Nurse education, as healthcare itself, has shifted towards community care delivery. Both government and Health Education England drivers have stated that 50% of pre-registration nursing students’ time in practice should be community based as this helps integrate services and enable further development of care in the community.
For a patient, their time in hospital is only a snapshot of their life and can often be a traumatic event which disrupts their whole lifestyle. As well as an effect on patient wellbeing the cost of a hospital stay is on the increase with an average spend of £400 per day. The need for hospital avoidance is therefore crucial for student nurses to understand, and this includes care delivery, prevention and management of complex conditions within a home environment.
“Nowadays community nursing is very different; no two days are the same”
Community nursing has traditionally been associated with an older generation of nurses who had already worked in a hospital setting for many years. Nowadays community nursing is very different; no two days are the same. One day could be prevention of hospital admission and another facilitating a hospital discharge. Having hospital experience before joining the community 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 in a hospital.
“Student nurses should not be afraid to work in the community as often areas have preceptorship programmes with structured inductions and development pathways.”
Nurses working out in the community are autonomous and provide care as a guest in a patient’s home. Student nurses should not be afraid to work in the community as often areas have preceptorship programmes with structured inductions and development pathways. Student nurses choosing to work in the community have a variety of settings to choose from which may vary from a Multidisciplinary Rapid Response Team to a Health Visitor for Older People.
“Structured development components help modernise the image of nursing and nursing careers through an ever-changing healthcare system”
As well as having a variety of roles to choose from 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 healthcare system.
“It is important […] student nurses acknowledge that practice nursing is another option in the community which is fast developing and often enables nurses to be based in one area.”
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. It is important at this point that student nurses acknowledge that 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 in community nursing as students have an understanding of the structure and process of a community establishment. In practice it is encouraged as part of learning objectives for pre-registration student nurses in their third 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, Kingston University and St George’s, University of London.