Meet Leeds’s frontline NHS community nurses visiting patients in their homes

District nurse Rachel Bishop, who provides nursing care to people in their own home who are housebound and over 18. Visiting Vivienne in her Leeds home.'7th March 2018.
District nurse Rachel Bishop, who provides nursing care to people in their own home who are housebound and over 18. Visiting Vivienne in her Leeds home.'7th March 2018.
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They’re the unsung heroes providing a vital frontline service to vulnerable people in Leeds, always carrying out their duties with a smile on their faces.

Today the Yorkshire Evening Post is shining the spotlight on the city’s community nurses as part of our We Love Our NHS campaign, which aims to praise dedicated healthcare workers across the region.

Rachel Bishop visits Mark in his Leeds home. 7th March 2018.

Rachel Bishop visits Mark in his Leeds home. 7th March 2018.

Often unseen and misunderstood, nurses with Leeds Community Healthcare NHS Trust’s Neighbourhood Teams support adults in their own home, which is fast-becoming the NHS’ preferred model as the health service places an increasing emphasis on community-based care.

The YEP was invited to spend the day with one of the trust’s community nurses, Rachel Bishop, who is based at Tribeca House on Roundhay Road.

Nurses spend an average of up to six hours per shift visiting patients, whose needs range from palliative and end of life care, to wounds or long-term conditions.

In a departure from hospitals - or even GP practices - often the same person will visit a patient regularly.

“In hospital, you won’t get to see end result of care, but we do,” mum-of-two Rachel said.

“You can build better relationships with people and you have more time to give care.

“Generally patients are really grateful for us visiting. A lot of them become quite connected to some of the nurses.”

Armed with a laptop and her car keys, the 34-year-old sets out on the first job of the day in East Leeds.

Rachel’s first patient is 68-year-old Vivienne, who lives alone, and the pair have met before during previous visits.

As a result of Vivienne’s complex needs, she has suffered from bilateral oedema - swelling in the legs or feet - for more than two years.

“Do you think they look any better?” she nervously asks the nurse, as Rachel begins to peel back one of her dressings while kneeling down on the living room floor.

“Definitely,” Rachel replies, with confidence and optimism in her voice.

“Are you going anywhere today?”

While changing the dressings, applying cream and washing her patient’s feet, Rachel skilfully interweaves questions asking Vivienne how she has been, if family are visiting and whether she is planning on leaving the house.

Far from a scatter-gun approach, she is logically, and sensitively, carrying out a holistic assessment alongside her care duties, to check on her general wellbeing.

At one point Vivienne’s legs were leaking fluid and so swollen that a nurse was visiting her twice a day to change the bandages.

The issue was made worse because she had difficulties getting into her bed at night.

But recently, the team managed to order her a specialised hospital bed for her home, and the swelling is beginning to subside meaning she only needs one visit every other day.

“Right, if you want to bob them in,” Rachel says, clasping a bowl filled with warm water as she opens some cream.

“This is an antimicrobial - it helps with the itchiness and dryness.”

Vivienne points out that the nurses are always prompt and friendly when they arrive at her door, and she often gets to see the same one. “They know what I like now,” she says, smiling at Rachel.

“When I pick the phone up and explain what is wrong, they are always really helpful.

“They come in and they have a look and do whatever they need to do.”

After a few more checks and some light conversation, Rachel, who is currently training to be a district nurse at the trust, fills out her notes and is back in the car.

It’s a 10-minute drive to her second visit, a patient who has completely different needs to Vivienne.

Mark, 52, has cerebral palsy and suffers from constant pressure sores because of his lack of mobility. The latest painful sore on one of his legs appears to have been caused by rubbing against the skin from a panel on his wheelchair.

“So how’s it feeling now Mark, your leg?” Rachel asks, as she takes off his dressing to inspect the sore.

“It’s probably the worst bit - taking the plaster off - isn’t it? It’s like a wax.”

“Yes,” he chuckles.

After changing the dressing, Rachel checks that Mark is happy with his current wheelchair.

Crucially, she also asks about his future appointments, if he has transport booked and how he is doing day-to-day.

As well as standard visits, the neighbourhood teams also help patients undergoing chemotherapy treatments, and is capable of providing cardiac, tracheostomy and end of life care.

And even the weather can’t stop them.

When the Beast from the East ground Leeds to a halt last week Rachel, who lives in Bradford, wasn’t able to travel to the city for work because of the snow.

Instead, she put out messages on social media asking if anyone nearby was in need of nursing care.

“I did some visits around my own local street in Bradford because I could not get into Leeds,” she says.

“Otherwise, they are not going to get it.

“It’s a job you do because you love it.

“You either have that sort of personality or you don’t.

“I say to my husband: ‘even if we won the lottery, I would still want to be a nurse’.”