Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/271
Since these graduate nurses are employed in hospitals and sanatoria the discussion of them will be facilitated by considering at the outset the standard ratio of nurses per unit of patient popuiation. The accepted standards for hospital nursing service in the average general hospital are conservatively estimated as a minimum of one nurse to five patients in general wards, and one nurse to every three patients in semi-private hospitals where a portion of the beds are for pay patients.[1] These ratios take into consideration the assistance of pupil nurses in training, but do not include the additional employees necessary to operate the hospital. It is therefore advisable here to mention the auxiliary staff in Indian Service although this phase of the subject will be discussed more in detail later under Hospitals. The graduate nursing service in Indian hospitals is augmented by hospital matrons (housekeepers) and other untrained employees.
The hospitals at Chemawa, Haskell, and Sherman are the only three in the Service where an attempt is made to train nurses and where this type of additional nursing service is utilized.[2] The character of this service, however, is not comparable to that for pupil nurses in general hospitals.
The practical nurse found in most Indian Service hospitals is, in some instances, in full charge of the hospital. She may or may not have had previous training. This type of personnel cannot of course render anything approaching skilled expert service even if there were a higher ratio of nurses to patients. One sometimes finds, too, evidence of an unsympathetic attitude toward patients and hears complaints from the Indians of neglect. Likewise complaint is sometimes made by the one physician attached to such a hospital, whose work must include, in addition to general medical practice, obstetrics and both major and minor surgery, that he is hampered by lack of trained assistance from nurses, not only during operative work but also in after care of surgical patients.
The accompanying tabular statement shows the number of available hospital beds in the Indian Service, the number of permanent nurses employed, and the estimated number of graduate nurses needed.