A midwife-public-health nurse's work in northern Finland, 1950-87

Public health nurses' professional dignity: An interview study in Finland

BACKGROUND

Dignity is a central human value supported by nurses' professional ethics. In previous studies, nurses in clinical practice have experienced that dignity increased their work well-being and pride of work. Dignity is also strictly interweaved to professional identity in the different nursing' roles, but little is known about dignity among public health nurses and primary care settings.

PURPOSE

This study aimed to describe the perceptions of nursing's professional dignity of public health nurses in primary care in Finland.

RESEARCH DESIGN

An inductive qualitative descriptive approach with semi-structured focus group interviews was utilised.

PARTICIPANTS AND RESEARCH CONTEXT

Twenty-seven Finnish public health nurses were interviewed via eight semi-structured focus group interviews in primary health care settings.

ETHICAL CONSIDERATIONS

Before data collection, research permissions were obtained from participating health care centres. This type of research in Finland, with competent adult participants, does not require ethical pre-assessment but written and oral informed consent obtained before the interviews.

FINDINGS

Based on our findings, public health nurses perceived that professional dignity was (1) part of their self-respect, an observed daily value based on their acknowledged competence. Besides, they perceived that (2) service users' trust in public health nurses was a strong expression of professional dignity, and it could be uncovered when recipients of care utilised their services. In addition, public health nurses experienced that (3) professional dignity was an expression of different intertwined interprofessional and social factors.

DISCUSSION AND CONCLUSION

Professional dignity is simultaneously an essential prerequisite and an outcome of public health nurses' work. In future, more information would be needed to implement strategies in primary health care to foster nurses' professional dignity also in international public health arenas.

A European union and Canadian review of public health nursing preparation and practice

OBJECTIVE

This study explores the preparation and role of the public health nurse (PHN) across European Union (EU) countries (Finland, Sweden, and the United Kingdom) and Canadian provinces (Alberta, New Brunswick, and Prince Edward Island).

METHODS

A literature review including relevant peer reviewed articles from 2000 on, in conjunction, with critical debate was undertaken. The results were considered in relation to the three essential areas of PHN practice, outlined in the World Health Organization (Moving on from Munich: A reference guide to the implementation of the declaration on nurses and midwives: A force for health, 2001b) recommendations, family oriented care, public health action, and policy making.

RESULTS

The major challenge the review revealed across a variety of international education and practice environments was the lack of consistent preparation for and engagement with leadership and policy making in practice.

Enabling nursing students to focus on the Ottawa Charter and the nurses role in tackling inequalities in health through international exchange

Student nurses in a transatlantic exchange program explored the role of registered nurses in five countries' public health systems. The Ottawa Charter provided a framework for students to examine the nurse's responsibilities in public health. Students took practice placements in geographically rural a reason another continent and explored inequalities in health care. If nurses are to understand their role in the health care system then they must be taught the scope of their practice including their role in health promotion,public health practice and community development. For this project nursing instructors developed an assignment relevant to the aims and suitable for students in all five nursing programs. Only three of 48 students offered an assignment which focused on building healthy public policy. Nurse educators need to explore this further to ensure nurses of the future are aware of their role and responsibilities in this area and have skills to work effectively to influence and build healthy policy. The international student exchange supported the students' developing understanding of the breadth of initiatives around the globe where nurses are actively engaged in addressing inequalities of health. Findings from an analysis of their assignments are presented in this evaluative report.

Practical nurses in elder care and changes in Finnish society - a biographical study

BACKGROUND

Substantial changes in the socio-economic circumstances in Finnish society over the past century have resulted in major changes in the case of older people, and in the status of nursing staff who care for them.

AIM

The purpose of this study was to describe and analyse the work of practical nurses in elder care through the experiences and life cycles of two practical nurses with a long working experience.

METHODS

The data consisted of oral biographical narratives produced by the two nurses in repeated interviews. The data were analysed using inductive content analysis.

FINDINGS

The following chronological stages and periods of the work of the informants emerged as the core themes of elder care: (1) Collective institutionalized care in the 1950s-1970s: The lowest caste in training, obedient subordinates, undemanding service and routine work; (2) Elderly orientated institutionalized care in the 1980s and 1990s: From subordination to co-operation as an experienced nurse, recognizing the specific qualities of the elderly; (3) Prospects of elder care from the 1990s onwards: Returning to custodial care?

CONCLUSIONS

The themes are related to the more general changes that have taken place in Finnish society and health care. The future prospects of practical nurses seem challenging because the principles of social work and health care in Finnish society have shifted from institutionalization towards community care. As a consequence, practical nurses are required to have higher qualifications.

Vertical equity in service provision: a model for the Irish public health nursing service

AIMS

This paper analyses the policy and conceptual basis of public health nursing service provision in the Republic of Ireland and situates it within an international context. It draws on the principles of horizontal and vertical equity in proposing a new model of public health nursing service provision. It gives the reader an understanding of a model of service delivery underpinned by the principle of vertical equity. BACKGROUND ISSUES: The Public Health Nurse in the Republic of Ireland has a wide remit encompassing primary, secondary and tertiary care at the level of the individual, family and community. The changing sociological and demographic nature of society in Ireland has impacted on a service that has largely remained unchanged since 1966. Since 1997 four review bodies have provided recommendations that are incompatible with each other. There remains a need to find a solution to the overwhelming demands placed on the public health nursing service in the Republic of Ireland.

KEY ISSUES

The public health nursing service goes beyond the provision of a purely clinical nursing service. Communities differ in demography, epidemiology, environment, history, composition, support and most importantly needs. Using three exemplars a new model for the public health nursing service is explicated. This model has as its main focus the needs of the community it serves.

CONCLUSIONS

A service underpinned by the principle of vertical equity can be used to deliver locally based, needs driven public health nursing services. The application of such a model would make the public health nursing service more flexible and responsive to local need. Public health nursing composition and provision must be determined using the principal of vertical equity determined by the needs of the community it serves.