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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
1972 has been a year of considerable growth and development in the nursing services. The
nursing management structure, introduced late in the previous year, has enabled new projects
to be introduced satisfactorily, and the health visiting, district nursing and midwifery staff have
responded well to working in teams led by the senior nursing officers.
Domiciliary Nursing Service
The work study carried out during November 1971 showed a clear need for additional nursing
staff, mainly in the state enrolled nurse and nursing auxiliary grades. A new and increased establishment
of nurses was agreed by the Council, and is gradually being implemented according to a
phased programme. This programme will be completed in November 1973, by which time there will
have been a 50% increase in staff.
A small recruitment drive was held in August and on the whole recruitment to the service has
been very good. There is even, at times, a waiting list for state registered nurses who wish to work
in the community.
Because of the employment of nursing auxiliaries it has been possible to free the qualified
nurses from some of the routine duties, thus giving them more time for skilled nursing tasks. The
state registered nurse, however, always retains responsibility for her patients even though she may
delegate some of their care to other members of the team.
In conjunction with Hillingdon Hospital, equipment from the central sterile supply department
has been used in a pilot scheme involving one third of the Borough. This scheme has been so
successful that it is hoped to extend it to cover the whole Borough during 1973.
The contents of the nurse's bag have changed greatly with the advent of pre-sterilised packs,
and it has therefore been necessary to re-design these bags completely. Some of the new type cases
are in use and eventually all nursing sisters will be issued with them.
During the year a survey was undertaken to consider the need for a laundry service for seriously
ill patients nursed at home. Plans are in hand for such a service to be established in 1973.
A community nursing service van, which came into service during the year, has proved invaluable,
both for the carrying of large items of equipment and for the use of nursing staff when their own
cars are out of service for any reason.
Because of problems which arose early in the year, due to lack of storage space for nursing
equipment, arrangements were made for the establishment of a store at Harefield Hospital. Although
this is not as centrally placed in the Borough as would be desirable, it has been reasonably satisfactory.
Night Nursing Service
This service, new in 1971, has grown rapidly and provides round-the-clock nursing care for
patients seriously ill who would otherwise have to be admitted to hospital.
A total of 184 patients received night nursing care, and the number of visits paid by the night
staff per month varied from 155 in May to 571 in November. The total number of visits made during
the year was 4,179.
On 177 occasions patients were cared for throughout the night by the auxiliary nursing staff
with supervision from the night sisters. Other patients were visited as necessary during the night
and treatment given as prescribed by the family doctor. It became obvious during the year that an
additional night sister was needed between 8 p.m. and midnight as this is a very busy time when
patients are settled down for the night. The establishment of nurses for this service has therefore
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