Achieving congruence in ‘being and doing’ community nursing

Abstract

Conceptual and theoretical frameworks for person-centred community nursing practices have not yet been fully developed. There is a need to explore this further in order to guide future district nursing, which forms part of the community nursing discipline in the UK. The contemporary district nursing role is undergoing change, although there appears to be little consensus about the district nurse's (DN) vision across the UK, and little indication of the theoretical position underpinning this change. Meeting strategic requirements ( National Health Service (NHS), 2019 ; Scottish Government (SG), 2017a & b ), DNs have advancing clinical expertise and are recognised for their technical skills. However, one may contend that this emphasis on ‘doing’ in practice contributes to practice decisions made exclusively on task performance by strategic decision-makers, and DNs continually viewing themselves as invisible ( National Assembly for Wales,, 2019 ; Queens Nursing Institute (QNI), 2006 ; Dickson 2018 ; 2020 ). District nursing education may contribute to this lack of clarity as curricula are based on borrowed theory from other disciplines that continue to focus on ‘how to do’, with little emphasis on ‘how to be’ a DN, and the continued decrease in DN numbers across the UK may be a consequence. In this paper, I explore current evidence that underpins district nursing practice, education and research in the UK, and advocate the use of the Person-centred Practice Framework (PCPF) ( McCormack and McCance, 2017 ) as a means of unifying and guiding ‘being a person-centred DN.’ This will enable practitioners who can draw on multiple forms of evidence to inform their advancing practice. This article offers philosophical and pedagogical principles to underpin person-centred education going forward. I argue this will promote congruence between ‘doing’ and ‘being’ a DN, giving a voice to DNs, and direction to their specialism.