View report page

The Midwifery Service
Two midwives serve on the midwives integrated
sub-committee at West Middlesex Hospital. This committee
considers matters of material concern to the practising
midwife as she looks forward to an integrated service in the
new Health Service. More important however is the
awareness of the midwives to the regard they have for
future safer delivery of the mother and baby. The
Domino scheme demonstrates this and has continued to
gain acceptance as a safer midwifery procedure.
There is a national fall in the birth rate of 8% and this is
reflected in 50 fewer home deliveries during 1971. The
Peel Report also recommends more hospital confinements
and this is continuing to gain momentum, with the
Domino scheme showing an increase of 57 deliveries, and
featuring the preservation of the same midwife giving
antenatal and post natal care, and delivering the baby in
hospital, thus enhancing the chances of the mother
benefitting both psychologically and emotionally.
Domiciliary midwives conducted 746 antenatal clinics of
which 450 of these were joint family doctor/midwives
clinics.
Home Nurses
Great emphasis is being placed on the total care of the
patient in the community. By this is meant team work and
drawing in other professional expertise to engage in
primary case work. Not only is the patient physically cared
for by doctor and home nurse, but the health visitor and
the social worker promote the social and psychosocial
well-being of the family and/or patient. In this way
recovery from illness or restitution of health is achieved
more comprehensively through group effort. Seventy eight
more patients were visited in their own homes during
1972, and 8,482, i.e. 8% more visits were paid to patients;
295 or 5% fewer visits were of more than 1 hours duration.
This would suggest that more frequent visits to patients and
more support was being given in the home. This is
attributed to improved team effort, better communication,
and higher motivation. 80% of the Home Nurses have
completed their District Nurse training and this too could
have a bearing on the year's increased endeavour.
The Health Centre/Doctors surgeries activities are also
very encouraging and demonstrate a better team effort:
5,130 treatments were given to patients at the Health
Centres and doctors surgeries. The Health Centre and
surgery activities are expanding steadily.
In addition closer links have been established with
hospital personnal in that Home Nurses have attended
Sisters' Study days, and hospital sisters have accompanied
Home Nursing Sisters on the rounds, each learning more
about the services which exist within hospital and beyond.
The Marie Curie Foundation has continued to support
the Home Nursing Service in caring for the terminal cancer
sufferer, by way of paying for the services of nurses
employed by local nursing agencies whose services are
required on night nursing duties so as to relieve the
families of much of their worry and stress associated with
this particular crisis. In 1972 the Foundation paid out more
than £300 towards this service.
Training
Training programmes featured high in the list of staff
participation. The great number of student nurses seeking
community care experience has engaged our newly
appointed Training Manager in a full time occupation. She
was appointed on 1st October 1972 but had been
specialising for sometime in staff training in the Borough
and so when appointed was very conversant with
contemporary staff needs. The main stream of students are
in general nursing, psychiatry and midwifery disciplines
and five students three times a year come from the
Middlesex Hospital, whilst 4-8 students three times per year
and five pupil nurses three times a year are from West
Middlesex Hospital.
The Leavesden Hospital send one student psychiatric
nurse to spend one day with a Health Visitor. This
appreciation of community nursing experience is thus
offered to about 26 students annually at fortnightly
continuous phasing intervals.
Pupil Midwives
Six pupil midwives from the West Middlesex Hospital and
Hillingdon Hospital each spend three months with a
domiciliary midwife, a sequence repeated four times a year.
Each pupil is able to gain experience in attending the
mother, booked for 48 hour discharge, in the antenatal and
post natal period and in addition observes the particular
aspects of Health Visiting in the primary care programme
by spending half a day with a Health Visitor and attending
five child health clinic sessions. Half day observation
sessions are arranged also for pupil Midwives from Queen
Charlotte's Hospital.
Seven Hounslow health visiting students were awarded
sponsorship and are undertaking theoretical training at the
Colleges. Five students from Chiswick Polytechnic have
been placed in this borough for practical supervised
training. The Social Services Department assist in extending
community experience to Nursing students by introducing
the latter to the non-nursing services which completes the
cycle of care to the majority of patients.
Integrated student training means that student nurses
are chosen and elect to qualify for three qualifications:
S.R.N, and H.V. certificate and District Nurse certificate.
During the first year four students spend one week with
Health Visitors; and in the second year two weeks with a
Practical Work Instructor Home Nurse, whilst in the third
year a further twelve weeks is spent with the Practical
Work Instructor Home Nurse.
General Practitioner Group Practice is the focal point
of the primary care team. In contemporary terms this is
the base for training two Health Visitor students from
Chiswick Polytechnic. In addition Surrey University and
Leicester Polytechnic each send one student Health
Visitor to the Hounslow Borough to undertake one week's
experience in Group attachment. It is significant to note
that overseas students, through the Royal College of
Nursing are offered study sessions in Hounslow to study
the health services. It is also interesting that fourteen Social
Work students spend three days in the Health Department
learning about the services offered. One social studies student
from Manchester University spent one week with Community
18