This week’s blog concentrates on good news by telling Nursing Times readers how a day spent in Milton Keynes proved to be uplifting, mainly because the community nurses were working in harmony with their general practice.
The point of this short story is that whenever the issue of community nurse employment raises its complicated head there is a wave of disquiet heard from the ranks of district nurses and health visitors, referring to the fact, that no thank you, they have no wish to be employed by general practice.
I know of only one general practice in the UK (if you know of more please tell me) which has taken the enormous step of employing its previously attached and well integrated district nurses and health visitors. When I heard of this set-up, my immediate thought was that this is a practice I must visit.
History is important and the fact that the DNs and HVs in question had been managed by the practice since 2000, and that considerable efforts had been made over the years in terms of integrating community health services with those of the practice was significant. When the practice offered to employ the community nurses, rather then simply second them from the PCT, the transactions regarding contracts of employment proved to be easier then anyone anticipated.
Since 2000 huge progress has been achieved for both patients and staff. Strong nurse leadership and enlightened practice management have served the nurses and health visitors well. It is accepted that the community nurses practice with a style of autonomy and independence – GPs make no effort to micro manage them. Teamwork is exceptional and the healthcare assistants who work with the practice nurses and community nurses were happy to talk about their enjoyable and well supported working lives. One healthcare assistant is planning to accept the opportunity to train as a registered nurse.
The moral of this story is that, when we consider changes to organisations and structures of employment, the form is less important then the character of the people involved. I am no longer excited or depressed by structures, but the energy, philosophy, values and style of nurses, doctors, therapists and managers never fail to intrigue me. Always remember, it is people who provide care, not buildings or policies.