Professor Julie Green

Pressures on placement availability within healthcare programmes impacts on student experience. Our community nursing teams are under increasing pressure, their teams are frequently being relocated and merged and the acuity of home-based patients is changing due to population demographics. These changes have the potential to impact on the breadth of student clinical experiences. A re-badging of all of our 'out of hospital care' as ‘home nursing’ here at the School of Nursing and Midwifery, may serve to limit a student’s access specifically to District Nursing placements since, in effect, these placements may be replaced by allocations to chronic and long term condition services such as Heart Failure services or the Diabetes team. Whilst it can be argued that these ‘home nursing’ experiences are also community based, they provide a very different insight into the care provided within a patient's home compared to a full District Nursing placement.

Patient stories of their experience of the care delivered by District Nurses, along with their teams, and the experiences of the carers that support them, provide our students with an insight into the lived experience of those who receive these services. This resource is invaluable to all students but specifically for those who are not able to experience a ‘full’ placement with the District Nursing Service.

The output to this project is a book entitled 'Collected Stories: being cared for at home'. This is an educational resource for case based learning for current and future cohorts of students, allowing them to explore the impact and experiences of patients and carers in receipt of care in their home.

Students are allocated a story to consider in their small group work, with discussions and debate centred on the experiences of the people involved. Discussions are then used in feedback to a larger group. The stories provide students with a rich insight into the experiences of ‘care at home’ from the perspective of the patient and their loved ones, ensuring their discussions are focused on a patient centred evidence base. We have a number of examples of positive feedback from student groups both at Keele University and elsewhere.

The 'Collected Stories: being cared for at home' book has been rolled out within the School of Nursing and Midwifery and sessions have been formally evaluated. Recent reapproval events for our Specialist Practice curricula with the Nursing and Midwifery Council, have utilised the book as evidence of user and carer involvement in our programme delivery. This resource effectively evidences the involvement of our partners and is used to inform curriculum development, especially for this hard to reach group.

Within nursing, the resource is used within our post-registration programmes, with a clear and immediate fit with the long-term conditions and specialist practice programmes. Use of a single case or the resource as a whole, challenges students to review and re-evaluate the care they deliver.

With the aim of the book being to enhance student knowledge of the care delivered in the home environment, this booklet presents an innovative, reusable resource which is not available elsewhere across the United Kingdom. The use of patient stories is known to bring the reality of the patient experience, good or bad, to students and to enable learning by applying case-study methods. Patient stories are an excellent technique to embed student learning in the reality of experiences of the end recipient of care and to raise awareness of the impact of ‘simple things’ on the patient's experience. This resource serves to enhance student awareness of the experiences of District Nurses and their teams, providing learning situated in the recollections of the patient users and carers.

Imaginative illustrations enhance the stories and target student learning on the key features of the story. Utilising an experienced illustrator, who has been involved in other projects within the School, highlights key learning features within each of the stories. The production of a resource that is professional in appearance has enhanced its use and has provided a resource that can be shared. The Queen’s Nursing Institute and Royal College of Nursing are keen to ‘evidence’ the impact of District Nurses and their teams; this resource goes some way to evidencing the impact of this ‘Cinderella service’.

This is the second of three story books all entitled 'Collected stories'. All are useful learning resources.

The other two are available at:

https://indd.adobe.com/view/8be91b37-72b4-4838-b310-c3df5962f94d [read Fading Violet on page 10]
https://indd.adobe.com/view/2aa6b847-db02-4e38-95dc-74fc41437b2a

We have had a number of publications/presentations to disseminate this project:

Green, J. & Wood, P. (2018). Collected stories: being cared for at home. The Journal of Academic Development and Education. Keele University. August 2018
Green, J. & Wood, P. (2019). Collected stories: being cared for at home. The development of a story book resource. Keele University KIITE Conference, 30th January 2019.
Wood. P. & Green, J. (2019). Collected Stories: being cared for at home. All Queen’s Nurse Meeting, London. 22nd March 2019.
Wood. P. & Green, J. (2019). Collected Stories: being cared for at home. Nurse Education Today, Keele University. 3rd-5th September 2019.