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Problem of Indian Administration
  1. warrants it, a special nurse should be placed in charge of surgical work and cases. The ratio of trained nurses per unit of hospital population should be increased one to ten, and practical nurses or other suitable assistants should be secured to bring the ratio to one to five. This will require 262 trained nurses and 243 practical nurses, or assistants suitable to assume bedside care of patients. In male wards, an orderly service is desirable.

    All practical nurses or those not holding certificates of graduation from approved training schools should be replaced with trained nurses graduated from grade A hospital training schools, unless they can be assigned to positions under the direction of trained graduate nurses.

    All hospital nurses should be assured the following hours off duty, based on a twelve-hour day:

    Two hours per day
    Two and one-half week days per month
    Two and one-half Sundays per month
    One month’s vacation per year

    The night and day duty nurses should arrange an alternate schedule.

    A careful survey should be made to determine the number of public health nurses needed on each reservation. The immediate goal should be one nurse to each reservation. The ultimate goal should be a ratio of one to each thousand population, or 262 based on the 262,293 Indians[1] now under the Indian Office on the reservations. If impossible to place so large a number immediately, there should be assigned at least one public health nurse to each reservation at the outset. Each existing field matron position should be replaced by a public health nurse as rapidly as possible.

    The latest civil service requirements for “Graduate Nurse Visiting Duty,” issued December 30, 1927, are to be commended.[2] If

  1. ↑ See Schmeckebier, The Office of Indian Affairs.
  2. ↑ These standards require (1) Completion of at least two years of a standard high school course, (2) graduation from a recognized school of nursing requiring a residence of at least two years in (a) a hospital having a daily average of fifty bed patients or more or (b) a hospital having a daily average of not less than thirty bed patients where the course includes not less than six months’ resident affiliation with a general hospital having a daily average of not less than seventy-five bed patients or where the graduate has completed a resident post graduate course of not less than six months’ duration in general nursing in a hospital having a daily average of not less than seventy-five bed patients; (3) not less than one year’s institutional or two
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