Primary Health Care – Making It a Reality for RNs
The phrase “primary health care” has been buzzing around for a few years now, so it was with just a bit of fear that I embarked on writing this article about it. I thought that you might take one look and turn the page, saying “boring” or “what does this have to do with nursing?”
Our recent RN grads have been immersed in primary health care throughout their studies, but some of you may be wondering what all the fuss is about. You certainly are not alone, and it is not a bad thing to be a doubting Thomas – at least until we have the facts. So, dear colleagues, I have gathered some of the basics on primary health care so that you as a professional RN can decide for yourself how best to embrace primary health care in providing the quality nursing care that makes your work rewarding and worthwhile.
Primary health care . . .
* is both a philosophy of health care and an approach to providing health services.
* was adopted over 25 years ago by the World Health Organization (WHO) as the basis for effective delivery of health services.
* is essential care (promotive, preventive, curative, rehabilitative and supportive) that focuses on preventing illness and promoting health.
* responds to the needs of individuals, families, communities and populations.
* works towards improving the root causes of ill health.
* empowers communities.
* has the following principles – accessibility, public participation, health promotion, appropriate technology and intersectoral cooperation.
* is a natural extension of nursing practice.
Primary health care is not . . .
* primary care, which is a medical concept where the practitioner provides diagnosis, treatment, and follow-up for a specific disease or problem.
* primary nursing, where nurses are responsible for planning the 24 hour care of individual patients.
* illness-oriented.
The SRNA strongly supports primary health care; it is one of Council’s primary ENDS. Our goal as nurses is to improve the health of our clients in all practice settings and in all communities. The principles of primary health care apply to all nurses, in all domains of practice: direct care providers, educators, administrators, consultants, researchers and policy advisors.
As a passionate advocate of PHC, Donna Brunskill, RN, Executive Director of the SRNA states: “We believe that primary health care provides the key to healthy individuals, communities and society, and nurses are vital to the successful implementation of primary health care”.
The following primary health care descriptors contain some familiar, but also some new concepts. As RNs, the principles of primary health care essentially embody how we practice nursing.
Accessibility – RNs believe in equity and that all Canadians should have access to essential health services, regardless of the ability to pay. What nurse has not been frustrated when patients are not cared for in a timely manner?
Public participation – Every day nurses work with clients and their families and together make decisions on how best to meet their health care needs, whether we are caring for them in ICU, in outpatient clinics, or planning their return to their communities and the services they will need to recover fully in their homes.
Health promotion – I am sure that the old adage of “an ounce of prevention is worth a pound of cure” was coined by a nurse.
Appropriate technology – MRIs do not a healthy person make, but technology is part and parcel of health care, used to diagnose, treat and cure disease. Its availability and use must reflect the local needs of the community, be affordable and socially acceptable.
Intersectoral collaboration – Nurses have always known that a person’s health is influenced by many factors beyond health care. Haven’t we observed this in caring for the ill child whose family cannot afford proper nutrition or clothing, or the resident of a northern community who becomes ill due to contaminated drinking water? Determinants of health, income, education, housing, community and family supports, all impact the health of individuals and communities. Intersectoral collaboration means working in partnership with all sectors that impact health, and the community, to increase community control over exactly those issues that are affecting their health.
As you can see we have already incorporated many of the principles of primary health care into our practice. But gaps still exist and there is always room for improvement. Overall, I personally think that primary health care and nursing make for a wonderful marriage. Certainly the commitment is there from nursing and nurses. It always has been.
Canadian Nurses Association. (1995) The role of the nurse in primary health care. Policy statement. Ottawa, ON: Author.
Saskatchewan Registered Nurses’ Association. (2001). Vision to action: A presentation to the Standing Committee on Health. Regina, SK: Author.
Wass, A. (2000). Promoting health: The primary health care approach. (2nd ed.). New South Wales, Australia: Harcourt Publishers International.
Patient Safety – Food for Thought
“You wouldn’t just decide to forget about recovering the black box after an air crash. So why should it be thought so strange to want to learn from every accident in health care.”
Liam Donaldson, Bristol, November 2001.
by Linda Muzio, RN, SRNA Nursing Practice Advisor
Copyright Saskatchewan Registered Nurses’ Association Feb/Mar 2005