It’s International Nurses Day and we’d like to introduce you to one of our out of hours Derbyshire Community Nurses, Nicola Johansen.
Nicola started life as a Health Care Assistant at a hospice in Nottinghamshire in 1997 until she was seconded to do nurse training in 2003. Her first nursing position was back at the same hospice before she very quickly moved into the community with Nottinghamshire Healthcare, joining DHU Health Care in May 2021. Nicola is now part of the community nursing management team at DHU, having started in her role as Team Leader in February 2022.
“I love being in the patient’s own environment,” Nicola said of her decision to move into community nursing. “You are a guest in their home and, having had some experience of ward and practice nursing, I find they are more relaxed and open as a result.
“For me it’s a joy to be able to provide that one-to-one care without distraction that you don’t necessarily get in a busy hospital environment; the focus is purely on them. They’ve not been in a waiting room and are generally happy to see you, particularly as the way we receive the calls is usually as a result of a referral from a day District Nurse, GP or via 111.”
Go where the care is needed
DHU has around 120 District Nurses, Community Staff Nurses, Assistant Practitioners and Health Care Assistants, many of whom work part time, covering North and South Derbyshire. Each will be based in a geographical area where they will receive referrals from the daytime community service, out of hours clinicians and via 111 to visit a patient in their home. The closest available nurse will then be assigned the patient which means they may sometimes cross areas to go where the care is needed although as with all emergency services, an element of prioritising goes into making those decisions. The community nursing team also supports the Palliative Care Urgent Response Service in Derbyshire, providing care to palliative care patients in crisis with the aim of enabling them to stay at home.
Nicola added: “It means that there’s no case load so once we’ve seen one patient and treated them, we move onto the next one. It does mean that we don’t necessarily get to know a patient as you might on a ward, but I love the variety and the number of patients I get to see. I generally treat patients who have a problem with their catheter or they’re on an end-of-life pathway and need support with their pain relief. I do see a lot of urological patients whose symptoms may have worsened or developed and they can’t wait to see a day nurse.
“That’s the beauty of my role, I go where I’m needed and I’m so proud and privileged to be able to do that in the patient’s home. It means they don’t have to go into hospital or travel unnecessarily to an Emergency Department to get the care they need and I know I have made a difference to their life both in that moment and for their long-term health.”
We support each other
Our Community Nurses work across out of hours, between 18:00 and 08:00, mainly seeing patients in an emergency or urgent referral. There are also planned visits each evening. They receive support from each other, the out of hours clinical lead, 111 health advisors who receive the calls and the co-ordinator who can identify where the nurses are and who is best placed to see which patients. It’s an essential service that meets the needs of patients outside the hours of general practice. The community nursing service is part of the 24/7 service delivered across Derbyshire, with DCHS operating 08:00-18:00.
So was this part of Nicola’s grand plan?
“Not at the beginning no,” she recalls, “in fact I initially wanted to move into social work until a friend suggested health care as a way to understand the needs of the patients. Working in that hospice 25 years ago was the driver for me wanting to care and I’m delighted with the choice that I’ve made. I was aware of community nursing in DHU and was looking for an opening as I love the family feel and the DHU values. It’s important to know that the organisation you work for shares your passion and values and I firmly share DHU’s vision of putting the patient at the centre of everything we do.
“What has kept me in nursing all of these years? We make a difference. Yes, we have some very difficult days and the pandemic has been incredibly challenging, but we nurse because we care. Whether it’s a little improvement in their overall condition or making them comfortable at the end, we are there to care for the patient when they need us to make that difference. That’s what nursing is to me.”
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