After my four years at University I choose a community nursing placement as my final, management placement. Community nursing is something in which I have always been intrigued by; I enjoy the aspect of the possibility of unknown, the everyday different challenges which can occur, and the uniqueness of patients in their own homely setting. Growing up in a rural and isolated location in Scotland has shown me the true importance of being an autonomous nurse and just how significant each person can be in contributing to another’s lives.
I have always been interested in public health. I have always believed that nursing is much more than nursing those who are ill and fragile, but about preventing illness too. With Scotland’s 20:20 vision for improving patient outcomes by having integration of health and social care, and with prevention and anticipatory care a key focus, nursing in the community has never been a more appealing time for me.
Although I have always wanted to work in the community, I was a bit apprehensive about having my management placement in this setting. The routine of the ward setting was a comfort; the majority of all my placements had been on a ward setting and it was an area where I could easily identify knowledge and skills in which I needed to develop to become a competent registered nurse. I was unsure at first if I would be able to progress as quickly in the community, as after all, I hadn’t been with the District Nurses since my first year, first placement. However, how wrong I was. From my very first day, I felt like a valuable member of the team. The team was small, so I quickly got to know everyone, all who were extremely welcoming and helpful. My mentor, who was the District Nurse on the team, was always very busy, however, continuously made time for other staff and myself.
My first week consisted of getting to know the caseload and the workload involved, I was reminded immediately about the diverse range of individuals who are seen by the District Nursing Team. The majority of early visits involved diabetic management. After meeting in the morning with my mentor, we would attend a range of individuals who required assistance for either administration of their insulin, or required supervision to maintain their self-care. Encouraging self-management of any long term condition seems more important than ever in the community due to individuals living longer and with more often than not, these individual having co-morbidities and therefore, increasing the caseload size. Promoting and empowering individuals to self-manage their care is a vital part for Scotland’s healthcare to cope with the increasing demands in the future.
After my first week I had been involved in a wide range of different types of care, working with a range of professionals, patients and their families. Ensuring communication flowed quickly and efficiently between all involved has been highlighted as a key part of providing the best care possible to patients. Whether this be working alongside home carers, so a patient can be showered before wound care is completed that day, or maintaining frequent contact with family to monitor how a patient is coping with a new regime, excellent communication is essential. From this experience my own communication skills have been developed to a very high standard.
I am now in my 12th week of placement in the community. I have developed my skills and knowledge to a sufficient level that I have my own small caseload. This has allowed me to have the confidence to independently visit an individual in their own home and manage my own work. I handover each visit back to District Nurse after each morning and give detailed feedback about my role that day and any other actions I may need to take about the individuals care. My time at university has not only prepared me clinically, and with theory providing me up-to-date evidence based practice, but to be an empathetic and compassionate nurse which is essential for all nursing. It is especially relevant in the community where building a genuine relationship with a patient is critical to provide holistic care. From my experience, providing and maintaining a high standard of care through community nursing is essential for Scotland’s future.