Shadowing a district nurse showed me their value

Since becoming chief executive and registrar of the Nursing and Midwifery Council (NMC), it has been an ambition to gain some understanding of what it is like to deliver care as a nurse or midwife in the UK.


Experiencing the demands of delivering patient care in the community was an ambition fulfilled last week when I shadowed Parveen, a District Nurse at Guys and St Thomas' NHS Foundation Trust in London.

It was a fascinating and eye-opening day, which highlighted for me some of the very real challenges nurses face in delivering care in the community, especially in deprived areas.

Our first port of call was an elderly gentleman who was living with dementia and diabetes. Living alone, in a deprived part of London and with little access to support, Parveen could see straightaway that what was needed from her and her district nursing colleagues was more than they initially expected. I observed with admiration how Parveen managed a patient with complex needs with kindness, professionalism and skill.

The second visit to a husband and wife was no less challenging. There were obvious signs of poverty, and a real need for 24-hour care; the husband had a serious heart condition and his wife had dementia. Parveen spent a lot of time with both of them, providing care and comfort to a couple who had no support and were living well below the breadline. I found this visit particularly sobering - to see two elderly people in such a situation was very tough.

Our final two visits were to patients nearing the end of their lives. I found these visits to be particularly poignant. Seeing the impact that terminal illness can have on a patient’s family and friends added a new dimension to the visit. It highlighted how a patient’s loved ones need care and compassion too, which Parveen displayed in abundance.

Shadowing Parveen for the day gave me a small insight into the world of district nursing, and brought into focus the harsh reality of delivering community care in the UK. It is not an easy job to do, and is certainly not for the fainthearted.

Watching Parveen go about her work reminded me that nurses and midwives working in the community are a lifeline to the outside world. The nurse or midwife who visits a patient may be the only person they interact with that day.

For me, this is why the NMC exists – to ensure that those who are privileged enough to provide care to those most vulnerable in our society have the right mix of skills, knowledge and compassion.

This was a really valuable experience which helped me to understand what life is like on the frontline. I would like to thank Parveen, and Guys and St Thomas’ NHS Foundation Trust, for facilitating this for me.

I am now looking for some other shadowing placements. Please do get in touch if you feel you could offer me an insight into your working world. Email me at: ceoffice@nmc-uk.org or send a tweet to @JackieSmith_nmc

About the author

Jackie Smith is chief executive of the Nursing and Midwifery Council