It is exciting to have this third week of action on public health nursing and the opportunity to promote and showcase the work nurses and midwives can do to improve health and advocate in health promotion.
Nurses and Midwives have always had an important role in health promotion. In many areas of practice they will see their role as having a health improvement element and in supporting and promoting health. For some, such as Health Visitors and Midwives, the health promotion role has been viewed more in a societal way, looking at individuals within the community or family. For others the role has arguably been more traditionally focused on disease prevention and changing the behavior of individuals to improve their health. There is also now a growing emphasis on the need to support people to take more responsibility for their health and to encourage them to be more proactive in self care. Such as managing minor conditions at home rather than going to A&E or in self management. In an aging population a growing number of people have to manage long term medical conditions.
Nurses and Midwives need to understand how to implement health promotion in all areas of their work. There is a sense that nurse education needs to embrace this so nurses have a understanding across all areas of their work of how they can best support people to adopt healthier lifestyles in a facilitative way. The RCN have developed a new resource to help staff support people with behaviour and lifestyle change without getting in to the traditional advice giving scenario’s and using Motivational interviewing type techniques. The resource is open access to anyone and is now available on the Continuing Professional development area of the RCN web site http://www.rcn.org.uk/development/practice/cpd_online_learning/support_behaviour_change
The RCN ran workshops in 2012 and 2013 and the evaluation from these demonstrated that there is a very definite need amongst nursing staff from all areas to develop skills in managing and supporting people to change behaviour.
Nurses and Midwives are in a unique position as effective health promotion practitioners; partly because they are involved in all aspects of health care and have a good knowledge of health across the lifespan and also an understanding of both the specific disease process and the epidemiology of the disease for their population. They are also generally trusted by the population as being able to give evidence based and trusted information.
There is growing recognition that different skills and approaches are needed depending on the patient groups involved. For those working with the elderly an understanding of the needs of these clients, for example, support with access to services and acknowledgement of specific issues around isolation and loneliness, is essential. The RCN have developed a range of resources and information on supporting people with dementia for example, this includes promoting health for the person with dementia and their carer and or family; http://www.rcn.org.uk/development/practice/dementia/supporting_people_with_dementia Whereas in a family situation the needs will be different with nurses needing to have the skills to then support the family where one or two members have specific needs and how they can best support this within the family unit. In promoting the health of these different groups, nurses and Midwives are often pivotal in understanding the specific needs based on their unique knowledge of the complexity of the individuals lifestyle. Where health promotion for patient groups who need high levels of care and treatment is required, Nurses and Midwives must have the ability to include health promotion activities in their daily practice. The winners of the public health nursing category in this year’s Nursing Standard award demonstrated this admirably with the domicillary alcohol detoxification service they initiated. One of their clear rationale for doing this was the benefits to the clients of detoxing within the context of familiar surroundings and with the support of family and friends. The winners Nurse consultant Pam Campbell and Anya Farmborough 'alcohol specialist nurse' said that ‘it is important to acknowledge the challenges daily life will pose to a life new without alcohol as early on as possible and being able to support patients in their own homes really helped.’
Helen Donovan is the Royal College of Nursing's UK Public Health Adviser
