Book Review
Community health nursing: theory and practice
Rorden J., and McLennan ].
ISBN: 07295 03 48 5; 1992; 358 pages; Harcourt Brace Jovanovich Sydney;
Shirley Schulz
Faculty of Nursing, University of Newcastle, NSW
This is the authors' second book on community nursing. The first (1979), aimed at generalist community nurses, sought to provide a conceptual basis for practice and practical guidance. It achieved its goals. It became at the time, and has continued to be, an invaluable resource for me as clinician and teacher. This new book seeks, and generally succeeds, to provide a theoretical foundation for students of nursing and community nurses. It lacks the directness of language of the earlier book. A surprising omission is reference to some significant recent Australian literature and research on community health, community health nursing, primary health care and health policy. In contrast with American community nursing texts this book is concerned with community nursing theory and practice, rather than nursing particular client groups within communities. The first of the three sections provides a context for community nursing, explaining what community nurses do.
This includes a brief history of community care in Australia, a model for community nursing, and discussion of the helping relationship. The second section emphasises an integration of working with individuals and community development in a way often lacking in other texts. It is concerned with community assessment, prevention and care, including assessment and treatment of individuals and families. Here the authors introduce concepts such as continuity of care, at-risk groups, basic and developmental prevention. Skills and strategies for community work such as group leadership, social action, facilitation, community development and health education are covered and practical guidelines provided. Section three covers topical professional issues such as preparation for community practice, teamwork, research and evaluation, future roles of nurses, and generalist versus specialist orientations. A cautionary note on the American health system concludes this section.
Strengths of this work are its emphasis on those aspects common throughout community nursing regardless of practice setting. The special needs of varying groups (e.g. homeless, mentally ill, disadvantaged) and clients with specific problems (e.g. AIDS, child abuse, drug dependence) are discussed in a way that demonstrates the authors' understanding of the complexity of practice, without losing sight of the overarching concern of community nursing for the health of populations in which the care of individuals is but a significant part. The best features are the chapters on prevention, the helping relationship, and the emphasis throughout the book on helping clients and communities become self-reliant with some stress on strategy development.
Other useful features are well selected case studies, comprehensive study questions and exercises, and understandable tables and diagrams. This book will be a useful text for undergraduate nursing students although I found the page layout sometimes hindered rather than facilitated reading, and the index and bibliography limited in some areas. For instance, while the index on nursing is excellent some authors referred to in the text, and some topic areas, are absent or subsumed in a generic classification, making the search longer. While both the bibliography and lists of further readings at the end of each section are useful, reference to recent work undertaken in Australia is somewhat thin in the text. Primary health care and health policy are topics included in nursing courses and indepth discussion of these areas is noticeably absent. The book could well be supplemented by other community health and community nursing texts.
Some readers may consider inclusion of selected nursing theories, nursing diagnosis and the nursing process to be beneficial for undergraduate students. I do not, since the authors developed their own model of community nursing and identified the various theoretical perspectives on which they drew, and plenty of texts exist on these topics. I would have preferred further discussion of the authors' own model. In spite of these criticisms I highly recommend this book, like its predecessor, as a useful text and reference for nurse academics, students of nursing and community nurses.
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