Community nurses and chronic disease in Israel: Professional dominance as a social justice issue

Abstract

Chronic diseases are major causes of health inequalities. Community nurses can potentially make large contributions to chronic illness prevention and management in Israel but may be obstructed by professional dominance of physicians. However, insufficient research exists about community nursing in Israel, and how it may differ from other countries. This study aims to document chronic disease‐related community nursing roles in Israel, identify changes and trends in community nursing roles that may increase social justice, and understand how the roles and trends in community health nursing in Israel may differ from developments in other countries. In‐depth interviews were performed with 55 Israeli health system professionals, and 692 nurse care‐givers were asked open‐ended questions. Interview answers were analyzed to find themes and trends. The study found that community nurse roles in Israel have expanded, especially for chronic disease control. Commonalities exist with countries such as the United States and the UK, albeit with important differences. However, continued conflicts with physicians exist, which can limit nurses' contributions to reducing health inequalities. Community nurses' importance is growing. Enabling them to overcome professional dominance and improve chronic disease control can help reduce health inequalities in Israel and elsewhere.

The State of the Evidence about the Family and Community Nurse: A Systematic Review

“…The literature affirms that the advanced competencies of FCNs equip them to better understand patients’ needs and know them holistically. For example, different articles have demonstrated a high-level control of FCNs over chronic diseases in communities in Israel [ 64 ].…”

“…FCNs are a valuable and strategic resource in many clinical and care settings. The implementation of FCNs continues to develop day by day, with diverse development concerning the context and healthcare needs of the population [ 19 , 64 ]. Accordingly, our state-of-the-art systematic review included 90 articles from which five interpretative themes emerged, underlining that FCNs can contribute to population health, play a key role in understanding and responding to patients’ needs, and positively influence patient-, nurse- and healthcare system-related outcomes.…”