. Ottawa. 1970. 278p.

49. Minister of Labour. Unemployment
insurance in the 70's. Ottawa, Queen's
Printer, 1970. 35p.

Quebec

50. Ministere des Affaires culturelles.
L'Office de la langue frangaise. Diffusion du
franiuis. Quebec, 1970. 3 v. Contents-no. I
Canadianismes de bon aloi.- no. 2 Vocabu-
laire des assurances sur la vie. -no. 3 Vocabu-
laire des elections.

United States

51. Department of Health, Education and

Welfare. Public Health Service. Headache:
hope through research. Washington. U.S.
Govt Print. Off., 1970. 19p. (U.S. Public
Health Service. Publication no. 905)

52. — .Nursing careers. Washington. U.S.
Govt Print. Off.. 1970. n.p.

53. National Heart Institute. Ad Hoc Task
Force on Cardiac Replacement. Cardiac
replacement, medical, ethical, psychological,
and economic implications. U.S. Dept. of
Health, Education and Welfare, Public
Health Service. National Institutes of
Health, 1969. 93p.

54. National Institute of Mental Health.
Essential services of the community mental
health center. inpatient services, rev.
rev. Chevy Chas, Md. U.S. Gov't. Print. Off.,
Wash.. 1969. 19p. (U.S. Public Health
Service publication no. 1624)

55. — .Essential services of the community
mental health center, out patient services
rev. Chevy Chas, Md. U.S. Gov't. Print. Off-
Wash., 1969. 26p. (U.S. Public Health
Service publication no. 1578)

STUDIES DEPOSITtD IN

CNA REPOSITORY COLLECTION

56. The effect of back rub on blood pressure
and pulse in patient with myocardial
infarction by Sister Jacqueline Laquerre.
Saint Louis, Mo.. 1970. 48p. (Thesis (M.Sc.
N)-Saint Louis) R

57. The effect of working conditions on
nursing care in eight general hospitals as
perceived by general staff nurses and patients

by Marilyn Smith Riley. London. 1970.
161p. R

58. Factors affecting faculty attitudes toward
curriculum change in selected diploma
schools of nursing b> Sheila Moreen Creegan.
London, 1970. 121p. R

59. Nursing problems of the paraplegic
patient as seen by the nurse by Myrna
Lindstrom. Vancouver. B.C.. 1970. lOOp.
(Thesis (M.Sc.N.)-British Columbia) R

60. The relationship of the faculty mem-
bers' perception of participation in policy
making to their perception of the usability
of the policy by Sylvia Brough et al. Boston,
1966. (Thesis (M.Sc.N.)-Boston) R

61. A study of the perception of the nurse
and the patient in identifyii.g his learning
needs by Patricia Mary Wadsworth.
Vancouver. B.C.. 1970. 98p. (Thesis (M.A.)-
1970) R

62. A study of selected factors affecting
the communication process employed by
general staff nurses in eight hosfitals in
referring patients with a longterm illness
to the community setting by Elizabeth
Ann Taylor. Vancouver. B.C.. 1970. 69p.
(Thesis (M.Sc.N.)-British Columbia) R

63. A study in the use of role playing with
a .select population by Kathleen Ruth
Miller. New Haven. Conn.. 1970. 146p. R

64. Survey of gradiuites of the University
of Toronto baccalaureate course in nursing
by Nora I. Parker. Toronto. School of
Nursing. University of Toronto. 1968.
66p. R ^

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 Author Short title (for identification)

No.

Requests 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

NOVEMBER 1970

THE CANADIAN NURSE 59

classified advertisements

ALBERTA

BRITISH COLUMBIA

ONTARIO

REGISTERED NURSES FOR GENERAL DUTY for a

37-bed General Hospital Salary $490 to $595 per
montti. Tram fare from any point in Canada will be
refunded after one year employment. Hospital
located in a town of 1100 population. 90 miles from
Capital City on a paved fiigtiway. For full particulars
apply to Two Hills fHunicipal Hospital. Two Hills
Alta.

REGISTERED NURSES FOR GENERAL DUTY m a

34-beo hospital Salary 1968. $405-$485 Experien-
ced recognized. Residence available. For particu-
lars contact Director of Nursing Service, While-
court General Hospital. Wfiitecourt. Alberta. Phone:
778-2285.

BRITISH COLUMBIA

SUPERVISOR Evening and night for the over
all coordination and management of a 150-bed
acute hospital (additional 111 beds under con-
struction). Position open December 1. 1970.
B C. R N personnel policies in effect. Salary
range — $659.00 to $883.00 For furlfier informa-
tion, write to Director of Nursing. Chilhwack
General Hospital. Chilliwacl(, British Columbia.

GENERAL DUTY NURSES lor modern 33-bed hospital
located on the Alaska Highway. Salary and personnel
policies in accordance with RNABC. Accommodation
available m residence. Apply to: Director of Nursing,
General Hospital. Fort Nelson, B.C.

ADVERTISING
RATES

FOR ALL
CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additiorxil line

Rotes for display
advertisements on request

Closing dole for copy and cancellotion is
6 weeks prior to 1st day of publication
month.

The Canadian Nurses' Association does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they ore interested
in working.

Address correspondence to;

The

Canadian ,^
Nurse ^

50 THE DRIVEWAY
OTTAWA 4. ONTARIO.

GENERAL DUTY NURSES for modern 35-becl hospital
located in excellent recreational area. Salary and per-
sonnel policies in accordance with RNABC. Comfor-
table Nurses' home. Apply. Director of Nursing, Boun-
dary Hospital, Grand Forks. British Columbia.

OPERATING ROOM NURSES for modern 450-bed hos-
pital with School of Nursing. RNABC policies in ef-
fect. Credit for past experience and postgraduate
training. British Columbia registration is required.
For particulars write to: The Associate Director of
Nursing, St.Josephs Hospital, Victoria. British Co-
lumbia.

NEW MUNSWICK

DIRECTOR OF NURSING required for 56-bed acute
General Hospital. Salary commensurate with
education and experience. Apply to Administrator,
Sackville Memorial Hospital. Sackville, New Bruns-
wick.

NOVA SCOTIA

GENERAL DUTY NURSES applications are invited
tor active treatment hospital caring for medium and
long term patients. Salary Range: $5,400. — S6.660.
Excellent Fringe benefits and working conditions.
Please apply to: Director of Nursmq. Halifax Civic
Hospital. 5938 University Avenue, Halifax, N.S.

ONTARIO

ROTATING SUPERVISORS required for 180-bed
General Hospital situated at St. Anthony. Newfound-
land. Excellent personnel policies, fringe benefits.
Residence accommodation available. Apply Mrs.
Ellen E McDonald, International Grenfell Association,
Room 701. 88 Metcalfe Street, Ottawa 4. Ontario

SUPERVISOR — PUBLIC HEALTH NURSING — for

generalized program in the Oshawa-Ontario County
District Healtti Unit. Good personnel policies and
salary schedule Position requires Diploma in advanc-
ed Public Health Nursing and Supervision or a
Baccalaureate Degree with Administration. Apply to
Miss G. H Tucker, Director of Nursing. Oshawa-
Ontario County District Health Unit, 50 Centre Street,
Oshawa. Ontario,

REGISTERED NURSES for 34-bed General Hospital.
Salary $525. per month to $625 plus experience al-
lowance. Residence accommodation available. Ex-
cellent personnel policies. Apply to: Superintendent.
Englehart & District Hospital Inc.. Englehart, Ontario.

REGISTERED NURSES needed for 81-bed General
Hospital in bilingual community of Northern Ontario.
French language on asset, but not compulsory. Start-
ing salary $530. monthly witti allowance for past ex-
perience. 4 weeks vacation after 1 year and 18 sick
leave days. Unused sick leave days paid at 100% eve-
ry year. Master rotation in effect. Rooming accom-
modation available in town. Excellent personnel pol-
icies. Apply to. Personnel Director. Notre-Dame Hos-
pital. P.O. Box 850, Hearst, Ont.

REGISTERED NURSES required for a 12-bed Inten-
sive Care-Coronary Care combined Unit. Post basic
preparation and/or suitable experience essential.
1970 salary range $535-645; generous fringe benefits.
Apply to: Director of Nursing, St. Mary's General Hos-
pital, 911B Queen s Blvd., Kitchener. Ontario.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS for 45-bed hospital. RN.s salary $525
to S600 with experience allowance and 4 semi-annu-
al increments. Nurses' residence — private rooms
with bath — $30 per month. R.N.A. s salary $350 to
$425. Apply to: The Director of Nursing, Geraldton
District Hospital. Geraldton, Ont.

REGISTERED NURSES. Applications and enquiries

are invited for general duty positions on the staff of
the Manitouwadge General Hospital. Excellent salary
and fringe benefits. Liberal policies regarding ac-
commodation and vacation. Modern well-equipped
33-bed hospital in new mining town, about 250-mi,
east of Port Arthur and north-west of White River,
Ontario, Pop. 3,500. Nurses' residence comprises
individual self-contained apts. Apply, stating quali-
fications, experience, age, marital status, phone num-
ber, etc. to the Administrator, General Hospital, Ma-
nitouwadge. Ontario. Phone: 826-3251.

REGISTERED NURSES for 100-bed General
Hospital, situated 40 miles from Ottawa. Excel-
lent personnel policies. Residence accommodation
available. Apply to Director of Nursing, Smiths
Falls Public Hospital, Smiths Falls. Ontario,

REGISTERED NURSES (2) Night Duty, small 18-bed
Chronic Hospital, Salary $495 to start, meals includ-
ed, annual increments, fringe benefits. 8 statutory
holidays. Apply Superintendent, Beverley Private
Hospital, 230 Beverley Street, Toronto 130, Ontario.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS. Our 75-bed modern, progressive Hos-
pital invites you to make application. Salaries for
Registered Nurses start at $51000, with yearly
increments and experience benefits. The basic
salary for R NA .s $382.00 with yearly increments.
Room is available in our modern residence. We are
located in the Vacationland of the North, midway
between Winnipeg and Thunder Bay. Write or phone:
The Director of Nursing, Dryden District General
Hospital, Dryden. Ontario.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS, looking for an opportunity wo work in
a patient Centered Nursing Service, are required by
a modern well-equipped hospital. Situated m a pro-
gressive Community in South Western Ontario. Ex-
cellent employee benefits and working conditions.
Write for further information to Director of Nursing;
Leamington District Memorial Hospital Leamington,
Ontario,

REGISTERED NURSES, for GENERAL DUTY and
I.C.U.. and REGISTERED NURSING ASSISTANTS

required for 160-bed accredited hospital. Starting
salary $525.00 and $365.00 respectively with
regular annual increments for both. Excellent
personnel policies. Temporary residence accommo-
dation available. Apply to: Director of Nursing,
Kirkland and District Hospital. Kirkland Lake,
Ontario.

REGISTERED NURSES FOR GENERAL STAFF AND
OPERATING ROOM, in welt-equipped 34-bed
hospital. Gold minimg and tourist" area, wide variety
of summer and winter sports. Modern nurses
residence, room and board and uniform laundry $55.
Cumulative sick-time, 9 sjatutory holidays. 4 weeks
vacation. Salary from $5^5 — $625. with allowance
for past experience and ability. Shift differential $1.
per evening or night shift. Apply to: Matron,
Margaret Cochenour Memorial Hospital. Cochenour.
Ontario.

REGISTERED NURSES FOR GENERAL STAFF AND
OPERATING ROOM, in modern, accredited 235-bed
General Hospital situated m the Nickel Capital of
the world- Good personnel policies. Recognition
for experience and post-basic preparation. Annual
bonus plan. Planned "in-service ", programs.
Assistance with transportation. Apply — Director
of Nursing, Sudbury Memorial Hospital. Sudbury.
Ontario.

PUBLIC HEALTH NURSES required by International
Grenfell Association for areas m Northern New-
foundland and Labrador, Programme based on New-
foundland Department of Health requirements.
Vehicles provided. Residence accommodation.
Excellent fringe benefits. Apply Mrs, Ellen E.
McDonald, International Grenfell Association, Room
701, 88 Metcalfe Street, Ottawa 4. Ontario.

GENERAL DUTY NURSES for 95-bed hospital
equipped with all electric beds throughout. Starting
salary $510.00 per month. Excellent personnal poli-
cies, and residence accommodation. Only 10 minutes
from downtown Buffalo. Apply: Director of Nursmg.
Douglas Memorial Hospital. Fort Erie, Ont

60 THE CANADIAN NURSE

NOVEMBER 1970

December 1970

MISS MTM MORRIS

290 NELSON ST APT 812
OTTAWA 2 ONT 000057 8j^

The

Canadian
Nurse

students have a right
to make mistakes

monitoring the mother
and fetus during labor

chemotherapy in hemodialysis

changing horizons

WHITE SISTER UNIFORM INC., 70 Mount Royal Avenue West, Montreal, Quebec.

WHITE
SISTER

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Fortrel/Nylon Blend.
TOP

Fit & Flair

Back Zipper Closing
Famous White Sister Action Back

PANTS

Elastic Fitted Waist

Extra length for cuffing or wearing plain-
adjustable to your desired length.

Sizes 6 to 16 . . . Sold as a Set only
about $21.00.

#3698: Fabric— Elite 80/20 Dacron Cotton

intimate blend.
TOP

% Length Convertible Sleeves
to be worn with or without self belt
Famous White Sister Action Back

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Dart Fitted waist with zip fly front
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Intimate Blend.
TOP

Hidden Zipper — front closing
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PANTS

Dart Fitted waist with zip fly front
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adjustable to your desired length

Sizes 6 to 16 . . . Sold as a Set only
about $24.00.

THESE

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ARE

AVAILABLE

AT ALL LEADING

DEPARTMENT STORES

AND

SPECIALTY SHOPS

ACROSS

CANADA

DECEMBER 1970

THE CANADIAN NURSt 1

greetings to you who
give patience and
understanding
all year 'round!

CLIIIC

TRADEMARKS REG US PAT, OFF & CANADA. MADE IN U S *

SHOE

THE CLINIC SHOEMAKERS • 7912 Bonhomme Ave. • St. Louis, Mo. 63105

The

Canadian
Nurse

A monthly journal for the nurses of Canada published

in English and French editions by the Canadian Nurses' Association

Volume 66, Number 12

December 1970

27 Students Have a Right to Make Mistakes D.S. Starr

28 Monitoring the Mother and Fetus During Labor T. Willis

32 Chemotherapy in Hemodialysis C. Frye

37 Esophageal Manometry H. Robidoux-Poirier

39 Information for Authors

40 On the Edge of a Cliff M.C. Ricks

I-XVIII 1970 Index

TTie 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.

Cover photo by Julien LeBourdais, Toronto, taken at The Hospital for Sick
Children in Toronto. Nurse Karen Toppings and patient Bill McBride help
to bring the Christmas spirit to the pediatric unit.

4 Letters

1 7 Names

23 Dates

46 Books

48 Accession List

9 News

20 New Products

24 In a Capsule

47 AV Aids

62 Index to Advertisers

Executive Director: Helen K. Mussallem •
Editor: Virginia A. Lindabury • Assistant
Editor: Liv-Ellen Lockeberg • Production
Assistant: Elizabelii A. Stanton • Circula-
tion Manager: Berjl Darling • Advertising
Manager: Rutli H. Baumel • Subscrip-
tion Rates: Canada: one year, S4.50; 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
registration number in a provincial nurses'
association, where applicable. Not responsible
for journals lost in mail due to errors in
address.

Vlanuscripl Infomialion: "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 reserves
the right to make the usual editorial changes
Photographs (glossy prints) and graphs and
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. Permit No. 10,001.
50 The Driveway, Ottawa 4. Ontario.
© Canadian Nurses' Association 1970.

\

a

wish

for

peace

at

this

holy

season

From the editorial staff

DECEMBER 1970

THE CANADIAN 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.

Defends nursing orderlies

As a nursing orderly student, 1 read
with interest your September editorial
comparing nursing orderlies with nurs-
ing assistants. I believe this is an unjust
comparison, and that it is your duty to
find out what is being done to correct
the conditions you mentioned and tell
your readers this. too.

Our nursing orderly school requires
Grade 10 for entrance, accepts persons
from 18 to 55 years of age, and offers
a 30-week program. A graduate is able
to change dressings, report observations
to registered nurses on changes in a
patient's condition, and chart. A trained
orderly can give the same care as a
nursing assistant, and, in addition, is
required to lift patients for the nursing
assistant. A good nursing orderly de-
serves the slightly extra salary he now
receives.

Anyone interested in information
about our training program could write
to: Nursing Orderly School. 10006-107
St., Edmonton, Alberta. — Ronald
Colp. Eili)U)iU()n. Alhcrta.

Reaction to abortion comments

The August 1970 editorial stated "that
abortion should be a matter that con-
cerns only the patient and her doctor..."
It also expressed regret that the
Canadian Nurses" Association was not
the first health profession to advocate
legalizing abortions.

Some would have us believe that life
is not present from the moment of
conception. If this is so, how can the
fertilized ovum develop into an embryo,
then a fetus, and finally a baby? There
can be no growth or development
without life.

How can abortion be a matter that
concerns only the patient and her
doctor? Abortion is the deliberate
killing of a living, though unborn
child, and is therefore murder. All life
is sacred and must be protected or no
life will be safe. Remember Dachau and
Buchenwald? Do not say it could not
happen here. Abortion is only the
beginning.

Nurses should be dedicated to pre-
serving life, not destroying it. I hope
the Canadian Nurses" Association
will never take the stand advocated in
this editorial. Rather, our association
should be protecting its members by
demanding that nurses be given the
4 THE CANADIAN NURSE

right to refuse to assist in abortion
cases. This right should be written into
the contract with hospital manage-
ment.

There must be hundreds of genuinely
concerned nurses in Canada with true
Christian principles. Let us hear from
them. — M. Smith, R.N., Vancouver,
B.C.

In reply to the letter, "Comments on
abortion" (Oct. 1 970), it is a shame that
nursing is a profession in which the
members think they are in a position to
moralize and pass judgment on others.
Abortion, in my opinion, is a private
matter between doctor and patient.
Bringing an unwanted baby into this
overpopulated world is a crime. In this
advanced society we are indeed back-
ward when we deny people a simple
operation that can prevent a life of
misery for an individual who was a
"mistake." A family or individual life
can be ruined because a woman was
unfortunate to become pregnant and
was unable to afford an abortion under
the old law. — R.N., Victoria, British
Columbia.

I was most disturbed by one reader's
views on abortion (Letters to the Editor,
Oct. 1970).

The statement, "We must accept
the consequences of what we do . . .
such as venereal disease or pregnancy"
sounds to me like making a value judg-
ment on the situation in which the pa-
tient finds herself. If we refuse abortion
to a woman, we should also refuse to
treat a woman injured in an auto acci-
dent that was her fault, because by this
reasoning, she must accept the conse-
quences of her actions. This stand seems
punitive.

We may "not know when a fertilized
ovum becomes a person." This ques-
tion is not to be dismissed lightly. How-
ever, as nurses we must be aware of
patients" needs and how best to meet
them. If an unwanted pregnancy takes
its course, the needs of neither the mo-

Letters 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.

ther nor baby can be fulfilled.

Let the champions of the unborn
fetus' rights state how the unwanted
child will be saved from neglect, abuse,
and indescribable hardships. Let us
get away from lofty statements like
"human life is sacred." What about
the quality of that life?

I sincerely hope the Canadian
Nurses' Association takes a stand in
favor of abortion as a matter between
a woman and her physician. If we are
to regard ourselves as belonging to a
progressive organization, there is no
other choice. — Catherine Melnitzer,
Toronto, Ontario.

Expanding role of nurse

Caps off to Mrs. Rosemary Coombs for
her excellent article, "Active-Care
Hospital Nurse Expands Her Role"
(Oct. 1970). I have read nothing in any
nursing journal more pertinent to the
restructuring of present-day nursing
service on a more effective clinical
basis.

The question that arises as a positive
reaction to the article is: how many of
us are ready and willing to put forth the
individual effort to prove ourselves
nurses in the interests of the most
efficient and economical provision of
nursing care?

One may quibble with the four cat-
egories of clinical nurse outlined in
this article. Perhaps such a concen-
tration of specialized nursing care is
possible only in the largest active-
treatment hospitals where the admin-
istration is inclined to direct all the
effort and means at its disposal toward
its immediate purpose — care of the
sick. These categories, however, provide
a starting point for discussing realign-
ment of all nursing personnel in a new
framework of clinical activities.

It is encouraging to see that the
registered nursing assistant, who has a
contribution to make in the care of
patients not requiring complex care,
has not been omitted from the nurse
category. What better way is there to
utilize these workers than to define
and limit their work to the patient
classification they are prepared to
nurse, thus relie\ing registered nurses
for more intensi\e duties in the clinical
specialties.

Mrs. Coombs is right to suggest that

expanding the nurse's role into a

DECEMBER 1970

clinical specialist is one answer to the
doctor assistant proposal. For years the
best nurses have often been the eyes
and ears of the doctor in diagnosis and
treatment. A new category of worker
could easily widen the nurse-patient
gap. Any rational step that will help
keep nurses in contact with patients
reduces the likelihood of someone
or something filling the vacuum.

The constant improvement of patient
care implies readiness to change in
accordance with the indications for
change in our health delivery systems.
By expanding or extending the hospital
nurses role in the clinical specialties
where experience and abilities can be
properly utilized for patients requiring
intensive care, and eliminating non-
nursing functions, we will make a
progressive move toward a truly pro-
fessional service.

We should thank Mrs. Coombs for
showing us a way that Canadian
nurses can realize this goal and expand
our clinical horizon in the right direc-
tion. — Albert W. Wedgery, Reg. N.,
M.A.

Although I agree wholeheartedly with
the principle of clinical expertise in
nursing, the editorial in the October
1970 issue puzzles me. I carefully read
the article "Active-Care Hospital Nurse
Expands Her Role" and I do not see
the experts referred to in this article as
substitutes for doctors' assistants.

In discussing physicians' aides, we
are talking about people fulfilling more
of a field role, which involves making
diagnoses, prescribing treatment,
delivering babies, and so on, in all
areas where a physician is unavailable.
If nurses are reluctant to accept this
kind of role, or if the law is unwilling to
permit them to accept it, there is no
alternative.

We have two choices. We can press
for legislation and subsequently edu-
cational programs to obtain from the
best of our own ranks people willing to
fill a role that involves diagnosis and
treatment, with all the implications.
The success of nurse-midwives in
almost all commonwealth countries
except our own, and of nurse-anesthe-
tists in the United States, shows that this
is safe and in keeping with the legiti-
mate functions of nursing.

Our second choice is to watch a
second category of health worker
emerge. If we are true professionals,
we will welcome this person and not
feel threatened by him. Our vanity will
have to be replaced by recognizing that
with the present shortage of doctors,
a new team member is needed. Pro-
fessional pride is fine, but it must never
come before the all-important consi-
deration of the right of every person to
have comprehensive health care. If we

DECEMBER 1970

abdicate this role, we must be prepared
for the arrival of someone who will
accept it.

We must always remember that our
colleagues, the doctors, are only now
approaching a matter that we are well
on the way to solving: overwork and
proper utilization of staff. Our problem
was solved by nursing assistants, a
worthy group of people who, under
direction, perform many aspects of
care once left to us. Surely the doctors
cannot be denied the same kind of help.
— Sandra Klyne. R.N., Montreal,

RNABC president replies

As someone who was actively involved
in the organized attempts of the Reg-
istered Nurses' Association of British
Columbia to help the two nurses re-
ferred to in the letter "Timely and
revealing" (Oct. 1970), 1 feel bound to
comment on this letter.

The RNABC set up a committee to
look into the situation referred to. (See
"Negligence in the recovery room,"
July 1970, The Canadian Nurse). The
outcome of the review was that no nurse
was condemned by the RNABC, no
license was withdrawn, and no repri-
mands given. However, we were not
meeting to challenge the decision of
the court, as we cannot do that. What
was published was the court's decision,
not ours.

This committee, I believe, recognized
that head nurses, supervisors, and
nursing administrators are all involved
and responsible for staffing during
break periods. Staff nurses are also
responsible to see that their tasks are
adequately delegated when they leave
patients for coffee breaks, for they too
are considered professional people and
are increasingly being held responsible
for their own actions. If they are to be
considered professional, they should be.

The action that the RNABC took
regarding individual nurses in this case
was to counsel and advise them. Fur-
ther, recognizing there were implica-
tions for all our members arising from
this judgment, the committee recom-
mended that several statements about
the position of the registered nurse
with respect to the !aw, and to the chart
as a legal document, be published and
brought to the attention of all members.
This was done through the RNABC
News.

The most important implication,
that of adequately staffing hospitals in
increasingly tight budget situations,
is not within the jurisdiction of the
RNABC. Repeated attempts have been
made, however, to inform the res-
ponsible authorities that in the opinion
of the association, the level of nursing
care in British Columbia hospitals is
becoming unsafe. — Monica D. Angus,
President, RNABC. ^

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THE CANADIAN NURSE 5

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news

Committee On Nursing Research
To Be Established By CNA

Ottawa — The Canadian Nurses' Asso-
ciation will set up a special committee
on nursing research as soon as possible.
This decision, made by the CNA board
of directors at its meeting October 7-9,
was based on a recommendation of the
CNA ad hoc committee on research,
which presented its report to the board
in June. 1970.

As approved by the board, the com-
position of this special committee will
be: a member appointed by each pro-
vincial association; the principal nurs-
ing officer, department of national
health and welfare; the director of CNA
research and advisory services; and the
president of CNA (ex officio). The
chairman will be elected from among
the members.

CNA board members questioned the
need to have a representative from
each provincial association, saying the
primary objective was to have a com-
mittee composed of persons with expert
knowledge ot research methods and an
interest in the development of research
programs. The board then approved a
motion stating that each provincial
association could decide whether or
not to appoint a member.

The board accepted the ad hoc com-
mittee's recommendation "that the
complete statement of policy with res-
pect to nursing research be adopted
by CNA." This statement of policy is
that CNA's role in relation to research
be: 1 . to provide a comprehensive
picture of the profession; 2. to encour-
age and influence the research activities
of individual practitioners and of edu-
cation and service agencies; and 3. to
serve as spokesman for the profession
in relation to research in health ser-
vices.

The ad hoc committee on research
recommended that CNA initiate dis-
cussions with the Canadian Conference
of University Schools of Nursing and
the department of national health and
welfare on the relative areas of respon-
sibility of CNA, CCUSN, and DNHW
for research in the field of nursing.
This was also accepted by the CNA
board.

One of the ad htx: committee's
recommendations, that CNA "accord
high priority to the need to allocate
funds for research, including $100,000
per year to prepare nurses with the

DECEMBER 1970

qualifications necessary to participate
in and direct research projects," was
amended by the CNA board. The
amended recommendation now reads:
"That the association accord high prio-
rity to the need to locate funds to pre-
pare nurses with the qualifications to
participate in and direct research pro-
jects in nursing." Although board
members agreed with the intent of the
ad hoc committee's recommendation,
they believed that other means of fund-
ing for research should be investigated
before specifying any set amount of
money.

Members of the CNA board agreed
that the special committee on research,
which will report its progress to the
CNA board, could meet up to three
times a year if necessary.

CNA Board Of Directors Accepts
Second Ad Hoc Committee Report

Ottawa — Salary increments and the
physician's assistant sparked a live-
ly dialogue at the Canadian Nurses'
Association board of directors meet-
ing October 7-9 when the second re-
port of the CNA ad hoc committee on
Task Force Reports on the Cost of
Health Services in Canada was pres-
ented to and approved by the board.

The ad hex: committee had studied
in depth recommendations having im-
plications for nursing, and had accepted
all but four of them. They had rejected
three and had commented on one that
had been insufficiently clearly stated
for a decision to be made.

Discussion at the board meeting cen-
tered on the task force recommenda-
tions and on the ad hix" committee's
decisions, quoted below:

Recommendation 35 (volume 2, page
160 Task Force Reports): "That the
annual salary increment programs for
health service workers based solely
on time in employment, be phased out,"
was rejected.

Recommendation 36 (volume 2,
page 160): "That criteria for salary
administration in the health services
be developed on the basis of levels of
responsibility and professional or tech-
nological proficiency required, that
salary scales be developed according
to such levels, and that progression
within established salary ranges be
based on improvement in performance

rather than on length of time in service,"
was accepted with the following com-
ments: "The first idea in this recom-
mendation is good, however, the idea
about merit rating is unacceptable at
this time for the reasons given for Rec-
ommendation 35 of this Task Force."

Basically, those reasons are: "...
that until the majority of nursing service
administrators are prepared through
educational programs and experience
for the position of management of
the nursing service department (Rec-
ommendation 20, page 84. volume 2J
or are replaced with a qualified person;
until objective standards for nursing
care have been established; until a
method of measuring the quality of
nursing care has been developed; un-
til criteria for measuring the prod-
uctivity of individual nursing person-
nel has been established; until job stand-
ards for each position in nursing service
departments are clearly outlined; until
nursing service departments have the
staff capable of assessing personnel
accurately and objectively (evaluation
as good as evaluator); support of the
principle of merit rating in salary ad-
ministration as applied to nurses is
premature, and would be detrimental
to collective bargaining programs in
each province of Canada. Improved
personnel policies are desirable, but
should be achieved through collective
bargaining for all those nurses eligible
and have the right to collective bar-
gaining."

Recommendation 28 (volume 3,
page 63): "That promising proposals
for more effective employment of allied
health personnel in the delivery of
medical care be evaluated using well
designed demonstration projects" was
accepted without comment.

Recommendation 29 (volume 3.
page 63): "That a project be funded
under the National Health Grants to
train at least a pilot class of 'practi-
tioner-associates' in a university teach-
ing unit under medical direction and to
evaluate their utilization" was rejected
"because it is premature until demon-
stration projects in relation to recom-
mendation 28 (above) are conducted
and evaluated."

Recommendation 93 (volume 3,
page 383): "That further study in the
use of physician-associates is required
and that such studji should take into
consideration the relationship between
THE CANADIAN NURSE 9

news

family physicians and public health"
was accepted "on the assumption that
it is complementary to and not inde-
pendent of recommendation 28,
(above)."

The summary statement of the com-
prehensive report to the minister of
national health and welfare will appear
in the January issue of The Canadian
Nurse.

CNA Librarian At Meeting
Of Interagency Council
On Library Resources

New York, N.Y. — Margaret L. Par-
kin, librarian at the Canadian Nurses'
Association, chaired the October 2
meeting of the Interagency Council on
Library Resources for Nursing. The
council, which meets in New York twice
annually, works to promote better libra-
ry resources for nursing and to provide
nurses with improved library services
by all health science libraries.

At the October meeting, the coun-
cil's name was changed from the "In-
teragency Council On Library Tools
for Nursing." Miss Parkin told The
Canadian Nurse the name was changed
because the council is now looking
at library resources for nurses in a
much wider way. "The ideal is to have
the nursing library as part of a health
sciences center. This gives each disci-
pline a much broader outlook," the
CNA librarian said.

The council appointed a commit-
tee to update the publication Guide
For the Development of Libraries in
Schools of Nursing by the National
League For Nursing. This publication.
Miss Parkin pointed out, is used all
over Canada.

CNA is the only non-American agen-
cy on the council, which next meets
in March 1971.

CNA Submits Proposals

For Tax Reform

To Minister Of Finance

Ottawa — The Canadian Nurse's Asso-
ciation has acted on a resolution passed
by delegates at the association's general
meeting in Fredericton June 14-19
that CNA make a presentation to the
minister of finance. This presentation
was to include a recommendation that
the minister, in his deliberations on the
White Paper Proposals for Tax Reform,
consider including as deductible ex-
penses, money married nurses spend
to care for children or other dependents
while they practice nursing.

10 THE CANADIAN NURSE

Margaret Myles Demonstrates Art of Midwifery
To Nurses Of The North

Margaret Myles, author of A Textbook for Midwives, is above all a teacher,
her subject — midwifery. Here she demonstrates delivery in a case of vertex
presentation to outpost nurses gathered at Whitehorse, one of her many points
of call during her recent visit to Canada. With Mrs. Myles are, /('// to right,
Alice Letitia Hodges (Gjoa Haven), Muriel Jane McKenzie (Fort Simpson),
Sister Charlotte (Fort Providence) and Ruth E. Sutherland (Cambridge Bay).

In a 10-page submission to the min-
ister, CNA noted that the present tax
structure "lacks incentives to enable
nurses to make provisions from after-
tax salaries for the care of dependents
while they are working," and discour-
ages married women from remaining
in, or re-entering the work force. The
submission stated that adequate induce-
ments would mean that the large num-
bers of nurses in Canada who are not
active in the profession could be prac-
ticing, which in turn would alleviate
many alleged nursing shortage prob-
lems. Also pointed out were CNA
statistics that 84 percent of nurses work-
ing part-time are married, and 84 per-
cent of registered nurses not nursing are
married.

CNA also recommended that revi-
sions in the Income Tax Act be made
to permit single women to deduct house-
keeping expenses from taxable income.

In its conclusion, CNA said that
a modernized tax structure, which
recognizes the role of the married wo-
man in the work force and permits,
as tax deductions, expenses incurred
in the care of family dependents, would
free them to engage in useful or essen-
tial work in the Canadian work force
and would provide beneficial effects
in the field of national health.

International Nursing Index
Loses Canadian Subscriptions

Washington, D.C. — The International
Nursing Index Editorial Advisory Com-
mittee held its annual meeting October
30 at the National Library of Medicine
in Bethesda, Maryland. The INI is the
nursing equivalent of Index Medicus,
the classic index for medical sciences.

Librarian of the Canadian Nurses'
Association, Margaret L. Parkin, at-
tended the meeting on behalf of the
CNA executive director. CNA is par-
ticularly interested in this periodical
nursing index, Miss Parkin says, be-
cause it is the only nursing index that
gives access to French-language lit-
erature.

As Canadian subscriptions to INI
have always been the largest propor-
tion of foreign subscriptions. Miss
Parkin was "distressed to find the num-
ber of Canadian subscriptions has
dropped from 103 to 86." She sees
this decrease as a reflection of the move
from hospital schools of nursing to
community and technical colleges.
These new colleges have not yet picked
up the subscriptions, Miss Parkin ex-
plained to The Canadian Nurse.

A French-language subject heading

guide was prepared for INI to assist

French-language users. To date, only

DECEMBER 1970

four copies have been requested from
the American Journal of Nursing Com-
pany, Miss Parkin said.

The meeting of the Editorial Advi-
sory Committee was held at the Nation-
al Library of Medicine so the mem-
bers could see the library's facilities,
particularly the MEDLARS machine
indexing and retrieval system.

CNA Librarian Consults
With Nursing Library Staffs

Ottawa — More and more schools of
nursing are asking the librarian at the
Canadian Nurses' Association for help
or suggestions concerning their librar-
ies. And as far as CNA librarian Mar-
garet L. Parkin is concerned, the more
requests the better. As she sees it, an
important part of her job is to provide
advice on library resources for nursing.
Miss Parkin was invited to Edmon-
ton October 13 and 14 to consult with

Nurses Seek Comfort, Style

These head nurses at Toronto's
Wellesley Hospital have introduced
what is now optional dress for the
nursing staff. Joyce Pember (left),
Eileen Ryan (center), and Florence
Smart (right), show off their new
dacron and cotton pantsuits, which
they say are ideally suited for bend-
ing, stretching, and climbing. Also
taken into consideration was that
"they're new and in fashion." Many
other nurses at the hospital are pant-
ing to follow suit, we understand.

the school of nursing at the University
of Alberta. She told The Canadian
Nurse the library resources at this
school of nursing were interesting to
see, as they are combined with the
overall health sciences. "This is the
optimum situation for a nursing libra-
ry." said Miss Parkin.

During her visit at the University
of Alberta, the CNA librarian spent
time with the faculty at the school of
nursing and the medical librarian. A
library committee has been formed,
she said, consisting of nursing faculty
and the medical librarian.

Public Health Nurses
Strike In Scarborough

Toronto, Ont. — Following the break-
down of contract negotiations between
the Nurses" Association of the Scarbor-
ough Health Department and the bor-
ough of Scarborough early in October,
the 65 public health nurses working for
the health department voted unani-
mously to strike on October 16. The
Scarborough Health Department has
been greylisted by the Registered
Nurses' Association of Ontario.

According to the nurses' association,
the strike occurred because conciliation
processes failed and the council of the
borough of Scarborough refused to ac-
cept the nurses' offer to be bound by
voluntary arbitration.

Salary is not involved in the dispute.
The nurses' demands center around
car allowance, vacations, posting of
vacancies, and hours of work, which
the employer has said are non-negoti-
able. The offer made to the nurses
in July, which gave them a 10 percent
salary increase this year, an eight per-
cent increase next year, 75 percent of
medical benefits paid this year, and 100
percent paid next year, was made on
condition that the nurses drop all
other proposals.

Behind the issue of car allowance
is the fact that ownership of a car has
been a condition of employment.
Nurses must carry business insurance
if they use their car for work. They
receive 15 cents a mile up to 2,000
miles per year. Approximately half
the nurses drive less than 2,000 miles
per year, the nurses' association says.
The nurses, arguing that allowable
expenses for mileage only do not begin
to pay the cost of keeping a car, are
asking for a flat rate based on the cost
of maintaining a car.

The Scarborough nurses, who receive
a four-week vacation after 20 years'
service and three weeks after one
year, want four weeks' vacation after
working one year. The majority of
public health nurses in Ontario receive
four weeks after one year, the nurses'
asscKiation says.

DECEMBER 1970

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Also demanded is the right that the
nurses be notified by the employer
when vacancies occur in any area of
the health department. As well, the
nurses want starting and stopping hours
of work to be stated in the contract;
they want the employer to state that
these are day-time hours so any sched-
uling that involves work after 5;00 p.m.
will bring overtime or shift differential
pay.

RNAO Replies To Ontario Report
On The Healing Arts

Toronto, Oni. — In its brief to the On-
tario minister of health, submitted in
July in reply to recommendations of
the Report of the Committee on the
Healing Arts, the Registered Nurses'
Association of Ontario noted that "many
areas. . . require joint consultation
with other groups concerned with the
delivery of health care in the province."

For this reason RNAO asked the
government to postpone action on the
recommendations until December 31,
1 970. The Ontario government received
the report from the three-man commit-
tee April 28 after nearly four years
of study.

The brief outlined the RNAO posi-
tion on the report's recommendations
on nursing, contained in a chapter
that discussed the role of nurses, condi-
tions of work, relations of registered
nurses with other groups, manpower
considerations, nursing education, reg-
ulation of nursing, and psychiatric
nursing.

One recommendation by the Com-
mittee on the Healing Arts was that
"an attempt be made by the disciplines
concerned and the department of health
to develop a nurse-midwife in Ontario
. . .regarded as a clinical specialist in
nursing. The committee foresees that
nurse-midwives would work in the
hospital setting under the general di-
rection of physicians but might in ad-
dition undertake pre-natal and post-
natal care in outpatient clinics and
group practices."

In reply to the nurse-midwife pro-
posal, the RNAO said it did not have
a policy, but was studying this recom-
mendation from a nursing point of
view and would be pleased to meet
with other groups to discuss implica-
tions of implementing the recommen-
dation.

The RNAO supported a recommen-
dation that "Ontario enact appropriate
legislation to facilitate collective bar-
gaining for nurses, ensuring .. .safe-

DECEMBER 1970

guards to maintain essential services
and that the legislation also provides
for compulsory arbitration of disputes.
Such legislation should not specifical-
ly designate any agency as the exclu-
sive bargaining agent for nurses but
should be broad enough to encompass
the Registered Nurses' Association of
Ontario which might act as the bargain-
ing agent when requested by the major-
ity of nurses employed in a given bar-
gaining unit.'"

But the RNAO also questioned this
proposal on bargaining. The associa
tion asked, "Is it the intent of this rec-
commendation that such legislation
would provide collective bargaining
rights for all nurses — i.e., nurses in
'management positions' as well as those
who are considered 'employees'? Is
recourse to compulsory arbitration as
the means of settling a dispute if nego-
tiations break down, to be available
to all nurses in collective bargaining
units, not just those in hospitals?"

Two recommendations on which
the RNAO withheld comment con-
cerned the College of Nurses of Ontar-
io. One of the Committee's recommen-
dations was that the College "remain
the certifying and regulatory body for
registered nurses in Ontario, but that
there be representation from the de-
partment of health and significant lay
representation on the board of the Col-
lege." RNAO said it would first like the
phrase "significant lay representation"
clarified, and wanted to know how
such representation would be chosen.

Replying to the recommendation
that "responsibility for the certification
and discipline of registered nursing as-
sistants be removed from the College
of Nurses and assigned to the propos-
ed Health Disciplines Regulation Board
through a division for registered nurs-
ing assistants," RNAO said it would
discuss this with the College of Nurses
of Ontario and the Ontario Association
of Registered Nursing Assistants.

MARN Centennial Workshop
On The Wagon

Winnipeg, Man. — During the spring
and fall of 1970, the Manitoba Asso-
ciation of Registered Nurses, as part
of its celebration of the province's
centennial, has sent its Centennial
Workshop Wagon program to all parts
of the province.

Workshop Wagon teams, made up of
different people from time to time,
met with nurses to discuss problems
of mutual interest and to give advice
and assistance where possible. Schools
and hospitals were visited, and com-
munity programs were organized in
some communities. In Portage La
Prairie the mayor proclaimed a "MARN
Week" and attended a public meeting
arranged for the workshop group.

DECEMBER 1970

jfm.

The MARN Centennial Workshop Wagon was received enthusiastically by nurses
throughout the province, including these nurses at St. Boniface General Hospital.
Standing beside the Centennial Wagon are, left to right, E. Aucoin, M. Cloutier,
L. Arnal. E. Jacques, P. Martel, Sr. A.M. LeFebvre, Sr. I. Pepin, and L. Jutras.
The workshop program was held in schools and hospitals in numerous communi-
fies throughout Manitoba during the spring and fall of 1970.

This workshop project, which was
financed by commissions from the sale
of centennial sweepstake tickets —
a promotion undertaken by the Mani-
toba Centennial Corporation — created
so much interest that plans are under-
way to continue the visits.

Three Schools Of Nursing
Get Together For Workshop
On Nursing Care Planning

Barrie, Ont. — In September, a three-
day Workshop on Nursing Care Plan-
ning, with some 100 nurses participat-
ing, was held at Soldiers' Memorial
Hospital School of Nursing in Orillia,
Ontario. The nurses were from nurs-
ing service and education at the Royal
Victoria Regional School in Barrie,
the Owen Sound Regional School,
Owen Sound, and Soldiers' Memorial
Hospital School.

Doris Carnevalli, asscKiate profes-
sor in the school of nursing at the Uni-
versity of Washington. Seattle, and
co-author of the recently-published
book, Nursing Care Planning, conduct-
ed the workshop. Films, lectures, group
discussions, and work sessions were
part of the workshop program. A visit
to a local hospital and nursing homes
gave the nurses a chance to interview

a patient, using the skills learned in
the workshop.

"Think big, start small," was an
idea stressed by Mrs. Carnevalli in
setting up a system of nursing care
planning. She explained that when a
nurse begins something new she has
to start with an area that is manageable
and reasonable for her. The nursing
care plan system can be spread gradually
from use with one patient to use with
a complete ward, she said.

Mrs. Carnevalli also urged instruc-
tors working with nursing students to
"start small" and help the students use
a care plan for one patient until they
are skilled enough to use the nursing
care plan system for their total patient
assignment.

The workshop leader stressed the
importance of skillful observation of
the patient, which involves recogniz-
ing the cues in the patient's responses.
It is necessary, she explained, to base
a judgment on groups of cues to be
sure the inference made from the cues
is valid. She also pointed out the value
of writing down recognized cues on
nursing care plans to help others make
more accurate judgments or serve as
a baseline for future judgments as the
patient's conditioi^changes.

In discussing the collecting of nurs-

THE CANADIAN NURSE 13

news

ing histories, Mrs. Carnevalli explained
why she thinks the person who collects
the data should formulate the initial
plan of care. This person, she said,
would have first-hand knowledge of
the patient's response during the nurs-
ing history interview, and this could
also help convey to the patient that
he and "his nurse" are working together
to plan his nursing care.

Guidelines she gave for collecting
data for histories were: collect only
information you plan to use, as this
will build up the patient's trust; be
flexible — it isn't necessary to fill out
every space on the form; make a note
of things as they occur in conversation
with the patient; choose the earliest,
yet most convenient interview time
for both nurse and patient; use methods
other than asking questions for a more
creative interview session.

Mrs. Carnevalli emphasized that
students should be given complete ex-
planations of what nursing care plan-
ning is and how it should work. Because
of limited space on the Kardex, they
should learn to think through their
patient's care, but write down only
the priority problems, she said. She
also suggested that the students try
nursing actions or orders already on
the Kardex and that they receive feed-
back on whether their nursing care
plans are functional.

Faculty Of Nursing At UWO
Celebrates 50th Anniversary

London, Ont. — A homecoming con-
ference for nursing alumni of The Uni-
versity of Western Ontario on October
16 commemorated 50 years of nursing
at the university.

"Nursing: Evolution Or Revolution"
was the theme of the conference, chaired
by Dean R. Catherine Aikin and Dr.
Amy Griffin, assistant dean of the Fac-
ulty of Nursing. Louise Brown, associate
professor on the faculty of nursing,
was chairman of the ad hoc committee
for the anniversary celebrations.

Speakers participating in the dis-
cussion of the diverse opinions on the
projected roles of nursing included
Dr. Loretta Ford, professor and coordi-
nator of community health nursing
at the University of Colorado Medical
Center, Denver; Jessie Mantle, assistant
professor on the faculty of nursing at
Western; and Dr. Ruth Elder, school
of nursing and department of sociology
at the State University of New York in
Buffalo.

In her speech. Professor Mantle

14 THE CANADIAN NURSE

Over 250 alumni of the University of Western Ontario's School of Nursing who
attended a special forum on October 1 6 were welcomed by the former dean of
the faculty. Dr. Edith M. McDowell (center) and the present dean. Professor R.
Catherine Aikin (right). Isobel Black, (left), principal nurse consultant of the
Ontario department of health's research and planning branch, read the minister
of health's speech in his absence.

discussed the development of clini-
cal nursing specialties. Stating her
belief that nursing is under pressure
to develop a formally-organized and
professionally-sanctioned structure of
clinical specialties, she emphasized
that the nature of the nursing needs
of patients "should be the organizing
focus"; that research must be conducted
into the needs of the patients to give
intelligent direction to the development
of clinical specialization; and that
"concurrently with the undertaking of
necessary clinical research should go
experimentation with the role of the
clinical nurse specialist.

"The most eloquent appeals for
direction and education in clinical
specialization are coming from nurses
themselves," Professor Mantle said.
"The demands of new technology, the
increasing complexity of medical man-
agement, the general increase in know-
ledge, and changes in the values related
to health care and patterns of delivery
of health services long ago made obso-
lete the idea that every nurse must
or can be au courant with the same
nursing knowledge and skills," she
continued.

The amount of formal education re-
quired to be a clinical specialist was
considered by Professor Mantle. She
referred to the position of the Canadian
Nurses' Association, which states that
the preferred education is a master's
degree in clinical nursing. Disagreeing

with this statement, the speaker said she
does not believe there is enough evi-
dence to support this, "due to the ab-
sence of research findings defining
the kind of knowledge necessary for
specialization and where this instruc-
tion should be obtained. Thus to argue
for a particular level of academic prep-
aration is premature at this time."

A suggestion put forward by this
speaker was that "short-term research
courses could be offered on an exper-
imental basis to registered nurses. This
would hopefully increase their aware-
ness of currently available research
findings, develop a more critical user
of research, and provide more knowl-
edgeable assistants for clinical research
teams.

"The clinical specialist role may
well represent the concrete symbol
that clinical practice is on an equal
footing with teaching and administra-
tion as a professional goal," said Pro-
fessor Mantle.

Pay Increase To Nurses
Prevents Strike

Amherst, N.S. — Nurses of Amherst's
Highland View Hospital will be richer
by $600 this year. On November 7 the
44 members of the nurses' staff associa-
tion of the Highland View Hospital
achieved a salary increase of $50 per
month retroactive to January 1, 1970,
with a further increase of $25 per month

DECEMBER 1970

for 1971. The 1970 increase brings the
nurses' monthly salary to $475.

The Amherst nurses were the first
group to be certified under the Nova
Scotia Trade Union Act, the first to
begin collective bargaining, and the
first to vote to strike in the province.

Negotiations and conciliation pro-
cedures over a period of 13 months
resulted in amelioration of all problem
areas except that of salaries. The re-
sulting impasse prompted 43 of the 44
association members on October 9 to
consider strike action, with the vote
date set for October 28.

The nurses did resort to the with-
drawal of some activities, such as car-
rying trays and ignoring verbal orders,
but did state that in the event of a full-
blown strike, all essential services
would be maintained.

Ontario Health Minister
Announces End Of Internship
For Diploma Nurses

Toronto, Ont. — Thomas Wells, On-
tario Minister of Health, told hospital
trustees and medical staff attending
the annual Ontario Hospital Associa-
tion convention October 27, that the
province will phase out the hospital
internship year for diploma nurses,
beginning in September 1971. The
minister's talk was reported in The
Globe and Mail October 28.

Phasing out of the two-plus-one
program, begun in Ontario in 1965,
will mean that by 1973 registered
nurses will graduate in two years,
Mr. Wells explained. He added that
about 23 nursing schools can end their
internship requirement in 1971, 15
schools in 1972, and another seven
in 1973. According to the health
minister, the goal set in 1965 to in-
crease the number of graduate nurses
each year to 5,000 has almost been
reached.

Before this announcement the OHA
had passed a resolution calling on
the minister of health for a guaran-
tee that the government would provide
hospitals with extra funds for post-
graduate inservice training for two-
year nursing graduates.

Stiff Competition For Jobs
Faces Nurses In B.C.

Vancouver, B.C. — Following press
reports that many registered nurses
recently graduated in British Colum-
bia cannot find employment in the
province's hospitals, a spokesman for
the Registered Nurses' Association
of British Columbia told The Canadian
Nurse the employment situation for
nurses is competitive with that in other
professions and reflects the economy
in general.

DECEMBER 1970

F.A. Kennedy, executive director of
RNABC, said the association has been
announcing since 1962 that there is
no shortage of nurses for first-level
positions in the province, but it could
not convince anyone that this was so.
"For many years nurses had no trouble
obtaining employment in British Co-
lumbia, and now the situation is com-
petitive," Miss Kennedy said.

RNABC's executive director pointed
out there is still some turnover in nurs-
ing positions, although nurses may
have to wait for positions as they open
up and no longer be as selective about
shifts and job location. Adding to the
problems nurses experience when they

are unable to find work for several
months is the fact that they are ineligi-
ble for unemployment insurance, Miss
Kennedy added.

An RNABC survey of 100 registered
nurses newly enrolled with the asso-
ciation's placement service during the
period of September 1 to October 26,
1970, showed that 85 nurses were look-
ing for employment at the end of this
period. A follow-up found that 41 of
these nurses are now employed and
19 are sfiU unemployed. The remain-
ing 23 nurses could not be reached.

A total of 278 nurses was taken
on staff at five British Columbia hos-
pitals in July, August, and Septem-

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THE CANADIAN NURSE 15

news

ber; 150 of these were British Colum-
bia graduates and 128 were graduates
from outside the provice.

RNABC is warning nurses outside
the province not to come to British
Columbia unless they are already as-
sured of employment. At the present
time there is no change in the asso-
ciation's recruitment program, although
the RNABC is emphasizing that stu-
dents who qualify should enter the
university program.

RNAO Membership Fee
Increased To $50

Toronto — At a special meeting of
members of the Registered Nurses'
Association of Ontario October 3, an
amendment was made to the associa-
tion's bylaw, which sets $50 as the
annual regular membership fee, includ-
ing subscription to The Canadian Nurse.

At the association's 1970 annual
meeting, the membership year was
changed from January 1 - December 3 1
to November 1 - October 3 1 , effective
November 1, 1970. As current mem-
bers and affiliates had already paid fees
to the end of 1970, and as the 1971
membership year will be a short one,
it was decided to adjust the fees ac-
cordingly.

To apply the principle of an ad-
justed fee to all 1971 members, the
regular membership fee for those who
were not members in 1970 will reflect
a two-month fee at the rate of $35 per
year, and a 10-month fee at $50 per
year.

Fees for 1971 and 1972 for regular
members and affiliates holding 1970
certificates are $42 and $50; $15 and
$18 for affiliate non-working members
and affiliate post-basic students; and
$10 and $12 for affiliate out-of-prov-
ince members. For members not holding
1970 certificates, regular members will
pay $48 in 1971 and $50 in 1972;
affiliate non-working members and
affiliate post-basic students will pay
$ 1 8 for both years; and affiliate out-of-
province members will pay $12 for
both years.

Nurse Claims Task Force
Sees Symptoms, Not Causes

Toronto, Ont. — The sections of the
task force report on the cost of health
services in Canada related to nursing
service in hospitals is largely a report on

16 THE CANADIAN NURSE

The uniform designed for students at
the University of Calgary's new school
ofnursiiig are made of while, anti-static
material. Students can change the color
if they wish, says the school's director.
Dr. Shirley R. Good, and the skirt
lengths won't be regimented either.
" Whether or not caps will be a part of
the uniform remains for the students to
decide. If sixty percent of the students
want to have caps, they will be asked
to design a style, and then they will
have to live with it, she added."

the symptoms, rather than their un-
derlying causes, according to one
nurse. Shirley M. Stinson, professor in
the division of health services adminis-
tration at the University of Alberta, was
addressing directors of nursing at a
panel discussion at the annual conven-
tion of the Ontario Hospital Associa-
tion in Toronto October 26-28. She was
replying to an address by Peter E. Swer-
hone, executive director of The Winni-
peg General Hospital, who outlined
the report's findings and recommenda-
tions.

In reply to the commission's recom-
mendation that nurses set up objectives.
Dr. Stinson said nurses already have
objectives. Their main problem, she
said, is that they are not always realistic.
"Too often we pay only lip service to
the objective of patient care, and in the
real situation it is some other objective
that is met first." She also pointed out
the difference between the objective
of health care given by the task force,
"the greatest good for the greatest

number," and the one generally held by
nurses, "whatever is best for the indi-
vidual." Neither, she said, could stand
by itself, but the conflict ought to be
recognized.

Dr. Stinson agreed with the report's
recommendation that criteria be set up
for the evaluation of nursing efficiency,
but pointed out their present lack does
not mean it is totally impossible to
evaluate nursing care. She emphasized
it is not only nurses who need criteria,
and that the approach must be an in-
terdisciplinary one. She called for the
upgrading of skills in all personnel,
including hospital administrators and
doctors. "Nursing cannot be judged in
a vacuum," she said.

The application of industrial and
management techniques to nursing is
of limited value, according to Dr. Stin-
son, as the patient is not a consumer
with whom certain risks can be taken
as on the industrial market. What is
needed, she added, is a systems ap-
proach in which the quality of nursing
care would be studied at the same time
as its efficiency and cost.

"But the application of management
techniques must be selective," she said.
"A group of yes-men would result from
the task force's recommendation to
reward extra service monetarily beyond
salary. Money is not the only reward of
good nursing."

M.J. Gerrow, assistant administrator
of Ajax and Pickering General Hospital,
and Margaret Charters, director of
nursing of Hamilton General Hospital,
also spoke briefly. The session, attended
by a capacity crowd, was chaired by
Sylvia Burkinshaw, director of nursing
at the Kingston General Hospital.

University Of Calgary Accepts
its First Class Of Nursing Students

Calgary, Alberta — Fifty young women
have been admitted to the first class of
the University of Calgary's new school
of nursing. The students, mostly from
the Calgary area, started a four-year
bachelor of nursing program in mid-
September.

The new program is "people-ori-
ented," says the school's first director,
Shirley R. Good, who was consultant
in higher education for the Canadian
Nurses' Association prior to assuming
her present post. Emphasis is on pre-
ventive and remedial care, and the
program has been developed to prepare
students for the changing role they will
be required to play in providing ade-
quate nursing care for the future. "What
we are hoping to do is to turn out
graduates who can see the whole nursing
picture, and are equipped to care for the
patient's total health needs — physi-
cally, mentally, and emotionally," Dr.
Good said. ^

DECEMBER 1970

names

It is with a sense of loss that we at CNA
House say farewell to Lois Craham-
Cumming who has made such a con-
tribution to nursing in Canada. She
was part of the brain drain from the
U.S.A. when she came to Canada to
become the bride of Dr. George
Graham-Cumming. It is due to his
retirement from the department of
national health and welfare that Lois
is leaving — after all. she has to look
after her man. and he has chosen to
retire to Vancouver. So, in a sense,
weVe not really losing our director of
research and advisory services of seven
years, for we're sure her nursing talents
and know-how will be sought after in
her new milieu.

Besides re-activating the concept of
research in nursing, and administering
the area of national nursing consulta-
tion, Mrs. Graham-Cumming found
time to initiate the most valuable of
references. Countdown. Its continued
publication will be her legacy to the
Canadian Nurses' Association.

Fay Lawson IVIcNaught (R.N., Win-
nipeg General Hospital; B.N., Univer-
sity of Manitoba) has recently been
appointed director of nursing education
of the Grace General Hospital School of
Nursing, Winnipeg. Mrs. McNaught is
also the first vice-president of the
Manitoba Association of Registered
Nurses.

Maila Maki (Wel-
lesley Hospital, To-
ronto) was elected
president of the
Canadian Associa-
tion of Neurological
and Neurosurgical
Nurses at its first
annual meeting held
in Toronto in June.
This meeting was held in conjunction
with the fifth annual meeting of the
Canadian Congress of Neurological
Sciences.

Other members of the executive are:
Past President: Jessie F. Young, To-
ronto; Vice-President: Lorina Friesen,
Vancouver; Secretary: Jacqueline
LeBlanc, Montreal; Treasurer: Carol
Schick, Winnipeg.

Council members elected are: Lorina
Friesen, representing British Columbia;
Lynn Baldwin, Alberta; Janet Barrie.
Saskatchewan; Carol Schick, Manitoba;

DECEMBER 1970

Lillian Pettigrew Honored At Investiture

Lillian L. Pcttigicu. a.^sov.aL^ executive director of the C<tiiauia/i Nurses'
Association, was invested as a serving sister in the Venerable Order of St. John
of Jerusalem by His Excellency the Governor General, at the Investiture held
at Rideau Hall, October 24, 1970. Miss Pettigrew, one of many honored on
this occasion, has had a distinguished career in nursing, having been executive
secretary and registrar of the Manitoba Association of Registered Nurses for
several years prior to her appointment as CNA associate executive director.

Maila Maki and Jessie F. Young,
Ontario; Jacqueline LeBlanc and
Geraldine Hart, Quebec; Catherine
MacDonald, Nova Scotia; Patricia
Courtney, New Brunswick, Prince
Edward Island, and Newfoundland.

Dean R. Catherine Aikin has announced
appointments to the faculty of nursing
at The University of Western Ontario.

Robert C. Leonard (Ph.D., University
of Oregon) — visiting professor for the
1970-71 academic year. Dr. Leonard
is on leave as professor of sociology
from the University of Arizona in
Tucson. He has been a consultant in
research methodology of the college of
nursing at University of Arizona for the
past six years and was assistant pro-
fessor of nursing and sociology at Yale
University from 1 960 through 1964. In
addition to research consultation with

the nursing faculty. Dr. Leonard will be
a consultant to the other health science
faculties and to the scKiology depart-
ment, assisting in the development of
a medical sociology program.

Sheila M. Creeggan ( Reg.N., Toronto
General Hospital; M.Sc.N., University
of Western Ontario) — assistant pro-
fessor. Miss Creeggan taught obstetrical
nursing and basic sciences at the
Ottawa Civic Hospital and was director,
school of nursing. Public General
Hospital, Chatham, Ontario.

Hattie Shea (R.N., Dallas Methodist
Hospital. Dallas, Texas; B.S.N. Ed.
and Graduate Study. University of
Texas) — assistant professor. Her
experiences include head nurse, office
nurse, public health nurse, OR super-
visor. Her last position was teaching
medical-surgical nursing at the
University of Texa» Nursing School,

Austin, Texas. iCani;!. mi pai;e IS)

THE CANADIAN NURSE 17

Whenyourday
starts at ^:^
6 a.m... you're oji
chargeduty... ^
you've skimped'
on me a I s...^?^
and on sleep. .^ '^
you haven't had^
time to hem

a dress. ..\^
mal(e an apple pie...
wash your hair...^
evenpowder ^|
your nose. ^^" '
in com fort 5

it's lime 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

DOXIDAN"

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 comfortable.
For detailed information consult Vademecum
or Compendium.

HOECHST

PHARMACEUTICALS

3400 JEAN TALON W , MONTREAL 301
blVISION OF CANADIAN HOECHST LIMITED

l-""l

18 THE CANADIAN NURSE

names

(Continued from pa^^e 11)

Elizabeth Weber (Reg.N., Victoria
Hospital, London, Ont.; B.Sc.N., Uni-
versity of Western Ontario) — lecturer.
Mrs. Weber was on the teaching faculty
of the school of Nursing, Women's
College Hospital, Toronto for five
years. She taught psychiatric nursing
for one year at the Atkinson School of
Nursing, Toronto.

Carolyn Petersson (Reg.N., Victoria
Hospital, London, Ont.; B.Sc.N.,
Wayne State University) — instructor.
Mrs. Petersson has experience in
general duty and psychiatric nursing
and in public health nursing with the
City of Toronto.

Lorraine Mahoney (R.N., Moncton
Hospital School of Nursing; B.N.,
McGill) — instructor. Miss Mahoney's
previous experience includes medical-
surgical areas and teaching at the
Hamilton Civic Hospital &:hool of
Nursing.

Vera R. Peacock has retired as assistant
director of nursing at the Manitoba
Rehabilitation Hospital - D.A. Stew-
art Centre, Winnipeg. Miss Peacock
taught school in rural Alberta before
training as a nurse at the St. Boniface
Hospital School of Nursing. After four
years as an outpost nurse in the north-
land, she returned to teaching — to
establish a training pogram for prac-
tical nurses at the St. Boniface Sanator-
ium, then to instruct at the Central
School for Practical Nurses in Winni-
peg. Followinga University of Manitoba
course in teaching and supervision, she
became science instructor at the St.
Boniface Hospital School of Nursing.
For the past eight years Miss Peacock
has worked at the Manitoba rehabili-
tation Hospital.

Rachel Young, Assistant Director of
Nursing, Alberta Hospital, Edmonton,
has retired. Mrs. Young began her
nursing career in 1939 at the Alberta
Hospital, Ponoka. In 1943 she moved
to the Alberta Hospital, Edmonton,
where she has worked throughout
most of her career.

The Director of the School of Nursing,
Dalhousie University, Halifax, has
announced the following staff appoint-
ments:

Ann Gwendolyn Jackson (B.Sc.N.,
M.Sc, McGill School for Graduate
Nurses, Montreal) as assistant profes-
sor.

Marilyn Riley (R.N., Payzant Mem-
orial Hospital, Windsor, N.S.; dipl.

hospital nursing service administration.
University of Saskatchewan. Saskatoon;
B.N., Dalhousie University; M.Sc.N.,
UniversityofWestern Ontario, London)
as assistant professor. Miss Riley was
a Canadian Nurses' Foundation fellow
while at the University of Western
Ontario.

Maggie Chan Kong

(Reg.N.,MountVer-
non Hospital, North-
wood, Middlesex,
England; B.N.S.c.
nursing education
and public health
nursing,Queen'sUni-
versity) has been
appointed assistant
director of the Scarborough Regional
School of Nursing, West Hill. Ontario.
Mrs. Kong's nursing education exper-
ience includes Hotel Dieu Hospital,
Kingston, Ontario; Brandon General
Hospital, Manitoba; Scarborough Gen-
eral Hospital and Whitby Psychiatric
Hospital. She succeeds Mrs. Veronica
Orton-Johnson, who has taken up
residence in England.

Dr. John J. Deutsch, principal of
Queen's University, has announced new
appointments to Queen's University
School of Nursing, Kingston:

Ruth Miller (B.N.Sc, University of
British Columbia; M.Sc.N., 'Yale
University), as assistant professor of
nursing. For the past two years Miss
Miller has studied at Yale as a Cana-
dian Nurses' Foundation fellow. She
has been an instructor in mental health
services in British Columbia and a con-
sultant in psychiatric nursing at the
Kingston General Hospital.

Marie Powers (B.S.N. , Nazareth
College, Rochester, N.Y.; M.Sc.N.,
Boston University School of Nursing)
as assistant professor of nursing. Miss
Powers was supervisor at Babies
Hospital, Columbia University Medi-
cal Center, New York, and more re-
cently assistant professor at Corning
Community College, Corning, New
York.

Barbara Kisilevsky (B.Sc.N., M.N.,
University of Pittsburgh School of
Nursing). Mrs. Kisilevsky has had
experience in institutional nursing and
as instructor in a hospital school of
nursing. Her husband. Dr. Robert
Kisilevsky has also joined the faculty
at Queen's University.

Kathryn Shrum (B.Sc. in food
science. University of Toronto; M.Sc,
University of Toronto) as half-time lec-
turer in the school of nursing and half-
time therapeutic dietitian at the King-
ston General Hospital, Kingston, On-
tario.

DECEMBER 1970

Muriel E. Small (R.N., Montreal
General Hospital; B.N., McGill Uni-
versity. Montreal; M.A., Washington
University) as assistant professor. Miss
Small worked for many years with the
Metro Health Services of Vancouver,
and was associate professor at the
University of Toronto School of Nurs-
ing, prior to returning to eastern
Canada.

Jo- Ann (Tippett) Fox (R.N., The
Montreal General Hospital; B.N., Uni-
versity of New Brunswick. Frederic-
ton) as assistant professor. Mrs. Fox has
been studying toward an M.Sc. degree
in physiology from Queens University,
Kingston, and expects to graduate in
1971.

Margaret Arklie (R.N.. Victoria
General Hospital School of Nursing;
Dipl. Nursing Service Administration,
Dalhousie University; B.N.. Dalhousie
University) as instructor. Miss Arklie
has been assistant head nurse at the
Calgary General Hospital. Its staff
nurses" association scholarship enabled
her to earn a diploma in nursing service
administration at Dalhousie University
in 1967.

Evelyn Joyce Carver (R.N., Prince
Edward Island Hospital School of
Nursing; Dipl. in Public Health and
B.N.. Dalhousie University) as instruc-
tor.

Judith (Hattie) Cowan (B.N.. Dipl.
Pub. Health. Dalhousie University) as
instructor.

Margaret Rose Matheson (B.Sc.N.,
Mount Saint Vincent University, Hal-
ifax) as instructor.

Nancy Elizabeth Riggs (R.N., Vic-
toria General Hospital School of Nurs-
ing. Halifax; B.N., with diploma in
teaching in schools of nursing,
Dalhousie University) as instructor.

Linda Robinson (Reg.N., Nightin-
gale School of Nursing. Toronto; B.N.
and dipl. in teaching in schools of nurs-
ing, Dalhousie University) as instructor.

Gail Dronyk (R.N., University of
Alberta Hospital, Edmonton; B.Sc.N.,
University of Alberta, Edmonton) was
recently appointed nurse-in-charge,
Victorian Order of Nurses, Owen
Sound. She replaces Loretta Baerg who
has returned home to Edmonton.

The New Brunswick Association of
Registered Nurses awarded scholarships
of $500 each to ui.dergraduates in the
baccalaureate degree course in nursing:
Jacinthe Chiasson of Lameque. who is
a student in the basic program at the
University of Moncton; Anna May
Doak of Doaktown, who is enrolled in
the basic program at the University of
New Brunswick School of Nursing,
Fredericton: Judith Walters, R.N., of

DECEMBER 1970

Authority on Midwifery Visits British Columbia
Institute of Technology

Mrs. Margaret Myles. author of the authoritative Textbook for Mkiwives,
visited the British Columbia Institute of Technology in September to address
nurses on her chosen topics: "Every maternity nurse as a teacher," "Critical
survey of methods of pain relief," and "Newer methods of obstetric practice."
Those present included nurses from many parts of British Columbia engaged
in maternity nursing, public health nursing, and in teaching.
With Mrs. Myles above, lefi. is Mrs. Barbara B. Kozier of the BCIT, who
is department head of patient care services.

Fredericton, who is enrolled in the
degree course at the University of New
Brunswick; and Yim Wong, R.N., of
Dalhousie, who is in the degree course
at the University of Ottawa.

Lois James (Reg.N..

Victoria Hospital
School of Nursing.
London, Ont.) has
just begun her sec-
ond two-year term
with MEDICO inSu-
rakarta. province of
Central Java, and
will be involved in
training student nurses and upgrading
nursing services at local hospitals.

Miss James, who previously served
with MIDICO in Honduras as director of
the School of Certified Auxiliary Nurses
at the Hospital de Occidente in Santa
Rosa, believes "only by a long-term
team effort can we assist the local
people in upgrading nursing and im-

proving health conditions in a develop-
ing country."

Mary Roberta Noseworthy (B.N.,
School of Nursing, Memorial University
of Newfoundland) was granted the first
award of the Annual Faculty of Nursing
Award (S200). Miss Noseworthy is now
staff nurse at St. Clare's Mercy Hos-
pital, St. John's, Newfoundland.

The University of Alberta, School of
Nursing, Edmonton, has announced
appointment of three lecturers:

Patricia L. Sullivan (B.Sc.N., Mount
Saint Vincent University, Halifax;
M.Sc.N.. Boston Univcrsitv).

Pegg> (Keith) Wilson (R.N., Calgary
General Hospital; B.Sc.N., University
of Alberta, Edmonton).

Brenda (Bayston) Wroot (R.N.,
University of Alberta Hospital. Edmon-
ton; B.Sc.N., University of Alberta,
Edmonton). §

THE CANADIAN NURSE 19

new products {

Descriptions are based on information
supplied by the manufacturer. No
endorsement is Intended.

Overhead Laundry Handling System

Continuous Flotation Therapy

The FloteBedPad, developed by DePuy
Inc., provides continuous flotation
therapy from wheelchair to bed. Used
with or without water, it distributes
body weight evenly, thus eliminating
excessive pressures and permitting
restoration of blood circulation to the
decubitus sites. The pad measures 18"
X 22" X 2" and fits into a polyurethane
foam leveling mattress. The leveling
mattress fits on a hospital bed of stand-
ard size.

Other total flotation products
manufactured by DePuy arc the Flotc-
Bed and the FlotePad.

For additional information write Guy
Bernier, 862 Charles-Guimond, Bou-
cherville, Quebec, or John Kennedy,
2750 Slough Street, Malton, Ontario.

Overhead Laundry Handling System

Eaton Yale & Towne's Automated
Equipment Division has introduced a
new overhead handling system that
increases production capabilities of
commercial and institutional laundries
by as much as 600 percent.

Called the American Monorail
20 THE CANADIAN NURSE

"Gravity-Flo" Laundry Handling Sys-
tem, it employs overhead monorail
equipment for speeding soiled linen
through complete laundering cycles by
means of heavy duty slings. The Ameri-
can Monorail 401 track can be bent or

turned, elevated or lowered to meet all
types of building requirements. Heavy
duty "Gravity-Flow" 4-wheel trolleys
with 1000-lb. carrying capacity convey
one or more slings through the system in
fast production cycles. Systems are
available complete with slings, sorting
equipment, carts. Installation is includ-
ed in cost.

For more information write Auto-
mated Equipment Division, Eaton Yale
& Towne Inc., Cleveland, Ohio 441 17.

Slow-K Tablets

Ciba's Slow-K tablets each contain
600 mg. of potassium chloride in a
unique, slow-release core specifically
designed to release potassium chloride
gradually from an inert base during
transit through the alimentary tract.

Slow-K tablets provide, in palatable
form, the correct salt where potassium
supplementation is necessary, partic-
ularly during prolonged or intensive
diuretic therapy. Because of the three
to four hours required for the complete
release of the potassium chloride, Slow-
K is unlikely to produce hyperkalemia
in patients with a degree of renal im-
pairment.

The range of indications for Slow-K
may be summarized as follows; as a
supplement to diuretics; ulcerative
colitis; hypochloremic alkalosis; ste-
atorrhea; Cushing's syndrome; chronic
diarrhea; liver cirrhosis; regional ileitis;
diseases characterized by persistent

Continuous Flotation Therapy

DECEMBER 1970

vomiting or diarrhea, continuous with-
drawal of gastrointestinal fluids; digita-
lis therapy; ileostomy; neoplasms or
obstruction referable to the gastroin-
testinal tract.

When administered as a potassium
supplement during diuretic therapy,
a dose ratio of one Slow-K tablet with
each diuretic tablet will usually suffice
but may be increased as necessary.

Slow-K is supplied in the form of
tablets (pale orange, coated), each
containing 600 mg. potassium chloride
in a slow-release, inert wax core; bottles
of 100 and 1000.

Ciba Company Limited. Dorval.
Quebec will provide further informa-
tion on request.

Drape Packs and Surgical Gowns

Johnson & Johnson Limited. Montreal,
has introduced moisture-repellent drape
packs and surgical gowns. Made from
reinforced nonwoven fabric, these packs
and gowns provide guaranteed sterility,
uniform pack design, complete dispos-
ability, and storage convenience.

For more information write to
Johnson & Johnson Ltd., 2155 Pie IX,
Blvd.. Montreal 403. Quebec.

Literature Available

Market Forge announces the availabil-
ity of a newly published, full-color,
loose leaf brochure describing its Hos-
pital Modular Systems Work Units
called HMS — a unique modular sys-
tems concept to solve material storage
and usage problems.

HMS combines stainless steel or
plastic laminate work surfaces with
modular shelf components that become
a highly functional storage/work unit
designed to improve operational effi-
ciency.

The brochure illustrates the bene-
fits of open storage HMS; the basic
modules that compose HMS; construc-
tion details, optional accessories, typi-
cal layouts for actual hospital situations,
and HMS specifications.

HMS satisfies the specific work
flow and storage requirements of such
diverse areas as central sterile supply,
operating room, anesthesia work rooms,
inhalation therapy, as well as nursing
service areas.

HMS units are shipped knocked down
to reduce shipping costs. Installation
is simplified due to the elimination
of field bolting, grouting, plastering,
and trimming.

In HMS installations the reduction
in the number of doors, hinges, han-
dles, latches, drawers, and related case-
work hardware cuts costly maintenance
expense. Since HMS stands free, no
wall mount supports, filled floor tile
or built-in masonary work are required.
Renovation or redesign of areas is thus
readily accomplished.

DECEMBER 1970

Thanks,
from my
other.

When Kim Young Sook thanked her
Foster Parents for her mother's wet
suit, she thanked all Foster Parents
for their understanding, their love and
their help.

Young Sook's mother dove for sea
greens and shellfish and sold them
to earn the 39(' a day that was the
family's income. She could dive only
in the summer, because in the winter
it was too cold.

Her Foster Parents knew that their
donation of $17 a month could help
make up for the loss of income and
provide the family with basic ne-
cessities. But they felt that their gift
of a wet suit could help the family
help themselves and so they sent a
wet suit to Young Sook's mother.

Soon a letter arrived from Young
Sook: "Reading in your letters that
you are trying to send the rubber
suit for my mother. 1 found it hard to refrain from tears. I don't know
just how to thank you for your kindness". The wet suit proved so helpful
to the family that Young Sook's Foster Parents sent another one to their
Foster Child's older sister.

This is an example of Foster Parents Plan at its best; a true reaching
out to less fortunate people to give a gift of love. The story of Foster
Parents Plan is more than food, clothing, medical care and schooling.
It is a Foster Parent helping a child and his family toward self-sufficiency
and a better way of life.

PLAN operates in Bolivia, Brazil, Colombia, Ecuador, Peru, Indonesia, Korea,
the Philippines and South Viet Nam.

Approved by Department of Revenue, Ottawa.

I Foster Parents Plan of Canada
Plan de Parrainage du Canada

I FOSTER PARENTS PLAN, Dept. CN 12-1-70

I 153 St. Clair Avenue West, Toronto 7, Ont. Can.

A. I wish to become o Foster Porent of o needy child for one yeor. If possi- |
ble, sex oge nationality

I I will pay $17 o month for one year or more ($204 per year). Poymenfi |

I will be mode monthly □ , quarterly □ , semi-annually □ . annually □ . I

I I enclose herewith my first payment $ . I

I B. I cannot "adopt" a child, but I would like to help a child by I

I contributing $ i

1 C. Pleose send me more infofmofion on Foster Parents Plan. '

I I

I Name '

I Address I

I City

Date

Prov.

L-

Cenfributions Income Tax DaductibU

When someone somewhere cares, someone somewhere sitfvives

THE CANADIAN NURSt 21

Next Month
in

The

Canadian
Nurse

• Nursing — Evolution
or Revolution?

• Management of Parkinson's
Disease

With L-Dopa Therapy

• Congenita! Rubella

— One Approach to Pre-
vention

&

^^P

Photo Credits for
December 1970

Julien LeBourdais, Toronto,
cover photo.

Yellowknife Photo Centre, Ltd.,
Yellowknife, N.W.T., p. 10
Roy Nichols Photographer,
Willowdale, Ont., p. 1 1
Manitoba Association of Regis-
tered Nurses, Winnipeg, Man.,
p.l3

Dept. Information Services &
University Publications, Univer-
sity of Western Ontario, p. 14
University of Calgary, Calgary
Alta., p. 16

Studio Impact, Ottawa, Ont., p. 17
Royal Victoria Hospital, Mont-
real, P.O., pp. 29, 30
Hopital Christ-Roi, Quebec
P.O., p. 36

Sudbury Star Photo, Sudbury,
Ont., p. 41

new products

(Continued from piijic 21)

The brochure may be obtained
through Gordon G. Brown Co. Ltd., at
Suite 23, 1875 Leslie St., Don Mills.
Ont., or at 25 Westminster Ave. S..
Montreal, Que.

Footguard to Prevent Footdrop

Now being marketed by the Posey
Company is a new footguard designed
to provide foot support and to prevent
pressure buildup on the heel or ankle.
Of non-breakable plastic, the guard is
light in weight but sturdy, and shaped
to fit the contour of the heel or ankle.
The insert of synthetic fur may be
removed and laundered. The use of a
T-Bar Foot Stabilizer (attached with
Velcro) prevents foot rotation.

For further information write Enns
& Gilmore, Ltd., 1033 Rangeview
Road, Port Credit, Ontario.

Suspended IV Unit

The Karapita intravenous unit elimin-
ates the danger of the accidental bump-
ing of a floor stand and the spilling of
liquids because it can be mounted
either on a track or from the ceiling.
It saves floor space, and with no
obstructions, the patient is rendered
more accessible to the nurse and to the
doctor. The unit can easily be adjusted
to any desired height, using one hand.
The unit is designed to hold several
bottles at one time and is constructed
of stainless steel for maximum dura-
bility, cleanliness, and ease in following
sterile procedures.

^ 1

■^ >

^: ^ 11

1

^-f •

\x r

OHKD

f"«R!

I

m

Suspended IV Unit.

For complete information on the
Karapita intravenous suspension unit,
write to ATM Industries Limited, 6380
Northwest Drive, Malton, Ontario.

Catheter Insertion Tray

C.R. Bard, Inc. has introduced a cath-
eter insertion tray with a choice of
either a 10 cc syringe or a 30 cc syr-
inge. The trays are adaptable to any
bladder care system used in hospitals,
and contain all items needed for cath-
eterization, except the catheter, in a
sterile package.

For further information, write C.R.
Bard (Canada) Ltd., 22 Torlake Cres-
cent, Toronto 18, Ontario. ■§'

Catheter Insertion Tray

22 THE CANADIAN NURSE

DECEMBER 1970

February-June

Continuing nursing education, non-credit
courses, at the University of British Colum-
bia have been scheduled for the first six
months of next year. For further information
write: The University of British Columbia,
Health Science Centre, School of Nursing,
Vancouver, British Columbia.

February 15, 1971

Six-week coronary course offered to nurses
currently working on coronary care units.
Enrollment is limited to six nurses, and
total sponsorship by present employee
is required. Registration fee is $75.

For further information write to the
Course Coordinator, Intensive Care Nurs-
ing H601, Winnipeg General Hospital,
700 William Avenue, Winnipeg 3. Man-
itoba.

Feb. 15-19, 1971

Five-day course in occupational health
nursing for registered nurses who have
five or more years experience in occupa-
tional health nursing, and who work alone
or with one other nurse. For further infor-
mation write to: Continuing Education
Program for Nurses, University of Toronto,
47 Queen's Park Crescent, Toronto 5,
Ontario.

February 16-18, 1971

First National Conference on Research
in Nursing Practice, Skyline Hotel, Ottawa
Purpose of this bilingual conference is to
stimulate research in nursing practice.
Registration is limited to 200. Fee: SIC
per day: S5 per day for nurses enrolled in
graduate programs. For further information
and registration forms, write to: Dr. Floris
E King, Project Director, School of Nursing,
University of British Columbia. Vancouver
8. B.C.

March 29-April 2, 1971

The third international congress of psycho-
somatic medicine in obstetrics and gynecol-
ogy will be held at the Bloomsbury Centre
Hotel, London, W.C.I. Scheduled conference
theme is "Womanhood and Parenthood. "
Write for information to: Kurt Fleishmann
and Associates, Chesham House, 136 Re-
gent Street, London, W.I., England.

March 31, 1970

Canadian Nurses' Association annual
meeting, business sessions only. Chateau
Laurier, Ottawa, Ontario.

DECEMBER 1970

May 11-14, 1971

The 6th International Hospital Exhibition
(Interhospital 71), held every three years,
is to be held in Stuttgart, Germany. Exhibi-
tors and visitors to previous exhibitions
were world-wide. Information can be obtain-
ed from: R.F. Haussmann, 130 Willowdale
Avenue, Suite 3, Willowdale, Ontario.

May 19, 1971

Catholic Hospital Conference of Ontario,
nursing committee, annual meeting. King
Edward Hotel, Toronto, Ontario.

May 20-21, 1971

Catholic Hospital Conference of Ontario,
annual meeting, King Edward Hotel, Toron-
to, Ontario.

May 26-29, 1971

Reunion of The Montreal General Hospital
School of Nursing graduates to celebrate
the hospital's 150th anniversary. Graduates
should send addresses to: Miss Phyllis
Walker, The Montreal General Hospital
(Dept. of nursing), Montreal 109, P.O.

May 30, 31 and June 1, 1971

The three-day annual meeting of the Mani-
toba Association of Registered Nurses
will be held in Dauphin, Manitoba.

June 1971

Canadian Association of Neurological
and Neurosurgical Nurses, second annual
meeting, St. John's. Newfoundland. For
further information contact the Secretary:
Mrs. Jacqueline LeBlanc, 5785 Cote des
Neiges, Montreal 209, Quebec.

June 2-4 1971

Canadian Hospital Association, National
convention and assembly. Queen Elizabeth
Hotel, Montreal, Quebec.

June 6-10, 1971

Ninth Canadian Cancer Conference under
the auspices of the National Cancer Ins-
titute of Canada, Honey Harbour, Ontario.

June 9-12, 1971

Canadian Psychiatric Association, annual
meeting, Lord Nelson Hotel. Halifax, Nova
Scotia.

July 13-19, 1971

International Hospital
gress, Dublin, Ireland.

Federation

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— jrot—

THE CANADIAN NURSE 23

in a capsule

stamping out stinging insects

We always like to hear of success sto-
ries, and this one is no exception. As
the saying goes, nothing breeds like
success.

By catching male mosquitos and
using x-rays to cause sterility. West
German professor Hannes Laven thinks
he has discovered a way of eradicating
stinging insects such as gnats and mos-
quitos.

The director of the Mainz Univer-
sity Institute for Genetics has been
experimenting in the field for the past
two years. The theory behind his method
is that since mosquitos normally multi-

ply rapidly, sterility caused by x-rays
should result in a generation dying out
within two or three weeks.

According to German Features, Pro-
fessor Laven was so successful that
in his own experiments he was able
to achieve up to a 15 percent reduc-
tion in offspring in one generation.
As a result, this method is now being
tested in France and India.

Advertisers look to women

Perhaps women don't realize the power
they have, or could have, in the market-
ing world. The possibilities of influence
yet to come have been raised by Jacque-

24 THE CANADIAN NURSE

line Brandwynne, president of a New
York ad agency, who addressed the
annual meeting of the Institute of Cana-
d i a n Advertising in Montebello,
Quebec.

Reported in Marketing October 19
were some interesting predictions made
in her talk. For example, she foresees
that in the 70s women will buy products
historically sold to men because they
will be earning more money. To market-
ing men she says this will mean women
will have great financial power, the
single woman's market will increase
enormously and create innumerable
new product needs, product life will
shorten, families will become smaller
and marriage less important, and daily
life will become computerized.

A young woman between the age of
16 and 25 will travel to Europe 15
times more in her lifetime than the
two-time traveler of the past, the
speaker said. "This means she'll need
everything from mini-TV to collapsible
sporting equipment to a sauna-in-a-
suitcase," the speaker added. Freeze-
dried beauty products that require
minimum space and can be activated
by a drop of water seem a sure bet to
her. We can also look forward to "cul-
ture ... in cartridges.

"With the continuing disappearance
of well-trained sales personnel, de-
partment stores will have to provide
new customer services to keep custom-
er loyalty." Illustrating what such serv-
ices might be, the advertising expert
predicted that department stores will
have to provide educators to teach
customers nutrition, decorating, crafts,
and so on, and could even offer gyms
where shoppers could take time out
for yoga.

Taking stock of supermarkets, the
speaker looked ahead to the not-too-
distant day when they, too, will have
to supply individualized services, such
as giving special cooking classes and
unlocking secrets of Chinese cuisine.
"Walking through your friendly super-
market now feels more like entering
a male-oriented aggression country
than shopping in an environment ap-
pealing to a woman. Does higher visi-
bility really require poor and sloppy
design, screaming colors and crowded
cartons?"

Today's young woman, she noted,
has a greater understanding of art and
appreciation for esthetics. ■§■

DECEMBER 1970

Fleet

ends ordeal by

Enema

for you and
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.

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
administration. Repeated administration
at short intervals should be avoided.

Full intormation on request.

"Kehlmann, W. H.: Mod. Hosp. 84:104, 1955

FLEET ENEMA® — single-dose disposable unit

qUALlTV MHAnMACeUTlCALS
KMUJMI MCMTMEAil CAMMM i

DECEMBER 1970

THE CANADIAN NURSfc 25

#

DEDICATED TO THE PURSUIT
OF CLINICAL EXCELLENCE

2nd EDITION

TEXTBOOK OF

MEDICAL-

SURGICAL
NURSING

BRUNN'ER
EMKkSON
KE KG I 'SON
StUUAKTn

Lippincolt

60 FRONT ST. WEST 'TORONTO

26 THE CANADIAN NURSE

DECEMBER 1970

OPINION

Students have a right to make mistakes

Several years ago, after reading an
article of mine in The Canadian Nurse
in which I wrote about the acceptance
of mistakes as motivation in learning,
a nurse sent me a letter saying how she
wished she had known as a student that
it was all right to make a mistake. Her
comment has haunted me ever since.

I am sure this nurse is not alone in
feeling this way. Many nurses expect
constant "rightness" from themselves
and their co-workers. They have learn-
ed, as students, that an individual should
consider herself obligated to learn all
the skills and techniques, to acquire
the helping attitudes necessary to nurs-
ing, and to make no mistakes!

It is simplistic to say that since nurs-
ing involves the care and responsibility
for other human beings, mistakes must
not be allowed to occur. Teachers,
ministers, lawyers, social workers, and
doctors are all students of some aspect
of care for human life. The forms of
insurance against injury to the client
upon whom the learner practices are
varied, but minimizing the potential
danger of an error — rather than seek-
ing to prevent it altogether — is an
assumption typical of the education of
groups other than nursing.

To say that nursing students have
a right to make mistakes is to say that
nursing students have a right to be
learners. Equating a student with a
learner seems redundant, but nursing
students are subjected to censure on
the first performance of a nursing tech-
nique. Nurses behave as though per-
formance without error is the minimally
acceptable standard, whether on the
first try or the fortieth.

If nurses are not to make mistakes,
it is necessary to evolve a pattern of
behavior that will produce a high degree
of conformity, regardless of situation,
which will give a clear pointer to the
individual guilt of non-correct perform-
ance. Isn't this what we have done? And
when an area of nursing proved not
amenable to this approach, did we
come to believe that it was not signif-
icant?

The crying patient, the dying patient,
the cranky patient, the bedraggled
woman who stares out the window and
DECEMBER 1970

Dorothy S. Starr, B.A., M. N.

answers in monosyllables — do we
give these people physical care and
avoid spending time with them? If we
are conditioned to make no mistakes,
we probably do. There are no proce-
dures for interpersonal relations; there
can be only a thought-through approach
with acceptance of a high risk of failure.
If we have to make no mistakes, we will
leave these people and many others,
alone.

If we cannot tolerate mistakes in our
own nursing care, we will be unable to
accept mistakes in others" care, so our
students and staff members will be
discouraged, subtly, silently, from try-
ing something new and possibly mak-
ing a mistake.

If we want new solutions, fresh ideas
in nursing, we must encourage creativity.
Dr. Fioris King has written: "The dis-
couragement which hurts creativity
most is that which comes from those we
regard most highly. Consequently, it
is essential to have a setting which
encourages ideation, one which even
welcomes mistakes. The very essence
of creativity is to keep on trying and
trying, harder and harder — and that
is almost too much to expect of human
nature without an expression of encour-
agement."'^

If we want nursing students to learn
by discovery, we must provide learning
situations in which the answer is not
immediately known; we must construct
problems in which the student will seek
answers, will make mistakes, and,
through discussion of the unworkable
approaches, will discover new ways
of thinking about problems, identify
information gaps, and become aware of
personal biases. Students have a right
and a need to make mistakes that arise
from new approaches to old nursing
problems.

One of the ways in which Hippoc-
rates antedated his colleagues by centu-
ries was his insistence that records

Mrs. Starr, a graduate of Yale University
School of Nursing, New Haven. Connecti-
cut, is Assistant Professor of Nursing at
the University of Ottawa School of Nurs-
ing, Ottawa. Ontario.

should show failures of medical treat-
ment, as well as the successes, leading
to growth of knowledge.

Involvement is the key to learning,
but the involvement must be with min-
imal fear of harm to that significant
other, the patient. We need to protect
learning situations by such means as
role playing, the teacher as role model,
discussion in pre- and post-care
conferences. The pertinent questions
are: In what setting will students' dis-
coveries and experimentation take
place? How will students be assisted
to use the mistakes as aids to further
discoveries?

We need to distinguish between a
careless mistake and a mistake res-
ulting from false reasoning or inade-
quate data. The repeated mistake is a
different matter from the mistake made
in a fresh approach to a problem.

Medication errors are of prime con-
cern. The student who gives a wrong
medication to a patient by failing to
read his wrist Identi-Band, and the
student who misjudges a patient's ability
to give self-medication have made
mistakes of a different order. Whatever
may be true of roses, a mistake is not a
mistake is not a mistake!

Mistakes that come as part of the
problem-solving process are the kind
of mistakes I believe students have
a right to make, because they have
a right to try to solve problems. And,
as a sociologist said to a group of nurse
educators, "The right to try always and
necessarily involves the right to fail."^

Let's set up more teaching situa-
tions in which the answers aren't known
by students; let's let them discover the
application of facts for themselves;
let's let them be wrong and find out
why, and then be right in a fresh, orig-
inal way that is new to them, and per-
haps new to all of us.

References

1. King, Fioris E. Opening doors: crea-
tivity in nursing. Nitrxinf- Papers.
Montreal. School for Graduate Nurses,
McGill University. 2:1:15. June 1970.

2. Hill. Richard J. The right to fail.
Niirs. Outlook. l.^4Jfi-4l. April 1965.

THE CANADIAN NURSE 27

Monitoring the mother
and fetus during labor

Intensive monitoring of high risic obstetrical patients is gaining acceptance as a
way to decrease maternal and perinatal mortality and morbidity. This article
describes the program at Montreal's Royal Victoria Hospital, and gives the advantages
of monitoring the mother and fetus during labor, the nurse's role, and the patient's
reaction to the care she receives.

Tanna Willis

Present perinatal and maternal mortality
rates in Canada are high. In 1968, for
example, the number of perinatal deaths
in this country was 8,727 out of 369,24 1
deliveries, or 23.7 deaths per 1,000
deliveries.^ In the same year, the
maternal mortality rate was 27 per
100,000 patients. 2

In the Province of Quebec, 1968
statistics show that the incidence of
perinatal deaths in the 98,678 deliveries
of infants over 1,000 Gm. was 1,946,
or 19.7 deaths of infants over 1,000
Gm. per 1,000 deliveries. Of these
1,946 deaths, 994 were stillborn, and
about one-third of these stillbirths
occurred during labor. 3 The 1968
maternal mortality rate in the province
was 37 per 100,000.4

To decrease this mortality rate of
infants and mothers, new methods of
diagnosis, treatment, and care have been
devised. Intensive monitoring of the
mother and fetus in labor, when there
is potential or real danger to one or
both, is becoming widely accepted as a
valuable method of reducing the mor-
tality rate.

Background

The monitoring of a fetus during
labor is patterned after the unit and

Miss Willis, a graduate of the Royal
Victoria Hospital, Montreal, is a staff
nurse in the Perinatal Unit at the Royal
Victoria Hospital.

28 THE CANADIAN NURSE

studies of Dr. Roberto Caldeyro-Barcia
in Montevideo, Uruguay. He developed
a method of measuring uterine activity
by introducing a thin polyethylene
catheter through the anterior abdominal
wall into the amniotic sac, to record the
amniotic fluid pressure. ^ The catheter
was connected, through a Sanborn
electromanometer (an apparatus that is
also used by cardiologists to record
adult heart rate patterns), to a Sanborn
"recording Poly Viso," and the con-
tractions were visualized on a graph
expressed as millimeters of mercury.

Later, the catheter's route of insertion
was changed from the abdominal wall
to the vagina, after artificially rupturing
the amniotic sac. This vaginal route is
used in our perinatal unit.

Caldeyro-Barcia also studied the
effect of the synthetic hormone Syn-
tocinon on uterine contractions, and
concluded that oxytocin infusion is
the most accurate, safe, efficient, and
easy way to increase uterine contrac-
tility for the induction and/or enhance-
ment of labor.6

Besides the monitoring of the pa-
tient's uterine contractions in labor,
many studies have been conducted on
monitoring and assessing changes in
fetal heart rate during labor. Dr. Edward
H. Hon did extensive studies on various
fetal heart rate patterns, showing which
patterns were physiologic (early decel-
erations), and which were pathologic
(late and variable decelerations).''

DECEMBER 1970

A continuous recording of the fetal
heart rate and fetal electrocardiogram
is obtained by placing a small "fetal
electrode" on the presenting part in
utero, after rupture of membranes.
Made of a Michel clip coated with
silver chloride, the electrode is attached
to two insulated, twined-wire threads,
and connected through an amplifier to
a channel in the Sanborn machine. Both
the uterine contractions and the fetal
heart rate patterns are constantly
assessed. (Figures 1,2, and 3.)

Another means of assessing the wel-
fare of the fetus during labor was
introduced by Dr. Erich Saling in
Berlin. Acting on the theory that,
"almost any disturbance affecting the
fetus results in an accumulation of
acidic compounds . . . which is easily
recognized by blood pH measure-
ments,"8 he devised a method of ob-
taining capillary blood samples from the
fetus in utero. The doctors in our unit
at the Royal Victoria Hospital follow
this technique.

An amnioscope is inserted into the
vagina to expose the presenting part.
By using a tiny blade on a long scalpel,
a minute incision (2 mm.) is made,
the blood is withdrawn by sucking it
into a long capillary tube, and then
tested for pH and p02. In our unit, as
in Dr. Saling's, this technique has
proved to be an excellent means of
assessing fetal wellbeing or distress.
(Figure 4)

Fetal distress

These are the methods of monitoring
the fetus during labor. But how do we
know when a fetus is "at risk" or in
distress, and needs to be monitored?
Because of limited facilities, we cannot
monitor every labor.

Fetal distress is difficult to define.

DECEMBER 1970

FETAL E.C.G.

LEAD C

Fig. 1. Electronic monitoring of fetal electrocardiogram. The method is similar
to obtaining an adult ECG. Through an electrode placed on the fetal scalp, the
ECG is transferred to the monitor to picture the fetal heart rate pattern (average
beatslmin.) and ECG.

l-CXUMLL
asCLL0OI/U>H

Fig. 2. Fetus being monitored in labor. Fetal electrode and ^intrauterine (trans-
cervical) catheter in place.

THE CANADIAN NURSE 29

-H minutes

tig. J. Uterine contractions and dips in fetal heart rale as seen on monitor A
Type I Dip (early deceleration) is considered normal and nonpathologic; a Type
II Dip (late deceleration) is considered a sign of fetal hypoxia.

LIGHT

Fig. 4. Diagram showing method of obtaining a fetal blood sample.
30 THE CANADIAN NURSE

According to Drs. N.J. Eastman and
L.M. Hellman, "There is no consensus
regarding the precise definition of fetal
distress .... Disturbances of fetal phys-
iology might well be considered part of
the syndrome .... Prolonged slowing
of the fetal heart rate, and. in vertex
presentation the passage of meconium,
are generally considered signs of fetal
distress .... Irregularity of the fetal
heart beat and abnormal vigorous fetal
movements ... are sometimes included
in the syndrome of fetal distress. "^

These symptoms, manifested during
labor, have guided our doctors in
deciding which fetuses should be in-
tensively monitored. But it is also
important to know, before labor, which
pregnancy is a potentially "high risk"
to the mother or fetus. To do this, we
have devised a Point Count System of
assessement according to the mother's
family and personal history, age, parity,
previous and present complications in
pregnancy, and coexisting diseases,
such as diabetes, cardiac disease.^ °
These high risk patients are selected to
be monitored through their labor and
delivery in the perinatal unit.

The nurse's role

By explanation and by getting to
know our patients, we help to overcome
their anxieties about the strange
equipment and the techniques. For
example, the evening before a mother
is to be induced, we visit her, introduce
ourselves, explain in some detail what
will happen to her, and answer her
many questions. She meets the same
nurses and doctors the next day for her
labor and delivery. Postpartum, the
nurses visit her again.

The mothers seem to enjoy this
continued contact with the same
nursing and medical staff. Several have
said, as they got to know the staff they
developed confidence in them and so
DECEMBER 1970

were more relaxed. As nurses, we were
pleased to hear this, because we, too,
feel a stronger attachment to the patient
when we can stay with her until the end
of her labor. This is ideal nursing care.

Our patients say the intensive mon-
itoring assures them their baby's safety
is always guarded. Many show interest
in the recording of their contractions
and the baby's heart rate. The hus-
bands, who are welcome to stay with
their wives during labor, are particularly
fascinated by the electronic equipment.
Often they will watch the graph and tell
their wives when the next contraction is
starting.

There is some discomfort to the
mother with this monitoring. Before or
during her stay in the unit, she must
have a major shave preparation, have
blood drawn for cross-match, and
refrain from eating or drinking to be
ready for a cesarean section at any time.

At present, because of the location
and type of monitoring equipment, the
mother must stay on the same bed
throughout her labor until her baby is
delivered. The vaginal insertion of the
intra-uterine catheter and the fetal
electrode is uncomfortable, and the
nurse can help the patient relax during
the procedure.

The perinatal unit will eventually
include antepartum, intrapartum, and
delivery areas. Nurses must be versatile
in all these areas and in the operating
technique for cesarean section. They
must also have knowledge in general
medical nursing, as the patients selected
often have disorders such as toxemia,
diabetes, or cardiac disease.

The satisfaction we gain from work-
ing in this unit comes from our involve-
ment in giving stimulating and com-
prehensive patient care. By working as
a team, with medical, electronic, and
technical personnel, we find we accom-
plish much more than if we worked in
DECEMBER 1970

isolation. The patients sense our enjoy-
ment and feel comfortable and secure.

We hope the intensive care given on
this unit will help to decrease the peri-
natal mortality in this hospital and
possibly in the surrounding areas.
Between the end of August 1969, and
May 1970, we monitored and delivered
170 high risk obstetrical patients. Our
experience shows we have definitely
helped to prevent stillbirths during labor
and neonatal deaths.^'' Also, we can
recognize during labor early signs of
fetal asphyxia and deliver the baby
when indicated, thus preventing fetal
morbidity, particularly cerebral damage
from asphyxia neonatorum. These
babies can be saved from mental retar-
dation and grow up to be healthy, active
members of society.

if this intensive perinatal care
achieves these goals, it is worth the cost
and effort.

References

1 . Canada Bureau of Statistics. Vital
Stalislics: Preliminary Annual Report,
1968. Ottawa, Queen's Printer, 1970,
Table 3.

2. loc. cii.

3. Province of Quebec, Perinatal Mor-
tality Committee. 1968.

4. Canada. Bureau of Statistics, loc. cit.

5. Caldeyro-Barcia. Roberto. Uterine
contractility in obstetrics. In Inter-
national Congress of Gynaecology and
Obstetrics. Montreal, June 1958.
Modern Trends in Gynaecology and
Obstetrics. Special sessions commu-
nications. Montreal, Bcauchemin,
1959. p. 65.

6. Ibid., p. 73.

1 . Hon. Edward H. An Atlas of Fetal
Heart Rate Patterns. New Haven,
Conn., Harty Press Inc., 1968.

8. Saling, Erich. Fetal and Neonatal
Hypoxia in Relation to Clinical
Obstetric Practice. London. Arnold
1968, p. 74.

9. Eastman. N.J. and Hellman, L.M.

Williams Obstetrics. 13ed. New York,
Appleton-Century-Crofts. 1966 p. 988.

10. Mercier, G. and Desjardins. P.D.
Evaluation numerique du risque pen-
dant la grossesse. Service d'Obstetrique
et Gynecologic, Royal Victoria Hos-
pital. Unpublished data.

11. Mercier, G. and Desjardins, P.D.
Unite perinatale: experience d'une
annee. Service d'Obstetrique et Gyne-
cologic, Royal Victoria Hospital.
Unpublished data. ^

THE CANADIAN NURSE 31

Chemotherapy in hemodialysis

Although hemodialysis is usually the treatment of choice in terminal renal failure,
certain common drugs play an important role in the therapeutic picture.

New equipment and techniques iiave
been developed over the past 10 years
to provide long-term, life-saving treat-
ment for patients with chronic kidney
failure. The treatment of choice in
terminal renal failure is usually hemo-
dialysis, sometimes leading to a kidney
transplant. However, certain drugs are
frequently used to alleviate symptoms
not adequately prevented or controlled
by dialysis therapy.

About a dozen common types of
drugs, all familiar to the general staff
nurse, may be used in conjunction with
dialysis therapy. The emphasis in this
paper is on the application of each to
chronic renal failure and hemodialysis.

Hemodialysis is the procedure in
which a patient's blood is shunted from
his body through membranes immersed
in a chemical bath and then back to his
body again. The bath solution contains
those chemicals normally found in
blood, mixed in warm tap water. Any
substance — other than blood cells and
most proteins — that is more concen-
trated in the blood than in the bath will
dialyze through the membrane from
blood to bath. Water is also removed
from the blood by osmotic and hydro-
static pressure.

Dialysis can be used to treat chronic
and acute renal failure and drug or fluid
intoxication. This paper deals only with
patients requiring chronic hemodialysis.
Depending on his condition and on the
32 THE CANADIAN NURSE

Christine Frye

type of artificial kidney machine used,
the patient is usually dialyzed for 10-36
hours per week.

Pharmacophysiology

Many factors influence the safety and
effectiveness of drugs, including dis-
tribution in the body, absorption,
metabolism, excretion or removal by
dialysis, effects of retention, and
adaptive limits or impairment of organs.
The rates of absorption and elimination
determine the amount of a drug in the
body at any given time after admin-
istration.

Drugs are eliminated by excretion
and by transformation into metabolites,
each drug having its own rate. At least
a fraction of almost all drugs is normally
excreted by the kidney. In renal failure,
the amount of any substance filtered by
the glomerulus is decreased. Most drugs
are not significantly reabsorbed by the
renal tubules; barbiturates and salicy-

Miss Frye. a graduate of the Mary Flet-
cher Hospital School of Nursing. Burling-
ton, Vermont, U.S.A., has been in charge
of the Artificial Kidney Unit at the Otta-
wa Civic Hospital for the past five years.
She is currently Vice-President for dialysis
of the Canadian Society for Extra-
corporeal Circulation Technicians, and an
Associate Editor of the U.S. publication
The Journal of Extracorporeal Tech-
nology.

lates are exceptions. Most active drugs
are bound to proteins that act as a
reservoir, preventing marked fluctu-
ations in plasma levels.

Plasma levels of some drugs, their
activity, and potential toxicity are
determined largely by renal function.
Thus the size and timing of doses of
these drugs must be determined for
each individual renal failure patient.
The use of p.r.n. orders is ill-advised,
and orders for drugs must be reevalu-
ated frequently. The toxicity of certain
compounds, such as opiates and
sedatives, is enhanced in the presence
of uremia, even when excessive blood
levels are not reached.

The kidney itself is particularly
vulnerable to toxic damage for many
reasons, including high blood flow and
high metabolic activity. The pathologic
changes induced by renal failure can
cause therapeutic problems. The most
obvious of these is irritation and ulcer-

Thc author expresses her thanks to
Miriam Ridley, Clinical Pharmacy Coor-
dinator at the Ottawa Civic Hospital,
and to the pharmacy staff for their
cooperation and help. Dr. Bernd Koch
and Dr. S.L. Jindal, nephrologists at the
Ottawa Civic Hospital, contributed
valuable criticism and suggestions. The
cooperation of various artificial kidney
units and pharmaceutical firms in eastern
Canada is acknowledged as well.

DECEMBER 1970

ation of the gastrointestinal tract,
resulting in nausea and vomiting, bleed-
ing, and intolerance to food and drugs.
Indiscriminate use of diuretics in renal
failure may lead to sodium and potas-
sium depletion, alkalosis, and dehydra-
tion.

In renal failure the nitrogen and
hydrogen ion and electrolyte content
of drugs is significant. Examples of
this are the magnesium in laxatives and
antacids; the potassium in salt substi-
tutes and penicillin potassium; the
sodium content of sodium bicarbonate
and intravenous solutions; and acid-
ifying agents, such as vitamin C. Drugs
may also be metabolized to acid or
nitrogenous waste products, or they
may stimulate catabolism.

Dialysis is known to remove certain
common drugs at varying rates, but
there are no available data for most
drugs. Conversely, trace metals,
glucose, and other substances present
in the bath water may cross the mem-
brane and cause symptoms in the patient.

Bone disease resulting from dialysate
fluoride levels is being investigated in
many centers. Two papers presented in
1969 to the American Society for
Artificial Internal Organs dealt with
hemolysis and death from copper
intoxication. ''2 The apparent cause
was exhausted deionizer columns in
the central bath delivery system, which
released acid to work on the hot copper
coil.

Anticoagulation

Probably the most commonly used
drug in hemodialysis is heparin, as
dialysis without anticoagulation would
not be possible. The patient's blood is
in contact with foreign material while
outside the body for at least a few
minutes. Without adequate hepariniz-
ation, this blood would clot in the
membranes, requiring an immediate end
to the procedure.

Every dialysis unit has its own
protocol for anticoagulation, but
generally what is called "systemic
heparinization" is used for routine
DECEMBER 1970

dialyses. A calculated amount of
heparin is injected into the system,
either at intervals of one to three hours
or by continuous slow infusion. Both the
patient's clotting times and the ma-
chine's clotting times are thus kept well
above normal limits, and there is no
danger of clotting in the membranes or
tubes.

Heparin is prepared from animal
liver or lung tissue and is effective in
various stages of blood clotting. The
principal action is interference with the
change of prothrombin to thrombin.
Adverse reactions following the use of
purified heparin are infrequent. The
unit of measurement commonly used
is the USP unit, established in 1942
by the Health Organization of the
League of Nations. The gram weight
of heparin bears no direct relationship
to the unit of activity.^-''

The main problem of anticoagulation
in these patients is undesired bleeding.
The patients have external arterio-
venous shunts or internal arterio-venous
fistulas that provide ready access to the
circulation. Bleeding may occur in these
areas, particularly with a shunt. Also.
uremic patients tend to have excessive
gastric acidity that may lead to hem-
orrhage during anticoagulation. There
seems to be considerable variation in
heparin metabolism, and the prolonged
clotting time may extend for several
hours following dialysis. If the patient
has had recent major surgery, there is
danger of fresh bleeding from the
wound.

Fortunately, there is a readily
available drug that counteracts the
anticoagulant effect of heparin. Pro-
tamine sulfate, a complex protein-like
substance, is itself an anticoagulant
when given in high doses. However,
when combined with heparin, the two
drugs neutralize each other's anti-
coagulant activity. Each milligram of
protamine neutralizes 78 to 95 USP
units of heparin. No specific contra-
indications are known to the use of
protamine; however, sensitivity is
possible due to its protein-like nature.

It must be given by slow intravenous
injection, never more than 50 mg. in
any 10-minute period.^

The prevention of bleeding in a
dialyzed patient is accomplished by
"regional heparinization." This is
generally used for fresh postoperative
patients and for anyone suspected of
having a bleeding problem, such as a
peptic ulcer. In this procedure, a
calculated dose of heparin is infused
slowly into the tubing leading to the
kidney machine. The correct dose of
protamine is infused at the same time
and rate into the tubing leading back to
the patient. The protamine neutralizes
the heparin before the blood reaches
the vein. The machine's clotting time is
elevated, while the patient's clotting
time remains normal.

Antihypertensives

One of the common causes of hyper-
tension is kidney disease. Two types are
seen frequently in chronic renal failure
patients: renoprival and renal.

Renoprival hypertension occurs in
patients with no functioning kidney
tissue, and is caused by sodium and
water retention. The treatment of choice
is dialysis to keep the patient at his
normal dry weight. The removal of
several ptiunds of fluid weight during
dialysis will effectively lower the blood
pressure. Renal hypertension results
from the renin-angiotensin complex
in the kidney and is treated by drugs
and, if necessary, by bilateral neph-
rectomy.

Alpha-methyldopa (Aldomet-Merck,
Sharp and Dohme) reduces both stand-
ing and supine blood pressures without
directly affecting cardiac or renal func-
tion. It is usually well absorbed after
oral administration, but can be given
parenterally as well. It is largely excret-
ed by the kidneys, so patients with
impaired renal function may respond
to smaller than usual doses. It is not
strongly bound to plasma protein, and
has been found to dialyze rapidly and
completely.

Aldomet is one of many drugs that
THE CANADIAN NURSE 33

initiates red cell destruction by an
immune reaction. For this reason,
patients talcing Aidomet may have a
positive Coombs" test, and difficulty
may result when crossmatching blood
or after a transplant.

A second commonly used drug is
hydralazine HC 1 (Apresoline — Ciba),
which reduces both systolic and diastolic
pressures and increases cardiac output
and renal blood tlow. Apresoline has
no sedative component, but may
potentiate the narcotic effects of
barbiturates and alcohol. It is given
both orally and parenterally, and is
used cautiously for patients with
coronary disease, advanced renal
damage, and cerebrovascular accidents.
Although many varied side effects have
been noted, particularly those associated
with hypotension, they tend to dis-
appear as treatment continues. If they
do not disappear, combination therapy
with other drugs, such as reserpine or
a diuretic, may be advisable.

Antibiotics

Chronically ill patients are always
susceptible to infections, particularly
when they have suffered from weight
loss and inadequate nutrition. Patients
with chronic uremia are no exception;
in fact, infections of various kinds are
among the most frequent complications
of renal failure.

Wound infections following surgery,
upper respiratory infections, and
urinary tract infections occur frequently
and must be treated vigorously. Re-
peated insertions of peritoneal dialysis
catheters may lead to peritonitis, and
local infection leading to septicemia is
a common complication of an A-V
shunt. The use of an A-V fistula when-
ever possible eliminates the latter
problem.

In treating any infection in a chronic
renal failure patient, the doctor re-
cognizes that the kidneys are the major
route of excretion for many anti-
biotics. Thus, the dosage may have to
be reduced to prevent a buildup of
dangerously high plasma levels. On the
contrary, some of these drugs are
highly dialyzable, and a large portion of
34 THE CANADIAN NURSE

an administered drug may be lost
through the machine. In these cases, it
is sometimes best to give the required
dose intravenously at the end of dialysis,
so the patient will receive the full
benefit in the ensuing hours.

Considerable research is being done
on the elimination and dialyzability of
various antibiotics. Results are often
conflicting, and little definite informa-
tion is available. Of interest is the anti-
anabolic effect of the tetracyclines,
which may produce an increased blood
level of non-protein nitrogen. In patients
with significant renal impairment,
higher serum levels may occur with
development of azotemia, hyperphos-
phatemia, and acidosis. The elevated
blood urea may not accurately reflect
changes in renal function; serum
creatinine is a more reliable parameter.

Analgesia and sedation

As with any chronic disease, there
is a danger in chronic renal failure of
drug dependence and habituation.
However, certain symptoms deserve
treatment, and prominent among these
are discomfort, anxiety, and insomnia.

Patients may complain of headaches,
muscle cramps, and peripheral neuro-
pathies. Many react to the stress of dial-
ysis therapy and dependance and are
not quite able to cope with their new
way of life. Inactivity for disabled or
unemployed patients, worry about
financial or family problems, and
discomfort all tend to prevent easy
sleep. For these patients, analgesics
and sedatives provide welcome relief.
With so many of these drugs available,
it is impossible to consider them all
in this brief review. However, the
most commonly used are the salicylates
and the barbiturates.

Both local and widespread pain of
low intensity is alleviated by the sali-
cylates, which have a lower maximal
effect than narcotic analgesics. Salicy-
lates are frequently combined with other
drugs, such as phenacetin, caffeine, and
codeine, to provide more effective pain
relief.

Orally-ingested salicylates are read-
ily absorbed from the stomach and

upper small intestine, and appreciable
plasma concentrations are reached in
less than 30 minutes. Salicylates are
excreted mainly by the kidney and in
trace amounts by other channels. Al-
though the drug can be found in the
urine within a few minutes after ad-
ministration, excretion is relatively
slow. Because of this, fairly constant
blood levels can be maintained with
doses spaced at four- to six-hour
intervals. Urinary pH directly affects
the clearance.

Salicylates are removed by hemo-
dialysis four times faster than they
would be by exchange transfusion or
peritoneal dialysis. Perfusion through
charcoal is even more effective.^ The
other components of the ASA
compounds are small enough to be
moderately dialyzable. with protein
binding being a limiting factor.

Codeine is generally absorbed from
the gastrointestinal tract. It is metabol-
ized in the liver and excreted chiefly
in the urine, largely in inactive forms.

Research is continuing on the role of
analgesics, particularly phenacetin, in
renal papillary necrosis. Because a
uremic patient has relatively little
functioning kidney tissue, there is less
danger to him than to a person with
healthy kidneys who abuses analgesics.
Nevertheless, the patient must be
warned of the risks involved in taking
excessive amounts of APC tablets after
a successful transplant.

The tranquilizer we find most useful
in the unit at the Ottawa Civic Hospital
is diazepam (Valium — Hoffman-
La Roche), which has sedative, muscle-
relaxant, and anticonvulsant properties.
It is indicated for the symptomatic
management of mild to moderate de-
grees of anxiety, but is not recommend-
ed for psychotic or severely depressed
patients.

Valium is well absorbed from the
gastrointestinal tract, and its effects
appear one-half to one hour after oral
administration. Results from parenteral
injection appear in 15 minutes. It is
detoxified in the liver, and the meta-
bolites are excreted in urine and stool.
Safety and efficacy in pediatrics and
DECEMBER 1970

obstetrics have not yet been established.

Other antidepressants, narcotics,
barbiturates, and alcohol may poten-
tiate the action of Valium. Also, abrupt
cessation after prolonged administration
may precipitate acute withdrawal
symptoms. The most common side-
effects are drowsiness and atavia,
making it effective for bedtime sedation
as well as for the treatment of anxiety.
No specific antidote is known, and
hemodialysis does not significantly
lower blood levels.

Perhaps the most commonly pre-
scribed sedatives are barbiturates, of
which there are over 30 type'.. They
depress activity of nerves, skeletal
and smooth muscle, and cardiac muscle.
However, barbiturates are iinspecific
in their effects and are capable of
depressing a wide variety of biological
functions. They are gener-.illy divided
into two groups: long-acting and short-
acting, depending on the rate they are
metabolized in the body.

Barbiturates not destroyed in the
body are excreted unchanged in the
urine. As much as 30 percent of a
total dose of phenobarbital may be
excreted this way. When kidney function
is impaired, barbiturates that depend
on the renal route for excretion may
cause severe depression of bodily
systems, thereby further reducing kidney
function. Uremia may increase sensi-
tivity to these drugs.

Depending on the specific drug
involved, hemodialysis generally re-
moves barbiturates 10 to 30 times faster
than diuresis. Removal of short-acting
drugs by diuresis and dialysis is limited
by protein binding and by sequestration
in body fat from which removal is slow.^
It is believed that hemodialysis removes
barbiturates about four times faster
than peritoneal dialysis; albumin
added to the dialyzing fluid binds the
drug and nearly doubles the removal
rate.

Digitalis

Uremic patients are apt to develop
physiologic changes suggestive of
cardiac muscle disease. One form of
cardiomyopathy is due to the specific
DECEMBER 1970

toxicity of the potassium ion on the
myocardial muscle cell. A second form
is due to hypertension, which has
already been discussed. A third form
is the result of arteriosclerosis, and a
fourth, the apparent congestive heart
failure produced by sodium and water
overload. Anemia may also play a part
in the development of heart failure.

Various preparations of digitalis are
sometimes used to treat these cardiac
symptoms. Digitalis has three principal
effects: it increases the force of the
systolic contraction, decreases heart
size and increases muscle tone, and
slows the heart rate. It is indicated in
congestive heart failure and in auricular
flutter and fibrillation. The digitalis
compounds are excreted primarily as
unchanged glycosides in the urine.
Excretion is prolonged in the presence
of renal insufficiency and in renoprival
humans.

Toxic levels of digitalis preparations
produce anorexia, nausea and vomiting,
and cardiac arrhythmias. Of special
interest in dialysis patients is the
relationship between potassium and
digitalis. Potassium depletion sensitizes
the heart to digitalis intoxication and
may produce arrhythmias even with
recommended doses. Frequently,
patients with renal failure do not excrete
their potassium and the serum level
builds up between dialyses. An attempt
is made to remove this excess potassium
during dialysis, as too high a level may
cause a cardiac arrest. Caution is taken
with any patient receiving digitalis to
avoid wide swings in potassium levels.

Toxicity from digitalis is also seen
in aged and debilitated patients,
those with hypothyroidism, and advanc-
ed hepatic disease. Increased myocar-
dial irritability, which may accompany
some of the biochemical changes of
renal failure, adds to the therapeutic
problem. For these reasons, digitalis
is ususally avoided in dialysis patients,
especially since more often than not
congestive failure can be controlled by
a negative sodium/fluid balance.

One study performed in the United
States in 1967 demonstrated the extent
to which digoxin is removed by

dialysis.8 It appeared that the largest
portion of the drug was stored in tissues,
and the small amount available in
plasma was the major factor limiting its
removal by dialysis. These experiments
indicated that the amount of digoxin
dialyzed out is sufficiently small to be
ignored in choosing doses for chronic
dialysis patients.

Other commonly-used drugs

The kidneys play an important role
in maintaining the acid-base balance
of the body. In the presence of chronic
renal failure, plasma bicarbonate some-
times falls to dangerously low levels.
The most convenient form of raising the
level is by giving sodium bicarbonate
tablets, but rapid intravenous adminis-
tration of sodium bicarbonate may be
necessary in a crisis. Also, commer-
cially-available dialysate solutions
contain sodium acetate or sodium
bicarbonate, and dialysis with a slightly
alkaline bath will temporarily restore
plasma pH to a level compatible with
survival.

Raising the plasma bicarbonate
level to 15-18 mEq/L is usually suffi-
cient; full correction (to approximately
23-26 mEq/L) is not justifiable, as it
carries with it the risk of overloading
the system, upsetting sodium and water
balance, and causing tetany. Therefore,
treatment is reserved for the patient
whose plasma bicarbonate level is below
15 mEq/L, the level at which symptoms
of acidosis commonly occur.

Among the compounds formed in
the gastrointestinal tract is aluminum
phosphate, which passes unabsorbed.
Dialysis patients tend to have high
serum phosphate levels, so are often
given aluminum hydroxide gels that
bind the phosphate in the intestine and
lower the serum level. Large amounts
are usually required to be effective,
and nausea or constipation can result
from continued large doses. All
aluminum-containing antacids are non-
systemic in effect, because their in-
solubility prevents their entering the
blood stream.

Although vitamins are generally

helpful to a chronically ill patient, the

THE CANADIAN NURSE 35

vitamin B ccmplex preparations may
be of additional benefit to a patient with
chronic renal failure. These complexes
contain a large number of vitamins
that differ greatly in chemical structure
and biological action. They are grouped
together because they are all water
soluble and are obtained from the same
sources.

It appears that the most beneficial
effect of the B vitamins is in treating
peripheral neuritis, parasthesias, and
other nervous system symptoms. Peri-
pheral neuropathy, including the
■'restless leg syndrome," painful, burn-
ing feet, and so on, is a relatively
common and disabling complication
of uremia.

Vitamin C is widely used for the
treatment of such diverse symptoms as
infections, anemia, malnutrition, and
hemorrhagic states. However, little
data exist on the relationship of vitamin
metabolism to uremia, and perhaps the
most valid reason for giving vitamin
supplements is that many diets for
uremic patients lack standard vitamins.
Loss by hemodialysis has been sug-
gested, but not proven.

One dialysis patient, who was given
several injections of 50 mg. of thiamine
(vitamin B, ) intramuscularly, ex-
perienced difficulty in speaking follow-
ing these injections. Whether or not
this was due to the thiamine is difficult
to say. Goodman and Oilman report
that isolated clinical evidence exists of
toxic reactions to the parenteral admin-
istration of thiamine, which probably
represent rare instances of hypersen-
sitivity.^

Male sex hormones are known to
have anabolic effects. Different brands
of testosterone are often prescribed for
male uremics because they cause an
increase in muscle mass and body
weight, with retention of nitrogen,
phosphorus, potassium, and calcium.
Since muscle breakdown is diminished,
there is less protein waste product
accumulation in the blood stream. It is
these waste products that produce the
elevated serum urea and creatinine
levels seen in uremia.

Excessive or prolonged use of testos-
terone can lead to physical and sexual
36 THE CANADIAN NURSE

changes, and it is contraindicated in
the presence of prostatic carcinoma.
Androgens tend to promote retention of
sodium and water, always a risk in renal
failure, and hypercalcemia may occur.
An androgen is usually given in an oil-
soluble form by intramuscular injection,
at three- to four-week intervals.

One manifestation of uremia is
anemia, which may cause symptoms
such as weakness and dizziness, palpita-
tions, or heart failure. The trend in
chronic hemodialysis is to transfuse
patients as seldom as possible, but these
patients do require occasional donor
blood. When symptoms of anemia
occur, or before elective surgery, packed
red cells are given during the dialysis.
As with any transfusion, a reaction may
occur, despite careful crossmatching.

Antihistamines reduce the intensity
of allergic and anaphylactic reactions.
They are readily absorbed from the
gastrointestinal tract and from par-
enteral injection sites. After oral
administration, effects can be noted in
15 to 30 minutes. Diphenhydramine
HCI (Benadryl — Parke, Davis),
probably the most commonly used,
leaves the circulation rapidly and
reaches peak concentrations in tissues
in one hour. Little, if any, is excreted
unchanged in the urine.

The most common side effect of
antihistamines is sedation, and this may
be accompanied by other nervous sys-
tem effects. This is of real importance
in hemodialysis, as the patients are
usually discharged soon after the
termination of dialysis. If an antihis-
tamine has been given, the patient
must remain in hospital until the
sedative effect has worn off, unless he
can be taken home by a responsible
adult. The digestive tract may also be
affected by antihistamines, but gastroin-
testinal disturbances are uncommon
with Benadryl. Despite its antipruritic
action, Benadryl does not alleviate the
itching commonly associated with
uremia.

Summary

A totally inclusive review of drugs
used in connection with chronic renal
failure and hemodialysis is impossible.

as the uremic syndrome involves the
entire body, and the number of possible
symptoms is limitless. Routine drug
orders vary from center to center,
depending on the preferences of the
physicians and the drugs available in
the hospital pharmacy. This paper has
dealt only with drugs commonly used
in most hemodialysis units.

Two points must be drawn from any
discussion relating pharmacology to
hemodialysis. Dialysis cannot do the
job alone, and many symptoms of
chronic renal failure require appropriate
medication as well as adequate dialysis
therapy. However, more dialysis is often
the best treatment of uremic symptoms,
and in many cases the use of drugs
would merely mask the patienfs
symptoms.

References

1. Matter. B.J. ci al. Lethal copper In-
toxication in hemodialysis. Trans.
Aincr. Soc. Arlif. Organs 15:309-15,
1969.

2. Ivanovich. P. et al. Acute hemolysis
following hemodialysis. Trans. Amer.
Soc. Arlif . Intern. Organs 15:316-20,
1969.

3. British Drug Houses, Toronto, Ontario.

4. Sterilab, Rexdale. Ontario.

5. Eli Lilly and Company (Canada) Ltd.,
Toronto. Ontario.

6. Maher, J.F. and Schreiner, G.E. Dial-
ysis of poisons and drugs. Trans. Amer.
Soc. Artif. Intern. Organs 14:440-53,
1968.

7. I hid.

8. Ackerman, G.L., Doherty, J.E.. and
Flanigan. W.J. Peritoneal dialysis and
hemodialysis of tritiated digoxin. Ann.
Intern. Med., 67:718-23, Oct. 1967.

9. Goodman, L.S. and Oilman, A. The
Pharmacological Basis of Therapeutics,
Third Edition. New York. Macmillan,
1965. p.1654. ^

DECEMBER 1970

Esophageal manometry

A record of esophageal motility, combined with a careful history and x-ray results,
can contribute to the physician's investigation of the patient with a suspected
esophageal lesion. '^

Huguette Robidoux-Poirier

Fig. 1 . The esophageal inaiionieier used to record esopliageal motility.
DECEMBER 1970

Differential diagnosis of chest pain
is complicated by similarities in the
symptoms produced by cardiac and
esophageal lesions. This is not surpris-
ing, as both the heart and the esophagus
are innervated by the vagus nerve.

A patient may complain of retro-
sternal pain, radiating down the left
arm or both arms; diaphoresis; weak-
ness; and may actually have diffuse
esophageal spasms. His discomfort may
even be relieved by nitroglycerin, with
the result that angina pectoris is sus-
pected. If, under such circumstances,
the electrocardiogram is normal, a
tracing of esophageal motility may be
the deciding factor in establishing a
definitive diagnosis.

Determining the underlying cause
of dysphagia may be easy or difficult.
It can be an unpredictable symptom,
sometimes appearing only under the
stress of great emotion, or during inges-

Mrs. Robidoux-Poirier. a graduate of
Hopital Saint-Michel Archange de Que-
bec, has been on (he staff of Hopital
Christ-Roi for six years. She is now wori<-
Ing in the gastrointestinal unit at l.e Centre
hospitaller de rUnivcrsiie Laval. Quebec.
She acknowledges the assistance of Claire
Michaud and Drs.%^la^cel l.acerte and
Michel Gagne.

THE CANADIAN NURSE 37

tion of cold fluids. Again, manometry
may provide the answer. Achalasia,
characterized by defective sphincteric
relaxation and loss of normal peristal-
tic action in the body of the esophagus,
usually is accompanied by severe dys-

8 sec.

RESPIRATION

jAyi\AAJ\AJ\/\J\AAA/,AAAAAJ\J
Fig. 2. An example of normal sequen-
tial peristalsis.

phagia and postprandial vomiting of
non-acid foods. On the other hand,
difficulty in swallowing has much less
relevancy and is a comparatively minor
factor in diffuse spasm of esophagus.
Esophageal manometry has particular
value in diagnosing scleroderma when
cutaneous signs are minimal. Epigastric
or retrosternal burning produced by
reflux of hydrochloric acid is indicative
of possible hypotonia of the esophageal
sphincter or diaphragmatic hernia. As
these abnormalities are sometimes
difficult to demonstrate radiologically,
manometry may be helpful.

Equipment and technique

An electronic recording device and
three polyethylene catheters comprise
the equipment. These intra-esophageal
catheters are connected to transducers
that register pressures from several
areas simultaneously. The oscilloscope
picks up variations in pressures imme-
diately and a permanent record is re-
gistered on photographic paper.

The completed graph shows four
bands: the first three correspond to the
pressures transmitted by the catheters;
the last one, to respiratory movements.
38 THE CANADIAN NURSE

The pressures registered at each level
are compared at the end of inspiration
and expiration.

The nurse's main responsibilities
are to check for proper functioning
of the equipment and to prepare the
patient, whose cooperation is essential.

The patient is placed in a supine
position, and the polyethylene catheters
are passed into his stomach. Each cathe-
ter has a single opening, and the three
catheters are arranged so that when
in place the openings are spaced at five,
ten, and fifteen centimeters from the
distal ends. A closed circuit permits
the introduction of a physiological
solution into each catheter. The pres-
sures produced in the esophagus are
then transmitted to the transducers. The
catheters are withdrawn gradually,
centimeter by centimeter. Respiratory
movements are recorded by a pneumo-
graph strapped around the patient's
chest.

The most critical areas are the points
of high pressure and pressure inversion.
The high pressure zone extends for
three to six centimeters, and corre-
sponds to the gastroesophageal sphinc-
ter. A positive pressure is recorded in
the stomach during inspiration; a nega-
tive one, in the esophagus. The point
of pressure inversion corresponds to the
line of demarcation between abdomen
and thorax. It usually occurs in the
middle of the high pressure zone, and
corresponds to the diaphragmatic hia-
tus.

The first recording is a "resting
study," with the patient refraining from
swallowing. The procedure is repeated,
during which time the patient is request-
ed to swallow at regular intervals so
that peristaltic action can be observed.
Normally, the waves are sequential,
that is, they move in an orderly fashion
from the top to the bottom of the esoph-
agus. In disease conditions the patient
may show abnormal repetitive contrac-
tions occurring in various portions of
the esophagus simultaneously. During
this second reading, the relaxation of

Figure 3. The sketch depicts the three
polyethylene tubes with their respective
openings.

the lower esophageal sphincter, which
precedes the peristaltic wave, is studied.
This action is faulty in achalasia.

In conclusion, esophageal manometry
has significant value in the clinical
investigation of patients suffering from
chest pain of questionable cardiac ori-
gin, dysphagia, or gastroesophageal
burning. 'S'

The

Canadian
Nurse

50 The Driveway, Ottawa 4, Canada

"^^

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DECEMBER 1970

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added at the end of the article stating the bibliography is
available on request to the editor.

For book references, list the author's full name, book
title and edition, place of publication, publisher, year of
publication, and pages consulted. For magazine references,
list the author's full name, title of the article, title of mag-
azine, volume, month, year, and pages consulted.

Photographs, Illustrations, Tables,
and Charts

Photographs add interest to an article. Black and white
glossy prints are welcome. The size of the photographs is
unimportant, provided the details are clear. Each photo
should be accompagnied by a full description, including
identification of persons. The consent of persons photo-
graphed must be secured. Your own organization's form
may be used or CNA forms are available on request.

Line drawings can be submitted in rough. If suitable, they
will be redrawn by the journal's artist.

Tables and charts should be referred to in the text, but
should be self-explanatory. Figures on charts and tables
should be typed within pencil-ruled columns.

The Canadian Nurse

OFHCIAL JOLFRNAL OF THE CANADIAN NURSES' ASSOCIATION

THE CANADIAN NURSE 39

On the edge of a cliff

Drug addiction in the schools is an accepted fact; therefore it was not necessary
for The Canadian Nurse to attempt an expose. While delving into the extended
role of the nurse, it became clear the drug scene was another facet of the nurse's
greater involvement in paramedical duties. Indirectly, the school drug problem
led to an insight into social responsibilities and fundamental issues requiring
cooperative community action.

Mona C. Ricks

Some charge it's the fault of parents,
others say it's the thing to do. Whether
young people are shifting the blame for
their actions on others or not, facts
show — drugs have entered the school
scene, and at many levels. What is
being done to prevent and control the
ogre seems hazy. Much depends on the
origin of help.

Social, health, and federal agencies,
maintained by public and tax donations,
have set up programs aimed at prevent-
ing and controlling. But the programs
are hampered by isolation. They lack
coordination of purpose. Perhaps this is
attributed to a theory — he who works
alone achieves the most.

Even though drug education is in-
cluded in school health programs, the
increasing number of students known
to be on drugs surely calls for a program
review.

One public health official, in a north-
ern Ontario town, places the weight of
responsibility for in-depth drug educa-
tion on a program of pooled knowledge,
managed by educationists familiar with
the need.

"Prevention is the greatest educa-
tional need," Florence Tomlinson,
director of public health nurses in Sud-
bury, contends. "If only we could get

Mona C. Ricks was assistant editor of
The Canadian Nurse when she wrote
this article.

40 THE CANADIAN NURSE

together as a team, we might get to the
students. As it is, drug education is
splintered, handed out piecemeal. Each
organization jealously guards its own
program, approaching the problem
from all angles."

Miss Tomlison's call has yet to be
fulfilled.

What is being done to educate young
people on the dangers of uncontrolled
drug use? Why should they listen to
adult reason, when adult reason cannot
control its own drug demand?

What, why?

The why is echoed by students, not
only in high schools, but also at the
elementary level.

Why, they ask, can't we do what we
want with our own lives? Why can't
we take drugs as adults do — and with
wild results?

It would be nice if the drug-aware
agencies could give a pat reply. Bet-
ter still, that medical and school author-
ities could cry, "Hold, here is the an-
swer." But they cannot. And the young
people know this — and laugh!

Apparently the Ontario and federal
governments are aware of the situation.
Through the Ontario-sponsored Addic-
tion Research Foundation, (ARF),
an Ottawa board of education survey
acknowledges that between 10 and 20
percent of the Ottawa student popula-
tion has tried drugs. And in a depart-
ment of national health and welfare
DECEMBER 1970

supplement, information supports the
long-known fact that drugs are part of
the Canadian school scene. But what is
being done to prevent it, and what is
being done to assist habitual users, is
inconclusive.

To get a nurse's reaction to the school
drug problem. The Canadian Nurse
went to a public health unit in Sudbury,
Ontario. How does the public health
nurse fit into the drug education pro-
gram — how does she attend to the
needs of students on drugs — how does
she meet the drug challenge?

Director of public health nurses.
Florence Tomlinson, said her staff is
aware of the problem. Coping with it
is a matter of meeting each case as it
comes, and hoping for the best.

Asked what the public health nurse
DECEMBER 1970

did when a student sought help, Miss
Tomlinson said, "So many come with
headaches, it's difficult to know right
away if there is a drug problem. But, if
the nurse sees symptoms of drug use,
she tries to encourage the student to
talk it out.

From then on the course of action
is a thorny experience. The nurse is not
committed to protect the student from
ensuing consequences. Although the
student may not want parents or school
and medical authorities to know, she
must get help for the young drug user.

Contact with parents is usually the
nurse's first move. The response isn't
always encouraging. Often parents get
angry and refuse to believe their child
takes drugs. They show little interest.
A few listen quietly and agree to talk it

over with the nurse and student.

Public health nurse Lola Holmes
of the Sudbury health unit, said parent
reaction to the problem is a determining
factor in getting at the problem. Will
they help or will they disown the child?

Many students are scared to go to
their parents, and have to be talked
into accepting this as the first step the
nurse must take.

With parent consent, the young drug
user is usually referred to the family
doctor, who may seek counseling assis-
tance from an outside agency, such as
the ARF.

Mrs. Holmes explained students
feel a school principal may take a
strong legalistic position and may
bring in the poli(^. The kids want
help, not punishment; they close ranks
THE CANADIAN NURSE 41

when they feel police are on a case.
It's fashionable to go against the law
and the kids feel this is the thing to do.
The nurse acknowledged a princi-
pal does have a responsibility to the
law and must notify police when a
student is known to take or push drugs.
What is frightening, is that the students
look on a principal and the police as
enemies. Yet, the parents hold the
principal and the law responsible for
the well-being of the student in school.
Contrary opinions clash with the de-
mands of law. The student is a mash,
held between absolute application of
the law, and an understanding nurse
who wants to help without causing fear
and hostility.

Miss Tomlinson says she has sym-
pathy for a school principal, who
is in a difficult position. "He has to
abide by the law and yet try to help
the student."

The head of Sudbury's public health
nurses is sure a cooperative approach
to drug education in the schools would
come to grips with the situation. Talks
with the local ARF have shown agree-
ment on this. The preventive role drug
education needs to take is a vital issue,
according to Miss Tomlinson. What
better than all agencies getting together
and working out a program which can
reach young people, without causing
hostility.

•'If we can have a student die of
drugs — if we can have them say they
do not understand that drugs are dan-
gerous — then something is wrong with
the educational system. We are not
getting to the kids if they are not fully
aware of what can happen to them
under drugs. We (adults) have failed.
We've missed the boat."

For the public health nurse it's a
matter of looking at budgets carefully
to see that more help can be made
available. "We have a public health
problem here, and an educational one,"
admits Miss Tomlinson.

Nurses in Sudbury public health
unit were against the appointment of
a central body to coordinate the efforts
of provincial and local agencies. As
they put it, "We don't want to confuse,
we want to sort out the scrambled mess."
They were more concerned with work-
42 THE CANADIAN NURSE

ing with what is available. In their view,
the ARF is the obvious agency to take
the leadership role in Ontario.

Public health nurse Jean Erion's
reaction to the drug problem is an
unending concern, mixed with help-
lessness.

"What can we do for young people?"
she asked.

In her visits as a volunteer in a down-
town Drop-In Center, Mrs. Erion says
she meets young people high on all
types of drugs. They experiment with
hard and soft stuff — opiates, heroin,
morphine, barbiturates, and a poor
mixture. Amphetamines, marihuana,
and hashish are treated as a "regular
thing."

"They don't care what they take
when they are hooked, as long as they
get drugs. Thcv'ii even shootup' banana
oil."

She hasn't given up hope.

Known users are starting to seek her
advice. Previously, students covered up
"very nicely" for each other, "it was a
real underground movement."

Now, drug talk is open. Students
talk freely in and out of school. But
the nurse admits there is a long way to
go before students really trust the author-
ities.

"They clam up if they feel we are
part of the establishment. We have to
feel our way with them. It's touch and
go all the time."

Getting to know the students' home
life is usually the key to why a young
person takes drugs. The root goes deep
into family life. When asked why they
take drugs, the reply is parrot-like.
The nurse says she can predetermine
the answer.

"Fed up at home. Need to get away
from problems at home and at school.
Sick of being pushed around. They
(the parents) take the stuff. They don't
have time for us."

Public health and ARF workers
agree, the home environment is the
root cause why young people start on
drugs — not necessarily economic.

Students admit you don't have to be
in the money to get drugs. If you want
them, there's always someone to take
care of you. What they don't get in
their own family they find in peer com-

munities — love and a family feeling.
There's a community among the student
drug faction that makes drugs readily
available. They help each other, even
if it means only a few square feet of
floor space to sleep off the effects.

Sudbury's help for the young drug
addict isn't any more or less than anoth-
er city or town with the same problem.
So why choose Sudbury as an example?
Because the health unit and the ARF
applauded the journal wanting to get
something to a public apparently deaf
to a social need.

For the provincial government spon-
sored ARF, work with drug and alco-
hol addiction is a continuous educa-
tional demand. What the agency learns
from close studies is passed to the public
in hordes of pamphlets and in audio-
visual outlets.

ARF Director of Northern Programs,
Basil Scully, says the agency is only
skimming the top of the school drug
problem. He, too, wants to see a coor-
dinated school drug program — even
though it means extensive changes in
the present approach.

Educational material on drugs and
drug abuse from ARF is constantly
under review. Until the beginning of
this year most of the literature was
directed to the adult. Hardly a sentence
recognized the adolescent problem.
During the last nine months the mater-
ial has either been rewritten or new
copy composed to meet the needs of
young drug users.

Research on the adolescent use of
drugs has not been easy. According
to Mr. Scully young people are scep-
tical of adult interest in adolescent
drug use. They view material on the
subject as propaganda. If a film or
piece of literature is slanted, it looses
its objective — student attention is
turned off.

The Sudbury ARF director main-
tains adolescent drug users do not face
the realities of the world around them
— another reason why he and his co-
workers try to avoid preuchinu when
telling what drug abuse can cause.

But there are many miles to tread

before students accept the dangers of

drug abuse. Education in the schools

is still an experimentation. More hard

DECEMBER 1970

facts are needed.

Describing how ARF gets into the
schools, Mr. Scully said, "When we
started to approach the high school
system in Sudbury our work was mainly
with the young alcoholic. School reac-
tion was unfavorable. Then the drug
scene erupted, parents and teachers
got upset, and requests for drug infor-
mation came rolling in."

The foundation goes into the schools
only after a request has been received
from the school authorities.

Individual classroom discussion,
involving the teacher, although not
ideal, at least gives the student a chance
to talk out problems. One of Basil
Scully's greatest concerns in school
drug education is how to involve the
teacher. "So often the teacher feels
inadequate to discuss drugs. The kids
know this. They sense when the teacher
is uptight."

As the public health nurses say, so
agrees Mr. Scully: drug abuse in the
schools is a community and parent
responsibility — cooperation is vital.

Talking to students in their own
language, in a meaningful dialogue,
and by a recognized authority, is anoth-
er necessary approach to pooling edu-
cational ideas.

According to Mr. Scully the public
health nurse is an important factor in
getting at the school drug problem. He
described her role as a facilitator — one
who applies pressure on school author-
ities to have drug discussions in the
school. Her contact with known drug
offenders gives her an insight into the
problem long before it comes to the
attention of school authorities.

It is also a nurse who talks to the
students when foundation workers go
into the schools.

On the Sudbury ARF staff two full-
time counselors are registered nurses.
With permission from school author-
ities they conduct classroom discussions
on drugs and alcohol. Personal prob-
lems are often revealed, and the student
is encouraged to seek advice and help.

Kathleen Lauzon and Rose McCann
have had many years experience as
registered nurses in community work.
Training nursing students on alcohol
and drug problems is another part of

DECEMBER 1970

Lola Holmes, shown entering a Sud-
bury school, says the nurse's first step is
to persuade the student to tell his par-
ents about his drug problem.

their work with the foundation. But,
says Mrs. Lauzon, we are barely touch-
ing the problem. We could do with
many pairs of hands.

If Kathleen Lauzon and Rose Mc-
Cann have an extensive hat wardrobe,
it is because their work so demands.
They change hats frequently, counsel-
ing marriage, social, welfare, alcohol,
and drug problems.

Doctor Bernard Lavallee, director
of the ARF Sudbury Centre specializing
in prevention, works with the nurses.
He says they are important to the team.
One strength they must have above all
others — empathy. If the nurse can
radiate an understanding of the stu-
dent's problem, she is indeed a jewel.

Asked if nurses were taking over
paramedical duties in the foundation's
work. Dr. Lavallee's positive reply
came quickly. He wondered why there
should be any question. "It is an accom-

plished fact. I think many doctors'
duties have hung on through tradition.
The doctor spends years establishing
a little empire, the nurse must know
how to crack it."

Doctor Lavallee described school
interest in the drug problem as "con-
troversial."

Most students the foundation is asked
to help are dropouts — 14, 15, and 16-
year-olds. Some arc younger — 1 2 and
13. He said his research found neither
the student nor the school were enamor-
ed of each other, and parents had lost
contact. "There's not much time left
when they get to us."

Praise for follow-ups and interviews
with parents by Sudbury public health
nurses came from the ARF medical
director. He agreed, the total perspec-
tive of drug prevention and help is
still inadequate.

Total perspective, according to the
doctor, means all agencies working
together. "Make no bones about it,
drug abuse in the schools is a problem
— we'd better move fast to help."

Dr. Lavallee's bull's-eye shot was
directed to education — not only do
students need to know what drugs are,
but also why they started to take them.

"Many kids live under family tur-
moil — an instant setup for drugs and
alcohol. They are exposed to parents
taking drugs to go to sleep and stay
awake, drugs to relax and pep up, and
alcohol to make merry."

Therapeutic counseling for the drug
user is a strong arm of the ARF. In
Sudbury Algoma Sanitorium, two full-
time workers keep watch on inpatients.
Assistant medical officer. Doctor Klara
Waldmann, and social worker, John
Scott, are in daily contact with school
drug users, not infrequently requiring
medical treatment for side effects of
drugs.

A 17-year-old female drug 'addict,
voluntarily in the sanitorium under-
going detoxification and treatment for
hepatitis, described drugs essential
for her to keep going. Conversation
with her went like this: Why did you
start taking drugs? I wanted to get a
kick, was fed up with my home and
school, and I didn't tare anymore. The
first thing I took was two tabs. I got
THE CANADIAN NURSE 43

them from a guy at school. I didn't get

off the first night, so I dropped some

more during history class the next

morning. I felt awful, but 1 didn't care.

I just wanted to get off. Then I started

to giggle, hallucinate, and wander —

right there in class.

Were you scared? A bit. When I talked

to the kids after school, I found this

was regular in my class. Many of the

kids were getting off.

Did you think this was the only way

to get away from your problems? It was

the only way. From two or three times

a week on different drugs, cocaine and

smoke, I got to need them daily. Then

I moved to speed.

How did you get the drugs and money

to buy them? I became a pusher. I went

to Toronto, got the stuff, and pushed

at school. I always had dope for myself

and enough for the kids.

What caused you to stop? I didn't want

to. Someone I knew got busted for

pushing. My parents got wind I was in

the gang and went to the police. They

were told I was being watched. So I

left home in a hurry, went to Spadina

in Toronto, and got sick. I saw a doctor

who referred me to my family doctor

in Sudbury, and I was brought to the

attention of the foundation, and then to

the san.

How are you feeling now? After four

weeks being brought down I'm feeling

a little better. It's terrifying being

brought down. I still want the drugs.

Do you want to get rid of the drug

desire? I haven't decided.

When you leave the san, what will you

do? Is there anything that will deter you

from taking drugs again? Nothing.

Probably be a repetition of what I've

gone through for the last two years —

taking and pushing drugs, and getting

busted.

Where do you think this will lead you?

It'll probably kill me.

Aren't you worried? No. I'm more

concerned with finding myself. I want

to know me. I haven't the slightest idea

how to start — but I have to.

Do you think drugs can help you find

yourself? It seemed so when I was on

them. I got some kind of security and

strength. 1 felt lost when drugs were

taken away.

44 THE CANADIAN NURSE

Do you want to go back to school? No.
I don't think they will have me anyway.
I've no ambitions.

On the other side of the fence, talking
to three children of a Sudbury commun-
ity worker brought these comments:
Two said they were not at all interested
in drugs. They knew of the school drug
problem, but had never felt inclined to
be involved. Both were university stu-
dents, both acknowledged they knew
students who were supposed to be
on drugs. The elder of the two said she
wondered how anyone could want to
take drugs — and if enough was said
to warn kids on drugs. The third teenag-
er said she was aware of the drug prob-
lem in Sudbury. She had been a curious
drug-taker herself for a short time. She
found smoke wasn't what she wanted.
But there were others who were "stuck
on drugs."

Because she was happy at home, this
teenager's curiosity remained as such.
She was able to talk about it with her
parents, found the kick was mostly
talk, and soon dropped the habit. Drugs,
she said, are easy to get in Sudbury.
"You can start at one end of the main
street and by the time you get to the
other end you can have enough money
for a fix — the gang takes care of the
gang."

One case under the care of Nurse
Lauzon was described as typical of
student turmoil and parent perplexity.
An 18 -year-old, grade 1 3 student, aver-
aging 90 percent marks, went on speed.
Six weeks later her average dropped to
70 percent. She was distraught and
escaped to Toronto, where she found
her peers. Sickness drew her back to
Sudbury. Referred to the foundation
by her father, the girl was hostile,
wouldn't talk, regarded the nurse as the
establishment image, would not trust.
Many hours talking between the girl
and the nurse and a rapport was estab-
lished. Mother and father joined the
talks. Both parents had a problem. The
father felt isolated in the family, the
mother a martyr to self-appointed tasks.
Each had a hangup, blaming one anoth-
er for the daughter's drug problem.
Family communication was nonexistent.
The daughter escaped family pressure
through drugs.

Success was Nurse Lauzon's finale
to this story. The family learned to
communicate, the girl dropped drugs,
went to university, and achieved good
marks.

But sunshine doesn't always follow
a stormy night. As the sanatorium pa-
tient said, "It'll probably kill me."

In the meantime, perhaps someone
will compose a recipe for the young
drug addict's search for himself. It's
been done for alcoholic hangovers.

Help for the young drug addict? It's
a community problem. Who fixes it? ^

DECEMBER 1970

NUTRITION AND
DIET THERAPY

By SUE RODWELL WILLIAMS, B.A., M.R.Ed., M.P.H.,
Instructor in Nutrition and Clinical Dietetics, Kaiser
Foundation School of Nursing; Nutrition Consultant
and Program Coordinator, Health Education Research
Center, Permanente Medical Group, Oakland, Calif.;
Field Faculty, M.P.H. -Dietetic Internship Program, Uni-
versity of California, Berkeley. 1969, 686 pages plus
FM l-XVIII, 7" X 10", 117 illustrations, including orig-
inal drawings by George Straus. Price, $9.40.

New! Teaching Guide to accompany
NUTRITION AND DIET THERAPY

By SUE RODWELL WILLIAMS, B.A., M.R.Ed., M.P.H.
August, 1970. 87 pages, 7" x 10". Furnished with-
out charge to instructors adopting the text.

A New Book!

NUTRITION AND DIET THERAPY
A Learning Guide for Students

By SUE RODWELL WILLIAMS, B.A., M.R.Ed., M.P.H.
August, 1970. 186 pages plus FM l-X, 7%" x 10)4".
Price $5.00.

A Revolutionary
Teaching-Learning
Package to
Stimulate
Inquiry and
Innovation!

"Someone has said that the only real learning is that
which one discovers for himself. If this is true, and I
believe that it is, then the function of education is to
provide a means whereby students can discover things
for themselves."

Sue Rodwell Williams

A unique new three-part presentation can help you
provide that means of discovery for your students of
nutrition and diet therapy. This creative teaching-learn-
ing package helps your students learn how to learn,
while instilling a sound understanding of nutritional
concepts and clinical applications.

The dynamic text which is the key to this exceptional
program continues to gain acceptance from instructors.
Now its effective correlation of basic nutrition with
patient-centered nursing is enhanced by two stimulating
supplements, just off the press. These important new
components — the learning guide for students and the
teaching guide for you — create an imaginative, innova-
tive educational tool.

Change and the accelerating rate of change permeate
this entire presentation, emphasizing the need for flexi-
bility of thought and method. Mrs. Williams views
teaching-learning as a single integrated process of mutual
inquiry, and shows how this process may be effectively
applied to nutrition education.

An enlightening demonstration of the current revo-
lution in educational technology, this three-part package
is its own best spokesman. Investigate its applications
in your own program . . . evaluate the new teaching and
learning guides, and see how they complement the
clearly written text. Discover for yourself how much
excitement and interest they can help you create in your
nutrition course!

MPS BY

TIMES MIRROR

THE C.V. MOSBY COMPANY. LTD. • 86 NORTHLINE ROAD • TORONTO 374, ONTARIO. CANADA

DECEMBER 1970

THE CANADIAN NURSt 45

Pharmacology and Patient Care, 3rd

ed., by Solomon Garb, Betty Jean
Crim. and Garf Thomas. 598 pages.
New York, Springer Publishing
Company, Inc., 1970.
Reviewed by N.S. Sutherland, Direc-
tor of Pharmacy, Colchester Hospi-
tal, Truro, Nova Scotia.

The third edition of this text presents
new and revised material to bring its
content up to date. The addition of Dr.
Garf Thomas. B.S., M.S., chief hospital
pharmacist of the University of Mis-
souri Medical Center, to the editorial
staff, shows a recognition of the need
for a team approach in the teaching
of pharmacology.

Several new chapters are introduced
in this edition. A unique chapter on
drug interactions and incompatibilities
reflects the increasing frequency with
which medication problems are encoun-
tered. Here tables are used extensively
to clarify the relationships between
drugs.

The chapters in Part I present an
orientation to the subject and its signi-
ficance for nurses. Basic pharmaco-
logic information is presented in Part
2. When practical, a single prototype
drug is discussed fully, and similar
drugs are related to it by means of
tables. The involvement of pharma-
cology and drug therapy in patient
care is demonstrated in Part 3.

Subject matter is presented as simply
as possible, but extensive references
for every chapter allow the student to
obtain more detailed information if
desired.

Although the use of chemical or
generic names is basic, the American
trade names in the tables could be
confusing in Canada. A cross refer-
ence of Canadian trade names would
be necessary for this book to be of gen-
eral use as a textbook in this country.

Community Health Nursing Practice by

Ruth B. Freeman. 229 pages. To-
ronto, W.B. Saunders Company,
1970.

Reviewed by Carole Mcllhagga, Pub-
lic Health Nurse, Ottawa-Carleton
Regional Area Health Unit.

Ruth Freeman proves to be an invig-
orating communicator in Community
Health Nursing Practice. She has a

46 THE CANADIAN NURSE

thorough understanding of her subject
matter and has done extensive research
for her most recent book. Data are
well fused with a tone of experience
and understanding. It is these basic
ingredients plus clarity, conciseness,
the use of example, and categorization
that relay to the reader structured and
meaningful information.

Dr. Freeman is realistic when dis-
cussing the various aspects of commun-
ity health nursing. She considers the
family to be the basic unit of the com-
munity structure. With the expansion
of nursing responsibilities in the com-
munity, the goal is to involve family
members in the health care of the indi-
vidual. Problems of the aged, of long-
term illness in the home, of child up-
bringing and development, and care
during illness of the mentally ill are
among those dealt with. Emphasis is
on the need for family responsibility.
The author strongly advises preserving
family ties and, at the same time, family
cooperation and function. Education,
assistance, support and guidance ex-
tended to the family in solving problems
are the nurse's greatest tools for preven-
tion and treatment.

How the nurse can best educate her
community is discussed. Channels for
health education are present in the
schools, in occupational health set-
tings, in neighborhoodclinics. The nurse
learns how to draw out the leaders in
her community and how to utilize these
people with skills she can provide to
them through education. Community
programs of family planning, disease
control, e.g., tuberculosis, and care
of the mentally ill and the aged, are
only a few of those studied.

The value of Community Health
Nursing Practice is not limited to the
nursing profession. This book pro-
vides a clear insight into the role of the
community nurse to members of social
agencies, community services, and
other organizations. Thus, in coopera-
tion with the health services available,
each service may offer its best facilities
to a community.

Community Health Nursing Practice
is a valuable reference book. Topics
discussed are not new to the health
field, but the nurse can benefit from
exposure to Dr. Freeman's interesting
approach, to her projection into the
community health field, and to her
realistic suggestions for improvement.

Crisis Intervention; Theory and Meth-
odology by Donna C. Aguelera, Jan-
ice M. Messick, and Marlene S. Far-
rell. 1 32 pages. Toronto, C.V. Mosby
Company, 1970.

Reviewed by Karen V. Walker,
B.Sc.N., former assistant director
of nursing education, Clarke Institute
of Psychiatry, Toronto, Ontario.

The first five chapters of this book
deal with the historical development
of crisis intervention in the United
States, a differentiation between psy-
choanalysis, brief psychotherapy, and
crisis intervention methodology, an
overview and evaluation of crisis group
therapy, an outline of sociological fac-
tors that can act as barriers in the psy-
chotherapeutic process, and a para-
digm of intervention clarifying the
sequential steps of crisis development
and resolution. This section of the
book is objective and complete and
includes reports on research studies
evaluating the approaches described.

The chapter discussing sociocul-
tural barriers to therapy is particularly
interesting. The authors point out that
traditional treatment methods identify
with middle class cultural values and
goals — the background of the majority
of professionals. The opinion is express-
ed that crisis intervention is more effect-
ive with lower socioeconomic groups.

The next two chapters of the book
present a brief analysis of case studies
of individuals in crisis, along with relat-
ed theoretical concepts and a descrip-
tion of the intervention. In chapter 7,
the author describes six typical situa-
tional crises, such as the delivery of a
premature baby, a status and role
change, experimentation with LSD,
divorce. The cases are organized into
the maturational crises of the life cycle
based on the theories of Erikson, Piaget,
and Cameron.

Case studies effectively demonstrate
the application of the crisis interven-
tion methodology outlined in the first
section. This section of the book is
exceptionally clear and well-organized.
The paradigm of intervention introduc-
ed in the fifth chapter is outlined for
each case, adding to the clarity.

The short final chapter focuses on
the authors' rationale for the nurse's
role as therapist in crisis intervention.
The objectives and learning experiences
of the training program of the Benjamin
Rush Centers in Los Angeles are bricfiy
DECEMBER 1970

outlined. The authors also include a
brief projection of the manner in which
registered nurses at all levels of educa-
tional preparation might be utilized in
a community mental health center.

The authors" objective of providing
a comprehensive overview as well as
an introduction and guide to crisis
intervention is well achieved in this
clear, concise and all-inclusive little
book. It should be of interest and value
to nurses in education and service
— particularly to those concerned
with community health and mental
health.

Nursing 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 arc published in the CNJ.

AV aids

Films

A matter of fat

The National Film Board of Canada
has just produced a most interesting
feature length film (running time 1 hr
39 mmutcs) entitled -'A Mailer of Fat^
Written and directed by William Wein-
traub, produced by Desmond Dew,
and narrated by Lome Greene, A Mai-
ler of Fat is designed to be shown in
theatres. It is also a good teaching film,
in that it deals sympathetically with
one-quarter of the population of North
America, 60,000,000 overweight peo-
ple who are made to feel miserable in
a society that worships youth and the
slender, though w e I I -proportioned,
figure.

A Matter of Fat is more tlian the
documented story of 37-year-old Gilles
Lorrain, accountant for a firm located
in a town about 100 miles from Mont-
real, who decided to do something
about his burden of 358 pounds. His
admission to a Montreal hospital for
treatment led to a well -monitored re-
gime of starvation — black coffee and
mineral water for periods of up to 30
days at a time, relieved only by short
weeks of nourishment not exceeding
800 calories daily. All in all it took
seven harrowing and discouraging
months trt shed 140 pounds. Through
it all, Gilles showed great fortitude
and much wry humor. Furthermore, he
DECEMBER 1970

proved to be, as one might say, a natu-
ral for his role. A year later he had
succeeded in maintaining his weight.

Threaded through the story are
glimpses of weight watchers meetings,
beauty resorts costing $700 a week or
more, camps for fat children, research-
ers at work in their laboratories, learned
authorities warning of the dangers of
pills prescribed by quacks, the fattest
lady in the world, scientists debunking
the mysteries of obesity, and so on.

Information on showings of this
film may be had by writing to the Na-
tional Film Board of Canada, 150 Kent
Street, Ottawa 4.

As we see it

This 16 mm. color, 26 1/2 - minute
film features a group of creative young-
sters who set up their own closed cir-
cuit TV documentary to persuade their
parents to give up smoking. Their
dramatic presentation includes a paren-
tal confrontation.

A group of young pre-teen reporters
then go on location to interview three
outstanding medical experts on various
aspects of the smoking problem. Seen
in the film are Dr. Charles Tate, Dr.
Stephen Ayers, and Dr. Oscar Auer-
bach.

As We See It presents its message
by indirection in that youngsters at-

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otherwise you will likely miss copies.

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OR
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MAIL TO:

The Canadian Nurse

50 The Driveway
OTTAWA 4, Canada

tempt to convince their parents to give
up smoking. The film evolves with a
high degree of drama and emotion and
contains a well-integrated amount of
basic educational information. As We
See It is suitable for both youthful and
adult audiences.

Produced by the National Tuberculo-
sis and Respiratory Diseases Associa-
tion, As We See It is distributed by
the Section of Education of the Quebec
Christmas Seal Society Inc., 264 rue
Chenier, Quebec 8, P.Q.

Immediate post-surgical prosthesis

Although Iniitiediaie P o s t-Surgical
Prosthesis (United States Veterans
Administration, 1966) is not a new
film, it graphically portrays the work
accomplished during the Seattle Pros-
thetic Research Study conducted by
Dr. Burgess and his team. It traces
the progress of a man of 60 who, be-
cause of a long history of osteomyelitis,
has his leg amputated below the knee
and is fitted immediately with a pros-
thesis. This procedure permits early
clean healing of the wound, early dis-
charge from hospital, and early fitting
of a permanent prosthesis. This proce-
dure, now gaining wide acceptance,
may be considered reconstructive rather
than destructive surgery.

This was aptly demonstrated at a
recent one-day course on amputations
at the Ottawa Civic Hospital, sponsored
by the Ottawa District of the Canadian
Physiotherapy Association.

Here, the hospital team of ortho-
pedic surgeon, physiotherapist, social
worker, and prosthetist used the film
as the basis for evaluating newer meth-
ods. Several local amputees came
to the meeting to demonstrate how
well they had adjusted to their loss of
limbs, how well their new appendages
functioned, and how much they enjoyed
their renewed health and ability to live
a normal life — well, almost normal.

This film (running time 27 minutes)
can serve as a valuable teaching aid.
It is obtainable on loan from the Central
Office Film Library (037BI). Audio
Visuals Service, Veterans Administra-
tion Central Office, Washington, D.C.,
20420, U.S.A., or Bert Mason & Son,
Inc., 1070 Bleury Street, Montreal 128,
Quebec.

Cancer

The following films on cancer are
available from The Canadian Cancer
Society, Ontario Division. 204 Eglin-
ton Ave. E., Toronto 12, Ontario.
All films are 16 mm. sound, and in
color.

After Mastectomy, 20 minutes
Cancer in Children. 27 minutes
Cancer of the Skin. 26 minutes
Cancer of the Sionu^li. 19 minutes

THE CANADIAN NURSE 47

Cancer of the Thyroid, 29 minutes

Early Diagnosis and Management

of Breast Cancer, 34 minutes

Nursing Management of the Patient

with Cancer, 29 minutes

What is Carreer? 2 1 minutes 'w'

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 in-
stitutions. Reference items (theses,
archive books and directories, almanacs
and similar 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 any one time.

BOOKS AND DOCUMENTS

1 . Lalimeiiuition a I'lwpital psychialriqiie
par Claude Nachin. Paris. Centres d"en-
trainement aux methodes d'education
active. Editions du Scarabee, 1969. 91 p.
(Bibliotheque de I'infirmier psychiatri-
que)

2. Annual report 1969. London, Queen's
Institute of District Nursing, 1970. 52p.

3. Allied Iwaltli manpower; trends and
prospects by Harry I. Greenfield, with
the assistance of Carol A. Brown. New
York, Columbia Univ. Press, 1969. 195p.

4. A hihliof,'rapliy of collective hargainint;
in hospitals and related facilities 1959-
1969 by William A. Rothman. Ann Arbor.
Institute of Labor and Industrial Rela-
tions. University of Michigan-Wayne
State University, 1970. 106p.

5. Biennial report of the Secretary-Gen-
eral. Fiscal years 1967-6811968-69. Ottawa.
Canadian Commission for Unesco. 1970.
Tip.

6. Canadian Hospital Association office
and association directory. Jidy 1970.
Toronto. Canadian Hospital Association.
1970. 60p. R

7. Cent ans de psychiatric: es.sai siir I'his-
toire des institutions psychiatriques en
Frame de 1870 a nos jours par Henri
Vermorel et Andre Meylan. Paris. Cen-
tres d'entrarnement aux methodes d'edu-
cation active. Editions du Scarabee. 1969.
81 p. (Bibliotheque de I'infirmier psychia-
trique)

8. Crisis intervention: theory and meth-
odology by Donna C. Aguilera et al.
Saint Louis, Mosby, 1970. 132p.

48 THE CANADIAN NURSE

9. Community dynamics and mental
health by Donald C. Klein. Toronto,
Wiley. 1968. 224p.

10. Cutting communications costs and
increasing impacts; diagnosing and im-
proving the company's written documents
by George T. Vardaman et al. Toronto.
Wiley, 1970. 281p.

11. Education in tlie liealth-relatcd profes-
sions. New York. New York Academy of
Sciences. 1969. p. 821-1058. (New York
Academy of Sciences. Annals, v. 166 art. 3)
Partial contents. — Trends in nursing edu-
cation by Joan Hartigan. — The pediatric
nurse practitioner and the child health
associate: new types of health professionnals
by Henry K. Silver.

12. Etudes sur I'universite, la societe et le
gouvernement par la Commission d'etude
sur les relations entre les universites et les
gouvernements. Ottawa. Les Editions de
rUniversite d'Ottawa, 1970. 2v.

13. The extended care facility; a guide to
organization and operation by Dulcy B.
Miller. Toronto, McGraw-Hill. 1969. 480p.

14. Handbook of pediatrics by Henry Silver
et al. 8th ed. Los Altos. Calif. Lange. 1969.
682p.

15. Health: man in a changing environment
by Benjamin A. Kogan. New York. Harcourt.
Brace & World, 1970. 642p.

16. A history of the General Nursing
Council for England and Wales. 1919-1969
by Eve Rosemarie Duffield Bendall and
Elizabeth Raybould. London. Lewis. 1969.
312p.

17. Hospitals, Journal of the American
Hospital Association. Guide issue. 1970.
Chicago. American Hospital Association.
1970. 636p. R

18. Hospitals and patients by William R.
Rosengren and Mark Lifton. New York,
Atherton Press. 1969. 225p.

19. The liunuin body in health and disease
by Ruth Lundeen Memmler and Ruth Byers
Rada. 3d. ed. Toronto. Lippincott, 1970.
388p.

20. Learning, memory and conceptual
processes by Walter Kintsch. Toronto. Wiley.
1970. 498p.

2 I . Meeting the crises in hetiltli care services
in our conimunity; Report of National
Health Forum. Washington. D.C.. Feb.
23-25. 1970. New York. National Health
Council. 1970. 249p.

22. Nurses and the law by Carol Miller.
Danville. 111.. Interstate Printers & Pub-
lishers. 1970. 217p.

23. The price of leisure: an economic
analysis of the demaiul for leisure time by

Library Loan Service

As usual, mailing of materials on
loan from the library will be curtailed
over the holiday mailing season. Loans
will not be mailed out, therefore,
between December 1, 1970and Janu-
ary 5, 1971.

John D. Owen. Montreal. McG ill-Queen's
University Press, 1970. 169p.

24. Profession of medicine: a .Uudy of the
.sociology of applied knowledge by Eliot
Freidson. New York, Dodd. Meade. 1970.
409p.

25. The professions in America edited by
Kenneth S. Lynn and the editors of Daedalus.
Boston. Houghton Mifflin. 1965. 273p.

26. Programmed instruction in arithmetic,
dosages and solutions by Doiores F. Saxton
and John F. Walter. Saint Louis, Mosby.
1970. 60p.

27. Psychologic de I'adolescent par Fran-
goise Cholette-Perusse. Montreal. Editions
du Jour. 1970? 203p.

28. Psychologic de I'enfant par Fran?oise
Cholette-Perusse. Montreal. Editions du
Jour, 1963. 181p.

29. La readaptation medicate par Michel
Dupuis. Montreal. Les Editions Intermonde.
1969. 128p.

30. Report. 1969. Ottawa. Victorian Order
of Nurses for Canada. 1969. 70p.

3 1 . Reprints. American Medical Association.
Committee on Nursing. Chicago. American
Medical Association. Committee on Nursing.
1962. Iv.

32. La sante sans pilules par Gerald Corri-
veau et C.C. Berrols. Tome 1. Montreal.
Les Editions du Jour. 1963. 222p.

33. The struggle for Canadian universities;
a dossier edited by Robin Mathews and
James Steele. Toronto. New Press. 1969.
184p.

34. Studies on the university, society and
government prepared by Commission on the
Relations between Universities and Govern-
ments. Ottawa. University of Ottawa Press.
1970.2V.

35. Le sy Sterne scolaire du Quebec 2. ed.
par Louis-Philippe Audet et Armand Gau-
thier. Montreal. Beauchemin. 1969. 286p.
35. Teachers for the real world in collabo-
ration with B. Othanel Smith et al. Washing-
ton. American Association of Colleges for
Teacher Education. 1969. I85p.

37. Le travail therapeutique ii Thopitat p.sy-
chiatrique par Frani;ois Tosquelles. Paris.
Centres d'entrainement aux methodes d'edu-
cation active. Editions du Scarabee. 1967.
87p. (Bibliotheque de I'infirmier psychistri-
que)

38. 20 lettres a line femme dans le vent par
Andre Soubiran. Paris. Kent-SEGEP, 1970.
222p.

39. L'Universite du Quebec par Serge La-
marche. Montreal. Lidec. 1969. 174p. (Col-
lection du CEP)

40. The university, society and government;
^ the report of the Commission on the Rela-
tions Between Universities and Governments.
Ottawa. University of Ottawa Press. 1970.
252p.

PAMPHLETS

41. Action times ten. New York. The United
Nations Development Programme. 1970. 19p.

42. Bed positioning procedures by Doris
Bergstrom and Catherine Haas Coles. Min-
neapolis. American Rehabilitation Found-

DECEMBER 1970

accession list

ation. 1969? 26p. (Rehabilitation publication
no. 701)

43. Declaration siir I'enseigneinenl et la
pratique des soins infirmiers. le service in-
firmier el le statu! social et economique
des infirmieres. Geneve. Conseil Internatio-
nal des Infirmieres. 1969. lOp.

44. First report for the period 1st Aug.
1968 to 31st Dec. 1969. Edinburgh. Scottish
Nursing Staffs Committee. 1970. 15p.

45. The Friesen no-nursing station concept:
its effects on nurse staffing. Ann Arbor.
Mich.. CHI Systems Inc.. 1970. 27p.

46. Indexes. Chicago. University Press.,

1969. 32p.

47. Medico-moral guide. Ottawa, Catholic
Association of Canada. 1970. lOp.

48. Principes direcieurs de la mise au point,
dans les universites, de programmes de hac-
calaureat et en sciences infirmieres. Ottawa,
Association des Infirmieres canadiennes,
1967. I2p.

49. Programs accredited for public health
nursing preparation. / 970-7 1. New York,
National League for Nursing. Dept. of
Baccalaureate and Higher Degree Programs

1970. 6p. R

."iO. Public affairs pamphlets. New York.
Public Affairs Committee. Asthma — how

to live with it by Ruth Carson. 1969. 20p.
(no. 437)

51. Blood — new uses for saving lives by
Michael H.K. Irwin. 1965. 28p. (no. 377)

52. Diabetics unknown by Groff Conklin.
I96l.27p. (no. 312)

53. Emphysema — the growing problem of
breathlessness by Jules Saltman. 1969. 20p.
(no. 326 A)

54. An environment fit for people by Ray-
mond F. Dasmann. 1968. 28p. (no. 421)

55. Epilepsy — today's encouraging out-
look by Harry Sands and Jacqueline Seaver.
1966. 28p. (no. 387)

56. Fads, myths, quacks — and your health
by Jacqueline Seaver. 1968. (no. 415)

57. Foodandscience . . .today and tomorrow
by Gwen Lam. 1961. 20p. (no. 320)

58. Food hints for mature people; more
years to life — more life to years by Charles
G. King and George Britt. 1962. (no. 336)

59. The health of the poor by Irvin Block.
1969. 20p. (no. 435)

60. How we can get the nurses we need by
Ruth Carson. 1966. 28p. (no. 385)

61. It's not too late to stop smoking ciga-
rettes by Alton Blakeslee. 1966. (no. 386)

62. Multiple .sclerosis — new hope in an
old mystery by Jules Saltman. 1962. (no. 335)

63. Private nursing homes: their role in the
care of the aged by Ogden Greeley. I960,
(no. 298)

64. Quiet guardians of the people's health
by Nettie Kline. 1962. 20p.

65. Leukemia: key to the cancer puzzle by

Pat McGrady. 1963. 20p. (no. 340)

66. Mental health jobs today and tomorrow
by Elizabeth Ogg. 1966. 28p. (no. 384)

67. School failures and dropouts by Edith
G. Neisser. 1963. 28p. (no. 346)

68. Science against cancer by Pat Mc Grady.
1962. 20p. (no. 324)

69. Water flinnidation: facts, not myths
by Louis I. Dublin. 1957. (no. 25 IB)

70. We can conquer uterine cancer by Eli-
zabeth Ogg. 1969. 23p. (no. 432)

71. What we can do about drug abuse by
Jules Saltman. 1966. 28p. (no. 390)

72. Purpose of college: statement of beliefs;
critical elements in Ontario. Regs. 23,24
and schedules 2. 3. 4, 5 of the Nurses Act.
1961-62. Toronto. College of Nurses of
Ontario. 1970. 6p.

73. Report of the special interest group
meeting on the international movement of
nurses. 14th Quandrennial Congress of the
International Council of Nurses. Tuesday,
June 24th, 1969. New York. American
Nurses Association. 1970. 3p.

74. Subiiii.'isi<m on future programmes in
nursing education for Prince Eilward Island
to Dr. Edward Sheffield. Chairman Uni-
versity Planning Committee. Charlottetown,
Association of Nurses of Prince Edward
Island, 1968. 7p.

GOVERNMF.NT DOCUMENTS

Canada

75. Bureau of Statistics. Training schools

Put your foot down. Insist on
KLING* conform bandages

KLING' Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes in bandaging areas that
are hard to bandage and hard to keep
bandaged.

KLING — the bandage that conformsl

MONTREALATORONTO - CANADA

'Trademark of Johnson & Johnson or affiliated companies

DECEMBER 1970

There's no waist with
KLING* confornn bandages

KLING' Conform Bandage — the unique
self adhering, elastic cotton bandage
that specializes In bandaging areas that
are hard to bandage and hard to keep
bandaged.

KLING — the bandage that conformsl

MONTREAL « TORONTO -CAWkDA

•Trademark of Johnson & Johnson or affiliated companies

THE CANADIAN NURSE 49

accession list

t969. Ottawa. Queen's Printer. 1970 44p.

76. Canadian Permanent Committee on
Geographical Names. Gazetteer of Canada
supplement no. 14. Ottawa, Queen's Printer.

1969. 67p. R

77. Dept. of Labour. Women's Bureau.
Women s bureau '69. Ottawa. Queen's Printer,

1970. 31 p.

78. Dept. of Manpower and Immigration.
Collective haraainin^ and the grievance
procedure in the federal public .'iervice; a
self-instruction manual in collaboration with
the Staff Relations Section. Personnel Service.
Dept.of Manpower and Immigration. Ottawa.
Treasury Board of Canada. 1970. 157p.

79. Supply and demand technological insti-
tute graduates 1969-70. Ottawa, Queen's
Printer. 1970. 16p.

80. Dept, of National Health and Welfare.
Biostatistics Division, Research and Statistics
Directorate. Statistics on the socio-eco-
nomic characteristics of contributors to the
Canada pension plan and le regime de ren-
tes du Quebec and non-contributors who
filled income la.x returns for 1966. Ottawa,

1970. 66p.

81. Economic Council of Canada. Annual
review, 1970. Ottawa, Queen's Printer, 1970.
109p. (Its Annual review no. 7)

82. Parliament. Senate. Special Committee
on Poverty. Interim report. Ottawa, Queen's
Printer, 1970. 17p.

83. Prime Minister. Income security and
social services; working paper on the
Constitution. Ottawa. Queen's Printer, 1969.
125p.

84. Royal Commission on Bilingualism and
Biculturalism. The federal capital, hook 5
and vocabulary associations, book 6. Ottawa,
Queen's Printer, 1970. 231 p.

85. Task Force on Labour Relations. Unfair
labour practices: an exploratory study of
the efficacy of the law of unfair labour
practices in Canada by Innis Christie and
Molly Gorsky. Ottawa, Queen's Printer,

1968. 220p. (Its study no. 10)
Michigan

86. Dept. of Public Health. Bureau of Med-
ical Care Administration. Cardiac care units;
minimal criteria and guidelines. Detroit,

1969. 32p.

87. Hospital hemodialysis units: minimal
criteria and guidelines. Detroit, 1970. 28p.

88. Intensive care units: minimal criteria
and guidelines. Detroit. 1970. 29p.
Northwest Territories

89. Laws and Statutes. Ordinances 1969
second .session. Ottawa. Queen's Printer,

1970. 94p.
Ontario

90. Hospital Services Commission. Report,
/ 969. Toronto, 1970. 22p.

United States

91. Dept. of Health, Education and Welfare.

Public Health Service. Research in Nursing
1955-1968; research grants. Projects support-
ed with funds administered by the Division
of Nursing, rev. 1969. Wash.. U.S. Gov't.
Print. Off.. 1969. 91p.

92. President. Answers to the most frequently
asked questions about drug abuse. Chevy
Chase, Md., National Clearing House for
Drug Abuse Information, 1970. 30p.

STUDIES DEPOSITED IN

CNA REPOSITORY COLLECTION

93. A comparison of .social attitiuies between
freshmen and seniors in a collegiate .school
of nursing by Mary Wranesh Gorrow. Salt
Lake City, Univ. Utah, 1960. 67p. (Thesis
(M.Sc. N.)— Utah)R

94. An investigation into the causes that
affect the normal introduction of foods to
infants registered at Babar Road Centre New
Delhi during September I, 1964 to August
31, 1964 by Saraswati Davi Gupta. Delhi,
India. 1965.73p. R

95. The nursing process analysis; adequate
tool for leaching and learning in the CE-
GEP's nursing program by Jacqueline Lau-
rin. Detroit, Mich. 1969. 56p. (Thesis (M.
S.C. N.) — Wayne State) R

96. Statistical report on nursing education
and registration. Toronto, College of Nurses
of Nurses of Ontario. 1970. 3p. R

97. A study of literature selection in bacca-
laureate students in nursing by Margaret F.
Munro. Minneapolis, Minn., 1967. 53p.
(Thesis (M. Ed.) — Minnesota) R ^

has received

URGENT

requests for

NURSES

to work in

INDIA

and

COLOMBIA

CUSO health department has high priority requests
for as many as 30 nurses for postings in India and
Colombia. A few RNs with only one year's
experience can be placed, but the real need is for
nurses with at least two years' experience. Following
are typical positions available for BScNs, BNs, RNs
with post-basic diplomas and RNs with experience:

Public Health nursing / teaching in schools for
nursing auxiliaries / teaching at both diploma and
baccalaureate level / ward administration and
clinical instruction in various specialties /
operating-room nursing / family planning

TERMS OF SERVICE: In addition to the
professional qualifications a CUSO assignment calls
for such personal qualities as maturity, initiative,
common sense, adaptability and sensitivity.

All assignments are for two years. Most salaries are
paid at approximately local rate by the overseas
employer. CUSO provides training, return
transportation, medical and life insurance.

Next training course begins early August. For further
information write NOW to; CUSO Health
Department, 151 Slater Street, Ottawa 4, Ontario.

50 THE CANADIAN NURSE

DECEMBER 1970

classified advertisements

ALBERTA

BRITISH COLUMBIA

ONTARIO

REGISTERED NURSES FOR GENERAL DUTY in a

34-bed hospital. Salary 1968, $405-$485. Experien-
ced recognized. Residence available. For particu-
lars contact: Director of Nursing Service, White-
court General Hospital, Whitecourt, Alberta, Phone:
778-2285.

BRITISH COLUMBIA

SUPERVISOR Evening and night for the over
all coordination and management of a 150-bed
acute hospital (addrtional 111 beds under con-
struction). Position open December 1. 1970.
B.C R.N. personnel policies in effect. Salary
range — $659.00 to $883. 00. For further informa-
tion, v^frile to: Director of Nursing. Chilhwack
General Hospital. Chilliwack, British Columbia.

GENERAL DUTY NURSES for modern 33-bed hospital
located on the Alaska Highway. Salary and personnel
policies in accordance with RNABC. Accommodation
available in residence. Apply to: Director of Nursing,
General Hospital. Fort Nelson. B.C,

GENERAL DUTY NURSES for modern 35-bed hospital
located in excellent recreational area. Salary and per-
sonnel policies in accordance with RNABC. Comfor-
table Nurses' home. Apply: Director of Nursing, Boun-
dary Hospital, Grand Forks, British Columbia.

ADVERTISING
RATES

FOR ALL
CLASSIFIED ADVERTISING

$15.00 for 6 lines or less
$2.50 for each additional lir>e

Rotes for display
advertisements on request

Closing dale for copy ond cancellation is
6 weeks prior to 1st day of publication
month.

The Canadian Nurses' Association does
not review the personnel policies of
the hospitals and agencies advertising
in the Journal. For authentic information,
prospective applicants should apply to
the Registered Nurses' Association of the
Province in which they ore interested
in working.

Address correspondence tO:

The

Canadian ^
Nurse ^

50 THE DRIVEWAY
OTTAWA 4. ONTARIO.

OPERATING ROOM NURSES for modern 450-bed hos-
pital with School of Nursing. RNABC policies in ef-
fect. Credit for past experience and postgraduate
training. British Columbia registration is required.
For particulars write to; The Associate Director of
Nursing. St.Joseph's Hospital, Victoria. British Co-
lumbia.

MANITOBA

GENERAL DUTY R.N.s for 17-bed active hospital,
owned and operated by United Church Board of Home
Missions, 90 miles north of Winnipeg. Starting salary
$530 per month with allowance for experience. Single
accommodation, meals available. Apply to: Director
of Nursing, Crowe fvlemorial Hospital, Eriksdale,
Manitoba. Phone: 739-2611.

NEWFOUNDLAND

GENERAL STAFF NURSES (VACANCY), 4 weeks
annual vacation, transportation advanced, pension
pian. Group Life. Blue Cross, etc., private room in
residence $25.00 per month. Salary scale $5,340 —
120 — $6,140 per annum. Apply: Mrs. Shirley M,
Dunphy, Director of Personnel. Western Memorial
Hospital, Corner Brook, Newfoundland,

NOVA SCOTIA

STAFF NURSES applications are invited for a 76-bed
active treatment hospital. Nurses interested in the
interest in retroactive functions of the patient would
Progressive Patient Care Concept, and having a keen
be preferable. Salary based on N.S.H.I.C. current
scale, taking into account individual experience etc..
Applications and enquiries should be directed to:
Director of Nursing, Halifax Civic Hospital, 5938
University Avenue, Halifax, Nova Scotia. Phone:
422-1731.

ONTARIO

NIGHT SUPERVISOR required immediately by
Wingham and District Hospital. Good personnel
policies, salary commensurate with experience.
Apply: Miss G. Norris, Director of Nursing, Wingham
and District Hospital, Wingham, Ontario,

SUPERVISOR — PUBLIC HEALTH NURSING — for

generalized program in the Oshawa-Ontario County
District Health Unit. Good personnel policies and
salary schedule. Position requires Diploma in advanc-
ed Public Health Nursing and Supervision or a
Baccalaureate Degree with Administration. Apply lo.
Miss G. H. Tucker. Director of Nursing, Oshawa-
Ontario County District Health Unit, 50 Centre Street,
Oshawa, Ontario,

REGISTERED NURSES tor 34-bed General Hospital
Salary $525. per month to $625 plus experience al-
lowance. Residence accommodation available. Ex-
cellent personnel policies. Apply to: Superintendent,
Englehart & District Hospital Inc., Englehart, Ontario.

REGISTERED NURSES required for a 12-bed Inten-
sive Care-Coronary Care combined Unit. Post basic
preparation and/or suitable experience essential.
1970 salary range $535-645; generous fringe benefits.
Apply to; Director of Nursing. St, Marys General Hos-
pital, 91 IB Queen's Blvd,. Kitchener. Ontario,

REGISTERED NURSES needed for 81-bed General
Hospital in bilingual community of Northern Ontario,
French language on asset, but not compulsory. Start-
ing salary $530. monthly with allowance tor past ex-
perience, 4 weeks vacation after 1 year and 18 sick
leave days. Unused sick leave days paid at 100% eve-
ry year. Master rotation in effect. Rooming accom-
modation available in town. Excellent personnel pol-
icies. Apply to: Personnel Director, Notre-Dame Hos-
pital, P.O. Box 850. Hearst. Ont.

REGISTERED NURSES for lOObed General
Hospital, situated 40 miles from Ottawa. Excel-
lent personnel policies. Residence accommodation
available Apply to Director of Nursing, Smiths
Falls Public Hospital, Smiths Falls, Ontario.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS. Our 75-bed modern, progressive Hos-
pital invites you to make application. Salaries for
Registered Nurses start at $510.00, with yearly
increments and experience benefits. The basic
salary for RNA, is $382.00 with yearly increments.
Room IS available in our modern residence. We are
located in the Vacationland of the North, midway
between Winnipeg and Thunder Bay. Write or phone
The Director of Nursing, Dryden District General
Hospital, Dryden. Ontario.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS lor 45-bed hospital, R.N.s salary $525
to $600 with experience allowance and 4 semi-annu-
al increments. Nurses' residence — private rooms
with bath — $30 per month. R.N.A.'s salary $350 to
$425. Apply to: The Director of Nursing. Geraldlon
District Hospital. Geraldton. Ont.

REGISTERED NURSES AND REGISTERED NURSING
ASSISTANTS, looking for an opportunity wo work in
a patient Centered Nursing Service, are required by
a modern well-equipped hospital. Situated in a pro-
gressive Community in South Western Ontario. Ex-
cellent employee benefits and working conditions.
Write for further information to Director of Nursing;
Leamington District Memorial Hospital; Leamington.
Ontario.

REGISTERED NURSES, lor GENERAL DUTY and
I.C.U.. and REGISTERED NURSING ASSISTANTS

required for 160-bed accredited hospital Starting
salary $525.00 and $365.00 respectively with
regular annual increments for both. Excellent
personnel policies. Temporary residence accommo-
dation available. Apply to; Director of fvlursing,
Kirkland and District Hospital, Kirkland Lake,
OntariO-

REGISTERED NURSES FOR GENERAL DUTY AND
OPERATING ROOM: for 104-bed accredited Gen-
eral Hospital. Basic salary — $525 — $625/m, with
remuneration for past experience. Shift differential
$1,00 per evening or night, shift. Yearly increments,
A modern, well-equipped hospital, amidst the lakes
and streams of Northwestern Ontario. Apply to; Mrs.
L. DeGagne, Director of Nursing, La Verendrye Hos-
pital, Fort Frances, Ontario,

REGISTERED NURSES FOR GENERAL STAFF AND
OPERATING ROOM, in well-equipped 34-bed
hospital. Gold minimg and tourist area, wide variety
of summer and winter sports. Modern nurses
residence, room and board and uniform laundry $55.
Cumulative sick-time, 9 statutory holidays, 4 weeks
vacation. Salary from $525 — $625, with allowance
for past experience and ability. Shift differential $1.
per evening or night shift. Apply to; Matron,
Margaret Cochenour Memorial Hospital, Cochenour.
Ontario,

DECEMBER 1970

REGISTERED NURSES FOR GENERAL STAFF AND
OPERATING ROOM, in modern, accredited 235-bed
General Hospital situated in the Nickel Capital of
the world. Good personnel policies. Recognition
for experience and post-basic preparation. Annual
bonus plan. Planned "in-service", programs.
Assistance with transportation. Apply — Director
of Nursing. Sudbury Memorial Hospital. Sudbury,
Ontario.

PUBLIC HEALTH NURSES (2) Vacancies exist in our
Elliot Lake and Espanola offices. Salary scale 1971.
$7,435.00 — $9.445 00 Liberal fringe benefits and
holidays. Enquire; Nursing Director, Sudbury and
District Health Unit, 50 Cedar Street, Sudbury.
Ontario,

THE CANADIAN NURSE 51

RIVERSIDE HOSPITAL
OF OTTAWA

Applications are called for Nurses for the
positions of:

ASSISTANT HEAD NURSES,
GENERAL STAFF NURSES

and

REGISTERED NURSING
ASSISTANTS

Address all enquiries to:
Director of Personnel
RIVERSIDE HOSPITAL

OF OTTAWA

1967 Riverside Drive,

Ottavt/a, Ontario

THE STRATFORD GENERAL
HOSPITAL

In the Festival City of Canada
invites applications for

SUPERVISOR

for the overall co-ordination and manoge-
ment of their OPERATING ROOM —
RECOVERY ROOM and EMERGENCY COM-
PLEX. These three areas are presently
staffed with experienced and competent
Head Nurses. Early appointment, Salary
negotiable.

Apply in writing, sending complete
resume to the:

Personnp! Director

STRATFORD GENERAL HOSPITAL

Stratford, Ontario

NEW YORK CITY

ST. CLARE'S HOSPITAL

IN THE HEART OF

MANHATTAN

S.R.N.'s

Modern 421 Bed Hospital

Starting Salary

$9,800

for eve and night shifts

Regular Increases. Excellent Benefits in-
cluding tuition refund and subsidized
housing.

Write giving full outline of training
and experience to:

Frank Folisi, Personnel Dept.

ST. CLARE'S HOSPITAL

415 West 51 Street

New York City, 10019, USA

ONTARIO

SENIOR STAFF PUBLIC HEALTH NURSE for

Huron County Health Unit. B.ScN. or diploma
m public healtti nursing and several years experi-
ence required. Generalized public fiealth nursing
service with new programme being aeveiopea.
Main office in Goderich. a pleasant town
situated on Lake Huron. Applications should be
directed to: Dr. G.P.A. Evans, Director and
Medical Officer of Health, Court House, Goderich
Ontario.

PUBLIC HEALTH NURSES required by International
Grenfell Association for areas in Northern New-
foundland and Labrador. Programme based on New-
foundland Department of Health requirements.
Vehicles provided. Residence accommodation.
Excellent fringe benefits. Apply r/lrs. Ellen E.
fvlcDonald. International Grenfell Association, Room
701. 88 Ivletcalfe Street. Ottawa 4, Ontario.

BE A
BLOOD
DONOR

B

QUEBEC

CERTIFIED NURSING ASSISTANTS required for
141-bed General Hospital. Located in the Eastern
Townships approximately 80 miles from Ivlontreal
Excellent winter and summer resort area. Apply in
writing to: Director of Nursing, Sherbrooke Hospital
375 Argyle Street. Sherbrooke, Quebec

SASKATCHEWAN

I]

DIRECTOR OF NURSING: Immediate applications are
invited for 45-bed Wadena Union Hospital. Super-
visory experience essential. Administrative Nursinq
course an asset. Apply to: Mr. D. Silversides.
Administrator, Wadena Union Hospital. P.O Box 10
Wadena. Sask.

UNITED STATES

REGISTERED NURSES — Arizona's new 200-bed
Acute Care General Community Hospital near
Phoenix, First 100 beds open November 1970.
Positions available all nursing areas: Intensive
Care, Coronary Care; Medical-Surgical; Emergency.
Help implement and develop newer ideas and
approaches in patient care. Build a cooperative
health team within hospital and community. Contact:
Director of Nursing, Walter O. Boswel! Memorial
Hospital. P.O, Box 10. Department C, Sun City.
Arizona 85351.

REGISTERED NURSES for general duty and spe-
ciality areas in expanding 350-bed general teaching
hospital located in prime southwest beach com-
munity. California license required. Excellent
salaries and employee benefit program. For
further information, please contact: Personnel
Dept,. St. Marys Hospital. 509 E. 10th Street.
Long Beach. California 90813.

REGISTERED NURSES — Immediate openings in
all services, medical, surgical, ICU'CCU, pediatrics,
maternity, psychiatry. JC.A.H. Hospital halfway
between San Francisco and Lake Tahoe. $700.00 for
beginnmg salary for R.N.'s in our hospital, with
shift differentials. Apply Director of Nursing Serv-
ices, Woodland Memorial Hospital, 1325 Cottonwood
Street, Woodland. California 95695.

SOUTHERN CALIFORNIA 403-bed private hospital,
liberal salary and outstanding personnel benefits.
Must have California Registration, Write: Personnel
Director, Hospital of the Good Samaritan, 1212
Shatto St.. Los Angeles, California, 90017.

NURSES for new tri-bed General Hospital Resort
area. Ideal climate. On beautiful Pacific ocean.
Apply to: Director of Nurses. South Coast Community
Hospital, South Laguna, California.

ST. THOMAS-ELGIN
GENERAL HOSPITAL

requires

REGISTERED NURSES

Full time employment in Active end
Chronic Units. Modern 400-bed, fully
accredited General Hospital. Pleasant,
progressive, industrial city of 23,000.

Excellent Personnel Policies, O.H.A. Pen-
sion Plan.

APPLY: Personnel Officer
ST. THOMAS-ELGIN
GENERAL HOSPITAL
St. Thomas, Ont.

UNIVERSITY OF NEW BRUNSWICK

requires

a qualified person to teach

Children's Nursing

Preference will be given to candidates
with a Master's Degree and teaching
experience.

Appointment to commence July I, 1971.

For further information concern-
ing the position; salary, rank and
personnel policies write to:

The Dean, Faculty of Nursing

UNIVERSITY OF

NEW BRUNSWICK

FREDERICTON, N.B.

Applications are invited
for the position of

DIRECTOR OF NURSING

This position carries responsibility for
the co-ordination of all facets of nursing
services within a 215-bed accredited hos-
pital and a nursing assistant school
with on onnual student enrollment of 54.
Salary commensurate with experience
and qualifications.

Apply in writing, stating experi-
ence, qualifications, references
and available date to:

Administrator

Norfolk General Hospital

Simcoe, Ontario.

52 THE CANADIAN NURSE

DECEMBER 1970

UNITED STATES

UNITED STATES

J

STANFORD UNIVERSITY HOSPITAL: extends an
invitation to |Oin our professional staff. A 600-bed
teaching hospital offering all speciality services.
Salary geared to education and experience; hberal
differential and outstanding benefits; internal
promotional system; continuing InservJce education.
Palo Alto, the home of Stanford University, is a
beautifully planned residential area located 38
miles soutfi ot San Francisco. We can assist in
visa procedure. Apply to: fvlrs. Sue Power, Employ-
ment Manager, Stanford University Hospital. Stan-
ford. Calif. 94305.

REGISTERED NURSES

Urgently required

For a small 20-bed community hospital in
Northern Ontario. Located within 35 miles
of two larger centers. Full active treat-
ment hospital — all services including
surgery. Full fringe benefits including
salary considerotion for experience. Ex-
cellent residence accommodation avoil-
able, a winter sports area providing
excellent opportunity for nurses who
enjoy small community living.

Send applications to:

Miss S. Davies

Director of Nursing

SMOOTH ROCK FALLS HOSPITAL

Smooth Rock Falls, Ontario

ASSISTANT

DIRECTOR

OF NURSING

Applications are invited for the
position of Assistant Director of
Nursing at Cobourg District Gen-
eral Hospital. Postgraduate train-
ing at University level in Nursing
Administration will be given pre-
ference. The hospital is 158 beds
with recently opened new fa-
cilities, situated in a pleasant
town of 11,000 on the shore of
Lake Ontario, 70 miles east of
Toronto.

Apply: stating qualifications, ex-
perience, when available, etc., to:

F. N. Abrams
Administrator

COBOURG DISTRICT
GENERAL HOSPITAL

Cobourg, Ontario

STAFF NURSES: To work in Extended Care or
Tuberculosis Umi. Live m lovely suburban Cleveland
in 2-bedroom tiouse for $65 a month including all
utilities. Modern salary and excellent fringe benefits
Write Director of Nursing Service, 4310 Rictimond
Road, Cleveland. Ofiio,

STAFF NURSES — Here is the opportunity to further
develop your professional skills and knoviiledge in
our 1.000-bed medical center. We have liberal
personnel policies with premiums for evening and
night lours. Out nurses residence located in the
midst of 33 cultural and educational institutions
offers low-cost housing adjacent lo the Hospitals
Write for our booklet on nursing opportunities.
Feel free to tell us what type position you are
seekina. Write Pat Ferry, Nurse Recruitment, Room
C-12. University Hospitals of Cleveland, University
Circle. Cleveland. Ohio 44106,

REMEMBER

HELP YOUR RED CROSS

TO HELP

ADDICTION RESEARCH FOUNDATION

UNIVERSITY OF TORONTO

INSTITUTE FOR THE STUDY OF ADDICTION

DIRECTOR OF NURSING

Applications are invited for the position of Director of Nursing
of the Institute for the Study of Addiction. This one hundred bed
university teaching hospital is to be opened in March 1971. It
will have standard hospital therapeutic and investigative fa-
cilities including emergency and other outpatient departments,
and wards for intensive care, convalescence, and clinical research.
There will be no facilities for major surgery. The clinical teams
will consist of members of a variety of medical specialties and
other professions appropriate to the management of patients
with alcohol and drug dependence and associated illnesses.

The Director of Nursing will be responsible for the complete
nursing function which will be program oriented. We intend to
develop nursing education and research in the Institute in as-
sociation with the School of Nursing of the University of Toronto.
The successful candidate will participate in policy making and
long range planning for the Institute,- co-ordinate nursing activity
and analyze nursing requirements within the multi-discipline ap-
proach to patient care. The Director will also initiate research
studies of nursing service and participate in the design and
implementation of other research projects.

Qualifications; Eligibility for registration in Ontario. Preferably
M.Sc. or B.Sc. in Nursing with several years of progressive
responsibility and varied nursing experience. Interest and expe-
rience in psychiatric nursing would be an asset.

The salary range for this position is $10,000 — $15,000.
For further information please write or telephone:
Personnel Director

ADDICTION RESEARCH FOUNDATION

33 Russell Street

Toronto 4, Ontario

Telephone: 595-6085

DECEMBER 1970

THE CANADIAN NURSE S3

REGISTERED NURSES

NURSE MIDWIYES

EXPANDING MEDICAL CENTER
DYNAMIC NURSING CARE PROGRAM

Modern 1300-bed hospital in N.Y.C.

• Subsidized Apartnnents

• Tuition Reimbursennent

Rich Cultural & Recreational Facilities
Active inservice educational program

Exceptional Health
& Pension Benefits

SALARY $9,400 to $10,780

per annum for staff nurses
CONTACT DIRECTOR OF NURSING

THE MOUNT SINAI HOSPITAL

n E. 100 St., N.Y., NY 10029, USA

SCARBOROUGH CENTENARY HOSPITAL

(Located Within Metropolitan Toronto)

Invites Applications for all services and positions
within the Nursing Department

This modern 525-bed hospital is fully equipped with the lotest
facilities to assist personnel in patient core and embraces the most
modern concepts of team nursing. Excellent personnel policies are
ovailable. Progressive staff ond management development programs
offer the maximum opportunities for those who are interested.
Sotary is commensurate with experience and ability.
Some Single Room Residence Accommodation Avoiloble.

For further information, please direct your enquiries to:
Personnel Department

SCARBOROUGH CENTENARY HOSPITAL

2867 Ellesmere Rd., West Hill, Ontario

ARE YOU INTERESTED IN EUPSYCHIAN MANAGEMENT!

REGISTERED NURSES

with

Demonstrated clinical competence, management
ability, creative ideas, leadership skill, to participate
in the progressive development of Nursing Services
in the position of:

CO-ORDINATOR AND SUPERVISOR OF NURSING
SERVICES

at

STRATFORD GENERAL HOSPITAL

Salaries Negotiable,
Accommodation available in staff apartments.

Apply in writing to:

Director of Nursing
STRATFORD GENERAL HOSPITAL

Stratford, Ontario.

Registered Nurses and R.N.A.'s required
HOSPITAL

260 bed (expanding to 415) accredited, mod-
ern, general hospital, with progressive patient
care, including a 5 bed coronary care unit
5 bed I.C.U., 22 bed Psychiatric and 24 bed
Self-care unit.

IDEAL LOCATION

45 minutes from downtown Toronto, 15-30
minutes from excellent summer and winter
resort areas.

FURNISHED APARTMENTS

Swimming pool, tennis court, etc. (see above)

OTHER BENEFITS:

Medical and hospital insurance, pension plan,
etc.

Please address all enquiries to:
Director of Nursing,

YORK COUNTY HOSPITAL

596 Davis Drive,
NEWAAARKET, Ontario.

54 THE CANADIAN NURSE

DECEMBER 1970

OTTAWA CIVIC HOSPITAL

ASSISTANT DIRECTOR
NURSING SERVICE

Applications are invited for the
above position in a fully accred-
ited teaching hospital of 1053
beds. The incumbent w\\\ be re-
sponsible for assisting in the ad-
ministrating and co-ordinating of
nursing services. Qualifications:
Baccalaureate Degree with ex-
perience in nursing service ad-
ministration and proven execu-
tive and administrative ability.

For further information apply to:

Miss Helen Cunningham, B.N.,

Director of Nursing Service,

OTTAWA CIVIC HOSPITAL,

Ottawa 3, Ontario.

NUMBER MEMORIAL HOSPITAL

Positions for Registered Nurses and Registered Nursing Assistants are
available in the Nursing Department of this new 350 bed active, general
hospital.

A high quality of patient core is given and a friendly working environ-
ment exists for all personnel associated with the hospital.

Furnished apartments ore available at subsidized rates.

• • •

Orientation and Inservice Educational programmes are provided.

• • •

Recognition is given for past experience.

• • •

You are invited to enquire concerning employment opportunities to:

Director of Nursing

NUMBER MEMORIAL HOSPITAL

200 Church Street, Weston, Ontario
Telephone 249-8111 (Toronto)

SUNNYBROOK HOSPITAL

UNIVERSITY OF TORONTO TEACHING CENTRE

OFFERS YOU
OPPORTUNITIES FOR DEVELOPMENT IN OUR NURSING DEPARTMENT

STAFF RESIDENCE ACCOMMODATION

PARKLAND SEHING

EXCELLENT TRANSPORTATION TO DOWNTOWN

EXPANDING PROFESSIONAL OPPORTUNITIES

THREE WEEKS VACATION

PAID SICK LEAVE

FOR MORE INFORMATION

ABOUT STAFF POSITIONS AND OUR DEVELOPING NURSING

RESEARCH UNIT WRITE TO:

CO-ORDINATOR OF PROFESSIONAL EMPLOYMENT
SUNNYBROOK HOSPITAL
2075 BAYVIEW AVENUE
TORONTO 12, ONTARIO

t _

1

DECEMBER 1970

THE CANADIAN NURSE 55

COORDINATOR
OPERATING SUITE

Required by

FOOTHILLS PROVINCIAL
GENERAL HOSPITAL

CALGARY, ALBERTA

To be responsible for the coordi-
nation, management and admi-
nistration of the Operating Suite
in an expanding 750-bed, Uni-
versity affiliated, hospital. The
operating suite consists of eight
operating rooms, two cystoscopy
units and the post-anaesthetic
recovery room. This is a senior
nursing administrative position
reporting directly to the Assis-
tant Administrator.
QUALIFICATIONS — Preparation
and experience in administration
with experience in Operating
Room nursing desirable but not
mandatory.

Please apply:

Personnel Officer

FOOTHILLS HOSPITAL

CALGARY 42, Alberta

NORTH BAY
PSYCHIATRIC HOSPITAL

requires

NURSES

Salary: $6,366 to $7,148
per annum

The Ontario Department of Health has
immediate openings at North Boy for
nurses to provide general nursing core
to patients in a psychiatric hospital.

QUALIFICATIONS: Registration as a nurse
in Ontario; preferably completion of a
post-graduate certificate course from a
university of recognized standing, com-
bined with the ability to obtain the co-
operation of staff and patients; good
physical and mental health.

Applicants w/ith additional qualifications
will be considered for obove-minimum
salaries.

Please submit resumes
In confidence to:

Personnel Officer

NORTH BAY
PSYCHIATRIC HOSPITAL

Box 1010
North Bay, Ontario

ST. JOSEPH'S HOSPITAL

TORONTO, ONTARIO

Registered Nurses

700-bed fully accredited hospital
provides experience in Operating
Room, Recovery Room, Intensive
Core Unit, Pediatrics, Orthope-
dics, Psychiatry, General Surgery
and Medicine, Observation Unit.
Orientation and Active Inservice
Program for all staff.
Salary is commensurate with
preparation and experience.
Benefits include Canada Pension
Plan, Hospital Pension Plan. Af-
ter 3 months, cumulative sick
leave — Ontario Hospital Insur-
ance — Group Life Insurance —
P.S.I. (Blue Plan) — 66 2/3%
payment by hospital.
Rotating Periods of duty — 40
hour week, 9 statutory holidays
— annual vocation 3 weeks af-
ter one year.

Apply:

Assistant Director of

Nursing Service

ST. JOSEPH'S HOSPITAL

30 The Queensway
Toronto 156, Ontario

there are over

200,000 more

who need your help!

\ -<w^

.^

REGISTERED NURSES # PUBLIC HEALTH NURSES
CERTIFIED NURSING ASSISTANTS

Have you considered a Career with the...

Indian Health Services of MEDICAL SERVICES
DEPARTMENT OF NATIONAL HEALTH AND WELFARE

for further information write to: MEDICAL SERVICES, DEPARTMENT OF NATIONAL HEALTH AND WELFARE, OTTAWA, CANADA

56 THE CANADIAN NURSE

DECEMBER 1970

CHILD AND ADULT PSYCHIATRY

HEAD NURSE
MALE AND FEMALE REGISTERED NURSES

(eligible for R.N.A.B.C. registration)

required to participote in the opening and develop-
ment of a 20 Bed Childrens Unit and to complete
the opening of four 25-bed acute adult areas.

The Fully Modern

ERIC MARTIN INSTITUTE OF PSYCHIATRY

is the major Psychiatric referral centre for Vancouver
Island, and an integral part of a 650 bed General
Hospital.

Many cultural and recreational opportunities are
available in this University City renowned for Beauty
and Temperate Climate.

Enquiries should be addressed to:
DIRECTOR OF NURSING

ROYAL JUBILEE HOSPITAL

VICTORIA, BRITISH COLUMBIA

DIRECTOR OF NURSING
SUNNYBROOK HOSPITAL

We are seeking a Director of Nursing to provide
dynamic leadership in nursing care concepts in
Sunnybrook Hospital. The position offers an exciting
challenge to a senior nursing administrator qualified
preferably at the Master's level.

Sunnybrook Hospital is a 1200-bed University Teach-
ing Hospital with an emphasis on Community AAe-
dicine. A close relationship exists with the School
of Nursing of the University of Toronto. The hospital
provides a climate for innovative approaches in the
delivery of health care.

An extensive facilities modernization programme is
in progress. This programme includes establishment
of new intensive care units and major renovation of
the patient care areas.

Please reply to:

Dr. J. K. Morrison,
Chairman, Selection Committee,

SUNNYBROOK HOSPITAL

2075 Bayview Avenue,
Toronto 315, Ontario.

the word is

OPPORTUNITY

for Registered Nurses in the medical
centre of Atlantic Canada

Opportunity for professional growth
Opportunity for advancement
Opportunity for specialization

If you are a registered nurse looking for new
horizons where you can fulfill the aspirations of
your nursing profession in the challenging
atmosphere of a large, progressive, teaching hospital
. . . join us at the Victoria General. Our need
is your opportunity. There are excellent general
staff openings in Medicine, Neuro-surgery, Surgery,
Recovery Room, Emergency and Operating Room
and Intensive Care Units. Excellent salary and
benefits with additional credit for experience and
skills learned in special units. You will enjoy
living in Nova Scotia with its almost unlimited
recreational opportunities and temperate climate.
We'll be glad to send you more information.

Write: D.R. Miller

Personnel Officer

VICTORIA GENERAL HOSPITAL

Halifax, Nova Scotia

DECEMBER 1970

THE CANADIAN NURSt 57

LAKEHEAD UNIVERSITY

requires

Chairman - School of Nursing

Challenging position in the continuing development
of programs in nursing at the Baccalaureate degree
level.

A Doctoral degree with an area of specialization and
experience in teaching in a University program are
desirable. (Present chairman retiring). Position avail-
able July 1, 1971. Academic rank with full Uni-
versity benefits.

Candidates are requested to submit application ac-
companied by vitae, and the names of three references

to:

Dr. H. S. Broun,

DEAN, UNIVERSITY SCHOOLS,

Lakehead University,
Thunder Bay, Ontario.

THE MONTREAL CHILDREN'S
HOSPITAL

Attention: Registered Nurses!

Certified Nursing Assistants!

At our Hospital we really care about each of our
children. We all want the best for them.

If we want our nurses to care, we feel we must
care about each of them too. Our nurses say that
our Hospital is a happy place and they like it here.
Would you like to join our staff? We might just
hove the job you have been looking for. Our per-
sonnel policies are good. Our In-Service programme
is good, and we think that the care our children
get is good. Maybe you con help us make it better.

Enquiries should be directed to:
The Director of Nursing

MONTREAL CHILDREN'S HOSPITAL

200 Tupper Street
Montreal 108, Quebec

ADMINISTRATIVE
ASSISTANT

for
PSYCHIATRIC NURSING AREAS

Must be R.N. with administrative
skills plus experience in psychia-
tric nursing, preferably with a
Master's Degree.

Successful applicant will be ex-
pected to assume responsibili-
ty for the management of pa-
tient care in two related ward
areas (116 patients) as well as
to provide nursing leadership in
therapeutic programs for an in-
creasing number of day care
patients.

Salary negotiable.

for further information write to:

Personnel Director

WINNIPEG GENERAL HOSPITAL

700 William Avenue
Winnipeg 3, Manitoba.

MEMORIAL UNIVERSITY
OF NEWFOUNDLAND

Invites applications for faculty
positions in the teaching of Psy-
chiatric Nursing and Medical-Sur-
gical Nursing. A Master's degree
in the specialty is required with,
preferably, a minimum of two
years' experience in teaching.
Instructors in Maternal and Child
Nursing ore required, preferably
with a Master's degree and ex-
perience in teaching, September
1971. This school opened in
1966. Field practice facilities are
within easy reach of the Uni-
versity. Personnel policies com-
pare favourably with other uni-
versities.

Apply:

MISS JOYCE NEVITT

Director, School of Nursing

Memorial University of

Newfoundland

St. John's, Newfoundland

Canada

WORK AND PLAY

IN SWINGING SUNNY

SOUTHERN

CALIFORNIA

Staff Nurse starting to 850/month plus
differential. Other positions pay ac-
cording to experience and education.
Select from 35 major hospitals, any shift
or department. Will assist in U.S. working
permit or immigration visa, housing ac-
commodation and California license.
Nothing to pay . . . FREE PLACEMENT.

TRANS U.S. INC.

(Authorized Representative of Hospitols)

1316 Wllshire Blvd.

Los Angeles, California 90017

U.S.A.

Tel.: (213) 481-0666 or 481-0691

WITHOUT OBLIGATION

Please send me more information about

working in California:

NAME

ADDRESS:

TEL.:
Specialty:

Licenses:

58 THE CANADIAN NURSE

DECEMBER 1970

TORONTO GENERAL HOSPITAL
DIRECTOR - NURSING SERVICE

Applications ore being invited for the position of Director —
Nursing Service at Toronto General Hospitol which wrill be open
in June, 1971. It is desirable that the successful applicant spend
OS long as possible wHh the present Director prior to her departure
on June 1, 1971 to continue her postgraduate education
programme.

THE POSITION

Toronto Generol Hospital is a 1200 bed principal teaching hospital
located adjacent to the downtow^n campus of the University of
Toronto. The Director — Nursing Service is a member of the
executive monogement team. She is responsible to the Executive
Director for the organization and administration of nursing
services in the Hospital.

THE APPLICANT

As the Hospital is directly involved in the clinical portions of
a number of educational programmes in the health sciences, on
applicant should possess a Master's Degree with a major in
Health or Nursing Administration. She should have a minimum
of five years in senior administrative positions in nursing as well
as experience in clinical nursing, preferably in a teaching
hospital setting.

Applications and enquiries, including a short
riculum vitae, should be directed to:

The Executive Director,

TORONTO GENERAL HOSPITAL

Toronto 101, Ontario.

cur-

Prepare for
a rewarding
career in
foreign lands ^s^

Take our special course in tropical diseases and
related subjects This equips you when applying
for overseas positions to enjoy special status,
gain valuable experience and serve where the
need is great

Open to graduate nurses, nursing assistants and
paramedical personnel Comprehensive 19-
week course commences in September and Feb-
ruary Tram in modern, fully-equipped centre
with attractive accommodation for living in. lo-
cated in Metropolitan Toronto

For more information write to

Co-ordinator. Health Service Course

international
health institute

4000 LesUe Street, VWUowdale,
Ontario, Canada.

/fyou are interested in, . .

• Total patient care

• Interesting research programs

• Ongoing orientation and in-service
education programs

• Unusual personal benefits

MAIMONIDES HOSPITAL

and

HOME FOR THE AGED

an internationally known 247-bed Geriatric Centre
located in the Paris of the New World

has all this to offer you

Openings for . . .

Head Nurses

and

General Duty Nurses

Apply: DIRECTOR OF NURSING
5795 CALDWELL AVENUE, MONTREAL 269, QUEBEC
Telephone (514)488-2301

THE SCARBOROUGH
GENERAL HOSPITAL

— A 650-bed progressive, accredited hospital — located in Eostern
Metropolitan Toronto.

— Active and stimulating In-Service Educational Program including
videotape telecasts.

— A modern Monogement Training Program to assist the odminis-
trative nurse to develop managerial sitills.

— Challenging opportunities in medical and surgical nursing,
including specialties such as Cardiology, Intensive Core, Burns,
Plastic Surgery, Ophthalmology, Poediotrics, Community Psychio-
try, and Emergency.

— An extensive clinical program of individuol patient core plans.

— Experience ond post-basic education ore monetarily recognized.
There is a future for you in Scarborough where young moderns,
live, work, and play.

For further information write to:
Director of Nursing

SCARBOROUGH GENERAL HOSPITAL

Scarborough, Ontario

DECEMBER 1970

THE CANADIAN NURSE 59

ST. MARY'S GENERAL HOSPITAL

SCHOOL OF NURSING

KITCHENER, ONTARIO

requires

TEACHERS FOR 2-YEAR
PROGRAMME

Affiliated with a modern, progressive,
400-bed fully-eccredited hospital. Student
enrolment, 130. Salary commensurate with
preparation and experience.

For further details apply:

Director

ST. MARY'S SCHOOL

OF NURSING

Kitchener, Ontario

Applications ore invited for the
position of

UNIT SUPERVISOR

CHILDREN and ADOLESCENTS

FLOOR

in this 450-bed General Hospital located

on the Boy of Quinte in South Eastern

Ontario.

QUALIFICATIONS DESIRED:

— Specialization in Paediatric Nursing

— Post-basic preparation at University
level

— Experience in Nursing Service Admin-
istration

Please apply to:

Director of Nursing Service

BELLEVILLE GENERAL HOSPITAL

Belleville, Ontario.

REGISTERED NURSES

and

REGISTERED NURSING ASSISTANTS

required for General Duty in a 313-bed
fully accredited hospital. Good salary
commensurate with experience, excellent
fringe benefits and gracious living in
the Festival City of Canada.

Apply In writing to the:
Director of Personnel,

STRATFORD GENERAL HOSPITAL

Stratford, Ontario.

THE HOSPITAL

FOR

SICK CHILDREN

OFFERS:

1. Satisfying experience.

2. Stimulating and friendly en-
vironment.

3. Orientation and In-Service
Education Program.

4. Sound Personnel Policies

5. Liberal vacation.

APPLICATIONS FOR REGISTERED
NURSING ASSISTANTS INVITED.

For detailed information
please write to:

The Assistant Director

of Nursing

AUXILIARY STAFF

555 University Avenue
Toronto 101, Ontario, Canada

OWEN SOUND GENERAL
AND MARINE HOSPITAL

Requires

REGISTERED NURSES

For all departments including Intensive
Core Unit, Coronary Core Unit, Operating
Room and Emergency Department. This is
a 250-bed fully accredited hospital lo-
cated in the vacotion centre of Georgian
Boy. Recognition given for experience ond
post basic education.

For information and application
Write to:

Director
Nursing Service

REGISTERED NURSES

required for

82-bed hospital. Situated in the Niagara

Peninsula.

For salary rates and personnel policies.

apply to:

Director of Nursing

HALDIMAND WAR MEMORIAL

HOSPITAL

Dunnville, Ontario

WILSON MEMORIAL
GENERAL HOSPITAL

requires

REGISTERED NURSES
FOR GENERAL DUTY

20-bed hospital. Located in Northwestern
Ontario community. Liberol fringe benefits
include pension plan, OHA group
insurance, paid vacation, 9 statutory
holidoys. Residence accommodation ovoil-
able at nominal rote. Salary scale —
$460. to $550. with recognition for past
service.

Apply:

Miss E.P. Hoffman

Administrator

MARATHON, Ontario

60 THE CANADIAN NURSE

DECEMBER 1970

ROYAL VICTORIA HOSPITAL

SCHOOL OF NURSING

MONTREAL, QUEBEC

POST-GRADUATE COURSES

(a) Six month clinical course in Obstetrical Nurs-
ing. Classes — September and March.

(b) Twelve week course in Care of the Premature
infant.

Six month course in Operating Room Technique.
Classes — September and March.

Six month course in Theory and Practice in Psy-
chiatric Nursing.
Classes — September and March.

For information and details of the courses, apply to:
Director of Nursing

ROYAL VICTORIA HOSPITAL

Montreal 112, P.O.

POST GRADUATE COURSES

The following courses in this modern 1200 bed
teaching hospital will be of interest to registered
nurses who seek advancement, specialization and
professional growth.

— Cardiovascular Nursing. This Is a six month
clinical course with classes commencing in
October and February.

— Operating Room Techniques and AAanagement.
This six month course commences September
and March.

For further information and details contact:

Director of Nursing

UNIVERSITY OF ALBERTA HOSPITAL

Edmonton, Alberta.

UNIVERSITY OF BRITISH COLUMBIA

SCHOOL OF NURSING

DEGREE PROGRAMMES

Baccalaureate — basic students

— registered nurses
This course for both groups of students leads to
the B.S.N, degree, and prepares the graduate for
public health as well as hospital nursing positions.

Master's

For qualified baccalaureote nurses leading to the
degree of M.S.N. This course, two years in length,
prepares the graduate for leadership roles in nurs-
ing with emphasis on clinical expertise.

DIPLOMA PROGRAMMES

— for registered nurses.

Public Health Nursing

(psychiatric nursing required prerequisite)

Administration of Hospital Nursing Units

Applications for diploma programmes must be in
by May 1, 1970.

For information write to:

The Director

SCHOOL OF NURSING, UNIVERSITY OF B.C.

Vancouver 8, B.C.

THE MONTREAL GENERAL HOSPITAL

offers a

6 month Post-graduate Course in

Operating Room Technique and

Management to

REGISTERED NURSES

Classes commence in September and

March for selected classes of

8 students

For further information apply to :
The Director of Nursing

THE MONTREAL GENERAL HOSPITAL

Montreal 109, Quebe^

DECEMBER 1970

THE CANADIAN NURSE 61

Index

to

advertisers

December 1970

Clinic Shoemakers 2

Facelie Company Limited 8

Foster Parents Plan of Canada 21

Charles E. Frosst & Co 25

Hoechst Pharmaceuticals 18

Hoft'man-LaRoche Limited 6,7

Johnson & Johnson Limited 49

Ladeside Laboratories (Canada) Ltd Cover III

J.B. Lippincott Company of Canada Limited 26

C.V. Mosby Company. Ltd 45

Reeves Company 5

W.B. Saunders Company Cover IV

Julius Schmid of Canada Ltd 23

Sterilon Corporation 11,12

White Sister Uniform, Inc 1 , Cover II

Winley-Morris Co. Ltd 15

Advertising

Manager

Ruth H. Baumel,

The Canadian Nurse

50 The Driveway

Ottawa 4, Ontario

Advertising Representatives
Richard P. Wilson
219 East Lancaster Avenue
Ardmore, Penna. 19003

Vance Publications,
2 Tremont Crescent
Don Mills, Ontario

Member of Canadian
Circulations Audit Board Inc.

62 THE CANADIAN NURSE

Bsa

DO YOU

WANT 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:

^AEMBERSHIP (payable annually)

Nurse Member — Regular $ 2.00

Sustaining $ 50.00
Patron $500.00

Public Member — Sustaining $ 50.00
Patron $500.00

BURSARIES $
MEMORIAL $

RESEARCH $
in memory of

Name and address of person to be notified of
this gift

(Print name in ful

REMITTER

Address
Position
Employer

N.B.: CONTRIBUTIONS TO CNF
ARE DEDUCTIBLE FOR INCOME TAX PURPOSES

DECEMBER 1970

INDEX TO VOLUME SIXTY-SIX

JANUARY-DECEMBER 1970

ABORTION

Abortion resolution. 7 (Nov)

British RCN requests review of abortion
act. 12 (Sep)

CMAJ editorial says abortion should be
patients choice, 14 (Oct)

CNA Board discusses abortion. 7 (Nov)

Editorial. (Lindabury). 3 (Nov)

Psychiatrists say abortion should be re-
moved from law. 19 (May)

ACCREDITATION

CCHA moves to accredit extended care
centers. 7 (Jan)

ADEWOLE, O. A.

Nursing leaders meet. (port). 20 (Nov)

ADMINISTRATION AND
ORGANIZATION

NBARN sets up management nurses"
association, 1 I (Apr)

ADOLESCENTS

Drug misuse in teenagers. (Loyd). 46 (Sep)

AGNEW, S. June

Lecturer. School of nursing. Memorial
University of Newfoundland, (port)

22 (Nov)

AISH, Arlene

Bk. rev.. 43 (jan)

AIKIN, R. Catherine

Alumni of University of Western Ontar-
io's school of nursing welcomed, (port),
14 (Dec)

AITKEN, Jane Y.

Maternal and child health consultant.
Saskatchewan Dept. of Health, (port).
12 (Jan)

ALBERTA ASSOCIATION OF
REGISTERED NURSES

Alberta nurses reject bill to set up nursing

council. 12 (Jun)
Alma Ferrier was named Alberta's nurse

of the year. 23 (Sep)
Presents views on bill 119 to health

minister. 12 (Mar)
Yvonne Chapman employment relations

officer, (port), 21 (Nov)

ALBERTA UNIVERSITY

see University of Alberta

AMERICAN NURSES ASSOCIATION

American Indian nurse is ANA choice
13 (Jul)

Eileen M. Jacobi appointed executive
director of the American Nurses' Asso-
ciation. 14 (Jul)

Hildegard Peplau appointed interim
executive director of the American
Nurses' Association. 24 (Mar)

House of delegates votes to double dues.
9 (Jul)

AMERICAN NURSES FOUNDATION

Susan D. Taylor appointed acting execu-
tive director, American Nurses Foun-
dation, 26 (Mar)

ALDERSON. H. J.

Bk. rev.. 55 (Apr)

ALLAN, Viola

Bk. rev., 55 (Apr)

ANGER, Marlene

Nursing instructor Mount Royal Junior
College, Calgary, (port). 12 (Jan)

ANTOFT, Kell

Cancer can be beaten. 39 (,\pr)

ARKLIE, Margaret

Instructor, Queen's University, 19 (Dec)

ARPIN, Kay

Issues CNA members face at 35th general
meeting, 33 (May)

ARTERIOSCLEROSIS

Arteriosclerosis studied. 19 (Jul)

ASSOCIATION OF NURSES OF PRINCE
EDWARD ISLAND

Many PEI nursing students must study in
other provinces. 10 (Apr)

Study issues. AN PEI president asks mem-
bers, 10 (Sep)

Two nurses given honorary membership
intheANPEI 10 (Sep)

ASSOCIATION OF NURSES OF THE
PROVINCE OF QUEBEC

Donates $ 1 5,000 to CNF, 1 5 ( Mar)
Quebec inservice education seminar assists

nursing care, 18 (Sep)
Sets up Claire Gagnon Foundation, 1 6 (Sep)
Workshop studies misuse of drugs, 14

(Aug)

ASSOCIATION OF OPERATING ROOM
NURSES

TVs Marcus Welby, MD, honored, 10
(Apr)

ASSOCIATION OF REGISTERED
NURSES OF NEWFOUNDLAND

Newfoundland nurses reject government
wage offer, 20 (Sep)

ATTITUDE

A study of the relationship between
patient involvement and patient atti-
tude in transfers occurring in a selected
unit of a general hospital, (Middleton),
(abst), 58 (Mar)

AUDIO VISUAL AIDS

AV aids, 56 (Apr) 39 (Jun) 46 (Jul) 47

(Aug) 47 (Oct) 47 (Nov) 47 (Dec)
Although immediate post-surgical pros-
thesis, 47 (Dec)
As we see it, 47 (Dec)

Computer in psychiatry, (Osborne), 19
(Oct)

Congenital dislocation of the hip in Sas-
katchewan Indians. Its natural history
and etiology. 47 (Aug)

EVR communications system. 50 (Feb)

The endless war. 47 (Aug)

Film catalogue. 40 (Jun)

Films dealing with food preparation,
48 (Oct)

Films on cancer, 47 (Dec)

Films on food, 47 (Aug)

"The Flower", new cancer film, 46 (Jul)

Gift of life/right to die. 47 (Aug)

A hospital is 48 (Oct)

A matter of fat. 47 (Dec)

Monday. 48 (Oct)

Nursing as a career. 56 (Apr)

The stroke patient comes home. 50 (Feb)

World ofa girl. 47 (Oct)

Medical film library. 46 (Jul)

Multimedia system launched in Canada

39 (Jun)
New super-8 movie system, 46 (Jul)

AUTOMATION

CHA holds symposium on computer
applications in the health field. 15 (May)

AUXILIARY WORKERS

Editorial, (Ricks), 3 (Sep)

ICN committee members outline basic

issues for 1969-73 quadrennium, 20

(Apr)
Salary levels of Ontario Hospital workers

under fire, 9 (Sep)

AWARDS

CNF fellowship awards, 15 (Aug)

CNF scholarship fund gets boost from

CNA, 6 (Jan)
Canadian Red Cross fellowship available

for graduate study. 9 (Jan)
Four public health nurses have been

awarded $500. scholarships by G.D.

SearleCo.. 25 (Mar)
Joanne Dolores Oss awarded the Abe

Miller Memorial scholarship. 25 (Mar)
Marion W. Sheahan recipient of the

Sedgwick Memorial Medal. 17 (Feb)
Mary Roberta Noseworthy granted the

first award of the Annual faculty of

Nursing award, 19 (Dec)
NBARN scholarships. 19 (Dec)
No Canadian candidate for 3-M award in

1970, 7 (Feb)
RCAMC offers annual bursary. 17 (May)
Red Cross bursary available. 18 (Mar)
St. John's bursaries awarded to nurses,

15 (Sep)
Sister Mary Felicitas awarded the Catholic

University's 1970 annual Alumni A-

chievement Award, (port), 20 (Nov)
3-M nursing fellowship awarded, 1 1 (Apr)

B

BARBARA, Marie, Sister

Candidate for nursing sisterhoods repre-
sentative. 43 (May)

BARNETT, R.

Bk. rev.. 43 (Jul)

BARRETT. Mary E.

Appointed chairman of the Nursing Edu-
cation Division of Dawson College,
(port). 25 (Mar)

BARTLEMAN, Cathe^pe

Director of Nursing. Vernon Jubilee

III

Hospital, (porl). 26 (Feb)

BAUMGART, Alice J.

Chairman. Committee on Nursing Edu-
cation, (port), 23 (Sep)

Research session sparks enthusiasm, 1 1
(Aug)

BAYER, Margaret Jean

Appointed Director of Nursing Education,
Nova Scotia Hospital in Dartmouth,
(port), 25 (Mar)

BECKWITH, Marjorie

Bk. rev,, 42 (Jan)

BEHAVIOR

Development of Likert scale to identity
one nursing behavior practiced in
general nursing, (abst). (Griffiths), 42
(Jul)

BELL CANADA

Preplacement health screening by nurses,
(Munro). 29 (Nov)

BENOLIEL. Jeanne Quint

Bk. rev., 43 (Jul)

BESWETHERICK, M. A.

Bk. rev., 46 (Oct)

BIAFRA

Editorial, (Lindabury), 3 (Mar)
From Canada to Biafra, (Kotlarsky), 39
(Mar)

BIDDINGTON, Irene E.

New director of nursing services, Hopital
Dr. Georges L. Dumont, Moncton,
N.B., (port). 25(Mar)

BIRTH CONTROL

Internal contraceptive proves successful
in US study, 16 (Sep)

BLATZ, Anne Elizabeth

Appointed instructor in nursing education.
Mount Royal Junior College, 22 (May)

BOOK REVIEWS

Abelson, Herbert I., Persuasion, (Karlins),
45 (Jul)

Aguilera, Donna C, et al. Crisis inter-
vention: theory and methodology, 46
(Dec)

Anderson, Carl Leonard, Community

health, 35 (Apr)
Bach. George R., The intimate enemy:

how to fight fair in love and marriage.

(Wyden). 47 (May)
Bain, W.H., Cardio-vascular surgery for

nurses and students, (Watt), 55 (Nov)
Bendall, Eve R. D., A history of the Gen-
eral Nursing Council for England and

Wales 1919-1969, (Raybould), 55 (Apr)
Bergersen. Betty S., et al. Current concepts

in clinical nursing, 60 (Mar)
Bergersen, Betty S., Pharmacology in

nursing, (Krug), 49 (Feb)
Brunner, Lillian S., et al. Textbook of

medical-surgical nursing, 46 (Oct)
Burchill, Elizabeth, New Guinea Nurses,

42 (Jan)
Cairney, J. Surgery for students of nurs-
IV

ing, (Cairney) 38 (Jun)

Carini, Esta. Neurological and neuro-
surgical nursing, (Owens), 38 (Jun)

Carlson, Carolyn E., Behavioral concepts
and nursing intervention, 46 (Oct)

Christy, Teresa E., Cornerstone for nurs-
ing education, 44 (Jul)

Clark-Kennedey, A. E., Man, medicine
and morality, 46 (Aug)

Cohen. Anthea, Popular hospital mis-
conceptions, 42 (Jan)

Cooper, Signe Skott, Contemporary nurs-
ing practice: a guide for the returning
nurse, 55 (Nov)

Costello, Charles G., Symptoms of psy-
chopathology: a handbook, 43 (Jul)

Cratty, Bryant J., Perceptual-motor
efficiency in children, (Martin), 43
(Jan)

Creighton. Helen. Law every nurse should
know, 46 (Oct)

Culver, Vivian M., Modern bedside nurs-
ing, 46 (Aug)

Davidson, Stanley, Human nutrition and
dietetics, (Passmore). 58 (Sep)

Eyres, Alfred E., A happier life, (Pearson),
58 (Sep)

Fishlock, David, Man modified: an
exploration of the man machine rela-
tionship, 60 (Mar)

Francone, Clarice Ashworth, Structure
and function in man, (Jacob), 57 (Sep)

Freeman, Ruth B., Community health
nursing practice, 46 (Dec)

Fuerst, Elinor V., Fundamentals of nurs-
ing, (Wolfn, 49 (Feb)

Gallagher, Richard, Diseases that plague
modern man. 42 (Jan)

Garb, Solomon, et al. Pharmacology and
patient care. 46 (Dec)

Gould. Marjorie. Orthopedic nursing.

(Larson). 46 (Aug)
Griffin. Gerald Joseph. Jensen's history

and trends of professional nursing.

(Griffin), 47 (May)
Guinee, Kathleen K., The professional

nurse, 57 (Sep)
Hospital Research and Education Trust,

You are Barbara Jordan, 55 (Nov)
Jablonski, Stanley, Illustrated dictionary

of eponymic syndromes and diseases

and their synonyms, 60 (Mar)
Jacob, Stanley W., Structure and function

in man, (Francone), 57 (Sep)
Karlins, Marvin, Persuasion, (Abelson).

45 (Jul)
Kerr. Avice. Orthopedic nursing proce-
dures. 42 (Jan)
King. Barry G., Human anatomy and

physiology, (Showers), 55 (Apr)
Krug, Elsie E., Pharmacology in nursing,

(Bergersen), 49 (Feb)
KiJbler-Ross, Elizabeth, On death and

dying, 43 (Jul)
Larson, Carroll B., Orthopedic nursing,

(Gould), 46 (Aug)
Levine, Myra Estrin, Introduction to

clinical nursing, 43 (Jan)
McGhie, Andrew, Psychology as applied

to nursing, 49 (Feb)

Martin, Margaret Mary, Sister, Perceplual-

motor efficiency in children, (Cratty),

43 (Jan)
Meltzer, Lawrence et al. Concepts and

practices of intensive care for nurse

specialists, 60 (Mar)
Mosby's comprehensive review of nursing,

47 (May)
Mowry. Lillian. Basic nutrition and diet

therapy. (Williams). 60 (Mar)
National League for Nursing. Present

involvement in nursing education of

institutions whose diploma programs

closed, 1959-1968,21 (Mar)
Nelson, Waldo E., et al. Textbook of

pediatrics. 44 (Jan)
Owens, Guy. Neurological and neuro-
surgical nursing, (Carjni), 38 (Jun)
Passmore, R., Human nutrition and die-
tetics, (Davidson), 58 (Sept)
Pearson, Charles T.. A happier life. (Eyres).

58 (Sep)
Peel. J. S.. Materia medica and pharma-
cology for nurses, 38 (Jun)
Raybould. Elizabeth. A history of the

General Nursing Council for England

and Wales 1919-1969. (Bendall), 55

(Apr)
Riehl, C. Louise, Emergency nursing,

47 (Oct)
Ross, Carmen F., Personal and vocational

relationship in practical nursing, 43

(Jan)
Schifferes, Justus J., Healthier living,

46 (Jul)
Secor, Jane, Patient care in respiratory

problems. 38 (Jun)
Showers. Mary Jane, Human anatomy

and physiology, (King), 55 (Apr)
Smith, Philip, Arrows of mercy, 57 (Sep)
Stotsky, Bernard A., The elderly patient,

55 (Apr)
Taylor, Carol, In horizontal orbit, hospitals

and the cult of efficiency, 43 (Jul)
Watt, J.K., Cardio-vascular surgery for

nurses and students, (Bain), 55 (Nov)
Watt, James Michael, Practical paediatrics:

a guide for nurses, 49 (Feb)
Williams, Sue Rodwell, Basic nutrition

and diet therapy, (Mowry), 60 (Mar)
Wolff, LuVerne, Fundamentals of nursing,

(Fuerst), 49 (Feb)
Whyden, Peter, The intimate enemy: how

to fight fair in love and marriage,

(Bach), 47 (May)

BOOKS

42 (Jan). 49 (Feb), 60 (Mar), 55 (Apr),
47 (May), 38 (Jun), 43 (July), 46 (Aug),
57 (Sep), 46 (Oct), 55 (Nov), 46 (Dec)

BOURASSA, Robert

Message of symphathy, 7 (Nov)

BOYD, Joanne M.

Lecturer. Univ. of Alberta, School of Nurs-
ing, (port), 16 (Feb)

BRACKSTONE, Margaret J.

Director, school of nursing at Public
General Hospital in Chatham, (port),
15 (Jul)

BRADLEY, Margaret L.

Candidate for vice-president, 40 (May)

BRENCHLEY, Maureen

Bradford frame covers, 35 (Jan)

BREWER, Marilyn

Chairman of the Committee on Social
and Economic Welfare, 23 (Sep)

BRITISH COLUMBIA OPERATING
ROOM NURSES GROUP

Held its second biennial institute, 9 (Jun)
BRKICH, Rita M.

A study to determine how patients view
their digoxin therapy, (abst). 54 (Apr)

BROOKBANK, C. R.

Nurses told to define role, look for change
in profession, 13 (Aug)

BROWN, Irene Kierstend

Nursing leaders honored by Ottawa friends,
(port), 19 (Nov)

BROWN, Mary E.

Bk. rev., 46 (Aug)

BUCHAN, Irene

Chairman of the Committee on Nursing
Service, (port). 23 (Sep)

IBURWELL, Dorothy

Spontaneity is key to helpfulness of psy-
chodrama, 10 (Aug)

IBUZZELL, Mary

Assistant professor. University of Western
Ontario, 23 (Apr)

CAMPBELL, Shirley A.

Lecturer Memorial School of Nursing,
(port), 22 (Apr)

CANADIAN ASSOCIATION OF
NEUROLOGICAL AND
NEUROSURGICAL NURSES

Maila Maki elected president, (port), 17
(Dec)

CANADIAN CANCER SOCIETY

Cancer can be beaten, (Antoft), 39 (Apr)
Miss Hope 1970, 14 (Apr)

CANADIAN CONFERENCE OF
UNIVERSITY SCHOOLS OF
NURSING

Special committee on nursing research to
be established by CNA, 9 (Dec)

CANADIAN COUNCIL ON HOSPITAL
ACCREDITATION

CCHA moves to accredit extended care
centers, 7 (Jan)

CANADIAN EXECUTIVE SERVICE
OVERSEAS

Canadian nurses give volunteer service
in West Indies, 20 (Apr)

CANADIAN HOSPITAL ASSOCIATION

Holds symposium on computer applica-

tions in the health field, 15 (May)
Three health groups study transfer of
duties, 8 (Mar)

CANADIAN MEDICAL ASSOCIATION

CM A House officially opened, 15 (Nov)
Douglas J. Wallace appointed Executive

Director, (port), 23 (Sep)
Government rejects CNA project, 5 (Jan)
Three health groups study transfer of

duties, 8 (Mar)

CANADIAN MENTAL HEALTH
ASSOCIATION

Council discusses mental health problems

17 (Apr)
Federal grant for CMHA, 5 (Jan)

CANADIAN NURSE

Are we getting to you? (Darling), 55

(Mar)
Information for authors, 52 (Sep) 38 (Oct)

51 (Nov) 40 (Dec)
J.M.M. is not dead, 28 (Apr)
Liv-Ellen Lockeberg appointed assistant

editor, (port), 17 (Oct)
Now here's Max . . „ 28 (Apr)

CANADIAN NURSE- ASSOCIATION

Abortion resolution, 7 (Nov)

Accepts federal unemployment insurance

plan, 12 (Nov)
Alberta nurse to represent CNA at ICN

seminar, 7 (Mar)
Auditors" report, 35 (Aug)
Awarded national health grant, 7 (Jun)
Committee to prepare brief on poverty

and health, 7 (Feb)
Editorial, (Lindabury), 3 (Aug)
Financial report. 39 (Aug)
Goals, 1970-72 Biennium, 8 (Nov)
Government rejects CNA project, 5 (Jan)
imai, Hisako Rose, new research officer.

(port), 20 (Nov)
Letters patent granted CNA, 16 (Nov)
Librarian visits libraries in Manitoba

Schools of Nursing. 7 (Feb)
Membership now more than 80.000. 10

(Mar)
Message of sympathy. 7 (Nov)
New executive, 7 (Aug)
Official directory. 64 (Aug). 80 (Sep). 64

(Oct). (Dec)
Poverty is cause of illness. CNA tells

senate committee. 5 (Jul)
President addresses RNANS annual meet-
ing. II (Jul)
Represented on health care committee,

7 (Mar)

Submits proposals for tax reform to Min-
ister of Finance, 10 (Dec)

Three health groups study transfer of
duties, 8 (Mar)

Ticket of nominations. Biennium 1970-
1972. 39 (May)

To withdraw application for letters patent,

8 (Mar)

CANADIAN NURSES* ASSOCIATION.
AD HOC COMMITTEE ON CNA
TESTING SERVICE

Members appointed to Ad Hoc committee

on CNA testing service, 6 (Jan)

CANADIAN NURSES' ASSOCIATION.
AD HOC COMMITTEE ON FUNC-
TIONS, RELATIONSHIPS, AND FEE
STRUCTURE

Editorial. (Lindabury), 3 (May)
Special report, 35 (Mar)

CANADIAN NURSES' ASSOCIATION.
AD HOC COMMITTEE
ON LEGISLATION

CNA legialation committee recommends

bylaw changes, 9 (Apr)
Members appointed, 7 (Feb)

CANADIAN NURSES ASSOCIATION.
AD HOC COMMITTEE ON RESEARCH

Report urges special committee on nurs-
ing research be set up, 7 (Aug)
Research committee meets, 7 (May)

CANADIAN NURSES' ASSOCIATION.
AD HOC COMMITTEE TO STUDY
RECOMMENDATIONS OF THE TASK
FORCE ON THE COST OF HEALTH
SERVICES
Committee studies health cost reports. 7

(Jun)
To study health cost reports. 7 (Mar)
Meets for final discussion, 7 (Oct)

CANADIAN NURSES' ASSOCIATION.
BIENNIAL CONVENTION 1970

Biennial meeting program highlights, 32

(May)
Board approves biennial meeting pro-
gram, 10 (Mar)
CNA meeting won't be "all work and no

play", 7 (May)
A call to action, (Huffman), 5 (Aug)
Convention key, 33 (Mar)
Convention report, 24 (Aug)
Follow me lassies and lads. 30 (Aug)
Fredericton — here we come. (Kotlarsky).

45 (May)
Fredericton — something for everyone.

(Fournier). 45 (Mar)
Friendship lounge at CNA biennial. II

(Jun)
Highly planned patient care essential.

nurses told. (Labelle). 1 1 (Aug)
Issues CNA members face at 35th gen-
eral meeting. 33 (May)
Legal implications of nursing reviewed

at convention, (Rozovsky), 12 (Aug)
NB government plans welcome for CNA

conventioneers, 17 (Apr)
NBARN's biennial plans progress. 8 (Mar)
Nurses told to define role, look for change
in profession, (Brookbank). 13 (Aug)
Nursing consultant criticizes deperson-
alized nursing care. (Poole). It (Aug)
Official notice of general meeting of
Canadian Nurses' Association. 7 (Mar)
Playhouse is hub CNA biennial. 6 (Jan)
Post-convention tour of Maritimes offered

nurses, 9 (Apr)
Research session sparks enthusiasm. (Ker-

gin. Baumgart. Perry). 1 1 (Aug)
Resolutions passed at CNA 35lh general

meeting. 26 (Aug)
Specialization calls f&t nursing changes.

V

(Green, Coombs, Fallis), 7 (Aug)
Spontaneity is key to helpfulness of psy-

chodrama, (Burwell), 10 (Aug)
Tentative program, 3 1 (May)
Urgent need shown for nursing textbooks

in French, 12 (Aug)
Welcome to the picture province, (Four-

nier), 33 (Apr)
What a gas! 23 (May)

CANADIAN NURSES' ASSOCIATION.
BOARD OF DIRECTORS

Accepts second ad hoc committee report,

9 (Dec)

Approves policy to ensure high standards

of nursing care, 7 (Mar)
Discusses abortion, 7 (Nov)
Takes stand on the physician's assistant

7 (Nov)

CANADIAN NURSES' ASSOCIATION.
COMMITTEE ON NURSING EDU-
CATION

Alice J. Baumgart appointed chairman,
(port), 23 (Sep)

CANADIAN NURSES' ASSOCIATION.
COMMITTEE ON NURSING SERVICE

Irene Buchan appointed chairman, (port),
23 (Sep)

CANADIAN NURSES' ASSOCIATION.
COMMITTEE ON SOCIAL & ECO-
NOMIC WELFARE

Marilyn Brewer appointed chairman.
23 (Sep)

CANADIAN NURSES' ASSOCIATION.
GENERAL MEETING 1970

see Canadian Nurses' Association. Con-
vention 1970

CANADIAN NURSES' ASSOCIATION.
LIBRARY

Accession list, 44 (Jan), 50 (Feb), 61 (Mar),
56 (Apr), 48 (May), 40 (Jun), 46 (Jul),

47 (Aug), 60 (Sep), 48 (Oct), 56 (Nov),

48 (Dec)

Librarian at meeting of Interagency Coun-
cil on Library Resources for Nursing,

10 (Dec)

Librarian attends Interagency Council
meeting, 9 (May)

Librarian consults with nursing library

staffs, 1 1 (Dec)
Nursing studies wanted. 47 (Dec)

CANADIAN NURSES' ASSOCIATION.
SPECIAL COMMITTEE ON NURSING
RESEARCH

To be established by CNA, 9 (Dec)

CANADIAN NURSES' ASSOCIATION.
TESTING SERVICE

Test service board holds first meeting.

9 (Apr)
Testing service gets new home, 6 (Jul)

CANADIAN NURSES' FOUNDATION

ANPQ donates $15,000 to CNF, 15 (Mar)
Board meets, 8 (Jul)
CNF fellowship awards, 15 (Aug)
VI

CNF membership still low, 8 (Feb)

CNF scholarship fund gets boost from

CNA, 6 (Jan)
Members recommend fee increase of $3,

6 (Aug)
Membership rising slowly, 1 1 (Oct)
NBARN project to assist CNF, 8 (Feb)
New nurse member makes CNF donation,

16 (Sep)
RNAO members support CNF, 14 (Jun)

CANADIAN PUBLIC HEALTH
ASSOCIATION

Nurse elected president of CPHA, 15
(Jul)

CANADIAN RED CROSS

Fellowship available for graduate study,
9 (Jan)

CANADIAN TUBERCULOSIS AND
RESPIRATORY DISEASE
ASSOCIATION

Lorette Morel appointed health educa-
tion and nursing consultant, (port), 18
(Oct)

CANCER

Cancer can be beaten, (Antoft), 39 (Apr)
Cancer detection clinic, (Cracknell). 37

(Apr)
Depression follows colostomy, 28 (Apr)
Miss Hope 1970, 14 (Apr)
Three patients with Hodgkin's disease,

(Jackson), 33 (Jun)

CARE/MEDICO

Lynda Lafoley to serve, 17 (Oct)

Nurse instructor needed for MEDICO in

Indonesia, 19 (May)
Sponsors project in Surakarta, Indonesia,

15 (Feb)

CARIGNAN, Therese, Sister

Instructor, U.B.C. School of Nursing,
(port), 13 (Jan)

CARTY, Elaine A.

My, you're getting big! 40 (Aug)

CARVER, Evelyn Joyce

Instructor, Queen's University, 19 (Dec)

CASTONGUAY, Therese, Sister

Director of Nursing Service, St. Boniface
General Hospital, Manitoba, (port), 12
(Jan)

CHAPMAN, Dorothy

One little boy with two big problems. 36
(Jan)

CHAPMAN, Yvonne

Employment relations officer Alberta
Association of Registered Nurses',
(port), 21 (Nov)

CHARRON, Monique

To participate in seminar in France, (port),
18 (Oct)

CHIASSON, Jacinthe

NBARN scholarship, 19 (Dec)

CHILDREN

One million children handicapped. Com-
mission finds, 13 (Aug)

CHUCHLA, Clare

Assistant Director of Nursing Education
Clarke Institute of Psychiatry, Toronto,
17 (Oct)

CHURCH, Jean G.

Candidate for vice-president, 41 (May)

CLARK, Annie E.

Assistant professor. University of Calgary,
21 (Nov)

CLARKE, Eileen

Bk. rev., 60 (Mar)

CLARKE INSTITUTE

Trinidad nursing instructors train at
Clarke Institute, 5 (Jan)

CLERMONT, Delia, Sister

Director, School for Nursing Assistants,
La Verendrye Hospital, Fort Frances,
Ontario 13 (Jan)

CLOW, Caroline

Home care of children with inborn errors
of metabolism, (Reade), 41 (Oct)

COADY, Barbara

Clinical instructor Memorial University
of Newfoundland, (port), 22 (Apr)

COLLECTIVE BARGAINING

At press time .... 15 (Aug)

Greylisting of Muskoka-Parry Sound and

Peel Country Health Units ended, 11

(Oct)
Hospital budget restrictions put damper

on bargaining, 10 (Apr)
Labour relations act proclamed in NB.,

10 (Feb)
NBARN bargaining council acts for

hospitals nurses, 9 (Sep)
New pattern developing in collective

bargaining for Ontario nurses, 12 (Feb)
New two-year contract for RNABC. 10

(Apr)
Nurses told militancy answer to labor

problems, 13 (Nov)
Pay increase to nurses prevents strike,

14 (Dec)
Public health nurses strike in Scarborough,

1 I (Dec)
Quebec registered nurses get 20 percent

wage increase, 10 (Jan)
RNAO announces greylisting, 8 (Jul)
RNAO lifts greylisting of Milton District

hospital, 9 (May)
Three staff associations certified in Nova

Scotia. 8 (Jul)

COLOSTOMY

Depression follows colostomy. 28 (Apr)

COLVIN, Isabel T.

Candidate for vice-president, 41 (May)

COMMISSION ON EMOTIONAL AND
LEARNING DISORDERS IN CHILD-
REN

One million children handicapped. Com-
mission finds, 13 (Aug)

COMMITTEE ON COSTS OF HEALTH
SERVICES

Task force reports published. 15 (May)

COMMITTEE ON HEALING ARTS

Ontario report on healing arts recom-
mends nursing charges, 12 (Jun)
RNAO replies to Ontario report on the
healing arts. 12 (Dec)

COMMUNICATION

Nurses discuss communication and eval-
uation. 20 (Apr)

Something to say . . . and how! (Reid). 52
(Mar)

The word is communication. 30 (Sep)

COMMUNITY SERVICES

Distress Center — may I help you? (Starr),
41 (Sep)

Maritimers have a TV nurse. (Ricks),
33 (Sep)

A study of selected factors affecting the
communication process employed by
general staff nurses in eight hospitals
in referrring patients with a long-term
illness to the community setting, (abst),
(Taylor). 54 (Nov)

This nurse coordinates patient services.
(Kotlarsky). 33 (Jul)

CONFERENCES AND INSTITUTES

BC operating room nurses meet. 9 (Jun)

Conference focuses on youth mental
health problems. 18 (May)

Directors of nursing attend federal sem-
inar. 8 (Jun)

Faculty of nursing at UWO celebrates
50th anniversary. 14 (Dec)

Federal government nurses meet. 10 (Apr)

Health care explored at McMaster sem-
inar. 14 (Nov)

McGill hosts conference. 9 (Apr)

Nurses discuss communication and eva-
luation. 20 (Apr)

Nursing practice subject of seminar, 16
(Nov)

OR nurses question panel on medico-
legal problems, 16 (May)

RNANS sponsors institute on human
relations in nursing, 9 (Jun)

Teaching problems discussed at RNAO-
GHA conference. 8 (Jan)

Three schools of nursing get together for
workshop on nursing care planning,
13 (Dec)

I :OOK, Lucy

•Assistant Director, Public Health nursmg.
Nova Scotia Dept, of Public Health,
(port). 13 (Jan)

1 :OOLEY, Donna E.

Lecturer, Univ. of Alberta, School of
Nursing, (port), 16 (Feb)

1 300MBS, Rosemary Prince

Active-care hospital nurse expands her

role. 23 (Oct)
Specialization calls for nursing changes.

7 (Aug)

:OOPER, Shirley

A day hospital for elderly persons, 4 1 (Feb)

CORDER, Davis W.

Director of Nursing. Victoria Hospital,
London, 23 (Sep)

COUNSELING

Counseling students in a hospital school
of nursing, (Ogston), 52 (Apr)

COWAN, Judith (Hattie)

Instructor. Queen's University, 19 (Dec)

CRACKNELL, Fanny H.

Cancer detection clinic. 37 (Apr)

CREEGGAN, Slieila Moreen

Assistant professor, University of Western
Ontario, 17 (Dec)

Factors affecting faculty attitudes toward
curriculum change in selected diploma
schools of nursing, (abst), 44 (Oct)

CURRICULA

Factors affecting faculty attitudes
toward curriculum change in selected
diploma schools of nursing, (abst),
(Creeggan), 44 (Oct)

Organization of the elements of a selected
nursing curriculum as revealed in
course outlines. (Gauthier). (abst). 54
(Apr)

Toward a value oriented curriculum
with implications for nursing education,
(abst). (Roach), 56 (Sep)

CYR, Kathleen, Sister

Candidate for nursing sisterhoods rep-
representative, 43 (May)

CYR, Yolande

Director, School of Nursing Sciences,
Edmunston Regional Hospital, New
Brunswick, (port), 12 (Jan)

CYSTIC FIBROSIS

One little boy with two big problems,
(Chapman), 36 (Jan)

D

DALHOUSIE UNIVERSITY

Staff appointments, 18 (Dec)

DARLING, Beryl

Are we getting to you? 55 (Mar)

DATES

15 (Jan), 18 (Feb), 28 (Mar), 24 (Apr), 24
(May), 18 (Jun), 18 (Jul), 20 (Aug). 24
(Sep), 19 (Oct), 23 (Nov), 23 (Dec)

DAVID, J.

Bk.rev., 55 (Nov)

DAVIDSON, Muriel H.

Director of Health Services, 22 (Nov)

DAWES, Joan M.

Director of Nursing Service for the B.C.
Cancer Institute, (port), 22 (Aug)

DAWKINS, Heather B.

Scholarship for excellence in psychiatric

nursing at Ryerson Polytechnical
Institute, Toronto, 18 (Oct)

DAY CARE

A day hospital for
(Cooper). 41 (Feb)

elderly persons.

DEAS, Miriam Anne, Sister

Opinions of graduate nurses from diploma
programs in British Columbia concern-
ing their preparation to function as
team leaders, (abst), 58 (Mar)

DeBRINCAT, Josephine

Honorary life membership, the Canadian
Public Health Association. 18 (Oct)

DELMOTTE, Justine

Bk. rev.. 42 (Jan)

DeMARSH. Kathleen G.

Candidate for vice-president. 41 (May)

DEPARTMENT OF NATIONAL HEALTH
AND WELFARE

Directors of nursing attend federal

seminar. 8 (Jun)
New nursing consultant joins DNHW

studies team. 8 (Jan)
Task force reports published. 15 (May)

DIABETES

Insulin storage important Food & Drug
Directorate warns. 12 (Feb)

A study of the perception of the nurse and
the patient in identifying his learning
needs, (abst). (Wadsworth). 56 (Sep)

DICK, Dorothy

Appointed supervisor of the Planned
Nursing program of the health services
at Red River Community College,
(port), 17 (Jun)

DIER, Tara

An invitation to a checkup, 34 (Feb)

DILLABOUGH, Andrea M.

"Epidurals" are here to stay, (Rosen), 34
(Oct)

DISASTERS AND EMERGENCIES

Distress Center — may I help you? (Starr),
41 (Sep)

DOAK, Anna May

N BARN scholarship, 19 (Dec)

DOBSON, Jean

Director of Nursing Nova Scotia Sana-
torium in Kentville. (port), 15 (Jul)

DOLAN, Rita

New product evaluation in hospital. 29
(Jul)

IX)L!V1AN, Sharon

Prinzmenlal's variant angina in a coronary
unit. (Paget). (Walkden). 23 (Jun)

DOLPHIN. Maude Irene

Assistant professor, U.B.C. School of
Nursing, (port), 13 (Jan)

DRONYK, Gail

Appointed nurse-in-chjrge, Victorian
Order of Nurses. Owen Sound. 19 (Dec)

VII

DRUGS

ANPQ workshop studies misuse of drugs,
14 (Aug)

Drug misuse in teenagers, (Lloyd), 46
(Sep)

Federal grant for symposium on drug
users, 1 5 (Oct)

Insulin storage important Food & Drug
Directorate warns, 12 (Feb)

New in psychiatry: moditen injectable
therapy and follow-up care, (Syming-
ton), 21 (Jan)

On the edge of a cliff, (Ricks), 40 (Dec)

Phenacetin warning, 19 (Jul)

DuGAS, Beverly

New nursing consultant joins DNHW
studies team, 8 (Jan)

DuMOUCHEL, N.

Are we really meeting our patients" needs?
39 (Nov)

ECONOMIC COUNCIL OF CANADA

Health care costs need closer look. 12
(Nov)

ECONOMICS, NURSING

"Million letter write-in" helps nurses'

campaign, 17 (Mar)
Quebec registered nurses get 20 percent

wage increase, 10 (Jan)

EDUCATION

Adapting instruction to individual
differences, (Mclnnes), 43 (Mar)

CNA awarded national health grant,
7 (Jun)

Counseling students in a hospital school of
nursing, (Ogston), 52 (Apr)

The development of an instrument to
measure selected affective outcomes of
a diploma program in nursing from
verbal responses of nurses on completion
of the program, (abst), (Roach). 44 (Oct)

Examining student nurses" problems by the
case method, (Wood), 3 I (Feb)

An exploratory study to determine if the
stated objectives of a maternity nursing
program provide senior diploma student
nurses with a family-centered philoso-
phy, (MacLeod), (abst), 41 (Jan)

Factors affecting faculty attitudes toward
curriculum change in selected diploma
schools of nursing, (abst). (Creeggan).
44 (Oct)

Health facilities receive federal grants. 15
(Nov)

The independent study tour. (Horn). 32
(Jan)

An institute as an educational experience
in the continuing education of a selected
population of nurses. (Griffith), (abst),
41 (Jan)

Many PEI nursing students must study in
other provinces, 10 (Apr)

Multimedia system launched in Canada,

39 (Jun)
NB committee set up to study nursing
VIII

education, 14 (Oct)

NLN favors open curriculum, 20 (May)

New diploma program for New Brunswick
students, 14 (Oct)

Nurses hold education day, 10 (Jan)

Ontario health minister announces end of
internship for diploma nurses, 15 (Dec)

Postgraduate students from the Interna-
tional School of Higher Nursing
Education, 7 (Oct)

Ryerson offers three advanced nursing
programs, 12 (May)

St. Lawrence college teams with regional
school of nursing, 14 (Apr)

Students need counselors to interpret
information. 8 (Feb)

A study of the withdrawal of nursing
students at the Saskatoon City Hospital
School of Nursing, Saskatoon, Saskat-
chewan, from September 1954 J.o
September 1960. (abst), (Long), 44
(Oct)

Study shows hospitals retain involvement
in education, 18 (Mar)

A study to compare the nursing care given
by professionally and technically pre-
pared nurses on a medical unit, (Sellers),
(abst). 41 (Jan)

Teachers — you are trespassing! (Meso-
lella). 21 (Jul)

Toward a value oriented curriculum with
implications for nursing education,
(abst). (Roach). 56 (Sep)

Trinidad nursing instructors train at
Clarke Institute. 5 (Jan)

Teaching problems discussed at RNAO-
OHA conference. 8 (Jan)

U of T nursing school offers new master's
program, 17 (May)

US nursing students protest suffocating
education. 9 (Jul)

UWO to offer new nursing program. 12
(Feb)

University schools of nursing in Canada.
4! (Apr)

Urgent need shown for nursing textbooks
in French, 12 (Aug)

Use of part-time teachers benefits students
and faculty. (McPhail), 36 (Jul)

EDUCATIONAL MEASUREMENT

Members appointed to Ad Hoc committee
on CNA testing service. 6 (Jan)

Testing service gets new home, 6 (Jul)

Test service board holds first meeting. 9
(Apr)

New product evaluation in hospital,
(Dolan), 29(Jul)

ELFERT, Helen Elizabeth

Assistant professor. U.B.C.
nursing. 12 (Jan)

school of

EMORY, Florence H.M.

Received an honorary Doctor of Laws
degree. University of Toronto, (port).
14 (Jul)

EQUIPMENT AND TECHNIQUES

Move equipment with ease. (Layhew). 30
(May)

EVALUATION

Test service board to set up and operate
CNA testing service. 10 (Mar)

EXTENDED CARE FACILITIES

CCHA moves to accredit extended care
centers. 7 (Jan)

EYES

Walking good for eyes. 23 (May)

FACULTY

Use of part-time teachers benefits students
and faculty. (McPhail), 36 (Jul)

FALLIS, F.B.

Specialization calls for nursing changes,
7 (Aug)

FALLU-TREYVAUD, Ginette

To participate in seminar in France, (port),
18 (Oct)

FEES

NBARN members approve fee increase,
10 (Feb)

FELICITAS, Mary, Sister

CNA president addresses RNANS annual

meeting. 1 1 (Jul)
Catholic University's 1970 annual Alumni

Achievement Award, (port). 20 (Nov)
Issues CNA members fact at 35th general

meeting. 33 (May)

FERGUSON, Max

The Shouldice story. 44 (Aug)

FERRIER, Alma

Alberta's nurse of the year. 23 (Sep)

FILMS

See Audio visual aids

FISHER, Sandra

Instructor. University of Western Ontario,
23 (Apr)

FITZGERALD, E.

Bk. rev., 49 (Feb)

FITZGERALD, Joan

On with new, out with the old, 17 (Nov)

FLANAGAN, Eileen C.

Bk. rev., 46 (Oct)

FOLLETT, Elvie

No time for fear, 39 (Jan)

FORD, Joan S.

Lecturer, Univ. of Alberta, School
Nursing, (port). 16 (Feb)

FOURNIER, Valerie

Bk. rev., 42 (Jan)

Fredericton — something for everyoni

45 (Mar)
Left Canadian Nurses' Association, (port),

21 (Aug)
She's a regular at the racetrack.... 22 (Jul)
Welcome to the picture province, 33 (Apr)

FOX Jo-Ann (Tippett)

Assistant professor. Queen's University,
19 (Dec)

FREDIN, Joyce

Protecting OR drapes, 53 (Sep)

FRYE, C

Chemotherapy in hemodialysis, 32 (Dec)

FUNKE, Jeanette T.

Lecturer. Univ. of Alberta, School of
Nursing. 16 (Feb)

GAGNON-MAILHOT, Claire

ANPQ sets up Claire Gagnon Foundation,

16 (Sep)
Killed in air crash, (port), 21 (Aug)

GAREAU. Olivette

To work with a WHO team in Thailand,
(port). 18 (Oct)

GAUTHIER, Cecile Marie, Sister

Candidate for nursing sisterhoods repre-
sentative, 43 (May)

Organization of the elements of a selected
nursing curriculum as revealed in
course outlines, (abst), 54 (Apr)

GEIGER. Elsbeth

Chief of Nursing of the Hospital for Sick
Children, (port). 23 (Sep)

GENERAL DUTY NURSING

The teaching role of the staff nurse, (abst),
(Muldoon), 42 (Jul)

GENEVA CONVENTIONS

Red Cross booklet available on rights and
duties of nurses under the Geneva
conventions, 1 1 (Feb)

GEOFFRION, Denise

She's a regular at the racetrack..., (Four-
nier), 22 (Jul)

GERIATRICS

A day hospital for elderly persons,

(Cooper), 41 (Feb)
Grant for University of Manitoba to study

geriatric hospital care, 14 (Oct)

GILMAN, J. Louise

Bk. rev., 49 (Feb)

GOOD, Shiriey R.

Candidate for vice-president, 42 (May)
University of Calgary accepts its first
class of nursing students, 16 (Dec)

GORDON, Barbara, Brigadier

"Welcome" to matron-in-chief and
director of Britain's Army Nursing
Service, (port), 8 (Nov)

GOWER, Philip E.T.

Assistant director of nursing service at
Queen Street Mental Health Centre in
Toronto, (port). 22 (Apr)

GRAHAM, Eleanor S.

Retired as executive director of the
Registered Nurses' Association of
British Columbia, (port), 22 (Sep)

GRAhAM-CUMMING, Lois

CNA Director of Research and Statistics

retires, 17 (Dec)
CNA represented on health care com-
mittee. 7 (Mar)

GREEN, Monica

Specialization calls for nursing changes,
7 (Aug)

GREEN, Robert J.

What is your will? 30 (Oct)

GRIFFIN, Amy

Chairman of the educational committee,
RNAO, (port), 20 (Nov)

GRIFFITH, J. Kirstine (Buckland)

An institute as an educational experience
in the continuing education of a selected
population of nurses, (abst), 41 (Jan)

GRIFFITH, William S.

Teaching problems discussed at RNAO-
OHA conference, 8 (Jan)

GRIFFITHS, Helen Frances

Development of Likert scale to identify
one nursing behavior practiced in
general nursing, (abst), 42 (Jul)

GYNECOLOGY

Some women suffer "utter hell" with pre-
menstrual tension, MD tells OMA
convention, 14 (Jun)

H

HAMILTON, Vera

Preventing hearing loss in industry, 37
(Sep)

HANDICAPPED

One million children handicapped. Com-
mission finds, 13 (Aug)

HARDY, Charlotte

Bk. rev., 46 (Oct)

HARTIG, Elisabeth E.

Nursing consultant for SRNA, (port). 15
(Jul)

HAYES, Patricia

Lecturer, Univ. of Alberta. School of
Nursing (port), 16 (Feb)

HAZEN, Elaine

Maritimers have a TV nurse, (Ricks), 33
(Sep)

HAZLETT, Stella L.

Lecturer, Univ. of Alberta, School of
Nursing, (port), 16 (Feb)

HEALEY, Eileen

Bk. rev., 46 (Aug)

HEALTH CARE

CNA represented on health care com-
mittee. 7 (Mar)

Health care costs need closer look, 12
(Nov)

Health care explored at McMaster
seminar, 14 (Nov)

Hospital nursing and the demand for
change, (Williams), 38 (Jul)

RNANBC urges inquiry into health care

financing 14 (Jun)
UBC family practice unit involves nurses,
21 (Mar)

HEALTH EDUCATION

Maritimers have a TV nurse, (Ricks), 33

(Sep)
Schifferes, Justus J.. Healthier living. 46

(Jul)
They came to our fair, (Owen), (port), 34

(Jan)

HEALTH MANPOWER

Active-care hospital nurse expands her
role, (Coombs), 23 (Oct)

CNA Board accepts second ad hoc com-
mittee report. 9 (Dec)

CNA Board takes stand on the physician's
assistant, 7 (Nov)

Doctor's assistants (editorial), (Lindabury),
3 (Jun)

French nurses not being recruited as
physicians' assistants, 7 (Oct)

Lack of health manpower acute in develop-
ing countries, 13 (Sep)

Public health nurses work with family
physicians, (Hutchison), (Mumby), 28
(Jan)

Task force on the cost of health services in
Canada. 23 (Feb)

HEARING

Preventing hearing loss in industry,
(Hamilton), 37 (Sep)

HEART AND HEART DISEASES

Don't overdo it, 19 (Jun)

Living longer, 26 (Nov)

New coronary teaching aid purchased by

SRNA, 14 (Oct)
Prinzmental's variant angina in a coronary

unit, (Dolman), (Paget). (Walkden),

23 (Jun)

HENDERSON, Virginia

Nurse honored at convocation, (port),

17 (Oct)
Received honorary Doctor of Laws degree

from University of Western Ontario,

15 (Jun)

HERNIA

The Shouldice story, (Ferguson), 44 (Aug)

HERSEY, Donald O.

Nurses told militancy answer to labor
problems, 13 (Nov)

HERWITZ, Adele

Takes six-month appointment as executive
director of the International Council
of Nurses in Geneva, Switzerland, 16
(Jun)

HEZEKIAH,JocelynA.

Assistant professor. University of West-
ern Ontario, 23 (Apr)

HOME CARE

Home care of children with inborn errors
of metabolism, (Reade), (Clow), 41
(Oct)
HORN, Ethel M.

Bk. rev., 55 (Apr) %

The independent study tour, 32 (Jan)

IX

HORNBY, Marguerite

New director of nursing at Mount Saint
Vincent University in Halifax. 26 (Mar)

HOSPITAL FOR SICK CHILDREN,
TORONTO

Animals and fish admitted to HSC, 8 (Oct)

HOSPITAL NURSING SERVICE

Decentralized nursing service. (McKillop),

36(Jun)
Hospital nursing and the demand for

change. (Williams). 38 (Jul)
NBARN bargaining council acts for

hospital nurses. 9 (Sep)
A split in the family. (Rose). 3 1 (Apr)
A study of the relationship between patient

involvement and patient attitude in

transfers occurring in a selected unit of

a general hospital. (Middleton). (abst),

58 (Mar)

HOSPITALS— ADMINISTRATION

Hospital ombudsman, 30 (Sep)

HUFFMAN, Verna M.

A call to action, (port). 5 (Aug)
Nursing leaders meet, (port), 20 (Nov)
Visitor to New Zealand, (port), 22 (May)

HUMAN RELATIONS

No time for fear. (Follett). 39 (Jan)
RNANS sponsors institute on human
relations in nursing. 9 (Jun)

HUNTER, Margaret H.

Bk. rev.. 47 (Oct)

HURD, Jeanne Marie

Clinical instructor, U.B.C. School of
Nursing. 13 (Jan)

HUTCHISON, D.A.

Public health nurses work with family
physicians, (Mumby), 28 (Jan)

HYDE, Naida

Changing horizons in psychiatric nursing,
49 (Mar)

I

IMAI, Hisako Rose

New research officer Canadian Nurses'
Association, (port), 20 (Nov)

IMMUNIZATION

First live mumps vaccine now available,
14 (Feb)

IN A CAPSULE

18 (Jan). 21 (Feb), 33 (Mar). 28 (Apr), 23
(May), 19 (Jun), 19 (Jul). 23 (Aug). 30
(Sep). 26 (Nov). 24 (Dec)

INDEX TO ADVERTISERS

64 (Jan), 72 (Feb), 80 (Mar), 80 (Apr),
72 (May), 64 (Jun), 63 (Jul), 63 (Aug),
79 (Sep), 63 (Oct), 72 (Nov), 62 (Dec)

INFANTS, NEWBORN

Screening newborns assists disease pre-
vention programs, 16 (Nov)

INSECTS

Stamping out stinging insects, 24 (Dec)

X

INSERVICE EDUCATION

Quebec inservice education seminar assists

nursing care. 18 (Sep)
Speaker relates inservice education, job

satisfaction, 18 (May)

INSURANCE, UNEMPLOYMENT

CNA accepts federal unemployment

insurance plan, 12 (Nov)
Unemployment insurance for nurses? 21

(Feb)

INTENSIVE CARE

Cure for wandering nurse, 33 (Mar)
Prinzmental's variant angina in a

coronary unit, (Dolman), (Paget),

(Walkden), 23 (Jun)

INTERAGENCY COUNCIL ON
LIBRARY TOOLS FOR NURSES

CNA librarian attends Interagency Council
meeting, 9 (May)

INTERNATIONAL COUNCIL OF
NURSES

Alberta nurse to represent CNA at ICN

seminar. 7 (Mar)
Committee members outline basic issues

for 1969-73 quadrennium. 20 (Apr)
Congress papers published. 9 (Jul)
"ICN Calling" gets new format, 22 (Mar)
Nursing legislation discussed at interna-
tional seminar, 7 (Oct)
Publishes new nursing statement, 19 (May)
Seeks new executive director, 18 (Mar)
Sheila Quinn leaving ICN headquarters,
(port), 12 (Jan)

INTERNATIONAL NURSING REVIEW

Editor needed for ICN nursing review,
1 1 (Apr)

INTERNATIONAL SCHOOL OF HIGHER
NURSING EDUCATION

Marie-Claire Portehaut and Janine Prevot
postgraduate students, 7 (Oct)

INTER-UNIVERSITY NURSING
CONFERENCE

McGill hosts conference, 9 (Apr)

JACKSON, Ann Gwendolyn

Assistant professor Dalhousie Univer-
sity, 18 (Dec)

JACKSON, Marion

Three patients with Hodgkin's disease,
33 (Jun)

JACOBI, Eileen M.

Appointed executive director of the
American Nurses" Association, 14 (Jul)

JAMES, Lois

With MEDICO in Surakarta, (port, 19

(Dec)

JANZOW, Esther A.D.

Director of nurses" training, Vancouver
City College, 22 (Sep)

JARVIS, G J.

Bk. rev., 43 (Jan)

JENKIN, Carol L.

Bk. rev., 46 (Aug)

JOHNS, Ethel

Forthcoming biography, 19 (Nov)

K

KAVANAGH, Marilyn

Bk. rev., 38 (Jun)

KEARNS, Barbara

Tracheotomy suctioning technique, 44

(Feb)

KEELER, Hazel B.

Honorary membership in SRNA, 20 (Nov)

K ELTON, Sheila

Instructor, University of Western Ontario,
23 (Apr)

KENNEDY, F.A. (Nan)

Interim executive director. Registered
Nurses Association of British Columbia,
(port), 18 (Oct)

KENNEDY, Rita, Sister

Candidate for nursing sisterhoods re-
presentative, 43 (May)

KERGIN, Dorothy J.

Bk. rev., 57 (Sep)

Director, School of Nursing, McMaster

University, (port), 15 (Jun)
Research session sparks enthusiasm, 1 1

(Aug)

KERR, Janet C.

Assistant professor. University' of Calgary,
22 (Nov)

The formulation of an instrument to
evaluate performance of nursing students
in clinical nursing based on correlated
behavioral objectives, (abst), 58 (Mar)

KERR, Margaret E.

Nursing leaders honored by Ottawa
friends, (port), 19 (Nov)

KIDNEYS

Chemotherapy in hemodialysis, (Frye),
32(Dec)

KIKUCHI, June F.

One hospitalized preschool girl's way of
dealing with separation anxiety, (abst),
54 (Apr)

KING, Floris E.

Awarded a federal health research grant,

(port), 17 (Jun)
Federal grant aids nursing practice

research, 15 (Sep)
Nursing practice subject of seminar, 16

(Nov) _

KISILEVSKY, Barbara %

Joined the faculty at Queen's University,
18 (Dec)

KLAIMAN, R. Roslyn

Named chairman of the nursing depart-
ment at Ryerson Polytechnical Institute
in Toronto, 17 (Jun)

KONG, Maggie Chan

Appointed assistant director Scarborough

Regional School of Nursing, (port).
18 iDec)

KOTL.\RSKY, Carol

Bk. rev.. 58 (Sep)

Fredericton — here we come. 45 ( May)
From Canada to Biafra. 39 ( Mar)
Nurse to the performing arts. 25 (Jan)
This nurse coordinates patient services.
3? (Jul)

KLTSCHKE, Myrtle A.

Associate director of the School of Nursing.
McMaster University, (port). 22 (Sep)

LABELLE, Huguette

Candidate for vice-president. 42 (May)
Highly planned patient care essential.
nurses told. 1 1 (Aug)

LACAVA, Marianne Eliaiabeth

Advisor in nursing service RNANS, (port).
13 (Jan)

LAFOLEY, Lynda

To serve with MEDICO. 17 (Oct)

LAPORTE. Pierre

Message of sympathy. 7 (Nov)

LAYCOCK. S.R.

Bk. rev.. 47 (May)

LAYHEW.Jane

Move equipment with ease. 30 (May)

LEACH, Nancy

Nurse on James Bay. (Pearce). (port). 26
(Jun)

LEASK, Jean

VON director reviews changes in past ten
years, (port). 6 (Jul)

LeCLAIR, J. Maurice

Appointed deputy minister. Dept.
National Health, (port). 25 (Mar)

of

LECLERC, Cecile. Sister

Candidate for nursing sisterhoods re-
presentative. 43 (May)

LEGISLATION

CNA legislation committee recommends
bylaw changes. 9 (Apr)

Legal implications of nursing reviewed at
convention. (Rozovsky). 12 (Aug)

Members appointed to CNA Ad Hoc
Committee on Legislation. 7 (Feb)

NBARN"s biennial plans progress. 8 (Mar)

Negligence in the recovery room. 26 (Jul)

Nursing legislation discussed at interna-
tional seminar. 7 (Oct)

Ontario RNs to carry out some medical
procedures. 8 (Feb)

What is your will? (Green). 30 (Oct)

LEONARD, Robert C.

Visting professor. University of Western
Ontario. 17 (Dec)

LETTERS

4 (Feb). 4 (Mar). 4 (Apr). 4 (May), 4 (Jun).

4 (Aug). 4 (Sep). 4 (Oct). 4 Nov). 4 (Dec)

LEUKEMIA

No time for fear. (Follett). 39 (Jan)

LEWIS, Geneva

Nurse elected president of CPHA. (port).
15 (Jul)

LIBRARIES

CNA librarian at meeting of Interagency

Council on Library Resources for

Nursing. 10 (Dec)
CNA librarian visits libraries in Manitoba

Schools of Nursing. 7 (Feb)
CNA Library accession list, see Canadian

Nurses" Association. Library
ICN committee members outline basic

issues for 1969-73 quadrennium. 20

(Apr)

International Nursing Index loses Cana-
dian subscriptions. 10 (Dec)

LICENSURE

Canadian nurses should be licensed by
endorsement. US council urges. 14 (Aug)

Keep licensing functions separate lawyer
tells RNAO members. 13 (Jun)

LINDABURY, Virginia Ann

Abortion reform, (editorial). 3 (Nov)
Ad hoc committee on functions, relation-
ships, and fee structure, (editorial). 3
(May)
Canadian Nurses" Association (editorial).

3 (Aug)
Doctor "s assistants, (editorial). 3 (Jun)
Nursing in the sixties, (editorial). 3 (Jan)
For smokers only, (editorial). 3 (Apr)
Task Force on the Cost of Health Services
in Canada, (editorial). 3 (Feb)

LINDSTROM, Myrna

Nursing problems of the paraplegic patient
as seen by the nurse, (abst). 53 (Nov)

LISTER, Jean Audrey

Coordinator of inservice education at St.
Boniface General Hospital, (port). 17
(Oct)

LLOYD, David

Drug misuse in teenagers, 46 (Sep)

LOCKEBERG, Liv-Ellen

Assistant editor of the Canadian Nurse.

(port). 17 (Oct)
Nursing leaders honored by Ottawa

friends, (port). 19 (Nov)

LONG, Barbara

Sleep. 37 (Feb)

LONG, Linda R.

Appointed associate director of nursing
service, (port). 15 (Jun)

A study of the withdrawal of nursing
students at the Saskatoon City Hospital
School of Nursing. Saskatoon. Saskat-
chewan, from September 1954 to
September 1960. (abst), 44 (Oct)

LOUNDS, Margaret

Bk. rev.. 49 (Feb)

M

McADOO, Frances M.

Assistant professor. Univ. of Alberta
School of Nursing, (port). 16 (Feb)

McCALLUM, Susan

Appointed instructor in the faculty of
nursing. University of Western Ontario,
(port). 16 (Jun)

McCLOY, M.

Bk. rev.. 60 (Mar)

McCLURE, Dorothy

Assistant professor McMaster University.
School of Nursing, (port). 22 (Sep)

McCOLL, Alberta G.

Associate director of nursing education at
Royal Columbian Hospital School of
nursing in New Westminster. British
Columbia, (port). 16 (Jul)

MacDONALD, EJ.

Bk.rev.. 60 (Mar)

MacDONALD, L.

Bk.rev.. 38 (Jun)

McDowell, Edith m.

Alumni of University of Western Ontar-
io"s school of nursing welcomed, (port),
14 (Dec)

MclLHAGGA, Carole

Bk.rev.. 46 (Dec)

McINNES. Betty

Adapting instruction to individual dif-
ferences. 43 (Mar)

MacKAY, Ruth C.

Associate professor at Queen's University
School of Nursing. 15 (Jul)

MACKIE, E. Jean

Director of Nursing Selkirk College,
Castlegar, B.C.. (port). 14 (Jul)

McKILLOP, Madge

Bk.rev.. 43 (Jul)

Decentralized nursing service. 36 (Jun)

Reelected president of Saskatchewan

Registered Nurses' Association, (port),

21 (Nov)

McKONE, Alma

Director of inservice education, the
Winnipeg General Hospital, (port), 23

(Apr)

McLEAN, Margaret D.

Candidate for president-elect, 40 (May)
Directors of nursing attend federal

seminar. 8 (Jun)
Issues CNA members face at 35th general

meeting. 33 (May)

MacLEAN, Winnifred

Nursing leaders honored by Ottawa
friends, (port). 19 (Nov)

MacLENNAN, Katharine

Given honorary membership in the
ANPEI. 10 (Sep) •

XI

MacLEOD, Catherine Shirley

An exploratory study to determine if the
stated objectives of a maternity nursing
program provide senior diploma student
nurses with a family-centered philo-
sophy, (abst). 41 (Jan)

McMASTER UNIVERSITY. SCHOOL OF
NURSING

Director. School of Nursing. Dorothy J.

Kergin. \^ (Jun)
Myrtle A. Kutschke appointed associate

director, (port). 22 (Sep)

McMillan, M. Helena

Died January 28. Boulder. Colorado. 16
(Jun)

McNAUGHT. Fay Lawson

Appointed Director, Nursing Education
Grace General Hospital School of
Nursing. Winnipeg. 17 (Dec)

McPHAIL, F. Joan

Use of part -lime teachers benefits students
and faculty. 36 (Jul)

McPHERSON, Marvelle

Appointed assistant director of nursing
service. St. Boniface General Hospital.
Manitoba, (port). 2.'' (Mar)

MacTAVISH. Diane

Coffee break with a difference. .'>4 (Sep)

MAGUIRE, Grace. Si.ster

Candidate for nursing sisterhoods re-
presentative. 4.3 (May)

MAHONEY, Lorraine

Instructor. University of Western Ontario.
18 (Dec)

MAKI, Maila

Elected president of the Canadian Asso-
ciation of Neurological and Neurosur-
gical Nurses, (port). 17 (Dec)

MANAGEMENT NURSES" ASSOCIATION

NBARN sets up management nurses"
association. 1 1 (Apr)

MANITOBA ASSOCIATION OF
REGISTERED NURSES

Celebrates Manitoba Centennial. 13 (May)
Centennial workshop on the wagon, 13

(Dec)
Committees, 20 (Nov)
Helen Sundstrom appointed coordinator

of continuing education. 23 (Sep)
Recommends $600 a month starting

salary. 10 (Jun)

MANOMETRY

Esophageal manometry. (Robidoux-
Poirier). 37 (Dec)

MANTLE, Jevsie

Assistant professor. Uhiversity of Western
Ontario. 23 (Apr)

MARQUIS, Rachelle

With CARE-MEDICO in Tunisia,
(port), 21 (Nov)

XII

MARSH, Marilyn

Lecturer at Memorial School of Nursing,
(port). 22 (Apr)

MARTIN, Carole L.

Bk. rev.. 46 (Aug)

MARTIN, Jeanne S.

Instructor. Mount Royal Junior College.
Calgary, (port). 23 (Apr)

MATHESON, Margaret Rose

Instructor, Queen's University, 19 (Dec)

MAUKSCH, Hans O.

Nurse should develop a "colleagueship of
equals." sociologist tells conference. 12

(May)

MELLON, Marie T.

Bk. rev,. 60 (Mar)

MEMORIAL UNIVERSITY. SCHOOL OF
NURSING

Announced four faculty appointments. 22

(Apr)
June S. Agnew appointed lecturer, school

of nursing (port), 22 (Nov)

MEN NURSES

First male nurse licensed to practice in

Quebec. 10 (Feb)
Quota remains the same for male nurses in

Canada's forces. 10 (Feb)

MENTAL HEALTH

CM HA council discusses mental health
problems. 17 (Apr)

Conference forces on youth mental health
problems. 18 (May)

New in psychiatry: moditen injectable
therapy and follow-up care, (Syming-
ton), 21 (Jan)

MENTAL RETARDATION

Needed; a positive approach to the
mentally retarded, (von Schilling), (port),
30 (Jun)

MESOLELLA, Daphne Walker

Teachers — you are trespassing! 2 1 (Jul)

MIDDLETON, George

A study of the relationship between patient
involvement and patient attitude in
transfers occurring in a selected unit of
a general hospital (abst), 58 (Mar)

MIDWIFERY

Margaret Myles demonstrates art of
midwifery to nurses of the north, (port),
10 (Dec)

MILITARY NURSING

Canada and Britain to exchange nursing

personnel. 7 (Nov)
Continuing to care — even in the air,

(Ricks), 33 (Nov)
On wi' I new. out with the old, 17 (Nov)
Quota remains the same for male nurses

in Canada's forces, 10 (Feb)

MILLER, Kathleen Ruth

A study in the use of role playing with a

select population, (abst), 52 (Nov)
Assistant professor, Queen's University,

18 (Dec)

MINER, E. Louise

Issues CNA members face at 35th general

meeting, 33 (May)
New president of the Canadian Nurses'

Association, (port), 20 (Sep)
Nursing leaders meet. (port). 20 (Nov)
President. 1970-1972, 39 (May)

MITCHELL, Eleanor

Night safety — a problem for nurses, 28
(Feb)

MONCRIEFF, Margaret J.

Assistant professor. University of Calgary,
21 (Nov)

MONTREAL UNIVERSITY

see University of Montreal

MOREL, Lorette

Health education and nursing consultant,
Canadian Tuberculosis and Respira-
tory Disease Association, (port). 18 (Oct)

MORGAN, Dorothy M.

Retired as director of nursing, Victoria
Hospital. London, 23 (Sep)

MOTTA, Grace

Honorary membership SRNA, 21 (Nov)

MOW ATT, Elizabeth Anne

Director, nursing service. Saint John
General Hospital. N.B.. 13 (Jan)

MUKERJEE, Joyfi

Lecturer Memorial School of Nursing,
(port), 22 (Apr)

MULDOON, Marie Barbara, Sister

The teaching role of the staff nurse, (abst),
42 (Jul)

MUMBY, Dorothy M.

Public health nurses work with family
physicians, (Hutchison), 28 (Jan)

MUNRO, L.B.

Preplacement health screening by nurses,
29 (Nov)

MUSSALLEM, Helen K.

Hidden talent. 18 (Jan)
Nurses in the future. 7 (Jun)
Nursing leaders meet, (port), 20 (Nov)
Students debate nursing issues, 12 (May)

MYLES. Margaret F.

Demonstrates art of midwifery to nurses

ofthe north, (port), 10 (Dec)
Giving 20 talks on midwifery, 22 (Sep)

N

NAMES

12 (Jan), 16 (Feb), 24 (Mar), 22 (Apr),
22 (May), 15 (Jun), 14 (Jul), 21 (Aug).
22 (Sep). 17 (Oct), 19 (Nov), 17 (Dec)

NATIONAL LEAGUE FOR NURSING

Favors open curriculum, 20 (May)
Study shows hospitals retain involvement
in education, 18 (Mar)

NATIONAL OPERATING ROOM
CONVENTION

Over 1.500 nurses attend first national OR
convention. 10 (Jul)

NATIONAL RESEARCH COUNCIL

Computerized walking. 12 iJul)

NATIONAL STUDENT NURSES
ASSOCIATION

Student nurses in U.S. show they -Give A

Damn". 13 (Jul)
US nursing students protest suffocating

education. 9 (Jul)

NEMIROFF, Leita

Bk. rev.. yH (Jun)

NEUROSURGERY

Neurosurgical nurses form world federa-
tion. 8 (Jul)

NEW BRUNSWICK ASSOCIATION OF
REGISTERED NURSES

Annual meeting sticks to business only

8 (Jull
Bargaining council acts for hospital nurses

9 (Sep)
Members approve fee increase. 10 (Feb)
Patient care highlighted at NBARN

workshops. 14 (Aug)
Project to assist CNF. 8 (Feb)
Scholarships. 19 (Dec)

Sets up management nurses" association.

I I (Apr)
Sister Mary Winslow life member. 2.3 (Sep)
NEW PRODUCTS

16 (Jan) 19 (Feb) 30 (Mar) 26 (Apr) (May)

'Jun) IViJul) 16 Augl 26 Sep) 20 ()cl i

24 .Nov)20iDecl

NEYLAN, Margaret

Director of continuing nursing education.
U.B.C.. (port). 24(Mar)

NEWS

5 (Jan). 7 (Feb). 7 (Mar). 9 (Apr). 7 (May).
7 (Jun). 5 (Jul), 5 (Aug), 9 (Sep), 7 (Oct).
7 (Nov), 9 (Dec)

NIGHT NURSING

Night safety — a problem for nurses.
(Mitchell). 28 (Feb)

NIGHTINGALE. Florence

Lady with lamp born 150 years ago. 7
(May)

NITINS. Barbara Mary

Instructor. U.B.C. School of Nursing,
(port). 13 (Jan)

NOISE

Preventing hearing loss in industry.
(Hamilton). 37 (Sep)

NORTHERN HEALTH SERVICES

Margaret Myles demonstrates art of mid-
wifery to nurses of the north, (port).
10 (Dec)

Nurse on James Bay. (Pearce). 26 (Jun)

NOSEWORTHV. Mar) Roberta

First award of the Annual Faculty of
Nursing award, 19 (Dec)

NUGENT, E. Margaret

Director of Nursing. Winnipeg General,
(port) 22 (Apr)

NURSES. INTERCHANGE OF

Canada and Britain to exchange nursing
personnel. 8 (Nov)

NURSING

Deprofessionalization in nursing (abst).
(Stinson). 58 (Mar)

Federal grant aids nursing practice re-
search. 15 (Sep)

Nurses told to define role, look for change
in profession. (Brookbank). 13 (Aug)

Nursing in the sixties. (Lindabury). (edi-
torial). 3 (Jan)

Nursing practice subject of seminar. 16
(Nov)

NURSING — FOREIGN COUNTRIES

CARE/MEDICO sponsors project in
Surakarta. Indonesia, 15 (Feb)

From Canada to Biafra. (Kotlarsky). 39
(Mar)

Nurse instructor needed for MEDICO in
Indonesia. 19 (May)

Nurses serve abroad with Miles for Mil-
lions funds. 8 (Jun)

NURSING CARE

Are we really meeting our patients" needs?
(DuMouchel). 39 (Nov)

Highly planned patient care essential,
nurses told. (Labelle). 1 1 (Aug)

The effect of working conditions on nurs-
ing care in eight hospitals as perceived
by general staff nurses and patients,
(abst). (Riley). 52 (Nov)

Nurse, please show me that you care!
(Poole). 25 (Feb)

Nursing consultant criticizes deper-
sonalized nursing care. (Poole). I I (Aug)

Patient care highlighted at NBARN
workshops. 14 (Aug)

One standard — or two? (Wedgery). 27
(May)

Sleep. (Long). 37 (Feb)

A study of the perception of the nurse
and the patient in identifying his learn-
ing needs, (abst). (Wadsworth). 56 (Sep)

A study to compare the nursing care
given by professionally and technically
prepared nurses on a medical unit.
(Sellers), (abst). 41 (Jan)
Three schools of nursing get together for
workshop on nursing care planning.
13 (Dec)
NURSING EDUCATION
see Education

NURSING MANPOW ER

A head nurses" association takes action.

29 (May)
Let students do work of RN. BC health

minister tells nurses. 5 (Jul)
Ontario health minister announces end

of internship for diploma nurses. 15

(Dec)
Stiff competition for jobs faces nurses in

15 (Dec)
NURSING TEAM

Opinions of graduate nurses from diploma

programs in British Columbia concern-
ing their preparation to function as team
leaders, (abst). (Deas). 58 (Mar)

NURSING TRENDS

Active-care hospital nurse expands her

role, (Coombs). 23 (Oct)
At press time.... 14 (Jun)
Editorial. (Lindabury). 3 (Oct)
Nurses in the future. 7 (Jun)
Ontario report on healing arts recommends

nursing changes. 12 (Jun)
Panelists debate extended role of nurse,

12 (Jun)
RNAO supports concept of expanded role

for nurse. 10 (Jun)

NUTRITION

Away from it all. 18 (Jan)
Murdering the menu. 23 (Aug)
RNs participate in nutrition Canada
project. 12 (Nov)

o

OBSTETRICS

"Epidurals" are here to stay. (Dillabough).
(Rosen). 34 (Oct)

An exploratory study to determine if the
stated objectives of a maternity nursing
program provide senior diploma student
nurses with a family-centered philo-
sophy. (MacLeod), (abst). 41 (Jan)

Health care explored at McMaster sem-
inar. 14 (Nov)

Monitoring the mother and fetus during
labor. (Willis). 28 (Dec)

My. you're getting big! (Carty). 40 (Aug)

A split in the family. (Rose). 31 (Apr)

OCCUPATIONAL HEALTH SERVICES

Nurse to the performing arts, (Kotlarsky),

25 (Jan)
Preplacement health screening by nurses,

(Munro), 29 (Nov)
Shes a regular at the racetrack... (Four-

nier). 22 (Jul)

O'DONOVAN. D.

Bk. rev.. 55 (Nov)

OGSTON. Donald G.

Bk. rev. 45 (Jul)

Counseling students in a hospital school
of nursing. (Ogston). 52 (Apr)

OGSTON, Karen M.

Counseling students in a hospital school
of nursing. (Ogston). 52 (Apr)

ONTARIO HOSPITAL ASSOCIATION

Nurse claims task force sees symptoms,

not causes, 16 (Dec)
Teaching problems discussed at RNAO-

OHA conference. 8 (Jan)

ONTARIO MEDICAL ASSOCIATION

Some women suffer "utter hell"" with
premenstrual tension. MD tells OMA
convention, 14 (Jun)

OPERATING ROOM

BC operating room nurse.s meet. 9 (Jun)

Xili

OR nurses question panel on medico-legal

problems. 16 (May)
Over 1.500 nurses attend first national OR

convention, 10 (Jul)
Protecting OR drapes. (Fredin), .53 (Sep)

OPERATING ROOM NURSES OF
GREATER TORONTO

OR nurses question panel on medico-legal

problems. 16 (May)
Speaker relates inservice education, job

satisfaction (Slavens), 18 (May)

ORDERLIES

Editorial. (Ricks). 3 (Sep)

One standard — or two? (Wedgery). 27

(May)
Salary levels of Ontario Hospital workers

under fire. 9 (Sep)

OSBORNE, Margaret

C omputer in psychiatry. 39 (Oct)

OSS, Joanne Dolores

Awarded the Abe Miller memorial
scholarship, (port). 2.5 (Mar)

OTTAWA UNIVERSITY. SCHOOL OF
NURSING

Nurses discuss communication and

evaluation. 20 (Apr)
Students debate nursing issues. 12 (May)

OUDOT, Edna L.

Coordinator. teacher. team nursing
project, (port). 25 (Mar)

OUTPOST NURSING

Federal team studies nursing in the north.

14 (Sep)
Summer help for nurses in the north. 21

(Sep)

OWEN, Gladys

They came to our fair, (port), 34 (Jan)

OXYGEN THERAPY

A study to determine how patients view
their digoxin therapy. (Brkich). (abst).
54 (Apr)

PAGET. Cynthia

Prinzmental's variant angina in a coronary
unit. (Dolman). (Walkden). 23 (Jun)

PARKER, Patricia

Instructor. University of Western. Ontario
(port). 16 (Jun)

PARKIN, Margaret L.

CNA librarian at meeting of Interagency
Council on Library Resources for
Nursing. 10 (Dec)

CNA librarian attends Interagency Council
meeting. 9 (May)

CNA librarian visits libraries in Manitoba
Schools of Nursing, 7 (Feb)

International Nursing Index loses Cana-
dian subscriptions, 10 (Dec)

PASSMORE, D. Jean

Assistant registrar for SRNA, (port), 15
(Jul)

XIV

PATIENTS

One standard — or two? (Wedgery). 27
(May)

A study of the relationship between patient
involvement and patient attitude in
transfers occurring in a selected unit of
a general hospital. (Middleton). (abst).
58 (Mar)

PEACOCK, Vera R.

Retired as Assistant Director of Nursing
at the Manitoba Rehabilitation Hospital,
18 (Dec)

PEARCE, Terry

Nurse on James Bay, 26 (Jun)

PECHIULIS, Diana D.

Assistant Professor, University of Calgary,

21 (Nov)

PEDIATRICS

Animals and fish admitted to HSC, 8 (Oct)
The autistic child, (Whitlam), 44 (Nov)
Bradford frame covers, (Brenchley), 35

(Jan)
Coffee break with a difference. (MacTa-

vish), 54 (Sep)
Fantasy in the communication of concerns

of one five-year-old hospitalized girl,

(abst), (Ritchie). 59 (Mar)
Home care of children with inborn errors

of metabolism. (Reade). (Clow). 41 (Oct)
Murdering the menu. 23 (Aug)
One hospitalized preschoolgirl's way of

dealing with separation anxiety, (Kiku-

chi). (abst). 54 (Apr)
One little boy with two big problems.

(Chapman). 36 (Jan)
A study of communicative behavior in

young hospitalized children. (White-
more), (abst), 54 (Apr)
Tracheotomy suctioning technique,

(Kearns), 44(Feb)

PEEVER, Mary V.

Assistant professor. University of Calgary,

22 (Nov)

PEITCHINIS, Jacquelyn

Part-time lecturer. University of Calgary,
22 (Nov)

PELLEY, Thelma

Bk. rev.. 46 (Aug)

PEPLAU, Hildegard

Appointed interim executive director of
the American Nurses" Association, 24
(Mar)

PEPLER, Carolyn Joan

Cognitive functioning of patients under
stressors of impending and recent
surgery, (abst), 52 (Nov)

PEPPER, Evelyn

Retired, nursing consultant in the emer-
gency health services division of the
Dept. of National Health and Welfare,
(port), 24 (Mar)

PERRY, Susan E.

Assistant professor. McMaster School of
Nursing, (port), 22 (Sep)

Research session sparks enthusiasm, 1 1

(Aug)

PETERSSON, Carolyn

Instructor. University of Western Ontar-
io, 18 (Dec)

PETTIGREW, Lillian

Honored at investiture, (port), 17 (Dec)

PFISTERER, Janet

Instructor, University of Western Ontario,
16 (Jun)

PHILATELY

Centennial stamp, 18 (Mar)

PHILLIPS, Margaret

Associate professor Univ. Toronto School
of Nursing (port), 22 (Apr)

PHYSICIAN'S ASSISTANT

See Health manpower

PILL, Miriam

Director of Nursing at Maimonides Hos-
pital and Home for the Aged in Mont-
real, (port), 16 (Jul)

PITTUCK, Ellen J.

Retired as Director of nursing, Ontario
Hospital School, Orillia, (port), 12 (Jan)

PLUMMER, Johanna

Director on Nursing Service at Owen
Sound General and Marine Hospital,
Owen Sound, Ontario, (port), 22 (Aug)

POISONS

Quote of the month, 33 (Mar)

POLICE

Tomorrow's cop today, 23 (Aug)

POOLE, Pamela E.

Nurse, please show me that you care! 25
(Feb)

Nursing consultant criticizes deperson-
alized nursing care, 1 1 (Aug)

PORTEHAUT, Marie-Claire

Postgraduate student from the Interna-
tional School of Higher Nursing
Education, (port), 7 (Oct)

POVERTY

CNA committee to prepare brief on

poverty and health, 7 (Feb)
Poverty is cause of illness, CNA tells senate

committee, 5 (Jul)

POWERS, Marie

Assistant professor, Queen's University,
18 (Dec)

PRACTICAL NURSING 1

Editorial, (Ricks), 3 (Sep)

Health facilities receive federal grants. 15

(Nov)
Salary levels of Ontario Hospital workers

under fire, 9 (Sep)

PREVOT, Janine

Postgraduate student from the Interna-
tional School of Higher Nursing
Education, (port), 7 (Oct)

PRINCE CHARLES

Nurses meet the Prince. 23 (Aug)

PROGRESSIVE PATIENT CARE

This nurse coordinates patient services.
(Kotlarsky). 33 (Jul)

PSYCHIATRY

The autistic child. (Whitlam). 44 (Nov)
Changing horizons in psychiatric nursing.

(Hyde). 49 (Mar)
Computer in psychiatry, (Osborne), 39

(Oct)
New in psychiatry: moditen injectable

therapy and follow-up care. (Syming-
ton), 21 (Jan)
Spontaneity is key to helpfulness of

psychodrama, (Burwell), 10 (Aug)
A study in the use of role playing with a

select population, (abst). (Miller), 52

(Nov)
Trinidad nursing instructors train at Clarke

Institute. 5 (Jan)

PUBLIC HEALTH

Public health nurses strike in Scarborough.

1 1 (Dec)
Public health nurses work with family

physicians, (Hutchison), (Mumby), 28

(Jan)
RNABC asks government to adjust PH

budget, 14 (Apr)
A study of the attitudes of public health

nurses in a selected agency toward direct

patient care, (abst), (Shepherd), 59 (Mar)

PURLISHOTHAM, Devamma

Assistant professor, Univ. of Alberta
School of Nursing, (port), 16 (Feb)

QUEEN'S UNIVERSITY

New appointments School of Nursing,
18 (Dec)

QUINN, David M.

Bk. rev.. 38 (Jun)

QUINN, Sheila

Leaving ICN headquarters, (port), 12 (Jan)

R

READE, Terry

Home care of children with inborn errors
of metabolism, (Clow), 41 (Oct)

RECOVERY ROOM

Negligence in the recovery room, 26 (Jul)

RECREATION

Dance it off, 18 (Jan)

RED CROSS

Booklet available on rights and duties of
nurses under the Geneva conventions,
1 1 (Feb)

REEVES, Fidessa

Given honorary membership in the
ANPEI, 10 (Sep)

REGISTERED NURSES ASSOCIATION
OF BRITISH COLUMBIA

Asks government to adjust PH budget, 14

(Apr)
BC nurses to study night travel problems,

17 (Mar)
Eleanor S. Graham retired as executive
director of the RNABC, (port), 22 (Sep)
F.A. (Nan) Kennedy appointed interim

executive director, (port). 18 (Oct)
Few jobs available. RNABC warns nurses.

9 (Apr)
Let students do work of RN. BC health

minister tells nurses. 5 (Jul)
New two-year contract for RNABC. 10

(Apr)
Nurses hold education day. 10 (Jan)
Public threatened. RNABC warns, 15

(Mar)
Urges inquiry into health care financing,
14 (Jun)

REGISTERED NURSES ASSOCIATION
OF NOVA SCOTIA

Advisor in nursing service RNANS, M.E.

Lacava, 13 (Jan)
CNA president addresses RNANS annual

meeting, 1 1 (Jul)
Sponsors institute on human relations in

nursing, 9 (Jun)

REGISTERED NURSES ASSOCIATION
OF ONTARIO

Announces greylisting, 8 (Jul)
Dr. Amy Griffin chairman of the edu-
cational committee (port), 20 (Nov)
Edna L. Oudot coordinator, teacher, team

nursing project, (port). 25 (Mar)
Give priority to members. RNAO

president tells nurses, 1 1 (Jun)
Keep licensing functions separate lawyer

tells RNAO members. 13 (Jun)
Lifts greylisting of Milton District hospital.

9 (May)
Members support CNF. 14 (Jun)
Membership fee increased to $50. 16 (Dec)
Nurse should develop a "colleagueship of

equals," sociologist tells conference, 12

(May)
Nurses told militancy answer to labor

problems, 13 (Nov)
Ontario RNs to carry out some medical

procedures, 8 (Feb)
Panelists debate extended role of nurse.

12 (Jun)
Publishes statement about TGH senior

nurses, 1 1 (Feb)
Replies to Ontario report on the healing

arts, 12 (Dec)

Supports concept of expanded role for

nurse, 10 (Jun)
Teaching problems discussed at RNAO-

OHA conference, 8 (Jan)
Three senior nurses leave Toronto General

Hospital, 9 (May)

REHABILITATION

Computerized walking, 12 (Jul)

Nursing problems of the paraplegic

patient as seen by the nurse, (abst).

(Lindstrom), 53 (Nov)

Symbol for disabled, 15 (Mar)
This nurse coordinates patient services.
(Kotlarsky). 33 (Jul)

REID, Alma

Retires as Director. McMaster University.
School of Nursing, (port), 15 (Jun)

REID, Helen Evans

Bk. rev.. 44 (Jan)

Something to say... and how! 52 (Mar)

RESEARCH

Federal grant for CM HA. 5 (Jan)
Government rejects CNA project. 5 (Jan)
Nursing practice subject of seminar. 16

(Nov)
Nursing Studies wanted. 47 iDecl
Report urges special committee on nursing

research be set up. 7 (Aug)
Research session sparks enthusiasm. 1 1
(Aug)

Special committee on nursing research to
be established by CNA. 9 (Dec)

RESEARCH ABSTRACTS

41 (Jan). 58 (Mar). 54 (Apr), 42 (Jul),
56 (Sept), 44 (Oct), 52 (Nov)
(Dec.

REYNOLDS, Laura

Honary membership SRNA, 21 (Nov)

RICKS. Mona C.

Assistant editor. The Canadian Nur.se,

(port). 22 (May)
Bk. rev.. 46 (Jul)
Continuing to care — even in the air, 33

(Nov)

On the edge of a cliff, 40 (Dec)
Practical nursing, (editorial). 3 (Sep)
Maritimers have a TV nurse, 33 (Sep)

RIDE, Winnifred M.

Australian visitor in Ottawa, (port). 15
(Jun)

RIGGS, Nancy Elizabeth

Instructor. Queen's University. 19 (Dec)

RILEY, Marilyn Smith

Assistant professor. Dalhousic University.
18 (Dec)

The effect of working conditions on
nursing care in eight hospitals as per-
ceived by general staff nurses and
patients, (abst). 52 (Nov)

RITCHIE, Judith Anne

Fantasy in the communication of concerns
of one five-year-old hospitalized girl,
(abst). 59 (Mar)

ROACH, Marie Simone, Sister

Toward a value oriented curriculum with
implications for nursing education,
(abst), 56 (Sep)

ROBERTS, Kay G.

Discrimination — that's what I call it! 44
(Sep)

ROBERTSON, Gertrud%

Director of Nursing

Service, Royal
XV

Columbian Hospital. New Westminster,
(port). 23 (Apr)

ROBERTSON, Jacqueline

Assistant Director of Nursing Service at
St. Boniface General Hospital. 22 (Aug)

ROBIDOUX-POIRIER, H.

Esophageal manometry, 37 (Dec)

ROBINSON, Linda

Instructor. Queen's University. 19 (Dec)

ROBITAILLE, Jean

First male nurse licensed to practice in
Quebec, (port), 10 (Feb)

ROSE, Shelagh

A split in the family. 3 1 (Apr)

ROSEN, Ellen L.

"Epidurals" are here to stay, (-Dillabough),
34 (Oct)

ROSS, Mary J.

Bk. rev., 57 (Sep)

ROVERE, Rita L.

In Indonesia with MEDICO, (port).
22 (Aug)

ROWLES, Dorothy

Executive assistant to the vice-president,
academic, at Ryerson, 16 (Jun)

ROWSELL, Glenna

Bk. rev.. 55 (Apr)

ROYAL CANADIAN ARMY MEDICAL
CORPS

RCAMC offers annual bursary. 17 (May)

ROYAL COLLEGE OF NURSES

British RCN requests review of abortion
act. 12 (Sep)

ROZOVSKY, Lome E.

Legal implications of nursing reviewed at
convention. 12 (Aug)

RYAN, Sheila

Associate Director of Nursing at Univer-
sity of Alberta Hospital, (port). 22 (Aug)

RYERSON POLYTECHNICAL
INSTITUTE

Offers three advanced nursing programs.
12 (May)

SABIN, Helen

Alberta nurse to represent CNA at ICN
seminar, 7 (Mar)

SAFETY

Don't rock the boat, 19 (Jul)
Females driven home, 19 (Jun)
Hazardous product symbols, 9 (May)
Night safety — a problem for nurses.
(Mitchell). 28 (Feb)

ST JOHN AMBULANCE

Lillian Pettigrew honored at investiture.

(port), 19 (Dec)
St. John's bursaries awarded to nurses.

XVI

15 (Sep)

ST. LAWRENCE COLLEGE

Teams with regional school of nursing,
14 (Apr)

STAFFING

Let's have permanent shifts. (Saunders),
21 (Jun)

SALARIES

CNA board of directors accepts second

ad hoc committee report, 9 (Dec)
Editorial, (Ricks), 3 (Sep)
MARN recommends $600 a month starting

salary, 10 (Jun)
"Million letter write-in" helps nurses'

campaign, 17 (Mar)
Newfoundland nurses reject government

wage offer. 20 (Sep)
Pay increase to nurses prevents strike.

14 (Dec)
Salary increase awarded to Nova Scotia

nurses. 1 1 (Oct)
Salary levels of Ontario Hospital workers

under fire. 9 (Sep)

SASKATCHEWAN REGISTERED
NURSES ASSOCIATION

D. Jean Passmore assistant registrar for

SRNA. 15 (Jul)
Elisabeth E. Hartig nursing consultant for

SRNA, 15 (Jul)
Hazel B. Keeler honorary membership,

20 (Nov)
New coronary teaching aid purchased by

SRNA, 14 (Oct)

SAUNDERS, Helen

Let's have permanent shifts. 2 1 (Jun)

SCHILLING, Karen von

Health care explored at McMaster

seminar, 14 (Nov)
Needed: a positive approach to the

mentally retarded, (port). 30 (Jun)

SCHOOL NURSING

Survey shows more schools employ full-
time nurses. 15 (Feb)

SCHUMACHER, Marguerite E.

Candidate for president-elect, 40 (May)
Issues CNA members face at 35th general

meeting. 33 (May)
President-elect of the Canadian Nurses'

Association, (port). 20 (Sep)

SEARLE (G.D.) CO. OF CANADA

Four public health nurses have been
awarded $500. scholarships. 25 (Mar)

SELLERS, Betty Louise

A study to compare the nursing care given
by professionally and technically
prepared nurses on a medical unit.

(abst). 41 (Jan)

SETHT, Saria

Assistant professor. University of Cal-
gary, 21 (Nov)

SEW ELL, E. Marie

Director of Nursing. New Mount Sinai
Hospital, (port). 23 (Sep)

SHAH, Kanchan Surendra

Nursing leaders meet. (port). 20 (Nov)

SHARP, Lillian

Bk.rev.. 58 (Sep)

SHARPE, Gladys

Life membership, (port). 22 (Nov)

SHEA, Hattie

Assistant professor. University of Western
Ontario. 17 (Dec)

SHEAHAN, Marion W.

Recipient of the Sedgwick Memorial
Medal. 17 (Feb)

SHEPHERD, Audrey-Elizabeth

A study of the attitudes of public health
nurses in a selected agency toward
direct patient care, (abst). 59 (Mar)

SHRUM, Kathryn

Lecturer, Queen's University, 18 (Dec)

SLAVENS, Myra K.

Speaker relates inservice education, job
satisfaction, 18 (May)

SLOAN, Harriet

On with new, out with the old, 17 (Nov)

SMALE, Shirley

Assistant professor, McMaster School of
Nursing (port), 22 (Sep)

SMALL, Muriel E.

Assistant professor. Queen's University,
19 (Dec)

SMALLPOX

WHO reports decrease in smallpox, 19

(May)

SMILLIE, Madeleine C.

Assistant Director, nursing division, To-
ronto, Department of Public Health,

22 (Nov)

SMITH, K. Marion

Assistant Director of Nursing, Surrey Me-
morial Hospital, Surrey, B.C.. (port),
18 (Oct)

Candidate for vice-president, 42 (May)

SMOKING

Discrimination — that's what I call it!
(Roberts), 44 (Sep)

For smokers only, (editorial), (Linda-
bury), 3 (Apr)

WHO bans smoking at its meeting, 17
(Apr)

SOCIAL SERVICE

A cake for Street Haven's fifth birthday,
8 (May)

SOUTH AFRICAN NURSING
ASSOCIATION

Life membership for Dr. Gladys Sharpe.

(port), 22 (Nov)

SPARKS, Elaine M.

Director of Nursing at Prince George
Regional Hospital, (port), 22 (Aug)

SPECIAL COMMITTEE ON POVERTY

Poverty is cause of illness. CNA tells
senate committee. 5 (Jul)

SPECIALISM

Changing horizons in psychiatric nurs-
ing. (Hyde) 49 (Mar)

Editorial. (Lindabury). 3 (Oct)

French nurses not being recruited as
physicians' assistants. 7 (Oct)

Specialization calls for nursing changes.
7 (Aug)

SPORTS

Winter isn't so very far away! (Williams),

48 (Nov)

STANOJEVIC, Patricia

Named assistant research and planning
officer, research and planning branch,
Ontario Dept. of Health, (port), 25

(Mar)

STARR, Dorothy S.

Distress Center — may I help you'' 41

(Sep)
Students have a right to make mistakes.

27 (Dec)

STEED, Margaret

Bk. rev.. 44 (Jul)

STEVENS, Karen R.

Lecturer. Univ. of Alberta School of Nurs-
ing, (port), 16 (Feb)

STINSON, Shirley M.

Deprofessionalization in nursing? (abst).

58 (Mar)
Nurse claims task force sees symptoms,
not causes. 16 (Dec)

STREET HAVEN

A cake for Street Haven's fifth birthday, 8
(May)

STREET, Margaret Mary

Forthcoming biography ofDr. Ethel Johns,
19 (Nov)

STUDENTS

Counseling students in a hospital school
of nursing. (Ogston). 52 (Apr)

The formulation of an instrument to eval-
uate performance of nursing students
in clinical nursing based on correlated
behavioral objectives, (abst), (Kerr),
58 (Mar)

Let students do work of RN, BC health
minister tells nurses, 5 (Jul)

Student nurses enjoy royal visit, 14 (Nov)

Students have a right to make mistakes,
(Starr), 27 (Dec)

Students nurses in U.S. show they "Give
A Damn", 13 (Jul)

A study of the withdrawal of nursing stu-
dents at the Saskatoon City Hospital
School of Nursing, Saskatoon, Saskat-
chewan, from September 1954 to Sep-
tember 1960. (abst), (Long), 44 (Oct)

US nursing students protest suffocating
education, 9 (Jul)

Use of part-time teachers benefits students
and faculty, (McPhail). 36 (Jul)

SULLIVAN, Patricia L.

Lecturer, University of Alberta, 19 (Dec)

SUNDSTROM, Helen

Coordinator of continuing education for
the MARN, 23 (Sep)

SURGERY

Cognitive functioning of patients under
stressors of impending and recent sur-
gery, (abst), (Pepler), 52 (Nov)

The Shouldice story, (Ferguson), 44 (Aug)

SUTHERLAND, N. S.

Bk. rev.. 46 (Dec)

SYMINGTON, Aileen

New in psychiatry: moditen injectable
therapy and follow-up care. 2 1 (Jan)

TASK FORCE ON THE COST OF
HEALTH SERVICES

CNA board of directors accepts second
ad hoc committee report. 9 (Dec)

CNA wants nurse on task force com-
mittee. 15 (Aug)

Nurse claims task force sees symptoms.

not causes. 16 (Dec)
Progress report issued on implementation

of health costs report. 13 (Aug)

Recommendations. (Lindabury). (editorial),

3 (Feb)
Special report, 23 (Feb)

TAXATION

CNA submits proposals for tax reform
to Minister of Finance. 10 (Dec)

TAYLOR, Effie

Died in Hamilton, May 20, 21 (Aug)

TAYLOR, Elizabeth Ann

A study of selected factors affecting the
communication process employed by
general staff nurses in eight hospitals in
referring patients with a long-term ill-
ness to the community setting, (abst),
54 (Nov)

TAYLOR, Helen D.

Bk. rev., 43 (Jan)

TAYLOR, Susan D.

Appointed acting executive director,
American Nurses Foundation, 26 (Mar)

TEACHING

Adapting instruction to individual differ-
ences, (Mclnnes), 43 (Mar)

New coronary teaching aid purchased by
SRNA, 14 (Oct)

Teachers — you are trespassing! (Meso-
lella), 21 (Jul)

Teaching problems discussed at RNAO-
OHA conference, 8 (Jan)

The teaching role of the staff nurse, (abst).
(Muldoon), 42 (Jul)

TELEVISION

Maritimers have a TV nurse, (Ricks). 33
(Sept)

TV medical hour, 23 (May)

TESTS AND MEASUREMENTS

An invitation to a checkup, (Dier) 34
(Feb)

Screening newborns assists disease pre-
vention programs, 16 (Nov)

TIME AND MOTION STUDY

Time-study results surprise VON, 26 (Nov)

TOD, Louise

Issues CNA members face at 35th general
meeting, 33 (May)

TORONTO GENERAL HOSPITAL

RNAO publishes statement about TGH

senior nurses, 1 1 (Feb)
Three senior nurses leave Toronto General

Hospital. 9 (May)

TRACHEOTOMY

Tracheotomy suctioning technique,
(Kearns). 44 (Feb)

u

UNICEF

Editorial. (Lindabury). 3 (Mar)

On with new. out with the old. 17 (Nov)

UNIFORMS

Midi or pantsuit'.' 26 (Nov)

Nurses seek comfort, style. 1 1 (Dec)

UNIVERSITY HOSPITAL, SASKATOON

Decentralized nursing service. (McKillop),
36(Jun)

UNIVERSITY OF ALBERTA

Appointment of three lecturers. 19 (Dec)

CNA librarian consults with nursing li-
brary staffs. II (Dec)

New staff members. 16 (Feb)

Summer help for nurses in the north. 21
(Sep)

UNIVERSITY OF BRITISH COLUMBIA

UBC family practice unit involves nurses,
21 (Mar)

UNIVERSITY OF CALGARY

Accepts its first class of nursing students,

16 (Dec)
New appointments, 21 (Nov)

UNIVERSITY OF MONTREAL

University of Montreal receives health
resources contribution. 14 (Feb)

UNIVERSITY OF WESTERN ONTARIO

Appointments. 23 (Apr) 17 (Dec)

Faculty of nursing at UWO celebrates

50th anniversary. 14 (Dec)
To offer new nursing program. 12 (Feb)

VANCOUVER GENERAL HOSPITAL

A head nurses' association takes action, 29

(May)

VICTORIAN ORDEROF NURSES

Director reviews changes in past ten years,

XVII

6 (Jul)
Gail Dronyk appointed nurse-in-charge.

VON, Owen Sound, 19 (Dec)
New look for VON, 8 (Jan)
Nurses meet the Prince, 23 (Aug)
Time-study results surprise VON, 26 (Nov)

w

WADSWORTH, Patricia Mary

Staff training coordinator, Vancouver
General Hospital, (port). 23 (Apr)

A study of the perception of the nurse and
the patient in identifying his learning
needs, (abst), 56 (Sep)

WALKDEN, Jean

PrinzmentaPs variant angina in a coro-
nary unit, (Dolman), (Paget), 23 (Jun)

WALKER, Karen V.

Bk. rev.. 46 (Dec)

WALLACE, Eileen Patricia

Lecturer, Univ. of Alberta, School of
Nursing, (port), 16 (Feb)

WALLACE, J. Douglas

Executive director, Canadian Medical
Association, (port), 23 (Sep)

WALLACE, Sarah A.

Retired, senior nursing consultant in occu-
pational health services, Ontario Depart,
of Health. 24 (Mar)

WALPOLE, Peggy Ann

A cake for Street Haven's fifth birthday, 8
(May)

WALTERS, Juditii

NBARN scholarship. 19 (Dec)

WEBER, Elizabeth

Lecturer, University of Western Ontario,
18 (Dec)

WEBER, Kirsten

Assistant professor U.B.C. School of Nurs-
ing, (port), 13 (Jan)

WEDGERY, Albert W.

One standard — or two? 27 (May)

WEILER, Doris

Bk. rev., 47 (May)

WITHMORE, Mary Anne

A study of communicative behavior in
young hospitalized children, (abst), 54
(Apr)

WHITLAM, V.

The autistic child. 44 (Nov)

WIEBE, James H.

Director Medical Services Branch De-
partment of National Health and Wel-
fare, (port), 22 (Apr)

WILLIAMS, B.

Winter isn't so very far away! 48 (Nov)

WILLIAMS, Ivan

Hospital nursing and the demand for
XVIII

change, 38 (Jul)

WILLIS, Lucy D.

Director of the School of Nursing, Univ.
of Saskatchewan, (port). 17 (Feb)

WILLIS, T.

Monitoring the mother and fetus during
labor, 28 (Dec)

WILSON, Jean Scantlion

Died April 8, (port), 22 (May)

WILSON, Peggy (Keith)

Lecturer, University of Alberta, 19 (Dec)

WINNIPEG GENERAL HOSPITAL

Announced two appointments, 22 (Apr)

WINSLOW, Mary, Sister

Life member. New Brunswick Association
of Registered Nurses, 23 (Sep)

WISE, Mary A.

Assistant Professor, University of Calgary,
2 1 (Nov)

WOMEN

Advertisers look to women. 24 (Dec)

WOMEN — EMPLOYMENT

Female graduates spurned. 15 (Feb)

WOMEN' COLLEGE HOSPITAL,
TORONTO

Cancer detection clinic, (Cracknell), 37
(Apr)

WONG, Yim

NBARN scholarship. 19 (Dec)

WOOD, Vivian

Examining student nurses' problems by
the case method, 3 1 (Feb)

WORLD FEDERATION

NEUROSURGICAL NURSES

Neurosurgical nurses from world federa-
tion, 8 (Jul)

WORLD HEALTH ORGANIZATION

Bans smoking at its meeting, 17 (Apr)
Nursing leaders meet, 20 (Nov)
Reports decrease in smallpox, 19 (May)

WRITING

Catchy heads, 19 (Jun)

Something to say . . . and how! (Reid), 52

(Mar)
Watch those writing rules, 2 1 (Feb)

WROOT, Brenda (Brayston)

Lecturer, University of Alberta, 19 (Dec)

XAVIER, Mary Clara

Nursing leaders meet, (port), 20 (Nov)

YELLOWKNIFE REGISTERED NURSES
ASSOCIATION

Nurses at Yellowknife form association,

6 (Jan)

YOUNG, Rachel

Kelircd as Assistant Director of Nursing.
Alherla Hospital. Kdnionlon. 18 (Dec)

ZILM, Glennis

Bk. rev., 47 (May)

\

/

A\

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.

Lakeside Laboratories (Canada) Ltd.
64 Colgate Avenue • Toronto 8, Ontario

'Traddfenark

Medical references that open
wider liorizons to tlie inquiring nurse

Guyton: TEXTBOOK OF

MEDICAL PHYSIOLOGY

Offers solid help In all aspects of physiology. Includes such
topics as: respiratory insufficiency, dietary balance, infection,
the normal electrocardiogram. By Arthur C. Guyton, M.D. 1100
pp. 757 illust. About $20.00. 4th Edition. Ready Jan. 1971.

Sodeman & Sodeman: PATHOLOGIC

PHYSIOLOGY

Presents o dynomic clinical picture of drsease resulting from
physiologic disturbance or dysfunction. An authoritative account
of the "hows" and "whys" of disease. By William A. Sodeman,
M.D. and William A. Sodeman, Jr., M.D. 1051 pp. 312 illust.
$20.55. 4th Edition. May, 1967.

Nelson, Vaugban TEXTBOOK OF
& McKay: PEDIATRICS

Here is the 9th edition of the "bible of pediatric care."
This revised edition covers topics ranging from eczema to
cardiovascular problems. Edited by Waldo E. Nelson, M.D.;
Victor C. Vaughon III, M.D.; and R. James McKay, M.D. 1590
pp. 527 illust. $23.25. 9th Edition. Aug. 1969.

Ge///$ & CURRENT PEDIATRIC
Kagan: THERAPY 4

A detailed guidebook on current methods of pediatric therapy.
Here you will find virtually every disease, disorder, accident,
emergency and emotional illness likely to be encountered.
By Sydney S. Gellis, M.D. and Benjamin M. Kagan, M.D. 1077
pp. $29.20. Volume 4. Jan. 1970.

Lynch et al: MEDICAL LABORATORY
TECHNOLOGY AND CLINICAL PATHOLOGY

Provides expert guidance in procedures for every clinically im-
portant test. Discusses physiologic mechanisms behind test results.
By Matthew J. Lynch, M.D.; Stanley S. Raphael, MB.; Leslie D.
Mellor, L.C.S.L.T.; Peter D. Spare, F.I.M.L.T.; and Martin J. H.
Inwood, B.Sc. 1369 pp. 590 illust. $24.85. 2nd Edition. July, 1969.

Healey: SYNOPSIS OF

CLINICAL ANATOMY

This practical text-atlas presents concise, well-balanced and
simplified descriptions of regional anatomy, and includes clinical
information on disorders common to coch particular region.
By John E. Healey, Jr., M.D. 324 pp. 671 figs, on 139 plates.
$19.45. May 1969.

Flint & Cain: EMERGENCY

TREATMENT

Offers precise instructions for quick evaluation and on-the-spot
care for over 100 medical emergencies ranging from sunburn
to frostbite; from diabetic coma to acute poi-soning. By Thomas
Flint, Jr., M.D. and Harvey D. Cain, M.D. 733 pp. Illustd.
$12.45. 4th Edition. May, 1970.

American College MANUAL OF PRE- AND
of Surgeons: POSTOPERATIVE CARE

A concise, well organized guide to techniques for management
of surgical patients. By the American College of Surgeons
Committee on Pre- and Postoperatiye Care. Editorial Sub-Com-
mittee: Henry T. Randall, M.D., Chairman; James D. Hardy, M.D.;
and Francis D. Moore, M.D. 506 pp. Illustd. $9.20. June 1967.

DORLAND'S POCKET
MEDICAL DICTIONARY

A standard authority for more than 60 years, this classic
reference is a "must" for all in the medical sciences. Based
on Dorland's Illustrated Medical Dictionary. 7/5 pp., 16 pp.
full color plates. Thumb indexed. $6.75. 21st Edition. April,
1968.

Jablonski: DICTIONARY OF EPONYMIC
SYNDROMES AND DISEASES

A reference to nearly 10,000 cponyms and synonyms used to
designate over 2,500 syndromes and diseases. Includes signs
and symptoms, etiology, pathology, metabolic factors, genetic
traits. By Stanley R. Jablonski. 335 pp. 152 figs. $13.80. Oct.
1969.

W. B. SAUNDERS COMPANY CANADA LTD. 1835 Yonge Street, Toronto 7, Ontario

Please send on approval and bill me:

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