Rural Nurse Specialist: A Model. Robin Williams RGON ADN Operational Manager and Clinical Advisor Community Health West Coast District Health Board. West Coast Rural Nurse Specialist Team. Heather Maw (Karamea) Elizabeth Burns (Moana/Otira) Bruce Hall (Harihari)
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Robin Williams RGON ADN
Operational Manager and Clinical Advisor
West Coast District Health Board
1996 variation in employment contract between Coast Health Care and the South Rural Nurses contract
lack of residential GP backup [on his/her days off]
on call work
2000 Public Health Nurse to Rural Nurse
A “multiskilled rural nurse – providing 24hr cover, 7 days a week”, advised that
“rural nursing is not for the faint hearted or the truly organized nurse. It is however rewarding, stimulating and a way of life, a darn good one at that”.
‘Rural nursing’ is not a scope of practice, it is a context of practice. Nursing practice is shaped by the rural context.
(Jones & Ross 2001)
It is a generalist role, but a specialised generalist
National health goals & local health needs e.g.
‘ PHC— rural health’ as a ‘scope’
Changes in the economics in demography of New Zealand through the past decade or more have led to hard times and the depletion of health and other social services in rural settlements have bought the health of rural community to the attention of policy makers
The difficulty in finding GPs for rural areas has gone on for along time. My father was Chairman of the Maniototo Hospital Board and I remember the difficulties – I have newspaper clippings -- they had in those days trying to find a GP for Ranfurly. It’s not something new and is not going to go away. I firmly believe that the Nurse Practitioner idea is something that needs to the developed more and more in rural areas to assist GPs so that they don’t feel so isolated and burnt out(Marg Eckhoff).
(ANA cited in Cronenwett 1995:115)
Specialization is concentrating or delimiting one’s focus to part of the whole field of nursing.
Expansion refers to the acquisition of new practice knowledge and skills including the knowledge and skills that legitimize role autonomy within areas of practice that overlap the traditional boundaries of medical practice.
Advancementinvolves both specialization and expansion and is characterised by the integration of a broad range of theoretical, research-based, and practical knowledge that occurs as a part of graduate education in nursing.
Primary Health Care contracts that provide for equal status of Medical Practitioners and Nurse Practitioners, whilst recognising each as having specialised roles with joint responsibility to improve health outcomes