District Nurses work manage care within the community and lead teams of community nurses and support workers. The role requires registered nurses to take a NMC approved specialist practitioner course. 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.

Scope of practice

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.

United Kingdom

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 The Drug Tariff, also known as Drug Tariff price, is that amount that the NHS repays pharmacies for generic prescription medications. It differs from prescription charges which are £9.35 per item/drug as of 2021 unless exemptions apply. They are ...

). 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 Welfare, or commonly social welfare, is a type of government support intended to ensure that members of a society can meet basic human needs such as food and shelter. Social security may either be synonymous with welfare, or refer specifical ...

. In England they were employed by primary care trusts and are now mostly employed by hospital or

community health trust As part of the English NHS programme of separating the provision of services from commissioning known as Transforming Community Services a number of community health trusts were established when these services were separated from primary care tru ...

s whereas in Wales and Scotland, they are employed by the health board and may be based at centralised health centres or

general practice General practice is the name given in various nations, such as the United Kingdom, India, Australia, New Zealand and South Africa to the services provided by general practitioners. In some nations, such as the US, similar services may be describe ...

s. District nurses, like all qualified nurses, are regulated by the

Nursing and Midwifery Council The Nursing and Midwifery Council (NMC) is the regulator for nursing and midwifery professions in the UK. The NMC maintains a register of all nurses, midwives and specialist community public health nurses and nursing associates eligible to pra ...

. 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.

Training

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 (NMC 2001).

New Zealand

New Zealand New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island count ...

, 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). District nurses in New Zealand have access to a higher pay scale compared to registered nurses in an acute setting.

Australia

Australian Australian(s) may refer to: Australia * Australia, a country * Australians, citizens of the Commonwealth of Australia ** European Australians ** Anglo-Celtic Australians, Australians descended principally from British colonists ** Aboriginal A ...

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. The introduction of the

National Disability Insurance Scheme The National Disability Insurance Scheme (NDIS) is a scheme of the Australian Government that funds costs associated with disability. The scheme was legislated in 2013 and went into full operation in 2020. The scheme is administered by the Na ...

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. 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.

History

Organised district nursing in England is considered to have begun in 1859. In 1858

Liverpool Liverpool is a city and metropolitan borough in Merseyside, England. With a population of in 2019, it is the 10th largest English district by population and its metropolitan area is the fifth largest in the United Kingdom, with a populat ...

philanthropist William Rathbone employed a nurse, Mary Robinson, to take care of his wife at home during her final illness.William Rathbone and the beginning of District Nursing
''DistrictNursing.org 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 Victoria (Alexandrina Victoria; 24 May 1819 – 22 January 1901) was Queen of the United Kingdom of Great Britain and Ireland from 20 June 1837 until her death in 1901. Her reign of 63 years and 216 days was longer than that of any previo ...

’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.

References

External links

District Nursing 150
website by Queen's Nursing Institute
District Nursing Service Development in New ZealandNZNO Meca 2015-2017
{{nursing Healthcare occupations in the United Kingdom Nursing in the United Kingdom Community nursing