Nursing in the Care Sector: An Important and Rewarding Role
By Professor Martin Green, Chief Executive of Care England
It is a fact that over the last few years the dependency level of people living in care in nursing homes has increased significantly. In days gone by, people who are currently in both nursing and residential care, would have been in a hospital geriatric ward surrounded by a plethora of doctors, nurses and other allied professionals. The increased focus on personalisation and the desire to ensure that people who are living with long-term conditions have a more normal and less medicalised experience, has led to moving people out of acute hospitals and into community settings. Sadly, this movement of people has not been accompanied by a movement of resources and this has led to people with significant long-term health problems being cared for in services that are under resourced.
Despite the increases in the dependency levels of people in care services, and the undoubted struggle to deliver higher levels of care on low levels of funding, what we have seen is both care and nursing professionals who have risen to this challenge, and have made the care sector a very rewarding and vibrant place to work.
With increased pressures on the NHS, we will see more nurses taking a decision to leave the health service and to move into independent care provision..
One of the things that I think is little understood is the amount of professional respect and autonomy that nurses in the independent sector have. Nurses are critical to delivering high-quality health and social care to people who are living with a range of comorbidities, which include both significant physical conditions, as well as dementia.
The revalidation of the nursing profession has also given care services a real opportunity to look again at the nursing and support function and identify ways in which it can become more attractive to nurses and also how those nurses can still access the continuous professional development and support, that is so much a part of a nurse’s career.
As I go out and about and meet nurses who are working in care settings, they constantly tell me that one of the most enjoyable and interesting parts of their work is being able to work in a proactive and supportive way with a population of residents who they know well, and with whom they can establish good quality professional relationships.
There are a range of specialist nurses who can get invaluable experience from working in care and nursing home settings and who will be able to significantly expand their knowledge in areas such as diabetic care and dementia. In these areas, care home nursing is in the very vanguard of delivering innovation, and what care home practice also enables nurses to do, is to really understand the people they are working with and develop very personalised approaches to meeting their needs.
In areas such as end-of-life care, care homes are probably amongst some of the most important places for the development of practice because they deal with issues such as end-of-life care, on a daily basis. In recent years we have seen some excellent examples of care homes and hospices coming together to work towards better end-of-life care. This, of course, also improves the amount of opportunities which nurses get for their own professional development in this extremely demanding, but very satisfying area of practice. There have also been a range of very important initiatives which have tried to improve the quality of end-of-life care in care homes. The Gold Standards Framework is working hard to support those nurses and care workers to have the requisite skills that are necessary to make end-of-life care, a good experience for the person who is dying and the people who care for them at a very difficult time.
Care and nursing home careers have often been frowned on within the nursing profession and one of our biggest challenges is to make training more appropriate to the needs of the 21st-century. Too much about training assumes that people will graduate and immediately work within an acute hospital. The ageing population and the drivers of government policy clearly state that nursing is now a community-based profession and nurses have to be skilled enough to go in and out of people’s homes and across boundaries into care and nursing home services to ensure that the care they deliver is of a high quality and in the appropriate place, where citizens require it.
I would urge every nurse who is considering the next phase of their career not only to think of the NHS but to think of the vibrant and dynamic sector in social care and examine whether both their professional and personal goals can be best achieved within an independent setting.