Welling N, Delnoij D
NIVEL, Nederlands instituut voor onderzoek in de gezondheidszorg, Utrecht.
Verpleegkunde. 1997 Aug;12(3):131-9.
In the Netherlands, experiments are taking place in which nurses work in general practice with physicians. In the United Kingdom, so-called practice nurses have been working in general practice since the 1960's. In this article, the experiences in the United Kingdom with the practice nurse are outlined. The focus is on the lessons that can be learned from these experiences. In the United Kingdom, the majority of practice nurses are employed by general practitioners. The most important reason for introducing nurses into the general practice setting was to decrease the physicians' workload. The practice nurse in the United Kingdom has evolved from a 'cheap, task-oriented practice assistant' to a more or less autonomous colleague of the general practitioner. The practice nurses' activities vary greatly. Problems encountered in the United Kingdom primarily concern the lack of training, the absence of a clear definition of the function and responsibilities and the problems associated with working conditions which result from the employment contract with a specific general practitioner. The previously mentioned Dutch experiments show a great deal of variation in terms of the nurses' activities and their position within general practice. Consequently, the development of a clear definition of the function and an adequate training programme are also difficult in the Dutch situation. An additional point of consideration for the Dutch situation is the difference in tasks and responsibilities between the practice nurse and other nurses employed in primary care settings.
在荷兰,正在进行护士与医生在全科医疗中合作的实验。在英国,自20世纪60年代以来,所谓的执业护士就一直在全科医疗中工作。本文概述了英国执业护士的相关经历。重点在于可以从这些经历中学到的经验教训。在英国,大多数执业护士受雇于全科医生。将护士引入全科医疗环境的最重要原因是减轻医生的工作量。英国的执业护士已从“廉价的、以任务为导向的执业助理”演变成全科医生或多或少的自主同事。执业护士的活动差异很大。在英国遇到的问题主要涉及缺乏培训、职能和职责缺乏明确界定以及因与特定全科医生签订的雇佣合同而产生的工作条件相关问题。前面提到的荷兰实验在护士的活动及其在全科医疗中的地位方面显示出很大差异。因此,在荷兰的情况下,明确职能定义和制定适当的培训计划也很困难。荷兰情况的另一个需要考虑的点是执业护士与在初级保健机构工作的其他护士在任务和职责上的差异。