I recently talked to a group of health visitors, who described how, until recently, their practice had felt like social work. Because they were nurses, and did not want to leave families unsupported, they had felt obliged to work beyond their role in health.
They had been trying to tackle problems no-one else - and no other agency - seemed prepared to address. The result of this 'mission creep' was frustration, exhaustion and a sense of loss for their public health skills and role.
Then, things changed. It was partly a new manager, who supported them in their desire to use skills appropriately and focus on making a difference through specialist work, rather than trying to backfill for others. It was also to do with the new national focus on health visiting - the 'call to action' - which had renewed their sense of purpose, and their pride, in their profession.
Leadership and support, rather than more money or resources, had revived and reinvigorated these professionals.
Thankfully, the DH has begun a programme of work on a strategy for community nursing, with the QNI working in partnership to help to identify and capture the key elements of the 'offer' in a new framework document.
What difference can community nurses make? What is the evidence? How should they be prepared, supported, deployed and enabled to make the biggest difference where it counts, in patient outcomes and service efficiency? These are the issues to be tackled, to produce some practical and applicable information for service commissioners and managers.
I am delighted the QNI is involved in this. It is another practical step in the next phase of our Right Nurse, Right Skills campaign, which I hope helped focus ministers on this essential, poorly-understood area of nursing. I hope the programme will impact on every nurse working in the community, restoring their pride and invigorating them in their work. Vulnerable adults living in the community need their skills and commitment as much as children need health visitors.
Rosemary Cook, director, Queen's Nursing Institute