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'Student nurses should not be afraid to work in the community'


Community care is often not seen as a viable first nursing role, but senior lecturer Neesha Oozageer Gunowa argues this belief is unfounded.

As healthcare has shifted towards community-based care, nurse education has followed a similar path. In fact, both government and Health Education England drivers state that 50% of pre-registration nursing student time in practice should be spent providing community care.

This not only helps to develop care in the community, but also helps to integrate services.

A patient’s time in hospital is only a snap shot of their life but can often be a traumatic event that disrupts their whole lifestyle. As well as this effect on patient wellbeing the cost of a hospital stay is ever increasing with an average spend of £400 per day.

“50% of pre-registration nursing student time in practice should be spent providing community care”

Therefore the need to avoid hospital admissions where possible is crucial for student nurses to understand.

Community nursing has traditionally been associated with an older generation of nurses who had already worked in a hospital setting for many years. Nowadays this type of nursing is very different, no two days are the same; one day could be spent preventing a hospital admission and another facilitating a hospital discharge.

“The need to have hospital experience before gaining a community post is now a myth”

The need to have hospital experience before gaining a community post is now a myth. The skills and philosophy used within someone’s home environment are very different to those used whilst working on a ward or within a hospital.

Nurses working out in the community are autonomous but student nurses should not be afraid of this. Often community teams have preceptorship programmes with structured inductions and development pathways.

Student nurses choosing to work in the community have a variety of roles to choose from, varying from a Multidisciplinary Rapid Response Team to a Health Visitor for Older People. There is also a progression structure which has been reinforced by the Agenda for Change and the Education and Career Framework produced by Health Education England in 2015. Both these structured development components help modernise the image of nursing and nursing careers through an ever changing health care system.

”Having a driving licence does open up opportunities however this is not always the case”

Students thinking of community nursing need to be aware that having a driving licence does open up opportunities however this is not always the case. In some areas community nurses either walk or use public transport to visit housebound patients whilst in others nurses are offered the chance to have a grant to fund a car when joining the community team.

Practice nursing is another option in the community which is fast developing and often enables nurses to be based in one area.

Community placements strengthen job applications as they provide students with an understanding of the structure and process of a community establishment. In practice it is encouraged as part of their learning objectives for pre-registration student nurses in their 3rd year to be “long armed” by their mentor so they can use their own initiative within their sphere of knowledge when seeing patients alone in their home environment.

Neesha Oozageer Gunowa is a senior lecturer, community nursing team at University of London



Readers' comments (4)

  • I absolutely love my "first year-first placement" in the community!

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  • I was a HCA in community and just about to qualify as a registered nurse, I have secured a position in community and can not wait to start my career.

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  • In my experience, this negative way of thinking is still upheld by many community team managers and nurses alike. I had a community placement in my first year, and it was made clear I was seen as an inconvenience. At the time I didn't realise just how much I didn't know, but now, as a 3rd year mental health student I relish the opportunity of working in the community rather than on a ward. But many community teams seem reluctant to employ newly qualified nurses, suggesting that I should get ward experience before considering a community post.

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  • I am a student, child nursing branch. The experience I have had of community working has been a positive one but not in regards to development of skills, knowledge and confidence. I am at the end of my 2nd year on my final 2nd year placement, and am in community with the health visiting team. I have also had a health visiting placement in first year. It is limited to what we are able to do, mentors are unsure and we spend a lot of our time with other professionals such as nursery nurses or family support workers as the health visitors do not have enough work on for us. A lot of our time is purely observational. Although it is good for our child development knowledge and seeing the 'well' child, at the end of my second year as a sign of progression point placement I do not believe it is an appropriate placement to have. To say 50% of our time as students should be spent in the community may work for the other fields of practice, but not for children's. There are currently not enough children's services rolled out into the community for this to be an effective learning experience as child branch students. Additionally, at my university there are no specific outcomes in our professional achievement diary's that relate to community, they are 99% clinical/ward based, making reflections and PDP's hard to do based upon health visiting placements.

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