View report page

some basic knowledge of the disease so that they can understand the patient's special
needs. Terminal cancer has often been nursed at home and in these cases the home nurse
has had not only to help the patient but also to support the relatives in their distress and
allay their fears. A special branch of the home help service was set up in 1952 to provide
sitters-in for two nights each week, to allow relatives the opportunity to sleep. The demand
has been surprisingly low, only 17 home helps were provided under this scheme in 1961.
The Marie Curie Foundation also provides sitters-in for these cases on the request of the
family doctor.
The shift of emphasis from hospital to the community care of mentally disordered
patients, since the Mental Health Act, 1959 came into force, has already had some repercussions
on the home nursing service. Senility was commonly a reason for repeated visits
by the nurse. Home nurses, too, have been called in to supervise the administration of
drugs to mentally ill patients discharged to their own homes, particularly in the first weeks
when relatives have not been able to cope or have gone out to work. Clearly the responsibility
for the care of mentally ill patients on discharge from hospital is laid on the general
practitioner, but it is still an open question whether he should call on the new divisional
mental welfare officers or the home nurse to help him in this task.
Conclusion—Undoubtedly the home nurse of today has a different but no less valuable
role than her predecessor of thirty years ago. The standard of nursing is high and health
education, always an essential part of every home visit, has become increasingly important.
The home nursing service has always been closely integrated with the general practitioner
service. Today the home nurse in London is also firmly established as a member of the
local health authority team and has co-operated at field level with the hospital service in
the continuity of care of patients discharged early to the general practitioner and home
nursing services. This close integration, so well begun, deserves the highest praise, for we
have now moved from the concept of limited services for the few to a vast network of
community services for all. No service can any longer work effectively in isolation.
143