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Nursing personnel and two student nurses from
Hounslow Hospital spent half a day with a Home Nurse
and half a day with a Health Visitor, also a Nursing Officer
from East Kilbride in Scotland spent one day in the
Department studying the activities at the Health Centre.
This year set the scene for the new option training
scheme for student nurses from West Middlesex Hospital.
The Borough of Richmond Nursing Service together with
the Hounslow nursing team will offer community nurse
training to student nurses and although this experience does
not lead to the qualification certificate in District Nursing
it does mean that more hospital trained nurses are made
aware of the total patient care programme and enables
them to consider patients beyond the confines of the
hospital ward.
Ward Sisters have also observed the work of District
Nursing Sisters and this can do nothing but good.
Dr. Herridge, Consultant Psychiatrist and Dr. Low-Beer
were special guest lecturers to the Course entitled
"Teaching techniques for minimisation of stress in
pregnancy and labour". This Course was arranged by
Mrs. E. Montgomery, Bristol, a specialist in this therapy.
Training courses in psychiatric nursing appreciation:
school/clinic nurses were arranged.
The family planning courses to which staff from
surrounding Boroughs were invited served to extend the
experience of field staff. Two Senior Nursing Officers
undertook a course in middle management and two Health
Visitors trained to be Field Work Instructors bringing the
number of the latter up to nine.
One Health Visitor is undertaking a course in Health
Education at Chiswick Polytechnic: two Home Nurses hope
to complete the District Nurse Training course in early
1973.
Study Days and Seminars arranged by the London
Borough's Training Committee have been most valuable
features of our training programmes and are regarded as
vital if high standards of nursing care to the patients are to
be maintained.
Hospital Liaison
The need for good liaison with local hospitals has been
recognised for many years, but the rapid pace of change and
the pending merging of the hospital and community
nursing services were the two poignant reasons for
appointing a hospital liaison officer who could spend time
setting up sound links of communication by demonstrating
the need for preventive care and support for the patient
and the associated family units.
In October of this year such a link was established and
the first approach was made in the paediatric wards of
West Middlesex Hospital. The officer was invited to
attend the Consultant's Ward Round, and thus link up with
the team of social workers and senior nursing staff. Points
of procedure with regard to two way flow of information
from hospital to the community is discussed and action
taken to secure the safe transferral of patients home with a
full background knowledge of the ability of the family to
manage the care of the patient with the help of appropriate
health visitor counselling or physical nursing care from the
district nursing sister. The Paediatric Outpatients Clinic also
brings this officer in touch with patients and families in
need of medical social support and referrals to the
community team are being done through this channel.
Some though is being given as to how the hospital/
community nursing team can interlink a supportive service
when a battered baby syndrome is suspected.
In the Maternity Department good liaison exists, but
the hospital liaison officer can offer additional links with
the primary care team as and when the needs are
identified.
Prevention of illness — care and after-care
Tuberculosis
Tuberculosis prevention, care and after-care services for
patients living at home are provided at the Hounslow and
Ashford Chest Clinics.
During 1972 there were 74 formal notifications of
pulmonary tuberculosis and 37 of non-pulmonary
tuberculosis, compared with 60 and 25 notifications
respectively in 1971.
The total number of cases on the register at the end of
the year was 1800 (pulmonary — males 814, females 657,
non-pulmonary — males 136, 193).
Table 13 shows an analysis of all cases notified during
1972.
There were 2 deaths from tuberculosis in 1972.
Loan of nursing equipment
The British Red Cross Society continues to operate a
scheme for the loan of nursing equipment on behalf of the
council. Charges for this service are nominal but in certain
circumstances are abated or waived. Monies received from
loan charges enabled the British Red Cross Society to
provide replacements for smaller items of worn equipment.
In addition some miscellaneous items of equipment were
purchased by the health department during the year and
stored centrally at Hounslow. These items were issued as
required free of charge on short term loan to neccessitous
patients when requested by members of the home nursing
staff.
Chiropody Service
The chiropody service is available to the elderly, physically
handicapped and children. This is provided at fully
equipped council clinics and health centres and in the
patients' own homes. During the year the service was
partially augmented by the Heston and Isleworth Old
People's Welfare Committee who, acting as agents on behalf
of the borough council, conducted their own clinics and
domiciliary treatments.
The demands on the council's directly-provided service
continued to increase during 1972. An average of 35
weekly sessions were held throughout the year in local
authority premises compared with 30 in 1971. This increase
was largely attributable to an amendment in the
establishment of chiropodists during the year whereby it
was possible to employ an additional full-time senior
chiropodist to undertake 10 clinic sessions a week. A total
of 1813 clinic sessions were held at which 3474 patients
made 13,528 attendances for treatment. Ten chiropodists
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