Last words

Published: 08 December 2011

Lynn Young's Final Letter to the District Nurse Forum

Dear District Nurses,

By the time you receive this letter from me I shall have said a final farewell to the RCN. I have had a wonderful 21 years at the RCN, as its primary care adviser and during that time met numerous fantastic district nurses, who have been nothing short of inspirational. Working for the RCN is one thing, but I have always acknowledged that without daily contact with members you are in danger of rapidly becoming rather irrelevant.

In short, it has been my joy to work alongside district nurses in our endeavours to improve working lives at  the same time as improving community nursing services for patients.

The  sad truth is though that I leave the RCN with a sense of failure, given the current fragile state of the district nursing workforce. Despite constant and considerable efforts to get the message across to commissioners, managers and politicians that district nursing needs urgent and substantial investment to ensure it is equipped to meet demand, quite frankly the appetite required to take the right action has been missing.

While district nurses struggle to maintain a decent service and despite the decline in numbers over the last decade all is not lost and the fight to invigorate the workforce when I am gone from the RCN will continue.

An RCN report on district nursing is currently being developed, and once published it will sit alongside other RCN papers on community nursing which have been produced since ‘Pillars of The Community’, August 2010. My ambition was to have this document available for RCN Congress, which might still happen as I have left the final work needed in very capable hands.

You know more then I that tough times lie ahead and in so many ways I regret that I will no longer be part of  the battle needed to make health care as good as it can be. But, I am also convinced that this is the right time for another, younger and brighter, lucky person to take my place.
The call from  the health departments of Northern Ireland,  Scotland, Wales and England is for more community nursing and less demand for hospital admission. The fact that this call, was originally made by Nye Bevan in 1948 at the birth of the NHS tells us, that regardless of the rhetoric the ability to achieve such a shift is almost impossible to achieve.

But, lets keep hope alive.  Talented and newly qualified nurses express their wish to work in the community, rather then the hospital and we await the success of Modernising Nursing Careers in terms of equipping new nurses to be competent in the community on qualification.

And here is my final plea – while this is excellent news, without substantial community nurse leadership in the form of adequate numbers of talented and supported  district nurses,  the UK will be unable to boast world class community nursing services.
So, goodbye from me and all the luck in the world as you continue to carry out such fabulous work in your communities every day of the week.

Lynn Young

Published April 2012

Final Letter from Sue Moody

Sue Moody remembers inspirational colleagues and events

This is my final letter as Chair of the District Nursing Forum and I have to say a huge thank you to many wonderful people I have met over the years. I hope you won’t mind me indulging myself as I share some of my experiences with you.

I began in 2003 having been fascinated by workshops run by the Forum Steering Committee on district nursing development. Coming from community nursing in Jersey, it was a fantastic opportunity to engage with others around the country and to compare the similarities and the differences. I was co-opted onto a very enthusiastic committee by Lucy Botting who was an excellent networker and ideas person. We had many productive debates on the future of district nursing.

My journey with the committee continued under the leadership of Bernadette Metcalf, who is still an inspiration. She has given so much to nursing and also to individual nurses who, I am sure, could tell their own stories. We travelled the country as a team and met many community nurses working in varied and very difficult circumstances.

I remember a meeting in Scotland where we met Queen’s Nurses from the 1950-1960s. They brought along some of the equipment they had needed back then and it was fascinating to hear about their experiences.

I took over the lead from Bernadette in 2009 following the restructuring of the RCN forums. The committee then consisted of Sue Sanderson from East Kent, who was a superb team member and could always be relied upon to question policy and organisational changes. But she also came up with alternatives that were workable, and did so with a sense of humour that is necessary in today’s climate.

The committee of "Sues" continued with the northern contingent. Susan Stephenson travelled miles for us and was superb as the "finisher". Susan is renowned for her extensive nursing and educational expertise in Northumberland among her farming neighbours and her patients in Newcastle. She was brilliant to work with - I miss her very much.

The UK perspective

Our Welsh member was Yvonne Thomas, who gave us so much insight into another political approach to community care delivery. Yvonne works very hard for the RCN Board in Wales and advises extensively on community practice. As well as this she looks after her locality which is extensive - and manages to study too.

The Scottish representative was Evelyn Ryan, again very well known for her work with the RCN in Scotland. Evelyn was also able to give us a perspective on Scottish policy and organised a fantastic meeting in Edinburgh which was very well received.

I would also like to thank Kay Durrant, Rosemary Wheeler and Teresa Cole who joined us later. They all contributed enormously to the forum and I am sure will continue to do so as our exciting new committee comes together. I look forward to their future work.

 RCN support

I have been supported throughout my journey with the District Nurses Forum by our Primary Care Adviser, Lynn Young, who has never failed to make me smile, challenge my thoughts and, at times, let me totally disagree with her! She has always been there for me and I have learned so much from her. Lynn, I thank you.

The person that I couldn’t have done without during my time as Chair is Sandra Hall, Membership Co-ordinator. Sandra has helped so much, making sure I was where I should be at the right time and my reports were sent to her so she could keep me on track. Thank you, Sandra – you are a saint!

The forum has given me so many experiences that I would never had been able to achieve on my own. I have met many of our members and this is the primary reason why all the committee give their time.

I have been invited to focus groups, including controlled drug reporting for the Shipman Report, the development of Telemedicine and the Workforce Development Programme (RCN) - to name but a few.

 At the centre of breaking news

My last commitment as the forum chair was to represent members at an emergency meeting for the Patient’s Association in October, looking at the poor care of older patients. The views of several specialists were expressed, including Baroness AudreyEmerton – the only nurse in the House of Lords – as well as patients, nurse educationalists, chief executives, directors of nursing... and Rosemary Cook, Director of QNI, who confirmed my comments that this was not just about poor hospital care, but all nursing care of older patients.

The Patient’s Association has now launched the CARE campaign following this meeting. I urge you to have a look at the video and publication that they have produced. It is very powerful and will be valuable when discussing critical events analysis with your colleagues.

So is Community care: transforming health care, recently published by the RCN. This is an excellent document and the examples are especially uplifting in a time of uncertainty. Even without extra resources these nurses have shown the difference that innovation and enthusiasm can make to patient care. Do read it yourself and circulate it to your colleagues.

 The rewards of activism

The opportunities I had to visit Congress cannot be overestimated - the time spent in Harrogate, Bournemouth and in Liverpool this year (which was superb) was absolutely invaluable. I have learned so much and met so many interesting and inspirational people - I urge you all to attend. There is funding available from your regional branch and if you haven’t been before, it’s worth a try.

I would like to campaign for the Government to pay for each and every nurse to attend Congress at least once in their working lives. This would certainly swell the membership, but also give nurses the uplift we all need to continue to do the challenging but exceptionally rewarding care we carry out.

 If you are interested in the development of community nursing and don’t feel you can commit to joining a committee, you might consider getting involved with forum projects or even just give your comments and opinions on nursing in your area. Sound good? Then do let us know!

Let’s spread the word

We need to use the skills and knowledge of community nurses in all four countries to continue to develop and expand our services so that we will meet the commissioning needs of the future.

The transfer of services to several different providers does not mean a new wealth of nurses are out there to take over. You are the wealth of nurses and therefore you need to be politically aware and positive about the services that you know patients need and you know how to deliver.

Finally I would just like to wish good luck, laughter and inspiration to our new steering committee, I look forward to the developments.

Published December 2011