Challenges to Community Nursing

• SUJATA BHARI PALIKHE

CHALLENGES AND TRENDS IN COMMUNITY NURSING

Community nursing is the coming together of primary health care and nursing profession with public health nursing. A community nurse not restricted to providing care to particular group or age but is encouraged to participate in all aspects of social life activities for the promotion of health and education. Community nursing as we know has come a long way in the last ten years with the change in the demography and diversity, technical advancement, educated consumers, use of alternative therapies and palliative care. Nurses are a major player towards building a healthier community, so they have to make their presence felt in each and every way possible for a healthier and disease free society. People involved in nursing profession have also been affected by the rise of electronic media and social networks like Facebook and twitters which now has a become a major factor in how a community nurse operates for the healthier society.

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Medical explorations in the last century has led to people live longer and have high expectations, so community nurses are required to be on their heels and ready for deviations that may come from any predefined theories .A community nurse must encourage and promote healthier living, build an operating environment and respond as required, give information and support they need for change. For nurses to make every contact count they need to understand the various attitudes and behaviors of people they are working with. The other challenge that community nurses has frequently came up with was alcohol abuse in the community and there was as a significant difference in number among the older and young, and the former is the unlikely winner as the statistics have shown. It seems to be very difficult to find out the exact cause of alcohol misuse in older people. Ethnicity, depression and loneliness are known to be the major factors for the abuse. Now, the community nurses have the difficult role of providing integrated care for alcohol misuse. Integrated care uses pre-defined assumptions and variables such as assessment of alcohol misuse, short and long term interventions, involvement of family members and carers, legal and ethical issues and nurses need to take extreme care so that patients autonomy is not over looked as well as duty of care performed.

The other major challenges facing community nurses are the fear and helplessness that they face when providing palliative care to children or young people. Simply applying the predefined models may not work as scenario changes and there may be a need of palliative care and those providing it develop very intimate relationships with everyone involved during the care process. They now need to be emotionally prepared for the end result, trying to integrate as a part of the family that they are giving the care, showing their professionalism as these nurses who are providing palliative care need to show all of these attributes to overcome the feeling of grief, emotional conflict and fear when the ultimate result i.e., death occurs .Although the Australia has seen a huge improvement in socio-economic and living standard of people there is still exists a significant gap between the Aboriginal and Torres Strait Islander peoples to other Australians. This gap in the socio-economic factors has led these people with a vulnerability to chronic illnesses in people on the wrong end of the economic ladder. Now, it has become ever more important in the part of the nurses in working in the community to find out causes at the base level and find out tailored solutions to eliminate the problem. They also need to have a good knowledge of their history, culture and health at the same time show professionalism to minimize these inequalities.

By the turn of the century, our social behavior has taken a significant change as we now has a found out a new way of tool to communicate and express ourselves in the society with the ever increasing use of social media. Almost every person in the community has been affected by this technological advancement and community nurses are no exceptions to it. This can have both positive and negative effects on the community and here it is up to the community nurses and their organization’s to keep up with the change and provide a better nursing service to the community. Social media provides them with a platform where they can share ideas, experiences and their take on the matter on their part .It provides them with opportunities to learn, share and engage. Community nurses are now using social media to create a sustainable and healthy community .It has offered a new dimension to how we work and communicate. It has thrown us with an opportunity to engage and build a nursing community irrespective of demography.

Community changes with time and community nursing has to modify itself to accommodate with the changing scenarios. Nurses working in the community now have to develop strategies and make their presence count by engaging and integrating as the part of the community they are working with. Nursing professional who have been involved in palliative care of young and children are vulnerable to the emotional trauma that comes with the death of those people they have been associated with during their final stages of their life, so there should be programs to allow nurses to overcome the grief and helplessness that comes with the unwanted truth of the death of the person they have been caring .These nurses have also played a part in bringing down the gap between the rich and the poor in regards to the quality of treatment they receive and as well as treating the misuse of substance and alcohol abuse. They must also embrace the changes that have been tossed up upon them with the rise of technology as this will allow them to integrate into the society ever so easily and also provide people with some tailored and some predefined solutions demanded by the situations and also give s them the chance to increase their knowledge base as they are able to share and understand their interest and experiences irrespective to their geographic locations.

References:

Reid, F C 2013,’Lived experiences of adult community nurses delivering palliative care to children and young people in rural areas’, International Journal of Palliative Nursing 2013,vol 19,No 11,viewed on 20 March 2014,CINAHL database(EBSCO)

Peate, I ’The community nurse and the use of social media’, British Journal of community nursing Vol 18, No14, viewed on 20 March 2014, CINAHL database (EBSCO).

Goold,S 2011,’Nurses and midwives closing the gap in Indigenous Australian health care’,eContent Management Pty Ltd. Contemporary Nurse (2011) 37(1): 5–7 Volume 37, cited on 21 March 2014, CINAHL database(EBSCO).

Jackson, D, Andrew, S & Cleary, M 2012,’Family and community health nursing: challenges and moving forward’, Contemporary Nurse, Vol. 41, no.1, pp. 141-144, viewed on 23 March 2014, CINAHL database(EBSCO).

Rao,T 2014 ,’The role of community nursing in providing integrated care for older people with alcohol misuse’,British Journal of Community Nursing February, 2014 Vol 19, No 2, cited on 20 April 2014,CINAHL database(EBSCO)

Almond,J D 2013 ,’Community nurses need to make every contact count’,JCN Vol.27 No.5, viewed on 26 April 2014, CINAHL database(EBSCO) .0 JCN 20