For those on the BSc Nursing with Registration as an Adult Nurse, within the first week of the programme of study, there is the option to choose the Central North West London and Imperial Community Care Pathway. This means that clinical placement experience throughout the Adult programme will mainly be in the community.
Your academic pathway will remain the same as students who choose to undertake their placement in the hospital setting. Practice elements will be supervised and assessed under the same standards for supervision and assessment as hospital students. Clinical placement mostly lasts six weeks in the first two years, and longer in the third year.
Over the three years, you will undertake a mixture of community and hospital placements, learning how to care for housebound patients and those with complex care needs. Your hospital placements will best place you to work in more acute, emergency or critical care areas, such as the Emergency Department or Intensive Care Units. You'll learn how to work with specialist community nursing teams, and hub and spoke experiences. By Year 3 of study, you'll be geared more towards working independently in the community, with placements including spoke leadership experiences. This will include time spent with the senior leadership teams, for example education leads, clinical leads or patient safeguarding teams.
Below, recently qualified Community Staff Nurse Amanda Looby Tierney writes about joining a community nursing pathway for her Adult Nursing degree. This was written as part of the London Higher #StudyNursingLondon campaign and originally appeared as a blog for London Higher.
A day in the life of a Community Staff Nurse: Amanda Looby Tierney (BSc Nursing with Registration as an Adult Nurse, 2023)
Discovering a community nursing pathway
Just as I was starting my nursing degree, I was offered the option to apply to join the community nursing pathway that my university was offering within their adult nursing programme. I will admit that the idea of working as a nurse outside of the traditional hospital setting had been something I had considered before applying to universities, but I had started my degree expecting to spend the next three years in hospital placements and looking forward to experiencing as many differing placements as I could.
Traditionally, you are placed with an NHS trust and you complete your placements at the hospitals within that trust. With the community pathway you still completed hospital placements, but the idea was that this would be once a year with the other placements being in the community. This idea was something that excited me. It seemed that I could get the best of both worlds: practical experience in both acute and primary settings.
Why it was important for me to learn on community placements
With nearly 90% of care provided to patients in primary care settings, it made sense to me to learn how to nurse outside of hospital wards. However, although universities try to give their students the experience of a community placement, this is not guaranteed and so I applied for the community pathway and I was accepted onto it. By the end of my degree I had completed half of my placements in hospitals and half community nursing teams. I feel my education, my personal and professional development was hugely enhanced by gaining so much exposure to community nursing and I consider myself extremely fortunate to have received a full and varied experience of nursing in general.
In the community I was able to immerse myself in learning directly from clinical nurse specialists. On hospital placements I was able to request to shadow any clinical nurse specialist I met but this was typically for a few hours to a day only. In community placements I would do this for weeks often with the option to request shadowing with other disciplines of CNS or allied professionals. I was able to learn in depth not just how to nurse according to care pathways but also more in depth about the health conditions that were the speciality of the placement. I experienced nurse-led care first hand and could explore treatment options from a nurse’s perspective.
The most important thing I learnt on my placements
I learnt how to care for patients where they feel most comfortable, whether that was a clinic, a community hospital or in their own homes. I saw first-hand the benefits of continuity of care and the formidable therapeutic relationships that they had developed with their patients and their families. The experience of nursing education on the community pathway showcased the huge variety and potential avenues of nursing that I could pursue once qualified.
Becoming a Community Staff Nurse after graduating
I qualified as an adult nurse about six months ago and started my nursing career as a Community Staff Nurse in a district nursing team in London. There has not been a second where I thought maybe I’d have preferred to do anything else. Community nursing is challenging and complex. You have to have the ability to establish that instant rapport as you would on a ward but then there is the unique aspect where you have to maintain this for as long as the patient is on your caseload which can be years. You usually work alone, often you are the only clinician in the room with the patient. I have found that my clinical decisions are generally more respected by other professionals involved in the care of our patients then I experienced when on placement in hospital. There is also the point of providing care in people’s homes which means you can never be sure what you are walking in to.
This role is impossible to do without delivering true holistic care so you may go to see a patient with a routine District Nurse visit care plan to find a situation that is very different then you were expecting. You have to be able and ready to deal with everything. I find this so very exciting and I feel I am able to genuinely make a difference to my patients, their families and the community where I practice.
I have no doubt that that completing my nursing degree on the community pathway equipped me with the skills, the knowledge and the confidence to do what I do today. The possibilities for career progression are endless and I am excited to see where my community career will take me.