District nurses work manage care within the community and lead teams of community nurses and support workers. [1] The role requires registered nurses to take a NMC approved specialist practitioner course. [2] Duties generally include visiting house-bound patients and providing advice and care such as palliative care, wound management, catheter and continence care and medication support. Their work involves both follow-up care for recently discharged hospital inpatients and longer-term care for chronically ill patients who may be referred by many other services, as well as working collaboratively with general practitioners in preventing unnecessary or avoidable hospital admissions.
District nurses assess people to see how to provide nursing care that allows people to remain in their own homes, maintain their independence, or have additional support after discharge from hospital. A district nurse will manage a team of nurses that may provide wound care, train carers to administer eye drops if individuals can not do it themselves, support catheter care, and administer complex medication within a patient's home as well as immunisations. As well as treatment, a district nurse can offer advice and support with health concerns and refer to other organisations. District Nurses can specialise in different areas such as palliative care.
District nurses who hold additional qualifications may prescribe certain medications to patients as Community Practitioner Nurse Prescribers under the Nurse Prescribers' Formulary for Community Practitioners (Part XVIIB(i) of the Drug Tariff). They may be trained to assess patient's needs for equipment provision such as mobility and independent living aids, medical equipment such as specialist beds and mattresses, as well as guidance in applying for grants and welfare benefits.
In England they were employed by primary care trusts and are now mostly employed by hospital or community health trusts whereas in Wales and Scotland, they are employed by the health board and may be based at centralised health centres or general practices. District nurses, like all qualified nurses, are regulated by the Nursing and Midwifery Council.
District nurses can also be known as community nurse specialists.
The Queen's Nursing Institute produced a report in 2019 which showed that 22% of respondents to their survey worked a day or more of unpaid overtime each week. 90% regularly did unpaid overtime. District nurses, a job which requires experience, are generally older than hospital nurses and 46% planned to either retire or leave in the next six years. A majority reported that they had insufficient time to devote proper care to patients and 75% said they had vacancies or ‘frozen posts’ in their teams. [3]
In the UK, training as a district nurse requires registration as a nurse in the adult branch, and consolidation of pre registration nurse education. A degree or postgraduate diploma course is then undertaken which is approved by the Nursing and Midwifery Council.
In New Zealand, district nurses are usually employed by the district health boards, although there are some who come under private institutions. District Nursing in New Zealand work under the primary integrated care model, and can be classified as secondary care in some DHBs. Like their UK counterparts, New Zealand district nurses have a wide range of specialized clinical skills applicable to the community setting, which is why district nurse positions usually require some degree of previous clinical experience. There is also a strong focus on health issues affecting specific population groups (i.e. Rheumatic Fever prophylaxis). [4] Veteran district nurses in New Zealand have had access to a higher pay scale compared to registered nurses in an acute setting. [5] : 17–19
Australian district nursing is currently undergoing pressure as a result of large changes in funding. Previously, community nursing was predominantly government-funded via block funding, having grown from volunteer or charitable organisations. [6] The introduction of the National Disability Insurance Scheme and the new aged care system means funding is being made accessible to clients who can then decide how to spend it. This has forced a greater level of competition on to the industry. [7] This has led to many previously large district nursing organisations, such as the Royal District Nursing Service, amalgamating with residential care providers to attempt to build a vertically integrated model. [8]
Organised district nursing in England is considered to have begun in 1859. In 1858 Liverpool philanthropist William Rathbone employed a nurse, Mary Robinson, to take care of his wife at home during her final illness. [9] After his wife's death in 1859, he engaged Mary to go into one of the poorest districts of the city to bring healthcare to people who had no means to pay for it. He spent the rest of his life working to build up the service, with assistance from Florence Nightingale and others. District nursing on the Liverpool model soon sprang up in other towns, cities and rural areas, funded by local philanthropists.
In 1887 Queen Victoria’s Jubilee Institute for Nurses was founded, centralising training for district nurses (or Queen's Nurses as they became known) until nursing education became nationalised in 1968. The charity, which became the Queen's Nursing Institute, continues to support community nurses to this day. The Institute always needed to raise funds and until the creation of the NHS in 1948, district nurses collected contributions from their patients.
A registered nurse (RN) is a nurse who has graduated or successfully passed a nursing program from a recognized nursing school and met the requirements outlined by a country, state, province or similar government-authorized licensing body to obtain a nursing license. An RN's scope of practice is determined by legislation, and is regulated by a professional body or council.
Sir Charles Gairdner Hospital (SCGH) is a teaching hospital in Nedlands, Western Australia.
Psychiatric nursing or mental health nursing is the appointed position of a nurse that specialises in mental health, and cares for people of all ages experiencing mental illnesses or distress. These include: neurodevelopmental disorders, schizophrenia, schizoaffective disorder, mood disorders, addiction, anxiety disorders, personality disorders, eating disorders, suicidal thoughts, psychosis, paranoia, and self-harm.
A licensed practical nurse (LPN), in much of the United States and Canada, is a nurse who provides direct nursing care for people who are sick, injured, convalescent, or disabled. In the United States, LPNs work under the direction of physicians, mid-level practitioners, and may work under the direction of registered nurses depending on their jurisdiction.
A nurse practitioner (NP) is an advanced practice registered nurse and a type of mid-level practitioner. NPs are trained to assess patient needs, order and interpret diagnostic and laboratory tests, diagnose disease, prescribe medications and formulate treatment plans. NP training covers basic disease prevention, coordination of care, and health promotion.
In the United States, a Certified Nurse-Midwife (CNM) is a nurse midwife who exceeds the International Confederation of Midwives' essential competencies for a midwife and is also an advanced practice registered nurse, having completed registered nursing and midwifery education leading to practice as a nurse midwife and credentialing as a Certified Nurse-Midwife. CNMs provide care of women across their lifespan, including pregnancy and the postpartum period, and well woman care and birth control. Certified Nurse-Midwives are recognized by the International Confederation of Midwives as a type of midwife in the U.S.
Nursing in the United Kingdom is the largest health care profession in the country. It has evolved from assisting doctors to encompass a variety of professional roles. Over 700,000 nurses practice, working in settings such as hospitals, health centres, nursing homes, hospices, communities, military, prisons, and academia. Most are employed by the National Health Service (NHS).
Nursing in Australia is a healthcare profession. Nurses and midwives form the majority (54%) of Australian health care professionals. Nurses are either registered or enrolled. Registered nurses have broader and deeper education than enrolled nurses. Nurse practitioners complete a yet higher qualification. Nurses are not limited to working in hospitals, instead working in a variety of settings. Australian nurses are in demand as traveling nurses, particularly those with advanced qualifications.
The Queen's Nursing Institute (QNI) is a charity that works to improve the nursing care of people in their own homes in England, Wales, and Northern Ireland. It does not operate in Scotland, where the Queen's Nursing Institute Scotland performs a similar function. The QNI is also affiliated to the Queen's Institute of District Nursing in Ireland. The QNI is a member of the International Council of Nurses.
A registered psychiatric nurse (RPN) specialises in a field of nursing that focuses on the mental health of patients. Psychiatric nurses assist the interdisciplinary team in the assessment and treatment of the patient's psychiatric illness and symptoms. They treat a variety of mental health disorders such as bipolar, depression, schizophrenia, anxiety, substance abuse addiction and eating disorders such as bulimia and anorexia. However, they do not diagnose the patient, this is the responsibility of a qualified psychologist or a psychiatric doctor. Psychiatric nurses are in charge of dispensing medication and the overall care of patients. Registered psychiatric nurses work under the supervision of doctors’ and they practice within the health care industry, mostly in mental health clinics, outpatient facilities, mental health agencies, long-term care centres or hospitals.
Nursing is a health care profession that "integrates the art and science of caring and focuses on the protection, promotion, and optimization of health and human functioning; prevention of illness and injury; facilitation of healing; and alleviation of suffering through compassionate presence". Nurses practice in many specialties with varying levels of certification and responsibility. Nurses comprise the largest component of most healthcare environments. There are shortages of qualified nurses in many countries.
Hospice care is a type of health care that focuses on the palliation of a terminally ill patient's pain and symptoms and attending to their emotional and spiritual needs at the end of life. Hospice care prioritizes comfort and quality of life by reducing pain and suffering. Hospice care provides an alternative to therapies focused on life-prolonging measures that may be arduous, likely to cause more symptoms, or are not aligned with a person's goals.
Nursing in Germany is provided by different levels of professional and specialized practitioners. German-registered nurses are called Gesundheits- und Krankenpfleger. Previously, the official name for a nurse practicing in Germany was Krankenschwester (female) and Krankenpfleger (male).
The Australian Pharmaceutical Advisory Council (APAC), active between 1996 and 2006, was "a consultative forum that brought together stakeholders from the medical, nursing and pharmacy professions, as well as industry, consumers and government, to advise the Australian Government Minister for Health and Ageing on medicines policy". In 1996 APAC contributed to the Industry Commission inquiry into the pharmaceutical industry. Over subsequent years the Council developed Australia's National Medicines Policy (NMP), and published several guidelines on medication management. Secretariat support for APAC was provided by the Australian Government Department of Health and Ageing - National Medicines Policy Strategies Section.
The timeline of nursing history in Australia and New Zealand stretches from the 19th century to the present.
A mental health nurse (MHN) refers to a nurse in the UK, who specializes in the care of patients with mental health issues. The practice of MHNs is called mental health nursing.
A midwife is a health professional who cares for mothers and newborns around childbirth, a specialisation known as midwifery.
A nurse midwife is both a nurse and a midwife, having completed nursing and midwifery education leading to practice as a nurse midwife and sometimes credentialed in the specialty. Nurse midwives provide care of women across the lifespan, including during pregnancy and the postpartum period, and well woman care and birth control.
Midwives in South Africa are nurses who focus on the care of pregnant women and the delivery of babies. Midwives have the ability to work independently in cases of healthy pregnancies and problem-free deliveries; however, they can refer patients to gynaecologists or obstetricians when complications are diagnosed. The majority of pregnant women in South Africa use the public healthcare system, and most of this care is provided by midwives.
The Queen's Nursing Institute Scotland (QNIS) is a charity which promotes high quality community nursing. Based in Edinburgh, the body was founded in 1889 with the opening of the small Central Training Home at North Charlotte Street. Due to the high demand for training for district nurses, the QNIS soon moved to the grand premises at Castle Street, where it remains.
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