District Nursing Out of Hours – Inspiring Future Nurses
9 November 2022 | Karen Cotici
Just over a year ago I had the opportunity to write for the QNI for the first time about my experience as a first year Apprentice Adult Nurse based at Mid Cheshire Hospital, and my community placement with the Winsford District Nurse Team.
One year on, and at the end of my second year, I was lucky enough to have another community-based placement, this time with the Out of Hours (OOH) Team who are based at Mid Cheshire Hospitals NHS Foundation Trust. This service covers a large area of Cheshire from 1700 in the evening to 0800 the following morning.
Once I found out I had another community placement, I contacted the manager from my previous community placement to tell her and ask her what to expect. Her advice was, “This will give you a whole new aspect of community nursing,” and there could not have been more truth in those words.
Starting my Placement
The first day of my placement, I met the management team at the start of my shift, who gave me a brief on their workload. They were enthusiastic about the service they provide, which made me feel excited to start. They also took time to understand my background and what skills I had and what I could learn, and I knew this placement was going to be tailored for me to get everything I needed and more, which I am very grateful for.
I met my assessor, who I can only describe as someone who was born to be a nurse. He was able to put me at ease immediately and by the time we had walked from the office to the car I felt like I had worked with him forever! And the same goes for the rest of the team, but this is what makes a District Nursing team, it is the key skill they possess that makes it possible to do their job to an excellent standard.
With Out of Hours District Nursing it is not just the patient that is your patient, it’s everyone under that roof, because they are your eyes, your ears and in some cases the patient’s voice, so understanding this side of District Nursing was very rewarding, and I would end my shift each night knowing that I had supported and made a difference to someone’s evening and their life, and this is, again, what makes this team remarkable.Karen Cotici
Communication and Understanding
We talk all the time about communication and how important it is in every context. The OOH team see cases that range from a call for assistance with dressing, to support at end of life. The team may be meeting some of the patients and relatives for the first time in that situation, because they do not carry their own case load, but they are highly trained to understand very quickly the requirements of a first visit.
Calls to the OOH team come in through the hub: the hub is the central point of contact for the District Nurse out of hours team and is always run by a senior sister or charge nurse, and then work is cascaded across the team. I attended calls that came through around concerns for patients in distress at end of life, that turned out to be relatives having the sudden realisation that end of life was imminent. As nurses we see this all the time, but nothing prepares a family member for this situation at home on their own.
My assessor and other members of the team all had the knowledge and skills to understand this and offer support and reassurance to the family. I helped comfort a relative who told me she had made a promise months ago to keep her husband at home, but who was worried she wasn’t doing enough, and having that talk and reassuring them that they were doing amazingly is all she needed.
Making a Difference
With OOH District Nursing it is not just the patient that is your patient, it’s everyone under that roof, because they are your eyes, your ears and in some cases the patient’s voice, so understanding this side of District Nursing was very rewarding, and I would end my shift each night knowing that I had supported and made a difference to someone’s evening and their life, and this is, again, what makes this team remarkable.
When we look at the training pathway, we discuss situations, but I don’t think anything could have given me the knowledge I’ve gained from the two District Nursing placements I’ve had. Both day and night services give insight and growing realisation into what District Nursing is truly about 24/7. I never really had any understanding of District Nursing at the start of my training, and I am sure even over the 12 weeks I have now done, I’ve still only scratched the surface.
Going into my third year now, District Nursing has been the most insightful and inspirational placements I have had to date, and I feel I have learned things that I can carry forward in many areas of nursing, but could never have fully understood in any other environment.
I would urge anyone to take this experience if it becomes available, and as I said earlier, I cannot thank the two teams that are part of CCICP (Winsford District Nurse Team and Out of Hours Team) enough for the knowledge and experience they have given me.
Find out more about CCICP here: https://www.mcht.nhs.uk/our-services/community-services-ccicp
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