District Nursing at a Glance. Matthew Bradby

Nurses in every community specialism, not just district nursing.

      This book is divided into six main parts, preceded by an introductory section.

      Part 1 Introduction aims to give the reader an introduction to the heritage of the district nursing profession and also to the charity, the Queen’s Nursing Institute, which has been indelibly associated with the profession for over 130 years.

      Part 2 The learning environment gives the reader an introduction to the framework of district nurse education at the present time, although this framework continues to evolve and develop at a rapid pace.

      Part 3 Working in the community focuses on the district nursing team, on the systems and ethics that guide its successful working, and on the place of the individual within that team.

      Part 4 Caring for the whole person in the community looks at the people district nurses will meet in their professional life as they carry out visits in their local community. It looks at the whole person, as a member of a family, of a culture and a community. That person may have carers, who may be friends or family members, or support workers. We have tried to use the word ‘person’ rather than ‘patient’; for people living with one or more long‐term conditions; they may not view themselves as a patient when they are being cared for at home, but they are all people whose quality of life is made significantly better by the support of a district nurse. Often it is this support that enables the person to live at home and avoid admission to hospital or residential care; in this role the nurse is both a vital support to the individual and their family and also a hugely important part of the whole health and social care system.

      Part 5 Physical and mental health in the community looks at a whole range of physical and mental health conditions that are commonly encountered by district nurses during the course of their work. The conditions covered in the book are not meant to be exhaustive but are indicative of the kind of long‐term conditions that require an in‐depth knowledge of the person and careful case management of their condition. The skilled district nurse will have the ability, working in partnership with the person she cares for, to progress and improve their health. He or she will also be one of the most important sources of emotional and psychological support to the person and their family.

      Part 6 Specialisms in the community explores some of the other specialisms that district nurses will encounter during their work. Again, this is not meant to be an exhaustive list but an introduction to some of the other specialisms that are employed by healthcare providers and voluntary organisations. This links back to Part 3 and the importance of collaborative working, drawing on the skills of the most suitably qualified professionals to deliver enhanced care to people in need.

Additional sources of information

      Some of the chapters contain links to additional sources of information and a final chapter gives a list of References and further reading.

      Acknowledgements

      The editor would like to thank the staff of The Queen’s Nursing Institute for their support and encouragement, in particular Dr Crystal Oldman CBE, Dr Agnes Fanning and Joanna Sagnella, QNI Publications Manager, who produced many of the illustrations in this book, and QNI interns Joanna Boughtflower, William Carter, Olivia Hicks, Alice Knapton and Chloe McCallum for their valuable assistance.

      The editor would also like to thank Hallam Medical, Malinko, Kate Stanworth, Mark Hakansson, Harriet Stuart‐Jones and the editorial staff at Wiley.

      Queen’s Nurses are supported by funding from the National Garden Scheme, a national charity that opens private gardens to raise money for nursing and caring charities. Since 1927 the garden scheme has raised millions of pounds for healthcare in the community.

      Introduction to District Nursing

      A District Nurse is a specialist generalist nurse in the community, an expert who is accountable at an advanced level of practice.

      The District Nurse serves a whole community, holding and being responsible for a large and varied caseload of people with complex health needs, and managing admission to and discharge from that caseload. They are responsible for autonomous clinical decision‐making, deploying a team of regulated and unregulated staff to deliver care in peoples’ homes, and leading all the nursing care required. A community staff nurse is one of the nurses working under the direction of the District Nurse. District Nurses work above all in people’s homes and may give support to staff working in Nursing and Residential Homes too.

      A qualified District Nurse is prepared for their role with a post‐registration Specialist Practitioner Qualification in District Nursing (SPQ DN) at a Higher Education Institution. These post‐registration programmes are currently approved and regulated by the Nursing and Midwifery Council (NMC) to ensure consistency and quality of standards for education and practice and to prepare nurses for the role of an autonomous practitioner.

      Specialist Practitioner Qualifications are also available in Community Children’s Nursing (CCN), Community Learning Disabilities Nursing (CLDN), Community Mental Health Nursing (CMHN), and General Practice Nursing (GPN), and the NMC is consulting on additional qualifications for other community specialisms (2021).

      This book describes some of the most important parts of a District Nurses’ role. It is not intended as an exhaustive or comprehensive list of everything that a District Nurse might be called upon to do, which is always changing and developing. The Covid‐19 pandemic has changed the landscape of nursing in the community profoundly and rapidly, and District Nurses are now caring for many people who are recovering from this novel disease.

      The landscape of health services in the United Kingdom is also changing, and there is growing variation between England, Wales, Scotland, and Northern Ireland. Healthcare policy demands that more care is delivered in people’s homes and communities and a greater reliance on self‐care and the prevention of ill‐health, lessening people’s dependence on hospital services.

      It is an exciting time to be a District Nurse, working with people, carers, and families across the life course, helping them to maintain health and independence, in communities in every part of the UK.

1 The early history of district nursing

       Matthew Bradby

Figure 1.1 Cartoon of Queen’s Nurses in 1918.

Figure 1.2 Queen’s Nurse with a bicycle, c. 1900.

Figure 1.3 The celebrated midwife’s case, 1925.

Figure 1.4 Queen’s