27 under the direction of the Dispensary Doctor, they are most useful ad¬ vocates for sanitary conditions in the houses and surroundings of those vith whom they come in contact.
Lady Dudley's nurses are resident at some of the places at which Cottage Hospitals might with advantage be built, and we consider that it would be wise and economical for the local bodies to secure the services of these nurses, if Lady Dudley's Committee were willing to guarantee a considerable portion of a nurse's salary on condition that the Nurses should always be Jubilee Nurses, or others pos¬ sessing such other high qualifications as the Committee might agree to.
There would be a double advantage in such an arrangement.
The best kind of nurses would be secured for the Cottage Hospital, and, as their salary would be partly paid out of the rates, Lady Dudley's Committee would be able to engage more nurses out of the money saved' 110.
Such a project opens up the wider anticipation that eventually the Possibility of a poor in every district throughout Ireland may possess the aid of a District gaJ !x*ension
Nurse 0 who could in serious cases ensure that the directions of the doctor Lrsin^ are carried out, and arrange that the best possible steps are taken when
°* patients are not removed from their homes to hospital.
In philanthropic matters our elected public bodies in the economical discharge of responsible duties have to proceed far more slowly and cautiously than private persons or associations that are moved or impelled by charitable enthusiasm.
Many, if not most, of our social and charitable improvements are suggested and initiated by such private efforts; and, when their value has been tested and acknowledged, public bodies, whose members are responsible for the economy with which they discharge their duties, are in a position to decide upon the value of any experiment or suggestion that may be made by private individuals.
Over and above the devoted labours of religious communities the nursing of the sick poor in their homes has, of recent years, been very widely attempted by persons and associations from a charitable motive in this country and in Great Britain; and it is likely that there will always be a great deal of such good work done in this way.
There are, however, many districts, as in the west of Ireland, where, owing to their poverty, sufficient voluntary efforts are not likely to be made locally.
Owing to the good work done elsewhere by voluntary Nursing Associations, it will become a question how far public bodies, with perhaps some State assistance in very poor districts, should undertake the duty of providing for the nursing in their own homes of such sick persons as cannot, or need not, be removed to hospital.
At all events, it is now generally admitted that no Dispensary District ought to be left without competent midwifery attend¬ ance in addition to that of the Dispensary Medical Doctor.
Apart, how¬ ever, from a provision for such midwifery duty District Nurses have not been appointed by local bodies, with the exception of an experiment in the Berry Poor Law Union, where midwives were engaged to do District Hursing, but these midwives had not been trained in medical and surgical gugffestion that nursing.
In both Lady Dudley's and the Jubilee Nursing Scheme the same the same woman woman is trained nurse and midwife, and this plurality of qualifications should be both in one person seems to be the proper and economical method of arranging for District Nursing, even though there are sometimes occasions when a nurse would be disqualified from attending a maternity case owing to the ^ptic character of another case that she might be in attendance upon.
Those who are seriously sick among the poor in small or overcrowded houses or rooms should for many reasons be removed to hospital when possible, but %re will always be case's of more or less serious illness that must be treated a the homes of the sick poor; and the question is now coming forward as ^ how far it is the duty of public bodies to supply nursing attendance for ^ch cases.
C1*) Lord Monteagle, 610; J.
Gregg, 1250-9; W.
Browne, 1674-6; Dr.
E.
C.
Thompson, *•*.,
5741; Dr.
Hall, 7427-9; J.
Dolan, 12578; Colonel Everard, 13073-4; P.
Sheridan, 13528; Dr.
J.
M.
S.
Kenny, 15353; Dr.
G.
A.
Moorhead, 15757-8; Lord Stopford, 19854; f-J-Hogan, 24808-9; Dr.
Faris, 24994; Dr.
Molony, 27484-95.
[Table.
E 2
District Nurse and Midwife.
