how the schools are meeting this need

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How the Schools Are Meeting This NeedAuthor(s): Harriet BaileySource: The American Journal of Nursing, Vol. 28, No. 5 (May, 1928), pp. 505-507Published by: Lippincott Williams & WilkinsStable URL: http://www.jstor.org/stable/3408213 .

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HOW THE SCHOOLS ARE MEETING THIS NEED

How the Schools Are Meeting this Need' BY HARRIET BAILEY, R.N.

SOME of the criticism directed against nursing practice today is that the service lacks the human

spirit-that the nurse is too apt to regard the patient as a case falling into this or that classification and for whom certain definite procedures and treatments are to be carried out. While we have been emphasizing the value of instruction in the funda- mental sciences, to the end that all the ministration to the patient may be on a sounder basis, we have not always placed as much emphasis upon the study of the patient himself-his adaptation, his behavior, his emotions, or the content of his thought. In other words, we have not in all in- stances helped the student to understand the patient.

Far too often the young, inexpe- rienced nurse is having to care for a group of patients, in number far in excess of that to which she can give real nursing care. The multiplicity of other duties, representing the exi- gencies of the nursing service, leave

scant time for really observing the patient-noting his reactions, his moods, his anxieties, etc. The student becomes proficient in observing, reporting, and recording changes in temperature, loss of appetite, pain, or headache. She has not been equally well instructed in the interpretation of mental symptoms and the relation of physical manifestations to mental causes. Dr. Macfie Campbell has characteristically

. said: " An upset

stomach may be due to inability to digest food. It is just as likely to be inability to digest a situation."

Many years ago, the need of instruction in nervous and mental nursing was felt. Against a great deal of oppo- sition, this was finally made a required course and included in the subjects for the State Board Examinations for Registered Nurse. Because it was an unwelcome subject, it was taught indifferently in many schools for many years. Physicians who had little experience and not a great deal of interest, gave the lectures. No one followed up this instruction with the application to the nursing.

Gradually, over a period of more I Read at the annual meeting of the New

York State League of Nursing Education, October, 1927.

MAY, 1928

505

damming up of energy, this energy is thrown into the other channel, causing overactivity of that branch of the stream.

Even a brief course in psychiatric nursing will do much toward helping the nurse to understand her own reactions to many situations which may arise. To have gained some knowledge of the conditions which cause mal- adaptation in others and to have seen the outcome in concrete form, will assist

her in understanding and aiding all mal- adjusted individuals as well as being of benefit to herself in helping to maintain a sane and balanced attitude toward her own problems and difficulties. When understood, maladjustments may often be righted. Machinery needs care in order to maintain a high degree of efficiency. How much more then does the human mechanism with all the demands made upon it, need understanding and guidance!



506 THE AMERICAN JOURNAL OF NURSING

than ten years, this condition has been changing. Due to the facts disclosed by the examinations of our soldiers during the war, the increased activity of the National Committee for Mental Hygiene, and the state and local com- mittees, the subject of mental hygiene has received a tremendous impetus. This is being reflected in the standard of teaching in our schools of nursing. Physicians who have not had special experience in the treatment of mental patients are no longer willing to give instruction, but are assisting the prin- cipals to secure the co6peration of physicians who are qualified.

In Buffalo, Rochester, Brooklyn, and Utica, a considerable number of schools in general hospitals now send all their students to the state hospitals for this course of instruction. In other schools, where the transporta- tion is a problem, the state hospital codperates by sending one of its staff to give the course of lectures. Usu- ally, during the course or at the close, the group of students is taken for one or two afternoons to the state hospital when, under the supervision of the principal and the physician, the students meet the patients and observe their care and treatment. Two state hospitals receive the students from the general hospitals for a whole day. Another state hospital received a group of ten nurses, for one week, for an intensive course of instruction. A staff physician gave the lectures and clinics, the principal and her assist- ants demonstrated the nursing care, and the social service worker also instructed them with reference to the follow-up work for the patient who has left the hospital.

Six schools offer three-months' affiliations in the care of nervous and mental patients as an elective course. The affiliations are with Bloomingdale Hospital, Rochester State Hospital,

and Butler Hospital, Providence, Rhode Island. Two schools supple- ment their medical experience by an affiliation in this branch, one with the Rochester State, the other with Butler Hospital.

There are four general hospitals in this state in which there are registered schools, which make provision for the admission of psychiatric patients. In these schools, this experience is an integral part of the basic course. The mental hospitals will always offer rich opportunity for experience. Much progress has been made in providing adequate classrooms, instruction, and supervision of the students. The problem of adequate housing has been a handicap in developing this opportunity for affiliating sttidents for general hospitals.

That this instruction is not being given satisfactorily in the very large number of schools is evidenced by the appeals for assistance which come to the office. Particularly, do the prin- cipals feel the need of securing a nurse instructor who not only can correlate the nursing but also utilize for dem- onstration all those opportunities which even the small hospital may present.

In contemplating the future of nursing education, must we not give more consideration to including experience in this branch? How much longer are we going to require instruction, without experience, or even adequate instruction in the nursing? It is so manifestly unsound from the educational standpoint. As well might one accept a course of lectures in obstetrics or medicine, as meeting the educational requirement. There is a special technic, if you please, to be employed in the care of borderline and frank mental conditions, which no amount of classroom instruction can possibly give the student.

VoL. XXVIII. No. 5



HOW THE SCHOOLS ARE MEETING THIS NEED 507

The prejudice against this type of nursing is rapidly disappearing when- ever knowledge replaces ignorance. Is it not significant that students are requesting this experience, either as undergraduates or postgraduates? Some time ago the special hospitals which have been approved for this experience reached their limit in ad- missions.

The value of this experience is no longer questioned. In closing, I am going to give you two statements to corroborate this:

A director of a large public health nursing association, who has had many years of experience and many opportunities to observe the results of our preparation of the students said that instantly she could single out the nurses who had had experience in the care of mental patients. These nurses always made so much better contacts with the patients and their observations were more inclusive.

Another is from a student.

I wish I could have a longer assignment in the psychopathic clinic. I am just beginning to learn something. The work in the general hospital is not nearly as interesting. Some- times there doesn't seem to be anything to do, the patient stays in bed and does everything else he is told. But for the patient who is mentally ill, there is something to do all the time and one's wits must be constantly at work. I feel it has been the very best part of my training.

Shall not one of our immediate aims in education be to provide opportunity for experience in this branch of nursing so that "all those who are sick in soul may be ministered unto more understandingly? "

Getting the League Proceedings

EACH autumn and winter bring letters of this type to Headquarters: "I did not

receive my Proceedings of the National League of Nursing Education. Will you please send me a copy?"

The League cannot guarantee copies of the Proceedings except to those members who have paid their dues for the current year by the close of the Convention. Immediately after the Convention, preparation begins on the manuscript, and the order for Proceedings is placed with the printer in accordance with the paid-up membership at that time. A small margin is allowed for special requests but it is obvious that provision cannot be made for an uncertain number of members who may later forward their dues.

If you reside in a state where no State League exists, as an individual member, send your dues directly to the treasurer of the Na- tional League of Nursing Education, Marian Rottman, 440 East 26th Street, New York City. If you reside in a state where there is a State League, send your dues to your State League treasurer and she will forward the National quota to the National League treasurer.

Sources of Vitamins for Young Children

ORANGE juice is the best for them and is now recommended by physicians where-

ever the fruit can be obtained. Tomato juice is the other best source of vitamin C for in- fants. There is no preference between orange and tomato juice and you can safely choose the one which you can get most conveniently. The tomato is a vegetable which has just come into its own during recent years. Modern investigations have shown it to be a very rich source of at least three vitamins, A, B, and C. Tomatoes which are marketed in large cities are often gathered while still green and allowed to ripen artificially. These have much less vitamin C than those which are left on the vines to ripen in the air and sunlight.-From an article by Dr. E. V. McCollum and Nina Simmonds in McCall's Magazine.

MAY, 1928



how the schools are meeting this need

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