What Does A Community Nurse Do?

“It’s a job which keeps you on your toes and can be physically and emotionally demanding. At the same time, patients come to trust you and they let you into their homes and hearts, which is a great privilege.”

Jessica details the different specialisms within community nursing and offers comprehensive guidance on all aspects of the role should you consider this to be the path for you?

Introduction

Community nursing is a vital part of the NHS, and yet there are still many misconceptions surrounding the role.

Have you ever heard someone say, “it’s only leg dressings and insulin injections”? Or that if you transition straight into the community as a newly qualified nurse, you won’t develop good clinical skills? Or even that there are no opportunities to progress and develop your career?

These are just some of the common myths associated with the role of the Community Nurse which this article helps to address.

The Different Roles Within Community Nursing

Community nursing includes a broad variety of specialities working outside of the hospital setting.

The term is used interchangeably to describe services which operate in the wider community healthcare sector and to refer more specifically to nursing teams responsible for supporting housebound patients and their families and carers.

The generic term includes roles such as Health Visitors, Learning Disability Nurses, School Nurses, General Practice Nurses, Health Inclusion Nurses, Prison Nurses, Care Home Nurses, Mental Health Nurses, Paediatric Nurses, Public Health Nurses, Occupational Health Nurses, Clinical Nurse Specialists such as tissue viability and Diabetes Nurses, Nurse executives, and Nurse Educators.

Due to the variety of different services across the community, the scope of each role can vary considerably depending on which area you choose to specialise in. For example, a nurse working within a health inclusion team will often oversee the running of clinics in homeless hostels and refugee centres, whereas a Nurse Educator will be focusing on how to help nurses develop their clinical knowledge and skills.

This article mainly focuses on the Community Health Nurse, which is closely linked with the role of the ‘District Nurse’. The term was coined around 1859 after a woman called Mary Robinson became employed as a private nurse for the wife of businessman William Rathbone. After she expanded her practice to the poor neighbourhoods in Liverpool, Rathbone commended Mary’s work to Florence Nightingale, who advised him to set up the first nursing school to provide district nursing training.

Today, a District Nurse refers to a Community Health Nurse who has undergone further training and education to assess and treat housebound patients and, depending on their qualifications, may even be able to prescribe medication.

A Day In The Life Of A Community Nurse

Every day in the life of a Community Nurse varies, depending on the needs of the patients you are allocated.

One day you will have patients requiring urinary or suprapubic catheter changes, central line care, a syringe driver for end-of-life care, or pressure ulcer treatment for a Category 3 wound. On another day, your diabetic patient may be hypoglycaemic and require you to quickly give them a sugary snack and monitor their blood sugar until it returns to a safe enough level to administer insulin. And then you may be called out to administer a subcutaneous injection to a patient who is in pain, or to another blocked catheter.

It’s a job which keeps you on your toes and can be physically and emotionally demanding. At the same time, patients come to trust you and they let you into their homes and hearts, which is a great privilege.

Being in people’s homes helps you to learn more about them than you ever would in the acute setting because you get to know their families and carers, their immediate environment, and even their pets!

Since the GP is responsible for the overall health care of patients within the community, you will sometimes need to liaise with them directly during your working week. For example, you might suspect your patient has developed a urinary tract infection, or perhaps their arterial foot ulcer is deteriorating, and they urgently need antibiotics.

Working autonomously gives you the opportunity to learn advanced assessment skills and gain further knowledge and expertise. This then allows you to advocate for your patients, since you may be the only healthcare professional who has regular and direct contact with them.

Community Nurses usually work within teams led by a Band 6 or Band 7 team leader and take part in daily handovers where concerns are escalated, and important information is exchanged.

Due to the unpredictable nature of community nursing, nurses need to use their initiative and clinical judgement in unexpected situations. Sometimes it is necessary to contact more senior nursing team members for advice or to call a colleague for backup.

It’s a job which keeps you on your toes and can be physically and emotionally demanding. At the same time, patients come to trust you and they let you into their homes and hearts, which is a great privilege.

Although nurses are mostly lone workers, there is always someone to speak to if you require more support.

Newly qualified nurses especially require more tailored support from their colleagues when they enter the role, and the Nurse Educator within the trust should also be on hand to assist them with learning a new skill or competency.

How To Become A Community Nurse

To become a Community Nurse, you will first need to complete your nursing degree, during which you can request a preference for placements in the community.

Whilst on placement, you will have the opportunity to familiarise yourself with the different services available in the trust you are in.

Many student nurses who find a particular area that they enjoy and build good relationships with patients and staff, often secure jobs with their placement team once they qualify.

This can ease their transition into the community setting and help them settle more quickly into the role.

Please visit our NHS Pay Calculator for current entry-level pay scales for a Community Nurse in the NHS.

More senior Community Nurses and District Nurses can earn up to £50,000 or more, depending on their qualifications, level of experience and management skills.

For some areas, such as Practice Nursing, GP surgeries have their own pot of funding, which allows them to set their own pay rates for their staff. This varies from practice to practice, and there may also be differences in policies regarding the terms and conditions of the role.

What Skills Do You Need?

The skills you require depend on what area of the community you choose to work in, and what role. For example, if you deliver home-based, routine care, you will need to learn hard skills such as urinary catheterisation, wound assessment and care, diabetes management, compression bandaging, Doppler ultrasound assessments, syringe driver administration, continence assessments, venepuncture, and central line care, to name a few.

A specialised area such as the Hospital at Home model requires nurses to have additional training in advanced physical assessment skills, which gives them the autonomy to complete a comprehensive assessment of each patient and create a home-based treatment plan. This includes using transferrable skills from the acute setting such as administering IVs and cannulating.

Community nursing also involves many soft skills. Time management and excellent organisation are essential for any nurse balancing a busy caseload of patients, especially as you must factor in travel time, documentation, clinical handover, referrals, and scheduling follow-up appointments.

Another key skill is good communication, as you will need to ensure that relevant information is communicated clearly within the team handover to maintain patient safety and continuity of care. The ability to use your own initiative and to think outside the box is also important because the community setting can throw up unexpected situations requiring creative solutions!

Entering the world of community nursing can seem like a daunting prospect for student nurses who have trained in the hubbub of the wards, where there is always someone nearby to lend a hand. But there is a great deal of variety in terms of the skills you can develop and the roles available when you enter the community setting.

You can rapidly progress in your career through pathways such as the District Nurse (DN), Advanced Nurse Practitioner (ANP) or Clinical Nurse Specialist (CNS) qualifications, which allow you to practice with greater autonomy and responsibility and become a highly skilled and knowledgeable clinician.

If this sounds like the career path for you, you can take a look at the latest Community Nurse jobs here for more information.