Understanding the value of the District Nurse qualification – A District Nursing Student’s perspective – early analysis. Jane Young, Dr Susan Walker, Kellie Norris FHSCE - with thanks to Anglia Learning and Teaching.

Background Demands for delivering health care in the community is known to be an area that is set to grow as populations living with multiple co-morbidities live longer (WHO, 2015; NHS,2017). Additional specialist qualifications can be obtained post nurse registration such as the Specialist Community District Nursing (SPDN). This requires qualified nurses to undertake a minimum of 32 weeks FT/PT (equivalent) Min degree level study, spending 50% of time in practice and 50% theory (NMC, 2001). DN Curricula is mandated by the NMC -  Nursing & Midwifery Council (NMC) standards for Specialist Community Nursing, Education and Practice (NMC 2001) .

The Department of Health model reinforces the role and contribution of the SPDN and comprises three core elements: Population and caseload management. Support and care for patients who are unwell, recovering at home or near the end of their lives. Support and care for independence. (QNI, 2015) SPDNs make up approximately 20% of the community nursing teams. Health Education England increased district nurse training places by 7% in 2014-15 (RCN, KCL, 2014). SPDN Training resumed at ARU Jan 2014 after a 7 year absence.

The SPDN specialist qualification is locally, nationally and strategically valued(QNI, 2015), yet there is very little research that seeks to understand its value or the application of this education in clinical practice. Aims: To understand from a SPDN students perspective, the effects and application of acquired learning over a 12 month full-time SPDN course. To understand what works well and what could be improved, in terms of teaching methods and course delivery.

Participants Jan 2016, FT SPDN Course, 2 campus’ Cambridge Chelmsford   Cambridge Chelmsford Participants/Students 7 /7 11 (male 1) /12 Yrs Qualfied: mean 10 (4-31) Yrs Community: mean 6.86 (1-27)

Methods Each campus : 4 x Focus Groups (within 4 weeks) at start of SPDN training, 6 months, 12 months and 24 months (12 months post qualifying). Focus Group led by academic member of staff not part of the DN teaching team. QNI (2015) voluntary standards were used to guide questions. 3 out of 4 FG have been undertaken on each site. FG uptake (100%- 92%) although attendance varied at each FG. Cambridge FG attendees : n7 (4-6) mean - 5 Chelmsford FG attendees: n11 (6-8) mean - 7.3

Results Transcripts analysed by Beebe (2014) Rapid Analysis Approach – themes mapped to 4 QNI domains, ‘being a student’ and ‘others’ Clinical Care Current practice & new skills ie evidence improving care, caseload management, empowerment pts & staff, Leadership & Operational Management Previously (theoretical) knowledge weak, organizational process’, leadership defined by individual, thinking out the box, adapting your style, empowerment, confidence Facilitation of Learning (from a theory to practice perspective) working with others – barriers and enablers, include weakness’ of staff, location. Evidence, Research & Development Time is a barrier, being critical of research, improved awareness, desire to keep up to date, enthusiasm of others ‘Being a Student’ Benefits and challenges – pushing you are achieve, time to investigate, being a DN, loss of established links/positions, Others Progression of learning, change to develop self, meet other students, theory to practice. refreshments provided no remuneration. – built FG into students days at Univ (post teaching) RAP – why this approach? - Transcripts analysed at this stage as one group as teaching was the same – deeper analysis at study completion may result in separating the students by campus.

Discussion points Students were able to highlight elements of learning that derived from practice and theory. Linking and relating the two. No learning specific points from pragmatic teaching particularly arose, although 1 student requested clearer objectives for in one particular module.

Conclusions QNI conference submission Plans for ongoing study of research participants ? Cohort.

NOT for sharing (Notes to Jane) Clinical care – NMC (2001) Clinical Practice   Leadership & operational management Care and programme management Facilitation of learning Clinical Practice Development Evidence, research and Development Clinical Practice leadership

Results