The Practice Nurse. Theory and practice. Pauline] effree SPRINGER-SCIENCE+BUSINESS MEDIA. B.V.

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1 The Practice Nurse

2 The Practice Nurse Theory and practice Pauline] effree s SPRINGER-SCIENCE+BUSINESS MEDIA. B.V.

3 First edition Pau line Jeffree Originally published by Chapman and Hali in 1990 Typeset in 10 on 12 pt Sa bon by Best-set Typesetter Ltd, Hong Kong ISBN AII rights reserved. No part of this publication may be reproduced or transmitted, in any form or by any means, electronic, mechanical, photocopying, record ing or otherwise, or stored in any retrieval system of any nature, without the written permission of the copyright holder and the publisher, application for which shall he made to the publisher. British Library Cataloguing in Publication Data Jeffree, Pauline 1. The practice nurse: theory and practice. 1. General practice. Nursing 1. Title ()10.73 ISBN ISBN (ebook) DOI / Library of Congress Cataloging in Publication Data available

No part of this publication may be reproduced or transmitted, in any form or by any means, electronic, mechanical, photocopying, record ing or otherwise, or stored in any retrieval system of any

4 To my Colleagues at Elm House Surgery

5 Contents Acknowledgements vm Preface 1x Foreword x 1 The National Health Service- history and reorganization 1 Appendix Reports 9 Dr Kenneth Scott 2 Primary health care- what is it and who does it? 10 Dr John Fry 3 Ethics and training 18 4 Administration of the practice 28 5 The treatment room 52 6 Nursing models 59 7 Screening as a function of primary care 69 8 Promotion of health and prevention of disease Clinics for special groups of people Research in general practice 182 Appendix Useful addresses 188 Index 192

10 Dr John Fry 3 Ethics and training 18 4 Administration of the practice 28 5 The treatment room 52 6 Nursing models 59 7 Screening

6 Acknowledgements This book for Practice Nurses would not have been written without the inspiration and encouragement of Dr Peter Jarvis. I would especially like to mention the following, to whom I am indebted: Dr Kenneth Scott, who not only contributed to the text, but also personally offered constant encouragement and support and whose comments have considerably enriched the text. Dr John Fry, who patiently and painstakingly shared with me the writing of the book and who kindly agreed to contribute a chapter to the book. Practice Nurse students who have helped me to clarify issues in our learning and teaching sessions at the University of Surrey and North East Surrey College of Technology. I would like to express my gratitude to those who have kindly given permission to reproduce from other sources. In the final analysis, however, the ultimate responsibility for the content of the book must rest with the author.

whose comments have considerably enriched the text. Dr John Fry, who patiently and painstakingly shared with me the writing of the book and who kindly agreed to contribute a chapter to the book.

7 Preface It is anticipated over the next few years that there will be major developments in the provision of service in community and primary care. This changing philosophy of care will place great demands on the Primary Care T earn. The Practice Nurse in particular will have a major role to play in the changing and expanding spectrum of primary health care provision. This book seeks to provide the theory and its practical application for Practice Nurse colleagues as we face the exciting challenges of the future and move forward with the Government's White Paper Working for Patients. Pauline jeffree

The Practice Nurse in particular will have a major role to play in the changing and expanding spectrum of primary health care provision.

8 Foreword A new concept of care has emerged in recent years with the introduction of nurses into General Practice working alongside General Practitioners in surgeries and health centres. Significant changes have occurred in both primary and community care with the changing philosophy of health provision and the introduction of 'Care in the Community'. This has further been compounded by a reduction of hospital services in some Districts and a shorter length of stay which has made greater demands for the Primary Care Team in General Practice. The attachment of Community Nurses to General Practices has not met the entire needs of the developing services and an increasing number of General Practitioners are employing their own Practice Nurse. The skills required by the Nurse in General Practice are numerous and varied, not only to meet the needs of the practice population but also to make an essential contribution to the Primary Care Team. The author of this book has had the foresight to realize that at the present time there are nurses who need guidance and information about the tasks they are expected to carry out in the surgery or health centre and she has covered a very wide spectrum of care programmes and procedures in a very comprehensive way. She has also given well deserved space in the book to advise nurses about the ethics and legalities with which a nurse in practice can be involved. At the time of going to press the Government's White Paper Working for Patients clearly indicates their expectations of a greater spectrum of health care, including treatment, surveillance and health promotion in General Practice. This can only be achieved

This has further been compounded by a reduction of hospital services in some Districts and a shorter length of stay which has made greater demands for the Primary Care Team in General Practice.

9 FOREWORD XI by strengthening Primary Care Teams and developing their professional skills in General Practice. Practice Nurses have a major contribution to make to the development of primary care and the purpose of this book is to equip them with the basic knowledge to provide that care. Kenneth Scott MB, BS, FRCGP, DRCOG General Practitioner, Beckenham, Kent. General Manager, Community and Mental Handicap Unit, Bromley Health Authority, Kent.

book is to equip them with the basic knowledge to provide that care.

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Project Governance This page has been left blank intentionally Project Governance Ralf Müller PM Concepts, Sweden Ralf Müller 2009 All rights reserved. No part of this publication may be reproduced, stored