6 Meet the district nurses bringing care into communities Not all our patients are able to come into hospital to receive the treatment they need – whether that’s because it’s not safe for them to move around outside their home, or they aren’t able to get out of their bed. Enter our dedicated district nurses, who bring the hospital to them. Part of North Mid community services, the team of more than 100 specialist nurses operate a 24/7 service delivering world-class care in the homes of hundreds of housebound patients across Enfield. The service works closely with local authorities, GP surgeries and community services to bring care into the community, helping to reduce hospital admissions and appointments. They receive between 450 and 500 referrals each month from hospitals, GPs and patients themselves. From wound dressing to medication administration, the wide range of care these nurses can provide means patients receive support in the best place for them: their own home. The six divisions of the district nursing team are based in various centres across Enfield, including St Michael’s Primary Care Centre, Highlands Practice, Arnos Grove Medical Centre, Eagle House Surgery and Lucas House. The Rowan Court district nurses, based at Pine Lodge at St Michael’s Primary Care Centre, shared with us the peaks and surprising challenges that come with providing treatment outside the hospital setting. Forging bonds and giving holistic care When starting their shift at their base, the nurses and healthcare workers receive their list of patients to visit. Mercy Amoako-atta, advanced community nurse practitioner, started her career in district nursing as a healthcare assistant in 2013. Explaining what the team’s work involves, she said: “We treat patients with long-term conditions; diabetic patients who need help administering their insulin; palliative care patients who have chosen to die in their own home; patients needing wound therapy or wound dressing. Most of our patients are over the age of 65 and housebound. “When we visit them, we do a holistic assessment. You might see a patient for one thing but treat them for something else too once you observe them. If we find something that we can’t manage, we escalate this and call an ambulance if needed.” Healthcare support worker Marta Zelzik said: “Apart from the clinical care, we also support patients. Some patients don’t have anyone else visiting them, so are happy to see us. We end up becoming like their family.” “ “ We end up becoming like their family L-R: healthcare support workers Marta Zelzik and Kelly Petro They see around 10 to 12 patients a day in their sector, and each has an allotted visit time. They also have an on-call service for emergency visits, which can come at any time. Ama Arthur, caseload manager, is the team lead for the Rowan Court nurses. She explained how some people can misunderstand their line of work: “We can be seen as an emergency service and receive requests to see patients there and then, but that isn’t how we work. We prioritise emergency visits that come through via our on-call service, but we usually have a time slot in which to see each patient.” In total, the district nurses travel up to 10,000 miles every week visiting patients across Enfield.
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