Practice Development – ein Konzept zur Entwicklung der beruflichen Pflegepraxis in Irland

Abstract

Significant health and nursing policy developments have impacted on the development of the nursing profession and practices over the last decade in Ireland. It is evident that nursing must demonstrate its value to those who have the influence to shape or determine the nature of nursing through policy decisions, allocation of resources and the impact on personnel development of nursing within their work organisational culture. The nursing profession is evolving within the broader context of healthcare, healthcare policy, personel development and indeed society at large. Nurses working in Ireland presently face considerable challenges in providing increasingly specialised care to patients with more complex needs than ever. There is a current public sector employment control framework in operation, including a moratorium on staff recruitment and mandated reductions in intakes into nursing programmes over recent years. These constraints place greater demands within a personel development context on practising nurses to do more, and better, with fewer staff. In an Irish context, as well as the economic downturn affecting health spending, two related sets of developments over the last decade are particularly relevant to and are shaping the debate about nursing skill mix. Firstly, the Irish health care system has been through significant and far-reaching restructuring, including the creation of the centralized Health Service Executive (HSE) since 2005. Driving this restructuring, there has been an explicit policy goal to shift resources and services from acute care into primary care and for greater service coordination and integration of services. The debate now lies within reforming the health service executive and the effective organisational culture that nurses can provide efficient and effective care in the future. Secondly, changes have taken place in the profession of nursing, particularly from a personnel development perspective such as the development of specialist and advanced clinical roles and responsibilities in education and in management roles, following the hugely influential Report of the Commission on Nursing (Government of Ireland 1998).