What is primary health care nursing?

What is primary health care nursing? With our recent change to our constitution, it is critical that we get a clear and concise definition and at our recent board meeting last weekend, there was considerable time devoted to thrashing this out.

Our change to our constitution was driven by pragmatic considerations arising out of interest from other nurses within primary health care, movement of nurses across the different settings, and addressing a long-term thorny issue for APNA of the slightly demeaning and non-descript term 'practice nurse'. Also other similar health care systems were moving in a similar direction e.g. New Zealand and Canada.

What d0 primary health care nurses do?

Firstly we need to define primary health care. Of key interest to nurses would be the document Primary Health Care: A Nursing consensus view - to which APNA among other nursing groups were key drivers and contributors http://www.anf.org.au/pdf/PHC_Australia.pdf. I encourage you all to read this veryr eadable document which not only defines primary health care but provides many readable case studies fo nursing work in primary health care. There is also an excellent summary on the PHCRIS website with links to other useful resources http://www.phcris.org.au/infobytes/about_phc.php
For an international perpective, the World Health Organisation released a paper recently which can be found at http://www.who.int/whr/2008/08_overview_en.pdf.

How do we define nursing role within primary health care? The New Zealand definition at present is

'Primary health care nurses are registered nurses with knowledge and expertise in primary
health care practice. Primary health care nurses work autonomously and collaboratively to promote, improve and restore health. Primary health care nursing encompasses population health, health promotion, disease prevention, wellness care, first point of contact care and disease management across the lifespan. The setting and the ethnic and cultural grouping of the people determine models of practice. Partnership with people – individuals, wha¯nau (a maori community), communities and populations – to achieve the shared goal of health for all, is central to primary health care nursing (Ministry of Health 2003:9).' http://www.moh.govt.nz/moh.nsf/0/7B8611D77164266ECC25705B001BB6BA/$File/EvolvNurse.pdf

In it discussions, the board was keen to also include concepts of improving quality of life where an improvement in health care is not feasible which is in line with broad definitions of nursing. They also discussed where research and advocacy or shaping health policy fitted in to a definition. The concept of teams was felt to be important in any definition, along with leadership, partnership with the community and patients/consumers, and management systems. Overall it was felt critical to clearly define the 'nursing perpective', the concept of a holistic approach to care.

The Board has directed me to start the development of an organisational definition, with a view to submitting to membership for feedback. I welcome any comments or thoughts at this time via this blog or via email to belinda.caldwell@apna.asn.au

On a lighter note, if any of you want to be part of these exciting Board discussions, consider nominating for the APNA Board. The closing date is 2nd April 2010. Go to website for further information or again email me.

Finally, if any of you have been wondering why the APNA website has been looking particularly tired and less up to date than usual - we are about to go to a new improved website. This process, as with all IT processes, is taking a bit longer than we anticipated but I am positive you will enjoy it when it gets there!