District and community nursing—‘still doing what we do’ through the pandemic
Never before has there been such a nationwide focus on the NHS. Daily TV briefings have been watched by record-breaking audiences, with viewers focused on the spread of infection, emergency department attendance, in-patient numbers, intensive therapy unit admissions and the tragic rising death rates.
Silently, in the background, district and community nursing teams have not stopped delivering complex care within patients' homes. In fact, the demand for their care has increased, with many reporting the need to undertake 20-plus patient visits during each shift. Each visit is complicated by a range of additional pandemic-related demands: donning and doffing of personal protective equipment (PPE), often in driveways, doorways and garages, and the need to communicate while wearing a mask. These make the provision of key information challenging, laborious and time-consuming.
There have been some positives from this newly imposed way of working. Reports of increased self-management, with patients more engaged, confident and concordant, especially in the area of wound care, which, on occasion, has actually optimised the healing of complex wounds. Some teams have welcomed additional team members, with staff deployed from services that were ‘stood down’ during the pandemic. This has led to enhanced clinical collaboration, reciprocal learning, increased bonding and, thus, stronger professional relationships. However, others have reported having no additional staff and, with team members being required to shield, they have continued to deliver an increased level of care, albeit with a smaller team. Some have even had to delay their annual leave to ensure the uninterrupted provision of care.
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