In this article we critically analyze the disconnect between much of the contemporary discourse and practice in Canadian community health nursing (CHN) that has contributed to the slow progress of strengths-based, health-promoting nursing practice. Appreciative inquiry philosophy and methods are introduced as a bridge to traverse this disciplinary gap. Two exemplars show how appreciative, strengths-based CHN research and action can move policies and programs toward more socially just practices congruent with CHN values. Exciting potential for nursing knowledge may arise from incorporating more strengths-based approaches into practice, education, policy, and research.
What is the potential of courses designed for nursing students to meet the learning priorities of other disciplines? Who could benefit? Nursing students at Brandon University interested in the 'community as client' concept requested a course that focused on the health of rural residents and the communities in which they live. Questions about (1) measuring the health of rural populations; (2) comparing health status, health resources and health care utilization of rural and urban populations; and (3) determining the health of rural communities emerged. As a result the course, 'Health of Rural Populations and Communities', was created. The Director of the Rural Development Institute examined the syllabus for the new course and asked that Rural Development students be allowed to enroll. This paper focuses on the challenges and opportunities for nursing education to address learning needs of other disciplines by sharing health and nursing knowledge. In doing so the learning of nursing students is also advanced. The development and delivery of a rural health course is used as a case study to illustrate the potential of this approach for nursing and interdisciplinary education.
Community health nursing in China is an emerging specialty. A multi-component collaborative endeavor between the Schools of Nursing of Tianjin Medical University, China, and the University of Ottawa, Canada is described. This project, funded by the Canadian International Development Agency, commenced in 1989. It has laid the groundwork for an expanded role for community health nurses in Tianjin, a municipality of 11 million people located in Northeast China. The historical context for the evolution of community health nursing in China and the emergence of community health nursing as a priority area within the project are described. Major project activities are highlighted, illustrating several underlying principles for strengthening the educational preparation of baccalaureate nurses who can apply community health skills. These include creating a critical mass of faculty who can teach community health nursing, modelling classroom and clinical teaching of community health nursing, bridging the gap between nursing in the community and nursing, in the hospital, and developing a prototype for baccalaureate community health nursing experience. Lessons learned from this initiative are summarized.
An urgent need to secure additional community health placements provided initial motivation to use alternate clinical settings. Subsequent student requests for placement in these settings, rather than the traditional community settings, drew attention to the sites' unique and far-reaching benefits. Presenting the findings of a qualitative study, the authors discuss the perspectives of students, instructors, and RNs regarding their experiences in these alternative clinical settings and provide recommendations for the use of alternative settings in nursing education.
The purpose of this investigation is to describe Scottish health visitors (HVs) experience of changes in their work and compare these with their Norwegian counterparts.
The renewed emphasis on community health care, health promotion and illness prevention is a strong reason to focus on health visiting work. Knowledge about changes in practice are of special interest for nursing science as such knowledge could contribute to the development and advancement of the health visiting service.
The study used a comparative descriptive design. The data are based upon in-depth interviews with nine HVs from Scotland and 12 HVs from Norway.
The results showed similarities as well as differences. HVs in Scotland and Norway experienced changes in work load with decreases in some areas and increases in others, changes in work practice, approaches and techniques with more emphasis on clients' empowerment, and also fewer management positions held by nurses. The differences mainly related to the ways that the health visiting service had specialized and expanded. The aim of Scottish health visiting from 'cradle to grave' service was not adopted by the Norwegian HVs to the same extent. Scottish HVs specialized individually in some areas and used each other's competence to a much greater degree than the Norwegian HVs.
It appeared that the Scottish HVs had found a path where health visiting work aimed at illness prevention and health promotion for everyone was on the way to becoming a comprehensive service and a stronger and more integrated part of the health visiting service. This is a pathway that Norwegian HVs still have to pursue. The qualitative approach and the slightly different samples limited the possibility for generalizations. Further research should address the question of changes and patterns in health visiting work, of how the development came about, and what are the bases for the differences in specialization and expansion of the service. Secondly it should be asked to what degree the development influences the quality of health visiting and consequences for clients, community and health visiting service.
Historically, baccalaureate nursing programs in Canada have prepared graduates to practice in the community. Two recent trends-the move to prepare all registered nurses in degree programs and the changing climate in which community nursing is practiced-made it timely to explore the educational preparation required for community health practice. This article reports on one part of the study, i.e., on findings that explicate the nature of community health nursing practice in a western Canadian province, as it has changed during the past decade, as it is currently practiced, and as it is expected to develop in the future. What, in other words, is the nature of the community practice for which nursing students should be prepared? An action research design guided the study. Participants were recruited from all major urban, rural, and northern settings in which baccalaureate nurses practice throughout the province. The perspective of relevant people was considered important, i.e., nurses practicing in the community, administrators, and educators of future community nurses. One hundred eighteen (118) participants were interviewed in 27 focus groups. Data were tape recorded, transcribed, and analyzed for content. Among the themes identified were those that captured changes community health nurses experienced in their nursing practice. Nurses also described how they thought practice would evolve in the years to come. These themes are discussed within a primary health care framework in which nurses can be expected to play a more active role in shaping community health nursing practice.