The RDNS Sisters are both holding the 1st day Cover Envelope issued by the Australian Postal Department in 1985 to commemorate the founding of the Melbourne District Nursing Society on the 17th of February 1885. A stamp is in the right hand top corner of the envelope. The main body of the stamp is pale blue. On the top of the stamp, written in deeper blue/grey, are the words "Centenary of District Nursing Services 1985" Below this, and to the right, is a pale bone colour original sign on a metal fence which reads, in white capital letters, "Melbourne District Nursing Society" Standing on the left in the foreground is a MDNS Trained nurse (Nurse) in her long grey uniform frock with white collar, cuffs and belt. She is wearing a grey helmet style hat which has a white hat band with a red Maltese cross in the centre. Her black shoes can also be seen. She is holding a bicycle; only the front wheel and part of the frame and the handlebars, which have a brown nursing bag strapped to them, can be seen, The nursing bag and handlebars cover part of the MDNS sign. At the bottom of the stamp, on a strip of white background, are the words in capital letters "Australia 33c". Below the stamp is a rectangular1st mark. On the left half of the envelope are some sketches of several two storey buildings either side of a set of steps. Some adults and children are standing on the steps as well as in the foreground; some are sketched and others dressed in various coloured clothing. In the foreground right in front of steps, stands a lady with her hair drawn up and wearing along grey frock and white apron; partly seen against her right side is a small child dressed in brown. Sister Willie Fleming is the Supervisor of the RDNS Sunshine Centre and Sister Phillipa Kariko is Supervisor of Essendon Centre. They are wearing their RDNS uniforms of white short sleeve blouses under royal blue V neck tunic style frocks. The RDNS insignia is round and has royal blue writing on a white background. In Melbourne in 1885 it was recognized that skilled nursing was needed to care for the sick poor in their own homes. On the 17th of February a meeting was held with prominent Melbourne citizens, five gentlemen and fourteen ladies. ‘Dr. Caffyn and Rev. Charles Strong explained the objects and scope of District Nursing Societies that had been formed in towns in UK’. On that day the Melbourne District Nursing Society (MDNS) was founded, the first District Nursing Service in Australia. Subsequent meetings were held to form a Committee and to draw up a Code of Rules of the Society. It was decided only nurses who had attended a Nurses Training School at a Hospital and were fully qualified would be employed by the Society, and that the Nurses would keep a daily journal of their work. After interviewing several candidates, the first Nurse, Mrs. Ferguson, was employed with a salary of £100 per annum and commenced work on the 1st of May 1885. She was employed for three months initially, but this was soon extended, “on the understanding she will make arrangements to live in the more immediate vicinity of her district”. A Doctor was consulted before any person was seen. In rotation, a member of the Superintendence Sub-Committee supervised the Nurse’s visits and could assist to alleviate some of the poor social conditions they found. Though only Trained nurses were employed, the term ’Nurse’ was used in those days, not the term ‘Sister’ that is used these days. A second Trained nurse, Mrs. Joanna Cannon, was employed in late 1885, with a trial period of six months which was extended. The two Nurses worked in the now CBD, ie from Spencer Street to Spring Street and from Victoria Parade to Flinders Street. At that time they walked the streets and lane ways amid the slums of inner Melbourne carrying their nursing bags containing lotion, ointments, powders, liniment, bandages, dressings, a case of spirits, and the Nurse's own clean apron, soap and small towel. They supplied equipment on loan, such as earthenware hot water bottles, splints, urinals, bed pans, bed cradles, feeding mugs, and air-cushions as well as providing blankets and clean bed linen, and nightdresses as necessary. From its inception the Society was at the forefront of health care and liaised with Doctors. They provided high quality nursing care to a range of people, often in destitute situations, some lying on rags on the floor as they had no bed, others with just a bed and maybe a thin blanket, a chair and nothing else. Their ages ranged from babes, children, adults to the elderly. The Nurses gave medications as ordered, dressed wounds e.g. to the injured, and surgical cases, and to those with leg ulcers; attended to patients with ‘surgical ailments’ such as ‘hip disease’; gave care to those with acute illnesses such as bronchitis, pleurisy, pneumonia, measles, and scarlet fever, as well as those with chronic illnesses such as consumption (tuberculosis), heart disease, arthritis, cancer, debility, neuritis and paralysis. They educated their patients, and their carers, in the curing and prevention of disease; teaching the importance of hygiene, cleanliness, ventilation and good nutrition. They taught them, by verbal instruction and demonstration, how to make poultices, to make and apply bandages, apply medical appliances such as splints; and the Nurses supplied milk, beef tea and they cooked soup when needed. As the work increased a third Nurse was employed but this was arduous work, particularly in the heat of summer and many Nurses only remained with the Society for several months. A Midwifery Service commenced in August 1893 with Nurse Fowler the first trained Midwife. She had previously worked with the Society carrying out General nursing. The Society expanded its areas using public transport and with the Society purchasing bicycles in 1903, before procuring its first cars to cope with the influx of patients during the Spanish influenza epidemic in 1919, though these were sold in 1927 due to their poor condition..A Motor Auxiliary was formed in 1929 to take Sisters to patients, and some Sisters used their own cars; even a motorcycle was used by one Sister in 1933. All these forms of transport were intermingled and in the early 1950s, and now as Melbourne District Nursing Service, seven Ford Prefect cars were bought followed by twelve Ford Anglia vehicles in 1955. Having received Royal patronage; the now Royal District Nursing Service (RDNS) had its own fleet of Holden vehicles by the mid 1960s and the Motor Auxiliary ceased operating in 1971 as by then all staff employed were required to have a driving licence. Seat-belts had been introduced to Victoria in 1959 and District fitted them to their cars from 1962, even though they did not become compulsory until 1970. The Holden vehicles were replaced with grey Holden Torana vehicles. After several years the fleet was changed to white Toyota Corolla vehicles. The Melways Directory of maps was introduced in 1966, which was a boon to the Sisters, though it was a few years before it went beyond Seville, so a large paper map was used by the Sisters visiting patients in the areas passed Seville. By 2009 there were 598 cars in the fleet and the Sisters travelled 9 million 200,000 kilometres – this is equivalent to 12 trips to the moon and back. Over its years of expansion the RDNS Trained nurses (Sisters), continued to visit patients in their homes and gave best practice care in many fields of nursing, and to people of many cultures. Initial visits not only assessed the specific nursing situation but the situation as a whole. Their patients ranged in age from babes, children, adults to the elderly and referrals were taken from Hospitals, General Practitioners and allied Health facilities. Some of the care the Sisters provided is as follows: – Post-Natal care given to mother and babe, Wound Care following various types of surgery, accidents, burns, cancer, leg ulcers etc. Supervising and teaching Diabetic Care, including teaching and supervising people with Diabetes to administer their own Insulin, and administering Insulin to those unable to give their own injections. Administering other injections and setting up weekly medication boxes. The Sisters performed Catheterizations on adults suffering from conditions such as Quadriplegia, Paraplegia, Multiple Sclerosis (MS), Motor Neurone Disease (MND) and Guillan-Barre Syndrome, and when required at school on children for e.g. those with Spina Bifida. The Sisters visited those requiring Cystic Fibrosis support and care; those requiring Haemo-Oncology care, including visiting children at school; those requiring Home Enteral Feeding care, and those requiring IV therapy at home and home Dialysis. Palliative Care was given including pain relief with the use of syringe drivers, personal care as needed, and advice and support to both patient and family. The Sisters provided Stoma management to those needing Urostomy, Ileostomy and Colostomy care and those requiring Continence care. HIV/AIDS nursing care was provided; visits to Homeless Persons were made. Personal care was given to patients ranging in age and with varying mobility problems, such as Amputees, those with MS, MND, Guillan-Barre Syndrome, Poliomyelitis, Quadriplegia, Paraplegia, Acquired Brain Injury, to those following a Cerebrovascular Accident (Stroke), those with severe Arthritis and those with a form of Dementia. When necessary the elderly were assisted with personal care and advice given on safety factors with the use of hand rails, bath or shower seats, and hand showers. Rehabilitation with an aim towards independence remained at the forefront of the Sister’s minds and when possible using aids and instruction on safe techniques enabled the person to become fully independent. All care included giving advice and support to the patient and their Carers. The Sisters liaised with the persons Doctor, Hospital and allied Health personal when necessary. On the left of the black and white photograph is Royal District Nursing Service (RDNS), Sister Willie Fleming, who has curly blonde hair, and on the right, Sister Phillipa Kariko, who has short dark hair. They are standing outside Essendon RDNS Centre.. They are both wearing their RDNS summer uniform of dark V neck tunic style frocks, with emblazoned RDNS insignia on its upper left, over short sleeve white blouses, Each are holding an envelope with writing, sketched buildings and figures on the envelopes left side, and a stamp is on the upper right corner. Below the stamp is writing in a rectangle. Behind the Sisters is a brick wall with them hiding some of the white capital letters of the words 'District Nursing Service' and 'Essendon Centre'. Windows and part of the fascia of the building is seen behind this.Handwritten informationmelbourne district nursing society, melbourne district nursing service, mdns, royal district nursing service, rdns, rdns centre, sister willie fleming, sister phillipa kariko, rdns 1st day cover centenary envelope