An award-winning internship programme is encouraging nursing students at the University of Northumbria to consider a career working in care homes
“In the past, nursing in a care home might have been looked down on and seen as a Cinderella service, but we’re trying to change that,” says Jemma James, who qualified in 2019, after spending much of her final year based in a care home in Durham.
Since taking part, she has continued to support the programme - which involves at least nine care home providers across the North East - giving a presentation to this year’s virtual RCN Congress about her experiences.
“As a nurse in this environment you’re working in a person’s home,” says Jemma. “It’s a totally different power dynamic, compared to working in a hospital. I love being able to have that close personal contact with someone, getting to know them.
I love being able to have that close personal contact with someone
In practice, her internship was split between working in a care home, alongside her mentor, and spending time with specialists based within the NHS and charity sector, where she was able to learn more about strategic decision-making.
"It helped me to understand the practical impact of decisions on issues such as assessment and funding, seeing the whole process from the top down and the bottom up,” says Jemma.
"On the ground, you may think, we need more funding," she adds. "But when you understand more about how that money is allocated, you can also see the challenges. It informs your thinking, but also gives you the tools to challenge constructively.”
Individual responsibility
For Jemma, the opportunity to have a high level of individual responsibility is among the key attractions of nursing in a care home. “You’re often working on your own, taking care of several poorly people, with no doctors immediately at hand,” she says. “You’re assessing someone rapidly, triaging and making referrals. The residents are reliant on you and your skills to know exactly what to do to help them.”
Holistic nursing starts with making a one-to-one connection
Last year, the programme – believed to be the first of its kind in the country – won a Cavell nursing star award. In response to students’ feedback, a short placement of a couple of weeks is now available to those at the start of their degree too. “You’re matched with a resident with the aim of helping you to really understand that individual,” explains Jemma.
“As a first-year student, you may never have been in a care home before or met anyone with dementia, so you can have a very set picture. This challenges your views, breaking down those stereotypes. Holistic nursing starts with making a one-to-one connection.”
Nurse-led care
Currently working with oncology patients, Jemma sees her future within the care home sector. “I have a vision of care homes becoming fully nurse-led,” says Jemma, who was shortlisted in the student category of the RCNi Nurse Awards in 2019.
“We need highly skilled practitioners who can also prescribe, as higher dependency is normal for residents now. I’m trying to gain as many skills as I can, so eventually I’ll be able to give a comprehensive service to people living in a care home.”
Older people’s nursing deserves more attention and respect
A new curriculum at the university means the next internship doesn’t begin until January. “But for the first time, we are including an older people’s stream in the third year, which is very exciting,” says associate professor in adult nursing Dr Juliana Thompson. “Most year three students will have a placement in an area providing care specifically for older people – a care home, hospital ward or community service.”
The university will also be providing practical sessions on a range of topics related to caring for this group of patients, including dementia, delirium, frailty and multi-morbidity.
“Older people’s nursing deserves more attention and respect,” says Jemma, who joins the steering committee of the RCN Older People’s Nursing Forum in January. “We need to shout from the rooftops.”
Pictures by Simon Veit-Wilson.
Get involved
Find out more about older people's care and how to join the RCN Older People’s Forum.
