International Nurses’ Day on 12 May provides an opportunity to reflect on and celebrate the incredible contribution nurses around the world make to our lives. The theme this year, invest in nursing and respect rights, comes at a time when nursing has been at the front line of the COVID-19 response internationally for more than two years.
At the Queen’s Nursing Institute Scotland (QNIS), we’ve been working for 133 years to enable the health and wellbeing of the most marginalised people in society and unleash the potential of community nurses to improve the health of communities. We run transformational programmes enabling community nurses to develop their skills as leaders and change makers, addressing inequality.
Impact of COVID-19 on community nursing
The shift that COVID-19 brought has been huge. Every nurse has been central to keeping people safe and many were deployed into unfamiliar, uncertain and frankly, frightening situations.
We have been providing a safe space for these practitioners to decompress, think about their own wellbeing and recognise that they’re not alone.
The policy to support people in their own homes as much as possible, reducing pressure on primary care, puts community nurses under huge pressure, yet the investment hasn’t followed. Nurses are exhausted and, with infection rates still high, the pressure is relentless.
As a result, we have been providing a safe space for these practitioners to decompress, think about their own wellbeing and recognise that they’re not alone. Many felt isolated, especially those working in remote rural areas. We gave people a space to feel connected and supported at a time of immense uncertainty and immense challenge.
Hearing community voices on society’s biggest challenges
Community nurses work in schools, workplaces, care homes and prisons; they are health visitors and community mental health nurses. There are specialist teams working with children, people with learning disabilities and those who are homeless to name just a few.
Community nurses are working in interprofessional teams, joining the dots between health and social care and the voluntary sector. We need to hear their voices.
These nurses see first hand the real health challenges facing communities and truly understand the social determinants of health.
Harnessing their knowledge and giving them a voice is critical to the shifts we need to make nationally and globally to improve nutrition, to build movement into people’s everyday lives, to support people to manage long-term conditions and, when the time is right, to enable a peaceful death in their place of choice.
Day to day, community nurses are working in interprofessional teams, joining the dots between health and social care and the voluntary sector. We need to hear their voices on these big issues.
Recognising nurses’ skills and expertise
There’s a lot of rhetoric around person-centred care and nurses are at the very heart of improvement in this area. But to achieve it, we need a workforce that is listened to, valued and respected for their skill and expertise.
Compassionate, person-centred care is highly skilled, requiring a huge knowledge base and professional skills. Sometimes we play down that real clinical expertise. More and more nurses are now prescribers: highly skilled, technical and professional. Their potential for improving health and care, through listening to what people are asking for and responding to that need, is huge.
Talking with the homeless community, they realised that recovery services were often not available at the times and places people needed them.
For example, a team of parish nurses, supported by QNIS, were able to transform the lives of people experiencing homelessness within the Dundee area. The Parish Nurses welcome people into the church for lunch and invite other services to come and meet them in a safe space. Those who find it hard to access services elsewhere can see a dentist, a chiropodist or a barber.
Talking with the homeless community, they realised that recovery services were often not available at the times and places people needed them. They brought together all the services from every sector for informal conversations. Together they mapped every recovery support opportunity – morning, afternoon and evening – and now have an app to find recovery support 24/7. This has been adopted across services and the police are now using it to signpost people.
How the Q community can support
During lockdown I was part of Q’s Network Weavers programme, which was a huge support and inspiration. I’ve been working on how we can most effectively support these phenomenal changemakers in community nursing and midwifery, to build a social movement of nurses who are advocating for social change around health inequalities. The programme was formative in helping me identify what we need to put in place to enable that.
When you next bring together an improvement team, pause and consider what voices might be missing. Are you listening to the expert voices of community nursing?
Queen’s Nursing Institute Scotland: www.qnis.org.uk