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Being a community matron

I have been a community matron with Northumbria Healthcare NHS Foundation Trust for four years. Prior to this role I was a nurse practitioner at a local Northumberland hospital and before that, a heart failure specialist covering community hospitals in the county. 

I became a community matron as I have always been interested in chronic diseases and the management of them. I manage patients with chronic obstructive pulmonary disease, heart failure and renal patients so it is very varied.

I work in the beautiful town of Alnwick, which is situated in the centre of rural Northumberland. We cover a large patch of 220 square miles with a practice population of 18,000 people who are spread over a large rural area. To deliver good community health services we have to think laterally. We have an aging population with the challenges that brings, and our geography means people who are housebound can be quite isolated. Often it's not a physical need they have but it is more down to infrastructure, so we have to address that too. It's a matter of getting a good balance between what patients need and what we can do for them.

We have quite a unique set up in that we cover two GP practices that are in the grounds of Alnwick Infirmary. We have a collaborative relationship with the GPs and we work closely with the hospital. My background as a nurse practitioner at the hospital, means we have reciprocal arrangements, for example if I need to see a patient before discharge.

I view myself as part of a large team. My success as a matron is because the team I work with are so good at what they do - our community nurses, the hospital staff, GPs, social services, Macmillan and Marie Curie.

I tend to deal with more complex patients in my role. But community nursing as a whole is becoming increasingly more complex.

We manage increasingly more complex procedures in the home, from draining fluid from lungs, and abdomens, managing catheters, both urinary and intravascular and giving sub cut fluids, all of which contribute to supporting people who wish to remain at home or chose to die at home. Care is less hospitalised and as a result, community nursing is becoming more technical.

An important focus of our role is empowering patients to take responsibility for their own health. We work in partnership with patients and their families to help them care for their loved ones. Everyone has a role to play in good care, it comes down to members of the family, extended family, friends and neighbours. We want to move towards this and away from dependency.

We are now able to teach patients how to spot signs they are becoming unwell. We can show them what the symptoms are of a chest infection, how to increase the dose of their inhaler to treat it and when to take antibiotics. We do this with urinary tract infections where we can show patients how to test their urine for signs of an infection; and if it is the weekend, to begin taking antibiotics they keep at home. We can also do this with skin infections like cellulitis. 

I feel that the nursing profession is always changing. I came into nursing in 1988 as a healthcare assistant so I am one of the last 'old school' nurses. We haven't lost our heart at all. Our training has changed so we can better cope with the scientific rigours. It also benefits our documentation and evidence that is better as a result. A doctor reading it can see how something has progressed or got better. I would hate to think we lost our soft side.

We are still concerned about patient welfare. My last question is always 'would you like a cuppa' before I go. I am on my feet already, it takes two minutes and it helps the person. Sometimes they might be anxious that their washing needs hanging out as the sun is shining and their relative might not be coming round for a few hours. It could be their only task of the day, so I will do that for them. We still have our human side.

Having a strong community spirit is really important for good health, checking on your neighbours to see they are ok. Social isolation and low mood can become a problem for someone as they may stop looking after themselves as well and fall ill. Sometimes a friendly face popping in to see if they are ok can make a real difference.