THE SHORTAGE OF NURSES IN SOUTH AFRICA.

PART I .

1. WHY THE FOUNDATION DECIDED TO INVESTIGATE THE POSITION.

a) In June, 1948, there was much public concern in Johannesburg over the shortage of nurses. The press at that time published pictures and stories of whole wards in Provincial Hospitals standing empty for this reason.

b) Although the Foundation's direct field is promotive health matters such as nutrition, recreation, education of the literate and illiterate in basic health matters, creation of a sound public opinion, e tc ., it is interested in all questions concerning the health of our people. In matters outside its direct field , it undertakes to find out the true facts, where necessary, and in co-operation with the Authorities or Voluntary Organisations concerned, to act as a ‘'pressure-group” in order that health conditions may be improved.

c) The Foundations direct interest in the question of whether sufficient nurses are available arose through the fact that, after long delays, an Irish Order withdrew an offer it had made to set up and staff a 60-bed hospital to serve Alexandra Township, Johannesburg. The Provincial Secretary informed us that the Administrator-in-Executive had already approved in principle the erection of a hospital to serve this Township, but, at a meeting called by the Johannesburg Hospital Board on 30th June, 1948, the Chair­man of the Hospitals Advisory Board pointed out that besides building d ifficu lties , there was also the shortage of trained nurses to contend with.

d) The matter was discussed by our Witwatersrand and S . Transvaal Action Committee, and it was suggested that one of the reasons for the shortage of African nurses might be the lack of general educational opportunity for Bantu girls. The Regional Technical Advisory Committee was requested to investigate the whole position.

2. PRELIMINARY ACTION DECIDED UPON.

a) It was decided that the available supply of European and Non-European female medical and surgical nurses and midwives, present training fa c ilit ie s , etc ., would firstbe investigated and, if possible correlated with the demand. As a second stage, the number of Bantu recruits who may be available would be investigated. -

b) Discussions were held with the Registrar and Assist­ant Registrar of the South African Nursing Council, the Secretary of the South African Nursing Association, and representatives of the South African Institute of Race Relations. The generous assistance so willingly given is acknowledged most gratefully. Questionnaires were then sent to the Superintendents of a ll Training Hospitals in South Africa. A summary of the replies, together with additional information, is contained in the following pages.

— 3 . / •. #

3 . IS THERE, IN FACT, A SHORTAGE OF NURSES?

a) The Report of the National Health Services Commission states (in paragraph 82, page 69)

"That there is a chronic shortage of nurses is admitted on all sides ..............."

b) Later ,(in paragraph 22, page 88) it goes on

"The Secretary for Public Health, in a. recent article published in the 'South African Nursing Journal', estimated that 20 ,000 nurses and mid­wives would be required for South Africa on the basis of 1 to every 500 of the population. It is questionable whether, for a very considerable time, this ratio will be required, but with increased demand for Western methods of treatment on the part of the Native population, there is little doubt that it w ill come sooner or later ."

This report was written in 1944. Using the latest (1946) Census figures, this ratio would mean that, to provide adequate health services, we now should have 22 ,784 nurses and midwives; 4 ,7 45 to care for Europeans and 18 ,039 to care for Non-Europeans.

c) The exact ratio at present required would be extremely difficult to calculate; but it appears that the demand amongst the Bantu for Western methods of treatment has out­stripped the supply of nurses. To a very considerable extent the expansion of health services is held up through the lack of .trained personnel. When addressing the first biennial meeting of the South African Nursing Association in Cape Town in November, 1946, the then Minister of Health said that the shortage of nurses was the limiting factor in present health services, and the shortage was bound to be­come worse as plans for the expansion of national health services were unfolded.

d) As at the 30th June, 1948, there were 13 ,535 registered nurses and 8,753 registered midwives. The number of unreg­istered practising nurses and midwives is unknown, and it is also unknown how many of the registered nurses and midwives are practising. As pointed out by the National Health Services Comiiiission (page 87 of Report, para. 19 e t .s e q .) , figures supplied for the number of nurses on the Register "do not bear any easily ascertainable relation to the actual number of such nurses in practice, because

" ( i ) Registration occurs only once, and is not annually renewed: consequently, large numbers remain on the register long after they have ceased to practice. Amongst female nurses the numbers who retire from practice owing to matrimony is very great.

(ii ) There is duplication of registration as betweentrained nurses and midwives, the same names appear­ing to a very large extent under both categories, as a large number of trained nurses are also qualified in midwifery."

e) The Commission calculated that, at the time their Report was written (May,1944 ), there were probably about 5 ,000 nurses and 2 ,500 midwives in actual practice. At

- th at /. .

that time, there were 7 ,205 nurses and 5,644 midwives regis­tered. If we take the same proportion of those registered to-day, we may assume that approximately 9,400 nurses and 3 ,800 midwives are at present in actual practice.

f ) To summarize, then, we need about 22,784 nurses and midwives for adequate health services, and we probably have some 13 ,2 0 0 . The exact number required for our health services in their present stage of development is unknown, but there is no doubt that there is a shortage of practising nurses, and that expansion of health services depends largely on an increased number of trained personnel becoming

available .

g) When addressing the Transvaal Hospitals' Congress in September, 1947, General J .J . Pienaar pointed out that the real problem lies in providing nurses for the non-European community. They did not yield more than one student nurse out of every 17 ,000 souls, against one in 600 amongst Europeans.

h) Later, when addressing the Conference on Nursing Education held in Pietersburg in August, 1948, General Pienaar said that student nurses should consist of one- quarter Europeans and three-quarters Non-Europeans. The actual proportions of the present strength of student nurses were the reverse. If the European nurse shortage was tobe overcome, mnre non-European nurses must be trained. There was a serious limiting factor, however, in that the bulk of the Native population was equipped neither by school educ­ation nor by tradition or culture for producing daughters suitable for training for the fu ll qualifications and responsibilities of a nurse. The number of really suitable native girls was very limited. The number of European nurses w ill , accordingly, for many years to come have to be higher than the strict proportions of the population. They must provide for the nursing of the Europeans and the super­vision of the non-European services.

4 . REASONS FOR THE SHORTAGE 0E NURSES.

a) The National Health Services Commission stated (on• page 69, paragraph 82 of its Report) : -

MWe conclude therefore that the shortage of trained nurses is due in the main to six factors :-

" (i) Student nurses abandoning their training either through having missed their vocation, dissatisfaction with the con­ditions of service, or marriage;

(i i ) Wastage through marriage and retirement of trained nurses;

( i i i ) The fact that hospitals train only sufficient for their own needs and that enough are not trained to make up for the wastage which is inevitable in any feminine profession;

(iv) Married women are not employed;

(v) Increased avenues of employment for women.

(vi) Lack of preliminary training schools and of accommodation for sufficient probationers

- b) / . . . .

b) Some of these factors are gradually being elimin­ated. Nursing Colleges are being established, training methods revised, and conditions improved. The main_problems which remain are obtaining and accommodating a sufficient number of suitable Non-European trainees, and imbuing all student nurses with a sense of vocation. General Pienaar said at the Pietersburg Conference on nursing education (August ,1948): ’’You all know that our present system of training nurses is unsatisfactory. It w ill be enough if i. say that of every two young women who come to our hospitals to learn the profession of nursing, only one q u a lifie s ."The cause lay in the fact that we regard nursing as employ­ment, and fa il to recognise it as a profession. ’’The new system of training nurses in the Transvaal, which w ill be considered by the Conference, w ill not profit us, however, unless we can at the same time capture a new s p ir it .”'

5. PRESENT POSITION IN THE TRAINING SCHOOLS.

a) During August, 1948, the Foundation circularised all training schools for medical and surgical nurses and midwives in South Africa.

b) In the following paragraphs is a summary of the replies received, together with comments from various train­

ing schools.

6. ' NUMBER Off HOSPITALS CIRCULARISED.

a) Questionnaires were sent to the 82 Hospitals recog­nised as training schools by the South African Nursing Council, and also, as a matter of interest, to 1? Hospitals which have not yet attained the standard of recognised_ training schools. Replies were received from 75 hospitals in the former class and 15 in the- latter, and we are extrem­ely grateful to the Superintendents and Matrons of these hospitals for the assistance they gave.

b) In respect of the 7 recognised training schools which did not reply, the South African Nursing Council very kindly supplied us with information regarding numbers in training and educational standard required of trainees.In other matters such as wastage, e tc ., a percentage figure

has had to be used.

7. EDUCATIONAL STANDARD REQ.UIRED OF TRAINEES.

a ) Standard 7 remains the required entrance standardfor commencing nursing training, although we understand this may shortly be raised to Standard 8 . The majority of recognised training hospitals, however, already demand Standard 8 or higher; and all of them give preference to those applicants with the best general education.

b) The present position is as follows :-

TABLE I . / . .

TABLE I .

Minimum General Educational Standard'Required of ___________________Nursing Trainees._______________________

PROVINCE TYPE OF TRAINEENo.of he

Std. 7>spiteu S t d .8

s requ Std . 9

ir in g :- Std 10

Trans VaaL European medical & surgical. 4 16 - -

N .E . ' " " " . 1 9 - -

European midwives 1 5 - -

N .E . " 1 1 - -

Cape European medical & surgicaL 4 15 - 2

N .E . " ” j - 12 - -

European midwives 2 4 - -

N .E . « 1 8 - -

Natal European medical & surgical — 3 2 -

N .E . " " " 5 c -

European midwives -'

7 2 -

N .E . "•

4 - “

O .F .S . European Medical & surgicaL 2 2 1 -

N .E . ' " " - 1 -ii

European midwives i 2 - -

1- !

N .E . »' — I,

UNION Total - European trainees 15 47 3 2

" N .E . " 3 34 31

-

COMBINED TOTAL 18

1

81

ii s i

f

2

I accepts Registered Nurses only.

c ) A Committee appointed by tlie Administrator of theCape published, on 1st March, 1946, a "Report on an Inquiry into the Training of Nurses in the province of the Cape of Good Hope' . In this report there is the following interesting statement

(Chapter I I I ,P a r a .10 (1 )) :-

■There is "a significant tendency for the percentage of failures in examinations to decline progressively with the higher standards of general education".

After weighing a ll available evidence the Committee found

- "that/..

"that Standard 8 may be accepted for the present as the minimum general education required to enable a girl to train as a medical and surgical nurse .”

3 ) On the whole, a higher minimum general educationalstandard is required of Non-European than of European trainees. According to the totals shown in_Table I , 92% of the hospitals training Non-Europeans require J .C . or above, while the corresponding figure for European trainees is 78%. Miss C .A . Nothard, in an address in the U .S .A . in May, 1947, pointed out that the majority of Non-European student nurses come from native areas where they live under conditions entirely different from those pertaining in the average European home. It is often necessary to teach such girls something about the European ways of living before they are in a position to assimilate the contents o f ' the course of nursing training.

e) Besides learning the European way of living , Bantutrainees also need to acquire the power of thinking clearly, and a higher educational standard is of assistance here.Some Provincial Hospitals have preliminary training schools for Bantu recruits, and some of the Mission Hospitals, find that girls trained in their own secondary schools prove very satisfactory Hospital trainees. The Robert Shapiro Trust (administered by the S .A . Institute of Race Relations) offers a few bursaries each year to Bantu girls who wish to pass Standards 9 and 10 before taking up nursing. The provision of further preliminary training schools or of_ further general educational bursaries would seem essential if the quality of Bantu trainees is to be improved and the wastage consequently decreased. These questions are discussed more fully later.

8. SCHOOL SUBJECTS TAKEN BY NURSING TRAINEES.

a) In an article published in "The Star" of 2nd August, 1948, it was stated: "From the point of view of being pre­pared for their nursing studies, girls who left school at Standard 8 were not always well equipped. The syllabus at that stage was very wide, and a g irl might scrape through the examination and enter as a student nurse without having taken any science subjects. She would then be confrontedby the preliminary examination which needed a lot of study, and would probably find it very d ifficu lt . A matriculated girl had more opportunity of learning the_technique of* swotting’ . It might be helpful if nursing training authorities stated the school subjects they required of candidates, as medical, law and engineering students were required to have taken stipulated subjects at school."

b) In replies to the questionnaire we circulated to training hospitals, several Superintendents or Matrons gave their views on what school subjects would be an asset to girls intending to train as nurses. The follow­ing are their recommendations

TABLE I I .

School subjects recommended for girls intending to train as nurses._______

Type of Trainee Subjects recommendedNumber of hospitals making such recommendation

European

Medical and

Surgical.

Science, especially Chemis try 6

Domestic Science 3

Hygiene & First Aid 3

Latin 2Maths 1

Non-European •

Medical and

Surgical

First Aid & Home N uts ing 2

Domestic Science 1

Science 1

Latin 1

English 1

o) Which school subjects actually^are taught to Bantugirls in the various standards will be discussed in Part II

of the Survey.

9. MINIMUM AGE FOR COMMENCING NURSING TRAINING,AND LENGTH OF THE

COURSES.

(a ) Medical and Surgical Training.

a) The S .A . Nursing Council lays down no minimum agefor commencing training, but w ill not register a nurse or midwife until she is 21 years of age. The Council permits women to write the final examination up to 6 months before their 21st birthday, so as to fit in with examination dates; and they can, in such cases, f i l l in the remaining period by taking courses in midwifery, fever, etc. The preliminary and final examinations take place three times a year.

t>) As the medical and surgical course takes 3|- yearsin a first class and 4g years in a second class Training School, this regulation regarding registration to a certain^extent fixes the minimum age for commencing training at 17g and 16g years respectively.

c) The ’’Report on an Enquiry into the Training ofNurses in the Cape of Good Hope” states (in Chapter I I I . para 1 1 (2 )) : ’’The medical and nursing witnesses are almost unanimous in the view that the training as a medical and surgical nurse is strenuous, both physically and emotionally,

- and / . . .

and the majority of the witness consider that a girl should not be admitted to training in a hospital ward until she is at least 18 years of age. There is a tendency amongst the witnesses to regard the age of 19 years or older as the most suitable for the admission of a girl to training” . The Committee recommended (in para. 3 (9 ) ) 17| as the minimum age for starting practical training in the wards .

d) Most hospitals f ix their own minimum age forcommencing training, as follows :~

TABLE I I I .

Minimum Age required by Training Hospitals for commencing medical & surgical training.

Number of Hospitals accepting girls at

16 yrs. 17 yrs. 17| yrs. | 18 yrs. 19 yrs.

-----Transvaal 1 17 3 9 -

Cape - 14 3 13 3

Natal - 2 - 11 -

O .F .S . - 2 1 3 -

-....... TOTAL 1 35 7 36 i 3e) One of the difficulties in obtaining sufficient

nursing recruits is , of course, that girls who leave school after Standard 8 are very often only 15 or 16 years of age. By the time they are 18, such girls are frequently earning £20 or £25 a month in an office, and, as ”The Star” , pointed out on 2nd August, 1948, it was not surprising if a girl "was reluctant to leave this comparatively easy life and go back to hard study, long hours, and discipline as strict as that of her schooldays. To do this she would have to have a strong sense of vocation1’ .

f ) To meet this difficulty , some hospitals place suitable girls on their waiting lists as soon as they leave school, and enter their names for the first course begin­ning after they have reached the minimum age required. In the meanwhile the girls may go as "learner nurses” to local convalescent homes.

(B) Midwifery 'Training.

a) The midwifery course at present takes 6 months for trained medical and surgical nurses, and 1 year for untrained women. This, to a certain extent fixes the minimum age for commencing training at 20| and 20 years respectively, since a midwife cannot be registered until she has turned 21.

b) Again, however, the hospitals f ix their own minimum age for commencing training, as follows ;

-TABLE IV

TABLE I V .

Minimum Age required by Training Hospitals for midwif ery training.

Number of Hospitals accepting girls at :-!

19 years 20 years 21 years--I

Transvaal 3 4 1 j

Cape - 5 4

Natal 1 2 4i

o .p .s .; - 1

‘

TOTAL

1--- ■— . -- —

4 12

o

1—1

Jt is understood that the length of the midwifery course may shortly be increased l«o S months for trained medical and surgico.l nurses and 18 months for untrained women. As a matter of interest, the National^Hta1th Services Commission advocated a 3 years’ training of midwives which would f it them, "according to the evidence before us, to undertake 90% of all midwifery cases without calling in a doctor. Where it is necessary to call in higher advice, it is tbe f ully—trained obstetrician whoshould be called in, and not the general practitioner.........At the same time, there is room for the maternity nurse, trained as midwives are.now being trained, to nurse cases which have been conducted by the midwife” (Page 134 of the

Report,, paras. 21 and 22 ).

10. i?Tiig„q PAYABLE BY STUDENT NURSES AND MIDWIVES.

At all hospitals training medical and surgical nurses, students in training receive salaries. The same applies to hospitals training midwives except A or one m the Cape, where, students are required to pay fees.

Registration and examination fees are charged,

as follows

£1. 5 . 0 for registration as a student nurse or midwife.

10. 6 examination fee for the Medical & Surgical preliminary examination.

£3. 3 , 0 to cover examination fee for Medical & Surgical final examination or the Midwifery examination, and also to co'ver registration.

11. SALARIES PA ID .

a) Provincial Hospitals have to conform to provin­

cial rates, which are

(i ) European Medical & Surgical Nurses.

- £66 x 12 - £102; plus C .O .L .A .

- £180 x 15 - £225, plus C .O .L .A .

- £225 x 15 - £240 x 20 - £ 320 ,plusC .O .L .A .

At some Transvaal hospitals, after 5 years on the £320 scale the salary is raised to £360, and after another 5 years to £400.

(i i ) Non-European Medical & Surgical Nurses.

Trainees Transvaal - £36 X 6 - £60, plus C .O .L .A .Cape £24 X 6 - £48, plus C .O .L .A .

Natal £36 X 6 - £54, plus C .O .L .A .

O .F .S . £24 X 6 - £48, plus C .O .L .A .

Staff Nurses- Transvaal - £105 X 12 - £165, plus C .O .L .A .

Cape £96 X 6 - £120, plus C .O .L .A .

Natal £105 X 12 - £165, plus C .O .L .A .

( i ii )European Midwives.

Trainees - £60 per annum to untrained women,plusC .O .L .A .

£80 n n " trained nurses,plusC .O .L .A .

Midwives - £135 x 15 - £225.

At Provincial hospitals, trainees and trained staff receive free board and lodging (or, in the case of trained staff, living out allowance which varies from £ 7 .10 .0 to £10 per month); also free laundry and shoes and uniform, or a uniform allowance of £15 per annum. (N .B . In some cases pupil midwives have to supply their own uniform.)They also receive ra il concessions for leave.

Cost of living allowance varies slightly in the different Provinces. There is now reciprocity between the Provinces in regard to Pension schemes, except that in the Cape, a nurse leaving the service is not refunded her pension contributions unless she has served for at least a year. This provision does not apply in the rest of the Union. So far, there is no reciprocity between Government and Provincial hospitals in regard to pension schemes.

b) Mission and Private Hospitals are not bound byprovincial rates,and the salaries vary very much, as

follows

(i ) European Medical & Surgical Nurses.

Trainees - Commencing salary £36 upwards.

Staff Nurses - often £165 x 15 - £225.

Trainees

Staff Nurses

Sisters

(ii) Non-European Medical & Surgical Nurses.

s

Trainees - Vary from £ 7 .7 .0 per annum, atcommencement of course to £54 per annum, at end of training.

Staff Nurses - Vary from £60 as lower limit to £132as upper limit.

( i i i )European Midwives .

Trainees - Provincial rates generally used.

Midwives - Vary from £180 as lower limit to £237 as upper lim it.

(iv) Non-European Midwives.

Trainees - Vary from £6 per annum at start ofcourse to £36 at end of training (or £48 for trained nurses).

Midwives - Vary from £60 as lower limit to £132as upper lim it.

Private institutions usually pay C .O .L .A ., but are not bound by Provincial rates. They also , in most cases, provide free board and lodging, laundry, uniform and shoes, and often contribute towards railfare for holidays.

c) Both nurses and midwives can often earn more inprivate practice or in the employment of local authorities or private hospitals than they receive in Provincial hospitals. To give two examples

(i> A non-European medical and surgical nurse in Cape Provincial hospitals earns £96 x 6 - £120 plus C .O .L .A . Recently a Local Authority in the Cape advertised a similar post at a salary scale £192 x 10 - £242 plus C .O .L .A .

( i i ) European midwives working on their own often charge from £ 6 .6 .0 to £ 1 0 .1 0 .0 a week for looking after a mother and child in a private home.

12. LEAVE PRIVILEGES FOR TRAINED STAFF.

The leave-scales in Provincial hospitals are

Transvaal - 30 days' non-accumulative leave plus 14 days’ accumulative leave per year. At the end of5 years continuous service, nurses receive 35 days’ bonus leave.

Cape - 30 days’ vacation leave, 18 days’ accumulativeleave on full pay, and 18 days’ accumulative leave on half pay per year.

Natal - 42 days per annum of which a portion can be accumulated.

O .F .S . - Not known.

Accumulated leave is not transferable if a nurse moves to another province.

13. NUMBER OF NURSES a ND MIDWIVES AT PRESENT IN TRAINING.

A . TABLE V .

European Medical and Surgical Nurses at present in training.

No. Of hospi­tals .

1st yr.

.. ” 12nd yr. 3rd yr.

4th & 5th y rs .

TOTAL

TRANSVAAL 20 567 365 309 195 1,436

CAPE 21 445 473 238 166 1 ,322

NATAL 5 102 78 78 37 295

O .F •S • 5 92 69 42 32 235

TOTALS 51 1 ,206 985 667 430 3 ,2 88

TABLE V I .

Non-European Medical and Surgical Nurses at present in Training.

No. of hospi­tals .

1st yr. 2nd yr. 3rd yr.4th &

5th yrs.

TOTAL

TRANSVAAL 10 399 149 114 90 752

Ca PE 12 185 142 89 65 481

Na TAL 8 139 105 70 81 395

O.F .S . 1 18 - - - 18

TOTALS 31 741 396 273 236 1.646

TABLE V I I .

European and Non-European Midwives at present in trainlngT^

N o .' o f " hospitals European

No. of hospitals

Non-European

TRANSVAAL 6 193 2 47

CAPE 6 132 3 49

Nrt-TAL 3 58 4 69

O .F .S . 2 32 - -

TOTALS 17 415 9 165

- I t / .

It should be remembered, of course, that the figures in Table V II include a number of trained medical and surgical nurses, who have no intention of practising as midwives.

14. PERCENTAGE. OF PASSES IN EXAMINATIONS.

From a graph kindly made available by the Registrar of the S .^ . Nursing Council, of those who entered for the examinations, the following percentages of passes have been worked out

TABLE V I I I .

Average percentage number of candidates who passed examinations.

192§to

1939

1940to

1943

1944to

1947

Average over last 3 years

Medical & Surgical. Preliminary 73 68 56 56

Medical & Surgical Final 95 90 77 75

Midwifery Examination 82 87 67 64

15. ANNUAL Wi-iSTa GE.

The Training Hospitals were asked to state the average annual wastage. As stated above, 7 of the 82 recognised training hospitals did not reply, thus to arrive at the overall annual wastage, a percentage figure was used for these hospitals. The result is

TABLE I I

Average annual wastage of student nurses and midwives.

......................... '

TYPENumber

inTraining

AverageAnnualwastage

Percentageaverageannualwastage

European medical & surgical

Non-European "

3 ,2 88

1,646

r

628

245

t

19$

15$

TOTALS 4 .934 873 . 18%

European Mid wives 415 58 14$

Non-European " 165 22 13$

TOTALS 580 80 1 .COMBINED TOTALS' 5 ,5 1 4 ..... 953 17$

16. REASONS FOR WiiS.Ih.GB.

a) Each hospital was asked to give' the chief reasonsfor wastage. The following is the result

( i) European medical and surgical trainees.

48 hospitals quoted reasons indicating that the trainees concerned were psychologically or morally unsuited to the profession. Of these

20 hospitals stated : "Find they are not really interested in the work or attracted by the profession". 1

2 hospitals stated: "Pay too low” ;

9 hospitals stated: ’’Decide would prefer office work with regular hours and free week-ends".

17 hospitals stated: "Unsuitable for train­ing", or ’’unable to conform to hospital discipline".

27 hospitals mentioned marriage (24) or Domestic reasons (3 ).

19 hospitals quoted reasons indicating that the trainees concerned did not possess the necessary intellectual ability or general educational standard, e .g . "Unable to cope with theoretical standard", or "Unable to pass Preliminary Examination".

6 hospitals mentioned ill-health, especially sore feet.

3 hospitals in the smaller towns mentioned: "Too lonely" or "Would prefer bigger hospital where course is 3| instead of 4| years".

(ii) Non-European medical and surgical nursing trainees.

19 hospitals quoted reasons indicating that the trainees concerned were psychologically or morally unsuited to the profession. Of these:-

8 hospitals stated the trainees concerned found they were not really interested in the work or attracted by the profession.

11 hospitals mentioned: "Unsuitable for training", or "Unable to conform to hospital discipline".

8 hospitals stated that part of the wastage was through girls becoming pregnant.

»- 14 / . . .

14 hospitals quoted reasons indicating that the trainees concerned did not possess the necessary general educational standard or intellectual ability.

9 hospitals mentioned ill-health.

(iil) -Suropean Midwifery Trainees.

hospitals quoted reasons indicating that the trainees concerned were psychologically or morally unsuited to the profession. Of these

7 hospitals stated the trainees who left found they were not really interested in the work or attracted by the profession.

2 hospitals stated: "Pay too low".

3 hospitals stated: ’’Unsuitable for training” , or ’’Unable to conform to hospital discipline” .

1 hospital stated: ’’Tired after General Training” .

9 hospitals mentioned ill-health.

4 hospitals quoted reasons indicating that the trainees concerned did not possess the necessary general educational standard or intellectual ability.

4 hospitals mentioned marriage (2) or domestic reasons (2).

(iv) Non-£uropean Midwifery Trainees.

5 hospitals quoted reasons indicating that the trainees concerned were psychologically or morally unsuited to the profession. 'Of these:-

1 hospital stated that the trainees who left found they were not really interested in the work or attracted by the profession.

4 hospitals stated; ’’Unsuitable for training” , or ’’Unable to conform to hospital discipline.”

5 hospitals stated that part of the wastage was through girls becoming pregnant.

: H i - e ^ t

£ 'v-5i! w ;. f •: 1 ̂ ‘ ’>'■* » .* ; •*;. * •2 hospitals quoted reasons indicating that the

trainees concerned did not possess the necessary general educational standard or intellectual ability.

1 hospital mentioned ill-health.

1 hospital mentioned domestic reasons.- To/.. .

t>) To tabulate the above

TkBLE X .

Reasons given by hospitals for Wa stage,

■» No. of aospitals giving these reasons..- — r -- ---- - .- ----->

REASONS

Euro­pean Medi­cal & Surg­ical

N.E.Medi­cal & Surg­ical

Euro­pean Mid­wives .

N .E.Mid-wives Total

Psychologically or morally unsuited 48 19 13 5 85

Too low educational stan­dard or intellectual ability 19 14 4 2 39

Marriage or domestic reasons 27 10 4 1 42

Pregnancies - 8 - 3 11

Ill-health 6 9 9 1 25

Prefer a larger hospital 3 - - - 3

c) Some idea of the number of trainees who leave for eachof the reasons mentioned can be obtained by correlating the reasons given by each hospital with, the annual wastage from

this hospital.

The results are :-

(i) European medical and surgical nursing trainees.

Psychologically or morally unsuited

To sub-divide this heading :-

20.1# lost interest in the work or were not really attracted by the profession.

0 .4% considered the pay too low.

8 .8# preferred to change to office work.

13.6# were unsuitable for training or unable to conform to hospital discipline.

Too low an educational standard or intellectual ability

Marriage or' domestic reasons

Ill-health ■

Preferred a larger hospital

42.9#'

16.4#

29.2#

,■7,.8*

3 .7 #

Collection Number: AD1715

SOUTH AFRICAN INSTITUTE OF RACE RELATIONS (SAIRR), 1892-1974

PUBLISHER: Collection Funder:- Atlantic Philanthropies Foundation

Publisher:- Historical Papers Research Archive

Location:- Johannesburg

©2013

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