EDITORIAL EDITORIAL Consultant Editor Alison While
Consultant Editor Alison While Professor of Community Nursing, King’s College London Professor of Community Nursing, King’s College London Editor Rowan Dennison
Editor Oisin Sands [email protected] [email protected] Sub-editor Peter Bradley Commercial ManagerAndrew FarhadWright Buffery Commercial Manager [email protected] [email protected] Group Classified ClassifiedManager ManagerRachel RachelMcElhinney McElhinney Group [email protected] [email protected] Circulation Director DirectorSally SallyBoettcher Boettcher Circulation [email protected] [email protected] Production Production Manager ManagerJon JonRedmayne Redmayne Production ProductionAssistant AssistantLarry LarryOakes Oakes Publishing DirectorExecutive Anthony Kerr Editorial Make-up Peter Constantine [email protected] Publisher Anthony Kerr Associate Smith Associate Publisher PublisherJulie Tracy Cowan Managing Benson PublishingDirector DirectorJon Adrian Johnston Chief Chief Executive ExecutiveOfficer OfficerBen BenAllen Allen EDITORIAL BOARD EDITORIAL BOARD
Ben Bowers Mandy Bowler Queen’s Nurse, Community Senior Nurse for Planned Cancer Nurse Specialist, Care Sunderland PCT Cambridgeshire Community David Briggs Services NHS Trust Senior Lecturer, Mandy Bowler University of Hertfordshire Clinical Business Manager, South Tyneside Ann Bryan NHS Foundation Trust Head of Community and Julie ChildBliss Health, Chester Head of Department: Mental University Health, King’s College London Julie Clennel David Briggs Head of Professional Senior Lecturer, Development, Directorate of University of Hertfordshire Nursing, NHS Darlington Julie Clennell HealthofPartnership Centre Head Clinical Governance, Dr Maria Horne County Durham & Darlington HealthFoundation Visiting Lecturer/ NHS Trust Research Fellow Manchester Jane Griffiths Lecturer in Community University Nursing, Dr Gill University Hubbardof Manchester Cancer Research Fellow, Vanessa Heaslip Stirling University Senior Lecturer, School
of Health and Social Care, Kay Kane Bournemouth University Nurse Manager, Maria Horne District Nursing, BelfastinHSC Trust Senior Lecturer Public Prof Catriona Health, School of Kennedy Health School University Director, Napier Studies, of Bradford University Julie Hughes Head of Quality Compliance, Dr Karen Ousey Marie CurieHead, Cancer Care Divisional University Kay Kane of Huddersfield Independent Consultant Vera Todorovic Catriona Kennedy and Manager, Dietetics School Director, Nutrition Service, Bassetlaw Napier University Hospital, Worksop Brian Nyatanga John Unsworth Senior Lecturer, Head of Nursing Division, University of Worcester Northumbria University Tricia Robinson Dr Tricia WilsonSt. George’s Nurse Consultant, Senior Lecturer, Hospital, University of London Vera Todorovic University of Hertfordshire Manager, Dietetics and Nutrition Service, Bassetlaw Hospital
UK PERSONAL PERSONAL SUBSCRIPTION SUBSCRIPTION RATES RATES UK Quarterly Quarterly Direct Direct Debit Debit Annual Direct Annual Direct Debit Debit
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MA Healthcare Ltd is part of the Mark Allen Group
www.markallengroup.com The British Journal of Community Nursing is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB Tel: +44 (0)20 7738 5454 Website: www.bjcn.co.uk © MA Healthcare Ltd, 2014. 2012. All rights reserved. No part of the British Journal of Community Nursing may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, (electronic, mechanical,photocopying, photocopying,recording, recording,or orotherwise otherwise) without prior written permission of the Publishing Director. ISSN 1462-4753 Printed by Pensord Press Ltd, Blackwood, NP12 2YA Cover picture: Science istockphoto.com Photo Library
The paper used within this publication has been sourced from Chainof-Custody certified manufacturers, operating within international environmental standards, to ensure sustainable sourcing of the raw materials, sustainable production and to minimise our carbon footprint.
An ongoing battle
I
have written in these pages before about the lack of attention given to district nursing issues in the media (Dennison, 2013a), and the lack of acknowledgement by the Government of the district nursing profession as one that is separate from hospital-based nursing, with its own set of difficulties (Dennison, 2013b). The Queen’s Nursing Institute (QNI) is dedicated to improving home-based nursing care by influencing policy and documenting the experiences of district nurses and patients that are cared for in their homes. This month, the organisation publishes 2020 Vision: Five Years On (QNI, 2014)—a snapshot of the profession 5 years after 2020 Vision (QNI, 2009), which celebrated 150 years of district nursing and outlined its views on how district nursing should develop over the following decade or so following a detailed survey of district nurses. The original 2020 Vision document noted that the profession was in flux—a technical, unpredictable job in which nurses have to manage short-term and long-term patients equally, requiring real intergration with others in the multidisciplinary team to provide high-quality care. District nurses’ contribution to the overall health-care workload was enormous and underacknowledged, and nurses required further training and support in order to maintain the very levels of care expected of them.The integration of technology as a supportive agent of change (rather than a replacement for care itself) was stated as being key—as was the need for acknowledgement that district nursing is an entirely different profession from hospital-based nursing, deserving of a very specific title and qualification to match its skill set (QNI, 2009). Where, then, do we find ourselves today, 5 years on? Well, there are areas in which we can celebrate improvement.The data indicate a positive improvement in recogition and usage of the specialist practitioner qualification for district nursing, and good working relationships with allied health professionals such as dietitians, occupational therapists and some GPs. However, the report makes for sobering reading when viewed from many other angles.The term ‘district nurse’ is clearly still badly understood and misused by district nurses themselves, by other health professionals and by patients, and this is having significant negative consequences on the advancement of the profession and the provision of quality care. District nurses remain overworked, with many areas responding very slowly or badly to these problems, and technology has not yet been implemented in the way that the QNI and many others hoped might be the case by now—only 25% of the survey respondents used mobile technology to record patient care in the home. Perhaps most worryingly, given the Government’s rhetoric around joined-up care, is that around 83% of respondents stated that communication with hospitals regarding discharge planning was not satisfactory (QNI, 2014). All of which serves to underline the importance of organisations such as the QNI, and the need for district nurses to document their experiences, publicise their views and make the profession known to their health-care colleagues and society at large. For the time being, the profession remains under the radar. Lasting improvement requires a more nuanced understanding on everyone’s part. BJCN Dennison R (2013a) Answering the QNI’s call. Br J Community Nurs 18(10): 475 Dennison R (2013b) Documenting reality. Br J Community Nurs 18(8): 371 Queen’s Nursing Institute (2009) 2020 Vision: Focusing on the Future of District Nursing. http://tinyurl.com/3qzhx3a (accessed 28 May 2014) Queen’s Nursing Institute (2014) 2020 Vision: Five Years On. Publication pending
British Journal of Community Nursing June 2014 Vol 19, No 6
Rowan Dennison Editor
265
Journal of Community Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 19, 2015. For personal use only. No other uses without permission. . All rights re
Consultant Editor Alison While Professor of Community Nursing, King’s College London Professor of Community Nursing, King’s College London Editor Rowan Dennison
Editor Oisin Sands [email protected] [email protected] Sub-editor Peter Bradley Commercial ManagerAndrew FarhadWright Buffery Commercial Manager [email protected] [email protected] Group Classified ClassifiedManager ManagerRachel RachelMcElhinney McElhinney Group [email protected] [email protected] Circulation Director DirectorSally SallyBoettcher Boettcher Circulation [email protected] [email protected] Production Production Manager ManagerJon JonRedmayne Redmayne Production ProductionAssistant AssistantLarry LarryOakes Oakes Publishing DirectorExecutive Anthony Kerr Editorial Make-up Peter Constantine [email protected] Publisher Anthony Kerr Associate Smith Associate Publisher PublisherJulie Tracy Cowan Managing Benson PublishingDirector DirectorJon Adrian Johnston Chief Chief Executive ExecutiveOfficer OfficerBen BenAllen Allen EDITORIAL BOARD EDITORIAL BOARD
Ben Bowers Mandy Bowler Queen’s Nurse, Community Senior Nurse for Planned Cancer Nurse Specialist, Care Sunderland PCT Cambridgeshire Community David Briggs Services NHS Trust Senior Lecturer, Mandy Bowler University of Hertfordshire Clinical Business Manager, South Tyneside Ann Bryan NHS Foundation Trust Head of Community and Julie ChildBliss Health, Chester Head of Department: Mental University Health, King’s College London Julie Clennel David Briggs Head of Professional Senior Lecturer, Development, Directorate of University of Hertfordshire Nursing, NHS Darlington Julie Clennell HealthofPartnership Centre Head Clinical Governance, Dr Maria Horne County Durham & Darlington HealthFoundation Visiting Lecturer/ NHS Trust Research Fellow Manchester Jane Griffiths Lecturer in Community University Nursing, Dr Gill University Hubbardof Manchester Cancer Research Fellow, Vanessa Heaslip Stirling University Senior Lecturer, School
of Health and Social Care, Kay Kane Bournemouth University Nurse Manager, Maria Horne District Nursing, BelfastinHSC Trust Senior Lecturer Public Prof Catriona Health, School of Kennedy Health School University Director, Napier Studies, of Bradford University Julie Hughes Head of Quality Compliance, Dr Karen Ousey Marie CurieHead, Cancer Care Divisional University Kay Kane of Huddersfield Independent Consultant Vera Todorovic Catriona Kennedy and Manager, Dietetics School Director, Nutrition Service, Bassetlaw Napier University Hospital, Worksop Brian Nyatanga John Unsworth Senior Lecturer, Head of Nursing Division, University of Worcester Northumbria University Tricia Robinson Dr Tricia WilsonSt. George’s Nurse Consultant, Senior Lecturer, Hospital, University of London Vera Todorovic University of Hertfordshire Manager, Dietetics and Nutrition Service, Bassetlaw Hospital
UK PERSONAL PERSONAL SUBSCRIPTION SUBSCRIPTION RATES RATES UK Quarterly Quarterly Direct Direct Debit Debit Annual Direct Annual Direct Debit Debit
£32 £32 £125 £125 £132 £132
Annual Credit Credit Card Card Annual 2yr 2yr Annual Annual Credit Credit Card Card £224 £224 3yr Annual Credit 3yr Annual Credit Card Card £316 £316 Subscribe online: www.magsubscriptions.com, Subscribe online: www.magsubscriptions.com Subscribe by +44 (0) (0) 1722 1722 716997 716997 Subscribe by phone: phone: +44
MA Healthcare Ltd is part of the Mark Allen Group
www.markallengroup.com The British Journal of Community Nursing is published by MA Healthcare Ltd, St Jude’s Church, Dulwich Road, London SE24 0PB Tel: +44 (0)20 7738 5454 Website: www.bjcn.co.uk © MA Healthcare Ltd, 2014. 2012. All rights reserved. No part of the British Journal of Community Nursing may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, (electronic, mechanical,photocopying, photocopying,recording, recording,or orotherwise otherwise) without prior written permission of the Publishing Director. ISSN 1462-4753 Printed by Pensord Press Ltd, Blackwood, NP12 2YA Cover picture: Science istockphoto.com Photo Library
The paper used within this publication has been sourced from Chainof-Custody certified manufacturers, operating within international environmental standards, to ensure sustainable sourcing of the raw materials, sustainable production and to minimise our carbon footprint.
An ongoing battle
I
have written in these pages before about the lack of attention given to district nursing issues in the media (Dennison, 2013a), and the lack of acknowledgement by the Government of the district nursing profession as one that is separate from hospital-based nursing, with its own set of difficulties (Dennison, 2013b). The Queen’s Nursing Institute (QNI) is dedicated to improving home-based nursing care by influencing policy and documenting the experiences of district nurses and patients that are cared for in their homes. This month, the organisation publishes 2020 Vision: Five Years On (QNI, 2014)—a snapshot of the profession 5 years after 2020 Vision (QNI, 2009), which celebrated 150 years of district nursing and outlined its views on how district nursing should develop over the following decade or so following a detailed survey of district nurses. The original 2020 Vision document noted that the profession was in flux—a technical, unpredictable job in which nurses have to manage short-term and long-term patients equally, requiring real intergration with others in the multidisciplinary team to provide high-quality care. District nurses’ contribution to the overall health-care workload was enormous and underacknowledged, and nurses required further training and support in order to maintain the very levels of care expected of them.The integration of technology as a supportive agent of change (rather than a replacement for care itself) was stated as being key—as was the need for acknowledgement that district nursing is an entirely different profession from hospital-based nursing, deserving of a very specific title and qualification to match its skill set (QNI, 2009). Where, then, do we find ourselves today, 5 years on? Well, there are areas in which we can celebrate improvement.The data indicate a positive improvement in recogition and usage of the specialist practitioner qualification for district nursing, and good working relationships with allied health professionals such as dietitians, occupational therapists and some GPs. However, the report makes for sobering reading when viewed from many other angles.The term ‘district nurse’ is clearly still badly understood and misused by district nurses themselves, by other health professionals and by patients, and this is having significant negative consequences on the advancement of the profession and the provision of quality care. District nurses remain overworked, with many areas responding very slowly or badly to these problems, and technology has not yet been implemented in the way that the QNI and many others hoped might be the case by now—only 25% of the survey respondents used mobile technology to record patient care in the home. Perhaps most worryingly, given the Government’s rhetoric around joined-up care, is that around 83% of respondents stated that communication with hospitals regarding discharge planning was not satisfactory (QNI, 2014). All of which serves to underline the importance of organisations such as the QNI, and the need for district nurses to document their experiences, publicise their views and make the profession known to their health-care colleagues and society at large. For the time being, the profession remains under the radar. Lasting improvement requires a more nuanced understanding on everyone’s part. BJCN Dennison R (2013a) Answering the QNI’s call. Br J Community Nurs 18(10): 475 Dennison R (2013b) Documenting reality. Br J Community Nurs 18(8): 371 Queen’s Nursing Institute (2009) 2020 Vision: Focusing on the Future of District Nursing. http://tinyurl.com/3qzhx3a (accessed 28 May 2014) Queen’s Nursing Institute (2014) 2020 Vision: Five Years On. Publication pending
British Journal of Community Nursing June 2014 Vol 19, No 6
Rowan Dennison Editor
265
Journal of Community Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 19, 2015. For personal use only. No other uses without permission. . All rights re
