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51
of rapid change in medical and nursing fields. The third reason for
increasing staff is the earlier discharge home of patients from hospital.
In 1971 the number of new patients referred and treatments given has
increased, and with more General Practitioners Attachment Schemes, and more
use being made of nursing skills by hospitals, this increase is likely to-continue.
In 1971 the number of new patients referred was 4,653 compared with 4,525
in 1970, and treatments given were 160,405 in 1971, compared with 154,703
in 1970.
Training is important for nurses who wish to work in the community
services since treating patients at home requires staff to be adaptable, to use
their initiative, to have a thorough knowledge of other services and facilities
which can be used to help to make patients as comfortable and happy as
possible at home, and to prevent for as long as possible their being removed to
hospital or institutional life. It was possible for 8 nurses to attend the District
Nurse Course at either Croydon or Chiswick Polytechnics in September 1971,
and all passed the examination. The opportunity arose also for a number of
staff to attend a refresher course, which is offered each five years for all staff,
or one day courses or conferences with particularly relevant subjects. Two
one-week courses were organised by St. Thomas's Hospital for community
nurses. These were most successful and staff were very appreciative of the
hospitality given. It is proposed that next year lectures on subjects particularly
requested by nursing staff should be organised in the Health Directorate as
in-service post certificate training.
The district nurses themselves have also contributed towards the training
of others, mostly from hospitals. The emphasis in many training courses is
very much on community needs and each year a number of students visit the
nurses to identify the needs of people in their own homes, and to see that
facilities and services provided by Local Authorities and voluntary organisations.
Overseas visitors also find this kind of visit of immense value, particularly those
from under developed countries.
Gradually the number of requests by general practitioners for an attachment
of or liaison with a district nurse is increasing. The requests are controlled
by the rate at which surgery premises are improved or replaced, but availability
of nursing staff who are interested in such schemes is another factor. Those
schemes already organised are working well, and the doctors involved have
nothing but praise for the contribution the district nurse makes to a busy
practice. Much time during the year has been given to reviewing the district
nursing service and to make an assessment of patient needs as well as doctor
and hospital possible future needs. A night service to give some relief to
relatives of sick, usually elderly patient who are restless, disturbed and sometimes