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