Covid-19 has changed many aspects of life and work and for none more so than those working in the health service.

Images of doctors and nurses in hospitals wearing PPE has become the new norm while the pandemic has impacted on how some services are being delivered.

But those who are out and about in the community tending to the housebound such as the District Nursing teams have also had to adapt.

There are nine District Nursing teams covering the Fermanagh area. Each team consists of Team Leader/ District Nursing Sister, who has undertaken further training as a Specialist Practitioner and Nurse Prescriber.

District Nursing Sister, Brenda Dolan and Sister Melanie Cox are over a team which covers a large rural area in Derrylin and Florencecourt.

“Our teams have community staff nurses, and health care assistants, who are competent, skilled professionals with many years’ experience,” explained Brenda.

“Over the years as care focus has moved to community, staff have undertaken enhanced training to facilitate their extended role to deliver care in the home. “

The District Nurses work closely and have a good working relationship with GPs, carers both formal and families, Social Workers and Occupational Therapist teams.

District Nurses work 9-5 seven days per week, 365 days a year delivering quality nursing care to patients in their own homes with their work complimented after 5pm by the Rapid Response Nursing teams.

Brenda explains some of the care delivered by the District Nursing teams: “Examples of care delivered include administration of medicines, wound care, assessment of risk and supply of equipment to support home living, venepuncture, continence, oncology treatments and after care, and end of life to patients in their last weeks, days of life. New staff remark about the extensive skill set required and the variety in our role.”

Now to add to the years of training and experience, District Nurses have had to change the way they work because of Covid. And while there was some trepidation at the beginning Brenda’s team have adapted to the new way of doing things.

“Covid-19 has changed the way most people work and it has also impacted on the way we deliver our care.

“Staff were anxious and felt vulnerable in our roles on the front line, but we adapted quickly and rose to the challenges, well supported by our line managers Elaine McGowan and Siobhan Maguire.

House to house

“As staff travel from house to house, we have always been meticulous with infection control measures. Additional training specific to Covid-19 ensures that staff work within the recommendations so that our patients nursing needs can be delivered safely. PHA guidelines dictate the PPE required and we wear disposable apron, gloves, fluid resistant mask and Visor in all homes. Gowns and FFP3 masks are required for some procedures.”

With the vaccine rollout gathering pace in Northern Ireland, District Nurses have been given training to administer the Covid vaccines for patients who are housebound.

Brenda says patients who have received the vaccines are “very grateful” and “appreciate that our work has never stopped as an essential service, care requires to continue to be delivered, whatever the circumstances”.

One of the biggest affects of the Covid-19 pandemic is the amount of social interaction people can have. For many patients who are housebound their District Nurse might be the only social interaction they have.

Brenda believes that the pandemic has highlighted the unique role of the District Nursing Service in community care delivery.

“Social isolation has been a major problem especially for older patients, missing their family and neighbours visits. Building relationships, supporting and enabling patients is part of the district nurses role in holistic care delivery and this Covid-19 has further enhanced this,” added Brenda.

District Nurses will continue to deliver high quality skilled nursing care to patients in their own homes, a varied role core to the primary care teams and as Brenda puts it: “It is a privilege to care for people at home at a time when they and their families need us most.”