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Professional Issues in Primary Care Nursing


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Foreword by Betty Kershaw Preface Acknowledgements Dedication List of contributors Part I: Setting the Scene of Practice and Walk-in-Centre Nursing 1 The historical development of practice nursing and walk-in-centre nursing (Marie Hill, Carol L. Cox and Shuling Breckenridge). Introduction Learning Outcomes Background Practice nursing WiC nursing Extended role in PN and WiC nursing Conclusion References 2 Practice nursing: the unique nature of practice nursing (Marie Hill). Introduction Learning Outcomes Background The GMS contract Practice nursing: a roller-coaster ride Education and training: are today?s PNs equipped for their role in primary care? Carpe Diem Conclusion References PM 3 Walk-in-centre nursing: the unique nature of walk-in-centre practice (Jane Bickerton). Introduction Learning Outcomes Background What is the clinical role of the nurse in the WiC setting? Communication interactions Promoting health and well-being in a WiC setting Clinical decision-making support Non-medical prescribers Clinical supervision Educating nurses in a WiC A nurse-led service Establishing a WiC Urgent care environment Patient satisfaction with WiC health care Conclusion References 4 The context of practice nursing and walk-in-centre nursing: domains of practice and competencies ?setting the scene (Carol Cox). Introduction Learning Outcomes Background Origins of the advanced practice role in the UK Delineation of advanced practice Role of the advanced practice nurse Educational preparation RCN (2002, 2008) and NMC (2005) Domains of Practice and Competencies Practice and WiC nursing and future directions of advanced clinical practice nursing Conclusion References Part 2: Domains of Practice Domain 1: Management of Patient Health/Illness Status 5 Critical thinking and diagnostic reasoning in clinical decision-making (Nita Muir). Introduction Learning Outcomes Background What is a decision? Theories of decision-making The analytical stance on decision-making The middle ground Knowledge within decision-making Errors within clinical decision-making Systems that improve decision-making Clinical decision support systems Reflective practice Conclusion References 6 Health education and health promotion (Daryl Evans). Becoming a health-promoting nurse in general practice and walk-in centres: Introduction Learning Outcomes Background Integrate with public health and health improvement strategies Ensure the nursing care structure enables all opportunities for health promotion to be taken for every patient Develop one-to-one skills of conversation and motivating behaviour change Settings-based health promotion ? working towards a healthy organisation Involve local support groups and reach out to the local community Keep up to date with news and take opportunities to study Conclusion References Domain 2: The Nurse?Patient Relationship 7 Working with individual patients and groups: creating and strengthening relationships (Karen Thompson). Introduction Learning Outcomes Background Verbal or vocal behaviours Barriers to communication Working with individual patients and clients Working with groups Conclusion References 8 Confidentiality, privacy and dignity: ethical, legal and cultural issues (Nicci Whiteing). Introduction Learning Outcomes Background Domain of practice area with specific competencies Key points in relation to the competencies for Domain 2 Conclusion References Domain 3: Education Function 9 Anticipatory guidance: National Service Frameworks (Vicky Lack). Introduction Learning Outcomes Background Domain 3: the education function How does anticipatory guidance relate to the NSFs? Knowledge of preventive strategies Pre-requisites for giving anticipatory guidance Conclusion References 10 The creation of an environment for effective learning (Marie Hill). Introduction Learning Outcomes Background Adult learning theories Adult learning Domain 3: The Education Function Creating a learning environment Conclusion References 46 PM Domain 4: The Professional Role 11 Clinical supervision: reflective practice; learning through experience (Chris Johns). Introduction Learning Outcomes Background Reflective dialogue Deeper reflection Reflection Burford reflective and holistic model Conclusion References 12 Use of theory and research to inform practice (Jane Bickerton). Introduction Learning Outcomes Background Domain of practice Health care research in practice Conclusion References Domain 5: Managing and Negotiating the Health Care Delivery System 13 Collaboration and working with the multidisciplinary team and agencies (Kathryn Waddington). Introduction Learning Outcomes Background Communication and partnership working Interprofessional discourses Factors promoting effective collaboration Organisational theories and collaboration Using metaphor to understand collaborative working Using metaphor to promote team reflexivity Putting it all together Conclusion References PM 14 Leadership and organisational decision-making: the nurse?s role in implementing policy and practice (Kathryn Waddington). Introduction Learning Outcomes Background The big picture A critical approach Policy formation, implementation and analysis Policy and organisational decision-making The sources and dynamics of power The current policy environment Looking back at leadership in the NHS New leadership agendas for PNs ? linking theory and practice Transformational and transactional leadership Leading advanced practice in primary care The ?dark side? of practice Shifting dysfunctional cultural patterns Conclusion References Domain 6: Monitoring and Ensuring Quality of Health Care Practice 15 Implications of the new GMS contract (Marie Hill). Introduction Learning Outcomes Background Domain of practice area content with specific competencies PNs and the new GMS contract The QoF The new GMS contract: is it working? Practice nursing and the new GMS contract: implications of role development and expansion Conclusion References 16 Art and science of providing quality nursing care in general practice and WiC settings (Carol Cox). Introduction Learning Outcomes Background 47 PM A framework for practice Conclusion References Domain 7: Respecting Culture and Diversity 17 Meeting the cultural and spiritual needs of patients in general practice and WiCs (Anjoti Harrington). Introduction Learning Outcomes Background Key concepts Key concepts and diversity A framework for care Conclusion References 18 Cultural diversity within the general practice and walk-in-centre settings (Maisie Allen). Introduction Learning Outcomes Background Nature, nurture, culture Nursing in a diverse and multicultural NHS How does multiculturalism and diversity impact on health? What can nurses in primary care do to improve health care in a multicultural society? Conclusion References Index

About the Author

Carol Cox is Professor of Advanced Clinical Practice Nursing and Research Lead for the Department of Applied Biological Sciences in the School of Community and Health Sciences, City University London and Nursing Research Lead, Moorfields Eye Hospital NHS Foundation Trust. Marie C. Hill is Senior Lecturer in Practice Nursing, Public Health, Primary Care & Food Policy Department, School of Community and Health Sciences, City University and Lead for Practice Nurse Development in City University.


"This is an excellent resource for nurses working to achieve a greater understanding of the professional issues affecting nursing practice and the current economic environment. Evidence-based examples are presented throughout. Previous and current practices are reviewed and explored. This book helps nurses to better understand that the practice of nursing is ever evolving." (Doody's, 3 February 2012)

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