Community Health Care Development by Deborah Hennessy BA PhD RN RM RHV Dip Public Health Nursing

By Deborah Hennessy BA PhD RN RM RHV Dip Public Health Nursing (eds.)

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The nurse's role of patient/client advocate will be vital here. This is not to say that clinical effective care is unimportant, indeed it may be unethical not to provide such care. Doubtless many ethical discussions will and must ensue. What is being underlined here is that nursing and nurses offer something which must not be lost, and which transcends the bio-medical and the shifts in the locus and status of primary and community care. Nurses stay alongside patients in their pain, emotional and mental as well as physical pain.

They are further accompanied by changes and developments in respect of technology in general, health technology and information technology in particular. Furthermore there have been, and continue to be, changes in nurse education, post-registration education and statutory requirements for the profession, and other professional issues of concern, and not only for nurses. Finally, this is all taking place in an economic climate and national prevailing ethos in which the economic and health status of individuals, families and communities is demonstrating great inequality and division.

At the time of writing this is a very recent development and not yet as well understood as it needs to be. 'Supervision is a dynamic, inter-personally focused experience which promotes the development of therapeutic proficiency. One of the primary reasons for all supervision is to ensure that the quality of all therapeutic work with the client is of a consistently high standard in relation to the client's needs. ' (Hill, 1989, pp. ' (Hawkins and Shohet, 1989, p. 5) The hitherto autocratic and hierarchical organisation of nursing inevitably leads to suspicion concerning the introduction of something which contains the word 'supervision'.

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