Community Nursing and Personalised Care – a Reflection

I am very lucky to work for Hertfordshire Community NHS Trust, a Trust that values and celebrates the contribution that Community Nurses make to patient outcomes.

I have been involved in setting up 18 Mass Vaccination Covid-19 Centres, in my role as the Deputy Director of Nursing. Early in the programme I was asked to meet Gavin, an expert by experience who was going to make a short film to encourage people with a Learning Disability to come into vaccination centres, to have their Covid-19 vaccination.

At that point, I had not been closely involved with supporting people with a Learning Disability, having come from a frail elderly and Health Visitor nursing background.

Meeting Gavin really opened my eyes to how taking the time and effort in personalising people’s experiences of care can have such a hugely positive impact on people’s lives. Gavin spoke from the heart and was passionate about encouraging other people with a Learning Disability to take up the offer of a Covid vaccination.

I later found out that this approach was called ‘reasonable adjustments’, but to me it was all about treating people as individuals, tailoring my approach to take into account people’s needs, diversity, likes, dislikes and wishes.

I started to hear about people in the community with a Learning Disability who were struggling to get vaccinated, finding attending GP practices, pharmacies or vaccination centres too traumatic, or overwhelming. So, I began to take referrals from Primary Care Nurses, Learning Disability nurses in the Local Authority and through local Covid-19 social media, to visit people at home where reasonable adjustments were needed.

During the last year, I have visited numerous people at home or in their day care settings to vaccinate them. Some of the visits have taken 15 minutes, others 2 hours, and each one has been completely different. Every one of those people have been successfully vaccinated in a stress-free way.

Some of the reasonable adjustments I have made include:

• Spending 30 minutes dancing with a young lady to the music of Boney M (her favourite) until she felt comfortable in my presence. I could then sit next to her and vaccinate her.
• Massaged a man’s hands to help him feel calm.
• Played with rubber balls to engage with one young man.
• I have done lots of colouring.
• I have had a long discussion about dinosaurs.
• Cuddled teddy bears with some young people, and then vaccinated them.
• Vaccinated two brothers in their parents’ car.
• Played Jenga with a lady – passing her bricks, so she got used to me.
• I have also eaten endless sweets, crisps, and biscuits (not good for my waistline) and drunk numerous cups of tea to help appear non-threatening and to fit in.

My reflection on the experience has been that taking the trouble to find out what interests, needs and wishes people have is key to delivering personalised care.

I know I am lucky to be in a role working for an organisation that supports me in this work and I recognise how lucky I am to be able to spend time with patients. The whole experience has again highlighted to me the unique and valuable position Community Nurses are in to work creatively to meet people’s needs.

Cath Slater RN HV Queen’s Nurse

Deputy Director of Nursing and Quality

Hertfordshire Community NHS Trust

The photo: Gavin Howcroft and Cath Slater – after Gavin’s second vaccination.

Permissions sought and obtained for the photograph used.