Primary Healthcare Nursing - Part A

Introduction

The role of a nurse has become increasingly central to the delivery of primary health care in Australia (Challis et al., 2018). Nurses working in primary health care can help address workforce shortages, improve access to health care and contribute to the management of chronic conditions and illness prevention (Dugani et al., 2018). In this essay, the role of a primary healthcare nurse in achieving community development has been addressed along with the benefits and challenges of the role.

The role and responsibilities of a community development nurse:

Primary health care (PHC) nurse contributes to the community in several ways, such as, by providing education to the community, about diseases which are highly prevalent or has an incidence rate in that particular community. A nurse may also provide the necessary advice and recommended guidelines for do’s and don’ts to be followed for any chronic illnesses such as asthma, cardiovascular disease, diabetes and high blood pressure which are common in the elderly population in any community (Grant et al., 2017). A primary healthcare nurse is competent to address and suggest changes for life-style disorders, providing the community members enough healthcare information, in form of hand out filers, training sessions, videos, so that they can make independent and well-informed choices in their daily routine and live a disease-free life. The nurse aims to provide information which is easy to understand by the community members, avoiding medical jargon while preparing education material is vital for clear establishment of understanding of the conditions and recommendations (CDC, 2009; Australian Commission on Safety and Quality in Health Care, 2017). Other responsibilities include dispensing of medications, pregnancy tool kits, immunization, conductive various screening tests, for instance, mammograms for breast cancer in women or screening for substance abuse in the adult/ millennials of the community (Martin-Misener et al., 2016). A primary health care nurse also undertakes community surveys to analyse the healthcare challenges within a particular community and provide evidence-based research solutions for treating the diseases or the conditions from which the community members are suffering from (Rudd, 2012). The role of a community development nurse is to also provide counselling and rehabilitative services in case of individuals exhibiting addictive behaviours such as smoking and alcoholism or depression.

The importance of the PHC nurse in attaining primary healthcare outcomes:

The role of a PHC nurse in the community is very important to promote health and human dignity. Following outcomes are achieved:

For an individual consumer: The nurses also distribute health-related items such as condoms and pregnancy detectors to individual consumers, which otherwise is difficult to be accessed by certain members of the community, especially in the rural and remote areas or the aboriginal and Torres Islanders community in Australia (Bond et al., 2019). The main reason of this is lack of resources and poverty to get access to the local chemist and also due to fear of being caught and isolated from the other community members if they found out one of the members is in a sexual relationship which is not approved by other members of the community, which refrains them from buying condoms.
For the community: It helps in decreasing the incidence rate of chronic illnesses and various life-threatening diseases such as stroke, cardiac conditions, HIV/AIDS and others by increasing the general awareness of the community related to these diseases, which can be assessed by using the “Patient Education Materials Assessment Tool (PEMAT)” (US Department of Health and Human Services, 2019), which helps the nurses to evaluate the comprehensiveness and actionability of the patient education materials. The primary health care nurse understands the social, physical, economical, interpersonal components of the community framework in which he/she provides the service and can address the challenges of the community members based on these skills. It helps in the identification of the vulnerable groups and meeting their healthcare needs, for instance, community with an increased number of migrants, who are living in poor economic conditions, struggling to meet necessities of safety and nutrition, will have the majority of diseases about diseases malnutrition, tuberculosis, other infections, in such cases the PHC nurse helps in providing care to them without the fear of accessing healthcare institutions (Whyte & Stone, 2016).
Policy related to the selected role: According to the Nursing and Midwifery Board of Australia, (2016), the primary healthcare nurse must ensure "culturally safe and respectful practise" in the community, by acknowledging various components of the community framework such as social, economic, cultural, historic and behavioural factors impacting the well-being, of an individual and the community as a whole. It also includes to exhibit competency in engagement in state governments policy arena for identifying and understanding the determinants of health in remote and rural communities for the upliftment and health promotion purposes (WHO, 2012).

Primary Healthcare Nursing - Part B

Introduction

COVID-19 has had a major impact on the lives of people and resulted in an increase in the mortality rate in communities which has a larger population of elderly. This is because they are more vulnerable to catch the novel coronavirus infection, owing to compromised immunity, the ageing process, slowed cellular regeneration, and weakened organ system Basic instructions shared with the group, which makes them the most vulnerable group.

Intended consumer group:

The intended consumer group would be the elderly, especially with one or more comorbid conditions such as asthma, diabetes, cardiovascular diseases and others, as well as those who are affected with fatal ongoing diseases, such as cancer or cystic fibrosis or any other terminally-ill conditions. According to the research, by the Centers for Disease Control and Prevention. (2019), this is because the elderly population exhibits high affinity for the novel coronavirus owing to compromised immunity, ageing process, slowed cellular regeneration, and weakened organ system.

Intended Purpose

The purpose is to improve the healthcare outcomes in the elderly population, by increasing the awareness of the spread of the infection. This can be done by employing various means of education, such as hand-outs, fliers, short documentary videos (Challis et al., 2018; CDC, 2019). It is necessary to educate them to maintain precautions so that they can be prevented from catching the infection as well as protect others from the spread of the same. Since the mortality rate in the elderly population is high in case of COVID 19, they must be provided with ample of information and necessary and immediate aid if acquired with the infection.

Suitability

The primary healthcare nurse is the most suitable for the task of educating the community members regarding the COVID-19 infection (Halcomb et al., 2016). There are many misleading sources of information on the internet and due to too many unauthoritative channels of information, the main message for educating the members about COVID-19 precautions and how the spread can be contained is lost, causing much confusion instead dispersing the relevant information. Therefore, a nurse who has a major role is a reliable and authentic source of information for the community members. The second reason for incorporating a primary health care nurse in the community development plan is because the nurse is skilled with deep knowledge of the body systems, symptoms of infection, early detection and conducting the COVID 19 tests on a large scale. This helps in promoting overall health and well-being of the community and provide apt or suitable measures to bridge the gap between healthcare amenities in the community. Few examples of the resources are provided below:

Benefits & Challenges:

The main benefit of PHC nursing in the community leads to health promotion within a community. The focus is made to rely on the members chances of increased immunity and self-care rather than relying on medical treatment and hospitalization (Bond et al., 2019). The awareness of the precautions to be taken at home and outside the home, proper use of masks, hand washing techniques, and maintaining social distancing, helps in containing the spread and improve the healthcare outcomes of the community. However, In the present time of COVID 19, many challenges are being faced by the healthcare professionals worldwide and most importantly the challenges faced by primary health nurses are critical as they form the front line of workforce amid community spread of the infection (Freeman et al., 2019; Nagesh & Chakraborty, 2020). These challenges encompass, lack of resources such as insufficient testing kits and lack of effective evidence-based approach regarding the infection, which offers limited scope of improving the health and well-being of the members infected with COVID 19. There has been no tested and verified vaccination or drug available for treating patients with severe cases, this has led to increase in the anxiety and fear of the infection in the community members as well as the nurses, as the cases continue to upsurge, especially in communities which lack proper sanitization facilities, and shortage of access to medical facilities (Nagesh & Chakraborty, 2020).

As many countries are facing the challenge of community spread of the infection, there is a severe shortage of staff to cover care for a vast number of people, thus the role of nurses is critical in reaching out and helping the community members in detecting symptoms and running tests on a larger level (Halcomb et al., 2018). Furthermore, the nurses are offer guidance to the community members and deliver coordinated care. It is a very difficult situation for a community if even one member is detected positive of COVID 19 virus, and he can only be helped by a nurse, who would guide him to approach a COVID special hospital and align the healthcare services required by the individual or the patient, such as aligning with the diagnostic teams, registered nurses in the hospital and various doctors/specialists. The impact on the mental health of the community members and the healthcare professionals is often ignored, while focusing on the physical aspects of care, resulting in increased work-related stress, mental fatigue and burn out in the PHC nurse. Adequate staffing should be ensured for managing the burden of healthcare to meet the healthcare needs of the community (Freeman et al., 2016).

References for Primary Healthcare Nursing

Australian Commission on Safety and Quality in Health Care. (2017). Health literacy fact sheet 4: writing health information for consumers. Retrieved from https://www.safetyandquality.gov.au/sites/default/files/migrated/Health-LiteracyFact-Sheet-4-Writing-health-information-for-consumers.pdf

Bond, C., Brough, M., Willis, J., Stajic, J., Mukandi, B., Canuto, C., ... & Lewis, T. (2019). Beyond the pipeline: a critique of the discourse surrounding the development of an Indigenous primary healthcare workforce in Australia. Australian Journal of Primary Health, 25(5), 389-394.

Centres for Disease Control and Prevention. (2019). The CDC clear communication index. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/ccindex/index.html#

Centres for Disease Control and Prevention. (2009). Simply put, a guide for creating easy-to-understand materials. Retrieved from https://www.cdc.gov/healthliteracy/pdf/simply_put.pdf

Challis, D., Chesterman, J., Luckett, R., & Stewart, K. (2018). Care management in social and primary health care: the Gateshead Community Care Scheme. Routledge, Singapore.

Dugani, S., Afari, H., Hirschhorn, L. R., Ratcliffe, H., Veillard, J., Martin, G., ... & Bitton, A. (2018). Prevalence and factors associated with burnout among frontline primary health care providers in low-and middle-income countries: a systematic review. Gates open research, 2.

Freeman, T., Baum, F. E., Jolley, G. M., Lawless, A., Edwards, T., Javanparast, S., & Ziersch, A. (2016). Service providers' views of community participation at six Australian primary healthcare services: scope for empowerment and challenges to implementation. The International journal of health planning and management, 31(1), E1-E21.

Grant, J., Lines, L., Darbyshire, P., & Parry, Y. (2017). How do nurse practitioners work in primary health care settings? A scoping review. International journal of nursing studies, 75, 51-57.

Halcomb, E., Ashley, C., James, S., & Smyth, E. (2018). Employment conditions of Australian primary health care nurses. Collegian, 25(1), 65-71.

Halcomb, E., Stephens, M., Bryce, J., Foley, E., & Ashley, C. (2016). Nursing competency standards in primary health care: an integrative review. Journal of clinical nursing, 25(9-10), 1193-1205.

Martin-Misener, R., Kilpatrick, K., Donald, F., Bryant-Lukosius, D., Rayner, J., Valaitis, R., & Charbonneau-Smith, R. (2016). Nurse practitioner caseload in primary health care: scoping review. International journal of nursing studies, 62, 170-182.

Nagesh, S., & Chakraborty, S. (2020). Saving the frontline health workforce amidst the COVID-19 crisis: Challenges and recommendations. Journal of Global Health, 10(1).

US Department of Health and Human Services. (2019). The Patient Education Materials Assessment Tool (PEMAT) and User's Guide. Retrieved from Agency for Healthcare Research and Quality: https://www.ahrq.gov/ncepcr/tools/self-mgmt/pemat.html

Whyte, N., & Stone, S. (2016). A nursing association's leadership in primary health care: policy, projects, and partnerships in the 1990s. Canadian Journal of Nursing Research Archive, 32(1).

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