United we (should) stand

Community nurses would benefit from forming a strong united face, writes Sandra Lucas.

The health care system of Australia, as in many other countries, is moving out of large acute care hospitals and into the community. This is due to many factors such as an aging population, the cost of acute care beds and government policy. The impact of this is that there are growing numbers of community nurses, who are required to deliver more complex and specialised services.

As a result the work loads are increasing and the care is not as holistic as many community nurses wish they could provide. Despite community nurses being seen as strong and confident nurses, they are not speaking out. This could be due to the lack of a strong united face that comes from a professional association.

Community nursing is a dynamic, interesting field a number of subspecialties. It encompasses many groups of nurses that are not united and represented in any other forum. I think they should be united in a national association for community nurses. This would be of benefit for them on many levels.

These nurses have not had a national association or body to provide a platform for representation at public or government levels. Nor have they had an easy access to Australian community nursing articles to inform them about their practice or a forum to discuss current issues regarding themselves and their community practice. Australian community nurses do practice differently to other countries community health nurses.  A national association could monitor community health trends and current issues. They could identify issues that concern community nurses and then hopefully lobby for changes in community health care.

So what associations are there for community nurses?

Australia has no national community nursing association or national community nursing publication. We have sub branches of special interest groups and a few speciality associations regarding community nursing. Canada, the United Kingdom and other countries have national community nursing associations; they also have national community nursing journals. These journals are great but the Australian content is very limited.

An internet search for Australian community nursing association retrieves the Australian Nursing Federation, The Royal College of Nursing Australia, Western Australia Practice Nurses Association and the Australian Faith Nursing Association. No independent national community nursing association.

Community nursing is a wonderful challenging profession that encompasses a broad range of nurses that work in and with the community:

Community Health Centre nurses
District nurses /Domiciliary nurses
School nurses - primary and secondary
Immunisation nurses
Hospital-in-the-home nurses
Drug and alcohol nurses
Occupational health and safety nurses
Indigenous health nurses
Practice nurses
Bush/rural nurses
Palliative care nurses
Faith or pastoral nurses
Prison nurses (correctional services)
Sexual health nurses
Remote area nurse
Private nurse
Community midwives
Maternal and child health nurses
Homeless person nurse
Community mental health nurses
Royal Flying Doctor Nursing
 Adolescents health nurse
 Community nursing educators
 Health promotion nurses

All of these nurses have one thing in common - they are community nurses. So why is there no national community nursing association?

I believe that one of the reasons is that this diverse group of nurses does not see themselves as one group. This assumption is incorrect. They share common philosophies and theories uniting primary health care principles, the Ottawa charter and a true holistic approach to care. They either work in a community or with a community. Also it is possible that may be that they are too busy with their daily business to create a national community nursing association. Community nursing workloads have increased over the years but the working day stills has eight hours. Finally starting an association would cost money.

And a third reason may be they feel powerless. According to the Australian Institute of Health and Welfare in 2008, the total number of nurses identified by the Nursing and Midwifery Labour Force Survey (after adjusting for multiple registrations) was estimated, 253,616 registered nurses in Australia. Also the Nursing Labour Force 2001 reported the number of nurses employed in community health services increased by about 80 per cent. I believe that this number is still increasing.

Yes, Western Australia does have a Practice Nursing Association. The Australian Nursing Federation does have a special interest group and the Royal College of Nursing have the community nursing faculty, but there is no national community nursing association. It would be of great value to community nursing if their individual voices could join together as one independent voice.

Sandra Lucas is a lecturer at La Trobe University's School of Nursing and Midwifery.

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