The role of the modern-day nurse might seem simple enough to those not in the know; a patient is admitted to hospital and care is administered by a nurse – simple, right? Far from it, as it is actually a far more complex role that spans many different areas, with each role separated by numerous differences, not least the care ‘setting’.
Take the roles of district and community nurse, for example. Often these two words are used to describe the same role. So what is the difference between district and community nurses? Is there a difference? Where do these nurses mainly carry out their work?
A district nurse is a registered general nurse who manages care within the community. Specially trained in community healthcare, these nurses play a pivotal role in the modern-day primary healthcare team and are charged with leading teams of community-based nurses and support workers.
Typically, a district nurse will perform their duties away from the doctor’s surgery with house-bound patients, although work can take place in local healthcare centres.
District nurses have a high level of autonomy, more so than nurses who work in multidisciplinary hospital teams and have other healthcare professionals to rely on to deliver judgement or help make key decisions regarding patient care.
While a district nurse’s patients will often be elderly, there is no restriction when it comes to the age of those in need of care. Suffering from a wide range of conditions, some patients may have recently been discharged from hospital, while others may have physical disabilities or terminal illness.
The role of a district nurse is to provide care to housebound patients by performing regular home visits. These visits may occur once a day or multiple times, depending on the level of care required by a patient.
As these visits take place away from the secure environment of a hospital, it is the duty of a district nurse to perform thorough risk assessments upon every visit, ensuring the safety of both themselves, the patient and any community-based nurses or support workers who are required in order to treat the client.
Individually tailored healthcare plans must be devised and delivered in order to best suit the needs of the patient, as well as their family or carer/s, while it is important that care and support are carefully monitored to ensure the patient is receiving the correct treatment to meet their unique needs.
During these home visits, a district nurse has a number of responsibilities, including wound management, medication support, rehabilitation assistance and catheter care. A district nurse should also identify any key healthcare needs and discuss them with the individual, their families or carer/s. In doing so, the district nurse can act as a teacher, imparting knowledge on the varying aspects of healthcare.
Much like a district nurse, a community nurse is a vital cog in the inner workings a community’s healthcare system. They perform their duties in patients’ homes or from a healthcare centre.
Delivering care to the elderly, disabled and vulnerable patients who are unable to travel to a hospital or doctor’s surgery, community nurses are registered nurses who have undertaken degree level training as a specialist practitioner. This course focuses on four key aspects of nursing including clinical nursing, care and programme management, clinical practice development and clinical practice leadership.
A community nurse is responsible for performing many of the same duties as a district nurse. These include basic care (checking temperature, blood pressure and breathing), wound management, administering injections, setting up intravenous drips and assisting doctors with examinations and medical procedures.
Community-based nurses are also able to provide vital information to clients, their families and carer/s, much in the same way as district nurses, while emergency support may also be required in cases when a patient is suffering cardiac arrest or a stroke. This demonstrates the many hats a community nurse must don in their line of care.
One of the common misconceptions about working as a community nurse is that it is an easier line of work than nursing in a hospital environment. This is far from the truth. Working in the community requires first-rate decision-making skills and an ability to communicate well on a one to one basis without the support of other healthcare professionals who would be on hand in a hospital setting; this means that being able to work alone, is a key factor to being a successful community nurse.
As you can see, the differences between community and district nurses are minimal, while in some cases, the two roles are near enough identical.
In fact, it might even be down to the evolution of language.
The term ‘district nurse’ was first coined in 1859 when Liverpudlian merchant, philanthropist and MP, William Rathbone, employed a nurse to care for his sick wife. Following the death of his wife, Rathbone retained the services of the nurse so that the people of Liverpool who could not afford to pay for hospital care could benefit from her services in their own homes.
After observing the positive effects of this new form of nursing, Rathbone, along with Florence Nightingale, worked in tandem to develop the service. Rathbone opened and funded a nursing school in Liverpool to specifically train nurse for the city’s 18 districts, a move which resulted in the role of district nurse being created.
In recent times, the terms district and community have become interchangeable as a way of describing areas of villages, towns and cities, meaning that there may be no difference between community and district nurses at all.
Of course, in some cases, community nurses may work under the guidance of district nurses and vice versa, but in most cases, the two titles refer to the same role. In truth, it is the client who ultimately decides which terminology they use to recruit nurses, so it’s advisable to explore both avenues when searching for work.
If you are interested in learning more about the range of district and community nursing roles that are available to you, or you would like to find out more about joining the Medacs Healthcare family in England or Wales, contact us via email or call 0800 442 207 during office hours.
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