From the District Nurse to the Community Nurse: the Development of a New Professional Role of the Community Nurse in Primary Health Care Teams of Lithuania
The aim of the study was to identify the issues related to the development of a new professional role of community nurses (CNs) within the context of teamwork in primary health care (PHC) by studying daily experiences of collaboration between CNs and general practitioners (GPs). MATERIAL AND METHODS. A qualitative study was performed. Six focus group discussions were held involving 29 GPs and 27 CNs (totally 56 participants) from PHC centers of Kaunas region. All the discussions were recorded. The data were obtained from verbatim transcripts of the discussions. A thematic analysis was then performed to analyze the data. RESULTS. Our study revealed certain circumstances that affected the development of the new CNs role in a PHC team. Five key themes were identified: a lack of understanding of the CNs’ scope of work; a lack of clarity in the formal framework of the CNs’ activities; cooperation in a team while the duties of CNs are obscure; protection of implicit professional boundaries; and the need for explicit differentiation between professional boundaries in a PHC team. CONCLUSIONS. The study indicated that there was a lack of explicitness of the CNs’ scope of work, which might hinder the establishment of a more autonomous role of CNs. CNs struggle for a more effective collaboration in a PHC team. The development of an explicit job description for CNs should be based on a relevant legal framework and eventually introduced into practice together with educational courses on the role of CNs in PHC teams. Such changes might be instrumental in further consolidation of the role of CNs in primary health care.
Correspondence to A. Kontrimienė Department of Family Medicine, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50161 Kaunas, Lithuania. firstname.lastname@example.org