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Thursday, 22 June, 2000, 12:36 GMT 13:36 UK
The role of the community nurse
District nurse
District nurses are in a position of trust
With more sick children being treated at home, the role of the community nurse is becoming more influential.

Community nurses work in schools, GPs' surgeries, and as district nurses, health visitors and specialist children's nurses.

Adult community nurses may provide care to terminally ill patients or people with chronic, long-term conditions in their own home.

Community children's nurses tend to look after youngsters who are terminally ill or those with long-term chronic conditions such as cerebral palsy, muscular dystrophy and heart disorders.

Types of community nurse
Health visitors
District nurses
Adult community nurses
Community children's nurses

The parents take on the bulk of the caring burden but often need help administering drugs, changing feeding tubes or setting up ventilators.

Many doctors now believe that sick children respond better to treatment when they are able to stay at home rather than hospital.

This means that the role of the community children's nurse is increasing in importance.

It also means that powerful drugs - such as those used to treat cancer - are being stored away from the close supervision of a hospital.

Although they cannot prescribe drugs for children, the nurses are free to determine dosages from a doctor's prescription.

Community nurses are many patients' closest link with the NHS, and often get close to those they treat and their families.

They are increasingly developing specialist skills, and are given a great amount of professional autonomy when administering drugs.

Clearly people - doctors and nurses - who go into people's homes are in a particular position of trust

Christine Hancock, Royal College of Nursing

Christine Hancock, general secretary of the Royal College of Nursing, said: "Nurses who work in people's homes obviously have much less close supervision.

"But they work within a management system, and supervising the actual practice of those nurses is an important part of that work.

"Clearly people - doctors and nurses - who go into people's homes are in a particular position of trust."

There are an estimated 30,000 full-time equivalent community nurses, although many work part-time.

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