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Time for change in community nursing? A critique of the implementation of the Review of Nursing in the Community across NHS Scotland

Authors

  • CAROLINE A. W. DICKSON BA, MSC, RN, DIP DN, RNT,

    1. Lecturer, Division of Nursing, Occupational Therapy and Arts Therapies, School of Health Sciences
    2. Lecturer, Division of Nursing, Occupational Therapy and Art, Therapies School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
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  • MARGARET A. COULTER SMITH PHD, MSC, DIP ADV NURS STUDIES, RNT, RCNT, GENERAL ICU CERT., SCM, RGN

    1. Lecturer, Division of Nursing, Occupational Therapy and Arts Therapies, School of Health Sciences
    2. Lecturer, Division of Nursing, Occupational Therapy and Art, Therapies School of Health Sciences, Queen Margaret University, Edinburgh, Scotland
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Caroline A. W. Dickson
Division of Nursing
Occupational Therapy and Arts Therapies
School of Health Sciences
Queen Margaret University
Edinburgh EH21 6UU
ScotlandE-mail: cdickson@qmu.ac.uk

Abstract

Aim  Current literature underpinning change is examined and a critique offered of the implementation of the role of the generic Community Health Nurse in Scotland, from a leadership and cultural perspective.

Background  In November 2006, Government strategy outlined a new service model for community nursing to be implemented in four demonstration sites across Scotland. Almost two-thirds of community nurses were not supportive of the model. There was belief this generic role would not meet the health needs of patients and carers.

Evaluation  Evidence supporting the model is presented and the implementation process evaluated from leadership and cultural perspectives. The literature is examined to offer explanations as to why implementation was unsuccessful.

Conclusions  Transformational and transactional leadership at all levels of the organization are required to make change happen. Evidence supporting change provides an impetus for change. The culture of an organization should be recognized and harnessed during the change process. Effective facilitation will empower staff to make change happen.

Implications for Nursing Management  Engagement with staff is vital, at the beginning of the change process. The concept of ‘nearby’ leadership offers an enabling style of leadership at an individual and group level which will enable effective change.

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