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More and more patients are treated outside a traditional hospital setting. As their numbers grow, the ability of the NHS to provide medical and nursing services is also changing and community nurses (also known as district nurses) play a vital role in this increasingly important aspect of our healthcare system.
Working in a variety of environments, from clinics and health centres to residential accommodation and patients' own homes, community nurses help the NHS meet the needs of elderly, disabled or vulnerable patients who may not be able to easily visit the hospital.
Community nurses are trained to perform a variety of nursing procedures which may include:
Community nurses also provide an important educational and advisory service for patients and families , offering information on various aspects of healthcare. In some situations, community nurses may be expected to provide emergency care - where patients have had accidents or suffered complications, such as cardiac arrest.
The role is more than a way to relieve the UK's busy hospitals and GP surgeries: community nurses offer their patients a level of emotional support and specialize in 'joint care management' for situations in which social services or wider care programmes may be involved.
What skills does a community nurse need?
Community nursing jobs can be high pressure: nurses work in environments which change from day to day and lack many of the resources available in a hospital. Given the demanding nature of the role and the spectrum of patients they are required to treat, community nurses should possess excellent communication and listening skills, while demonstrating sensitivity towards the specifics of each unique situation.
Before taking an available nursing post a community nurse must be a qualified and registered nurse (usually with two years' practical experience) - and will also need additional, degree level training as a 'specialist practitioner'.
Specialist practitioner training courses usually last no less than one academic year but trainees may be able to shorten that training period by counting previous experience towards their qualification. Courses, which can be taken on a full or part time basis, are split into practical and theoretical elements - and focus on four key areas:
Training and working as a community nurse
Prospective community nurses may be able to fund a specialist practitioner course through their employer or primary care trust - but should make inquiries before embarking on any period of training. After successful qualification, a community nurse may register as a 'Specialist Community Public Health Nurse' and apply for available positions. Community nurses can expect to earn between £25,783 and £34,530 a year - while community team manager positions come with salaries of up to £40,500 a year.
Community nurses offer a way to comprehensively engage a diverse and challenging healthcare landscape . As NHS local authorities work to meet the needs of their patients, community nurses consistently find themselves at the forefront of modern healthcare strategy with opportunities to make a direct and positive change to the lives of hundreds of patients.
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Community health nursing, also called public health nursing or community nursing, combines primary healthcare and nursing practice in a community setting. Community health (CH) nurses provide health services, preventive care, intervention and health education to communities or populations.
In the past, public health nurses worked for the government or the public health department. Their role has since expanded. In fact, some may not work directly with patients. According to “The Definition and Practice of Public Health Nursing” from American Public Health Association , “Public health nursing is the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences.”
Unlike a nurse who works with patients one-on-one, community health nurses focus on communities. CH nurses can have various roles in a community setting. They may provide some or all of the following:
What they do depends on the communities they serve; lower income, school, and culturally diverse communities all have different needs. CH nurses also work for public health departments or parishes.
A nurse working with a lower income population will evaluate their healthcare needs and then find free or low-cost services. They may cover some or all of these areas:
Some cultures have customs that affect the care they wish to receive. Nurses working with these cultures must build relationships and gain trust in these communities. It allows them to advocate for the community to ensure respect for their beliefs.
The healthcare workforce is becoming more diverse, which is one of the biggest changes in nursing — and a benefit to patients. Nurses with similar cultural backgrounds to the communities they serve know how to respect mores and communicate more effectively.
Another community health specialist is the school nurse. Children who do not feel well go to the school nurse and report their symptoms. If it turns out multiple students have the same illness, the nurse informs the school’s community that there is an illness going around, educates them on its symptoms, and advises them what to do. Some school nurses may also communicate with residents who live near the school to let them know about any trending illnesses or other public health issues.
Community nurses rely on data and analysis to assess communities, create plans of action and establish procedures. The Public Health Foundation has established core competencies for public health professionals based on the 10 Essential Public Health Services that are organized into eight domains:
The core competencies fall into three tiers, which represent the stages of a public health professional’s career. Tier 1 is front-line staff. Tier 2 is program management and supervision. Tier 3 is senior management.
CH nurses have the same qualifications as other licensed nurses — typically a Bachelor of Science in Nursing . The BSN integrates communications, analytics, scientific reasoning and culture, which correlate with the eight domains.
In some cases, the job may require a Master of Science in Nursing. Those interested can meet this requirement through an online MSN program. These programs help students expand their clinical, theoretical, leadership, teaching and research skills. Some programs may also offer concentrations in areas such as administration or education. Online nursing programs allow nurses to continue working while earning a degree.
There is a growing need for more RNs in public health nursing. According to “ Public/Population Health Nursing ,” the AACN has created a five-year cooperative agreement with the Centers for Disease Control and Prevention. The initiative, Academic Partnerships to Improve Health , aims to improve health outcomes by incorporating public health concepts into nursing programs.
Working in community nursing takes patience, advanced communication skills, political savvy and organization. With great challenge comes great rewards, especially for those who work with culturally and socioeconomically diverse populations.
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