Table Of ContentTThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk
Professional Issues
in Primary Care Nursing
TThhiiss ppaaggee iinntteennttiioonnaallllyy lleefftt bbllaannkk
Professional Issues
in Primary Care Nursing
Edited by
Carol Lynn Cox
PhD, MSc, MA Ed, PG Dip Ed, BSc (Hons),
RN, ENB 254, FHEA
Marie C. Hill
M.H.M., Pg Dip, BSc (Hons), RN
This edition fi rst published 2010
© 2010 Blackwell Publishing Ltd
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Library of Congress Cataloging-in-Publication Data
Professional issues in primary care nusing / edited by Carol Lynn Cox, Marie Hill.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4051-8755-8 (pbk. : alk. paper) 1. Primary nursing. I. Cox, Carol Lynn.
II. Hill, Marie, 1959–
[DNLM: 1. Primary Nusing Care. 2. Ambulatory Care. 3. Nurse–Patient Relations.
WY 101 P964 2010]
RT90.7.P76 2010
610.73—dc22
2009028298
A catalogue record for this book is available from the British Library.
Set in 10 on 12.5 pt Sabon by MPS Limited, A Macmillan Company
Printed in Malaysia
1 2010
Contents
Foreword by Betty Kershaw xii
Preface xiv
Acknowledgements xv
Dedication xvi
List of contributors xvii
Part I: Setting the Scene of Practice and Walk-in-Centre
Nursing 1
1 The historical development of practice nursing and
walk-in-centre nursing 3
Marie C. Hill, Carol L. Cox and Shuling Breckenridge
Introduction 3
Learning Outcomes 3
Background 3
Practice nursing 4
WiC nursing 5
Extended role in PN and WiC nursing 8
Conclusion 8
References 9
2 Practice nursing: the unique nature of practice nursing 11
Marie C. Hill
Introduction 11
Learning Outcomes 11
Background 11
The GMS contract 14
Practice nursing: a roller-coaster ride 14
Education and training: are today’s PNs equipped for their role
in primary care? 16
Carpe Diem 19
Conclusion 20
References 20
vi Contents
3 Walk-in-centre nursing: the unique nature of
walk-in-centre practice 22
Jane Bickerton
Introduction 22
Learning Outcomes 22
Background 23
What is the clinical role of the nurse in the WiC setting? 23
Communication interactions 26
Promoting health and well-being in a WiC setting 27
Clinical decision-making support 27
Non-medical prescribers 28
Clinical supervision 29
Educating nurses in a WiC 29
A nurse-led service 32
Establishing a WiC 33
Urgent care environment 34
Patient satisfaction with WiC health care 35
Conclusion 35
References 36
4 The context of practice nursing and walk-in-centre
nursing: domains of practice and competencies –
setting the scene 39
Carol L. Cox
Introduction 39
Learning Outcomes 39
Background 40
Origins of the advanced practice role in the UK 41
Delineation of advanced practice 42
Role of the advanced practice nurse 44
Educational preparation 45
RCN (2002, 2008) and NMC (2005) Domains of Practice and
Competencies 46
Practice and WiC nursing and future directions of advanced
clinical practice nursing 49
Conclusion 50
References 51
Part 2: Domains of Practice 55
Domain 1: Management of Patient Health/Illness Status 57
5 Critical thinking and diagnostic reasoning in clinical
decision-making 59
Nita Muir
Introduction 59
Contents vii
Learning Outcomes 60
Background 60
What is a decision? 61
Theories of decision-making 61
The analytical stance on decision-making 62
The middle ground 66
Knowledge within decision-making 68
Errors within clinical decision-making 70
Systems that improve decision-making 71
Clinical decision support systems 72
Refl ective practice 73
Conclusion 73
References 74
6 Health education and health promotion 78
Daryl Evans
Becoming a health-promoting nurse in general practice and
walk-in centres: Introduction 78
Learning Outcomes 79
Background 79
Integrate with public health and health improvement
strategies 80
Ensure the nursing care structure enables all opportunities for
health promotion to be taken for every patient 82
Develop one-to-one skills of conversation and motivating
behaviour change 84
Settings-based health promotion – working towards a
healthy organisation 86
Involve local support groups and reach out to the local
community 89
Keep up to date with news and take opportunities to study 90
Conclusion 92
References 93
Domain 2: The Nurse–Patient Relationship 95
7 Working with individual patients and groups:
creating and strengthening relationships 97
Karen Thompson
Introduction 97
Learning Outcomes 97
Background 98
