Letter from the Adviser
Published: 08 December 2011
Lynn Young on efforts to rebuild the district nursing workforce
The RCN has, in recent months, carried out an extensive survey of its members who are district nurses. As you know we have been lobbying for improved investment in the district nursing workforce for a number of years, in the knowledge that during the last decade there has been a significant decline in the number of district nurses and that district nursing programmes have disappeared from many universities.
This district nursing report is based on the findings from the RCN 2011 Employment Survey – Views from the frontline
While there are no surprises it is quite alarming to have your fears confirmed and see some starting statistics in terms of the age profile of today’s district nurses.
We have much work to do - at a time of financial restraint - if we are to successfully rebuild district nursing. In light of the new pre registration nursing programme, Modernising nursing careers we may need a radical rethink on how we prepare nurses to take on leadership roles in the community. Decisions have not yet been made on such developments, but in the meantime the Nursing and Midwifery Council (NMC) has stated that it will be embarking on a review of the community specialist programmes.
Transition is seldom easy
People are waiting for this to happen so that they will be better able to plan ahead. The trouble is that meanwhile, in effect, nothing will be done.
Transition times are notoriously difficult to cope with, but this is the position that all community nursing disciplines are now in. The past is not fit for the future, but we do not know what else to do.
Community nursing needs are increasing all the time as you try and deal with care closer to home, more older people needing care and a population with ever rising nursing requirements as a result of long term conditions. It’s a deep irony, then, that community nurse numbers continue to decline.
The truth is that the conventional district nursing programmes may be coming to an end, but this does not mean that they do not need replacing with something different. Newly qualified nurses do not manage hospital wards and we cannot expect them to manage the care of home-based patients with complex needs either.
A few stats to get you thinking
Some 58 per cent of district nurses are aged between 45 and 54 years, while a mere four per cent are sprightly young things between the ages of 26 and 34. Nurse managers, nurse educators and people involved in workforce development must gather together and agree an affordable strategy for ensuring that the future community nursing workforce is well placed and well prepared to provide a high quality service to those who need it.
This can be done, but in the meantime we also need creative and confident people who understand community nursing to develop local solutions to local problems. You never know what might happen as a result of the brave and perhaps radical actions taken by the few.
And here is the good news you have been waiting for. When the formal proceedings were over at a recent meeting, I was lucky enough to be approached by a hospital nurse who spoke in almost lyrical terms about the district nurses who cared for her father at the end of his life. She had little idea before about how spectacular district nursing could be, but she certainly knows now.
Lynn Young is RCN Primary Care Adviser.