Hi, I am a nursing student in Australia, studying NRSG 371 BUILDING HEALTHY COMMUNITIES, help me to learn and understand in the best possible ways, by acting as most experienced educator, i will be sharing my lecture notes

Let's really talk about NURSING! Often when people think of nursing they associate it with nurses working in major tertiary institutions (hospitals) in a medical or surgical ward or critical care area. However, nurses have a much wider scope of practice than this and they influence the health care of many individuals, families, communities and populations in a large variety of settings. This unit is designed to highlight the ever changing dynamic health care environment in which we live, work & play and the impact that nursing has within this environment. Sticking to a medical model of illness, does little to promote the impact that nurses can have in a much broader scope of health care. So, what is the definition of nursing? According to the International Council of Nurses representing the global voice of nursing: DEFINITION OF ‘A NURSE’ "A nurse is a professional who is educated in the scientific knowledge, skills and philosophy of nursing, and regulated to practice nursing based on established standards of practice and ethical codes. Nurses enhance health literacy, promote health, prevent illness, protect patient safety, alleviate suffering, facilitate recovery and adaptation, and uphold dignity throughout life and at end of life. They work autonomously and collaboratively across settings to improve health, through advocacy, evidence-informed decision-making, and culturally safe, therapeutic relationships. Nurses provide people-centred, compassionate clinical and social care, manage services, enhance health systems, advance public and population health, and foster safe and sustainable environments. Nurses lead, educate, research, advocate, innovate and shape policy to improve health outcomes. Further, nurses play a unique role in health and care for populations of all ages, and in all settings, building trust with individuals, families and communities and gaining valuable insights into people’s experiences of health and illness. Building on a foundation of personalized direct and social care, nurses advance their capabilities through ongoing education, research and exploration of best practices. A nurse’s scope of practice is defined by their level of education, experience, competency, professional standards and lawful authority. They play a key role in the coordination, supervision of, and delegation to others who may assist in the provision of health care. Often at the front line, they respond to disasters, conflicts and emergencies, demonstrating courage, dedication, adaptability and commitment to the health of individuals, communities and the environment" (ICN, 2025) ICN_Definition-Nursing_Report_EN_Web_0.pdfLinks to an external site. So, what does this mean? In this unit we will explore the much broader role of nursing in the primary health care setting where nurses are able to provide care for individuals, families, communities and populations. Primary health care nursing incorporates many different clinical areas such as: community health nursing community mental health nursing maternal and child health nursing school and youth health nursing sexual health nursing drug & alcohol nursing rural health nursing refugee health nursing occupational health nursing nursing in general practice home based care correctional nursing defence force nursing Despite these different areas that nurses can work in primary health care, they are all guided by the same principles: accessible health care appropriate technology health promotion intersectoral collaboration community participation cultural sensitivity and cultural humility; Let's talk about HEALTH When we talk about health what exactly do we mean? As we know, most health care systems have been developed to respond to illness, rather than to support wellness. There have been many benefits to this model of health care, with increased longevity, decreased morbidity and mortality. However, this model has been challenged over the last few decades and increasing evidence which demonstrates that health and health care is much more complex. When you think of health what definition do you use? We have all heard the WHO definition from 1946 which states " Health is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity" However, we know that health reflects on the complex interactions of a person's genetics, lifestyle (exposure to risk factors) and environment. We also know that health is quite variable between individuals, communities and populations - between countries and within countries. TASK Have a look at the image below and examine the life expectancy of some of the countries in Africa. Why is there such a large difference between countries? Life expectancy in 30 countries is shown shown in this graphic https://www.weforum.org/agenda/2022/11/countries-compare-on-healthcare-expenditure-life-expectancyLinks to an external site. image.png TASK Click on the link above and examine the graphic which shows life expectancy and associated healthcare expenditure per capita. For instance look at the expenditure in the USA compared to Australia, then look at Japan & then look at Chile - why are there such huge differences? Chile spends approximately 1/10 of the USA but has higher life expectancy! Why do you think this is the case? The Alma Ata - where it all started In 1978 the WHO & UNICEF jointly convened the historic Alma-Ata conference that focused the world's attention on primary health care as the key to achieving an acceptable level of health throughout the world. “The promotion and protection of the health of the people is essential to sustained economic and social development and contributes to a better quality of life and to world peace.” (Declaration of Alma-Ata, 1978, p. 1) A copy of the Alma Ata is available in the Talbot & Verrinder text - hereLinks to an external site. The original full documents are located here - ehvd264.tmp (unicef.org)Links to an external site.Ottawa Charter here - The Ottawa Charter for Health Promotion - ClinicalKey for NursingLinks to an external site.Declaration of Astana In October 2018, 40 years after the Declaration of Alma Ata there was a Global Conference on Primary Health Care titled: From Alma-Ata towards universal health coverage and the Sustainable Development Goals held in Astana, Kazakhstan 2000 delegates from more than 120 countries renewed the commitment to comprehensive primary health care for all with the Astana declaration and made the following Declarations: Promote and protect people’s health and well-being, at both population and individual levels, through strong health systems; Primary health care and health services that are high quality, safe, comprehensive, integrated, accessible, available and affordable for everyone and everywhere, Individuals and communities are empowered and engaged in maintaining and enhancing their health and well-being; Partners and stakeholders aligned in providing effective support to national health policies, strategies and plans. This image shows a family READ The Global Conference on Primary Health Care From Alma-Ata towards universal health coverage and the Sustainable Development Goals Astana, Kazakhstan, 25 and 26 October 2018 - https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdfLinks to an external site. Let's talk about Primary Health Care! Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said a PHC approach offers the most effective means to improve health and well-being, including through the delivery of essential health services to all people. It is a driver of universal health coverage, one of the United Nations Sustainable Development Goals (SDGs). image.png https://www.who.int/news/item/23-06-2023-multilateral-development-banks-and-who-launch-new-investment-platform-to-strengthen-primary-health-care-servicesLinks to an external site. image.png “Primary health care will have a major contribution to make in the future in relation to addressing lifestyle issues and reinforcing prevention and better management of chronic conditions.” (World Health Organization, 2003, p. 2) Future Directions of Primary Health Care: https://apps.who.int/gb/ebwha/pdf_files/EB113/eeb11311a1.pdfLinks to an external site. What exactly is Primary Health Care? “Primary health care will have a major contribution to make in the future in relation to addressing lifestyle issues and reinforcing prevention and better management of chronic conditions.” (World Health Organization, 2003) An issue which is often debated is the operationalisation of the term “primary health care”. When used in the health sector, the terms primary health care and primary care are often used interchangeably which causes confusion (McMurray, 2003). Some define primary care as the first line of care or “family doctor-type” services (Muldoon, Hogg, & Levitt, 2006). Whereas primary health care – which may include primary (initial) care, also includes a range of activities which encourage general health and well-being (McMurray, 2003). The broader concept of primary health care or comprehensive primary health care (Talbot & Verrinder, 2005) incorporates many components including: care that is affordable; the utilisation of resources effectively and efficiently; places an emphasis on multidisciplinary collaboration; and brings healthcare close to where people live and work. Primary health care focuses on the root causes of ill-health (Wass, 2000) rather than just the medical treatment of illness. Medical care is only one aspect of a comprehensive primary health care approach (Wass, 2000). Therefore, an essential aspect of primary health care is to determine the causes of ill health, whether that be for example, poverty or nutrition and physical activity. Longer-term benefits to the community are evident with this approach to health care as opposed to only dealing with the end result – illness. Young. J., (2013). Nurse-led chronic disease management in general practice: a mixed methods evaluation of the impact on patients' health. https://espace.library.uq.edu.au/view/UQ:334845Links to an external site. Reflection questions Consider three health care related issues that are currently affecting a community that you belong to. How have you become aware of these issues? Who has been responsible for identifying these issues? What is being done to address these issues and by whom? How could you, as a nurse, become involved in the action to address these issues?Nurse interview - Nikki, Reflection questions Nikki talks about her journey into nursing in the community, to work in the Hospital in the Home Service on the Central Coast of NSW. There are many different roads to nursing in the community; if you were going to consider a role in nursing in the community, what role would you consider and how would you get there? You might like to do a job search on Seek and have a look at some of the requirements for a role you might find interesting in future. Nikki explained the ins and outs of the role of the Hospital in the Home nurse. Does this role appeal to you? Why/ why not? Hospital in the Home nurses have seen some astronomical changes in the type of care that is being provided in the community setting. Nikki discussed breast cancer care, severe infection care and warfarin and INR management to name a few. Does any of this surprise you? Why/ why not? What other nursing care do you think might move into the community setting in the future? You might like to complete some research around this – these are very exciting times for nurses working in the community! From basic equipment to the many advances in technology – in considering all of what Nikki has discussed regarding her role and the current technological advances that are being utilised, can you think of any technological advances that could be used in Hospital in the Home care? Be creative.