Save one life, you’re a hero. Save 100 lives, you’re a nurse

Queen Victoria reigned for nearly 64 years. She did so through a period of immense industrial, social,  scientific and political change. Our present Queen, Elizabeth II, has already been on the throne for longer than Victoria, and next year will celebrate 70 years as Queen. She will be the first king or queen to have reigned for seven decades. Like Victoria, Elizabeth has witnessed much change both here and internationally during her reign. The Queen’s celebration will be her Platinum Jubilee, and as well as the promised ‘once in a generation show’ we will all get an extra Bank Holiday next June. Let’s hope we have turned a corner in dealing with the pandemic by then.

Queen Victoria perhaps gave the nation something a little longer lasting than an extra day off, with the funds raised through her Golden Jubilee celebrations. In 1887, she was persuaded by a chap called William Rathbone, along with two Florence’s (Nightingale and Lees), to make a donation of £70,000 (nearly £10 million in today’s terms) from her Golden Jubilee funds to nursing. The money was used to continue the work Rathbone had started, using his own money, to train and educate the precursor to the modern day District Nurse. He wasn’t a nurse, but was passionate about nursing and the difference nurses could make to people’s lives. He was an early ‘expert through experience’, something that possibly sparked his philanthropy. You can get a glimpse of his story here. It’s fascinating.

The early Rathbone training programme produced 18 trained nurses, all of whom went on to work in different districts across Liverpool. From the very beginning the role of the District Nurse was to promote health and prevent illness rather than only simply treating the sick. Their clinical arena was the patient’s home. The role of the District Nurse today still has these elements at its core, albeit the world and indeed the nursing profession have changed significantly since that time. Queen Victoria’s money (plus an additional £68,000 she donated from her Diamond Jubilee funds) was used to establish the Queen Victoria’s Jubilee Institute for Nursing, now a charity known as the Queen’s Nursing Institute (QNI). You can read about their history and work here.

Whilst contemporary health policy has foregrounded integrated care being provided at place (neighbourhoods and communities), the pandemic has focused on our acute hospitals and the unimaginable demands they have faced during the last 18 months. However, despite the pandemic appearing to be in a less ferocious phase, our hospitals are busier now than they have been for many a year. The demands upon our emergency care, children’s and ambulance services are unprecedented. In acknowledging this, I am also mindful of the work that goes on every day in primary and community care. District Nurses are very much in the frontline of this work.

So last week it was great to be able to venture out of the office in Stockport and meet some of my District Nurse and Community Nurse colleagues. Interestingly for me, my first stop was on the 9th floor of an office block, which housed a group of people providing our ‘discharge to assess’ service. This service model was introduced by the UK government last year and was aimed at improving the flow from acute hospitals to the community, avoiding emergency re-admissions and facilitating an individual’s recovery at home rather than in a hospital bed. Additional funding was made available to provide care post discharge for up to six weeks. Unfortunately, this funding might cease in September this year.

What impressed me about what I saw and heard described was the way in which my colleagues had developed this service. They did so without much in the way of official guidelines, but from what they knew might be a way forward based upon their own experience. So, across what looked like any other call centre was a very sophisticated operation that picked up individuals who were medically fit to leave hospital in order to get them home and supported until such time as they were able to look after themselves. District Nurses played a part, but so did other healthcare professionals, social workers therapists and other care professionals. There was a link, (in real time) to our emergency department (ED) dashboard so that early intervention could be put in place before folk were sucked into the ED system. Equally impressive was the work that was being done with people who lived with long-term conditions. They could be supported to live in their own homes and when and if they needed a little bit of support to help them stay there, it was available.

Which brings me to Tina. It’s her real name, and I can only apologise for not asking her permission to include her in this blog. I have asked her to come and speak to our Board in October so maybe she will accept this is a bit of a long-winded introduction to that presentation. Tina has been a District Nurse for some 27 years. That in itself is remarkable. She had a great story to tell of her journey, which it would be unfair to share here. She can choose to do so at our Board. Suffice to say, it was a story that acknowledged great change, but more impressive for me was her notion that the story was never ending. If I ever need the care of a District Nurse, I know I can rest easy in the knowledge that those attributes Rathbone wanted to see as an outcome to the training and education of future District Nurses is right here, right now, and can be seen in those District Nursing folk who, each and every day, #makeadifference to so many people.