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'The pressure on district nursing services is leaving staff broken'

  • 4 Comments

District nurses reduce unnecessary admissions and therefore stress on the hospital system.

When the media turn their attention, as they do most winters, to the nursing shortage, they mainly focus on nurses providing care in hospitals. Occasionally a health correspondent will refer to a care home, but rarely do they ever consider the workforce issues in district nursing.

Maybe that’s because this often overlooked field of nursing is an invisible glue that holds the health service together.

District nurses keep patients – generally people with long-term conditions and older patients often with many co-morbidities – out of hospitals. In other words they reduce unnecessary admissions and therefore stress on the hospital system.

According to a King’s Fund report, the pressure on district nursing services is leaving staff broken, on their knees and is also affecting the quality of the care these nurses can give.

Patients admitted to hospitals often have multiple co-morbidities, complex needs, and require highly skilled care. But the same is true of many patients who are cared for in their homes.

”The work of a district nurse is no less challenging than in hospital”

The work of a district nurse is no less challenging than in hospital. In fact, some would argue it is more difficult because of the limited resources, working singlehandedly and in an environment you can’t control.

And yet because this side of nursing is often neither seen nor heard, the public often seems to assume district nursing is a “soft” job. One that involves riding around on a bike, cape flapping in the wind, hat on a jaunty angle – if you are to believe the images used to promote London’s “Boris bikes”. But district nurses will tell you that image is wrong, and their working lives are a far cry from drinking tea all day with lovely old ladies.

The TV programmes, the media obsession with nursing in hospitals and the public’s lack of awareness of the importance of this role are genuinely damaging this part of the profession. And that is giving those in charge an excuse to cut costs and force district nurses to cut corners in care quality.

”Some brand new thinking around the nursing workforce and resourcing is long overdue”

If patients are to be cared for where they want to be cared for, and the burden on already over-stretched hospitals is to be reduced, some brand new thinking around the nursing workforce and resourcing is long overdue.

There needs to be a focus on getting the numbers of district nurses up, encouraging nurses to train for these jobs and ensuring they stay in the roles, rather than forcing them out by giving them impossibly large caseloads.

”More importantly, the profession should recognise the value of district nurses’ contribution”

More importantly, the profession should recognise the value of district nurses’ contribution. They keep patients safe, they keep them well and they care for them in a place where they want to be cared for, and in a place that is better for their families. The improved quality of life a district nurse’s care can lend is inestimable, and yet it seems to be constantly forgotten when those in charge of the healthcare budgets do their sums.

  • 4 Comments

Readers' comments (4)

  • michael stone

    Spot on Jenni - I agree 100%.

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  • They should also be paid more for the responsibilities that they have - as you say - limited resources, working singlehandedly and in an environment you can’t control! Many band 5's will be managing a case load for much of the time too but do not get the recognition for this in their pay packets!

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  • so pleased to see district nursing being debated! we are a forgotten service and perhaps we have only ourselves to blame in some ways We have always worked beyond our remits, long hours and will much goodwill to ensure that our patients come to no harm. Our workload has increased now to the point of collapse and we need to get out there and get our voice heard! my advice is to keep your staff motivated and make the job fun where you can! make sure you get involved and influence the decisions being made about the future of community nursing as it is an exciting time and we all need to be involved.

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  • I am a band 3 on the community and have been so for 29 year's. I do many job's and feel that band 3's on the community should now be paid a band 4, as we work alone making decisions, doing chronic disease management, phlebotomy and many more task's that we were not expected to do, although this makes are role more interesting this does not reflect in our pay.......I go out most day's with 23 call's because staff our leaving and nobody seems to care or are looking why are they leaving.This job year's ago was like trying to get gold , now anyone can apply and get the job ..........that speaks volumes

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