Nursing in New Zealand: History and Reminiscences
Chapter VI. — Hospital System and Early Hospitals
Hospital System and Early Hospitals.
Here I think it would be well to give a little resume of the hospital system in New Zealand, the training of nurses, and the history of the early hospitals, so far as I can do so mainly from recollection.
The hospital system is laid down by Act of Parliament and the finance is based on rates raised in the various districts and subsidised by the Government. The Government, on account of the payment of subsidy, the amount of which has varied from time to time, to the rates collected, the donations and subscriptions, possesses a share of responsibility in the management of the hospitals. It is laid down by Act of Parliament what authority the Government by its Department of Health can exercise, and what check it can hold over the Boards in their administration of these funds. New buildings must be authorised by the Minister of Health, plans must be approved and the raising of loans for building must be approved, appointment of administrative officers, such as medical superintendent, matron, and secretary must be confirmed. The hospitals are under inspection by officers of the Health Department, under the Nurses' Registration Act, those hospitals recognised by the Nurses' Board must comply with the regulations for the training and State examination of nurses.
The whole Dominion is partitioned off into districts in which one or more hospitals are established, and to page 42 manage which the ratepayers elect bi-annually a Board composed of men and women interested in philanthropic work.
The system of charitable aid for the poor is incorporated with the hospital system, the Boards being charged with the dispensing of relief in their districts from the funds collected by rates and subsidised by the Consolidated Fund; many of the Boards have old people's homes connected with, but not part of, the hospital. During the years of economic depression with much unemployment the dispensing of relief has been found too great a burden on the Boards, and they are now relieved of all but sick poor.
During the time I have been in New Zealand, there have been several amendments of the original Acts, and entirely new Acts for the administration of public health and hospitals. The last, brought in by Dr. Valintine in 1923, is considered by many authorities to be the best system for hospital administration in existence—New Zealand being a newly settled and small country is able to try out many things which, in an old country with many vested interests, would be impossible.
Although in the early part of my time in New Zealand I had a good deal to do with the inspection of charitable institutions other than hospitals, with enquiry into outside relief, with visiting homes for boarded-out children, and so on, much of which is now conducted by other departments, my chief interest was in the hospitals, and especially the training schools for nurses. I soon became acquainted with the matrons of the hospitals who, I found, were very ready to welcome visits of inspection, and, with few exceptions, I found that they were doing conscientious work, sometimes under difficult conditions. They were page 43 glad to have someone with whom to discuss their difficulties and who would fully understand them. I was a sort of safety valve for them.
I took an interest in the early history of the hospitals, and in 1910 was asked to write a short history of Nursing in New Zealand for the History of Nursing from the Earliest Times, by Miss Dock, who, with Miss Nutting, was the authoress of a most delightful and interesting book. This book brings up the story of nursing from centuries b.c. to the present time, and should be read by all nurses. In the fourth volume, to which I contributed the chapter on New Zealand, “Nursing in New Continents” is dealt with.
I endeavoured to get some particulars of the commencement of hospitals in New Zealand, but found it rather difficult to obtain authentic details. However, it may be interesting here to give a little of what I learnt.
In the beginning, when the Provincial Governments found it necessary to provide some hospital accommodation for the people, there was no system of nursing and no trained nurses. At that time, about 1850, the first hospital was established at Auckland, Auckland then being the seat of Government for the North Island. A lovely site was chosen and the present fine hospital is there. A very small building was erected with about ten beds for each sex. There were a master and matron, but no qualified nurse. At first it was a Government hospital, but in 1883, was placed under a committee partly elected by the subscribers. By that time there were hospitals in other parts of the islands, and a Government inspector was appointed to supervise all hospitals. Dr. Grabham's old reports are very interesting and are quoted in the History of Nursing.page 44
To resume about Auckland Hospital. Dr. Phylson was the first medical officer and held office for over 40 years. A tablet to his memory is in the hospital. He was succeeded by Dr. Mackellar, who was a very fine man, and even at the time I took office, was still interested in the hospital and in the training of nurses.
At last a trained nurse was appointed as superintendent and the real nursing of the patients commenced, a great change from the early days, when aged inmates were placed in charge of the primitive wards and expected to take care of the sick.
Miss Crisp was the first matron, she was trained at Netley and had seen active service in Egypt. On her appointment Dr. Mackellar advised a staff of female nurses for men as well as women, and five years later, the training school for nurses was established. The hospital then had about 100 beds. It has now 600.
At one time there was a maternity ward at the Auckland Hospital, when nurses were instructed in maternity work, but this was discontinued when the St. Helens hospitals were started.
Later matrons were Miss Squire, Mrs. Wootten, (whom some of the present generation of nurses will remember), Miss Peiper, who served in the South African War, and on her return was matron of St. Helens Hospital. She left Auckland Hospital on her marriage, and a Miss Griffiths, an English nurse, was appointed but remained only one year. Miss Orr, also from England, was then appointed on the recommendation of Mrs. Bedford Fenwick, and was there during the trying period of the war. She was succeeded by Miss Taylor and Miss Taylor by Miss Nutsey, a former trainee of the hospital, and one who served with distinction during the Great War.page 45
In Wellington a small hospital was established in Pipitea Street in 1846, but was later moved to the position it now occupies at Newtown. Wellington has the honour of being the first training school for nurses. In 1883 the old type of untrained nurse was supplanted by “probationers, drawn from a higher order of society,” under Miss Moore, the Lady Superintendent.
After Miss Moore came Miss Godfrey, who trained under Miss Moore, then Miss Payne, and under these ladies many of our best matrons and leading nurses took their course. Dr. John Ewart, who was medical superintendent for twenty years to 1908, was very keen on the training of nurses, and did much to establish a high standard. Though not opposed, as some of the hospital authorities were, to the State examination and registration of nurses, he was a little jealous of it, and would not hold the final hospital examination till after the final State examination was over, so that he could see the questions set, and have a somewhat higher standard for his own candidates. This was rather unfortunate, as sometimes a nurse would pass her State examination and be registered, and yet fail to obtain her hospital certificate. Sometimes, however the boot was on the other leg.
Now this is altered, and the hospital final certificate must be produced before a candidate can sit for her State examination.
The Wellington Hospital was the first to initiate the eight hour day system. In 1898, Dr. Kenny organised this somewhat on the lines of engineer's hours on board ship, and more or less it has been carried on since then, and extended to other hospitals. In a way it works out fairly equitably, but has never been very rigidly adhered to. By a provision in the Hospital and Charitable Aid page 46 Bill, 1909, it was made compulsory for nurses in training, but owing to the protests of the Trained Nurses Association, was not extended to the trained staff.
No doubt by initiating some limit to the working hours of nursing, which in other countries has in the past almost amounted to slavery, Dr. Kenny did good to New Zealand nurses, though I have never really approved of the division of time as practised here, especially that which allows of the nurses not commencing their duty till late in the day, when the temptation of being free and going out for the morning, sends them on duty already fatigued, and with the freshness of the night's rest already dispersed. Work first and play afterwards has always been my motto, and I feel sure that it is the natural thing to start the main duty of the day, before any amusement, otherwise the duty of nursing the sick becomes not so much the main object of a nurse's life as it should be.
The Christchurch Hospital was first built in 1862, and was carried on with a house steward, and housekeeper, some women nurses, not trained, but probably of higher class than the servants, and who treated the patients kindly. The building was a picturesque old gabled two-story erection, in wood, dark and ill-ventilated, and full of odd corners and corridors. The top stories for many years were used as lumber rooms, but had to be hurriedly put into action as wards again, when fire destroyed two more modern wards.
In 1885, the first trained matron was appointed; she was called trained, but had been only six months in a London hospital; this was Miss Palin. There were then 80 beds. In 1887, an attempt was made to train nurses, and the chairman offered a gold medal to the first nurse page 47 who trained, but there is no record to show who received it.
Two years later “the nursing system, one of the most essential features of hospital management,” the report says, “is well organised.”
Miss Maude, so well known for her great work in district nursing in Christchurch, was the matron in 1894, but subsequently resigned. Miss Ewart, who was trained in Belfast, succeeded her, and under her the school progressed, turning out many fine nurses. Miss Ewart, a little woman, who was an excellent nurse herself, set the example to her probationers, and was much loved and respected. She died in her old hospital in 1930. She was nursed by one of her old nurses.
She was matron for fourteen years, and was succeeded by Miss Thurston, a Wellington trained nurse, who was then matron of Greymouth Hospital.
The Christchurch Hospital is now a very fine hospital, with well-built, up-to-date wards, and theatre, and a beautiful nurses' home. Miss Thurston remained there, initiated many improvements, and largely helped in raising funds for a children's ward, a very beautiful building, until during the Great War, she went to England and was first matron of the War Contingent Hospital, and then Matron-in-chief of the Expeditionary Force, gaining her Royal Red Cross, and her British Empire Medal.
The Dunedin Hospital, although smaller than those in the other centres, is perhaps the most important, having the medical school of the Dominion.
The first building was in the middle of the town.
At first the hospital erected was ahead of its time and for over two years not one of its beds was occupied. Then it was used as a hospital for insane, as well as sick, but gradually the sick predominated.page 48
It was after the discovery of gold fields in Otago, in 1861, when immigrants were poured into Dunedin in ship-loads, that there was much demand for hospital accommodation.
The training of nurses was started in 1888, when lectures were given by the honorary staff, and an examination held at the end of twelve months. At this time the matron, Miss Burton, an estimable elderly dame, was quite untrained. When the question of giving lectures to the nurses arose, she said, “What do they want with lectures? I'll lecture them!” A very amusing article describing her experiences was written for Kai Tiaki by the first probationer in training.
Nurses at first were only placed in the women's wards. The first trained matron was Miss Edith Maw, who came from England in 1892, but she only remained a year, and in 1893, Miss Isabella Fraser, who trained in the Edinburgh Infirmary, and was a sister in the Melbourne Hospital, came to take charge. Miss Fraser was a fine matron, keen for the improvement of her hospital and the success of her nurses. She inspired them with the highest ideals of their profession, and was most highly respected and loved by those who appreciated her kindly motherliness, and were not afraid of her touch of asperity.
Miss Fraser was in office twenty years, and made many improvements; after her retirement, there were three matrons, two trained in the Old Country, and one at Dunedin. The fourth, now in office, is Miss Tennent, a Wellington Hospital nurse.