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Practical nurse training, in addition to offering opportunities to girls who have just graduated from high school, provides a training opportunity to many women whose children are grown and who are forced to work in order to supplement the family income. Approximately 15 percent of the enrollment in 2 of the programs in our State has been persons over 40 years of age.

Practical nurse training programs are expensive to establish and maintain. In one city in our State the program will be discontinued if outside support of the program is not continued in financing 50 percent or more of the cost.' Federal aid is, therefore, needed to supplement State and local funds to pay for the cost of establishing new training programs and maintaining existing programs. This will result in an equalization of costs of practical nurse-training programs and will assist in maintaining specifications and standards of a high type in the training programs which are established.

In some States Federal aids for vocational education are already fully committed to other areas of vocational education. Additional specific Federal-aid appropriations are, therefore, necessary in order that practical nurse-training programs may be further developed and expanded.

The following considerations are important to incorporate in legislation providing Federal aid to the States for the maintenance of present programs of practical nurse training and the further development of new programs:

1. Administration on the Federal level through the United States Office of Education.

2. Administration on the State level through State boards for vocational education as the sole agency for the State administration of programs with provisions for developing a satisfactory State plan to be submitted to and approved by the United States Office of Education outlining policies and methods which will be used in conducting practical nurse training under the provisions of a Federal act.

3. An appropriation which is specifically earmarked for practical nurse training, the allotment to each State being based on the ratio the State population bears to the population of all the States or some other satisfactory plan of allotting funds to the States.

4. A continuing appropriation which would provide for:

(a) Not to exceed 75 percent matching on costs of new projects during the first 2 years of operation.

(b) Not to exceed 50 percent matching on costs of projects for following years of operation.

(c) Federal funds to be used for reimbursing State supervision costs, instructional salaries and initial purchases of specialized equipment.

Now, that is my statement, Senator Hill and Senator Lehman; and if you have any questions, I would be glad to try to answer them.

Chairman Hill. That is a most interesting statement.

You are so much in agreement with those of us here that I do not imagine that we have many questions.

You have certainly made a fine, splendid presentation, and most helpful in behalf of this legislation.

Senator Lehman, do you have any questions?

Senator LEHMAN. I have no questions. I though it was a very interesting statement.

Chairman HILL. We certainly want to thank you for this most interesting and very fine and helpful statement. We appreciate your being here, Mr. Greiber.

(The attachments to Mr. Greiber's prepared statement follows:)

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Comparison of hospital and sanatoria need for nurses with nurses engaged in

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WISCONSIN STATE NURSES ASSOCIATION,

Milwaukee, Wis., April 11, 1955. Mr. C. L. GREIBER, State Director, State Board of Vocational and Adult Education,

Madison, Wis. DEAR MR. GREIBER : There is a definite need for more practical nurses in Wisconsin. We understand that there are more applicants than can be accepted, especially those living in the areas where no accredited schools exist.

We advocate that the Wisconsin Vocational and Adult Education Department expand its present program for the training of practical nurses and where no accredited school for practical nurses exist to set up a like program in order to give applicants from those areas the opportunity of practical nurse training. Sincerely yours,

CLARA BAUER,
Mrs. Walter Clara Brauer, R. N.

DEPARTMENT OF NURSES,

Madison, Wis., April 12, 1952. Mr. C. L. GREIBER, Director, Board of Vocational and Adult Education,

State Office Building, Madison, Wis. DEAR SIR: Recently the analysis of the 1954 annual reports from all accredited schools of professional and practical nursing was completed. I though you would be interested in comparing the 1954 findings on practical nursing with previous years since all accredited programs in Wisconsin are sponsored by boards of vocational and adult education.

Since 1946 when the first school was accredited, we have had a slow, but I believe sound, increase in the number of schools and in enrollment.

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Two schools admit 2 classes a year; 2 schools admit 3 classes and 1 school admits 5 classes each year. All have reached their maximum enrollment. This means that if Wisconsin is to accommodate all persons seeking enrollment to practical nurse education, as well as to meet the demand for this trained worker, more programs need to be developed.

A modest estimate of today's need for licensed trained practical nurses is 7,500. This includes the need not only of general hospitals but public health agencies, industry, mental institutions, sanatorium, and nursing homes. On April 1, 1955, Wisconsin had 1,420 licensed trained practical nurses.

Before the end of 1955 the commission to develop a statewide plan for nursing education will be seeking your assistance to determine which of your schools have the facilities, personnel, and resources to develop programs in practical nursing. The commission hopes to locate schools strategically throughout the State in order that we may prepare the trained practical nurses within a radius of 75 to 100 miles of her home.

Certainly we have a public which recognizes the need for and accepts this trained worker. Our attention, therefore, needs to be focused on finding the prepared faculty and the funds to establish and maintain these programs.

I know we can depend upon your assistance in our plans to expand the practical nursing education programs because of your interest and support since 1946. Sincerely yours,

ADELE G. STAHL, Director. Chairman Hill. Mrs. Kellogg Fairbank, president of the board of directors of the Lying-In Hospital, Chicago, Ill.

Mrs. Fairbank it is nice to have you here. You may proceed in your own way.

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STATEMENT OF MRS. KELLOGG FAIRBANK, PRESIDENT, BOARD OF

DIRECTORS, LYING-IN HOSPITAL, CHICAGO, ILL. Mrs. FAIRBANK. I am happy to be here today in the capacity of citizen trustee representing one hospital in our country and, as such, to endorse the sentiments of the American Hospital Association in their support of these two bills, 929 and title III of S. 886.

I believe just in my own personal experience in one hospital alone, the Chicago Lying-In Hospital, that there is a great need for vocational training for practical nurses and auxiliary people.

To give you an example of how our hospital operates, to bring it down to some basic facts, we have a hospital which has about something over 200 beds, and we employ 163 people.

Of these people, 46 are in the category such as we are talking about today, constituting about 28 percent of our personnel.

These people are trained by us at our expense and at our time.

We find it a tremendous problem because along with the training of these people we have a certain number of nurses in training approaching the graduate nurse, so we have a tremendous burden on our graduate staff in the training of these people. We have a very successfully run hospital as a result because the team nursing is very successful there.

In Billings Hospital, which is part of our university clinic setup there, which has about 500 beds, they have the same proportion there pretty much. They have 417 personnel working for them, and 159 of those, or 30 percent, are of the variety of attendant, practical nurse, clinical, clerical workers, that is, technicians, of one sort or another, who are trained in the hospital.

I would be delighted to answer insofar as I am able to, any questions.

Chairman Hill. Well, Mrs. Fairbank, you have made a most interesting statement.

Let me ask you this: Do you experience much difficulty in getting the practical nurses that you

need?
Mrs. FAIRBANK. Yes, we do.
Chairman HILL. You do.
You feel you have a shortage today?
Mrs. FAIRBANK. Yes, we do.
Chairman Hill. You do have a shortage today?
Mrs. FAIRBANK. Yes.

Chairman Hill. Would you care to make any comment on the fact that by a shortage of practical nurses, you make it even more difficult for the professional nurse and you make it more necessary to employ more professional nurses! Mrs. FAIRBANK. Well, it works the other way around so far as I

We have such a shortage of graduate nurses that there is a tremendous necessity for these auxiliary people to come in to complement the situation.

We do have difficulty in finding them because the training program is such in a specialized hospital such as ours, it takes some time, and we are not too well equipped financially to support these people while their period of training is going on, and we find that that is discouraging to them, as a result, these candidates for jobs in our hospital.

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