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An address given before the Association of State and Territorial Health Officers, at Washington, D. C. - MARGARET LOSTY - NEW YORK RN


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."