(BQ) Part 2 book “Community nursing and primary healthcare in twentieth-century Britain” has contents: Town nurse, country nurse - district nursing landscape; technology, treatment, and TLC; portraits of a district nurse; discussion and conclusion, and other contents. | Part II Themes and Issues The District Nurse and the Changing World of Primary Health Care 5 Town Nurse, Country Nurse: District Nursing Landscape INTRODUCTION This chapter explores the relative impact of regional demography and local community on the working experience of district nurses. We introduce the urban–rural split that was and remains particularly evident in British district nursing. Although in theory district nursing practice adhered to strict standards, the conditions of work varied widely between nursing situations, most notably between those of the city and rural areas, with remote or island districts providing the most extreme examples. The picture used on the front cover of a 1964 recruitment leaflet (see Figure ) depicts two quite different lifestyles: on the left, the modern, industrial urban setting with its factory chimneys and back-to-back houses, and on the right, an idyllic rural image reminiscent of a previous century. The district nurse transcends both. Nurses in rural or remote districts (and in some small towns) were often organised differently, in that they were invariably employed as double- or triple-duty nurses: As well as district nurses, they also acted as HVs, midwives, or both. Strictly speaking, triple-duty nurses should have held the relevant qualification for each role but dispensation to work without the HV’s certificate was given at the discretion of the QNI with the qualification to be gained at a later date. The responsibility of triple-duty nurses to their community was more keenly felt and wide ranging than that of the single-duty nurse. Triple duty also provided a continuity of care within the community that was disrupted in the cities by the involvement of separate midwives and HVs. Those who worked as triple-duty nurses recall the long hours of work necessary when they were the only nurse, midwife, or HV serving a community. Despite this multiplicity of roles, district nurses were clear about the distinction .
