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1800 results in Nursing

Page 72 of 90

  • 2 - Rural health

  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 18-33

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • define ‘rurality’

  • describe rural and remote Australia as a place to live and work, highlighting recent changes in the economic, social and industrial fabric of rural and remote communities that impact on health

  • recognise the importance of rural and remote area nursing within the rural health workforce

  • identify the advantages and disadvantages of rural and remote area nursing and midwifery

  • create a resource bank of references and web links for readers to use in further exploring rural and remote area nursing in Australia.

    • Key words

  • Rurality, rural health, health workforce, rural nursing and midwifery, health status

    • Chapter overview

    This chapter contextualises ‘rurality’ as a criterion for classifying populations living in areas outside major cities. Differences in health status of rural compared to metropolitan communities are described, as is the composition of the health workforce. The chapter concludes with an overview of the rural nursing and midwifery workforce and the challenges these clinicians face in the delivery of care.

    Introduction

    Approximately 31% of the Australian population live outside major cities (e.g. capital cities or large regional centres with populations over 250 000). Only about 2% of this rural population live in what are considered to be ‘remote’ communities (Australian Institute of Health and Welfare [AIHW], 2012a). The percentage of the Australian population living in rural areas has declined considerably over the two centuries of white settlement. Much of this attrition has been caused by the merging of family farms (agribusiness) and young farmers leaving ‘the land’ to work and live in major centres (Smith, 2007). The economics of agriculture (e.g. the strong Australian dollar) and the increasing regulation of the industry have meant that the rural population has declined. Further, those still working in the agricultural sector represent an ageing workforce. This population decline and the ageing of the agricultural workforce have been a continuous feature of rural Australia and have occurred not only in livestock and grain industries but also in the fruit and vegetable industry (Smith, 2007; Sutherland, 2012).

  • 4 - The practice of rural nursing and midwifery

  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 46-64

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • describe the rural health workforce

  • discuss the role of a rural registered nurse or midwife

  • explain the challenges of practising as a registered nurse or midwife in a rural context

  • identify methods for ensuring currency of practice

  • explain cultural responsiveness and how this concept can be embedded in practice.

    • Key words

  • Rural nursing and midwifery, practice, workforce, education, recency of practice

    • Chapter overview

    This chapter focuses on rural nursing and midwifery practice. For the purposes of discussion, the context of rural practice will include remote area nursing practice encompassing a wide range of health services and settings, including small inpatient and multipurpose facilities, aged care, general practice and community health, outreach services, sole practitioner sites and locally controlled Aboriginal community health services (Francis & Mills, 2011). Nurses and midwives employed in rural and remote health services face numerous challenges that will be discussed.

    Introduction

    Australia, as highlighted in Chapter 1, is characterised as a large continent in which the majority of the population reside along the coastal perimeters and within urban or regional locations, with over two-thirds living in major cities (Baxter, Gray & Hayes, 2011). The population in rural and remote areas of Australia is small in comparison to the urban and regional areas of the continent (Baxter et al., 2011). Therefore, as the population dwindles in size, so do the resources available to these rural and remote populations. This affects the ability of an individual to receive the same health care as their urban counterparts (Carey, Wakerman, Humphreys, Buykx & Lindeman, 2013). The provision of healthcare professionals is another issue; it is often difficult to attract and maintain the services of healthcare providers in rural and remote areas of Australia (Yates, Kelly, Lindsay & Usher, 2013).

  • 8 - Living longer, living well

  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 126-139

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • empathise with older people in rural Australian communities

  • discuss the attitudes towards healthy ageing in rural communities and their association with living well

  • identify the role that lay carers play in support for older people with healthcare needs

  • identify the role that professional health services play in the maintenance of healthy lifestyles for older people in rural communities

  • appreciate the advantages for older people, their carers and family members of preparing advanced care directives.

    • Key words

  • Living well, chronic and complex care, self-care, health promotion, advanced care directives

    • Chapter overview

    This chapter provides a positive picture of living well as an older person in a rural community. It covers self-care and formal and informal support services for older people by profiling a fictional senior Australian, Sarah Atwood, as she becomes frail and in need of extra support.

    Introduction

    Community is a key word in rural living as it signals benefits of mateship, reciprocity and security. These are particularly valued aspects of rural living for older people and can make the difference between a contented old age and one full of ill-health, social isolation and insecurity. Active older people are the backbone of any rural community through the contribution of their time and talents to family life as informal and formal carers for partners, friends and family. They also get involved in politics, voluntary services, social networks and charities. Such activities keep people interested and involved and add substantially to feelings of self-worth and dignity, which are so necessary for mental health and wellbeing.

  • 6 - Childhood and adolescence in rural communities

  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 86-106

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • discuss the normal growth and development (developmental milestones) related to children in rural communities

  • define and identify common health issues related to children and adolescents in rural communities, including respiratory disorders, injury/accidents and burns

  • identify health promotion practices such as access to and application of appropriate screening tests as well as age-relevant immunisation requirements

  • briefly discuss issues relating to mental and sexual health in relation to adolescence in rural communities

  • describe and discuss access issues that children and adolescents in rural communities have in relation to accessing metropolitan health facilities.

    • Key words

  • Childhood conditions, mental health, adolescents, immunisation, growth and development

    • Chapter overview

    This chapter provides a brief snapshot of children and adolescents in varying contexts of practice in rural environments. Common childhood conditions and aspects of adolescent health will be presented in conjunction with case studies and reflective questions to facilitate practical application.

    Growth and development

    Factors affecting growth and development fall into two main categories: heredity and genetic and environmental factors. In the early prenatal environment, the uterus shields the foetus from external adverse conditions, which may include maternal nutritional deficiencies, metabolic or endocrine disturbances, infectious diseases such as rubella, Rh incompatibility, smoking, alcohol and drugs. In the postnatal period, the environment determines the pace and pattern of growth and development. During this time, nutrition, infections, trauma, socioeconomic level, climate, cultural influences, emotional factors, chronic diseases and growth potentials will lay the groundwork for development of the child.

  • 9 - Mental health in rural communities

  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 140-158

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • understand the rural environment and its relationship to mental health and wellbeing

  • discuss attitudes towards mental illness in the rural context

  • identify mental health matters from a lifespan approach

  • acknowledge the roles of rural generalist nurses/midwives and mental health specialists within interdisciplinary teams

  • understand that rural people are faced with particular challenges when accessing mental health information and services and recognise the specific needs of Indigenous Australians.

    • Key words

  • Interdisciplinary teams, mental ill-health, stigma, contemporary models of care, access and equity

    • Chapter overview

    This chapter provides an overview of mental health and wellbeing in rural Australia. The narrative will be guided by a lifespan approach exploring health promotion, information, and access and equity with respect to mental health services for children, adolescents, youth, adults and older adults. The specific healthcare needs of Australia’s Aboriginal and Torres Strait Islander people will also be addressed. The chapter covers current trends, models of care available to individuals experiencing mental ill-health, and the roles of generalist nurses/midwives, mental health clinicians and other interdisciplinary team members. Collectively, they aim to support rural healthcare users to help them achieve their individual goals, with additional support from family members and significant others.

  • 7 - Working with adults in rural communities

    • By Ysanne Chapman, James Cook University, Charles Sturt University, Monash University and the University of Adelaide., Karen Francis, Charles Sturt University
  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 107-125

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • describe and critique the division of labour in rural communities

  • discuss and critique employment opportunities in rural Australia

  • debate the impact of the mining boom on rural Australia

  • outline the major healthcare issues of working adults in rural Australia

  • explain the role and function of the nurse in providing health care to adults in rural communities.

    • Key words

  • Adults, rural, employment, division of labour, nurses

    • Chapter overview

    The adult in rural settings is the focus of this chapter. In it we will discuss how employment openings present themselves as opportunities for adults to settle and grow in rural areas. According to Reimer (1997), informal social networks assist with gaining employment or developing employment opportunities in rural areas. Changes in kin and friendship relationships, divisions of labour and economic viability also impinge on rural employment. When economic factors threaten the viability of local employers, unemployment challenges arise – and these will also be discussed. Common health conditions and serious threats to wellbeing from either those employed or those not employed will be outlined. The central role of nurses in various practice settings and their interaction with the adult population will be weaved through the discussions.

    Gender and work

    More than one-third of Australians live in rural and regional areas (see Chapters 1 and 2). However, many rural areas are characterised by an ageing and declining population. Young people and families migrate to urban centres for improved work, education and lifestyle opportunities. Gender equality within rural areas enables women to become viable economic players in sustaining employment. Gender norms and patterns can be rigid in some countries; women are often placed in a disadvantaged position to men. Unequal pay, hours of employment and rights of the individual are all factors that contribute to such inequality (Food and Agricultural Organization of the United Nations [FAO], 2010). When women are equal contributing partners in a household, the health of that household increases, and women’s leadership and decision-making participation are also strengthened (FAO, 2010).

  • 1 - The context

    • By Karen Francis, Charles Sturt University, Ysanne Chapman, James Cook University, Charles Sturt University, Monash University and the University of Adelaide
  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 1-17

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • describe an overview of the history and culture of the Australian population

  • discuss the statistics of the Australian population

  • describe the current health priorities for Australia

  • provide an overview of how health care is provided in Australia and how the various governments impact on health policy development

  • source how education of healthcare workers is provided in Australia.

    • Key words

  • Australia, health policy, population, healthcare worker, education provider

    • Chapter overview

    This chapter provides background to the text. The Australian population, legislative frameworks and policies, health challenges and health priorities are described. A profile of the health workforce in Australia is included.

    Background

    Australia is an ancient island continent covering 7 682 300 square kilometres (Australian Government, 2013b and is the world’s sixth largest country (Tourism Australia, 2013a). The traditional peoples of this land arrived approximately 50 000 years ago from South-East Asia during the last Ice Age (Tourism Australia, 2013b). These peoples dispersed across the land, adapting their ways of life to accommodate the bounty offered and developing unique languages and cultures (Australian Bureau of Statistics [ABS], 2013a). The Indigenous peoples established tribal lands and trade partners with neighbouring groups. Kinship ties were formalised as members of the neighbouring groups established relationships that bound tribes and clans together (Indigenous Australia, 2013).

    Archaeological evidence suggests that the northern borders of Australia were regularly visited by traders from South-East Asia who contributed to the diversity of the Indigenous populations (ABS, 2013a). European sailors also visited Australia prior to Captain James Cook claiming Australia for England in 1778. Willem Janszoon travelled from Indonesia to Cape York Peninsula in 1606, and Dirk Hartog, another Dutch explorer, came ashore on the west coast of Australia in 1615 and probably interacted with local peoples. Hartog’s discovery of the ‘Great Southern Land’ led to its inclusion in world maps of the time and facilitated increased expeditions by other European sailors (Australian history, 2013).

  • 3 - Understanding the community

  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 34-45

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • describe the features of a community profile and identify sources of data to inform this process

  • critically examine issues of access and equity in respect of health services

  • identify the information needed to inform prospective community planning

  • discuss the concept of burden of disease

  • appreciate the impact of contemporary communication systems on health outcomes.

    • Key words

  • Burden of disease, community profile, rural communities, rural nursing, midwifery

    • Chapter overview

    Working effectively in any community requires understanding of the community. Such an understanding can be obtained through knowing the population demographics, resources and assets of that community. Together, these features make up a community profile that forms the basis for planning to address the burden of disease and inequity in health outcomes and accessibility to services in rural and remote areas. This chapter provides details of methods for building a community profile in which rural nurses and midwives work.

    Community profile

    A community profile is a summary of the community that is inclusive of the population, assets, resources and trends (social, political and economic) that provide baseline data (Australian Bureau of Statistics [ABS], 2013b). These data provide the context for determining need, planning and assessing the impact of proposed initiatives (New Forest District Council, 2013). The community profile is harnessed by drawing on primary data that are generated through observations, stakeholder interviews, surveys, an inventory of services and facilities, and secondary data sources such as reports produced by local councils, businesses, the ABS census, workforce/labour and housing data, newspapers and other media communications (Community profiling, 2004; New Forest District Council, 2013). These data must be collated in a manner that is informative and useful. Developing community profiles is an iterative process that allows for new information to be included as it is isolated (Francis, Chapman, Hoare & Birks, 2013).

  • 5 - Pregnancy, paternity and parenting in rural communities

  • Karen Francis, Charles Sturt University, Wagga Wagga, New South Wales, Ysanne Chapman, Central Queensland University, Carmel Davies, Charles Sturt University, Wagga Wagga, New South Wales
  • Book:
    Rural Nursing
    Published online:
    06 August 2018
    Print publication:
    22 August 2014, pp 65-85

  • Summary

    Learning objectives

    On completion of this chapter, the reader will be able to:

  • identify the unique needs of rural families in accessing health care

  • describe normal pregnancy care and recognise the importance of involving fathers in pregnancy and parenting

  • discuss child and family health, including immunisation targets

  • recognise vulnerable groups and specific care needs

  • identify the needs of children exposed to life-limiting illnesses.

    • Key words

  • Pregnancy care, paternal role, immunisation, life-limiting illness, vulnerable groups

    • Chapter overview

    This chapter provides a snapshot of rural health care from the perspective of young families. It captures pregnancy care models, involvement of fathers in birthing and caring roles, the promotion of health and wellbeing in children, identification of vulnerable groups, and the support of children with life-limiting illnesses.

    Introduction

    Healthcare access and equity continue to be significant issues for rural Australians, particularly for women and their young families. The centralisation of services to regional, urban and metropolitan areas has led to enforced travel to access health care or, alternatively, reliance on intermittent outreach services to outlying communities. Thus, the health and wellbeing of this rural cohort require special consideration to ensure optimum health outcomes. Health service and professional regulatory authority reforms highlighted in previous chapters pose issues for rural nurses who are also midwives and for those who hold midwifery-only qualifications; these are further discussed in this chapter.

    Pregnancy

    In 2009, the Chief Nurse and Midwifery Officer, Rosemary Bryant, led a review of maternity services on behalf of the Federal Government. Subsequently, Improving Maternity Services in Australia: The Report of the Maternity Services Review was released following extensive consultation (Commonwealth of Australia, 2009). All contributors acknowledged that ‘safe, high-quality and accessible cared based on informed choice must be the goal’ (p. iii), with these factors being central to future policy development and implementation.

Page 72 of 90