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ment staff, taking over many duties that need nursing knowledge but not health
visitor training.
It is important to sort out from the many things which can reasonably be
claimed as the rightful function of health visitors the things which they alone can
do. The most important of these is still the routine visiting of families with young
children. There are numerous officers from whom help can be sought for a
variety of special problems. But only the health visitor has the opportunity to
know the family in the home before the difficulties arise, to realise the existence of a
situation that may cause a future mental or physical problem, and so to prevent it.
The establishing of the right foundation in these early years can set the pattern for
the way in which a person faces life, and can prevent many of the mistakes and
failures of adjustment which lead on to breakdowns.
Liaison with Hospitals
For some years now we have been more alive to the need to deal with illness
in relation to the whole person. It is not merely enough to set the fracture or
relieve the blood pressure or cure the heart failure. Treatment must take into
account the home circumstances, family relationships and mental outlook of the
patient and the kind of life he will return to. It must aim to make him well enough
to take his full share in family and community life again.
The National Health Service Act created a division in the total care of the
individual by splitting the community, the home and hospital care amongst the
local health authority, the practitioner's executive council and the hospital board.
There is a lot of lip-service payed to liaison committees, but the only way to overcome
this division of responsibility is for each person engaged in the service to get
to know the other people in it and to try to understand fully the functions of the
others, and to maintain close contact.
In this area there has always been exchange of information by letter or telephone
between the hospital and local authority medical and nursing staffs. Nevertheless,
believing there was room for improvement and that personal contact
offered better opportunity for full co-operation, it was agreed that health visitors
should attend the hospital on the days when the children's doctor was doing a
round of the premature baby ward and the children's wards. They should also
visit the almoners once a week to discuss problems related to the home circumstances
of patients about to be discharged.
Each health visitor attends two rounds of the premature baby ward and one
on each of the three medical wards for children. Those who have attended so far
have all said how very helpful it has been. They have had an opportunity to meet
the senior children's specialist and to ask about her particular methods of baby
feeding and treatment. This has resulted in their being better able to help the
mothers carry out her instructions after the children return home. They have also
been able to explain to the hospital doctor some of the particular problems of a
home they know and the difficulties which will arise when a convalescent child
returns to it.
It is a long time since many health visitors have worked in hospital and in
addition to the exchange of information it is interesting to know how treatment has
changed and see up-to-date methods. The contact with almoners is maintained
by one health visitor specially selected who acts as liaison officer. Personal discussion
in certain circumstances can lead to a better understanding of the scope
and limitations of each other's functions.
In order that nurses in training shall also understand the need for looking at
all aspects of their patients' lives, the student nurses spend one week at the end of
their first year of training observing the work of the health department, including
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