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Winter work


Social care nursing is a unique profession – Covid-19 must not tarnish its appeal


George Coxon, author.


Covid-19 has had a massive impact on every part of our health and care system over these last few months.  We have seen clapping for health and care staff after the desperate battles fought cross the system, with several frontline staff paying the ultimate price. And, of course, the consequences of the trauma from being exposed to so much loss and stress has yet to be fully realised. The substantial strain on services has been difficult to quantify but it can be easily demonstrated that nursing has been one of the professional groups hardest hit by the pandemic.

And nurses have been coping with the extra pressure at a time when they are diminished in numbers. Even prior to the crisis there were 40,000 NHS nurse vacancies across the system. In my part of the world, Devon, we are forecasting 600 vacancies year on year for the next four years and this doesn’t take into account the already huge attrition rate in social care. Social care already had over 120,000 vacancies in England even before Covid-19.

Best estimates tell us we have between 42-45,000 nurses working in social care in England. But the official figures tell us of the 15,500 residential homes in England there are not much over 4,000 with nurses – so less than a third.  With increased complexity and the sizable strain placed on nursing homes we must ensure we can recruit the people we need. But how can we go about addressing the recruitment challenges in social care nursing as we move forward?

As a very animated champion for social care, I believe we need to shout about just what an amazing experience working as a social care nurse can be. The role is unique and an attractive proposition with a great many distinct differences to a nurse working in the NHS. For a start, if offers autonomy. As you use core nursing skills and competencies to exercise clinical judgment about the needs of those in our care, I see it as empowering and confidence enhancing. Leading the care team in a nursing home offers excellent prospects for growth and promoting great care.

There is also great diversity within the role. I have often spoken about the need to ‘touch every base’ in the care home setting, meaning we need to have a good grasp on a holisitic approach to caring for the person. There is much said about holistic care in all aspects of nursing but in a nursing home it really is the case. From hearing aids to fall prevention to cardiovascular disease management to cancer care along with people management and creating atmospheres in everyday life – social care nursing has it all. It can also offer a person extensive and varied experience, learning and development.  The range of ways a social care nurse can develop special expertise or special interest in a care theme is infinite. 

Unlike other healthcare professions, working as a nursing home allows continuity of care. The nature of the work is primarily about relationships, particularly knowing the person you are looking after extremely well. Because it is person-centred, care means just that – having a trusted, close knowledge of wants and needs is integral to the care of residents. The nurse/resident relationship often lasts over many months and years in most cases. Working as a care home nurse also allows you that time to combine nursing practice with sharing stories and be an important person in a resident’s life.  The ambiance and culture of life in a nursing home is about having a more relaxed atmosphere, a more homely pace of life – it’s less about task-focused work. It is also less driven by the medical model. Whilst the medical model is vitally important in the treatment of illness, injury and disease and thus a vital part of NHS nursing, it’s less the dominant model in nursing homes where a more informal approach to care is generally encouraged.

And finally, and very importantly, working as a care home nurse is fun. It is difficult to have fun in a fast-paced acute ward or busy clinic in a primary care centre. But in a nursing home laughter is commonplace. We believe people feeling calm and cheerful, feeling loved, safe and secure – whilst they maybe living with frailty and dementia – is the most essential ingredient to living well.

Care homes have suffered a raw deal during Covid-19. With constant reports of high numbers of cases and deaths they may not look like an attractive place to work. But whatever its difficulties, being a care home nurse is a hugely rewarding job – and we must make sure people don’t forget it.

Read more: Karen Rennie, registered nurse and PhD candidate at the Centre for Person-centred Practice Research, Queen Margaret University, Edinburgh, writes how important touch is for older people