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15
NURSING SERVICES
In spite of the re-organisation of the work of the department resulting from the implementation of
the Social Services Act and the transfer of some of the services previously carried out by the nursing section,
there was in fact an increase in the activity during the year. It is obvious that although some of the services
are no longer under direct administration of the section, time is still spent on these as help or advice on
nursing matters is frequently required by the Social Services Department.
The day-to-day work continued with the aim of all public health nurses in mind, i.e. the promotion of
health, the improvement of conditions in the social and physical environment, rehabilitation and the prevention
of illness and disability.
Attachment and/or liaison of health visitors and home nurses to general practitioners has increased so
that 38% of health visitors and 10% of home nurses now work in these schemes.
A group of general practitioners, concerned about the health and welfare of their patients in the 65+
age group, requested the help of the nursing services to ascertain the needs of these people. Geriatric visitors
and health visitors, including staff of the London Borough of Hackney where some of the patients lived, cooperated
in this project. Many of these elderly people were found to be well and active, some still in full-time
or part-time employment. The majority of those who were frailer, housebound or ill, were receiving a variety
of domiciliary services from the boroughs concerned. Additionally, a geriatric visitor was involved in the
planning of a pilot survey questionnaire for screening of the elderly, and later in carrying out this survey on
patients in one group practice.
The year has been a busy one for the home nurses; an increased number of patients entailing a larger
number of visits. 75% of the patients are over 65 and many are between 80 and 90 years. The chronic sick,
handicapped and terminally ill make up the largest proportion of patients, many requiring prolonged and
intensive care.
Co-operation with hospitals gained momentum. A second health visitor attends paediatric ward round
at Whittington Hospital, and a health visitor now goes to Elizabeth Garrett Anderson Hospital for case
conferences involving Islington patients. These arrangements were made after consultation with the London
Borough of Camden. Visits were made to St. Bartholomew's and University College Hospitals to facilitate
entree to these hospitals for home nurses, so that patients can be seen either after admission or prior to discharge,
thus ensuring continuity of care. Staff are frequently invited to nurse-study days at the hospitals with
which they liaise.
The importance of community medicine has also been receiving increasing recognition by medical
schools; several medical students obtained experience in this field in the Borough during the year. A lecture
on the work of public health nurses was given to doctors taking the Diploma of Public Health at the
Royal Institute of Public Health and Hygiene by the Chief Nursing Officer.
Visits were arranged for nursing officer colleagues from other London Boroughs to see the new River
Place Health Centre. Others came to glean information gained from work with the Keystone Vision Screening
apparatus which the school nurses have used successfully during the year. On the other hand, three of the
nursing officers gave a symposium to nursery nurses at the North London College and a meeting was held
with the Area Team Leaders of the Social Services Department to explain the aims, functions and duties of
the nursing service.
Apart from refresher courses attended by staff, in-service training included:-
(i) mouth to mouth resuscitation - talks to all nursing staff;
(ii) domiciliary family planning - symposium for health visitors and midwives; and
(iii) training sessions concerning the computerisation of child health records - health visitors.