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THE WORK OF THE COMMUNITY NURSING SERVICE
Miss J. Byatt, S.R.N., S.C.M., M.T.D., Q.N., H.V., Chief Nursing Officer
The new nursing management structure agreed during 1970 was implemented during 1971.
A chief nursing officer took up her duties in August and by 22nd November two principal nursing
officers and seven senior nursing officers were in post. All posts in the new structure except that
of the chief nursing officer were filled by promotion of existing staff. The management structure
now gives three clearly defined levels of responsibility as is shown by the organisation chart on
page 42. Nursing staff at field level are now in teams of 12-15 nurses, each team having its own
first line manager who co-ordinates the work of the team and gives support and help where
necessary. The first line managers are responsible to the principal nursing officers who, at middle
management level, see that their own services are running smoothly. At top level the chief nursing
officer co-ordinates the work of the various services—home nursing, midwifery and health visiting.
Most of the community nursing staff at field level are highly qualified and therefore are not
in need of supervision from nursing management staff. Newly qualified staff, however, need
support and guidance as do the many nurses in training who now spend time in the community.
IMight Nursing Service
A night nursing service commenced on 1st December, staffed by state registered nurses
and nursing auxiliaries. At first the service was a limited one, but it is planned that a state registered
nurse and two nursing auxiliaries will be on duty every night from 10 p.m. to 6 a.m. The state
registered night nurse visits seriously ill patients and those in need of specialised nursing care,
and supervises the work of the nursing auxiliaries who stay all night with patients needing continuous
care. Patients are referred from the day district nurses, from general practitioners or from
hospitals. It is not possible to accept night nursing requests directly from the general public. At
first the service was based at Brookfield old people's home but has now been transferred to
St. John's Hospital, Hillingdon, where the night nurse has an office equipped with a telephone
answering device—this allows messages to be recorded during her absence. It has been possible
through the appointment of state registered night nurses to relieve the day nurses of some of their
late night visits to seriously ill patients and to allow these patients to be settled for the night at
a more realistic time.
Attachment and Liaison Schemes
It is important that the implementation of attachment schemes should take place under
optimum conditions with adequate staff available to deal with what is known to be an increased
work load. For this reason new attachment schemes have been delayed during 1971, the difficulty
in recruiting health visiting staff being the main problem. However, various general practitioners
have shown enthusiasm and interest and it is hoped to start new attachments early in 1972.
The liaison and attachment schemes described in earlier reports continue successfully. It is
notable that when community nursing staff are working closely with general practitioners their
field of work expands, adding to their interest and job satisfaction.
Liaison between Hospital and Local Authority Nursing Service
The very good relationships between hospital and community nursing staff which has built
up during the past years continues. During the year plans have been finalised with both Mount
Vernon and Hillingdon Hospitals for the "community care" training of their student nurses. Nurses
in general training now have the option of doing from 6-10 weeks community care and it is expected
that up to 30 students each year will take up this option. In addition all nurse students spend a
short time with community nurses and receive lectures during training from the community nursing
officers. The liaison schemes formerly at Hillingdon Hospital and the Duchess of Kent Maternity
Wing have been extended to include Mount Vernon Hospital and continue to function well to
the benefit of both patients and nurses.
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