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93
the nurse visited as required for Dispensary purposes and took clinics.
In 1921 an additional nurse was appointed part time. Next year the
appointment was made a whole time one. The nurse appointed became
ill in the following year and later resigned. Another nurse was
appointed, but remained for only a short time so that a fresh appointment
had to be made early in 1925.
Changes in a satisfactory staff carry many disadvantages.
New Visitors lack the accumulated knowledge of old patients and
their circumstances and require time to get acquainted with patients and
conditions in their districts. Changes in Tuberculosis Officer bring
the same disadvantages, and in addition there is a loss in continuity
of Clinical experience and knowledge of individual cases over a period
of years. It is of much interest and instruction to see cases again
after a lapse of 4 or 5 years, and learn how some have done unexpectedly
well, and some unexpectedly badly, and more particularly
to see how those cases of doubtful disease, especially in children have
turned out. Experience gained in this way by prolonged knowledge
of cases is of very great value to the Tuberculosis Officer and his
patients and is lost when changes are frequent.
The number of Sputum examinations is now larger than ever.
Owing to the increase in co-operation with General Practitioners
and School Medical Officers, Hospitals and local bodies, (such as the
Guardians, Red Cross Society, Invalid Children's Aid Association,
Charity Organisation Society), in addition to reports to the Ministry of
Health and London County Council, there has been a great increase
in the volume of clerical work in keeping registers, sending reports,
copying, filing, compiling statistics, etc.
This work is now carried out largely by Miss Greig who has also
to do dispensing for the Tuberculosis Dispensary, and orders and
allocates drugs, etc., for the Infant Welfare Centres. She also prepares
Sputum tests, not only of dispensary patients, but also of specimens,
sent by doctors, of persons residing in the Borough, even though they
may not be dispensary patients. Much purely clerical work is also
done by the Tuberculosis Officer, the Nurses, and the Secretary of
the Care Committee.
As an example of the amount of Clerical work involved, possibly
in a single case—An ex-service man may present himself for examination
with a card from his own doctor asking for an opinion. A report
on the condition is made to the doctor, and if the case is one requiring