Support nursing in the community

Most nurses do not work in a hospital. Two thirds of the RCN’s membership work in the community.

Adults and children with complex conditions receive care in the community as do those recovering from treatment or operations. Health Visitors support new mothers and those in vulnerable circumstances. Learning Disability Nurses support people to live full independent lives in the community. School Nurses support children and young people. Mental health nurses, prison nurses, substance misuse nurses and practice nurses are all working hard across Wales to make sure we are supported in our daily lives.  Some of our most vulnerable older people are supported to continue to enjoy living in their own home 365 days of the year by community nursing delivering complex care and treatment packages at home.

Did you know?

Most nurses do not work in a hospital. Two thirds of the RCN’s membership work in the community.

For the last decade in Wales, Health Boards have been reconfiguring acute hospital services, reducing bed numbers, encouraging shorter patient stays and enabling more complex treatments and care to be delivered at home.

All of these services mean we need more nurses and nursing staff in the community. The good news is the numbers of community nurses and nursing staff are rising in Wales! However, investment in modern technology is urgently needed – many of our community nurse are still carrying around large suitcases of paper notes and writing these up for hours at the end of the day. We need investment in independent non-medical prescribing to provide timelier infection control and pain relief to the patient and prevent unnecessary referrals

Wales urgently needs more District nurses (which have a specialist practitioner qualification) or community nurses with a community master’s level degree. These senior nurses are the ones who are the leaders and deputies of community nursing teams. They provide clinical supervision to the nurses and support workers in the team and make critical decisions to support vulnerable people who need complex care. Without this level of leadership patients are likely to be readmitted unnecessarily and serious health issues are less likely to be spotted and dealt with in a timely fashion.

The numbers of District nurses and community nurses have been falling for many years in Wales. The Welsh Government has consistently failed to commission more postgraduate education in this area and Health Boards often block any attempt to increase it. The main reason for this failure is that Health Boards will need to backfill the vacancy on the frontline while a nurse undertakes studies. This perpetual short-term thinking has created a crisis for Wales by severely undermining community healthcare provision.

ACTION – increase the number of district nurses and nurses with a community master’s degree. Increase the number of infection prevention and control nurses working in the community. Invest in IT support for community nursing.

Support nursing in care homes. Invest in the quality of life for older people

Nursing in care homes is a rewarding role. A Registered Nurse presence in care homes for residents with nursing needs is essential for continuous monitoring and assessment of residents’ health and wellbeing.

As autonomous practitioners their clinical skills are used to recognise and anticipate problems, taking swift action if needed and avoiding unnecessary hospital admissions. Registered Nurses are key to managing acute illness, making decisions around the management of long-term conditions, palliative and end-of-life care and delivering complex interventions in emergency or crisis situations. They also help to support the seamless transition from hospital back into the care home.

Did you know?

There are only 1,545 Registered Nurses employed by Commissioned care providers in Wales. This is only 3% of the total care home workforce employed by commissioned care providers.

Unfortunately, nurses and nursing staff in care homes are often paid a lower salary compared with nurses and nursing staff working for the NHS. They also need access to continuous professional development to support their skills and knowledge and the right equipment (such as PPE). 

ACTION – Equalise pay, terms and conditions between health and social care.

Unfortunately, nurses and nursing staff in care homes are often paid a lower salary compared with nurses and nursing staff working for the NHS. They also need access to continuous professional development to support their skills and knowledge and the right equipment (such as PPE). 

ACTION – Equalise pay, terms and conditions between health and social.

COVID-19 has highlighted the need to have a Registered Nurse in every care home across Wales. The pandemic has shown the extra mile that nurses and nursing staff working in care homes go to care for our loved ones. We need to make nursing in a care home a career of first choice for our graduates and young people.

ACTION – Launch a national campaign to raise the profile of Registered Nursing in care homes and encourage student nurse placements in care homes

Nursing is an international profession. Many international nurses and nursing staff come from various countries to offer their expertise to Wales. Attracting international nurses is important for research and innovation in practice. The ageing population in Wales also means that migration of younger people to Wales helps us to provide the social care support our older people need. The RCN believes any immigration rules must encourage the international nursing workforce to immigrate to Wales.

ACTION – Ensure the immigration system encourages the international nursing workforce to immigrate to Wales

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