• Journal of Korean Academy of Nursing
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• v.3 no.1
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• pp.13-40
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• 1972

Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

• MISULJARYO - National Museum of Korea Art Journal
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• v.96
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• pp.239-260
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• 2019

This paper examines the circulation and dissemination of painting during and after the nineteenth century through a case study on the One Hundred Fans paintings produced as decorative folding screens at the time. One Hundred Fans paintings refer to depictions of layers of fans in various shapes on which pictures of diverse themes are drawn. Fans and paintings on fans were depicted on paintings before the nineteenth century. However, it was in the nineteenth century that they began to be applied as subject matter for decorative paintings. Reflecting the trend of enjoying extravagant hobbies, fans and paintings on fans were mainly produced as folding screens. The folding screen of One Hundred Fans from the collection of the Museum am Rothenbaum Kulturen und Künste der Welt (hereafter Rothenbaum Museum) in Germany was first introduced to Korean in the exhibition The City in Art, Art in the City held at the National Museum of Korea in 2016. Each panel in this six-panel folding screen features more than five different fans painted with diverse topics. This folding screen is of particular significance since the National Museum of Korea holds the original drawings. In the nineteenth century, calligraphy and painting that had formerly been enjoyed by Joseon royal family members and the nobility in private spaces began to spread among common people and was distributed through markets. In accordance with the trend of adorning households, colorful decorative paintings were preferred, leading to the popularization of the production of One Hundred Fans folding screens with pictures in different shapes and themes. A majority of the Korean collection in the Rothenbaum Museum belonged to Heinrich Constantin Eduard Meyer(1841~1926), a German businessman who served as the Joseon consul general in Germany. From the late 1890s until 1905, Meyer traveled back and forth between Joseon and Germany and collected a wide range of Korean artifacts. After returning to Germany, he sequentially donated his collections, including One Hundred Fans, to the Rothenbaum Museum. Folding screens like One Hundred Fans with their fresh and decorative beauty may have attracted the attention of foreigners living in Joseon. The One Hundred Fans at the Rothenbaum Museum is an intriguing work in that during its treatment, a piece of paper with the inscription of the place name "Donghyeon" was found pasted upside down on the back of the second panel. Donghyeon was situated in between Euljiro 1-ga and Euljiro 2-ga in present-day Seoul. During the Joseon Dynasty, a domestic handicraft industry boomed in the area based on licensed shops and government offices, including the Dohwaseo (Royal Bureau of Painting), Hyeminseo (Royal Bureau of Public Dispensary), and Jangagwon (Royal Bureau of Music). In fact, in the early 1900s, shops selling calligraphy and painting existed in Donghyeon. Thus, it is very likely that the shops where Meyer purchased his collection of calligraphy and painting were located in Donghyeon. The six-panel folding screen One Hundred Fans in the collection of the Rothenbaum Museum is thought to have acquired its present form during a process of restoring Korean artifacts works in the 1980s. The original drawings of One Hundred Fans currently housed in the National Museum of Korea was acquired by the National Folk Museum of Korea between 1945 and 1950. Among the seven drawings of the painting, six indicate the order of their panels in the margins, which relates that the painting was originally an eight-panel folding screen. Each drawing shows more than five different fans. The details of these fans, including small decorations and patterns on the ribs, are realistically depicted. The names of the colors to be applied, including 'red ocher', 'red', 'ink', and 'blue', are written on most of the fans, while some are left empty or 'oil' is indicated on them. Ten fans have sketches of flowers, plants, and insects or historical figures. A comparison between these drawings and the folding screen of One Hundred Fans at the Rothenbaum Museum has revealed that their size and proportion are identical. This shows that the Rothenbaum Museum painting follows the directions set forth in the original drawings. The fans on the folding screen of One Hundred Fans at the Rothenbaum Museum are painted with images on diverse themes, including landscapes, narrative figures, birds and flowers, birds and animals, plants and insects, and fish and crabs. In particular, flowers and butterflies and fish and crabs were popular themes favored by nineteenth century Joseon painters. It is noteworthy that the folding screen One Hundred Fans at the Rothenbaum Museum includes several scenes recalling the typical painting style of Kim Hong-do, unlike other folding screens of One Hundred Fans or Various Paintings and Calligraphy. As a case in point, the theme of "Elegant Gathering in the Western Garden" is depicted in the Rothenbaum folding screen even though it is not commonly included in folding screens of One Hundred Fans or One Hundred Paintings due to spatial limitations. The scene of "Elegant Gathering in the Western Garden" in the Rothenbaum folding screen bears a resemblance to Kim Hong-do's folding screen of Elegant Gathering in the Western Garden at the National Museum of Korea in terms of its composition and style. Moreover, a few scenes on the Rothenbaum folding screen are similar to examples in the Painting Album of Byeongjin Year produced by Kim Hong-do in 1796. The painter who drew the fan paintings on the Rothenbaum folding screen is presumed to have been influenced by Kim Hong-do since the fan paintings of a landscape similar to Sainsam Rock, an Elegant Gathering in the Western Garden, and a Pair of Pheasants are all reminiscent of Kim's style. These paintings in the style of Kim Hong-do are reproduced on the fans left empty in the original drawings. The figure who produced both the original drawings and fan paintings appears to have been a professional painter influenced by Kim Hong-do. He might have appreciated Kim's Painting Album of Byeongjin Year or created duplicates of Painting Album of Byeongjin Year for circulation in the art market. We have so far identified about ten folding screens remaining with the One Hundred Fans. The composition of these folding screens are similar each other except for a slight difference in the number and proportion of the fans or reversed left and right sides of the fans. Such uniform composition can be also found in the paintings of scholar's accoutrements in the nineteenth century. This suggests that the increasing demand for calligraphy and painting in the nineteenth century led to the application of manuals for the mass production of decorative paintings. As the demand for colorful decorative folding screens with intricate designs increased from the nineteenth century, original drawings began to be used as models for producing various paintings. These were fully utilized when making large-scale folding screens with images such as Guo Ziyi's Enjoyment-of-Life Banquet, Banquet of the Queen Mother of the West, One Hundred Children, and the Sun, Cranes and Heavenly Peaches, all of which entailed complicated patterns. In fact, several designs repeatedly emerge in the extant folding screens, suggesting the use of original drawings as models. A tendency toward using original drawings as models for producing folding screens in large quantities in accordance with market demand is reflected in the production of the folding screens of One Hundred Fans filled with fans in different shapes and fan paintings on diverse themes. In the case of the folding screens of One Hundred Paintings, bordering frames are drawn first and then various paintings are executed inside the frames. In folding screens of One Hundred Fans, however, fans in diverse forms were drawn first. Accordingly, it must have been difficult to produce them in bulk. Existing examples are relatively fewer than other folding screens. As discussed above, the folding screen of One Hundred Fans at the Rothenbaum Museum and its original drawings at the National Museum of Korea aptly demonstrate the late Joseon painting trend of embracing and employing new painting styles. Further in-depth research into the Rothenbaum painting is required in that it is a rare example exhibiting the influence of Kim Hong-do compared to other paintings on the theme of One Hundred Fans whose composition and painting style are more similar to those found in the work of Bak Gi-jun.