Developing Community Nursing Practice

Developing Community Nursing Practice

Developing Community Nursing Practice

Developing Community Nursing Practice


Developing Community Nursing Practice is the first book to identify and debate the key issues around community nurses taking responsibility for developing the ways in which they deliver care. Modern health care expects the individual practitioner to develop patient-focused, accessible and evidence-based community services. Despite the fact that the introduction and management of change is now a feature of professional education, community nurses often feel ill-prepared for introducing change in the real world, perceiving a gap between theory and practice. Developing Community Nursing Practice aims to close that gap.

This book interweaves thinking about change and innovation with wide-ranging case study experience of contemporary community nursing. It addresses often neglected issues in practice development such as evaluation and sustainability. It gives guidance on how to identify what aspects of practice need to be developed; on how to convince others of the need to change; on how to work across organizational boundaries; and on the likely hazards and how to tackle them.

This is a key resource for all student and practising community nurses (across all specialisms), providing information on how to initiate and implement change and on how ultimately to succeed in developing their own practice.


The latter part of the twentieth century saw a period of extensive and radical change in the structure and operating practices of the UK National Health Service (NHS). The dawn of the twenty-first century heralds a new era, during which the pace of change will be no less dynamic. The publication of the NHS Plan (Department of Health 2000a) presents new challenges for both NHS management and practitioners as the government seeks to modernize the delivery of health care. While the NHS Plan represents a top-down drive towards the development of clinical practice and patient-focused services, opportunities also exist for practitioners themselves to initiate change. The current climate of commissioning and quality provide a unique combination of challenges to nurses working within the community. On one hand, they can begin to visibly contribute opinions as to how services should be provided but on the other hand, they also have to demonstrate effectiveness, and develop their own practice and the way they deliver services. These two challenges may be seen by some as the Straw that breaks the camel's back and sends them off into early retirement or long-term sick-leave. However, the contributors to this book have, collectively and differently, seen these challenges as the greatest opportunity community nurses have had to demonstrate their contribution to health benefits for the population.

The UK NHS is different, if not unique, in terms of its organizational structure. Not only is the health service the largest single employer in Europe, but it is also a highly complex bureaucracy, with many interconnecting constituent parts. Most organizations separate out the functions of manufacture and new product development/innovation. Rarely, if ever, is an employee on the shop floor expected to generate ideas about new ways of working, never mind plan their implementation and . . .

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