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Student nurses in Los Angeles completed daily symptom diaries throughout the period of their training. Average daily symptom rates were compared to daily pollutant data recorded at a nearby monitoring station. Eye discomfort, cough, and chest discomfort all increased with maximum hourly oxidant levels. Headache also increased when symptoms were adjusted for intercurrent morbidity. The relative increase of adjusted symptoms on highest oxidant days ( ≥ 0.40 ppm) ranged from 1.4 for headache to 6.1 for eye discomfort. Temperature, carbon monoxide, and nitrogen dioxide did not explain these associations. Nor were cigarette smoking, a history of allergies or bias in symptom reporting likely confounding factors. Headache and eye discomfort frequently interfere with work and personal habits. Excess cough and chest discomfort attributable to oxidant exposure may easily impose additional physiologic hardships upon high-risk population subgroups.

AS nurses are assuming an increasing number of the privileges of professional workers, it follows that they will inherit many of the obligations of the independent professional practitioner. The student nurse is safeguarded in many ways while she is under the protection of the hospital and thus is exempt from responsibility in many matters of potential legal significance. It may be both pleasant and expedient to save her from disturbing situations in which there are elements of legal implication. Perhaps these same situations arise from professional misdemeanors on her part, in which case the hospital assumes the responsibility. One may seriously question how far the hospital should go in these matters. While the degree of legal responsibility is usually defined, there would seem to be a moral responsibility to prepare the nurse to accept her share of accountability in the future. If nursing is to gain a firm footing on the professional level its members must be prepared to accept the obligations as well as the privileges of professional workers. Nurses must learn under a system of proctorship what is expected of them. They will be students, with the security that our present system affords, for but a brief moment. They will be full-fledged members of the nursing profession with responsibilities and liabilities for a much longer time. Along with her coworkers in other fields the nurse realizes the need for special instruction. The Honorable William Renwick Reddell, LL.D., D.C.L., Justice of Appeal for the Province of Ontario, said at a professional meeting last year

IN a general manner of speaking, the problems of the student nurse from the mental hygiene standpoint are problems which are the common lot of girls and young women in the later years of adolescence, no matter what their day-by-day occupations may be. A need for looking at, looking into, and holding up these problems in their proper perspective-the development and expression of what we call the personality--is nowadays recognized as an essential part of the business of preparing young people to be, first, efficient in their jobs (that is, satisfactory to the demands of the environment); and second, to find elements or aspects of their jobs which are personally satisfying to themselves. The environmental requirements for efficiency (in the case of the student nurse these are the demands made on her by the patient, the supervising nurse and the physician) are paramount from the standpoint of arranging that required services be performed with skill and dispatch. But that is not the fullness of the matter. Efficiency measured only in this way is analogous to the proverbial beauty that is only skin deep. Aware of this fact in its application to an almost limitless number of occupations and professions, educators and personnel managers have turned their minds receptively to the philosophies practiced in psychiatry and mental hygiene. We see now increasing evidence that those who are charged with the training of young people are mindful of the necessity of making it possible for the individual student to learn not only a set of skills and disciplines, but also a satisfying way of life oriented toward the circumstances of organized society. The best way of life comes about through understanding, and understanding of others does not flow from one unless there is, to a large degree, understanding of oneself in relation to the human family. It was Spinoza, the brilliant scholar and penetrating philosopher of the Seventeenth Century, who wrote

Osteoma of the mastoid is rarely encountered, and until the present data, only 32 cases have actually been reported in medical literature.1These neoplasms are not dangerous, but because of their rarity, are interesting curiosities and should be reported when encountered. Report of Case Patient is a 19-year-old white female. At the time seen, she was a student nurse at St. Mary's Hospital, Passaic, N.J. According to her history, a simple mastoidectomy, left, had been performed at the same hospital on Feb. 17, 1955. Recovery had apparently been uneventful. There had never been any aural discharge; symptoms were constant pain and a pressure sensation, radiating down to the tip, into the back of the head, and down the neck. X-ray diagnosis was "acute mastoiditis." Despite that surgery, the symptoms had never completely cleared, although some improvement was noted. Shortly after recovery, a hardly perceptible enlargement of the mastoid process

Resume L'article decrit les elements d'appreeciation des eleves-infirmieres dans les six types de cours experimentaux et les compare entre eux, ainsi que les etudiantes qui les suivent et les etudiantes d'un cours de formation traditionnel d'une duree de trois ans, a la lumiere du test d'etude des valeurs. Les 229 eleves du cours experimental et les 625 qui recevaient la formation tradionnelle dans la meme ecole d'infirmieres ont ete examinees a des jours convenus. On peut decrire sommairement les cours comme suit: 1. A. Cours aboutissant au grade et au brevet (“undergraduate”). 2. B. Cours pour universitaires (“graduate”). 3. C. Cours aboutissant a trois qualifications en matiere de nursing (“integrated”). 4. D. Cours aboutissant au brevet et au diplome d'infirmiere (“diploma”). 5. E. Cours pour candidates a qualification scolaire superieure a la moyenne (“2 + 1”). 6. F. Cours aboutissant a une qualification d'infirmiere et d'enseignante (“RNMS/teacher”). 7. G. Cours de formation de trois ans conduisant au brevet (SRN). Les 6 premiers cours sont des cours experimentaux. Le dernier (G) est un cours du type traditionnel. La signification des differences entre les moyennes des groupes a ete verifiee par les techniques d'analyse des variations et du test “t” . Les resultats montrent clairement qu'il existe une similitude marquee entre les traces d'appreciation des eleves des differents types de cours experimentaux, sauf pour les universitaires (“graduate”), tres nettement detaches sur l'echelle d'esthetique. Les eleves des cours experimentaux, pris en groupe, contrastent avec les eleves feminines du cours A (“undergraduate”) et se montrent plus interesses par les gens et grandement influences par ce qui semble utilitaire. Ils evaluent nettement leurs croyances et pratiques religieuses. Ils ne semblent pas s'interesser authentiquement au savoir scolaire et a la creativite dans l'effort intellectuel. Ils n'ont, non plus, fait preuve d'orientation politique dans leur maniere de penser et dans leurs relations. Les differences entre le groupe experimental et le groupe “SRN” sont axees sur les evaluations sociales et economiques, qui se refletent dans les raisons pour lesquelles les eleves du premier groupe choisissent le nursing comme profession: plutot le gout de s'occuper des gens que des facteurs de retribution et de chances de promotion personnelle. Les resultats de cette etude et des deux etudes anterieures tendent a etayer l'opinion de beaucoup d'enseignants en nursing, opinion selon laquelle l'organisation de ces cours attirerait beaucoup d'eleves excellents, sous le rapport des aptitudes, des valeurs, des attitudes et des traits personnels. L'etude semble soulever quelques questions importantes sous l'aspect de la politique educative, par exemple celle du recours eventuel a des mesures non intellectuelles ou de motivation pour selectionner les candidats a la formation en nursing. Il est propose de suivre les eleves au cours de la seconde, de la troisieme et, dans certains cas, de la quatrieme annee de stage a l'hopital afin d'acquerir une connaissance approfondie de leur processus de developpement intellectuel et emotionnel.

AT the American Hospital Conf^L vention, held in Minneapolis in October 1927, Dr. Hugh Cabot made the statement that if he had to choose between the hospital and the out-patient department, as a teaching field for the medical student, he would choose the out-patient department. For many years the medical profession has utilized the teaching facilities of the dispensary, but educators of nurses have, with comparatively few exceptions, completely failed to realize the unlimited opportunities for teaching which the out-patient department presents. Perfection of nursing technic may be acquired in the hospital ward, but since the great public health movement has opened wide the gates of opportunity for the nurse, and the bedside is no longer her only sphere of service, it must be granted that the out-patient department has something to contribute toward the education of the student that the hospital is unable to give. The curative function of the hospital is gradually being supplemented with the modern program of preventive medicine, but as yet the out-patient department, in that it reaches a greater number of individuals, seems to be the logical field for the beginning of teaching positive health and the prevention of disease. By encouraging periodic health examinations, we are going to reach the individual before the invasion of disease. Dr. Dewey defines the aim of education to be " to develop in the individual, continued capacity for growth." Dr. W. W. Charters gives this definition: "The aim of education is to give the individual an appreciation

A group of student nurse volunteers were found to obtain scores on the Stanford Hypnotic Susceptibility Scale which did not differ when they were hypnotized by experienced or by inexperienced hypnotists. Neither did scores vary from first to second occasion regardless of the experience of the hypnotist. The results are interpreted to mean that the factor of hypnotist experience is likely to be irrelevant to subject performance in the standardized, research situation.

Resume Le taux eleve d'echecs aux cours de formation pratique pour eleves en nursing a donne lieu a bon nombre de recherches sur la maniere de selectionner ces eleves. Les resultats ont ete peu coherents, d'autant que les taux d'echecs varient selon le type d'ecole, le sexe et la region. Il arrive que l'analyse ne tienne pas compte des effets des echecs precoces ou des differentes causes d'echec. Un groupe de 108 sujets britanniques et de 48 sujets etrangers, qui s'exercent au nursing psychiatrique dans le meme hopital, a ete etudie en vue de la determination de ces effets sur un groupe-echantillon. L'analyse des resultats a revele que l'influence du sexe et celle de la nationalite sont evidentes, aussi bien en taux de passages qu'en taux d'echecs au debut de la periode de formation. L'influence de la nationalite a ete evidente dans le taux de passages chez les differents groupes d'âge. Elle a aussi ete mise en evidence dans les patterns de correlation entre deux jeux de resultats de tests d'eleves et dans la distribution des resultats des deux tests. Des eleves qui obtenaient des resultats passables aux examens ont manifeste des tendances inverses quant aux taux de passages aux deux tests. L'analyse de ce groupe-echantillon confirme que l'âge, le sexe et la nationalite influent plus qu'on n'admet generalement sur les taux d'echecs et sur l'interpretation des donnees des tests. Des effets d'interaction complexes peuvent etre frequents. La recherche qui omet de s'informer sur ces trois variabes empeche la replique et obscurcit les estimations exactes des effets emanant du milieu hospitalier. Des tests precoces des eleves et l'analyse complete des echecs sont necessaires si l'on veut obtenir des resultats permettant de guider autrui dans des techniques de selection approrpiees.

Resume Les caracteristiques personnelles de 1614 eleves-enfirmieres formees dans les polycliniques de la region de Birmingham en 1955–1956 ont ete enregistrees lors de leur admission. On a enregistre pareillement les progres accomplis par chaque eleve jusqu'a son depart ou jusqu'a sa qualification a l'examen final de l'Etat. Trois caracteristiques particulieres—l'âge d'admission, l'experience professionnelle anterieure et la formation generale—ont ete etudiees separement par rapport aux resultats de la formation professionnelle. 58% du total des eleves admises ont subi avec succes l'examen final. La moitie des eleves etaient âgees de 18 ans lors de leur admission et 61,5% d'entre elles ont satisfait a l'examen. De meme pres des deux tiers deseleves admises a 25–29 ans, la proportion etant de 1 sur 2 pour celles admises a 20–24 ans. Ces differences sont imputables a un certain degre a la relation existant entre l'âge a l'admission et l'experience professionnelle anterieure. Comme on pouvait le prevoir, les eleves deja titulaires de qualifications en matiere de nursing ont obtenu de meilleures notes que celles qui ne possedaient pas de telles qualifications. Les eleves qui avaient subi apres le cours de Pre-nursing la premiere partie de l'examen de l'Etat ont aussi obtenu de bons resultats. La relation entre la formation generale et les resultats de la formation professionnelle est nettement etablie. Presque les trois quarts des eleves titulaires du Certificat General avec une moyenne satisfaisante dans cinq branches ou plus (ou mieux cotees encore) ont satisfait a l'examen, ce qui ne fut le cas que de juste la moitie des eleves depourvues de cette qualification. Les proportions d'echecs aux examens sont largement imputables a ces differences. Si l'on repartit les hopitaux, selon la moyenne des reussites, en groupes a pourcentage eleve, moyen ou faible, on remarque que le premier groupe admettait des eleves plus "cultivees" que ce n'etait le cas du second groupe et a fortiori du troisieme. D'autre part, a egalite de niveau d'education, les eleves du premier groupe d'hopitaux ont obtenu de meilleurs resultats que celles des hopitaux a pourcentage de reussites moyen ou faible.

PSYCHOLOGISTS tell us that we derive from 75 to 85 per cent of our education by way of the eye; that a picture is more firmly rooted in the memory than is a written word. Teachers in all branches of education bear out these claims and take advantage of the fact by using illustrative material for the teaching of students, from the nursery school to the great university. New methods are being developed constantly to make the essential facts in both the arts and in the sciences assume a more concrete form in the mind of the student. It is not sufficient that the textbook of today contain only the essential facts relating to a definite subject, however fundamentally sound they may be from a scientific standpoint. It must be all of that, and in addition it must be sufficiently interesting to enable the student to visualize the subject matter discussed therein, and if called upon, to illustrate her knowledge in the more graphic form of posters, charts, etc. From a pedagogical standpoint, the science of nutrition and diet therapy offers an exceptional opportunity to the student nurse for illustrating her knowledge of foods and their effect on the body, in health and disease. A student who has learned to demonstrate her knowledge by putting it into picture form is more likely to remember the essential facts than she would be if she simply read over the chapter once or twice before the lesson began. It is not always possible to make use of such a teaching project during the brief time allotted in many training schools for the teaching of nutri

Mrs. Franceschi, mother of three children, is a student nurse now completing her second year at Foothill College, Los Altos, California. Following an assignment for which each student was given a patient to observe through surgery and recovery, Mrs. Franceschi wrote her observations. She has mentioned what impressed her as being important in good patient care and has indicated her ability to adapt and apply the principles which she has learned during her training.

ROUTINE work that restricts initiative . . . thwarts the nurse's purpose, and makes her unhappy!" Quite. But routine work need not thwart her purpose! If it does so the fault is probably either with the person directing the work or with the spirit in which the student considers routine. Perhaps we do not have room for so very much actual "initiative" in the carrying out of this part of the care of our patients! What actually is routine? Is it not the repetition of those procedures which must be carried out day after day in the same manner because there is one best and shortest way of doing this particular work? What would be the effect on the patient if each student nurse were allowed to give full play to her own "initiative" in this matter! From personal experience, may I say to any tired senior wrestling with a "raw and impossible junior" (such as I now recognize myself to have been), "perhaps her first vision of the possibilities of wardwork and routine may come through you." Vividly I can still recall my first "senior nurse" and the way in which she said to me as I labored up the ward with a tray full of "fluid cups," overpoweringly conscious of my twodays-old cap and my stiffly starched bib: "Miss , it is not enough just to put down that patient's cup beside him and then take it away again full, with a zero entry in the fluid-intake book. Look at the temperature he's running; and his scanty

A 19-year-old student nurse became reactive to tuberculin after exposure to an active case of tuberculosis; she reverted to the nonreactive state after one year of isoniazid therapy. One year later, the patient was exposed to another active case of tuberculosis, and the skin test was again reactive. After a second course of isoniazid therapy, she became nonreactive a second time.

While we have realized that this is actually done, it does come with a bit of a shock to see it so worded. Be our reaction to it what it may, however, we must acknowledge that the student nurse is often doing just this. We also realize that it will not be possible soon to revolutionize the system of nurse education. Most of us would agree that we cannot readily or wisely lessen costs by paying smaller salaries, by cutting already minute appropriations for library and equipment, by reducing the number of instructors and supervisors, or by offering fewer classes. Rather we wish to add to all of these. Some of us are convinced that there is one expense which can be safely and wisely reduced and that in no small measure. The quotation above gives the clue to this. These "classmates" who have "left training either voluntarily or because of dismissal" both can and should be lessened in number. This can be done by more careful

the National Committee, it is interesting to know that almost 3,500 pieces of Campaign material have been distributed from A. N. A. Headquarters, upon the request of nurses throughout the country who have been interested in studying the organization and history of the A. N. A. at this time. We are looking forward with keen interest to the' closing of the contests in June and to the selection of the student nurse and the district association which will lead in this matter. Announcement of winners of the contests, together with the state and district making relatively the greatest membership increase, will be made in the September issue of the American tional Commit e , it is interesto that almost 3,50 pieces of Journal of Nursing which, of course, will appear on approximately the anniversary day, September 2. It seems now undoubted that our birthday gift of 100,000 members will be ready for our guardian, the A. N. A., when she celebrates her 35th anniversary at that time. Those of us who have not yet quite made ready our part in this birthday gift, no doubt will make June their month of greatest effort, in order to complete this present and have it ready when the time comes when we may say, "Here are 100,000 nurses, proud of your accompli hments of the last thirty-five years, and ready to enrich the coming years of the American Nurses' Association."

(1955). What Can we Teach the Student Nurse in the Operating Room? Hospital Topics: Vol. 33, No. 6, pp. 84-86.

SINCE 1929 the Students' Health Service at the University of Minnesota has been carrying out a program of immunization against scarlet fever among the student nurses of the University of Minnesota School of Nursing. Nurses in the University School are assigned to the Minnesota General Hospital (University), the Minneapolis General Hospital, and the Charles T. Miller Hospital in St. Paul. Their service is a rotating one and at some time in it they receive training in the care of contagious diseases on the ,contagious wards of the Minneapolis General Hospital. This contagious service includes the care of scarlet fever patients. This report presents the results of the Dick test for susceptibility to scarlet fever done when these students enter the University of Minnesota School of Nursing and the results of immunizations done on those who were found susceptible during the years 1929-1933 inclusive. Within one week after admission to the University School of Nursing, each student nurse was given a Dick test. This test was carried out according to the directions of the Scarlet Fever Committee. Exactly 0.1 cubic centimeter of Dick toxin was injected intradermally in the forearm. The test was read between twenty and twenty-four hours afterwards. Any redness about the site of injection, even the slightest erythema if it measured 10 millimeters in diameter, was called a positive reaction. The Dicks1I h ve frequently called attention to the fact that, unlike the Schick test, a positive reaction to scarlet fever toxin as used in the Dick test seldom shows any induration and that the slightest flush or reddening constitutes a positive reaction.

RECRUITMENT to the nursing profession continues to lag far behind the requirements of the hospital service. Outspoken comments have recently been made on why this shortage of nurses persists. A correspondent to the Daily Telegraph suggests that it is because in no other profession is a young girl subjected to arduous and often dirty manual labor, vigorous and often intolerant discipline and inadequate rates of pay. These views have stimulated a lively correspondence. They have been endorsed by some writers and disputed by others. It is true that in the past the student nurse was expected to undertake the cleaning . . .

Resume Les pertes en eleves-infirmieres, qui s'elevent courament a 30 p.100, ont fait l'objet de nombreuses recherches. Celles-ci ont degage un facteur institutionnel, l'aptitude ou l'inaptitude des hopitaux a retenir leur personnel different considerablement. Beaucoup d'etudes de la question prennent pour indice de pertes un chiffre global et il semble qu'on pourrait s'appliquer a analyser mieux les modes et raisons du phenomene. Ceux-ci varient aussi d'un hopital a l'autre, comme le prouvent les 11 groupes de donnees presentes par l'auteur. Les pertes determinant l'effectif en eleves-infirmieres d'un hopital en ses proportions d'eleves de 1 e , de 2 e et de 3 e annee, il va de soi que tout essai de politique du personnel doit considerer cet element de survie caracteristique de chaque institution prise en particulier.

The diploma school of nursing in the United States is, according to the stated policy of the American Nurses’ Association, slated to disappear. The leaders of professional nursing have adopted a policy which involves the upgrading of academic standards in nursing education. At the same time, society’s demand for nurses and the increased use of medical services mean that the diploma schools which, in 1965, accounted for 80% of the total number of nursing students who graduated that year, and furnished 78% of all the nurses in practice, are not about to die quickly.

Students in small schools are often confronted with problems which are technically unrelated to the formal socialization goals of the institution. Behind the “kidglove” treatment which many small schools engage in, lies the tendency for “total person evaluation” which often proves stifling and frustrating for students who fail to conform. The “home away from home” character of small schools may be intolerable for students who wish to establish or to maintain some measure of autonomy. Student officers often function as cadres for school administrations. The system possesses attributes which press toward encroachment upon student privacy. Subjective, “personalized” evaluation by administrators may be as punitive to some students as it is charitable to others. From one theoretical perspective, the “goody-goods” are as deviant as the “wild ones.” Specific structural changes in small school systems might increase the correlation between ability and receiving a degree.

On the third day of my hospitalization, I was awakened at 7:80 A.M. by a cheerful voice. An attractive young lady was standing at the foot of my roommate's bed. "Good morning," she said, "I'm Miss Jones. I'm a student nurse. I've been assigned to your room this morning." Her voice fell slightly but still clung to the note of good cheer. "This is my instructor, Miss Hogan." Miss Hogan cast an appraising eye over us, smiled briefly, and was gone, leaving us to Miss Jones who proceeded to demonstrate her training. I watched fascinated as my fellow patient disappeared in a flurry of elbows and flying linen. I watched as his teeth were taken out of his mouth, polished to a brilliant gleam, and replaced. I heard him protest feebly that he was capable of washing his own face. At that moment five or six other girls entered the room to make his bed. Somebody pulled the curtain between the beds and I took this opportunity to sneak into the bathroom. Through the door I could hear their gay chatter. "Isn't that better?"