An Introduction to Community and Primary Health Care

Introduction

Sexual health nurses are employed to work in a range of practice settings and with diverse population groups. Work settings include dedicated sexual health clinics, family planning services, community health centres, women's health services, correctional services, general practices and tertiary education settings. The scope of practice varies between settings, within and across states and territories. There is no single, nationally recognised qualification or role description (Knight et al., 2003). Some practice settings may be gender-specific, but in general sexual health nurses work with people of both genders and diverse sexualities. As there is a lack of consistency in role expectation, this chapter explores a range of activities that may be undertaken by sexual health nurses.

The role of the sexual health nurse

In general, sexual health nursing practice focuses on two key areas: reproductive health issues and sexually transmissible infections (STIs). Some roles may focus predominantly on one area, but many engage in aspects of both (Knight et al., 2003). Most sexual health nursing practice involves seeing people on an individual basis, for screening, assessment, treatment or health education (O'Keefe, 2005). Fundamental to sexual health nursing is non-judgemental practice (O'Keefe, 2005). The role of the sexual health nurse is to support individuals to achieve their best sexual functioning physically, psychologically and socially (O'Keefe, 2005).

Taking a sexual health history

People who attend sexual health services may be symptomatic or asymptomatic; taking a sexual history should occur in either circumstance (Skelton & Matthews, 2001). Being asymptomatic does not necessarily mean that STIs are not present; chlamydia, HIV and other infections may occur without symptoms. Therefore, focusing the discussion on symptoms such as pain, bleeding or discharge perpetuates the misconception that infections are only present when symptoms occur. A thorough sexual health history is required to properly assess the needs of the individual. However, many people, including health care professionals, find talking about sexual activity embarrassing (Skelton & Matthews, 2001). Practising how to ask relevant questions can assist the nurse to overcome some of the embarrassment, enabling them to be presented comfortably and with confidence. People are more likely to overcome their embarrassment when the nurse does not appear embarrassed by the conversation.

Talking sexual health

Some health care professionals try to cover their embarrassment through the overuse of medical terminology.