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that night. Each midwife on the rota is on call from 6 p.m. to 6 a.m. and
will be called to patients through the Ambulance Service during these
hours. When a midwife is summoned out she telephones Ambulance
Control on her return from the case. Each expectant mother is given a
card containing details of the midwife who will attend if she is confined
during the day and details of what to do should she require a midwife
during the hours of 6 p.m. to 6 a.m.
During the year the North West Metropolitan Regional Hospital
Board wrote to the Edgware Group Services Liaison Committee pointing
out that pressure on maternity beds would soon be greatly increased and
asking that consideration be given either to the introduction of a 48-hour
discharge scheme for maternity patients, or if already in being, an increase
in the number of patients discharged after 48 hours.
Previously the limiting factor as to when such a scheme could start
was the number of midwives employed by the Local authority. However,
with the increase in establishment this year, it was possible to proceed
with the 48-hour discharge scheme and this was introduced in November
1963 and deals with approximately 10 cases per month. In this scheme the
patients are booked for early discharge only when home conditions are
satisfactory and where for some medical or obstetric reason it is considered
by the hospital medical officer to be safer for the actual delivery to take
place in hospital. Many mothers are so keen to have home confinements
that even when on account of some medical or obstetric reason hospital
confinement is indicated, they still need much persuasion. They are,
however, more willing to accept hospital confinement if they know they
will be discharged after 48 hours, provided the obstetrician is satisfied
with the condition of mother and child. No mother is pressed to come out
of hospital against her will.
The work of the midwives is co-ordinated by the Non-Medical
Supervisor of Midwives, Miss R. C. Speaight, of 585 Honeypot Lane,
Stanmore, telephone number Wordsworth 5564.
Home Nursing.
The area has an establishment of 23 home nurses, who work under
the instruction of the general practitioners responsible for the patient,
ihey carry out treatment such as general nursing care of the acute and
chronic sick, blanket baths, injections, etc., and are supervised by the
area Superintendent of Home Nurses, Miss R. C. Speaight. The number
of nurse employed during the year was the equivalent of 23 whole-time
staff and during the year they paid in all 56,049 visits.
A point of clinical interest is that during this year all injections have
been carried out using sterile disposable syringes. This gets over the
Problems of trying to sterilise syringes in the unsatisfactory conditions
sometimes found in domiciliary practice—it saves valuable nursing time
and of course ensures a sterile instrument at all times.