“I have worked in Edinburgh for nearly 15 years and have had a range of different District Nurse posts, working in various areas in Edinburgh – from affluent to deprived, which each bring their different challenges – which I have found stimulating and enjoyable.
I have been fortunate to have been supported by NHS Lothian to continue to develop as a Band 6 which has now led to a promoted Band 7 post as an Advanced Nurse Practitioner. Development has included secondment to the IMAPCT team, the clinical decision making course, vascular access as well as a multitude of general District Nurse training and education.
The IMPACT (IMProved Anticipatory Care and Treatment) service is a nurse led service which was set up to improve the quality of life for people with long term conditions, offer support to their carers and reduce preventable hospital admissions
As a result of my secondment I obtained the ANP post which maintains the clinical aspects of the district nursing role and patient contact which is really important to me, while also affording the opportunity to develop a more strategic perspective as a manager.
There are a lot of secondment opportunities in Edinburgh and the Lothians if you are willing to be stretched, and see the potential benefit to your career.
District Nursing is a tough job at times with varying demands on you personally and professionally, but I have had good support from my colleagues and managers and on a tough day, Edinburgh is a lovely place to be at work.”
Video Transcript
The Impact Project: Jennifer Crerar
“Impact is a team that was set up to help people with long-term conditions manage their own condition, so very much from the self management perspective, with some advice and support from the district nurses.
While I was in the Impact team I had the opportunity to develop some of my clinical skills and I went in the clinical decision making course, which is a nine-month course that focuses on abdominal, respiratory and cardiac assessments and I think combined with the outcomes approach moving back into my general practice – back into general district nursing – has actually made me a much better practitioner.
I’m much more able to get accurate patient histories, I feel I’m able to listen to the patient’s experience and I’m also better able to elicit what’s important to the patient, and I think these skills actually make things much better for the patient. They’re more involved in the process of looking after their own health. I see it as an interim stage where they move from being able to manage their care and then having to transition into general district nursing – as their condition deteriorates, and develops – back into district nursing where you’re looking more at a palliative care aspect.
I think the outcomes approach has certainly helped – not only me develop a better understanding and a better interviewing technique for patients – I’ve actually been able to utilise it in managing my team, because as I say, it’s quite gentle and people are having difficulties moving forward with district nursing management plans or treatment plans that we’re putting in for patients because sometimes it can take a long time to see progress and the outcomes approach is actually really useful and I certainly find it and has helped me and some of the managerial decisions I have to make.
I find that I use it on myself if I’m having a difficult day, I might find myself asking: Why am I feeling like this?, What’s so difficult?, What could I do differently?, and I think it just helps me calm down. I think it gives me perspective, so again I think it’s a very useful approach that most district nurses would find the benefit of taking on board. So what was good about it? I think the the time that I had to focus on these new approaches and embed them in my daily practice, I think were additional benefits – obviously from the managerial point of view – that I hadn’t anticipated I would I would gain.
What could make it better? If everybody could do it would be great – that might not always be feasible – but I don’t think any nurse, or district nurse, going on these additional courses or secondments would would lose anything – I think they could only gain an experience and learning.”
