Factors Affecting Nursing Practice in Lightning Ridge, NSW - Case Study Example

Factors Affecting Nursing Practice in Lightning Ridge, NSW Student’s Name Institution Date Factors Affecting Nursing Practice in Lightning Ridge, NSW Introduction Rural areas are affected by various nursing practice issues because they are remotely located. There are many social, economic and environmental issues which affect people living in rural locations. Nurses need to be aware of various issues they are likely to face in their practice within these locations. They need to be prepared to handle all issues that their patients are exposed to which have an impact on their health and wellbeing. In rural areas, nurses have to take more responsibility for their patients’ wellbeing to ensure they satisfy patients’ needs in different remote locations. Nurses need to acquire high quality skills which are suitable for solving crucial healthcare problems which exist in locations they are operating from (Daly, Speedy & Jackson, 2010). They also need to understand the local context within which community health services are provided to become more effective in their duties. Nursing caregivers need to be aware of demographic, economic, political and cultural factors which are likely to impact on the way they perform their duties. Demographic factors which nurses need to be aware about include population profiles of different people living within a particular location and healthcare issues that affect people of a specific population group. Economic factors that are analyzed are what people in a particular rural area do to sustain themselves economically (Daly, Speedy & Jackson, 2010). Political factors are those factors which people in a rural area are exposed to due to the way they are administered. Cultural factors are those factors which affect people in a particular population due to their cultural attitudes and practices. Nursing practitioners need to initiate effective approaches to help them achieve positive results out of different tasks they are involved in. Description This paper will focus on Lightning Ridge, which is administered through Walgett Shire Council, New South Wales. The town is located in the north western sections of New South Wales close to the Queensland border. It is a mining town which has been dependent on opal mining for the last 100 years. Lightning Ridge has many transient residents who do temporary work in its mining firms. The town also hosts many indigenous populations who face different socio-economic challenges. This paper will first look at the scope of practice a nurse needs to be aware of as he or she starts practicing in this area. Overview on the Role of a Nurse There are different categories of nurses who are given different types of responsibilities based on their training and skills as mandated by the law in Australia. An assistant in nursing (AIN) is a nurse who works under a registered nurse and performs different functions in a healthcare setting. An AIN attends to patients in different healthcare settings and gives them with personal care. An enrolled nurse (EN) cares for patients and works under a registered nurse (RN). This is a second level position where a caregiver needs two years of training which culminates in a Diploma in Enrolled Nursing. An EN cares for patients by giving them first aid during emergencies, educating them on how they need to maintain their health and giving them a good recuperative environment. An EN also assists patients with rehabilitative programs meant to improve their health. An endorsed enrolled nurse (EEN) is a nurse who has undergone more training which allows him or her to administer medication to patients. For one to qualify for this role, he or she needs to complete an enrolled nursing program together with experience in a high quality hospital (Willis, Reynolds & Helen, 2012). Before they give out any medication, they have to seek the guidance of a RN or any other senior medical practitioner. A registered nurse (RN) is a nurse who has undergone three years of training in a university and attained a Bachelor’s Degree in Nursing. He or she is supervised by the Nurses and Midwives Board and performs more complex roles than AIN’s and EN’s. RN’s perform administration, assessment, medication, specialized care and research roles in different healthcare settings. A midwife is a registered nurse who handles specialized maternal care responsibilities. A midwife collaborates with other nurses to provide specialized care during pre-natal, labor and post-natal situations to provide mothers and their infants with high quality care. A midwife helps a mother overcome different types of complications which are related to pregnancies to ensure they stay healthy (Willis, Reynolds & Helen, 2012). A nurse practitioner (NP) is registered nurse who has undergone additional training for two years to help him or her perform more complex roles. An NP has experience in a specific line of practice and orders diagnosis on different patients who are various complications. Nurses’ Scope of Practice Nurses who intend to practice in different parts of the country need to be certified by the Australian Nursing and Midwifery Federation to obtain a practicing license. Nurses are required to have adequate training and experience to qualify for various levels of nursing as stipulated by the board. They need to exhibit the required set of skills to enable them provide high quality care to patients that visit different healthcare facilities they are working in. There are several branches of the ANMF operating in different states and territories across Australia. Nurses in New South Wales operate under the ambit of New South Wales Nurses’ Association. This association takes care of nurses’ welfare and certifies all nurses who have been trained to serve in different healthcare facilities across NSW (Hurme, 2009). Nurses are required to familiarize themselves with various health processes related to their expertise to ensure they give their patients high quality care. Nurses work in a variety of environments which expose them to different types of situations. In rural areas, nurses have to be prepared to work in far flung locations where residents do not have access to quality healthcare services. In such environments, nurses need to take note of different types of lifestyles which residents in these communities practice to enable them provide quality healthcare services. Nurses also need to understand different demographic issues that are responsible for different health issues in various healthcare settings. Nurses need to develop appropriate programs to enable them provide quality health services to patients living in different communities in rural areas (Hurme, 2009). They have to develop programs which respond to unique health challenges in communities they are operating in to ensure residents access quality healthcare which satisfies their needs. Nurses need to demonstrate high levels of competence to obtain practicing licenses from respective licensing authorities. They also need to abide by all codes of practice which specify how they need to perform their responsibilities in different environments they are working in. The scope of nursing in Australia as applied to an individual nurse’s practice takes note of the nursing environment, customers’ needs, skills and education and other healthcare policies which have an effect on the way healthcare services are provided. The scope of nursing practice also stipulates specific functions which nurses can and cannot delegate as required by their professional practice (Fleming & Parker, 2009). As they practice, nurses have to be continually assessed to ensure they give out high quality care to their clients. They also have to conform to all standards of practice which are enforced in different healthcare settings they are operating in. A nurse also needs to understand cultural and demographic issues which affect different areas and the impacts they have on healthcare practice. He or she needs to exercise fairness to ensure quality healthcare is provided to different categories of people without any bias or discrimination. A nurse is expected to perform many responsibilities which require selflessness, patience and dedications. He or she needs to promote peoples’ wellbeing, prevent illnesses and care for the ill and other people who are either physically or emotionally incapacitated. Nurses need to work hard to satisfy expectations of various people who need health services. A professional nurse needs to promote a safe environment for all patients to ensure they overcome different types of health problems they are facing (Fleming & Parker, 2009). Nurses need to understand situations of practice they are operating in before making any decisions. This will guide them to understand the impact of their decisions on all patients who are under their care. Major principles which are related to the scope of nursing include: delegation, adherence to standards, consultation and planning, accountability, competence and assessments on skills and supervision. Discussion Part B Demographic Factors There are several demographic factors which have an impact on nursing practice in Lightning Ridge. The population in lightning ridge changes constantly because some of its residents are not permanently settled in the town. According to the 2011 census, Lightning Ridge has a population of 2,492 people consisting of 55.4% males and 44.6% females. The average age of the town is 48 years which is higher than the national average. It is estimated that close to 70% of the population living in this area were born in Australia (QPZM, 2013). There are significant numbers of people born in England, Eastern Europe, New Zealand and Germany. A majority of people living in the town speak English while others speak Croatian, German and Serbian. Anglicans, Catholics and atheists make up the largest religious groups in the town. Lightning Ridge also has considerable numbers of people who are Orthodox, Presbyterian and Reformists. It is estimated that more than 33% of the people aged 15 and above living in the town are married, 36% have never been married while more than 16% of the population have never been married. Lightning Ridge had a population of more than 1800 people in 2001 and 18% of the population consisted of indigenous Australian Aborigines. The town is mainly dependent on opal mining which has been taking place in the town for more than a century. Black opals mined from the town are sold locally and some are exported to other countries. This has made the population in the town to be highly variable because many miners are only employed as part time workers (QPZM, 2013). They settle in temporary accommodation and return to their original towns once their short term work contracts elapse. It is difficult to estimate the exact number of permanent residents living in the town because the town’s settlement patterns change constantly. It is estimated that 49.5% of the people living in Lightning Ridge are full time employees, 30.2% are part time employees while 13.2% of the people are unemployed. It is also estimated that more than 16% of the people are community and personal service workers, 15.9% are managers, 12.6% are professionals, 12.1% are laborers and 11% do clerical and administrative jobs (QPZM, 2013). 11% of the town’s residents are technicians and trade workers, 10% are machine operators, 9.8% are drivers while the remaining 9% are sales workers. It is also estimated that the median income for individuals living in the town is 350 dollars per week while the median income for households is estimated to be approximately 540 dollars per week. It is also estimated that the town’s median rent is 120 dollars per week while the median mortgage is 867 dollars per month (Walgett Shire Council, 2013). There are various issues which affect different categories of people living in Lightning Ridge. Indigenous populations in the area are affected by literacy problems which hinder them from making good healthcare decisions that can help them experience better standards of living. This is a big issue that affects the way healthcare in the area is provided to different categories of people. The town also shares many characteristics with other rural towns in NSW. Many people live in such towns are isolated from crucial healthcare services because of their remote locations. Some sections in Lightning Ridge are not adequately served with transport, communication and other crucial services which are needed to enable health professionals provide quality healthcare services (Walgett Shire Council, 2013). Economic Factors Lightning Ridge has an aging population because its median age is 49 years. There are many old people living in the town who need specialized care from nursing practitioners. This shows that in the near future, there will be more elderly people living in the town who will be dependent on social services for survival. There are considerable numbers of people who are either part time employees or not employed at all. Most of these people are likely to experience problems in accessing healthcare because they do not have adequate incomes to pay for medical insurance and other preventive healthcare services. Lightning Ridge’s population is made up of many transient workers who work as part time laborers in opal mines (Van Her, Smith & Andrew, 2010). Therefore, they are likely to suffer from different health hazards which result from living in areas with poor sanitation. There are various socio-economic issues which many Lightning residents face. The town is heavily dependent on opal mining and recent trends in the industry paint a gloomy picture. It is estimated that opal prices will continue to decrease in the near future and as such, many mining companies are likely to be severely affected (QPZM, 2013). There is also a possibility that production costs are likely to rise because opal deposits in the mines are getting depleted. Therefore, more residents who are employed in the mines are likely to face economic difficulties resulting from their inability to afford different types of basic services. There is likely to be a reduction in taxes remitted to the local town council and this will reduce the amount of money available for important social programs in the town. Therefore, healthcare programs which are funded by the local council are likely to experience a shortage in funding which is likely to affect people who depend on them negatively (Van Her, Smith & Andrew, 2010). In some parts of the town, there are social problems being witnessed which have an impact on nursing practice. Some areas have high rates of crime and they make it difficult for different types of services to be provided to residents living there. As a consequence, there is likely to be an increase in the number of people experiencing healthcare problems which result from insecurity in different areas. Crimes such as rape, violence and drug abuse require urgent solutions from nursing professionals working within this locality (CRH, 2013). For instance, drug abuse requires nursing professionals to initiate major campaigns to discourage people from engaging in dangerous lifestyle habits which are likely to have a negative impact on their health. Voluntary and peer counselors need to be encouraged to assist nursing professionals in their communities to encourage people to carry out rehabilitative programs. This will ensure more people who are affected by domestic violence and drug abuse are rehabilitated to ensure they do not degenerate into complex mental conditions. Political Factors There are limited water resources in the town which cause conflicts between residents and mining companies. Dry conditions are being experienced in areas that surround the town and this is likely to worsen water shortages experienced by the town’s residents. There are also many people who live in remote areas and they do not have adequate access to water resources and other crucial government services (Talbot & Verrinder, 2009). Outlying areas which surround the town are sparsely populated and this makes it difficult for people to get access to important government information. People living in these areas are disadvantaged due to their low socio-economic status and this makes it denies them an opportunity to access important social services. Therefore, this exposes them to various chronic diseases which result from poor lifestyle choices and their inability to access preventive health services. These people are not included in healthcare policy frameworks which make it easy for residents in rural areas to access preventive health services. Healthcare provision policies do not take into consideration multicultural approaches which can improve healthcare access to different demographic groups living there. The migrant population needs to be included in planning healthcare programs to ensure they are not denied healthcare services provided to different people. Aged migrant workers who temporarily reside in the town face a myriad of challenges which deny them access to health services. Some of them are not registered which makes it difficult for health service workers to track their movements and monitor the level of progress they are making (Talbot & Verrinder, 2009). Lack of registration also disqualifies them from various healthcare programs offered by different companies which allow more residents to access primary healthcare services. Some of these people live in zones which are not clearly mapped out by street addresses which make it difficult for health practitioners providing services in remote areas to reach them. It is also difficult to provide emergency care for people living in isolated locations. Some residents do not have proper access to vital means of communication such as telephones because they live in areas which are not properly served by communication networks (FaHCSIA, 2013). Some of them are illiterate and this denies them an opportunity to improve their health and wellbeing. Therefore, they are not able to understand different types of healthcare information that advise them on healthy lifestyle choices. Road networks which serve some rural communities in some areas around Lightning Ridge are in a poor state. Ambulance services are not able to respond to distress calls related to emergency healthcare issues in some areas surrounding the town promptly (FaHCSIA, 2013). Many people in Lightning Ridge live in temporary shelters which do not have proper electricity connections and running water. Therefore, they are at risk of contracting different types of communicable diseases which result from poor hygiene and overcrowding. Cultural Factors Language barrier is a major problem for some people living in Lightning Ridge. There are foreign residents in the town who are not able to communicate effectively with health practitioners. Therefore they are not able to get useful interventions to help them deal with various health problems they are facing. The median age of the Aboriginal population is younger compared to that of other population groups living in the area (ANPHA, 2013). It is estimated that there are less than 3.5% Aborigines who are aged 65 and above in NSW compared with more than 14% of other population groups living in the region. This shows that many Aborigines have low life expectancy due to different healthcare challenges they are facing. It is estimated that more than 7 out of 1000 Aboriginal babies die in their infancy (ANPHA, 2013). Diabetes, food and water poisoning and other types of injuries also cause many Aborigines to die, a factor which is not common in other demographic groups living in the town. Some cultural practices discourage people from indigenous demographic groups from seeking modern medical interventions. Illiteracy and language problems make such people not to value modern healthcare interventions for chronic illnesses such as diabetes, respiratory complications, heart ailments, mental problems and cancer (ANPHA, 2013). As a result, they are either unwilling or unable to take time to use better methods of care and practice good lifestyle choices. For instance, there are many people in the indigenous population who do not take seriously dangers associated with obesity, smoking and alcoholism. Healthcare priorities need to be changed to ensure people from marginalized communities are able to understand the importance of different medical interventions to improve their welfare (Huntley, 2008). Cultural and clinical matters need to be integrated to ensure people living in remote settlements have equitable access to healthcare. Social factors which are common in the region due to cultural practices need to be given more attention to ensure people living in remote communities take various health issues they are facing seriously. Primary healthcare services are not well developed in rural communities and this denies many people a chance to get quality healthcare services in far flung areas. Lightning Ridge residents depend on Walgett Health Service, a small hospital which offers emergency and inpatient services to patients, located more than 70 kilometers from the town. There is also an Aboriginal Medical Service in Walgett town which mainly serves indigenous populations living in different rural areas in the whole of Walgett Shire. However, these facilities do not have the capacity to deal with large scale emergency situations and disasters in areas surrounding the town. There is a need for rapid response units in the town and other isolated areas which are not properly served by the road network (Huntley, 2008). The town lacks adequate aircraft to evacuate and provide relief to different residents trapped in remote zones cut off from main communication lines. For instance, some of these areas are severely affected by floods which expose many people living in temporary settlements to high risks of water borne diseases. Conclusion Lightning Ridge is a town that has many factors which impact on nursing practice. These factors determine the quality of healthcare offered to residents living in this town. Road and communication networks need to be improved to ensure residents have better access to healthcare in the town. Socio-economic issues need to be given more consideration to strengthen preventive healthcare services which are provided to residents. Proactive approaches need to be implemented to ensure residents are given high quality care. References ANPHA. (2013). State of Preventive Health 2013 Report. Canberra, Australia: Australian National Preventive Health Agency. Center for Remote Health (2013). Remote area nursing. Retrieved 28th August 2013 from http://www.crh.org.au/content/view/16/13/ Daly, J., Speedy, S., & Jackson, D. (2010). Contexts of nursing. Sydney, NSW: Elsevier Australia. FaHCSIA (2013). Working together to close the gap in Walgett. Canberra, Australia: Department of Families, Housing, Community Services and Indigenous Affairs, Australia. 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