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The truth about district nursing

Reanne White, a district nurse in Greater Manchester, dispels the most common myths about district nursing.  

District Nursing has been around long before the birth of the NHS yet a day in the life of a district nurse is steeped in mystery and myths. 

Time and time again, student nurses on placement in the community tell me they had no idea about the challenges and complexities of being a district nurse. They are often told the work is at a slower place or for nurses who are ready to retire. Most commonly, they think that district nursing deskills nurses.             

These myths are damaging to the future of district nursing. So for all those considering a career in district nursing, I will try and help dispel some of the myths that still surround the service. 

Myth one: You need one year on an acute ward before becoming a district nurse 

I recall when my university lecturers said we must have at least one year working on a ward before considering a job in the community  

This common myth is often generated from misunderstandings of the role. Traditionally, nurses were taught in hospital, which was considered ‘grounding’. But now nursing has progressed to require high academic achievement and specialist knowledge, newly qualified nurses are able to gain ‘grounding’ in all manners of settings including the community.  

Thankfully, my tutor at the time came from a district nursing background. I was able to share my passion for the role and she inspired me into securing my very first job as a newly qualified district nurse.  

If you have what it takes and are passionate about nursing people in their own homes, there is no reason a newly qualified nurse cannot start their career in the community. If anything, the nurses who begin their career in the community progress quickly and bring so much enthusiasm to the role, which inspires others to follow.  

Myth two: Working in the community deskills you  

In the community, you become a general specialist: you nurse adult patients of any age and cover specialities including medical, surgical and acute areas.  

District nurses walk into the most challenge environments, often alone. We do not have backup like the police or paramedics. We are autonomous practitioners that are forced to think on our feet and act fast, working closely with social services and the wider multi-disciplinary team as safeguarding is a huge part of the role. 

You might be treating a patient with an acute exacerbation of COPD before moving onto a patient on a syringe driver as they at the end of life. You might walk into a patient's home and find them unresponsive and in cardiac arrest – and as we have no red buzzer, you must call the emergency services. You could then be called out for a blocked catheter, then onto a CVC line flush.  

Patients with unstable diabetes are a very common theme and we are faced with treating hypoglycaemias and hyperglycaemias daily. We are also specialists in wound care and palliation, and able to look beyond the diagnosis.   

Myth three: District nursing is where you go to retire  

I don’t think any area of nursing is where you go to retire, regardless of your area of speciality. 

Nursing is a challenging job and district nursing is no different. The pace of the service is fast and the number of patients now requiring health care at home is at an all-time high. There is so much focus on keeping people out of hospital that demand far outweighs the capacity, especially with no cut off for referrals to the service.  

If you are looking for a slow-paced job in nursing, unfortunately this no longer exists.  

Myth four: Career progression is difficult  

To put this into perspective, I am a team leader, district nurse sister, non-medical prescriber, district nurse community specialist practitioner with a speciality in safeguarding and leg ulcer management – and I am just three years qualified.  

If you have passion and determination, you only need to say yes to the opportunity when it comes.  

Myth five: District nursing is not real nursing

This is the hardest myth to face and I often have no words when I read this: just looking at the article above, you can see district nursing is absolutely real nursing. When reacting to this false statement, district nurses must remain professional at all times, smile and continue being their fabulous selves. Your actions say far more than words.