Community Placement for Adult Branch Nursing Students 2011/2012
What is community health care?• Community health care is provided in people’s own homes, health centres and specialist clinics.• A diverse group of professionals, agencies and independent sector workers provide both general and specialised health care in these settings.• Nurses provide a range of services in the community, including: Community or district nurses Palliative care Tissue viability Public health specialist practitioners Sexual health Bladder & bowel care Practice nurses Community paediatric nurses
Primary Health Care• Primary care describes community based health services that are usually the first, and often the only, point of contact that patients make with the health service• General Practice will take the lead role in commissioning the majority of care for patients. In the White Paper, Equity and Excellence: Liberating the NHS (DH, 2010) the current Primary Care Trusts (in England) will pass their provider and commissioning roles over to collective groups of GP practices, known as consortia.• It is expected that nurses will be represented within the consortia.
Who else will you expect to meet during your community placement?• In your placement you may liaise with general practitioners, community matrons, practice nurses, school nurses, physiotherapists, speech therapists, dentists, opticians, pharmacists and many more.• You may be in contact with NHS walk-in centres, NHS Direct and community based minor surgery clinics. You may learn more about community based screening or keeping healthy initiatives. Search for health initiatives in the area where you will undertake your community placement e.g Adult Health & Social Care, Enfield, http://www.enfield.gov.uk/info/100004/health_and_adult_social_care• As you familiarise yourself with your clinical area consider how the patient or individual accesses services, how integrated you find community care and the ways in which needs are met.
What health care needs might you come across in the community?• Many people, living in the community, have multiple and chronic health problems that we classify as long term conditions, e.g rheumatoid arthritis, urinary incontinence and hypertension• They may require care from many different services e.g GP, bladder & bowel nurse specialists• To co-ordinate these complex needs a case management approach has been developed in the community supported by case managers and community matrons (Cubby & Bowler, 2010).• Read more about long term conditions on, http://www.dh.gov.uk/en/Healthcare/Longtermconditions/index.htm• On your placement explore who is caring for patients with multiple needs, who is coordinating their care and how does this approach benefit the patient.
Working in partnership with patients• Health and social care staff in the community setting work in partnership with patients to promote autonomy & self management• Self-care does not mean ‘no care’, but rather supporting people to know when to contact services and ask for help and when they should manage their own health needs (Beasley, 2009).• Can you think of one health need that patients can self manage and one that they should seek help for?
Learning opportunities for pre-registration students in community placements• Spend time with your mentor identifying learning opportunities• With your mentor, decide on the skills you would like to be assessed on• Identify your own personal learning needs & work with your mentor in meeting this need. E.g Use your community placement to work alongside a tissue viability specialist nurses or to attend a bed wetting clinic.
Guidance on medicine administration in the home• You may not fill Dosette™ or similar medicine containers.• You may not give medicines of any kind by mouth or injection unless directly supervised by a qualified nurse.• You may administer eye drops, apply wound care products, skin preparations and glycerine suppositories provided that you have been briefed on their use.
Supplying and administrating medicines• During your placement you will have the opportunity to observe different methods of supplying and administrating medicines.• You must never give medication unsupervised however, you will have the opportunity to administer a variety of medications under direct supervision of your mentor.• You should note the different prescribing and supply strategies available, including clinical management plans, patient group directions and conventional prescriptions (FP10s).• It is important that you are aware of the legal and professional issues inherent in all aspects of medicine management and you should refer to the NMC Standards for Medicines Management (updated 2010) for in depth advice• http://www.nmc-uk.org/Documents/Standards/nmcStandardsForMedicin
Your responsibility• Attendance• The team leaders will submit a record of attendance each week, to the University• Absence• You should ensure that both the clinical placement and the placement office her aware of your absence. It may not always be possible to make up the time you have been absent. All queries should be referred to the link lecturer.
Final placement students• Middlesex University students with a special interest in developing their skills in the community setting will be offered the chance to undertake their final placement in one of the community placement areas.• You will need to be assigned a ‘sign-off mentor’. That is, an experienced mentor who has gained further experience in mentoring final placement students, as stipulated by the NMC (www.nmc-uk.org)
Link lecturer contact details• Camden PCT• Kate Brown, Institutional link; Archway Campus; 020 8411 6930; email@example.com• Carol Lincoln; Archway Campus; 020 8411 5961; firstname.lastname@example.org
References• Beasley C. (2009). Supported self care and care planning for patients with long-term conditions. British Journal of Community Nursing . Vol 14, No 9; p394-7• Cubby A & Bowler M. (2010). Community matrons and long-term• conditions: an inside view. British Journal of Community Nursing . Vol 15, No 2, p71-76• DH (updated 2011). Long Term Conditions. Available from: http://www.dh.gov.uk/en/Healthcare/Longtermconditions/index.htm• DH (2010). Equity and Excellence: Liberating the NHS. Crown. Available from http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH• NMC. (2008). Standards to Support Assessment & Learning in Practice. Available from: http://www.nmc-uk.org/Publications/Standards/• NMC (2007; updated 2010). Standards for Medicines Management. Available from: http://www.nmc-uk.org/Documents/Standards/nmcStandardsForMedicinesManagementBooklet.pd