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'Community nursing is not a dead end job'


Amy Perry qualified three years ago and wants to dispel the myths about her job

'Community nursing is not a dead end job'


Having loved growing up in the farming community I always knew that I wanted a job out and about in the countryside.

While many of my fellow graduates opted for the safety, comfort and warmth of the familiar hospital wards of their first jobs, I was keen to don my wellies, brave the cold and head for the unknown.

“But all you do is dress smelly legs all day.”

That was the most common reaction to my unusual career choice. I’m here to dispel the myths that I often hear of it being dead end, that we’re all deskilled and it’s just for ‘older nurses’.

My first visit of the day is to a dairy farmer who needs IV antibiotics. He was born here on this this farm and more than likely he’ll die here - that’s the way of life in these parts.

As he hobbles out of the barn he yells over to me “I got a touch of lameness”, said as if he were one of the cattle. Roughly translated for those not au fait with language more suited to vets, this means he has septic arthritis.

We’ve been coming in over the past few weeks to give him treatment that usually requires hospital admission. We get chatting and he tells me that being in hospital would have been disastrous as there’s “n’other to feed the girls”, by which he means his beloved herd.

There is no bank or agency staff to cover in his profession. As soon as I finish flushing the line he’s back out the door into the barn to get on with his day which started before the sun was up.

On next to a lady who needs her chemotherapy pump disconnecting.

Talk is good therapy, especially in these isolated parts

She lives in a small village where the bus runs once a week. She looks tired today, and I’m not surprised. Her transport to her radiotherapy appointment picks her up at 5am and takes her the 200 mile trip there and back three days a week. She’s home by 7pm for a cup of tea and catches the tail end of Emmerdale.

By disconnecting her pump at home we’re saving her an extra journey into the local hospital just to have a 15 minute procedure.

She needs all the rest she can get and I marvel at her determination and how she’s always smiling come what may.

We chat while I’m fiddling away with the pump and I fill her in on the bits she’s missed of her favourite soap opera – talk is good therapy, especially in these isolated parts.

A few other visits and it’s back to the office.

Just as I bite into my sandwich the phone rings – it’s a call from a man with a blocked catheter. We’re not an emergency service but we do have to respond quickly, and this is one that can’t wait. He’s already uncomfortable and starting to worry. That smelly leg will have to wait til later!

Off I go and he’s grateful to see me. You get familiar with catheters as I seem to either insert or remove them on a daily basis. I pray this one will be easy and it passes like a dream. He’s so grateful and relieved. Another job done that means he’s spared a 30 mile trip to A&E.

For all my graduate friends - I can’t deny that I dress smelly legs, but there’s a whole level of skill behind it

Right. The smelly leg. No more putting it off. Actually it’s not as bad as I make out, and if I’m honest I quite enjoy the complexity of the bandaging.

There’s something wholly therapeutic about spending an hour getting a four-layer on so it looks like a piece of art.

So yes, for all my graduate friends out there I can’t deny that I dress smelly legs, but there’s a whole level of skill behind it in assessing and applying compression therapy safely.

While the patients I see may be steeped in tradition, the nursing care we are providing for them is at the forefront of modern clinical nursing and equal to that of any acute setting.

I guess the job application should read “part nurse, part social worker, part shoulder to cry on, part tea maker and part miracle worker”

We’re doing more and more for patients at home, not just to keep them out of a hospital bed but to enable them to stay in the places they love, live and work.

No two days are ever alike in the community. They’re not alike on the wards either. But no matter what mother nature throws at us we’re out there.

Whether you’re newly qualified, or oldly qualified, if you think you can take the challenge of going into the unknown then go for it.

The preceptorship, training, skills and experiences you’ll get will stay with you for life. I guess the job application should read “part nurse, part social worker, part shoulder to cry on, part tea maker and part miracle worker.”

But whatever you are, you’re part of something that is radically changing the way in which nursing care is delivered, and that can’t be a bad place to be.

Amy Perry is a community nurse on the Welsh borders, she is studying a specialist community health practitioner postgraduate diploma at Birmingham City University.


Readers' comments (3)

  • bill whitehead

    This is a great article. Starting your first job as a community nurse is as valuable and sensible a career choice as starting out in hospital or any other nursing setting. There are real advantages for community teams in bringing in nurses who have just completed their preregistration education.
    However, I'd disagree with the concept that this is an unpopular career choice for newly qualified nurses (NQNs). I have been asking third year students at the University of Derby the question "where would you like to work as your first job after qualifying?" every year for the last five years. For most cohorts about half of the soon to be NQNs say that they would like to work as a community staff nurse. However, despite this desire only one or two NQNs actually secure posts in the community after qualifying.
    Why is this? I think the issue is illustrated by a recent student story. She was an excellent student, her final placement was in the community and her mentors had all provided very good testimonies and references. This ideal candidate applied for eight posts in the community. For the majority she didn't even get to interview. Why? When she asked for feedback some of them were honest enough to admit that the main reason was that she was applying as a newly qualified nurse. I think that this is entirely understandable. As an employer if there are candidates applying for the post with experience then, all things being equal, they will take the experienced candidate. I have heard stories from colleagues offering community staff nurse posts where they will have a hundred candidates. A straightforward and fair way to shorhotlist prior to interview is to look at those with the most experience. In hospitals I know that this simply isn't the case. I spent five years as a nurse involved with recruitment to acute medical wards. For entirely understandable reasons (24 hour shifts, punishing workloads, relatively low status etc.) the only staff we could attract were NQNs. That is despite the fact that this was a highly respected hospital and that we devised attractive packages of support and education to try to attract more experienced staff.
    There are about three times as many nurses working in hospital than community and the turn over on acute hospital wards is about 50% every three years. This is in stark contrast to the longevity of community and district nurses.
    To sum up, well done for securing a post as a community nurse as your first job. Lots of NQNs want to be community staff nurses but the jobs that they are offered are not in the community. Therefore, by default they take hospital jobs as their first job and then apply for community posts later in their careers. By that time they out perform NQNs and the cycle continues.
    We have very near to 100% employment for our new registrants. Nevertheless, employers (community, hospital, or other sectors) who would like to recruit our excellent graduates are welcome to come to the University of Derby to present your cases. Community employers will be especially welcomed by a sizeable number of our third years. Don't hesitate to get in touch with me to arrange.

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  • Thanks Amy, you have cleared all the uncertainties off my way as I've been unsure to go straight to the community as a nurse after graduating in 2015. I like that therapeutic countryside nursing. Am a student at Birminghan city university too. Enjoy you training at BCU, all the best AMY.

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  • I've been a community carer for 3 years and have applied to do nursing as a way to further my career and community nursing feels like a very natural progression for me. Thanks for you article Amy, it made me feel even more determined to forge ahead. I've loved my care service users and the challenges I meet. Now I feel confident I'll enjoy my community patients just the same.

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