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Chapter XX.
Affiliated Training.

A defect in the Nurses' Registration Act of 1901, and a serious one, was the permitting of small hospitals to train probationers. When the Act was first drafted by Mrs. Grace Neill and Dr. Macgregor, it was desired to limit training to hospitals of 40 beds, but political influence defeated this proposal and no limit was set. Some excuse for this was in the sparse population of the colony in those days and the necessity for small hospitals in country places. It did not interfere greatly with the standard of nurse training, as the number of probationers coming from very small hospitals was very few. Also, as transport was difficult, the small hospitals often had to deal with serious cases, such as now are usually sent on to larger and better equipped centres, and nurses in these hospitals had the opportunity of helping with every step in the treatment of the cases, and of having to assume responsibility much earlier than girls in the large hospitals.

However, it appeared to me that it would be much to the advantage of both the small and the large hospitals to have a plan of affiliation for training. With the approval of my chief, I drafted out a scheme by which the hospitals in each district would be linked together as one training school. For instance, the Wairarapa Board, which was the first to adopt the scheme, constituted the Masterton Hospital its base hospital, with Greytown and Pahiatua as subsidiary hospitals. Probationers to commence their page 101 course at Masterton, and after a certain time to be sent for three months or six months to Pahiatua and Greytown, returning to finish their course at Masterton. This scheme was adopted by several other Boards, and in a limited degree has been carried on, but it has been hampered by non-co-operation between the matrons of the two classes of hospital. The smaller hospital matron always thinking she was put off by having the least desirable probationers sent to her, and the wish for independence of the local Hospital Committee.

The Nurses' and Midwives' Board has been able since my retirement to close many of the small places as training schools altogether, and to lay down regulations for affiliated training with more authority than under the first Registration Act was possible. This, of course, is outside the scope of my recollection, so I will not go into details, but a chapter at the end of this volume contains details of present regulations.

At one time there was a shortage of trained nurses in New Zealand, and it was then necessary to take every opportunity of training the women who were working in hospitals, and so the smaller hospitals could not be debarred from teaching their probationers, and our department could not forbid their sitting for the State examination, and if successful in passing it, their being registered as qualified nurses. I can say, too, that some excellent nurses came from these little hospitals.

However, about 1912, there was such a shortage of trained nurses for hospital positions, and for the district work so recently started, that it was decided to get some nurses out from Home. An invitation was sent by the Inspector-General for twelve nurses to come out at their own expense and to be guaranteed positions on arrival. A page 102 very large number of applications was received, and the twelve nurses were selected by the British Women's Emigration Society.

It was intended, if the nurses turned out satisfactory, to invite more to come out from time to time on the same conditions.

They were required not so much for the larger hospitals, but for the little country places, and for back-block district work.

The first twelve who arrived were rather disappointing; only one remained permanently at work in New Zealand, and is still here. Of the others, some married and some returned to the Old Country after a short time. I felt that the scheme was not a success, and we did not renew the invitation.

As a matter of fact, the necessity became not so pressing, as twice a year the increasing number of girls coming up for the State examination provided enough qualified nurses for all requirements.