Community Health within Australia - Essay Example

Community Health within Australia Introduction In order to provide primary nursing and health care services, community nurses work across varied community set ups. In the traditional sense, these nurses not only manage diseases but also look after promoting public health and developing the community (Keleher et al.). For the community nurse, the client needs to be viewed in a holistic manner and should be given proper care taking into consideration the various relationships as well as social conditions that may impact the client’s wellness. It has been seen that in the recent past, the role of the community nurse has also changed considerably, with the shift in focus towards providing recovery care and helping the client transition from the environment of the hospital to the community set up (Davidson et al., 2006). Further, the community nurse also needs to look for any sign of relapse or complications and monitor the health of the client carefully to avoid admitting the client in the hospital. However, it has been found that community nursing in Australia is not a developed practice. Due to the absence of national policies, lack of proper training and education and little knowledge about the importance of community nursing has resulted in the under-development of this nursing practice in Australia (Diamond, 2001). This paper would focus on the role of community nurses in Australia and address various issues that are affecting the role of community nurses. Further, the paper would also highlight some of the qualities that are required to become an effective community nurse. In the end, the paper would discuss the future role the community nurses would play in the healthcare industry. Community nursing in Australia Community nurses try to develop self determination and empower the patients by working in close contact with them. These nurses help the patients to re-establish their links with the family and community by aiding them to realise their true potential (Wilson et al., 1995). Community nursing has developed considerably in the past three decades, with the practice focusing on identifying the wider needs of the community and thereby, creating various health programs to fulfill those requirements (WHO, 1974). In Australia, around 14,000 nurses work as community nurses, as per an AIHW survey. The community nurses in Australia work towards fulfilling two major duties, i.e. providing primary health care services and clinical care based on community model. The primary health care also consists of providing health education, teaching how to prevent diseases and promoting health within the community (Kemp et al., 2005). In the primary health care set up, the activity of the community nurse is guided through a framework consisting of philosophical ideologies. This framework is based on the political, social, environmental and economic factors affecting the health of a person (WHO, 1978). In the beginning, community nursing only focused on finding out about certain health issues and means to prevent and control these health problems in a community set up. However, soon this outlook changed and the community nurses were required to look after other factors as well to promote general wellness in the community. Therefore, the community nurses were also required to consider issues like providing safe drinking water and balanced diet, proper sanitation facilities and prevention of infections through immunisation (Tablot & Verrinder, 2005). Further, these nurses also took special care of various social, economic, political as well as environmental issues that could have also contributed towards the spread of a disease (WHO, 1978). The community nurses also focused on other factors such as affordability, availability and accessibility of health services, so that proper health care is provided to all the people (WHO, 1978). In Australia, during the 1970s, the client was referred as a stakeholder, which means that the client has vested interest in the policy results. However, this policy was soon changed and the client is now being referred to as a consumer, which means a person who consumes resources (van Loon, 1998). This change in the terminology itself indicates that the community nursing in Australia is undergoing a change. Now the central focus for the community nurses is to create disease intervention and provide clinical services. This is quite different from the focus of promoting health care facilities and preventing diseases within a community, which were the focus areas in the 1970s (Kemp et al, 2005). In the contemporary world, the community nursing professionals are required not just to create a broad based community health by looking after the general welfare of the people, but also provide individualised and customised services as well (Davidson et al., 2006). These days, community nurses are also entrusted with the duty to help out the client and its family to manage the health conditions in the house. These nurses are asked to liaison with the support services providers, advice clients and provide updated health information and develop skills in the client for self-managing the disease (Davidson et al., 2006). The community nurses are required to fulfill their duties within a range of health care providers and are constantly asked for their services not only in the client’s house and community health centres but also in nursing clinics, hospitals, rural communities, educational institutes etc. Issues affecting the community nursing role Various pressing issues are affecting a change in the community nursing practice and are resulting in the evolution of the role of community nurses in Australia. Some of these issues affecting the role of community nurses in the contemporary world are discussed below: Change in social demography The life expectancy in Australia has also improved considerably in the last few decades. It is predicted that the life expectancy for Australian men will increase to around 92 years and for Australian women to be around 95 years by 2050 (ABS, 2004). Further, the baby boomers generation is also nearing retirement. Therefore, these contributing factors such as decrease in the mortality rate and increase in people nearing retirement age would in turn increase the dependency on community services. Further, it has also been found that the birth rate in Australia has also decreased, which means that the younger population would witness a downfall, whereas the population over the age of 65 years would increase (ABS, 2004). This would also affect the social, economic and health policies in the country as more and more people, especially the aged, would require support in terms of housing, health care, economic support and other community services support (Rowland, 2003). In order to create a sustainable community nursing practice in Australia, the community nursing organisations would have to modify their care services and improve their health care facilities. These organisations should focus on providing continuous care, avoiding duplication of health care services and assisting the patients to self-manage their diseases (Nolan et al., 1998). However, such extended community nursing practices would also mean stretching the budgets. Therefore, these organisations would also have to rationalise their costs to provide quality care within the restricted budget. Change in perception and client complexity With the population ageing rapidly, a number of complex health care demands would also increase considerably. It was estimated that in 1998 around 3.6 million people in Australia suffered from some or the other form of disability as per the National Survey of Disability, Ageing and Carers. This survey was carried out by the Australian Bureau of Statistics (ABS, 1999). Further, out of this disabled population, around 2.8 million people were not able to even move or communicate (ABS, 1999). It is projected that this figure would increase by as much as 70 per cent in the next three decades. Some of the major diseases that would result into disability within the older generation in Australia would be diseases of the nervous system, musculoskeletal problems, circulatory disorders, respiratory problems and heart attack (Giles et al., 2003). Therefore, in the next few years, community nurses in Australia would encounter various complex conditions that would impact the self-care ability of the patients as well. Change in data requirements With the increase in the requirement for resources, the community nurses would need to collect data and evidences in order to justify the budgets. Further, resources would also be put into places where they are required the most. Therefore, there would be changes in the allocation of resources as well (Lavis et al., 2003). The community nurses would also need to learn how to operate software along with managing various hardware devices. Such devices would help the nurses to collect the data and send it to the organisation for assisting the management to allocate the resources as per the requirement (Lavis et al., 2003). Change in health funding Some of the nursing services may find only a limited amount of providers. The healthcare industry need to initiate a billing system based on providing itemised accounting. However, such a system should be user friendly, secure, reliable and provide a correct transaction system which would help the health care providers to get their claims sanctioned directly from the Australian medical care department or from the private healthcare funds (Smith, 2000). This would also save the nurses from fulfilling the healthcare administrative work of their patients. Change in the value system The value system in Australia consists of a diverse system of various race, culture, ethnicity and religion. Such a value system also has its impact on the community nursing practice, as the system defines how the client and the nurse interact with each other, how the disease is being viewed in the community and how the community perceives the role of the nurse (Kemp et al, 2005). The belief system of a person impacts the value system as well. Therefore, it is evident that clashes due to differing values would occur. Such clashes also take place between different generations. In case such clashes occur between nurses and the client, it would eventually lead to miscommunication between them and hamper the overall quality of the healthcare service (George, 2003). Therefore, community nurses should be competent enough to handle cultural differences and understand the value system of their patients as well. Further, they should not let their own biasness towards their value system to come in between while promoting self-management of diseases in the patients. This type of differences in culture and value system is increasing in Australia and the nurses need to be trained enough to handle such differences properly. Therefore, it is also important for the future community nurses to be aware of the cultural diversity in Australia to help in providing similar healthcare services to the native Australians as well as to the people from diverse cultural backgrounds (George, 2003). Qualities to become an effective community nurse As per van Loon and Kralik (2006), in order to become an effective community nurse, one needs to have the following qualities: Personal qualities: The nurse should have solid value system and characteristics such as respect for human beings, good communication skills, confidence, intelligence, integrity as well as trustworthiness (Smith, 2000). Behavioural qualities: The nurse should be able to respond and act as per the situation and demonstrate qualities such as creativity, ability to motivate, respond to crisis, support the client and show responsiveness (Smith, 2000). Knowledge-based qualities: The nurse should also be able to showcase professional knowledge, exchange valuable information and have competence to handle clinical cases. The nurse should also develop confidence to undertake reflective practice and tackle a situation through his or her work experience (Breu et al., 2001). Role-based qualities: The nurse should be able to understand the perspective of the patient, exhibit professionalism, mentor, teach, advice, evaluate the client on a regular basis (Breu et al., 2001). The future community nurses The role of the community nurses in the future would expand manifold and would include tasks such as assessing not only the personal but also the developmental and environmental impact on the general welfare of the patient. Further, the nurse should be aware of when and how to consult with other caregivers, especially in case of long-term disease management (Smith, 2000). Such a process would also require creating a plan for self-managing the disease. In the future, these nurses may also have to negotiate and communicate on the behalf of their client with other community service providers. They have to negotiate on the care objectives, monitor the progress of the care giving services as well as coordinate with the service providers to ensure that the care provided to their client is appropriate and proper (Tablot and Verrinder, 2005). Further, the technology advancement in the healthcare industry would also mean more sophisticated machinery for monitoring the health of the client (Breu et al., 2001). Therefore, the nurses should not only need to keep themselves updated about such modern technology but may also have to coordinate with the specialists to understand about the results. They should also be aware about the various government policies and insurance terms regarding such technologies, so that the expenses of these machineries are not incurred by the client alone (Breu et al., 2001). The community nurses in the future should also be given some prescribing rights, i.e. in case of emergencies these nurses should be able to prescribe certain drugs to save the lives of their patients. Further, these nurses should be able to conduct different types of investigative tests and treatments (Davidson et al., 2006). Such tests and treatments would be especially beneficial for patients with disabilities, suffering from mental diseases, diabetes, sexual diseases such as HIV/AIDS or people who are under drug or alcohol rehabilitation. Finally, the community nurses should be able to develop and demonstrate leadership as well as management qualities while performing their responsibilities (Davidson et al., 2006). References: ABS (1999). 1998 Disability, Ageing and Carers: Disability and Long Term Health Conditions. Australian Bureau of Statistics, Canberra. ABS (2004). Australian Social Trends, 2004 4102.0. Australian Bureau of Statistics, Canberra. Breu, K., Hemingway, C.J., Strathern, M. and Bridger, D. (2001). Workforce agility: the new employee strategy for the knowledge economy. Journal of Information Technology, 17(1), 21–31. Davidson, P.M., Elliott, D. and Daly, J. (2006). Clinical leadership in contemporary clinical practice: implications for nursing in Australia. 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