Journal of Community Nursing - page 111

2013,Vol 27, No 4
iven the current healthcare
landscape and the focus of
government policy, the way
nurses are prepared for working in
people’s homes needs reconsidering.
The standards for pre-registration
nurse education (Nursing and
Midwifery Council [NMC], 2010)
do prepare nurses to work in the
community at initial registration.
However, staff nurses at this point of
their career, or those that move from
the acute sector to the community, do
need to work under the supervision
of a qualified district nurse during
this transition.
The Queen’s Nursing Institute
(QNI) are about to launch an online
resource (‘Transition to community
nursing practice’), while NHS
Scotland’s‘Modernising nursing in
the community’website (
. aims to support
community staff nurses in developing
the required skills and expertise.With
nursing now a graduate profession,
some may choose to develop their
careers with a postgraduate district
nurse qualification.
Currently, district nursing
education is underpinned by
specialist practice standards (NMC,
2001), which have not been updated
since 1994. While higher education
institutions have continued to meet
these outdated standards, many have
built on them to reflect local practice.
However, this lack of cohesion has
resulted in divergence across the
UK as employers have brought
in alternative roles and models of
service delivery. This is reflected in the
number of nurses accessing district
nursing programmes in recent years
(QNI, 2013).
It has previously been suggested
that the NMC (2004) standards for
Specialist Community Public Health
could be adopted for district nursing
(Dickson et al, 2011). However,
while it is acknowledged that public
health is the responsibility of every
clinician, recent reports focus on
the clinical aspect of the district
nurse role (Scottish Government,
2012; Department of Health [DH],
2013; QNI, 2013; RCN, 2013). All
acknowledge that district nurses’
expertise is at the forefront of acute,
long-term and end of life care.
District nurse education standards
need to recognise the advanced level
of skills required if contemporary
district nursing is to deliver safe,
effective and person-centred care.
The Scottish Government (2012)
acknowledges the principles of
advanced practice and recommends
postgraduate education as the future
of district nursing. Meanwhile, the
DH (2013) suggests a graduate
specialist practitioner programme is
required. The strong argument for
district nursing to move to Master’s
level advanced practice is supported
by district nurses who are already
performing at this level. For district
nursing as a whole to achieve this,
nationally recognised benchmarks
for advanced clinical practice (RCN,
2012) could be integrated with specific
competencies. For example, one
Scottish institution has led the way by
mapping the NMC standards (2001)
to RCN accreditation (2012) and level
7 of the NHS Education for Scotland
(NES) career framework (2011).
There is no need to reinvent the
wheel — the resources needed to
support a cohesive flexible approach
to community nursing education
are already there. However, the
NMC needs to take note of recent
developments and support this work
to protect the public and meet future
service delivery needs.
DH (2013)
Care in Local Communities: a new
vision and model for district nursing
. DH,
Dickson C, Gough, H, Bain H (2011) Meeting
the policy agenda, part 2: is a‘Cinderella
J Comm Nurs
NES (2011)
Career and Development
Framework for District Nursing
. NES,
NMC (2001)
Standards of Education for
Specialist Practice
. NMC, London
NMC (2004)
Standards of Proficiency for
Specialist Community Public Health Nurses
NMC, London
NMC (2010)
Standards for Pre-Registration
Nurse Education
. NMC, London
QNI (2013)
Report on District Nurse Education
in England,Wales and Northern Ireland
QNI, London
RCN (2012)
Advanced Nurse practitioners:
An RCN uide to advanced nursing practice,
advanced nurse practitioners and programme
. RCN, London
RCN (2013)
District Nursing, Harnessing the
Potential: the UK’s position statement on
district Nursing
. RCN, London
Scottish Government (2012)
District Nursing
Skills Requirement and Options for Future
Education Provision
. Scottish Government
Heather Bain, Course Leader Masters
Portfolio, Robert Gordon University,
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