MARGARET L0STY, R.N. & Nursing Consultant for Maternity and
Newborn Services. New York City Department of Health
This premature baby is being fed by a nurse who has been specially
trained in caring for such babies. Because he is too weak to suck, the
nurse feeds him with a medicine dropper.
A PREMATUKE baby's life may depend on whether or not the person who
takes care of him has the knowledge and skill needed for the care of
such infants. Unfortunately, there are not as yet enough professional
workers with this special knowledge, and undoubtedly many premature
babies die who might have been saved by better care.
New York City recently gathered some evidence pointing to this
conclusion, when the maternal and newborn division of the city
department of health joined with the Kings County Medical Society in
inquiring into the preparation of nurses who had cared for the 55
premature infants who had died during a specified month. Of the 135
nurses who had cared for these 55 babies, only 1 had had any training
in the care of prematures.
Seventy-seven of the one hundred and thirty-five nurses were
graduate nurses (and it was one of these who did have the special
training). Twenty-five were licensed practical nurses; 16 were
non-licensed practical nurses; 8 were student nurses; 1 was a hospital
attendant; 3 were student practical nurses; and the status of 5 nurses
was unknown.
The impression that there are not enough nurses with special
preparation in the care of premature babies is strengthened by
observations made in the hospitals of New York City by the city health
department's hospital consultation service, whose purpose is to
improve the hospital care given to mothers and newborn infants,
including prematures. This service sends survey teams to the various
hospitals to observe the quality of care and make recommendations for
improving it. Each team includes an obstetrician, a pediatrician, and
a public-health nursing consultant.
These teams report that too many premature babies are improperly
cared for because the members of the hospital staff simply do not know
what should be done. Many of the nurses, incidentally, have told the
survey teams that they realized how inadequate their training in the
care of prematures had been, and that they would like to receive
better preparation.
And, according to the pediatric members of the survey teams, it is
not only the nurses who need further instruction in the care of
premature babies, but also the doctors.
An ideal plan would seem to be for the nurse and the pediatrician
who are responsible for the care of the premature babies in a hospital
to be taught jointly, along with the public-health nurse who visits
the babies in their homes and helps the mothers to care for their
babies.
Joint training of this kind is now being given at the New York
Hospital. Another hospital in New York City that offers preparation in
the care of the newborn, including premature babies, is the Sloane
Hospital for Women. This is a A weeks' work experience, but it is for
nurses only.
It is well recognized that there is great value in learning about
different programs. Therefore, many nurses from New York City go for
training to hospitals and schools of nursing in various cities that
offer special work with premature babies.
Courses in nursing care of premature babies are given in the
following schools of nursing: University of Colorado, Denver;
Louisiana State University School of Medicine, Division of Nursing
Education, New Orleans, La.; and Los Angeles County General Hospital
School of Nursing, Los Angeles, Calif.
Some hospitals that offer periods of supervised experience (not
courses) in nursing care for premature infants are Margaret Hague
Maternity Hospital, Jersey City, N. J.; Michael Reese Hospital,
Chicago; Presbyterian Hospital, New York City; and the Johns Hopkins
Hospital, Baltimore, Md.
In all these institutions opportunities for clinical instruction
and experience in the care of the premature baby are open to both
institutional and public-health nurses.
Here is a typical report by a nurse who had the opportunity to
receive preparation in a hospital that gives good care to premature
babies:
"Before I went for additional training, I had only the vaguest
knowledge of how to care for a premature baby, for I had had only 2
weeks' experience in this field during my student days. I was actually
afraid to handle such a baby. But at X hospital my whole attitude
changed. I was amazed at the attention the nurses gave the babies at
feeding time. At the hospital I came from, the nurse would prop up the
baby's bottle and leave him to feed him self even a premature baby!
But in X hospital the nurse would sit in a chair and hold the baby
while feeding him. She was not in a hurry; she cuddled the baby and
talked to him (this was a large premature baby) and in the meantime
she had a wonderful opportunity to observe him and see how he was
reacting to feeding."
