A research proposal? What is community nursing anyway?

The seed for my research idea is in a desire to articulate the artistry in community nursing. The true work that community nurses do is often unrecognised as it occurs in the spaces between nursing tasks. As a community nurse I used to describe my role as consisting of wound management, palliative care, a little bit of medication management and some post acute, surgical care. After a time I became uncomfortable in describing my role in this way as I felt that most of my energy was being spent in other ways. I was helping people negotiate tricky family circumstances; helping find ways that compression bandaging didn’t interfere with weekly lawn bowls or helping doctors think that they had made decisions about management plans for the clients that I worked with. My role was more about supporting self management, building self efficacy, increasing health literacy and collaborating with patients and the broader health care team.
Related to this was an emerging awareness of what made a good community nurse. As a nurse unit manager in community nursing I recognised that in recruiting new nurses, it was not always the best clinician that made a good community nurse. I saw excellent clinicians from the acute sector find community nursing unbearably stressful and invariably these nurses had short careers in the community and often returned to the acute sector. Some nurses seemed to find the autonomy that went with the role, very stressful and burdensome. I remember one nurse, who put a dressing on in the morning, rang the patient at morning tea to see if it was ok, visited to check again at lunch time and on the way home, visited again the next day (after a sleepless night) to remove the dressing to see if everything was ok. Another nurse may have had the same concerns but would possibly have been more comfortable with a partnership with the patient to monitor the dressing in the short term and confidence to leave the dressing undisturbed for a longer time. The fact that there was no 24hr care, no medical, clinical leader to defer to and that the nurse was required to make clinical decisions on the spot in locations that were physically removed from her colleagues was not an easy thing for her.
I recently had a conversation with colleagues in community nursing regarding a former student, an exceptionally bright and motivated student, who found her community graduate rotation stressful. She expressed feelings of an inability to cope and despite nearing the end of her rotation it was decided that she would move into an acute area.
This has inspired me to conduct research into the preparation of students to work in primary health care settings.