- Email: [email protected]
A NURSE IS A NURSE IS A NURSE
1105
legislation along the lines you mention. Natural emotionalism on this important issue should always be tempered with caution. Meanwhile, facts and figures relating to the possible harmful effects of publicity given to violent crimes are urgently needed. Shelton Hospital,
Shrewsbury, Shropshire.
SIR,-I
was most
J. C. BARKER.
impressed by
the
logic put forward and
precedent cited in your annotation seeking abatement of the public nuisance created by the appearance of sensational details in the lay Press on violent crimes. The same arguments could be applied to the detailed lay reporting of suicide, in which, as Dr. Richard Fox pointed out on television recently, the question of imitation is in much less doubt. Suicide, however, is no longer a crime (although just as violent and exhibitionist on occasion), and is more clearly a medical matter than is the purely psychological management of healthy offenders by the social disciplinary services. Perhaps it should be the responsibility of mental hygienists therefore to establish exactly what sort of details might be considered " restricted ", as far as the lav Press is concerned. in suicide. Gravesend and North Kent Hospital, J. P. CRAWFORD. Gravesend, Kent.
A NURSE IS A NURSE IS A NURSE SIR,-May I comment briefly on your leading article of last week ? In 1960 the joint working party, under the chairmanship of Sir Robert Platt, published their views on medical staffing structure in the Hospital Service. This committee was, as I have pointed out,1 totally unrepresentative of most British hospitals and for this reason alone has done little to solve the medical man-power shortage now facing the provincial
hospitals. We now have the report of yet another Platt Committee 2this time under the chairmanship of Sir Harry Platt-and again, for largely the same reasons, it is most unlikely to solve the increasingly serious problem of nursing shortage. In both committees the teaching hospitals were grossly over-represented and it is scarcely surprising that, with the plentiful supply of applicants for both medical and nursing posts in such hospitals, these members failed to grasp the urgency of the problem facing most provincial hospitals-particularly mental hospitals-in
this country. It is difficult to imagine anything more likely to increase, rather than diminish, the size of this problem than the committee’s recommendation that five 0 levels are essential for entry to the profession. The committee were of course quick to point out that this was not the only criterion of selection, and that other factors " not easy of exact assessment " should be taken into account in selection. There is an enormous potential of young girls in this country well motivated to enter the nursing profession and possessing the degree of kindness, sympathy, and humane compassion essential for this work who, nevertheless, will not measure up to these educational standards. It would be a tragedy if they were lost to nursing because of the pan-rationalistic approach of this committee. We cannot, as a nation, afford this wastage. High intellectual endowment is not to be equated with wisdom (or indeed humanity)-a fact painfully obvious from this report. Park Prewett
Hospital, Basingstoke, Hampshire.
ARNOLD PEARCE.
registration studies for the more able. There are many arguments against this-not least of which is that this was the procedure from 1919 to 1943, and it did not work. A century ago Miss Nightingale founded a school of nursing and sought to make nursing a worthwhile profession for educated women, but Miss Nightingale was also remarkably good at statistics and never made the mistake of thinking the whole country could be nursed by her highly trained young ladies-they trained to train and to supervise the more homely and less aspiring nurses of the day. Later, purists were determined to keep nursing in the hands of one type of qualified practitioner, regardless of the shortages this would create. For this reason successive governments turned a deaf ear to the Registration lobby, and when the principle of Registration was conceded by the Select Committee in 1904 it maintained there should also be a second register for the less well qualified. They were wise in their generation. The battle for state registration was won at the expense of exploiting probationers and creating a shortage. The inevitable happened: hospitals unable to get qualified nurses or probationers took unqualified assistants-eventually, and again inevitably, these received some training and finally were recognised. Brian Abel-Smith says, 40 years too late. If we revert to one portal of entry the same will happen again. Why not recognise the demographic tables as they are and the pools of ability available to nursing, and plan accordingly ? This is precisely what the Platt Committee tried to do. There are 64,000 girls with five 0 levels leaving school each year; if we reduce our demands for the Register we should be able to attract enough of these. At the same time we must recognise that much of the nursing of the future will be done by part-time married staff who want a shorter and more practical training, and the Enrolled course is in every way more suitable-and more economical. The argument that there was no difference in the educational standards of the girls who withdrew from training and those who stayed is not an argument against asking a reasonable educational standard for those about to embark on an exacting and responsible career. What the Platt Committee argued was that if wastage was to be reduced there must be better selection for the Register and the Roll, and that the courses must be reformed so that they are more meaningful to the students and are education in the true sense-and not, as they so often are at present, a haphazard 11!’:E’
nf a labour ffwff*
MONICA E. BALY.
STERILISATION AND THE LAW SIR,-Your helpful leader (April 30) concludes: " Doctors who adopt the safeguards recommended [by this Trust] should have nothing to fear from the law ..." But have you perhaps overstressed the " close parallels between the law on abortion and that relating to sterilisation " ? You do not mention the enormous difference which dwarfs the parallels. What are the parallels ? Are they not that abortion and sterilisation are both concerned with human reproduction, that both raise moral issues, and that the same Act of Parliament is concerned with both ? The statute is the Offences against the Person Act of 1861. How are abortion and sterilisation touched in this Act ? As to abortion the Act is unambiguous. Section 58 declares that " whosoever with Intent to procure the Miscarriage of any woman " administers a poison " or uses " any Instrument or other Means whatsoever with like intent shall be guilty of a shall be liable ... to be kept in penal servitude Felony and for life ", and to other lesser penalties. What could be clearer ? The immemorial practice of abortion was widespread when civilisation dawned: but surgical sterilisation is a recent innovation. Primary vasectomy was unheard of in 1861. It is first recorded some thirty years later. Hence the legislators of 1861 "
...
SiR,ńYour leading article last week on the Oxford research of Mrs. MacGuire into nursing attrition cites her conclusion that the Roll should be abolished and that there should be only one nursing qualification-State Registration-with post1. Pearce, A. Br. med. J. 1963, i, 607. 2. A Reform of Nursing Education. London, 1964. See 1375.
Lancet, 1964, i,
legislation along the lines you mention. Natural emotionalism on this important issue should always be tempered with caution. Meanwhile, facts and figures relating to the possible harmful effects of publicity given to violent crimes are urgently needed. Shelton Hospital,
Shrewsbury, Shropshire.
SIR,-I
was most
J. C. BARKER.
impressed by
the
logic put forward and
precedent cited in your annotation seeking abatement of the public nuisance created by the appearance of sensational details in the lay Press on violent crimes. The same arguments could be applied to the detailed lay reporting of suicide, in which, as Dr. Richard Fox pointed out on television recently, the question of imitation is in much less doubt. Suicide, however, is no longer a crime (although just as violent and exhibitionist on occasion), and is more clearly a medical matter than is the purely psychological management of healthy offenders by the social disciplinary services. Perhaps it should be the responsibility of mental hygienists therefore to establish exactly what sort of details might be considered " restricted ", as far as the lav Press is concerned. in suicide. Gravesend and North Kent Hospital, J. P. CRAWFORD. Gravesend, Kent.
A NURSE IS A NURSE IS A NURSE SIR,-May I comment briefly on your leading article of last week ? In 1960 the joint working party, under the chairmanship of Sir Robert Platt, published their views on medical staffing structure in the Hospital Service. This committee was, as I have pointed out,1 totally unrepresentative of most British hospitals and for this reason alone has done little to solve the medical man-power shortage now facing the provincial
hospitals. We now have the report of yet another Platt Committee 2this time under the chairmanship of Sir Harry Platt-and again, for largely the same reasons, it is most unlikely to solve the increasingly serious problem of nursing shortage. In both committees the teaching hospitals were grossly over-represented and it is scarcely surprising that, with the plentiful supply of applicants for both medical and nursing posts in such hospitals, these members failed to grasp the urgency of the problem facing most provincial hospitals-particularly mental hospitals-in
this country. It is difficult to imagine anything more likely to increase, rather than diminish, the size of this problem than the committee’s recommendation that five 0 levels are essential for entry to the profession. The committee were of course quick to point out that this was not the only criterion of selection, and that other factors " not easy of exact assessment " should be taken into account in selection. There is an enormous potential of young girls in this country well motivated to enter the nursing profession and possessing the degree of kindness, sympathy, and humane compassion essential for this work who, nevertheless, will not measure up to these educational standards. It would be a tragedy if they were lost to nursing because of the pan-rationalistic approach of this committee. We cannot, as a nation, afford this wastage. High intellectual endowment is not to be equated with wisdom (or indeed humanity)-a fact painfully obvious from this report. Park Prewett
Hospital, Basingstoke, Hampshire.
ARNOLD PEARCE.
registration studies for the more able. There are many arguments against this-not least of which is that this was the procedure from 1919 to 1943, and it did not work. A century ago Miss Nightingale founded a school of nursing and sought to make nursing a worthwhile profession for educated women, but Miss Nightingale was also remarkably good at statistics and never made the mistake of thinking the whole country could be nursed by her highly trained young ladies-they trained to train and to supervise the more homely and less aspiring nurses of the day. Later, purists were determined to keep nursing in the hands of one type of qualified practitioner, regardless of the shortages this would create. For this reason successive governments turned a deaf ear to the Registration lobby, and when the principle of Registration was conceded by the Select Committee in 1904 it maintained there should also be a second register for the less well qualified. They were wise in their generation. The battle for state registration was won at the expense of exploiting probationers and creating a shortage. The inevitable happened: hospitals unable to get qualified nurses or probationers took unqualified assistants-eventually, and again inevitably, these received some training and finally were recognised. Brian Abel-Smith says, 40 years too late. If we revert to one portal of entry the same will happen again. Why not recognise the demographic tables as they are and the pools of ability available to nursing, and plan accordingly ? This is precisely what the Platt Committee tried to do. There are 64,000 girls with five 0 levels leaving school each year; if we reduce our demands for the Register we should be able to attract enough of these. At the same time we must recognise that much of the nursing of the future will be done by part-time married staff who want a shorter and more practical training, and the Enrolled course is in every way more suitable-and more economical. The argument that there was no difference in the educational standards of the girls who withdrew from training and those who stayed is not an argument against asking a reasonable educational standard for those about to embark on an exacting and responsible career. What the Platt Committee argued was that if wastage was to be reduced there must be better selection for the Register and the Roll, and that the courses must be reformed so that they are more meaningful to the students and are education in the true sense-and not, as they so often are at present, a haphazard 11!’:E’
nf a labour ffwff*
MONICA E. BALY.
STERILISATION AND THE LAW SIR,-Your helpful leader (April 30) concludes: " Doctors who adopt the safeguards recommended [by this Trust] should have nothing to fear from the law ..." But have you perhaps overstressed the " close parallels between the law on abortion and that relating to sterilisation " ? You do not mention the enormous difference which dwarfs the parallels. What are the parallels ? Are they not that abortion and sterilisation are both concerned with human reproduction, that both raise moral issues, and that the same Act of Parliament is concerned with both ? The statute is the Offences against the Person Act of 1861. How are abortion and sterilisation touched in this Act ? As to abortion the Act is unambiguous. Section 58 declares that " whosoever with Intent to procure the Miscarriage of any woman " administers a poison " or uses " any Instrument or other Means whatsoever with like intent shall be guilty of a shall be liable ... to be kept in penal servitude Felony and for life ", and to other lesser penalties. What could be clearer ? The immemorial practice of abortion was widespread when civilisation dawned: but surgical sterilisation is a recent innovation. Primary vasectomy was unheard of in 1861. It is first recorded some thirty years later. Hence the legislators of 1861 "
...
SiR,ńYour leading article last week on the Oxford research of Mrs. MacGuire into nursing attrition cites her conclusion that the Roll should be abolished and that there should be only one nursing qualification-State Registration-with post1. Pearce, A. Br. med. J. 1963, i, 607. 2. A Reform of Nursing Education. London, 1964. See 1375.
Lancet, 1964, i,