1950 "Statement of Deficiencies" from NCSNA to Hamlet Hospital SON

Exhibit A


Statement of Deficiencies of

Hamlet Hospital School of Nursing

Hamlet, North Carolina



                Your school of nursing fails to meet the minimum requirements and standards prescribed by the Joint Committee on Standardization and approved by the North Carolina Board of Nurse Examiners, as set forth in the “Regulations for Schools of Nursing in North Carolina 1948” as amended, as follows:


  1. Records.


  1. No record of required clinical instruction for students.


(1)    In violation of Regulations, page 13, paragraph Records, reading as follows: “It is essential that a good system of records be established and maintained.  They should begin with the application of the student and serve as a continuous history of her education and practice.  The records shall be open for the inspection of the Educational Director at all times.  They should state the student’s efficiency in work, attendance, and rating in her classes; lectures and demonstrations; the time she has spent in each department (day and night); absence from duty; sickness; and vacation.”


(2)    In violation of Regulations, page 9, paragraph 13, reading as follows: “Schools shall give each student at least the minimum required instruction provided in the curriculum, including clinical services and classroom instruction as outlined hereinafter on pages 17 and 18.”


  1. Senior students’ final records did not tally in class hours with findings in the class roll book.  Final records stated 65 hours in medicine and medical nursing, 65 hours in surgery and surgical nursing, 35 hours in medicine and surgery combined.  Class roll book varied for individual students and did not add up to the above number of hours for any one student.  In violation of the Regulations as amended May 28, 1948, reading as follows: “Since the records kept in the nursing school for action in regard to approval of schools, and falsification discovered on these records will result in the failure of the Committee to consider the school for approval.”


  1. Records showed that an entire new curriculum was not started for the pre-clinical class admitted September 20, 1950, but that they began anatomy and physiology classes with the June 20, 1950, group.  In violation of Regulations, page 16, paragraph reading as follows: “A new curriculum shall be started with each new class.”


  1. Personnel Practices for Students.


  1. Student nurses on night duty were working eight hours per night plus class hours during the day – no evidence of these added hours being made up to the student so that she would be working a 48-hour week.  In violation of Regulations, page 12, reading as follows: “Hours on Duty.  The time on duty including clinical practice and class hours shall not exceed forty-eight hours per week.”


  1. Annex home used as student residence did not have a reception room where the nurses could entertain their friends.  Neither did it appear to have adequate graduate supervision.  Annual report states student housing supervision, furnishings and bath facilities inadequate.  In violation of Regulations, page 7, paragraphs 5 and 6, reading as follows: “There shall be a reception room where nurses can entertain their friends.  The health and education of a nurse are much affected by her environment.  It is important that she have comfortable living quarters with provision for rest and recreation.”


  1. Clinical Facilities.


  1. Students now affiliate in obstetrics and pediatrics due to daily patient average not meeting requirements – 1950 daily census of medical patients 13.  In violation of Regulations, page 9, paragraph 16, reading as follows: “The associated hospital or the affiliated institution shall maintain the following annual daily average of patients in each field: a daily average of twenty patients each in the medical and surgical departments, and a daily average of ten patients each in the pediatric and obstetric departments.”


  1. Hospital equipment appeared inadequate for students to practice good patient care.  (Two thermometers for 20 patients.  One bedpan sterilizer for entire hospital and that not in use.  Majority of patients did not have individual equipment.)


  1. Nutrition and cookery laboratory inadequate for teaching of course.  In violation of Regulations, page 13, paragraph Laboratory, which reads as follows: “Laboratories separate from those used in regular hospital services shall be provided for teaching the sciences and dietetics.”


  1. Library Facilities.


  1. Library is in one end of upper hall of nurses’ home – size small, seating space inadequate for number of students in school.


  1. Book content is inadequate.  Annual report lists only 75 books.  Survey of books showed that majority were out of date and there was no reference book on nutrition or dietetics.  In violation of Regulations, page 13, paragraph Library, which reads as follows: “A good reference library is essential to satisfactory teaching; and the students should be encouraged to make the fullest use of it.  There should be at least one hundred well selected reference books, twenty-five per cent of which shall be above the textbook level, representing all course included in the nursing curriculum and related subjects.  The recommended one hundred books should include new editions and no duplications.”


  1. Student Supervision.


  1. Only one full time instructor and she does not supervise the students during their preclinical nor subsequent practice on the wards.  The instructor in the nursing arts course in in charge of the third floor which is the medical surgical service.  This does not give her time to teach and supervise the students properly.  Sixteen registered nurses were listed as employed on the annual report; there were twelve the day of the school visit, and one of these was working in the business office.  In violation of Regulations, page 8, paragraph 7 (a), which reads as follows: “Head nurses and floor duty nurses shall be employed as needed in order that the nursing service of the hospital may go on without interruption, and that student nurses may be properly taught and supervised throughout the twenty-four hour period.”