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Community Health Nursing in Australia: A critical literature review and implications for professional development
Kim Brookes
Clinical Nurse Consultant, St George Hospital, Sydney South East Illawarra Area Health Service, School of Nursing, University of Western Sydney, Sydney NSW
Patricia M Davidson
Professor of Cardiovascular and Chronic Care, School of Nursing and Midwifery, Curtin University of Technology, Sydney Campus, NSW
John Daly
Dean, Faculty of Nursing Midwifery and Health, University of Technology Sydney, Sydney NSW
Karen Hancock
Research Fellow, University of Western Sydney, NSW
Abstract
Background: Increasing emphasis on community-based care mandates an examination of the community health nurse (CHN).
Aim: A critical literature review of the CHN role internationally, with an emphasis on Australia, was undertaken in order to understand historical precedents and inform policy and strategic directions for the CHN.
Method: A search of the CINAHL, EMBASE, and COCHRANE electronic data-bases from 1982 to June 2002 using 'community' and 'nursing' as key words and hand searching of books and government reports was undertaken.
Findings: This search strategy revealed a lack of literature compared with other areas of nursing. Key themes emerging from this review are: (1) an absence of clear role definitions and lack of clarity of roles; (2) variability in educational requirements for CHNs; (3) diminished CHN power in policy decision making; (3) conflicting role expectations between different facets of the health care system; (4) underutilisation and untapped potential of the role of the CHN in the contemporary health care system; (5) the emerging influence of specialist nurses in community based-care; (6) uptake of traditional nursing roles by non-nurses and (7) an absence of a cohesive model of professional development of CHN that is able to articulate with contemporary social, political and economic trends in health care delivery.
Conclusions: Community health nursing in Australia has a low professional profile when compared to other nursing specialties. An emerging issue, gleaned from the literature review is the tension and debate between specialist and generalist services. It is apparent from this review that CHN have to more actively participate in research and peer reviewed debate in order to have their voice heard and promote their unique and valuable contribution to the nursing profession and the health care system.
Keywords
community health nursing, community, Australia, nursing profession
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