My name is Esther and I’m a district nurse.
Community care is important to me as it fully aligns with my
values of looking after the whole person, providing holistic care,
and understanding somebody within their own setting. If we can
treat people at home and keep them out of hospital that is good
for them and good for the hospital system.
I do this because it provides me the opportunity to care for
patients and make a difference to the quality of life they have at
home.
I chose nursing right from a very young
age. My mum is a nurse and I really
admired what she did. I helped care for my
grandmother at the end of her life and it
was a really life-changing experience. I felt
very privileged to become a nurse myself.
Having trained in Kenya, I didn’t
understand what the community nurse
role was, but spending some time with
the community team absolutely made up
my mind. It fully aligns with my values of
looking after the whole person, providing
holistic care, and understanding
somebody within their own setting.
I came to England as an overseas nurse
and I am a hundred percent sure I made
the right decision. Living and working in
England has been phenomenal for me
and my career. International nurses
coming here have to do a series of
assessments, from an online exam in their
home country, then a structural exam
here within 12 weeks of arrival. There is
also a whole programme of support,
which the NHS is exceptionally good at.
I live with my son as a single parent, so my
sister and her family help me with
dropping off my son to school, or picking
him up. Family support is really important,
and I could not possibly do this job without
them. They enable me to keep on nursing.
My main role is Area Nursing Manager for
the community nursing service, which is
integrated into a neighbourhood team.
My role is to support district nursing
specifically. We look after patients with
acute needs, like coming home after
surgery, to chronic disease management
for patients who have long-term
conditions. As Service Manager, I need to
be able to fully understand the needs of
my population, my area, and use that to
ensure that the team have the right skills
to be able to support those patients.
I never understood why people said they
loved studying, until I did a master’s
degree in advanced clinical practice. And
as an advanced nurse practitioner I’m able
to do a lot more for my patients. If I go and
find my patient is unwell, I can assess
them in a more advanced way. I can listen
to their chest. I can take more clinical
information that might be helpful, I can
prescribe for them and they don’t have to
call out the doctor.
Being an advanced nurse practitioner is
really important to me, because holistic
care is really critical to help patients stay
safe and well at home. Having that ability
to complete the care by writing a
prescription is something really
significant, and a core part of district
nursing now.
One of the things that we do in the
community is support people to stay at
home. When they have got an acute
illness or when managing a long-term
condition, they can be supported and can
have clinical care while staying away from
hospital. What is really critical is the ability
to respond very quickly when patients are
ill, to identify when they’re deteriorating.
You can prevent things from getting to
the point where they’ll need hospital
admission. We save lives by doing that, we
change people’s trajectory.
With digital patient records we can access
the patient’s full notes from their home.
The physiotherapist, the doctor, the
occupational therapist, any mental health
input, all the records are in the same place
and all these different clinicians are able
to see the same record. It means the care
is more joined up and responsive, and it’s
more personalised to the needs of that patient.
Unlike hospital nursing, which is more like
a global role, community nursing doesn’t
exist in the same way in other countries.
So information on the community nursing
role has been made available, which then
has allowed NHS trusts to advertise and
recruit international nurses into
community roles. And that’s my job, at the
moment, which is really, really exciting.
I am currently seconded into the Chief
Nursing Officer for England’s team,
supporting the international recruitment
of nurses into community nursing
settings. The direct recruitment of nurses
from overseas into a community role is
relatively new, and is very key to helping
us achieve the NHS Long Term Plan.
I am part of the Ethnic Minorities Network,
to support nurses who are newly arrived
in this country. We give them an
opportunity to share some of their
concerns, and we identify ways to help
them. We run open webinars for nurses to
ask questions, share experiences, tell us
what’s being done well. It brings nurses
together and connects them to the things
they need. It’s a very exciting part of my role.
In December 2020 I was successful at
becoming a Chief Nursing Officer’s Clinical
Fellow. That was a very exciting moment
in my career. The fellowship opened up an
opportunity to set up the first National
Shared Decision Making Council for
community nursing in England, bringing
together 24 point-of-care nurses from
across the country. They have been
phenomenal at contributing to national
policy and sharing innovative ideas in
their own regions and organisations. It has
been a very successful council, and it will
create a ripple effect of opportunities for
councils across the country.
I would like to continue learning, continue
progressing and developing, and sharing
what I have done. So I would like to write
up and publish some of what I have done
and achieved, and some of what we have
achieved as a team. I would like to
continue to support nurses who are
developing in their career. I would like to
continue providing care, as well as
working with the national team,
contributing to policy and changes that
improve what we can do as community nurses.
It’s a very exciting time. It’s very critical to
be looking after patients who don’t need
to be in a hospital setting. There’s real
opportunity to create care settings
outside of the hospital, and community
nursing is very well placed to deliver that.
