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.