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Home nursing - a new career horizon

Home nursing: RDNS district nurses
Photo: Home nursing: RDNS district nurses
Home nursing is dusting off its old-fashioned image to showcase itself as a diverse, modern career that embraces cutting-edge technology and offers a wealth of job opportunities, writes Karen Keast.

Home nursing is proving to be a new career frontier for nurses.

Home nursing, where health care is provided in the home environment, has come of age – not only providing nurses with a varied, challenging and rewarding career but one which is also focused on the future to meet increasing demands.

Australia’s population is rapidly ageing. Government statistics forecast the number of Australians aged over 65 is set to double to almost seven million people in the next 30 years.

With a public health system already under stress, the government has turned its focus to a raft of health reforms, including more home care packages, aimed at keeping people living in their homes for longer.
And that’s where community nurses such as Kirsty LeGassick and Kosta Michalopoulos come in.

Kirsty, 38, was working as an EN in a Victorian hospital and studying to become an RN at university when she knew she needed a change of scenery.

The mother-of-two routinely came across patients who accessed Australia’s largest provider of home nursing services, the Royal District Nursing Service (RDNS).

Kirsty also visited a nursing and health expo where she spoke with RDNS nurses and spent her final university placement at the RDNS Knox site, when she realised she had found her new calling – to home nursing.

“I thought - that’s definitely for me, working out on the road in people’s homes,” she says.

Fast-forward two years, and Kirsty now works three days a week as a grade two district nurse for RDNS, which employs more than 1200 registered nurses.

Kirsty covers a large geographical area within the Yarra Ranges and visits between 10 and 15 people in a shift, with time allocated for travel.

Her clients range from people with dementia needing assistance with their medicine to people who have suffered strokes, people with wounds, those recovering from surgery and those with cancer.

“Home nursing is providing holistic care to a person in their home with a goal of keeping them in the home and working with them as a team,” she says.

“It’s diverse. A lot of people think when you do RDNS it’s just wound care but it’s not, we do everything.

“I love that you might be going there for one thing and you then can really make a difference to a person’s life by picking up on other things – they might need help with a wound or you realise they are not having much support with meals so you can help them out by referring them to Meals on Wheels.

“It’s not just one part of nursing, it’s holistic and that’s what I really love.”

Kirsty’s car is her office. She carries her computer and phone with her in what is mostly an autonomous role but where she can tap into RDNS support when required.

She says working on a variety of sites also poses its own challenges, from “not always having everything at your fingertips” to occupational, health and safety issues ranging from clients’ dogs to slippery surfaces.

“I think people are afraid they are going to come to community nursing and not use their skills,” she says.

“I think it’s the opposite – you have got to use your skills more and you are working in an ever-changing environment and nothing is ever going to be the same twice.

“You have really got to think quick on your feet.”

The home environment can also pose challenges for the patient, which Kirsty can assess and address.

“Every environment is different and challenging. I have one client who chooses to live with no electricity and water in his house and he’s 90,” she says.

“I love going there. He has so many wonderful stories. You can really build up great relationships with your clients and just learn so much about people.

“You really see what they are like in their own home and you get a full picture.”

As home nursing faces an ever-increasing demand, the sector is also embracing and even pioneering cutting-edge technology.

RDNS has been trialling an innovative telehealth project aimed at connecting clients with nurses at its customer service centre at Camberwell, for medication management.

Clients use a remote broadband monitoring system, featuring a purpose-built hand-held device with a large video conferencing touch screen.

The move towards virtual nursing not only eliminates the need for RDNS nurses to travel, requiring less time on the road, it also provides nurses with additional time to care for more clients.

Home nursing also offers a variety of career opportunities, enabling nurses to specialise in areas such as wound management, Diabetes, palliative care, medication administration, self-management and dementia.

Kosta is another district nurse who loves home nursing.

The 35-year-old was a surgical nurse in Greece who moved to Australia in 2002.

When his qualification wasn’t recognised in Australia, he worked as a carer in a nursing home and also studied full-time before deciding to venture into home nursing with RDNS almost two years ago.

“Because I had been working in aged care in nursing homes, I realised the importance of being able to keep the client home as long as possible,” he says.

“I wanted to work in community nursing and make a difference that way.”

Kosta says he thrives on being able to build long-term, professional relationships with clients and their families.

“You are able to see the difference you make in the clients’ lives and you work around the clients’ needs with a holistic approach,” he says.

“I really love working with the veterans; we have lots of veterans that we look after, and we have discussions about the war – it’s amazing, the stories people have.”

Kosta says home nursing does have its challenges.

“Because you are working in the community, you are working independently. It sounds really appealing but it can be quite challenging,” he says.

But he wouldn’t have it any other way.

“I think we are doing something really good,” he says.

“I plan to stay with home nursing because it’s quite rewarding.”

It’s a sentiment Kirsty echoes. She says her move into home nursing was the “best decision ever”.

“You are working as a team with the client and their family – it’s really nice. It’s a really nice nursing atmosphere. You are not stuck in four walls,” she says.

“It’s such a rewarding field to be in. It’s a career - I won’t leave community nursing.”

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Karen Keast

Karen Keast is a freelance health journalist who writes news and feature articles for HealthTimes.

Karen regularly writes for some of Australia’s leading health news websites and magazines.  In a media career spanning 20 years, Karen has worked as a senior journalist in newspapers and television. She has covered the grind of daily news and worked as a politics reporter at countless state and federal elections.

Since venturing into freelance writing five years ago, Karen has found her niche in writing about the health sector for editors, businesses and corporations.

Karen has interviewed the heads of peak health organisations in Australia and overseas, and written hundreds of news and feature articles covering the dedicated work of health professionals who tread the corridors of hospitals and health services, universities, aged care facilities and practices, day in and day out.

Follow Karen Keast on Twitter @stylemywords