View report page

33
so continuous and so strenuous that no one but a school-nurse giving her whole time to the work should
ever be considered, and except for country districts nurses under voluntary societies or associations
should be out of the question. The nurse's work falls into four main groups, some of which have not
yet been fully developed, for reasons to be discussed later. These groups are — inspection of heads
for presence of lice (pediculi capitis) ; inspection of clothes and bodies for vermin (pediculi vestimentorum)
the detection and control of ringworm ; assisting the teacher with the nurse's knowledge and experience,
in sundry small questions that occasionally arise either in carrying out the medical officer's orders, or
in suggesting temporary procedure in cases of suspected outbreaks of infectious or contagious diseases,
scabies, ophthalmia, offensive discharges and so on. She can also often give temporary help to the
teacher in many small and doubtful points about school hygiene, such as open windows, damp feet
or clothes. Fault is found occasionally with the nurses but the complaint that they do not visit
the schools often enough comes in a hundred times more frequently than all other complaints put
together. Sentimental complaints about want of privacy in examining children are occasionally made,
but they are quite unreasonable. Anything like privacy in such work would, by doubling the time
taken, also double the cost of the work, not only for the nurses but also for the doctors. Cases which are
at all likely to require such private examination are exceptional and must always be left to the discretion
of the nurse or doctor by any reasonable parent. Children can only have their heads
inspected by taking them in large numbers. Where a case of suspected ringworm, or even so-called
scurfiness of the head is seen the child is put aside and examined after the others. The nurse uses
careful measures for asepsis after each of such suspected children. She is provided with permanganate
of potassium, with corrosive sublimate for a stronger disinfectant. She has also a powerful lens, and
forceps for manipulation of ringworm cases, and spirit lamp sterilizer for her metal instruments. Complaints
against the nurses usually come from parents whose pride has been wounded by the receipt of
a notice about vermin. Although in such cases the child is generally cleansed there is sometimes
opposition. Even secondary school pupils take up that attitude, and occasionally training college
students referred to me have argued that their heads were clean enough and a few nits counted for
nothing. The nurses work is often the first step towards dispelling a cloud of ignorance ; the fact is
brought home that cleanliness and the physical condition of the child are as important to the Education
Authority as the training of the mind, and there is a moral training in the lessons of self respect and
courage, the perseverance to effect cleansing in a home where often all is against it, and in the teaching
that cleanliness is within the reach of those who strive for it.
The superintendent has now organised the service so that no school shall be left unvisited more
than seven weeks, but for a really efficient service every school should be visited at least once a week,
this would require sixty-five additional nurses. In addition to this routine visit there are, of course,
very many more visits paid to different individual schools, but by arranging a fixed hour for the
routine visit the teacher can prepare for the nurse and arrange for out of school cases to be present.
This saves time and causes little disturbance of the school work. The numerous requests from secondary
school mistresses for nurses visits is also increasing the work in this direction. Each nurse sends in
a weekly report of schools visited ; numbers examined ; numbers noted and details of any special
cases. She also makes a formal report to the superintendent at the office, viva voce, once a month.
Originally there was opposition on the part of some teachers to the work of the nurses; this has almost
ceased. As in all other matters of medical inspection the teachers in the majority of schools have
come to take the greatest interest in the work of the visiting nurse, and identify themselves with her
aims. This aid and active co-operation is a necessity. If the nurse does not get such help, difficulties
with parents soon arise which do not occur in schools where there are strong, sympathetic and discreet
head teachers. There are no regulations yet as to the nursing costume and the Council school nurses
do not wear any regular uniform. Such a distinctive dress should be provided, because it is important
that the school nurse should be recognisable by all as a regular officer of the Authority. Parents
should learn that it is no use to attempt evasion of regulations by moving children from school to school,
as the school nurses attend all schools. It also ensures suitable washable clothes being worn by the
nurses in school. Again, parents respect the uniforms of the nurses whom they see in hospitals and
infirmaries, and as the Council's nurses visit many places where they would be liable to insult in an
ordinary dress, a Council nurse's uniform would protect them in any locality.
1st APRIL TO 31st DECEMBER, 1908.
There are now 51 school nurses with a Superintendent and two Assistant Superintendents. The
districts have been re-arranged and each nurse has now an average of about 13,000 children under supervision.
In order to ensure efficiency arrangements have been made for each school to be visited at
least once a month. This is effected by devoting the morning of each day to the inspection of a separate
school and the afternoon to dealing with the most unclean schools. Three days' notice is given to the
Head Teachers of the Nurses' intended visits in order that they may arrange for any special cases, upon
which advice is wanted, to be present.
PERSONAL HYGIENE.
Elementary Schools.—The cleansing of children from vermin is accomplished by bringing
pressure to bear on their parents.
20261 E