To think they’ve ruined District Nursing?

[GJD23000]

I wonder if anyone else feels the same. I have been a Community Nurse for many years and have seen such a decline in the service (I’m based in Midlothian - Scotland) I am so sick of it and considering leaving… but not sure what I would do!! Sorry this is a rant….

Firstly, the introduction of the evening service (the ‘24 hour’ service) which meant that nurses who were used to working either days or nights were forced to work both, no consideration for personal circumstances. So many experienced, great community nurses left the year that was introduced. Management then refused to allow people to only work days or nights, saying they had to do both so they struggled to fill community roles which they would have easily done before. You couldn’t get a job on the community when I joined! Six years later and they realised that that decision was probably a mistake and guess what, an evening service has formed again!! Not that they would admit that.

Then the introduction of the ‘Band 7’ role was the worst decision ever, they basically took the most experienced nurses off the floor and made them managers, they never see patients and spend all day on the computer. When I started there was 1 band 7 covering a cluster, now there are 4. District nurses saw an opportunity to get a Band 7 and moved up, leaving no SPDNs within teams… so they introduced the ‘CNP’ role, which totally undermined the SPDN role as suddenly you could be a band 6 in charge of a caseload without having to undertake the very intensive SPDN course (the divorce course as some know it by!) The government have continuously refused to give SPDNs a band 7 and now there is this ‘job revaluation’ in which Band 5 nurses are arguing their case to get band 6s and it appears that some are getting it, some are not!! Most community nurses do the exact same role so what is that going to do for team moral.

I’ve seen so many nurses leave and return to the hospital… which is mad as that never would have happened before!

I’m sorry for the rant but after 15 years of nursing and almost 10 on the community (which I always saw as a better option!) I think I’m done working for the NHS!

I was a GP in SE Lothian so I'll wave at you. 34 years ago our DN was attached to our practice and also had years of experience. I found in the last few years of my career that the moving of the nurses into clusters whilst maybe more efficient meant we didn't have such a good relationship with them. We also had a period where many of the nurses were really inexperienced. I loved the days when I would come back from a visit and all I had to do was nip upstairs to see the DN and plan patient management. The trouble is the growth in the population....you will have seen all the new houses in SE Edinburgh and Bonnyrigg and surrounding areas...also Tue population is getting older and we look after far more in the community than we did. Even getting a bed in the hospice is a problem as their beds have been reduced. Im glad to be retired now.