page 49

Chapter VII.
Visits to Mental Hospitals.

I mentioned above that shortly after I joined the department, the Inspector-General, Dr. Macgregor died. His death was sudden after a short illness, but the plans which he had unfolded to me after my appointment, must have been laid before the Government; very shortly the department was split into two; Dr. Valintine was made Inspector-General of Hospitals and Charitable Aid with me as Assistant Inspector, while the late Dr. Hay was made Inspector-General of Mental Hospitals. At that time there were nine mental hospitals entirely administered by the Government, with no boards or committees. They were maintained by the State, with the aid of payments by the patients. When the division came about I was relieved from the Mental Hospital work, but shortly after was invited to resume my work under Dr. Hay, and so with a short interruption, I continued visiting the mental hospitals, thus serving with two departments.

When in Dunedin on my second visit after Mrs. Neill's departure, I went out to Seacliff, a large mental hospital about an hour's journey from Dunedin. I found my visit was a surprise, as notification had not been sent of my re-appointment.

I can never forget my first meeting with Dr. Truby King. It was in the matron's room, where he had come to meet me. Here I sat and listened to a long dissertation on the training of nurses, while he paced like an angry page 50 lion in his cage, up and down the room. He seemed to be aggrieved that the nurses in his hospital could not be registered as the nurses of the general hospital were, and tried to maintain that the training they received was equivalent to that obtained in a general hospital. Although at that time I had little knowledge of the mental hospitals, I did know that very little experience of sick nursing was obtainable and of surgery, practically none. I endeavoured to get out my opinion, but vainly, and simply had to listen in silence. Anyone who has had an encounter with Sir Truby King will realise my position and that it was practically impossible to argue with him. During the year I worked in the Health Department, when I had at one time a good deal to do with the Plunket nurse work; I had many other meetings with Dr. King, and was several times hospitably entertained at his house at Seacliff, when he and his wife always made me welcome. On the first occasion after he had unburdened his mind regarding the training of nurses, he and the matron took me round the establishment, and I went on to lunch at his house.

I was often regretful that I could not go wholeheartedly into his scheme for baby welfare. Excellent as it was and good work as it undoubtedly has done, I have felt that he has arrogated to it the whole credit for the decrease of infant mortality, whereas it should be shared very largely by the State maternity hospitals, which trained midwives and instructed mothers in the care of their infants; and the Health Department which, by its dairy inspection, had ensured a supply of good milk, and by its sanitary inspectors, clean and healthy towns. I have felt also that the work of the Plunket nurses, already trained as nurses or midwives before taking their special page 51 course in infant care, might have been greatly extended and widened especially in country districts.

Financially, it seemed wrong to me that the services of these nurses should be given free to all classes of the community, and that those able to pay should not have contributed to the upkeep of the nurses.

The Plunket nurse system is known throughout the world and to Dr. King must be given the honour of drawing special attention to the problem of infant mortality and the means of prevention.

I have written a good deal about the general hospitals of the Dominion. The mental hospitals, especially those in or near to the chief towns, were large buildings set in extensive grounds, the cultivation of the gardens and farms being an occupation for many of the patients. They had the usual large dormitories, and recreation rooms, and courtyards set apart for different grades of patients. When I first became connected with this department, the question of a better classification of patients was being discussed, and during the years to follow, many improvements were made. Buildings for voluntary patients, some on the villa system, were put up, and an endeavour made to separate chronic patients from those who had a prospect of cure.

The patients were on the whole kindly treated, the female wards were under women, the male under male attendants, but of late years, women nurses have been placed in many of the male wards, and it has been found that the patients respond better to their influence, and are more obedient and quiet.

A system of training similar to that given under the Medico Psychological Society in England was started, and page 52 both nurses and the male attendants had to attend a course of lectures and pass examinations before they could obtain promotion.

One of my duties was, twice a year to conduct the oral and practical examination in nursing of these candidates at the various hospitals. This was a duty I did not enjoy, as I felt that the candidates had little opportunity to acquire much experience in nursing, some were not able to spend any time in the sick wards in which there were few patients. I felt that promotion in their own special work should be given entirely without reference to their being able to pass even a simple examination in work in which they could get so little practical experience. Occasionally I found, especially among the women candidates who, during an epidemic of typhoid fever, or during a season when bronchitis or pneumonia was prevalent, had some opportunity, some who had quite a fair knowledge of nursing, but this was necessarily confined to a few.