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Nursing in New Zealand: History and Reminiscences

Chapter XVI. — Back-Block District Nursing

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Chapter XVI.
Back-Block District Nursing.

Dr. Valintine, before taking up his Government appointment had been practising in the country, and well knew the difficulties of the far back settlers in case of illness or accidents. Near to his heart, was the establishment of a nursing service for these people; I fully sympathised with him in this, and was of course, prepared to help him.

Dr. Valintine outlined a scheme shortly as follows:—If in any part of a hospital district, the need of a nurse is felt, the settlers of the district who are already contributing to the hospital funds by the rates, have only to make an application to the board of the hospital, accompanied by a guarantee of a certain proportion—not more than half of the necessary salary and expense of a nurse—to have a nurse sent among them. Provisions had been made in the Hospitals and Charitable Institutions Act, 1909, giving hospital boards power to devote their funds supplemented by the Government subsidy to providing nurses for the care of the sick outside their institutions. So settlers could have their share of some of the benefits for which they contribute their share, but are too far from the hospitals to make use of.

The first Hospital Board to appoint a nurse for their country district was one with which Dr. Valintine had been associated while a private practitioner, and was the New Plymouth Hospital Board.

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The settlers of a little country place called Uruti made the necessary application and on the 14th August, 1909, Nurse Bilton, who was selected, commenced duty and immediately she arrived there she was sent for to attend a child with pneumonia.

She was attached to the staff of the New Plymouth Hospital, and the kindly matron, Miss Brown, told her she was to look upon the hospital as home, and when free to look upon the Nurses' Home as hers.

At this time a cottage was not provided for the nurse, who had lodgings in a home of a resident. Later on a nice little cottage was built with a room attached for an emergency case. Plenty of need for the nurse was soon manifested and she had long trips by coach, for cases of illness, which if they were serious she would bring into the District Hospital.

Thus was inaugurated the scheme of “back block nursing,” which now has extended throughout the Dominion. Few hospital boards there are which have not a district nurse to attend to their district cases, often a small cottage is provided with a bed or two for emergency cases. In the early times the nurse had many hardships to encounter, long lonely rides through the bush, rivers often to ford, outbreaks of typhoid for which camp hospitals had to be organised, and I fear she had little comfort when not at work. They were brave women who took these positions. I used to visit them when possible, but as a rule my office duties and hospital inspections did not allow of the time to go long journeys to see one nurse. Very welcome were visits from headquarters, and later on when more nurse inspectors were appointed to my staff, visits were more frequent. Also, as time went on roads improved, and more transport became possible which all page 88 made the district nurse's work more pleasant. Most district nurses now have motor cars.

In the nurses' journal are many accounts of this back-block nursing.

Linked with this work, but more immediately under the department's control, was a system of nursing for the Maoris. Nurses were appointed by the Government and stationed in or near Maori settlements to nurse the natives when ill, and to instill into them some knowledge of hygiene and sanitation. The pahs were quite devoid of the latter, but it is wonderful what good work the nurses and also the sanitary inspectors of the department have accomplished. The natives had a great objection to hospitals and it was exceedingly hard to persuade them to send their people in, they would take them away to the bush and hide them if they expected a visit from the Native Health nurse, or from an inspector. It took years to overcome their fear or prejudice and outbreaks of infectious diseases such as typhoid, were common. Now, partly owing to innoculation, and partly to the better sanitation of the pahs, which need constant supervision, such outbreaks are almost unknown.

An assistant inspector was appointed to the Auckland district in 1908, and at the time, one of her chief duties was the supervision of the work of the Native Health Nurses and she was called “Superintendent of Native Health Nurses.” Nurse Amelia Bagley, who was trained at the Dunedin Hospital was appointed, and remained in office until 1930. She was a most loyal officer to me, and we worked together in the greatest harmony until my retirement. She personally started some of the native health districts, notably the cottage hospital at Te Araroa, where she remained for some months, until a permanent nurse was sent. She had a great deal to do with the page 89 camp hospitals, getting equipment for them, finding suitable nurses and supervising them generally.

Later the work in the Auckland district grew so much that it was necessary to have an assistant.

Also connected with the Native Health Nursing was a system established before I joined the department, but in the development of which I had a great deal to do. This was the training of Maori girls as nurses with the view to their working among their own people. The plan was shortly, this:—In the schools established for native girls, any recommended as suitable by the head mistresses, and who wished to undertake the work of nursing, were sent for a year as day pupils to an adjacent hospital, the Education Department keeping them for this time and allowing them a small sum for books and clothes. Afterwards, if satisfactory and showing aptitude, they were taken into hospital to commence their regular training. Only a few hospitals were willing to co-operate in this scheme, and sometimes it was difficult to find vacancies for these girls.

The principal colleges for Maori girls were at Auckland and at Napier, so the hospitals in these towns took the day pupils and often carried on the whole training If no vacancy at these hospitals occurred, I had to try to place the girls at others. Wellington Hospital took a few, also Palmerston North, Invercargill, Waikato; and some very fine and capable nurses were turned out. They passed the same examination as the Pakeha girls. Nurse Akenei Hei, trained at Napier Hospital, who was an exceptional woman, and was doing fine work among her own people when she contracted typhoid from a nephew she was nursing, and died. She was a great loss to her race. I remember spending a day with her at Gisborne, when she drove me in her little buggy out to the home of a page 90 relative, where I had a real Maori dinner cooked in a hangi. A hangi is a hole in the ground lined with large stones. Over the stones a fire is lighted, and when they are thoroughly heated the ashes are removed, the food put in, first a circle round of eels, then potatoes and kumara, and other vegetables, then the meat. All is then covered over with mats held in place by stones and left to cook. A very tasty meal too!

Other Maori nurses were appointed to districts, at first under Pakeha nurses until they gained experience and proved themselves; later, as nurses in charge of their own districts. Some remained on the staff of their training schools and proved satisfactory; one I remember in charge of the operating theatre—a very responsible post.

On the whole, however, the young Maori women have not shown themselves keen to take up the profession of nursing, and after their general education, return to their homes and relapse into their old native ways. Many marry, and some of these have been very helpful to the health nurses, especially in times of epidemic.

There is no doubt the Maori nurses had more difficulty in establishing any influence over the natives than the Pakeha nurses, and it has not been possible to leave this work entirely to them.

While writing of district nursing in the country, I must not omit some mention of the work carried on for the sick poor in the cities. The St. John's Ambulance took a great part in providing some attendance on the sick who were not requiring admission to hospital, such as chronic cases, who could well be nursed in their homes. In Wellington for many years, an old English nurse, Mrs. Sexton, carried on this work, at first alone and later with an assistant, Mrs. Martin. Mrs. Sexton page 91 was a well-known figure about the poorer part of the city. The organisation was under a special committee, the late Mrs. Moorehouse being president, and was greatly helped financially by the late Mrs. Rhodes. It is still carried on under the St. John's Ambulance and a special committee and does excellent work with three nurses on the staff for whom the association is providing some special matron allowance.

In Dunedin there is a similar organisation, also in Auckland and in many of the towns a nurse is maintained either by St. John's or by the Hospital Board.

Only in Christchurch there is a departure from this system. A very active District Nurse Association was started in 1898 by Miss Maude, Matron of the Christ-church Hospital. She felt the call to nurse the sick poor and gave up her hospital appointment for this purpose, being assisted by Mrs. Heaton Rhodes who promised her £100 a year. Nurse Maude herself was for a time the only nurse. As the city grew and the sickness and poverty also grew, so did the little District Nursing Society. A committee was appointed and helped to raise funds. Some Government help was given by subsidies and the Hospital Board took on some responsibility, but through all it was always known as Nurse Maude's District Nursing Association. Nurse Maude herself resides at the headquarters in Madras Street and supervises a staff of nurses. Relief in food and clothing is given from this depot and very wisely the recipients of help are expected to pay some small sum for what they receive. A loss to the Society was the recent death of Lady Rhodes whose help and sympathy had encouraged Nurse Maude to start her great work. In connection with this also Nurse Maude had started a camp with shelters for tuberculosis patients, long since supplemented by the Cashmere Hills Sanatorium.