I heard on the news this week that the government have plans to enable every cancer patient “one to one” nursing care.

Do they mean qualified nursing care or partly trained care assistant care?

I have seen the changes in home care over the decades from the SRN CMB (part 1) District nurse who gave all care ( including personal care) to patients in their own homes,  to the contracted out service now where care assistants with little training call in for 15 minutes before rushing off to their next assignment.

Friends, (qualified District nurses), who did this work often told me about the extra jobs they did when they went to give both nursing and social care, e.g. lighting the fire, bringing in shopping etc.

The District nurse was often a familiar figure in a neighbourhood and worked the same district for many years. In some country districts they also combined nursing, midwifery and health visiting and were known locally as The Nurse, and were greatly respected and often became the unofficial social worker too!

In 1963, while I was waiting to start the midwifery course, I worked for a few months in the Marie Curie Service. This was a service which was run in co-operation with the District nurses. It was run by Superintendent of the D. N., a very competent lady, and the patients were referred by the D.N.s. Marie Curie paid our salary, but it worked like a private nursing agency and we were assigned to one patient and stayed with that patient as long as they stayed in their own homes. The drugs and medical equipment was supplied by the district nursing service.

When I was first offered the job I was a bit dubious, as I thought it would be a very depressing job. I could not have been  more wrong! The patients I had were lovely people and so were their families.

I  had only three patients in my time with them, but they were all cheerful and determined to make the most of the time left to  them. The families were grateful that I was helping to keep the patient as comfortable as possible and were only too happy to co-operate in the care.

I know that there are far more complex treatments for cancer care now, but good basic nursing care and the right attitude will be little changed. I wonder where all these nurses are coming from? I doubt that nurses will be assigned just one patient at a time and suspect they will be too overladen with patients to do the job as they would like to do it, and will be frustrated by this, instead of getting the satisfaction I felt with my Marie Curie patients in an era when they understood  that nursing was looking after the whole patient, not just performing the medical treatment,and  also supporting the families.