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Charting the changes in infection control nursing: the history of infection control nursing in this country is one of rapid expansion in less than 30 years. One nurse, who was there right at the beginning, shares some of her reflections.

A shift from "everybody wearing absolutely everything they possibly could to cover themselves" before entering an isolation room to standard precautions; the move from individual hospital policies and procedures to national guidelines; the shift from "contain and eradicate" to "contain and control"; the arrival of a range of infectious diseases on our shores from methicillin-resistant staphylococcus aureus to HIV/Aids to the threat of Lassa fever and severe acute respiratory syndrome (SARS); the development of infection control nursing from one novice practitioner in the mid '70s to a fully-fledged practice speciality--these are just some of the developments infection control pioneer Berry Bird has witnessed in her career.

Bird began working in the field at Palmerston North Hospital in 1976. The "dream job" was for a part-time infection control nurse and staff nurse, who was also a midwife and who had experience in theatre, with school holidays off. "Every married woman in town was looking for that job," Bird laughingly recalls.

She was ideally suited to the role, having trained as a nurse and midwife in South Africa. She and her husband and three children emigrated to Christchurch 1973, where she worked as a midwife and in theatre.

When her husband was appointed chief social worker for the Palmerston North Hospital Board, she began work at a private surgical hospital in the city. When appointed as the infection control nurse, she was the only one in the country. She was stepping into an area that compared poorly with what was happening overseas. "Possibly because of its isolation, New Zealand had been very slow to respond to the infections emerging in hospitals from the '50s. Britain had its first infection control nurse in 1959, Australia in 1962, but New Zealand didn't have such a position until mine in 1976."

In 1974 the Government had called on all hospital boards to establish infection control committees. In 1975 the Palmerston North Hospital Board had appointed medical microbiologist Gordon Scrimgeour as infection control officer. From England, he had worked with infection control nurses and knew their value, so a position was created and Bird joined Scrimgeour in the fledgling infection control team. "There was just one textbook, Control of Hospital Infection, which was put on my desk and I was ton to go to it. Initially the rote was one of surveillance but I soon realised that in the absence of courses, I had to plan my education. I learned by extensive reading and from laboratory and ancillary staff. If any changes were needed, policies and procedures had to be developed. I was very lucky to have Gordon Scrimgeour as my mentor. I also read American and British journals, but they took such a long time to reach New Zealand. There was no easy access to the web, as there is today."

In 1979, Christchurch Hospital appointed an infection control nurse and the following year Dunedin followed suit. Bird finally had infection control colleagues, who both spent time with her in Palmerston North as part of their orientation.

In 1980 the Department of Hearth approached Scrimgeour and Bird to host an infection control course. The four-day course was attended by 28 people, including seven nurses. Those nurses met after the course and became the nucleus of a group that would later evolve into NZNA's national division of infection control nurses. Berry played an integral part in the development of the division and was made a life member in 2001.

Education and networking

Education and networking were priorities for the growing specialty. An inaugural conference was held in Auckland in 1982. In the mid '80s Waiariki Polytechnic responded to the can for an education course for infection control nurses and that course continues.

Once established, infection control nursing developed rapidly. From one nurse in 1976, there were 68 ten years later.

The development of a national standard and audit tool for infection control has been a significant development. Instead of individual infection control nurses working in their hospitals, developing their own procedures and protocols, there are now standardised guidelines all practitioners have to adhere to.

Better deal for patients

The development of standard and transmission-based precautions has meant a much better deal for patients. "Before we knew the different ways diseases were spread, we treated everyone in isolation in the same way and always wore glvoes, gowns and masks. Precautions are now related to the transmission and that's so much better for patients because there are fewer barriers."

What nurses today take for granted--sharps boxes and alcohol hand rubs--were revolutionary in Bird's time. She and Scrimgeour developed New Zealand's first sharps boxes, made of cardboard, ending the dangerous practice of dipping off needles and blades.

In 1978 an outbreak of klebsiella in the neonatal unit led to Bird identifying cake soap as a fomite. The soaps were replaced with liquid soap. The international literature at the time recommended alcohol hand rubs. They were not available in New Zealand but undeterred, Bird, on behalf of the infection control committee, located a prescription and the chief pharmacist at the hospital made it up. "Because the hospital was a pioneer in infection control I had a very supportive medical and nursing administration to work with. Our work was always treated with respect."

Her expertise in the field has seen her serve on many national committees and the Australian/New Zealand Standards Committee.

When she retired from the hospital in mid 2003, there were two furl-time infection control nurses, and one part-timer in outlying hospitals. Finishing at the hospital did not mean an end to her career. Bird organised the infection control nurses' conference in Palmerston North last year, attended by 250 delegates. She is now doing consultancy work for private hospitals and rest-homes. "It keeps my hand in and my interest. Infection control has been such a satisfying career for me."
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Title Annotation:Profile
Author:O'Connor, Teresa
Publication:Kai Tiaki: Nursing New Zealand
Geographic Code:8NEWZ
Date:Mar 1, 2005
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