Mary Kinninmonth is a District Nurse Team Leader with NHS Fife. Her blog shows the positive impact of a supportive, integrated workforce when faced with the unexpected challenges of the COVID-19 pandemic.
There is no question that COVID-19 has had a huge impact on everyone’s lives and all within a relatively short space of time. The District Nursing service has risen to the challenge and my colleagues and I have embraced the change. The patients on our caseloads are mostly housebound and dependent on others to provide their care. Naturally, the arrival of the pandemic has created increased anxiety for our vulnerable patient group but as a district nurse, their physical and mental wellbeing is at the forefront of our minds and we do everything we can to reduce this burden. . We have embraced and embedded the guidance on PPE and social distancing measures into our daily working practice to allow us to continue to deliver home visits whilst at the same time, protecting our colleagues and patients.
Although the focus has been on dealing with the immediate challenges of COVID-19 there have been many positives which we can look to take forward in future practice.
Cascading information to our teams was a challenge in the beginning due to the constantly evolving nature of the information we were given. Decisions about staff deployment and PPE had to be communicated clearly, concisely and rapidly. . Who would have known that MS Teams would become our new best friend, even if it did take a bit of getting used to? Like my colleagues, I have been very fortunate that I have been able to carry on doing my job as a District Nurse Team Leader with the support made available to me. My priority has always been the safety of my staff and our patients throughout.
During these unprecedented times, many necessary changes had to be implemented very quickly. I was grateful that we were well supported throughout this process. Although initially apprehensive, I did feel properly prepared to adopt the changes required, including taking on additional responsibilities. District nursing forged good working relationships with the care home sector to support the Care Home assurance work which is still ongoing. There have been relatively low numbers of COVID-19 infections on our caseloads, and we have continued to provide end-of-life care enabling people to be cared for in their own home if they wish. Everyone worked collaboratively. An example of this is where pharmacy services supported us to use the ‘Grab Bag’ medication resource 24/7 which was prepared in advance to ensure a timely response for essential palliative care medications. These interventions were invaluable in supporting the effective management of patient symptoms. Another new development within our role includes our ability to attend and confirm death. This was a really person-centred initiative which meant we could reduce the number of healthcare professionals attending the patient or their family ensuring the right person at the right time.
District Nursing is a very resilient workforce and DNs actively strive to deliver proactive, person-centred care. Many of us altered our working pattern to support our colleagues in the out of hour’s period to support the additional palliative care callouts. The introduction of a Fife Wide waking nursing service has also ensured access to district nursing care 24/7 which is hugely positive for our patient group.
With time, processes around sourcing PPE has become easier, changes continue albeit at a slower rate and levels of anxiety have reduced. Although the focus has been on dealing with the immediate challenges of COVID-19 there have been many positives which we can look to take forward in future practice. Collaborative working with specialist palliative care and our Marie Curie colleagues and a closer working relationship with our colleagues in the care home sector are just two of the benefits of adapted working. The pandemic has given us the opportunity to learn from each other and in turn provide our patients with the best possible evidence-based care. My District Nursing teams have welcomed support from other services, including podiatry, phlebotomy, dietetics, and diabetic nursing to ensure we had enough staff to ensure both general and complex care could be delivered. This was also complemented by 3rd-year student nurses who have proven to be a real asset to our service.
Within District Nursing our strong values and beliefs are reflected in our high standard of practice. As a service we have embraced the many changes, working collaboratively with our colleagues to ensure our patients receive the best possible care. Going forward I know I will embed the positive changes gained from integrated working into my practice. By building on the relationships we have developed I know our services will go from strength to strength to support those we care for.