Nurses’ experiences of transition to community-based practice

Abstract

Objectives: This paper describes the findings from interviews, presented as the second stage of a study aimed at developing a career pathway for community nursing and midwifery for one Australian state, with a particular focus on early transition to community-based practice.Background: With the increasing incidence of chronic conditions, health services are focused on primary and community care as the central point of care provision, and with it, the realisation that nurses have a central role to play in care delivery. Yet, community nursing is a poorly defined area of practice, and it is often seen as an unattractive career option.Methods: Semi-structured interviews were conducted with seven experienced registered nurses currently employed and working in the community. Data analysis was undertaken using a pragmatic approach that allowed for the examination of themes emerging from the participant narratives. One member of the research team conducted interviews, with cross-checking of transcripts undertaken by other members of the team. Narrative was drawn from the transcripts and aligned to themes emerging from a draft pathway informed by a systematic review. COREQ checklist was adhered.Results: Participants identified elements essential to a good transition that included responsive orientation, innovative leadership and the development of community-based networks related to social, legal, financial and practical elements of care. Experiential knowledge and a sense of belonging within the community were two important factors considered essential to successful transition.Conclusion: Community nursing is a specialised practice which requires a revision of expectations, preparation for practice and acknowledgement of its value, before nurses can become responsive to the changing community emphasis on health service delivery.Potential implications: For a career pathway to accommodate early transition into community practice, key issues need to be addressed in relation to educational preparation, support for practice, and acceptance.

Facilitating an early career transition pathway to community nursing: A Delphi Policy Study

“…We selected a Delphi policy approach, guided by a previous systematic review (Harvey, Hegney, Sobolewska, et al, ) and semi‐structured interviews (Harvey, Hegney, Tsai, et al, ). The approach was chosen to refine, substantiate and finalize an early career pathway model for Registered Nurses in the area of community care.…”

“…This study is phase three of a project, commissioned by the Queensland Government, Australia, to investigate and design a model for the early career transition pathway in the speciality of community nursing. This work builds on phase 1 comprising of a systematic review (Harvey, Hegney, Sobolewska, et al, ) and phase 2 consisting of a semi‐structured interview study of community nurse (Harvey, Hegney, Tsai, et al, ). The systematic review identified a deficiency in the published evidence, especially in the area of “pre‐entry,” a concept referring to a point in time before commencing a transition career pathway (Harvey, Hegney, Sobolewska, et al, ).…”

New Graduate Nurse Transition into Rural Home

“…The role of a home care nurse encompasses a wide range of knowledge and skills to care for diverse populations and health conditions across urban and rural settings (Ganann et al, 2019; Harvey et al, 2019). Home care nurses are responsible for planning and initiating individualized care that requires negotiation with patients and families and other community services (Melby et al, 2018).…”

“…The limited availability of experienced mentors with staffing shortages and high workloads is not unique to rural settings (Calleja et al, 2019). Leaders must advocate within their organizations to address the challenges of being understaffed and under-resourced to ultimately protect an organization's investment in NGNs and provide for the future workforce (Charette et al, 2019; Harvey et al, 2019). Leaders can address the limited availability of experienced mentors by championing training opportunities and support of protected time for mentors which will also provide for reciprocal benefits of development of leadership skills and attention to best practice (Kakyo et al, 2022; Perumal & Singh, 2022).…”