Nursing - a day in the life of:
A District Nurse & A Contact Centre Nurse
A day in the life of a District Nurse
Hi, I'm Caroline and I work part time which includes working on some weekdays and alternate weekends, although weekend work is by choice.
This suits me down to the ground as I can pursue my other interest in training and education outside of RDNS. 
Some of my colleagues work full time and some part time. Most of us start at 8am but we have an early start shift (0730) and a later start shift (0900) to cover the early morning and tea time medications.
My weekday round includes a group of the east/north-eastern suburbs, and my weekend round skims along the beaches.
On arriving at work, I usually spend about 15 - 30 minutes organising my worksheet, collecting stock, speaking to my Team Leader, arranging any additional help I may need from the palliative care specialist nurse for my terminal client, speak with my Clinical Nurse Consultant about a client with a difficult wound I’m due to visit tomorrow, then I charge off into the wild blue yonder in my Corolla. The fresh air and sunshine (most days) is fantastic.
The weekends are slightly different in structure as we cover essential services only. I usually visit a number of clients for medication administration for the first half of the morning. These clients usually need our care, seven days a week to be able to remain at home safely and it’s great that we can provide the care to allow them to do so. From mid morning, I visit my other clients providing palliative care and wound care.
Week days have a combination of these essential services and comprehensive client care which includes: organising services with Domiciliary Care and other healthcare agencies, admissions and assessments, care planning, client advocacy, counselling, liaison and review by specialist RDNS staff for my clients with complex wound care, palliative care, continence care, diabetes management, disabilities and mental health or behavioural issues.
I really enjoy the variety of clients and health conditions that I am challenged with (and the fact that fabulous support and assistance is there for me, if I need it). I may see anywhere from 5 to 18 clients in a day depending on what level of care is required. I’ve had some clients who have care requirements which have only taken 15 minutes and others that have needed 1½ hours.
A typical day will see me ordering supplies through the Client Support Officers, changing client’s schedules, contacting doctors, leaving messages for case managers at Domiciliary Care about a client we share, rearranging the round schedules to even out the workload and sometimes contacting the RDNS Call Centre (e.g. for information about a new drug one of my client’s has been prescribed.) There is often an admission scheduled later in the day for a new client. The end of the day back in the office is a good time to debrief, review and organise my work for the next day, and attend education if there is a session scheduled.
Some days go exactly as they should on paper. Other days, despite all planning and good intentions, the course of human nature and changes to clients’ health status impact on the whole round. What started out as a medication visit has the potential to turn into an exercise of managing services to deal with a crisis situation, e.g. a client falling in their home. If I do come across an unexpected situation I can always contact my Team Leader or CNC, my team mates or the Call Centre for advice and assistance.
Probably the biggest part of the transition from acute/aged care nursing to District Nursing is the increased level of autonomy to do my job and the relationship that develops with the client in getting to know them as a whole person. I feel really lucky to have found a job where I can make such a difference to people’s lives and really use and develop my nursing skills and knowledge.
Although it sometimes feels like I’m brushing through people’s lives at a rapid pace, I am reminded that my clients receive just as much care from me as being in a facility (i.e. hospital or nursing home) it’s just more concentrated. The big bonus is that I am giving individual quality time, the client has the opportunity to maintain a level of control and independence in their lives, and as their nurse, I can work with my client to deal with the issues straight away at the time of my visit.
I can honestly say I have had more job satisfaction in the last 3 months than I have had in the last 5 years before I joined RDNS.
A day in the life of a Contact Centre Nurse
My name is Nicole and I am a Clinical Nurse within the RDNS Contact Centre (called RDNS Direct) which is based at Glenside. I work full time, 5 days a week
with no weekend work. Currently I start at 0700 or 0800, however there are a
variety of start times and shifts, with people working part time, weekends and
after hours.
I am one of the Team Leaders and I lead the Core Business Nursing Team. Most of
the day I manage the referrals received by RDNS for both our public programs
divisions and Focus Healthcare (our private division). I do assessments and
problem solving with other staff members to provide the best possible care for
our clients. I also provide nursing advice to RDNS clients regarding issues such
as wound care, catheter care and general nursing advice.
There are approximately 8-12 nurses in the Contact Centre during business hours,
including Team Leaders, a Systems Support Nurse and a Clinical Manager. During
the day, we have three teams of nurses each working on specific contracts –
- core business
- health advice/incident reporting (AIMS)
- Advanced Community Care Association (hospital avoidance program)
We have 3 after hours teams to cover weekends, evening and night shifts. After
hours and at night, there are between 2 and 3 nurses working. Our teams are made
up of Clinical Nurses, Registered Nurses and Enrolled Nurses.
Coming into the
Contact Centre from working as a field nurse six months ago, I
experienced a significant change in my working life. The biggest challenge was
adjusting to assessing clients over the phone, without having the opportunity to
use my hands on skills (e.g. touch, smell and vision) to assist my decision
making. I have found my listening and questioning skills have really improved
and I am much more confident in my assessment skills. When I came to the Contact
Centre I thought I had really good assessment and clinical skills but I was
surprised to find that my assessment and clinical skills have developed more
since I came to the Contact Centre than when I was doing hands on work.
For me the best parts of this job are the positive attitude, the variety of the
work performed and the fun we have at work. I enjoy coming to work as there is
such an enthusiastic vibe and team spirit within the clinical teams. We have a
casual day once a month and that usually means lots of food as well as the fun.
The recent growth of the Contact Centre has us all excited about the care and service that we are providing to clients. Every day is different, whether you are providing health advice or setting up a nursing service for a client of the Advanced Care in Residential Living program, the work is never boring. In a normal day, I can go from providing health advice to a mother of a baby with a rash, to assessing incoming RDNS referrals for need and suitability.
The other good thing about the Contact Centre nursing is that it can suit nurses
with a variety of experience. Prior to working for RDNS, I was an Intensive Care
nurse. Other nurses in the Contact Centre have worked in public and private
hospitals, as midwifes and in emergency departments. I believe what makes a good
team is the variety of skills pooled together to provide the most comprehensive
care possible.
I can honestly say that I enjoy working in the Contact Centre more than I have
any other area of nursing. I love the feeling of satisfaction I get from
providing the best possible care to a wide range of individuals in need.
For information on other services visit our web site: www.rdns.org.au
