Page:LewisMeriam-TheProblemOfIndianAdministration.djvu/272

Indian Service statistics showing ratio of permanent graduate nurses per unit of bed capacity for all classes of Indian Service hospitals, 1926

As Indian Service hospitals are as a rule small and unsuitable for training schools, the major portion of the nursing service should be supplied by graduate nurses as is the practice in other federal hospitals. The estimated ratio of such nursing service per unit of population should be one to five, preferably, and not less than one to ten, providing the ratio of one to five is secured by other suitable employees devoting their time solely to care of patients.

With due allowance for the fact that not all hospital beds were in use, it is, nevertheless, true that these hospitals were still greatly understaffed. An analysis of the total hospital employees for 1927 will show approximately the same deficiency.^[1]

These figures indicate clearly that the nursing service rendered the patients hospitalized must have been far below accepted standards. First hand observation showed this to be the case in every institution visited. These nurses are on duty twenty-four hours a day; there are no regular hours or half-days off, and it is only on rare occasions that any time off is possible. Many of these hospitals have only one graduate nurse and some have none. Because of a like deficiency in other hospital employees, these nurses devote a large proportion of their time to the multitude of activities incident to hospital work, such as cooking, cleaning, and household