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An overview of the role of the district nurse caring for individuals with complex needs

02 January 2019
Volume 24 · Issue 1

Abstract

The role of the district nurse is imperative in the care of patients in a district nursing team's caseload. Through the role of care manager, district nurses are accountable for the overall coordination of the care patients receive. Their responsibilities include caring for acutely ill patients, those with long-term conditions and people who require end-of-life care, in addition to health promotion and patient education. They provide personcentred, preventive and coordinated care, which reduces unnecessary hospital admissions and enables patients who have a range of complex needs to remain at or return to home. In this article, a case study is used to provide an overview of the role and accountability of the district nurse in the care of patients who have complex needs.

This case study provides an overview of the role of the district nurse (DN) in the care provision, care planning and coordination of care for individuals and carers with a range of needs. The role and responsibilities of the DN and accountability in nursing will be discussed using a case study from the community setting for illustrative purposes.

A DN is a registered nurse who has completed a specialist practice qualification in district nursing (Queen's Nursing Institute (QNI), 2014). This qualification provides DNs with higher technical skills, a wider knowledge base and broader experience, allowing them to have better decision-making ability (Barrett et al, 2007).

The role is unique in that it is considered a generalist role (Randall and Ford, 2011) which is multifaceted in nature. The uniqueness and indispensability of the district nursing role is highlighted by Bain (2015), who suggests that DNs have ‘unique knowing’ in practice and ‘tacit knowledge’, which are key elements in their role. Unique knowing and tacit knowledge are knowledge types that allow nurses to act on a hunch or intuition (Royal College of Nursing (RCN), 2004) and are gained through previous knowledge, experience and professional expertise (Kothari et al, 2012).

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