Queen’s Nurses in Primary Care

Guest blog by Paula Messenger, Nurse Advisor, Somerset LMC

I look back to January 2020 when I was busy juggling work, family life and writing my application to become a Queen’s Nurse… 

Little did I know that within weeks the country and the world would be hit by a global pandemic.

The Queen’s Nursing Institute is a charity that works to improve the nursing care of people in their own homes in England, Wales, and Northern Ireland. It does not operate in Scotland, where the Queen’s Nursing Institute Scotland performs a similar function.

The QNI’s main sources of funding are from grant-making organisations, donations, and investment income. The QNI is not part of the NHS and receives no regular Government funding. Its most important financial contributor on an annual basis is the National Garden Scheme, which was created by the QNI, and has supported the charity since 1927.

In 1859, Liverpool merchant and philanthropist William Rathbone employed a nurse named Mary Robinson to care for his wife at home during her final illness. After his wife’s death, Rathbone decided to employ Robinson to nurse people in their own homes who could not afford medical care. The success of this early experiment encouraged him to campaign for more nurses to be employed in the community.

In the 1880s, Elizabeth Malleson was concerned to find that there was little local service of nurses for pregnant women. Malleson arranged for a trained nurse and midwife to be available to serve the people of Gotherington. Malleson’s scheme was not the first, but she decided to form a national organisation and her appeal for help brought her into contact with Lady Lucy Hicks-Beach.  She was the wife of Michael Hicks-Beach, 1st Earl St Aldwyn, and they gathered enough support to launch a Rural Nursing Association. This was despite the opposition of Florence Nightingale. 

These were the beginnings of organised district nursing. By the end of the 19th century, with the approval of Queen Victoria, the movement became a national voluntary organisation responsible for setting standards and training nurses. In 1887 ‘the women of England’ raised a Jubilee Fund of £70,000 to mark Victoria’s Golden Jubilee. The Queen announced that the money should be used for nursing, and Queen Victoria’s Jubilee Institute for Nurses was chartered in 1889. Elizabeth Malleson’s nurses became the Rural Nursing Division in 1891.  Rosalind Paget was the main organisation’s first Superintendent, and later Inspector-General. Queen Alexandra agreed to be a patron in 1901, and a Queen has been Patron of the charity ever since. From 1928 the Institute was known as The Queen’s Institute of District Nursing until it assumed its present name in 1973.

The title of ‘Queen’s Nurse’ was first given to nurses who had trained at the QNI, but the institute no longer trains nurses. It does provide them with professional support and development. The QNI re-instated the title of Queen’s Nurse in 2007 after a gap of 40 years to safeguard and promote high standards in patient care.

Today’s Queen’s Nurses have experience of caring for people in their homes or in other community settings. In 2020, there were over 1400 Queen’s Nurses. 

The charity provides grants to nurses in financial need, and educational grants to support nurses taking accredited community nursing courses. In 2020, during the Covid19 pandemic, the QNI launched TalkToUs, a confidential listening service for community nurses to be able to speak to someone about work or personal challenges. The QNI also has a programme called Keep in Touch, that puts working and retired Queen’s Nurses together for regular phone contact.

Since 1990 The Queen’s Nursing Institute has supported hundreds of nurse-led projects through its Fund for Innovation.[7] Dissemination of project results also helps nurses in other areas to learn from and implement new ideas. The projects—led by community nurses, midwives or health visitors—set up new services or improved ways of working. Grants of up to £5000 are available, in addition to a full year of professional development and support. All project leaders benefit from a professional development programme, supported by the Burdett Trust for Nursing.

The QNI launched the Homeless Health Programme in 2007, piloted with funding from the Big Lottery Fund until 2010, to offer support to all community nurses, health visitors, midwives and other health professionals working with the homeless.  This initiative established a national network of homeless health professionals, offering training events, specialist publications and other support. 

What does being a Queen’s nurse mean?

A Queen’s Nurse is someone who is committed to high standards of practice and patient-centered care. The QNI supports innovation and best practice, to improve care for patients.

What are the Queen’s nurse values?

The QNI supports leadership, innovation, and best practice in order to improve care for patients. We believe that one way to do this is to bring together community nurses who share common values with a shared title.

To become a Queen’s Nurse, you must:

• Be currently registered with the Nursing and Midwifery Council.

• Have a minimum of five years community nursing or health visiting experience.

• Be currently working in England, Wales, or Northern Ireland with people in their own homes or other community-based settings.

The original closing date for applications was the middle of February 2020. I waited 4 long months before I received an email from the QNI informing me of the outcome of my application. 

I could barely open it and had resigned myself to be declined the award. 

Much to my surprise I was congratulated and advised my application had been successful. 

The Queen’s Nurse title connects you with a supportive professional network. Gives you access to the QNI free developmental programme, bursaries and networking. It also provides formal recognition of your commitment to improving care for patients.

There was not the usual QNI ceremony held in London to receive our awards and badges. The pandemic meant we had our awards and badges posted to us and an online zoom event was held. 

To my surprise it was an emotional few hours staring into my laptop, seeing all the happy faces of nurses just like me being named as new Queen’s nurses. A special film made by the cast of ‘Call the Midwife’ made it even more memorable.

Since then, I’ve had the honour of spending over a year as Deputy Chair for the Southwest Queen’s Nurses Group. Due to the pandemic, we held virtual quarterly regional meetings which brought so many of us together for support, sharing projects and discussing innovative ways of working.

I am very proud to be a Queen’s Nurse in Primary care and highly recommend any GPN to consider applying.

Paula Messenger RN BSc (Hons) QN

GPN Advisor Somerset LMC and GPN Wells Health Centre

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