Community nurses in parts of the country hit by flooding have been faced with a new set of challenges in recent weeks, with many working longer hours and volunteering for extra shifts in order ensure vulnerable patients receive the care they need.
With parts of the south and west under water after weeks of heavy rainfall, patients have been left at risk of being evacuated, cut off or simply harder to reach.
Nursing Times asked how community nurses in some of the areas affected are coping with the challenges presented by this winter’s extreme conditions.
Worcester has been hit by serious flooding, with the River Severn reaching its highest level reached since records began.
Worcestershire Health and Care Trust’s district nursing teams have battled through heavy traffic and some have ditched the car completely and completed their visits by foot.
District nurse team leader Julie Money said teams had to re-organise their case loads once the city’s main bridge over the river was cut off and praised colleagues for their willingness to go further than normal to give people the care they needed.
She said: “We have all got our wellington boots in our cars just in case we need them, but the last few days shows just how important community services are to vulnerable people. It really has been a case of all hands on deck.”
As has been widely highlighted by the national media, parts of Somerset have been seriously affected by the flooding.
District and community nurses from Somerset Partnership NHS Foundation Trust are using 4x4 vehicles to get to patients in the worst affected areas and in early January a few visits were made on the backs of tractors.
Flooded village of Moorland in Somerset
A trust spokeswoman said staff had been “coping incredibly well”. As well as reaching patients, she said the floods had affected the ability of staff to get into work. “Where, in recent weeks, the flooding has extended into new areas and they have had trouble getting in, colleagues have been swapping or extending shifts to give them more time,” she said.
Trust chief executive Edward Colgan paid tribute to staff for the “inspiring” way they had responded to the difficult conditions “every day since flooding started more than five weeks ago”.
Meanwhile, in Kent, the city centre of Canterbury and its surrounding villages have been flooded after local rivers burst their banks. The area has been on flood alert for more than a month.
Patricia Campbell, a band 7 lead clinical nurse with Kent Community Health Trust, spoke to Nursing Times ahead of more severe weather expected over the weekend.
“The rivers are overflowing, some of the fields look like lakes and a lot of the B roads are closed,” she said. “You cannot see the road at all, you’re just going through water so we have issues of getting to patients – we have to take much longer routes.”
“We’ve identified vulnerable patients that live along the rivers and made contact with them,” she said. As well as continuing to visit patients in rural areas, she said staff were on a volunteer roster for opening up centres, such as village halls, for flood victims in the event of evacuation.
She said staff morale was “pretty good”, despite the extra hours needed to get to patients. “People do get tired – the nurses are out for quite long periods and not getting back till quite late, but morale is pretty good. They’re bearing up.”
Ms Campbell said her main focus at the moment was a care home with 53 residents that was at risk because of its location near a river. “The ground has been flooded and the cellars are flooded,” she said.
Health and social care services have been working together all week to support the needs of residents and draw up an evacuation plan to transfer them, if needed.
“When you are dealing with patients with mixed health needs – long term conditions, plus short term needs plus residents with dementia – life becomes very complicated for them and for us really,” she said.
“Some of them are bed bound, they need pressure relieving equipment, feeding, continence issues – all those things have to be assessed. The last thing we want to do is evacuate them because it would cause some of them a lot of distress and confusion.”
But as a “last resort” she said some of the residents would be moved to another home that was currently empty and some beds had also been ring fenced at a cottage hospital.
“They [the beds] are blocked at the moment which does have an impact on our acute colleagues but needs must at this time,” she noted.
Crystal Oldman, chief executive of the Queen’s Nursing Institute, said the conditions highlighted the value of community nursing teams.
“How community nurses manage to cope and reach patients at home during severe whether is just another reminder of how vital their role is, in preventing hospital admissions and reducing pressure on ambulance and other services,” she said.
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