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Autumn 2003

Members Voice Concerns on Community Nursing Strategic Plan

The Community Nursing Strategic Framework document has received a mixed reaction from HACSU community nurse members at a series of forums held across Tasmania.

Whilst acknowledging a need for change, members were concerned about a range of issues.

Primarily concerns focused on statements that the new framework would be implemented within existing budgets, with nurses worried this would mean reduced care or more work, and possibly both.

Community nurse members argued, given the importance of community nursing to reducing hospital bed time and aged care, proper resourcing would mean long term savings. Community nurse members stressed the need for educational support, and the development of proper protocols.

There was also discussion around the need to develop and maintain IT services and support in order to implement many of the proposals outlined.

Most members said they thought this would require some additional funding.

Outlines in the framework around changes to nursing structure that threatened the current Award Classification of Registered Nurse - Community Health, Family and Child Health were not popular.

Maintaining this classification is seen as vital in ensuring that the expertise of community nurses is maintained, particularly in the provision of primary health care services.

The proposed changes to the nursing structure also raised concerns about duty of care and skill mix.

It was argued that extending centre- based care has many implications of a negative nature. Whilst this service is currently offered in a somewhat limited capacity, with any extension, there needs to be consideration of -

• practical issues such as transport availability and client mobility when offering this service,

• the fact that an assessment by a community health nurse in the clients home may be more holistic and better able to fulfill the function of health promotion,

• current centre numbers offering such services are low and any expansion of such services may require capital costs in construction of new buildings which may not be cost-effective,

  any model supporting the use of centre-based facilities must still allow for individual client choice in electing to use such services and allow for continuation of home based care, if it is preferred.

here was a positive response to the suggestion in the framework of the development of collaborative partnerships.

It was also considered the existing communication between services could be improved upon.

The reaction to call-centres was mixed. Whilst it was acknowledged that these centres are successful interstate, some members were concerned that the different Tasmanian demographic may have an impact.

Others were concerned from a medico-legal perspective.

However, perhaps more detail on the actual operation of call-centres would be useful, as there was some concern nurses may be required to conduct assessments over the telephone.

HACSU representatives will be presenting feedback to the next Steering Committee meeting and will be working to ensure the voice of the membership is heard.

If any members wish to make comment on the Framework, please contact your local Nursing Organiser.