What is a District Nurse? How is it different from the traditional clinical roles? Can you progress as a District Nurse in the UK?
Meet Mervic, a thriving Deputy Nurse Team Leader in the Community/District Nursing Sector. Read & be inspired by her story.
I am Mervic, I have been working with the NHS for the last 18 years as a Nurse. I started as a Rehab Nurse, an NHS 111 Nurse Advisor and gradually shifted to Community Nursing and now acting as a Deputy Team Lead covering an area in London.
I worked with one of the Health Trusts in London and leading a team of Community Nurses looking after patients in the comfort of their home.
My team delivers a wide array of high quality services such as wound care, medication management and pressure ulcer care. We also deal with other medical problems like continence management, catheter care and managing chronic and complex diseases as well as looking after patients discharged from acute hospital settings, rehab units or from GP referrals. Our role also attends to Palliative and End of life Care should a patient choose to die at home or with their loved ones by giving them a comfortable and pain free death.
Working in the community is just like being a nurse in the acute setting but delivering the care at home. Exceptions to this may include when a patient needs to undergo surgery or needs to be monitored in Intensive Care Units. We also liaise and work with other multidisciplinary teams and specialists such as the Social services, Physiotherapist, OT’s as well as Rapid Response team to deliver the treatment and care patients need as managed at home.
Community and District nurses play a great role in the community setting. We aim to lessen hospital admissions by ensuring that patients are well taken cared of in their homes. We are also the extension of the acute hospitals when patients are being discharged and back to the community. We are the bridge between the patient and their GP acting as their advocates for the treatment plan they have agreed with us.
What my typical day is
As a Deputy Team lead, my key role is overseeing my team and supporting them as they carry out their roles in the community. I make sure that the allocated patients have been visited, cared for and the outcome has been reported. I also receive calls from patients, next of Kin and other services that needed to be answered via phone, emails and other forms of correspondence. I also triage referrals, tasks and complete weekly, monthly reports and allocate patients for the next following days of the shifts.
Our Team starts at 7:30 AM with nurses taking note of their allocation for the day. Each (Community Health Nurse or District Nurse) has a responsibility of visiting and caring for 8 to 12 patients as allocated. Responsibilities include but not limited to Insulin Administration, Wound care, leg ulcer care as well pressure ulcer care, IV antibiotic administration, catheter care/insertions, syringe driver anticipatory medications, compression bandaging and PICC line care. It’s basically a busy hospital like care but being delivered at home.
All team members return to the office at 14:00 for a hand over of what the day had been for each nurse after seeing their patients. The nurses then start to complete outcomes and documentations including sending emails to GP and other teams about the patient status, requesting dressings for wound care, catheter supplies for catheter care and insertions etc. Late to evening shift nurses then again leave the office to continue seeing patients till 20:30.
What I love District /Community Nursing
As nurses, we are embodied by the skills and knowledge that we have gained through years of service and the experience we have while working in different areas of nursing. Together with renewing our licenses as nurses is the responsibility of updating ourselves through learning, research and training that enhances our nursing skills.
I love this particular nursing field because you are not only concentrated on one skill or one area of nursing. As a District Nurse, you are a lone worker who needs to have a mix of skills as we provide a wide range of procedures and support to our patients. Aside from basic nursing procedures such as IV administration, a clinical eye is necessary to perform well in this job. You need to have expertise on different types of wounds, how to treat them, grading pressure ulcers, ordering pressure relieving equipment, creams and dressing to prevent wound deterioration as well as skills on catheter care and insertions. You also have to be skilled in dealing with palliative patients and in handling their pain and discomfort whilst giving assurance to NOK and other family members that we are there with full knowledge on how to support them and their needs at home.
My job as a team leader has its fair share of challenges. Staff shortage, pressure from demanding relatives, frustration from team members who are less willing to deliver a high quality service, language barrier, racism and contrasting beliefs between you and the patient, shortage of supplies and other factors can delay the needed treatment are some of the setbacks that you may encounter in this role.
Despite its challenges, I consider this as a rewarding job. You get to know your patients close and personal as you build a trusting relationship whilst attending to their long term care. It feels like you are their rock, their friend especially to those who live alone. I feel fulfilled after I have done my job and that I’m keeping vulnerable people safe at the comfort of their own home.
My best weapon is being a God fearing person. I always start my day praying to God for guidance, wisdom and humility so that I can deliver the highest standard of care to my patients tailored for them. I also pray for all my patients that we have in our caseload that they will continue to get better, comfortable and safe in our hands.
My Advice to other Nurses
There is a high demand for Community and District nurses as the NHS aims to lessen hospital admission and allow patients to be cared for in the community setting. Career progression to be on a higher grade in District nurses is also fast paced. It can also give you the opportunity to go into management and be Locality Managers or a Specialist Nurse.
After mastering your medical and management skills as a Community Nurse, you can build your skills in management, supervision, leadership in managing a set of nurses, HCA’s etc. Taking and passing a Nurse Prescriber Course will allow you to prescribe medications to patients. All of these skills and qualifications can lead you to be a District Nurse.
Working as a District Nurse is a very good starting ground to develop and hone your nursing skills as you deal with the different aspects of care. You are in control of how you will manage your workload and plan your day. Working in the comfort and beauty of nature, being out and about and sneaking a random exercise as you travel, walk or cycle from one patient to another. It is truly a rewarding job and can fulfil your heart with satisfaction as you build that trust from a patient that he/she is in good hands under your care.
Want to know more?
About the Writer:
Mervic has been in the NHS for 18 years. She is currently a Deputy District Nursing Team Leader. Aside from being a Nurse, she is also an award winning performer & singer. She was one of the grand finalists in the World Championship of Performing Arts last 2018. She won 9 gold, 1 silver and 2 bronze medals during the said competition.