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11 - Diabetes mellitus
- from Part 2 - Nursing care of clients with chronic conditions
- Edited by Linda Deravin, Charles Sturt University, Bathurst, New South Wales, Judith Anderson, Charles Sturt University, Bathurst, New South Wales
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- Chronic Care Nursing
- Published online:
- 18 June 2019
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- 21 May 2019, pp 183-200
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4 - The practice of rural nursing and midwifery
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- By Jenny Davis, Monash University, Moira Williamson, Central Queensland 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
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- Rural Nursing
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- 06 August 2018
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- 22 August 2014, pp 46-64
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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).
Acknowledgements
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- By Karen Francis, Charles Sturt University, Ysanne Chapman, James Cook University, Charles Sturt University, Monash University and the University of Adelaide, Carmel Davies, 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
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- Rural Nursing
- Published online:
- 06 August 2018
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- 22 August 2014, pp xi-xii
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Contents
- 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
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- Rural Nursing
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- 06 August 2018
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- 22 August 2014, pp v-viii
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7 - Working with adults in rural communities
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- 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
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- Book:
- Rural Nursing
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- 06 August 2018
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- 22 August 2014, pp 107-125
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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).
Frontmatter
- 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
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- Rural Nursing
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- 06 August 2018
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- 22 August 2014, pp i-iv
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1 - The context
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- 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
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- Book:
- Rural Nursing
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- 06 August 2018
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- 22 August 2014, pp 1-17
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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).
Rural Nursing
- The Australian Context
- Karen Francis, Ysanne Chapman, Carmel Davies
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- Published online:
- 06 August 2018
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- 22 August 2014
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The Australian rural environment is unique, diverse and challenging for nurses who are the most significant providers of health care in this context. Rural Nursing: The Australian Context provides readers with an understanding of the knowledge and skills required to practise in rural locations and communities. This book includes chapters on pregnancy, parenting, childhood, adolescence, adulthood, ageing and mental health. It examines rurality, population and health demographics, and the different practice opportunities available in rural settings. The authors outline the importance of having well-established professional networks and encourage readers to develop practice skills in response to a particular community. Each chapter features a vignette, reflective questions and a list of websites for further reading. Written by a team of academics and practising rural nurses, Rural Nursing will equip nursing students with the confidence to provide high-quality health care in a range of practice settings.
List of Contributors
- 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
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- Book:
- Rural Nursing
- Published online:
- 06 August 2018
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- 22 August 2014, pp ix-x
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Index
- 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
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- Rural Nursing
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- 06 August 2018
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- 22 August 2014, pp 185-188
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3 - Understanding the community
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- By Ysanne Chapman, James Cook University, Charles Sturt University, Monash University and the University of Adelaide, Karen Francis, Charles Sturt University, Melanie Birks, James Cook 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
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- Book:
- Rural Nursing
- Published online:
- 06 August 2018
- Print publication:
- 22 August 2014, pp 34-45
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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).
10 - Conducting research in rural contexts
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- By Ysanne Chapman, 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
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- Book:
- Rural Nursing
- Published online:
- 06 August 2018
- Print publication:
- 22 August 2014, pp 159-175
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Summary
Learning objectives
On completion of this chapter, the reader will be able to:
discuss various reasons for implementing research
describe the research process
identify methods for data generation and collection
list strategies for dissemination of research findings
discuss the implications of research for rural nursing practice.
Key words
Research, methodology, methods, dissemination, rural nursing and midwifery
Chapter overview
It is fitting that a chapter of this book considers the place of research in rural nursing. Research in health disciplines potentiates quality in healthcare delivery and can introduce new and effective evidence-based practices, consider the success and usefulness of health policies, or describe and comment on clients’ or patients’ experiences of particular phenomena. Initiating research may at times seem an overwhelming venture, and we hope this chapter will provide some insights into how to start. The authors have used a research study they undertook in 2007 with three other colleagues on overseas trained nurses’ experiences in rural settings as an exemplar to illustrate the approaches adopted to ask and answer questions of practice (Francis, Chapman, Doolan, Sellick & Barnett, 2008).
Introduction
Enquiry – asking questions of practice
Good research stems from a well-designed and articulated research proposal. The proposal is a snapshot that captures the depth and breadth of the research study and provides a frame of reference as researchers progress the research. Without a robust proposal, research can be fragmented, tangential or may never come to fruition. Initial ideas about a research project can be captured on a one-page document and diagram. This summary can be used to ‘sell’ the research idea to collaborators and provide a template to develop a proposal (see Figure 10.1).
11 - Conclusion
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- By Karen Francis, Charles Sturt University, Ysanne Chapman, James Cook University, Charles Sturt University, Monash University and the University of Adelaide, Faye McMillan, Charles Sturt University, Jane Havelka, 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
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- Book:
- Rural Nursing
- Published online:
- 06 August 2018
- Print publication:
- 22 August 2014, pp 176-184
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Summary
Learning objectives
On completion of this chapter, the reader will be able to:
discuss the implications for nursing practice in rural and remote Australia
describe the diversity of populations who reside in rural and remote Australia
appreciate the common health challenges of rural people at each stage of the lifespan
identify strategies for securing a sustainable nursing and midwifery workforce for rural and remote practice
isolate future opportunities for nurses and midwives working in rural and remote practice settings.
Key words
Rural and remote populations, culture, health status, nursing and midwifery, research
Chapter overview
The final chapter provides a précis of the book content followed by concluding remarks on the future of rural communities, the health workforce, and challenges and opportunities for nurses and midwives who wish to practise and advance their careers in rural settings.
Introduction
Understanding the nature and character of rural Australia and of the people who live there is a prerequisite for anyone contemplating practice in these contexts. The vastness of the land and the diversity of the populations who reside in it are reflective of the opportunities available. Nurses and midwives are the largest group of health professionals and the most evenly distributed throughout Australia (Francis & Mills, 2011; Health Workforce Australia [HWA], 2012). The contribution they make to the health and wellbeing of rural Australians is significant. Choosing to work in rural and remote Australia is a wise career option that affords opportunities to extend and advance practice that impacts positively on individuals, groups and communities.