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28
THE WORK OF THE PUBLIC HEALTH NURSING SERVICES
Miss L.E. Oakley, S.R.N.,S.C.M.,H.V. Cert.
Superintendent Nursing Officer
1967 was the year in which attachment and liaison schemes with general
practitioners took on a fresh impetus, particularly in the cases of the domiciliary
midwifery and home nursing services. All midwives are present at
ante-natal sessions held by the family doctor, some attached to a particular
practice, others serving doctors on their areas who undertake midwifery.
General practitioner attachment has widened the scope of the home
nurses' work. She now spends a certain amount of time in the doctor's surgery,
particularly at the time the doctor sees patients who require dressings
and treatment at home following that given at the time of the surgery visit.
The fact that patients see doctor and nurse discussing their treatment together
gives them a sense of security which was lacking when each worked
in apparent isolation. The nurse too has far greater satisfaction in her work.
Staffing difficulties made it impossible for the health visitors to go
ahead as quickly as the other services. Two liaison schemes became complete
attachments and four new liaisons came into being. Liaison proceeding
to attachment is, it is believed, the best way of dealing with this matter as
far as the health visitor is concerned.
During the year a questionnaire on the progress of liaison and attachment
schemes in the health visiting and home nursing spheres was the subject
of a Ministry of Health research project. Croydon was one of the areas
which was studied in some depth following completion of the questionnaire.
Domiciliary Midwifery Service
Although the number of deliveries have dropped, early discharges from
hospital have increased. This has meant a slight change of emphasis on the
duties of part-time midwives who tend to take over these nursings from colleagues
working full-time. The majority of mothers prefer being nursed in
their own homes once the delivery is over, but neither the hospital or domiciliary
midwife get as much 'job satisfaction' as neither is completely responsible
for seeing their patient through the birth and puerperium.
Throughout the year the taking of cervical smear tests for the early
detection of signs of cancer of the womb have continued to be the responsibility
of the midwifery service. Unfortunately it was not found possible to
give more than a limited service until October, when the numbers were
increased by 50%.
In December the Guthrie test for detecting phenylketonuria was put
into operation. It is more sensitive than the urine tests previously carried
out by health visitors. It requires the collection of two or three drops of