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NURS6120 - Contemporary Nursing - University of Newcastle, Australia

Topic - The provision of rural and health service

1. Describe a contemporary issue in health care and explain why it presents a challenge in clinical practice.

Answer - Description of the contemporary issue in health care:

Accessibility to health care services is one of the chief concerns that decides the quality of the health care services being availed to the people at large. Rural areas are disadvantaged regions in this regard. They are not provided with sufficient number of health care services. Private organizations(for profit organizations) not willing to keep health care centres in the rural regions due to profit aspects, health care professionals not willing to work there for personal and career aspects.

Since the rural regions are the locations where considerable population of the villages are residing, there is need and obligation on part of government to let them get the basic health facilities. It is also an obligation on part of government to provide them support from time to time on all recurrent and epidemic diseases from time to time. Since the trained and specialist health care professionals are not willing to relocate to the rural regions, the private organizations not willing to establish their health care centres in this region, it became a big challenge to enable health care to all the people residing in the rural regions. Also due to variety of reasons like ignorance, lack of knowledge, lack of coverage, most of people did not turn up to health care organizations in the rural regions. All these factors are manifesting in great challenges to continue health and clinical practice in these regions. Buerhaus et al (2017) indicated that the uncertainty in the health care services delivery model in United States is a major challenge to the current nursing practices in the region. Aging of the baby boom generation, physicians uneven distribution particularly in the rural regions, accelerated growth of the registered nurse retirements are some of the other challenges for health care services in the rural region (Buerhaus et al,2017). Douthit et al(2015) indicated that disparities in availing the Affordable care advantages to the rural people is a considerable challenge to be taken care of. Kaufman et al(2016), provided alarmingly increased rate of closure of the rural hospitals in the recent years.

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2. Identify the issues for people affected by this problem including the impact on individuals and their communities or workplace.

Answer - Impact on individuals, community and Workplaces:

One of the obvious disadvantages that the people residing in the rural regions are facing is the loss of health. Both the physical and mental health problems of the people in the region are not being looked in. This is detoriating their health and the people are not able to work properly in the work places. Loss of health making them less productive. Sometimes these conditions are escalating them to get into accidents in the workplace, due to lack of attention, focus and presence of mind in the workplaces. There is increased morbidity rate in the rural regions when compared with the main stream urban locations for variety of diseases due to lack of health care facilities to look into their health aspects. There are several occasions where the maternity health of the women got impacted in the rural regions, the neo-natal health care problems escalated to serious dimensions due to lack of proper health care facilities availability. Trained health care professional unavailability also resulting in hampering the delivery of right health care in the right time in the serious complications cases.

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3. Critically discuss strategies that could be considered for implementation in the acute care AND primary health care/community setting (including cultural considerations) to address these issues.

Answer - Strategies to be implemented:

There is need for multi dimensional strategies to improve the health care of people in the rural regions.

There is need to augment the number of health care facilities available in the rural regions. There is need to take up budgetary allocations strictly to improve the access to the health care facilities to the people in the region. Increasing the total number of health care facilities, providing them with necessary means like resources and equipment for diagnosis and treatment is very much needed.

In the locations where there is no infrastructure already available and in the occasions where it will take time for getting funds and establishing the full time functional health care facilities, there is need to collaborate with other health care service facilities by establishing mobile health care facilities in the region.

Primary health care facilities for basic health care needs are one of the other important aspect that strategically needs to be considered for in the rural regions. There is need for providing health care facilities for maternity, new-born (neo-natal), epidemic diseases. Acute health care facilities for basic and routine problems need to be established on priority basis.

Community health workers training and developing health care voluntaries for midwifery and other regular ailments for taking care of the problems of the community is an important aspect of health care service provisions in the regions where there is shortage of regular services.

In the regions where there are cultural complications like aboriginals not willing to take up regular medical practices, trained workers from the community groups can help them overcome the apprehensions and also they will let the community people get the necessary trust and reliance on the medicine.

Developing more effective procedures for coverage, developing custom packages of health care for people under poverty and at lack of knowledge will let every person in the rural locations get entitled to the health care facilities.

Encouraging health care professionals shown willingness to work in the rural regions by providing them the allowances and incentives in the form of wages and career development opportunities.

Providing honorium for the health care volunteers in the rural regions, providing them with good training and development opportunities.

Taking the cooperation and collaboration of the voluntary organizations and other humanitarian organizations in providing assistance to the rural people.

Conducting health care awareness camps, providing health care check up programs in the regions.

Free medical distribution for prevention and sustenance of well being are some of the several formats in which the health conditions in the region can be improved.

Marcin et al(2016) indicated that tele-medicine is one of the key facilitation that can support the health care needs of the rural people by taking advantage of training offered to the advanced health care nurses in the region.

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4. Describe the implications of these issues for advanced practice nurses or nurse practitioners in terms of their need for education, resources and support.

Answer - Implications to Advanced health care nurses or nurse practitioners

Education:

Imparting nurses with the necessary education and knowledge to take care of health care needs of the rural people. Consideration to the cultural sentiments, ignorance and other environmental conditions of the people is needed to provide them special training to deal with these conditions. They need to be provided with the special training to understand the sentiments and conditions and subsequently to provide with the best health care facilities.

Other implications include knowledge of the environmental conditions of the rural regions in focus, in terms of the most commonly possible diseases identification in the region. Possible health detoriating conditions for the common people as well for the people at maternity, new birth, acute health care, elderly care etc.

Also nurses need to be provided with the essential training to train the health care volunteers in the region to support the needs of the locals.

Resources:

Mobile transport resources for moving in the extreme conditions of the rural regions.

There is need to keep communication devices both traditional and non-traditional (like Ham Radio) for emergency communication requirements.

Nurses to be provided with emergency medical care packages for each categorized ailment and health care requirements.

The resources provided should be in line with the quantity and the quality of the health care needs in the region.

Also sufficient health care equipment to be provided for disbursal in the nodal centres of the health care in the rural region from time to time. (This should include emergency health care equipment, routine medicines and other requirements as needed from time to time).

Support:

Humphreys et al(2017) indicated that the decentralization of the health care work force can contribute for sustaining the health care facilities in the rural regions. Terry et al(2015) emphasized the need for providing the necessary occupational safety and immunity from work place violence for the health care professionals working in the rural regions.

Most significant support is needed by the government in terms of the financial and strategic policies.

Availing incentives to the health care professionals working in the rural regions.

Providing them with the support staff to help them render their duties in the rural regions is very much significant.

Advanced health care nurses can be provided with mandatory internship in the rural region for short time before completing their regular term for getting orientation to the health care needs of the people in the region.

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