Community matrons as problem-solvers for people living with multi-co-morbid disease

New to the community setting: nurses' experiences and the importance of orientation

There has been little research about the experiences of nurses transitioning into community nursing (CN), despite the growing demand for nurses in this setting and impending shortfall in the nursing workforce in Australia. In this study, nurses from a busy metropolitan CN service were interviewed to explore how they experienced their first months in their new role. The interviews were analysed thematically, with three themes emerging: Adaptation, Focus of Care and Context. Participants detailed their experiences adjusting to new work practices and the community setting, and expanded on their enjoyment from increased autonomy, career goal recognition and rewarding patient relationships and outcomes. The findings of this study are aligned with previous literature about nurses entering the primary healthcare setting from acute care, and particularly highlight the need to individually tailor orientation, preceptorship and ongoing career development programs to each nurse.

HEALTH PROMOTION IN CARE FOR PEOPLE WITH CHRONIC NON-TRANSMITABLE DISEASE: INTEGRATIVE REVIEW

ABSTRACT Objective: to analyze the health promotion practices developed by nurses in the care of people with non-transmittable chronic disease in primary health care, in scientific publications, between 2007 and 2017. Method: an integrative literature review of a qualitative approach, conducted in five databases, in which was read and critical analysis of the studies in order to know the practices of health promotion. Results: 40 articles were selected and organized according to the fields of the Ottawa Charter: public policies, reorientation of health services, creation of personal skills, reinforcement of community action and favorable environments. Thus, most of the experiments were mainly related to two fields of action: development of personal skills and reorientation of the health system. There is a movement towards the development of a health promotion in which the collective, the social determinants of health and multidisciplinarity are advocated. Conclusion: some limits were identified that need to be overcome, among which stands out the inter-sectoral work that needs to grow beyond the health sector.

The role of the district nurse in Northern Ireland

A district nurse is an expert generalist practitioner who uses advanced clinical skills and knowledge to fulfil an ever-evolving role. The district nurse is accountable for the care planning, coordination and management of people with multi-faceted and intricate health care needs. In addition, an interprofessional approach to health and social care is required to enable the district nurse to co-ordinate care and enable patients to be cared for and remain within their homes. As the demand on primary and community services increases, care is further enriched by working in partnership with families, carers and voluntary service providers. The nurse patient relationship is the founding component for person-centred, holistic care. Through holistic assessment and shared decision making, co-produced care planning permits people to fundamentally take ownership of their health and enhances formal care provision. This case study reflects the role of the district nurse in Northern Ireland, through comprehensive assessment in clinical practice and highlights how a therapeutic relationship, being centred on the patient and shared decision-making impact positively on the care process.