Bliss J, While A
Florence Nightingale School of Nursing and Midwifery, King's College, London, UK.
Int Hist Nurs J. 2000 Summer;5(3):22-9.
Much has been written regarding the challenges facing district nursing in light of the constant change and development of the NHS. This paper follows the chronological development of district nursing up to the reorganization of the NHS in 1974. The paper commences with a brief outline of the origins of district nursing as a charitable activity before the inception of the NHS and moves on to consider the relationship between district nurses and general practitioners. A review of policy and legislation identifies that district nurses, in the early days of the NHS, were working for the GP, no longer an autonomous practitioner of a charitable organization. Other challenges experienced by district nurses included being employed by the Local Health Authority, a separate organization to the NHS. By exploring the clinical practice of district nurses, alongside the management and organization of district nursing it is possible to critically discuss the challenges facing district nurses in the current health care climate of teamwork and collaboration.
鉴于国民保健制度（NHS）的不断变化和发展，关于地区护理所面临的挑战已有诸多著述。本文追溯了地区护理按时间顺序的发展历程，直至1974年NHS的重组。文章开篇简要概述了在NHS成立之前，地区护理作为一项慈善活动的起源，接着探讨了地区护士与全科医生之间的关系。对政策和立法的回顾表明，在NHS成立初期，地区护士是为全科医生工作，而非慈善组织的自主从业者。地区护士还面临其他挑战，比如受雇于地方卫生局，而地方卫生局是与NHS不同的一个组织。通过探究地区护士的临床实践以及地区护理的管理和组织情况，就有可能批判性地讨论在当前团队合作与协作的医疗保健环境中地区护士所面临的挑战。
