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Employers' duty of care to district nursing team members: health and safety concerns with lone domiciliary visits

02 August 2019
Volume 24 · Issue 8


District nurses and their teams often work in isolation during domiciliary visits. As employers, providers of district nursing services have responsibility to ensure that appropriate policies and procedures are in place to keep district nursing teams safe. If the employer fails to do everything that was reasonable in the circumstances to keep the employee safe, the employer can be deemed to have breached their duty of care. Employees also have responsibility for their own health and wellbeing at work, and they are entitled by law to refuse to undertake work that is not safe, without fear of disciplinary action. Staff training in risk management, personal safety, handling aggressive behaviour, using safety devices such as mobile phone trackers, incident reporting and debriefing are essential for district nurses and their teams, as they face a steeply increased demand for their services and a severely compromised skill mix within their teams.

The focus of this article is the duty of care owed by employing authorities to district nurses. Throughout this article, the term ‘district nurses’ refers to qualified nurses who have undergone specialist training in district nursing and hold the Specialist Practice Qualification in District Nursing (SPQDN. This is to distinguish them from ‘community nurses’ which, while including district nurses, also encompasses other nursing staff who may or may not be registered nurses, but who are also working in community settings as district nursing team members. Solo domiciliary visits expose district nursing team members to risks associated with lone working because they are usually working in isolation from other team members.

Negligence and the standard of care in district nursing to patients has been clearly set out in Griffith (2019). However, it is also important to consider the duty of care to district nursing team members, including promoting health and safety to ensure safe solo (lone) domiciliary visits, because it calls into question the responsibilities of employing authorities and, acting in accordance with delegated responsibility, those of district nurses themselves, who may be managing district and community nursing services. As team leaders and professionals, district nurses are responsible for ensuring that the workload, tasks, staffing structures and necessary supporting mechanisms are in place for other district nurses and their community nursing teams to undertake their work safely and to achieve the required standards of care set out by their profession, employer and the law.

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