Supporting patients in the community

Posted on Wed, 18/12/2019 by Phoebe Fiddler & Karen McCoy

This week we chat with district nurse Phoebe Fiddler and community nurse Karen McCoy to learn more about their roles in the Gateshead East locality team.

Increasingly much more NHS care is given to patients in their own home and research shows that people often recover much more quickly in this environment.

It’s also much more convenient for patients than having to travel to the hospital which is often very busy and can really be unnecessary for many things.

The team in East Gateshead see housebound patients aged over 18 and deal with a really wide range of healthcare needs such as palliative care, giving injections, managing wounds and dressings, supporting diabetic patients, emergency health care plans, catheter care, pressure ulcer prevention and long term care management.

The East is one of five localities across Gateshead and they are usually aligned with GP practices across the town.

Last month the five locality teams completed 25,802 home visits to the people of Gateshead providing care and support to some of the most vulnerable people in society.

They can often see people who have been discharged from hospital but much of the work is about preventing unnecessary admissions to hospital - which are often not what the patient wants and can add strain to the already busy care system.

The teams in Gateshead provide a service from 8am–8pm, with each nurse doing up to 16 home calls a day as well as ward rounds in care homes.

There is also an urgent rapid response team who can visit patient homes in more pressing circumstances.

Phoebe is a district nurse within the team and enjoys the closer and longer term relationships it enables her to build with people in the community.

“You do get more one to one time with patients and there’s much more continuity over time so you get to know people and their families. I really love the job and every day is different,” she says.

To become a district nurse she completed extra training which included leadership development, health assessments, population analysis and many other areas of healthcare. She is also able to prescribe medication for patients.

The team have recently been part of a trial of new electronic tablets which they can use for a wide variety of tasks. This is proving a really successful initiative that helps patients access quicker care, improves record keeping, saves paper and prevents unnecessary travel back to the office.

Karen explains that like the rest of the healthcare system frailty, dementia and mental health are growing challenges facing the team. As well as this they are having to adapt to a society where people are living longer, but doing so with more complex conditions and needs.

“The role is about providing really holistic care to people in their own homes but also fixing a wide range of potential problems.

“You may be going into a home to replace a dressing but then realise the heating isn’t working and the patient hasn’t taken their medication. We have a duty of care to everyone we see so that also involves working with other professionals or getting the right people involved.

“We’ve dealt with everything from very poorly patients to flooded homes,” she explains.

Fiona Clarkson manages the team and explains how working together as a whole healthcare system out in the community is really driving improvements for patients and helping the hospital better manage demand.

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