District Nurses work in the United Kingdom's National Health Service, managing care within the community and lead teams of community nurses and support workers. The role requires registered nurses to take a NMC approved specialist practitioner course. Duties generally include visiting house-bound patients and providing advice and care such as palliative care, wound management, catheter and continence care and medication support. Their work involves both follow-up care for recently discharged hospital inpatients and longer term care for chronically ill patients who may be referred by many other services, as well as working collaboratively with general practitioners in preventing unnecessary or avoidable hospital admissions.
Scope of practice
District nurses assess people to see how to provide nursing care that allows people to remain in their own homes, maintain their independence, or have additional support after discharge from hospital. A district nurse will manage a team of nurses that may provide wound care, train carers to administer eye drops if individuals can not do it themselves, support catheter care, and administer complex medication within a patient's home as well as immunisations. As well as treatment, a district nurse can offer advice and support with health concerns and refer to other organisations. District Nurses can specialise in different areas such as palliative care.
District nurses who hold additional qualifications may prescribe certain medications to patients as Community Practitioner Nurse Prescribers under the Nurse Prescribers' Formulary for Community Practitioners (Part XVIIB(i) of the Drug Tariff). They may be trained to assess patient's needs for equipment provision such as mobility and independent living aids, medical equipment such as specialist beds and mattresses, as well as guidance in applying for grants and welfare benefits.
In England and Wales, they are employed by Primary Care Trusts on behalf of the NHS, whereas in Scotland, they are employed by the health board and may be based at centralised health centres or general practices. District Nurses, like all qualified nurses, are regulated by the Nursing and Midwifery Council.
District nurses can also be known as community nurse specialists.
In the UK, training as a district nurse requires registration as a nurse in the adult branch, and consolidation of pre registration nurse education. A degree or postgraduate diploma course is then undertaken which is approved by the Nursing and Midwifery Council (NMC 2001).
Organised district nursing in England is considered to have begun in 1859. In 1858 Liverpool philanthropist William Rathbone employed a nurse, Mary Robinson, to take care of his wife at home during her final illness. After his wife’s death in 1859, he engaged Mary to go into one of the poorest districts of the City to bring healthcare to people who had no means to pay for it. He spent the rest of his life working to build up the service, with assistance from Florence Nightingale and others. District nursing on the Liverpool model soon sprang up in other towns, cities and rural areas, funded by local philanthropists.
In 1887 Queen Victoria’s Jubilee Institute for Nurses was founded, centralising training for district nurses (or Queen’s Nurses as they became known) until nursing education became nationalised in 1968. The charity, which became the Queen's Nursing Institute, continues to support community nurses to this day. The Institute always needed to raise funds and until the creation of the NHS in 1948, district nurses collected contributions from their patients.
- "Explore roles: Roles: District nurse". www.healthcareers.nhs.uk. Retrieved 29 October 2016.
- "Job profiles: District nurse". nationalcareersservice.direct.gov.uk. Retrieved 29 October 2016.
- William Rathbone and the beginning of District Nursing DistrictNursing.org
- District Nursing 150 website by Queen's Nursing Institute