Journal of Community Nursing

12 JCN 2020,Vol 34, No 4 planned a series of learning events around the country as part of our new Care Home Nurses Network, but we know that for many nurses, taking time off to travel to a seminar can be difficult. Now nurses can register online to join the Network and we will email details about future virtual learning events, which we hope will be easier for people to access: www.qni. org.uk/nursing-in-the-community/ care-home-nurses-network/ One other great benefit of the‘new normal’could be a real reduction in the NHS carbon footprint. Marcello Rossi, Sussex Community NHS Foundation Trust, wrote:‘This new way of working will be a permanent now, as it has worked so well for both trusts and patients. It will allow teams to assess patients remotely and have a consultation remotely. This will increase the capacity of the team to accept more patients and will be a first step to support the“Care without Carbon”trust project, as the journey to visit the patient will be replaced by a remote consultation.’ We have also asked nurses what barriers still exist. Not surprisingly, technology poses problems as well as solutions. Staff stress continues to be a major challenge and the QNI’s chief executive, Dr Crystal Oldman, has joined other nursing leaders in encouraging nurses to take annual leave while they can. At this stage, the trajectory of the pandemic cannot be predicted and there are concerns about how it will be compounded by winter pressures in six months’time. Attention is also being refocused on nursing recruitment and retention; we must have adequately resourced teams that have the capacity to deliver the care needed in the community. Finally, if you are experiencing workplace stress, please get in touch with us and arrange a call with one of our trained listeners who will be able to offer you some personal support: www.qni.org. uk/help-for-nurses/talktous/ C ommunity nursing services have had to adapt radically to the needs of individual and population health, because of Covid-19. The reduced opening of some GP practices was just one of the most obvious public impacts, as primary care moved to telephone consultations and other means of advising and signposting patients. Inevitably, some non-urgent care has been deferred and the impacts of this remain to be examined and assessed. The Queen’s Nursing Institute (QNI) is keen to learn from nurses about how they have adapted their services, with colleagues and with new technology, to cope with the pandemic. We put out a call for case studies during June and currently there is no closing date for new submissions, as we anticipate services will continue to innovate in coming months and years, as powerful new technologies become available. While the initial four months of the pandemic have been extremely stressful, there is also a huge amount of optimism being expressed by nurses who have finally been able to work around longstanding barriers. We have heard how some care delivery has become more convenient and person- centred, families have become more confident in self-care, and virtual consultations are easier for many people. Many nurses are reporting that they are now beginning to deliver on many ambitions of the NHS Long Term Plan that until recently remained hypothetical. Nurses have used Microsoft Teams to complete patient handovers and they can link with a GP more quickly and easily to discuss a long-term care plan. One district nurse, Jo Paterson, Midlands Partnership Foundation Trust, wrote:‘The nurses have been able to work remotely, utilising digital tech to access records and daily virtual handover, huddle and supervision. Patients identified for self-care were those with leg ulcers who have good cognition, ample dexterity and able to safely mobilise to apply dressings, with telephone support. In addition, those patients receiving B12 injections were reviewed and joint decision with patients and their general practitioner to assess their eligibility for oral vitamin B12 medication. This caseload review allowed our team to visit patients that were identified as high priority, such as those requiring end-of-life symptom management and nursing care.’ She continues:‘digital technology has supported us to facilitate continuity of care, enhancing communication between us and the wider multidisciplinary teams and specialist services to provide a seamless, joint working as best practice during these unprecedented times. It has been easier to connect to other professionals and build relationships. It is clear that our patients and team have been empowered; increased confidence through increased knowledge as well as building on new skills such as supporting patients over the phone, asking probing questions and recognising patients who may need more education or support to improve patient outcomes.’ We hope this description is familiar to other community nurses. Nurses have also reported how they can access training more easily online, increasing the speed at which they can develop skills and knowledge. This year, the QNI had Community nursing stories during Covid-19 Viewpoints Matthew Bradby, head of communications, QNI JCN