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Fundamental Aspects of Community Nursing
Quay books, Aug 2006, Pages: 130
There is no theory-practice gap within the content of this book, as it is written by real people living and working in the real world. It is a book about experiences of what it is like to work as a community nurse, of being a student on a community placement and (most important of all) what it is like to be a patient in the community. Each chapter captures the experience of community nursing, and I am indebted to all the contributors who took time out of their busy lives to write an account of their experiences. When writing a nursing textbook it is quite easy to describe assessment procedures, theorise about interdisciplinary working and describe communication systems, but it is not so easy to portray the realities of assessment or working with other professions or the practicalities of planning care. The contributors of this book have really captured the realities not only of working in the community, but of being a student on placement. Central to all is the first chapter, by Nancy Telford, which gives you an insight into the realities of a being patient who lives day after day with a devastating illness.
Many books on community nursing will be structured on such themes as assessment in the community, managing care and multidisciplinary working; these topics are to be valued and as a student they will help you examine some of the core issues relating to community nursing. However, for me nursing is about the experience of caring, and this book captures how different nurses put that ideal into practice. Most of us learn from our experiences far more than we do from listening to a lecture. During your training it is unlikely that you will be able to spend time working with all of the different types of nurse that work in the community and hence gain that experience. However, this book allows you to enter into the vicarious experience of a number of specialist nurses. Helen McVeigh and Ruth Rojhan are both District Nurses, but each with distinct differences within their role. Ann Clements is an experienced health care assistant and gives you a wonderful insight into her role and perceptions of others.
Zoë Wilkes and Helen Rhodes are both consultant nurses and function in very unique and different ways; as you read their accounts both of them will make you feel, ‘I would really like to do that job’. The work of the Health Visitor is well portrayed by Karen Ford, who gives you a sample of how health education and health care practice can be incorporated into practice. Tony Scarborough’s account of working as a therapist in mental health within GP surgeries is a fascinating description of how ordinary people’s lives are often traumatised by relationship problems and of the way in which a mental health worker can intervene before the person’s health becomes more seriously affected. The development of the role of the practice nurse has increased over recent years and Lindsey Wilkins’ account gives you a flavour of the variety of interesting work that they undertake.
Much of the future development of health care will take place in the community. Health centres are increasing in size and in the variety of services that they offer to patients, often in a far more accessible format than attendance at large hospitals. There are considerable differences in running a ‘one-person GP practice’ to running one that has eight or more GPs, four or more practice nurses and a host of other facilities. This needs management and organisation, and Pat Brookhouse’s account of being a practice manager gives an excellent account of the importance of having dedicated people managing practices. Finally, there are the accounts of Stuart Ward and Sarah Hudson, who at the time of writing were third year students who had recently undertaken their community experience. Whilst the memories were still fresh in their mind they wrote their accounts of that experience. These are excellent accounts and capture the experience of being in the community and the sorts of nursing skills and knowledge they learned. They also give you their tips on how to make the most of the experience and also how to survive.
Finally, introductions and comments are provided for each chapter. As you read all of these accounts you can process the information on at least two levels, Firstly, there is the appreciation of what each person is saying and the development of quite a broad understanding of different people’s roles and abilities; this is very useful and will help you appreciate the wide role and responsibilities of community nurses. But there is a second level that requires deeper reflection and an unpacking of your previous views, perceptions and understanding about not only community nursing, but also the wider body of nursing and how you as an individual function.
What you are reading about in this book are accounts of what people do, what they believe in, and to some extent why they are doing it. This is a great privilege, because people are letting you not only into their working role but also into their beliefs aspirations, and implicitly into the way they think. If you can reflect on these accounts and on your own nursing practice in ways that really make you explore and challenge your beliefs and understanding, not only about community nursing but also about how you function as an individual, then you will learn some very powerful lessons.
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