Community and primary health care nursing is experiencing a rapid metamorphosis as our population ages and the prevalence of chronic and complex conditions increase. To meet these changing needs, our health workforce has evolved with a range of specialised disciplines now working in diverse health settings. Throughout these changes, nursing continues to be the largest global health workforce providing the most direct client care. Historically, nurses were the original transdisciplinary health care workers, providing basic physiotherapy, occupational therapy, nutritional advice and all other care as required. As more detailed knowledge developed in an area of practice, specialised areas of care evolved and a variety of allied health professions emerged. Nursing itself became more specialised due to developments in clinical practice, technological advances and clients requiring more complex care. This chapter examines how professional identity and culture influence interprofessional practice, describes the behaviour and skills that facilitate effective communication, and identifies the barriers and facilitators to multidisciplinary health professionals working well together.

Community and primary health care nursing is experiencing a rapid metamorphosis as our population ages and the prevalence of chronic and complex conditions increase. To meet these changing needs, our health workforce has evolved with a range of specialised disciplines now working in diverse health settings. Throughout these changes, nursing continues to be the largest global health workforce providing the most direct client care. Historically, nurses were the original transdisciplinary health care workers, providing basic physiotherapy, occupational therapy, nutritional advice and all other care as required. As more detailed knowledge developed in an area of practice, specialised areas of care evolved and a variety of allied health professions emerged. Nursing itself became more specialised due to developments in clinical practice, technological advances and clients requiring more complex care. This chapter examines how professional identity and culture influence interprofessional practice, describes the behaviour and skills that facilitate effective communication, and identifies the barriers and facilitators to multidisciplinary health professionals working well together.

Despite current and predicted ongoing primary health care (PHC) nursing workforce shortages (Heywood & Laurence, 2018), the undergraduate nursing curricula in Australia and internationally remain largely directed towards acute care (Calma, Halcomb & Stephens, 2019; Mackey et al., 2018). Additionally, the efforts of schools of nursing in supporting the career development of new graduate nurses and their transition to practice also remain largely focused on employment in acute care tertiary settings. This chapter highlights the extent to which current undergraduate nursing curricula prepare registered nurses to work in PHC, reviews the attitudes of nurses regarding PHC employment and discusses the current challenges regarding nurse transitions between acute and PHC practice environments. Understanding the preparation nurses have for a PHC career, nurse attitudes towards and knowledge of PHC, andchallenges associated with transitions between practice environments are important to promote recruitment and retention of the PHC nursing workforce.

Despite current and predicted ongoing primary health care (PHC) nursing workforce shortages (Heywood & Laurence, 2018), the undergraduate nursing curricula in Australia and internationally remain largely directed towards acute care (Calma, Halcomb & Stephens, 2019; Mackey et al., 2018). Additionally, the efforts of schools of nursing in supporting the career development of new graduate nurses and their transition to practice also remain largely focused on employment in acute care tertiary settings. This chapter highlights the extent to which current undergraduate nursing curricula prepare registered nurses to work in PHC, reviews the attitudes of nurses regarding PHC employment and discusses the current challenges regarding nurse transitions between acute and PHC practice environments. Understanding the preparation nurses have for a PHC career, nurse attitudes towards and knowledge of PHC, andchallenges associated with transitions between practice environments are important to promote recruitment and retention of the PHC nursing workforce.

Introduction

The nature of community health needs has changed and continues to evolve as the population ages and there is an increase in chronic and complex conditions. To meet these changing needs, our health workforce has evolved with a range of specialised disciplines and health professions present in contemporary health care. Historically, nurses have provided most direct client care. In a sense, nurses were the original transdisciplinary health care workers, providing basic physiotherapy, occupational therapy, nutritional advice and all other care as required. As more detailed knowledge developed in an area of practice, specialised areas of care evolved and a variety of allied health professions emerged. Nursing itself also became more specialised due to developments in clinical practice, technological advances and clients requiring more complex care. This inevitably necessitated the development of various nursing specialty areas.

Primary health care (PHC) nurses are integral to the provision of safe, efficient and high-quality care (Australian Nursing Federation, Australian Practice Nurses Association, Royal College of Nursing Australia, Australian Nurse Practitioner Association & the Australian College of Mental Health Nurses Inc., 2008; New Zealand College of Primary Health Care Nurses [NZNO], 2016; Nursing Council of New Zealand, 2016) and are seen as key deliverers in the agenda for strengthening PHC services internationally (Australian Nursing Federation, 2009; Irvine, 2005). Despite the valuable contributions made by individual groups of health professionals, it has been demonstrated that organised care delivery, where a range of health professionals and support workers provide integrated care to clients, leads to the best health outcomes (Wagner, 2000).

To be effective, the health team needs to have knowledge and understanding of the various professional roles, an ability to communicate well and, above all else, maintain a client-centred focus (Suter et al., 2009). Positive workplace relationships between health providers have benefits for both the providers and the individuals for whom they are providing care (Almost et al., 2016). An enabling workplace culture enhances staff satisfaction, improves retention and reduces both stress and burnout (Delobelle et al., 2011), while a client-centered focus ensures that the needs and preferences of the recipients of care are central to service delivery (Eaton, Roberts & Turner, 2015).