Chairman HILL. Would you not think a great city, a relatively rich city, like Chicago would, perhaps be able to secure practical nurses better than many or most of the cities and communities throughout the United States?

Mrs. FAIRBANK. I should think it would.

Chairman HILL. Senator Lehman, do you have any questions? Senator LEHMAN. Do you know approximately what the budget of your hospital is?

Mrs. FAIRBANK. The hospital, the supervisory end of my hospital, has a budget which is given to it by the university. They apply to the university for their budget needs.

My concern with the hospital, and I do not know how large that is, it has the usual running deficit, as it is called. My own budget. which, as a president of the board of directors in a fund-raising capacity, runs between eleven and twelve thousand dollars a year. We very often help to pay for this type of training program out of that kind of funds, and of anything over that for specific needs of the hospital, we raise that separately.

Senator LEHMAN. As I understand it, your funds either come from the university——

Mrs. FAIRBANK. From the university.

Senator LEHMAN (continuing). Or from private contributions. Mrs. FAIRBANK. That is right.

Senator LEHMAN. And I assume that it runs into a very substantial figure?

Mrs. FAIRBANK. It does.

Senator LEHMAN. This bill provides for an authorization of $5 million for the whole Nation. It is fair to assume under those circumstances that Illinois, as a whole, would not get, even if the full $5 million were appropriated, over $250,000 or $300,000, which would have to be used throughout the entire State.

Now, assuming all that I have said is correct as to the amounts, your hospital was given Federal aid to a certain extent-it could not be more than a very few thousand dollars-you think that would lessen or sap local initiative or the interest that the university or the public-spirited people of Chicago would have in the hospital? Mrs. FAIRBANK. No, sir; I do not.

Senator LEHMAN. I do not either.

Chairman HILL. Do you think it might serve as a stimulus to get the people interested in your hospital to do even more than they are doing now?

Mrs. FAIRBANK. I think so, perhaps.

Chairman HILL. You think it would serve as a stimulus.

Let me ask you this, Mrs. Fairbank: One of our biggest problems today, of course, is the increased cost of hospital care. Perhaps if some of our friends in the American Hospital Association had not been sitting out there I might have said the high cost of hospital care. [Laughter.]

I wish you would comment on this: Do you feel that if we could get more of these practical nurses, that the acquisition of these nurses might reflect itself into a little lower cost of hospital care?

Mrs. FAIRBANK. No, sir.

Chairman HILL. If you have more practical nurses, the cost would not be quite as much as for the other nurses, would it?

Mrs. FAIRBANK. I do not suppose it would.

Chairman HILL. You do not suppose it would. Would that not be true?

Mrs. FAIRBANK. On the other hand, a good deal of the cost per day of a hospital patient is determined by the amount of expenses that you have that would have to come out of what you bring in, and a lot of our training at the moment of practical nurses has to be carried by our high cost, as you call it.

Chairman HILL. The cost of training has to be really in the end carried by the hospital.

Mrs. FAIRBANK. It has to be carried by the hospital.

Chairman HILL. Which means it has to be carried by the patient who comes to the hospital; is that right?

Mrs. FAIRBANK. Carried by the patients.

Chairman HILL. Yes, carried by the patients.

Excuse me, Senator Lehman.

Senator LEHMAN. I just wanted to say one thing. Mr. Greiber testified that in his State of Wisconsin the number of practical nurses required was 7,500; there were only, I think he said, 475 in the entire State, so that certainly gives evidence of a very great shortage.

While I have not got the figures, I think it has been pretty clearly demonstrated that at least in many of the localities of the country there is a shortage of graduate nurses, too.

Mrs. FAIRBANK. There is.

Senator LEHMAN. The figures that have been given to me have been quite startling on that.

Now, if that be the case, the better training of practical nurses or possibly the training of a small increased number of practical nurses would certainly not satisfy the needs either of graduate nurses or even satisfy the needs of practical nurses; is that not a fact?

Mrs. FAIRBANK. Yes, that is very correct; you are correct in saying that.

Chairman HILL. We want to thank you, Mrs. Fairbank.

Mrs. FAIRBANK. Thank you very much. It was a very fine privilege to be here.

Chairman HILL. It is very fine of you to come all the way from Chicago and bring us this testimony.

Mr. Henry Hooper, immediate past president, Ohio Hospital Association; superintendent, General Hospital, Cincinnati, Ohio. Mr. HOOPER. Thank you Senator.

Chairman HILL. We are happy to have you here, sir, and appreciate your coming. If you will just proceed in your own way, please, sir.

STATEMENT OF HENRY N. HOOPER, SUPERINTENDENT,
CINCINNATI GENERAL HOSPITAL

Mr. HOOPER. Thank you, Mr. Chairman. I am Henry N. Hooper, superintendent, Cincinnati General Hospital, immediate past president of the Ohio Hospital Association and a member of its board of trustees, whom I represent. The Ohio Hospital Association has a membership of 248 of the 258 hospitals registered in Ohio. I also happen to be a member of the Public Health Council of Ohio, which is the State board of health.

I am here to make known the Ohio Hospital Association's support of bills before this committee for assistance in practical nursing and auxiliary hospital personnel service. We are in support of these bills, and particularly Senate bill 929, because of the following reasons:

1. There can be no doubt of the need for additional bedside nursing for all types of ill persons in hospitals, particularly in the general hospitals. In my own institution, we have 148 professional-nurse positions authorized and are currently able to recruit only 104. The difference must be made up somehow.

We cannot even provide one registered nurse round the clock in each nursing unit in which acutely ill patients are cared for. The practical nurse has proven her place in relieving professional nurses of those duties which she can perform.

She has been accepted by the professional nurse as a qualified assistant. In addition, the growing number of older patients suffering from long-term illnesses is particularly evident in my community, and the services of the practical nurse offer the only possible means of meeting the needs of this increasing group.

2. Qualified candidates for practical-nurse training are available. In the program conducted by the board of education in the Central Vocational High School of Cincinnati, there are currently 120 to 149 applicants for each class of 40 practical-nurse students. Even after screening, there are 70 such applicants. Ohio has 8 vocational education practical-nurse training programs, which have trained some 2,000 graduates over a period of 5 years. Ninety-eight percent of the practical-nurse trainees of the Cincinnati program are actively engaged today in practical nursing, most of them in hospitals. The State of Ohio is devoting its available funds to these programs and sharing from local resources is evident in each case.

The provision of State vocational education funds has made possible these eight programs. Participation in training needs has been limited to assistance in the payment of teacher and supervisor salaries. In many localities this participation needs to be expanded to make possible the provision of additional programs. Particularly are programs needed in rural areas, using one school and satellite hospitals. Also, assistance by State education resources has stimulated provision of local funds for practical-nurse training.

In Ohio, Federal assistance has been used to supplement and broaden practical-nurse training facilities. In no case have these funds been used to supplant State and local funds.

Assistance is needed in more fields than that of practical nursing. The supply of professional dieticians is equally short, and the only feasible answer to this shortage lies in the training of dietary assistants. Other technical fields are equally short, notably those of laboratory assistants and the teachers of nurse aids.

We believe that assistance to the States for the training of practical nurses and other vocational groups has proven its value in the care of hospital patients. We are now at the point where expansion of these programs and the establishment of additional training facilities offers the only feasible answer to the current needs for the bedside care of hospitalized patients. We believe that this bill will go far toward providing and stimulating this necessary expansion, and therefore we urge its strong support by the committee for passage.

Chairman HILL. Now, Mr. Hooper, you come from one of the great, relatively rich States of the United States, but you feel that there is a definite need for Federal aid; do you not?

Mr. HOOPER. We feel, sir, that the provision of Federal aid provides the impetus, the stimulus, that many areas need. It is a moral stimulus as well as a financial one, Senator.

Chairman HILL. In other words, instead of the Federal aid encouraging the States or causing them to fail to meet their responsibilities in the matter, it encourages and stimulates and really challenges them to do more; is that not right?

Mr. HOOPER. That has been the case in Ohio, sir, yes.

Chairman HILL. You have been watching this for some time, have you not?

Mr. HOOPER. That is right, sir.

I have been trying to urge the State to set up more programs in Ohio. I would like to see our own local board of education have three programs instead of one.

The competition for local vocational education funds is keen, and it is pretty difficult, I guess, to tell one vocational area, "We must cut you down in order to expand practical nursing."

Chairman HILL. Then your experience is that the Federal funds do stimulate and bring forth the greater effort on the part of your local communities?

Mr. HOOPER. Exactly, sir.

Chairman HILL. Would you care to make any comment about the effect that meeting this shortage of practical nurses, giving us the nurses that we need through this program, might or would have on the cost of hospitalization?

Mr. HOOPER. From my own experience, sir, it has not indicated that it will be an active, considerable factor in reducing the daily cost of hospitalization.

In our case, where we cannot hire the registered professional nurses, I tell our nurses service director that she may hire the equivalent in dollars, in dollar cost, in practical nurses, or if they are not available, in nurse aids, because obviously it takes more nurse aids to make up for what a registered nurse can do.

I would like to think that it might have some effect upon the cost of hospitalization, but I would not make so bold as to state that I think it would.

Chairman HILL. How large a hospital is your General Hospital in Cincinnati?

Mr. HOOPER. 810 beds.

Chairman HILL. That is a large hospital, is it not?

Mr. HOOPER. It is big enough for me, sir.

Chairman HILL. You mean the problems are big enough.

Mr. HOOPER. Yes.

Chairman HILL. Senator Lehman?

Senator LEHMAN. No questions.

Chairman HILL. Mr. Hooper, we certainly appreciate your coming all the way from Cincinnati and bringing us this very splendid and helpful testimony.

Mr. HOOPER. We are most grateful for the opportunity, Senator. Chairman HILL. Thank you, Mr. Hooper; thank you again, sir.

Mrs. Jean Corcoran, president of the Licensed Practical Nurse Association of Illinois, Chicago, Ill.

Mrs. Corcoran, it is nice to have you here.

Mrs. CORCORAN. Thank you; it is nice to be here.

Chairman HILL. We will be very glad to have you proceed in your

own way.

STATEMENT OF MRS. JEAN CORCORAN, PRESIDENT, LICENSED PRACTICAL NURSE ASSOCIATION OF ILLINOIS

Mrs. CORCORAN. This is a statement by Jean B. Corcoran, licensed practical nurse, graduate of the first class of the first accreditated school of practical nursing in the State of Illinois, president of the Licensed Practical Nurse Association of Illinois, to the United States Senate Committee on Labor and Public Welfare."

The Licensed Practical Nurse Association of Illinois, an association of licensed practical nurses, with a membership of over 2,100, in its 12 constituent divisions in the State of Illinois, supports the need for Federal aid to the States in order to improve the health service in our country.

We wish to emphasize the need in our State for Federal aid to our State vocational education department, which would enable it to increase the practical-nurse training program.

Great progress has been made by our vocational education department in this field. However, practical nurse resources are far from sufficient to meet the increasing demands for their services. It is necessary that we have more schools to prepare practical nurses for our expanding health programs.

Our school boards have had a great task in meeting the needs of education financially with all the children coming to school. Limited funds have hampered the expansion of our practical nurse training programs. Today we have only three schools under vocational education. Our greatest need is in the central and southern parts of the State. We are desperately in need of such a program in the southern part of the State where there is no school at all.

It is the proper function of our department of vocational education to prepare practical nurses for this field through sound educational programs, and also to provide the necessary extension courses that will enable practical nurses, licensed by waiver, to improve their contribution to nursing.

The need for these services far exceeds the supply.

The excerpts from a survey made by the United States Department of Public Health, in conjunction with the Illinois Department of Public Health, in 1950, indicate the need for daily patient care for professional nurses and nonprofessional nurses, as follows: Medical patients per bed per day professional nurse service nine-tenths hour; nonprofessional service 110 hours; surgical patients per bed per day, professional nurse service, 111⁄2 hours; nonprofessional service 1810 hours.

In the semiambulant patient per day, professional nurse service, six-tenths hour; and nonprofessinoal nurse service, nine-tenths hour. In the ambulant patient per day, professional nurse service, fourtenths hour; nonprofessional service, one-tenth hour.