There are few meetings these days, after all there few people so far who know what they will be doing in 3 months time. Today though I did go to a meeting, one which is a way in which we can share governance issues, and work out how learning can take place from them. A district nurse presented a critical incident about an old lady discharged from hospital during the July heat wave and who died a few short days later. Up until a day or two before discharge she had been recovering well from her hip fracture, but it seems that when her condition deteriorated no one was prepared to stop her going home.
When the district nurse arrived the day after discharge, she found an elderly lady in a terrible state, unable to weight bear, suffering diarrhoea and in much more of a confused state than she had previously had been. The district nursing team and GP then proceeded to give that lady and her family the best care the NHS can offer, with many long visits several times a day until her death a week later. But the whole thing leaves a bad taste, it seems that good nursing care cannot be provided in hospital for elderly people, at least in the area within which I work. It seems that once a discharge has been arranged, the patient must be got rid of as soon as possible. It seems that no one is prepared to give the time and attention to a confused old lady when she needs it most.
I am helping with some work on defining what district nursing can offer in 2006, the above story (which I haven’t gone into detail about because I am concerned that I am identifiable in the local area) demonstrates the complexity of what district nurses have to cope with and the challenges they face. I am proud to have been a district nurse, and to be honest it is the only type of nursing to which I would be prepared to return. I am worried though that any good work that our district nurses do, it being undone by what goes on in the local hospital!