Recognising and valuing the skills of a care home nurse
Kirsty Cartin QN, Care Home Manager, LittleInch Limited, Renfrewshire, Scotland
Just before Christmas, I decided to mark Advent by shining a light on the skills of care home nurses. Each day, I shared one skill on social media, offering a window into our practice and the depth of our role. This blog brings those reflections together and summarises the skills highlighted along the way.
Care home nursing is often misunderstood, yet it is a complex, skilled and relationship-based role. The care home nurse combines clinical expertise with deep personal knowledge of the people they support, keeping individuals safe, comfortable and in a homely environment.
Medication administration alone reflects this complexity. Care home nurses often manage the largest medication rounds in nursing, requiring detailed knowledge of each medicine, timely administration of critical drugs such as Parkinson’s medication, monitoring the effects of medication, and challenging polypharmacy by advocating for residents’ needs. Medication administration is a central responsibility in care homes, but it does not define the full scope of care home nursing. The role extends far beyond the medication round, encompassing complex clinical judgement, leadership, and compassionate care.
And what about other clinical skills? Wound care could be preventing pressure ulcers to assessing skin tears and leg ulcers, choosing appropriate dressings, preventing infection and ensuring comfort. Monitoring vital signs is not just technical; it requires reassurance, patience and emotional awareness, because emotions are vital signs too.
Care home nurses are expert observers. They recognise deterioration through subtle changes: someone not reading their paper, withdrawing from activities, or behaving out of character. They assess pain in people who cannot always verbalise it, noticing body language and behaviour, understanding that pain is not always physical.
Care home nurses safeguard vulnerable adults, balancing protection, choice and the realities of communal living. They write person-centred care plans with residents and families, grounded in outcomes and life stories. They support people living with dementia, managing stress and distress with detective-like curiosity, kindness and creativity.
From infection prevention, catheter and enteral feeding care, to falls risk assessment, nutritional support and emergency responses, care home nurses hold broad clinical responsibility, often working autonomously as the only nurse on duty. They lead multidisciplinary teams, advocate in adversity, and build trusting relationships with everyone in the home.
At the heart of it all are relationships – noticing people, valuing their choices, and keeping them in the place they call home. Care home nurses share many of the same clinical skills as hospital colleagues, but with something extra: deep, human knowing.