Community development and health in Canada

Collaborative and interdisciplinary health care teams: ready or not?

Collaborative team-based practice within an interdisciplinary health service environment is an important consideration for the nursing profession. Policy directions suggest that collaborative professional skills can address complex client needs within a framework of primary health care and social accountability for health service quality, cost, and access. The pursuit of collaborative and interdisciplinary care is generally agreed to be a worthy goal. However, implementation methodologies and outcomes related to collaborative and interdisciplinary care remain elusive within a rapidly changing health care environment. This article provides a critical analysis of the multiple historical, political, economic, and social professionalization challenges associated with the achievement of collaborative team-based practice. The author argues that it is not feasible to implement broad-based team structures at the present time. Considerable effort would be required to prepare disciplines to function as a team and to address fragmented services, equitable service funding, and procurement of resources to sustain team efforts. Strategic and influential use of power and knowledge may support the efforts of nurse leaders in practice, education, research, and administration to effect change for the development of collaborative and interdisciplinary practice.

Advancing nursing theory through theory-guided practice: the emergence of a critical caring perspective

Critical caring is proposed as a hybrid, midrange theory that builds on nursing science and critical feminist theories. As such, it has the potential to root public health nursing practice in an expanded nursing caring science that reincorporates the social justice agenda characteristic of early public health nursing practice but not featured prominently in contemporary nursing theories. Critical caring transforms the carative processes of Watson's theory into 7 carative health-promoting processes that form the "core" of public health nursing practice and reflect the legacy and reality of public health nursing practice.