The QNI annual conference provided an opportunity for thought and reflection in response to our excellent speakers. Following last year's conference, the QNI has been developing a narrative about the language we use to describe the work of nurses working in the community. We have been very clear that using the term 'acute' to describe hospital care can be misleading. This is because there are acutely ill patients of all ages who are cared for in community settings whenever it is safe to do so. Where the nursing skills exist to support patients with acute episodes of their illness to stay at home, acute nursing care is delivered by community nurses. This is a growing area of work for the district nursing and community children's nursing services work as they seek to support earlier patient discharges and to prevent unplanned admissions.
Last year at the QNI annual conference I suggested that the use of the terms 'acute' (for 'hospital') and 'community' were misleading, and that by implication, it transmitted a message that community nursing is the opposite of 'acute'. I proposed that we should all endeavor to change the language to 'hospitalbased care' and 'community-based care'. This was well supported by the delegates and this language has become part of the QNI narrative. I would argue that these terms are more meaningful to patients carers and families too.
It was a joy therefore to hear Simon Stevens speak at the QNI conference this year and suggest that we should not be using the term 'out of hospital' to describe the care and the services that are provided in the community. The term 'out of hospital' assumes that all patients have been to a hospital in the first instance and it describes what something is not rather than what it actually is – like saying a man is a 'nonwoman' rather than a man! Let's call it what it is – care in the community, the place where people live their lives and where, whenever possible, they would choose to receive care. The QNI supports Simon Stevens' proposal that we should stop using the term 'out of hospital' and I urge you to do the same in the narrative you use to describe your work.