EDITORIAL COMMENT

One of the most disconcerting facets of the present day approach as employed by the advocates of change is the cacophony of sound deemed so essential as accompaniment to the prelude. Analysed it is usually "full of sound and fury, signifying nothing" and does little except to serve as a disguise and veneer for lack of logical reasoning behind starry-eyed concepts which have no foundation in fact and less in realism.

Change for the sake of change can lead to disaster, change born of necessity, carefully planned, piloted and subjected to testing processes, generally leads to betterment; though oft times in the generating processes the main aims of purposive endeavour, are over-shadowed by a self interest defensive mechanism.

Alternatively because of change becoming a fashionable garment there are those who prefer to wear it and endure its discomforts rather than be considered as being behind the times.

In the undertaking in which we are engaged, the first consideration in all contemplated change should be the effect of such upon our end product. The end product is the well being of those committed to our care expressed either in terns of full recovery, improvement, appreciative capacity, comfort, contentment, or high standards of care.

Elsewhere in this issue we publicise for general information the changes which were given effect as from Monday last in the Medical Nursing Structure, and in the measure in which the result of these innovations reflect improvement at this level, in that measure can they be regarded as successful? Our hopes run high.

RE-ORGANISATION OF THE NURSING SERVICES

Basically, the hospital has been divided into 'Units' consisting of a group of wards which will be the responsibility of a clinical team headed by one Consultant Psychiatrist with the exception of Delph Hospital and the psychogeriatric units which will still involve a number of Consultants. The unit will be the special administrative and clinical concern of the Nursing Officer designated to the team. In this way it is envisaged that each clinical team will develop an active and co-ordinated therapeutic policy.

A number of units forming an area will be controlled and cc-ordinated by the Deputy Matron and Deputy Chief Male Nurse. Units 1 - 5 will form Area I and will be the responsibility of Mr. J. E. Wright and Units 6 - 10 will form Area II and be the responsibility of Miss M. T. Downey.

Mr. J. Dawson will continue to be the Nursing Officer in charge of Operating Theatre, C.S.S.D. Clinics, etc., and Mr. J. Jolley will carry on his role of Social Therapy Officer. As these departments serve all the hospital these two Nursing Officers will be directly responsible to the Head of Nursing Services.

Although over the last few weeks some decentralisation from the central nursing office has taken place there still remains much to be finalised. In order to do this Miss A. T. O'Connell will remain in a central role and will be directly responsible to the Head of Nursing Services.

Nursing staff will be allocated to Units and not to individual wards and the Nursing Officer will allocate then according to the needs of the wards and when necessary deploy them on a day-to-day basis in an emergency situation assistance will be sought from the Area Nursing Officer. Day-to-day decisions will be made within the Unit in accordance with hospital policy, but anything involving change of policy must be reported to the H.O.N.S. before implementation.

Each Unit Officer will be responsible for communications within the Unit and will provide the necessary 'feed-back' to Nursing Officers' meetings.

It is envisaged that ultimately an Acting-up scheme will be fully introduced within each Unit, but it will be necessary to familiarise ward staff with the responsibilities involved in this over the next few months and will be the subject of another memorandum.

Although at present the Units are not situated in close proximity to each other this will be rectified over a period of tine in conjunction with the phased completion of the up-grading of the central heating.

This is not a Salmon Scheme, but a new structure introduced with the aim of providing an efficient, integrated nursing service with more effective communications at all levels leading ultimately to greater job satisfaction and improved patient care. In the light of experience the scheme will be reviewed periodically.