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Rosemary Cook - Patients want competent, confident care

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After a year-long Right Nurse, Right Skills campaign, and months of data collection and analysis, the QNI launched its new report on community nursing at the House of Lords on 21 November. Nursing People at Home - the issues, the stories, the actions marks the end of the second phase of the campaign.

The first was raising awareness and support among nurses. The second was reaching out to the general public, and hearing from them about the quality of their experiences of community nursing. The next phase will be to deliver actions from the report.

So what did we learn? It was clear that patients wanted three things from the nurses who visit them at home: competence, confidence and caring. The middle one is interesting. It is not enough for nurses to be competent and caring: they should also have visible confidence in their skills. Some people described it as 'poise': the nurse showing they know what they are doing, and instilling trust and confidence in the patient and the family.

There are also three attributes that patients look for in their nurses: the ability to assess complex situations, and take action as necessary; the ability to build a network of care and services to meet needs; and the knowledge to answer questions and give information about treatment.

These are the attributes of skilled, experienced community nurses; not of newly-qualified nurses or health care assistants. They are a call to action for commissioners and employers of nurses, to ensure they balance the workforce between experienced and novice team members.

Regulation and inspection cannot ensure patients get what they need. Neither the Care Quality Commission nor any other body can visit every patient's home to check on the quality of care. The solutions are people-based: if we get the practitioner right, we will get the care right. That means a focus on education, regulation and workforce planning; all difficult, tedious subjects, that nevertheless ensure that the nurse who walks through the patient's door will be confident, competent and caring.

  • Rosemary Cook, director, Queen's Nursing Institute

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