COMMUNITY HEALTH NURSE

Community Health Nurse

Community Health Nurse

The sphere of professional community health nursing has been characterised by a process of rapid development, professionalisation and augmentation of community health nursing practice, driven by international policy drivers, national policy drivers, changes in medical and community health nursing paradigms (including shifts towards evidence-based practice) and the effects of a more consumer-driven culture within the US. Community health nursing practice has responded to a variety of rapid advancements in healthcare practice and medical technology by extending and advancing the scope of community health nursing roles (Simons, Lathlean, & Kendrick, 2006). Advanced community health nursing practice, with its associated roles of clinical, managerial, academic and combined natures, has afforded nurses the scope to augment their roles within specialist or other spheres, often stepping into areas which were traditionally the province of doctors.

Community health nursing practice has advanced in a number of ways, including extended responsibilities, and the emergence of new roles that include titles such as Community health nurse Practitioner and Clinical Nuse Specialist. These have their roots in the 1990s when a range of new advanced roles were emerging in the community health nursing sphere, not all of which stood the test of time (American Nurses Association, 2010). However, with the approval of the Royal College of community health nursing, certain of these roles have gained in status and have developed into integral parts of clinical practice in certain areas. There is, however, no separate registration for community health nurse practitioners or clinical community health nurse specialists with the Community health nursing and Midwifery Council, and no central qualification which relates to all advanced practice roles.

There are key areas here which relate to the move into the sphere of medical practice, including the idea of making complex clinical decisions, which relates to the focus of this essay, the development and implementation of community health nurse led surgical pre-assessment clinics (American Nurses Association, 2010). This is an area where expert clinical judgement, based on a specialist knowledge base, is required in order to carry out complex and holistic assessments to support optimal patient care. Community health nurse as being founded in community health nursing paradigms which are focused on holistic principles and patient-centred, individualised care, despite such roles comprising medical tasks (Shia, 2009). Despite this orientation of the advanced role, there are those who continue to see such nurses as merely taking on extra tasks in order to act as substitutes for the Junior Doctors who used to perform such basic medical procedures. This author believes it does not matter how the role is viewed, but only that nurses have espoused these roles and seized the opportunity to not only advance their practice but gain the recognition they deserve for their specialist expertise, whilst simultaneously making use of the opportunity to improve patient care.

Advanced community health nursing roles such as community health nurse practitioner roles allow for a focus on quality of care and on consumer satisfaction, despite a lack of clarity about the scope ...