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Call for community nurses to be more 'carer aware'

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A senior nurse at the Department of Health has urged community nurses to be more “carer aware” when visiting their patients.

Carers are often some of the “youngest children and the oldest, vulnerable people” in society, said Wendy Nicholson, DH professional officer for school and community nursing.

“They are that invisible workforce supporting many people to stay in their own home… [But] they often neglect their own health and wellbeing,” she told delegates at the Queen’s Nursing Institute’s annual conference earlier this month.

She said nurses needed a “really clear understanding” about how to identify carers “much more robustly” and how to support them in a “really positive way”.

“If we don’t have an invisible workforce that is well and healthy, they are not going to be able to able to help us,” she warned.  

“It’s about asking carers how they are, recognising them as experts in care and making sure they don’t feel isolated”

Wendy Nicholson

Ms Nicholson said that supporting the health and wellbeing of carers more effectively would result in a “double whammy”, where outcomes improved for both the carer and the cared for.

She noted that carers often had low self-esteem, were socially isolated and felt judged by health professionals. “What they often tell us is that when their loved one is admitted to hospital or goes on to other care, then they are often excluded,” she said.

In particular, she called on nurses to “listen” to carers and find out what they needed in order to feel supported. “It’s about asking carers how they are, recognising them as experts in care and making sure they don’t feel isolated through linking them with carers’ associations.”

Queen's Nursing Institute

Wendy Nicholson

Ms Nicholson identified school nurses, district nurses and general practice nurses as three key professional groups that have an “interface with people who care”.

However, she acknowledged that community nurses might question how they were expected to find the time “to do something new”. But she said the expectation was “not to actually do all of the support but to actually be able to signpost”.

“One thing community nurses do more than anybody else is have that ability to hold people together,” she said. “Community nurses are that glue, we hold things together, we signpost, we support.

“We know that there’s a vast amount of opportunity through the work that’s undertaken to make every contact count,” she added.

For example, Ms Nicholson highlighted that school nursing was a universal service for all children and one in four 75 year olds had contact regularly with a district nurse.

“Imagine if we could support and signpost those people that care for all of those,” she said. “It would make a huge difference.

Ms Nicholson also told delegates about progress made in the two years since the publication of the national school nursing strategy – Getting it right for children, young people and families.

She highlighted, in particular, a programme to train school nurses as “champions for young carers” and a young carer’s pathway to help school nurses deliver more effective services.

“We now have about 200 school nurse champions that have been trained directly by young carers,” she said. “Those school nurses have now gone on to pledge to make a difference locally.”

In addition, she highlighted the adult carer’s pathway, launched earlier this year, which she said provided “really good guidance for district nurses and general practice nurses in terms of signposting and recognising the health and wellbeing needs of adult carers”.

For example, she asked: “When visiting an older person with their carer present, why are we not giving them the nudge to say have you had your seasonal flu jab?”

“Often the community service is just not adequate enough to support that and to ensure the carers get a good deal”

Linda Henson

However, Linda Henson, a community palliative care nurse manager, warned that the increasing move towards patient-centred care actually posed a challenge, when taking into account the views of carers.

“Very often we take a lot of consideration of what are the patient’s views and preferences, often to the detriment of and exclusion of the carer,” she said. “Often the community service is just not adequate enough to support that and to ensure the carers get a good deal.”

Ms Nicholson agreed there was a need to raise awareness among community nurses about not “excluding carers” from discussions with patients.

“We might not have it right yet, but at least we can start to make people more carer aware, which has got to be a positive really,” she added.

Queen's Nursing Institute

Wendy Nicholson (centre) at the QNI annual conference 2014

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