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PRACTICE COMMENT

'Limited training places could render district nurses extinct'

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Through my experience in community nursing I believe registered nurses in district nursing teams need further academic support and clinical development after being in community practice for one year

After one year, nurses who are newly qualified or who joined the community from hospital would have completed mandatory and skills-related training. The next stage in development is often linked to leadership but there is still a gap in learning and development. Before becoming a leader, we should be fully competent and confident in our own sphere of practice.

A community development programme, one year on, reinforces learnt skills and directs nurses towards more complex assessment skills such as nursing needs assessments, advanced care plans and risk assessments. These focus on patient safety in their own home and prevention of hospital admissions. In other words, a shift in practice can occur where task-oriented care is dismissed and holistic care is ensured as nurses feel more confident and are competent to carry out complex skills.

Since becoming an academic a year ago, I have been involved in many successful development training sessions for community nurses. Through evaluations in a recent bespoke programme for these nurses, we identified that a training package one year after qualifying would be beneficial. A successful course run for one particular group took place over six weeks; students attended various interactive theory-based sessions including dementia care, end-of-life care and risk management.

Research indicates that mortality is lower in areas where nurses are trained to degree level. It is imperative that workforce development is given priority and that nurses are encouraged to be educated to degree level. As well as reassurance and clinical development, a programme offers nurses the opportunity to gain academic credit at either Level 6 or Level 7. This would encourage development towards a district nursing course or a degree in long-term conditions management.

Research commissioned by the Royal College of Nursing and carried out last year by the National Nursing Research Unit predicted that district nurses would become extinct in the next 10 years due to the limited nurse training and high levels of retirement. It is vital we find ways to develop the existing workforce and encourage uptake of district nurse training.

District nurse training is linked to the financial agenda of localities as nurses often have to take a year out at a lower pay scale to complete the training. As a result, part-time district nursing courses are becoming popular. However, it is important to consider the impact of working and developing in the same environment.

Creating training after a year in practice enables nurses to develop complex skills. The insight into advanced skills from a course may also encourage nurses to take a step towards the district nursing programme or towards specialising within the community field.

Neesha Oozageer Gunowa is senior lecturer, community team, Kingston University and St George’s, University of London.

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