Meeting the policy agenda, part 1: the role of the modern district nurse

Abstract

The challenges posed by the current context of health and social care offer opportunities for different models of care delivery. District nursing has evolved, and continues to evolve to meet these challenges. The traditional reactive role of district nursing has developed as contemporary practice expects district nurses to meet both planned and unplanned care required by practice populations. Modern anticipatory care approaches to care are being adopted, while care and case management is being facilitated and delivered to patients and families with complex health and social care needs. Additionally, district nurses are recognizing the need to further develop management and leadership skills as the teams delivering care consist of a skill mix of nurses and other disciplines. They are also charged with evidencing the impact of what they do and influencing care delivery at every level of healthcare organizations. This first paper of two will explore the current UK policy context and ways in which district nursing services within each country are changing to meet the challenges posed. A second article will argue the need to ensure the district nursing workforce is underpinned by robust educational standards that ensure protection of the public. The influences of education and development from professional and organizational perspectives will be examined.

The health promotion work of the district nurse: interpreting its embeddedness

“…Perhaps the health promotion perspective within expert practice might usefully be teased out in dialogue between community nurses and colleagues familiar with health promotion theory and practice. However, given the complex and demanding context of the work of experienced DNs (Dickson et al ., 2011), which can limit opportunities for direct patient contact and hands-on care, some time targeted specifically by educators and practitioners for case analysis and building a bank of helpful practice scenarios might be of value.…”

“…The DN's role currently requires a challenging combination of clinical, management, leadership and educational expertise and advanced decision-making skills (Dickson et al ., 2011). The DNs invited to participate in the study were experienced registered nurses who held a graduate-level qualification as specialist practitioners in community nursing and led a skill mix team of community staff nurses and health-care assistants.…”

Challenges and opportunities: the role of the district nurse in influencing practice education

“…The role of the DN in practice is to teach and assess as competent those undertaking the SPQDN to ensure that the highest standards are met in clinical practice for students who wish to become qualified DNs (Hollinshead and Stirling, 2014;NMC, 2001;Sayer, 2011). One essential role within District Nursing is to ensure education based on these standards maintains congruence with contemporary best practice, however disappointingly the DN qualification remains underpinned by standards and definitions written more than 20 years ago (Dickson et al 2011). In response to this, the Queen's Nursing Institute [QNI] and Queen's Nursing Institute Scotland [QNIS] worked collaboratively with senior groups from education, commissioners, voluntary sector, the NMC, and UK national governments to introduce voluntary standards in 2015 (Oldman, 2016;QNI, 2015).…”

The Evolving Roles of Nurses Providing Care at Home: A Qualitative Case Study Research of a Transitional Care Team

“…With the need to provide holistic and coordinated care, nursing teams have evolved from a traditional flattened structure of nurses to multi-skilled and multi-professional teams [ 10 ]. The elderly often require coordination of care among multiple healthcare and social-care providers [ 11 ] and transitional care from the hospital to home [ 12 ].…”