Rural Nursing - Jan18

 Liz Laird
◦ Grey-Bruce
 Judy White
◦ Huron- Perth
 Wendy Boyle
◦ London-Middlesex
 Ida Tigchelaar
◦ Elgin-Oxford
Palliative Pain and Symptom Management Consultant
Huron/Perth County London
 Rural /agriculture  Urban
 Population: 133,669  Population: 352,395
 Area: 421 square km
 Area: 5627 square km
 6 hospitals: total 1966
 8 hospitals: total 379
beds
beds  Ranging from 170-500
 Ranging from 17-150
beds
beds
“Increased attention needs to be given for both
specialized continuing education and mentoring
in order to improve the sustainability of rural
nurses”
(Hunsberger et al., 2009)

 Fundamentals of Hospice Palliative Care
 AHPCE-Advanced Hospice Palliative Care
Education for Unregulated Health Care

Providers/Volunteers
 CAPCE-Comprehensive Advanced Palliative
Care Education for nurses

 Pain Management in LTCH (long term care
homes)
 Individualized programs developed to meet the
needs of LTCH, community or hospital staff

 They must have a broad knowledge base to care
for clients with a variety of health conditions
across the life span and they are expected to
function more autonomously in expanded nursing
roles.
 Bushy (2002) describes them as having “a rich
heritage of resilience, resourcefulness, adaptability and

creativity. Their greatest attribute is knowing about
formal and informal community resources and how to
access these for client systems”
 In rural areas of Canada in 2000, 18% of RNs had
attained a bachelor’s degree in nursing as their
highest education in nursing
 This compared with 24% in 2000 for urban RNs
 There is an apparent contradiction between the
expanded role of practice demanded of RNs in

rural areas and the comparatively lower level of
their formal education.
(Hanvey, 2005)
“Evidence suggests that providing rural nurses
with continuing education and support for roles
that are demanding ,increases both their job
satisfaction and retention in the rural
workforce”
( Hunsberger et al., 2009)

 Nurse retention is cause for concern
“Rural nurses are challenged in their practice to

be generalists, but also need to have specialized
knowledge and skills to meet the needs of a
widely diverse patient population”
(Rural Nursing Practice in Canada-CNA,2005)

Huron/Perth
 One nurse sees between 8-12 clients /day
 Travels 65-220 km/day
London
 One nurse sees 12-15 clients/day
 Travels 10-20 km/day
 Contextual features of the environment
 Professional Realities
 Patient – related considerations
CAPCE Nurse/PPSMC consults with
Community front line nurse
Capacity Building for
front line nurses
Physician and nurse Capacity Building Capacity building CAPCE Nurse

dyads education Network
Mentorship All CAPCE Nurses
PPSMP
Consultation Capacity Building
Capacity Building Education
Mentorship
Linkages
LTCH- Interdisciplinary
Unique education Community Palliative
needs Capacity Building Patient Rounds
Capacity Building
PPSMC/CAPCE
Community,LTCH and
Nurse consults Hospital
Needs identified= Consults, best practice,

Education/mentor CAPCE Nurse PPSMC is resource
programs Hospital Teams
PPSMP=Pain & Symptom Management Program

C=Consultant
front line nurses

PPSMP
Mentorship
Linkages
Capacity Building
PPSMC/CAPCE
Community,LTCH and


C=Consultant
 Patient has a PPS of 60% or lower and/or have a
significant palliative pain or symptom
management issue receives a comprehensive
palliative care assessment from PPSMC, in
concert with nurse who is not CAPCE trained
 PPSMC does not carry a case load
 CAPCE Nurse leads the care
 PPSMC is resource to CAPCE Nurse
front line nurses

PPSMP
Mentorship
Linkages
Capacity Building
PPSMC/CAPCE
Community,LTCH and


C=Consultant
Supports the ongoing building of capacity and
networking opportunities for all AHPCE and CAPCE
–trained graduates in Huron and Perth Counties.
 Meetings four times /year Mitchell Town Hall

 Case studies, education, guest speakers,
networking
 Bulletins, new information disseminated via e-
mail between meeting dates

front line nurses

PPSMP
Mentorship
Linkages
Capacity Building
PPSMC/CAPCE
Community, LTCH and


C=Consultant
Goal:
 ↓ unnecessary visits to Emerg and to hospital
Improve care to patient and family at all sectors

 Common use of tools
Membership:
 Interdisciplinary- Community, Hospital, LTCH
Meetings:
 Meeting once/month, face to face,tele/video
conferencing
 Venue flexible
Community Palliative Rounds
Community
Community
LTCH Hospital
Long Term Care Home Hospital

front line nurses

PPSMP
Mentorship
Linkages
Capacity Building
PPSMC/CAPCE
Community,LTCH and


C=Consultant
 Team of CAPCE hospital nurses available to
complete comprehensive palliative assessments
& make recommendations
 PPSMC is the resource for the CAPCE nurses
either by phone, e-mail or at monthly meetings

 Supported by hospital- guidelines have been
developed as to compensation for nurses time

completing the assessment and process for
accessing
front line nurses

PPSMP
Mentorship
Linkages
Capacity Building
PPSMC/CAPCE
Community,LTCH and


C=Consultant
 PPSMC resource to CAPCE Nurse
 Consults with nurses
 Needs assessment dictates what education
developed for each LTCH

 Palliative Care Education Program developed
specifically for LTCH

 Palliative Pain Management Program developed
for LTCH
front line nurses

PPSMP
Mentorship
Linkages
Capacity Building
PPSMC/CAPCE
Community,LTCH and


C=Consultant
LEAP
(Learning Essential Approaches to Palliative
and End of Life Care)
 For physicians & nurses in dyads
 LEAP is an interdisciplinary. face-to-face,
palliative care course developed to enhance the

competence of nurses and other health care
professionals.
“Not only is a wide range of knowledge and skills
needed when starting to practice, but each nurse
must also ensure that they remain current and
thus adapt as health and technology and other
advancements occur. The shift of palliative care
to more home based environments has added to
the responsibility and complexity of care
required for rural and remote nurses”
(Dewar et al.,2002)
 Small town lifestyle
 Range of experiences
 Ability to provide much needed services
 Opportunity to give back to the community
 Working with unique population
 Financial consideration
 Not as many layers of bureaucracy as there is in
the city
“Being the “nurse” in the rural setting provides a
opportunity to practice in a setting where there
are many challenges, rewards and opportunities.
The rural nurse provides care in a variety of
settings, across the life span with a holistic people
centered approach always mindful of community
strengths and limitations. It is the chance to
practice “nursing as it should be”
(Canadian Association for Rural and Remote Nursing, Rural and

Remote Nursing Parameters Discussion Document-2008)

Rural Nursing - Jan18

Hochgeladen von

Dokumentinformationen

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Rural Nursing - Jan18

Hochgeladen von

Copyright:

Verfügbare Formate

 Liz Laird

(Hunsberger et al., 2009)

Education for Unregulated Health Care

Care Education for nurses

needs of LTCH, community or hospital staff

heritage of resilience, resourcefulness, adaptability and

expanded role of practice demanded of RNs in

( Hunsberger et al., 2009)

“Rural nurses are challenged in their practice to

(Rural Nursing Practice in Canada-CNA,2005)

Physician and nurse Capacity Building Capacity building CAPCE Nurse

Needs identified= Consults, best practice,

PPSMP=Pain & Symptom Management Program

Physician and nurse Capacity Building Capacity building CAPCE Nurse

Needs identified= Consults, best practice,

PPSMP=Pain & Symptom Management Program

Physician and nurse Capacity Building Capacity building CAPCE Nurse

Needs identified= Consults, best practice,

PPSMP=Pain & Symptom Management Program

 Meetings four times /year Mitchell Town Hall

mail between meeting dates

Physician and nurse Capacity Building Capacity building CAPCE Nurse

Needs identified= Consults, best practice,

PPSMP=Pain & Symptom Management Program

Improve care to patient and family at all sectors

Long Term Care Home Hospital

Physician and nurse Capacity Building Capacity building CAPCE Nurse

Needs identified= Consults, best practice,

PPSMP=Pain & Symptom Management Program

either by phone, e-mail or at monthly meetings

developed as to compensation for nurses time

Physician and nurse Capacity Building Capacity building CAPCE Nurse

Needs identified= Consults, best practice,

PPSMP=Pain & Symptom Management Program

developed for each LTCH

specifically for LTCH

Physician and nurse Capacity Building Capacity building CAPCE Nurse

Needs identified= Consults, best practice,

PPSMP=Pain & Symptom Management Program

palliative care course developed to enhance the

(Canadian Association for Rural and Remote Nursing, Rural and

Das könnte Ihnen auch gefallen