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45
The Chiropody Service in Walthamstow is fortunate in having six
full time and three part time Chiropodists, and is the only Clinic in
Essex with a full staff. This situation has not been brought about
by higher salaries or elaborate surgeries, but I think, by the happy
relations which exist between the Chiropodists and the other members
of the Health Department Staff.
District nursing of the elderly
The primary aim and object of the district nursing service is to
provide total nursing care to patients in their own homes, especially
the chronic sick and aged, in order to cater for their physical,
mental, emotional and social needs; to assist in rehabilitation and
to play an important part in health teaching and prevention of disease.
The 'home nurse' or district nurse has had special training to
equip her for these highly skilled duties, and has the privilege of
right of entry into all homes she visits. She works as right hand to
the doctor and the family whenever skilled nursing care is needed in
the home. Any responsible person may summon her, in fact she is a
public servant, but she may not continue to visit without the family
doctor's consent.
In a busy district her day's work may entail twenty calls, giving
injections to patients suffering from diabetes, cardiac failure,
cerebral degeneration, cancer, respiratory infections, doing dressings
for a variety of cases, varicose ulcer, leg ulcers, burns, scalds or
any post-operative wounds, to carrying out general nursing care for a
variety of conditions from a terminal case of carcinoma, where she may
spend two hours daily in the house, to a young child with whooping
cough.
Daily reporting of all patients under her care to the family
doctor and the Nursing Superintendent is necessary, as well as writing
accurate concise reports on the appropriate message form left at the
house. Occasionally she will meet the family doctor in order to
discuss the progress of the patient and to see if anything more can be
done to help him.
General nursing care consists of attending to the daily toilet,
including care of the skin, hair, teeth and nails, as well as blanket
bathing. This is very important to the comfort of the patient if
there is any question of bedsores.
Where long term illness exists, i.e. an advanced stage of
carcinoma, the condition calls for all the skill, patience, ingenuity,
cheerfulness and moral support which a nurse can give to the patient
and his family and this is nursing of the highest order.
It may be necessary for sick room equipment to be borrowed i.e.
special bedstead with hoist, mackintosh sheet, urinal bed cradle
back rest air cushion, commode etc. The relatives are requested to
call for these at the District Nurses Home, or the local authority or