What is Community Nursing?
Most community nurses work in the government sector while some work as domiciliary nurses for private organisations such as Bluecare, Ozcare and St Luke's Health Services (also see Domiciliary Nursing).

Community nurses work with clients to match assessment results against current or evidence based treatment options when implementing health care. Community nurses usually work in multidisciplinary teams that ensures the client receives the full range of health care. Much of the work is focused toward illness/disease prevention or early intervention to prevent exacerbations of chronic illness and unnecessary hospital admission.
Community Nurses work across the full range of health care delivery

Community nurses assist clients and their carers/families in focusing on their health situation in relation to their environment and coping skills to maximise their management of the disorder. Community nurses use health promotion, prevention, early intervention, treatment and referral as the mainframe for community nursing service delivery. They work with the acute care sector, domiciliary and community mental health nurses, specialists, general practitioners, allied health specialists, health advancement specialists and community based care providers and organisations to provide a continuum of care in the following range of interventions and case management:

• clients at risk for complications of conditions/diseases such as diabetes, asthma, chronic respiratory, cardiac and renal conditions, palliative care, depression, other mental illness including risk of suicide, drug misuse or addiction, managing serious drug withdrawal states and early intervention for first time convicted illicit drug users;
• notifiable infections, sexual health/contraception including pap smear and breast screening services and HIV/AIDS management;
• risks associated with aging as in continence management, risk of falls, dementia, arthritis, improving social networks;
• improving access to adequate nutrition, shelter/housing and employment;
• men’s health, well woman clinics;
• child health information and advice, parenting advice, injury prevention improving immunisation rates throughout the lifespan;
• advocating on behalf of people who are at risk for domestic violence, financial abuse, marginalised by social bias or disadvantaged by gaps in aging government policies;
• managing the transition from home-hospital-home continuum of care for acute interventions, eg., wound management, in home IV services.

Community Nurses work in general and speciality areas and the following are just some examples of the diversity of community nursing.

Generalist Community Health Nursing
The Community Health Nurse works with other members of the Community Health Team and the general public to plan and deliver services that promote and maintain the health, safety, independence and well being of people living in the community. Their clients include the frail aged and their carers, people with a disability and those with chronic illnesses as well as those who need before and after hospital services. The Community Health Nurse visits clients in their home to assess physical, functional, emotional, social, environmental and safety factors. Nurses assist the client to identify their care goals and organise agreed care activities and together with the client, monitor the care plan and makes changes where necessary. They consult with, and refer to other care support services such as Meals on Wheels, Domiciliary Nursing Services, Medical Aids Subsidy Scheme, Home care Service, Taxi Subsidy Scheme, and many more.

Community Health Nurses work together with hospital staff to prevent unnecessary hospital admissions by identifying support needs, providing education and organising appropriate care for the people in our community. Where hospitalisation occurs, the Nurse can assist by coordinating and supporting the client's care before and after a hospital stay. Orthopaedics and Respiratory are two areas where the Nurse works in partnership with The Prince Charles Hospital. Community Health Nurses undertake Health promotion activities and have speciality roles in areas such as Diabetes, Continence, Dementia Care and Asthma Education.

Alcohol and Drug Nursing
Alcohol and Drug Nurses work across a range of health settings in clinics, health centres, homes, community-based organisations and work with government sectors, ie Education, Police and Corrective Services. Primarily they offer assessment, withdrawal management from psychoactive drugs, brief and early intervention programs, opioid treatment services, alcohol and drug counselling and relapse prevention. Consultation liaison services are provided to General Hospital Services, Mental Health, Watchhouse, General Practitioners and other community services on the management and treatment of people with alcohol and drug services. Nurses work closely with Mental Health and general Community Health Services to provide holistic services to clients who have more than one diagnosis. Health promotion and education on alcohol and drug issues is undertaken within specific alcohol and drug campaigns, clinician education programs and with the community, families and individuals.

Public Health Nursing
Public Health Nurses play a major role in the surveillance of all notifiable conditions and the timely follow up of priority notifiable conditions that require public health action eg vaccine preventable diseases and meningococcal infections. The nurses are also responsible for implementing immunisation programs that will enable the Health Service District achieve the immunisation targets set by the National Health and Medical Research Council (NHMRC) and Queensland Health. Both these areas involve providing extensive education and advice to health professionals, community organisations and the public.

Indigenous Health Nursing
Indigenous Health Services are targeted at addressing the health status inequities of the Indigenous population. Nurses working in this area focus on providing culturally appropriate services across the lifespan with particular emphasis on those health issues with higher prevalence in the indigenous community. New mothers and babies who are considered at risk are provided with an in-home nursing service to assist in lactation and care of the new babe.

The major burden of disease for indigenous people is cardiovascular disease, alcohol and drug issues, cervical and breasts cancer and diabetes. Most of these conditions are treatable and preventable, but the outcomes of these diseases result in higher morbidity and mortality rates in indigenous populations than those in non-indigenous populations and significantly shorter life spans. Nurses work with Indigenous Health Workers, community leaders and elders to ensure services provided are culturally sensitive and appropriate to the specific community and individual. Immunisation is also a significant part of the nurse's role.

Sexual Health and HIV/Aids Nursing
This Service provides a free and confidential service to the public by offering sexual health tests, information, counselling, and pregnancy testing, emergency contraception and family planning advice. The Service also has a specialist and community based HIV/AIDS service that provides clinical care, ongoing chronic disease management and support for clients and their carers/families. Services are provided to the public and those clients in institutions, ie correctional facilities.

Sexual health nurses work as independent nurse practitioners in relation to the control and prevention of sexually transmissible diseases including HIV and other blood borne viruses such as Hepatitis B and C. Nurses fully assess, perform routine serology for pathological examination and provide routine treatment and medication for clients. They provide topical treatments, HIV testing with counselling and are responsible for contact tracing and follow up for notifiable diseases. Clients are case managed with particular emphasis on clients with dual diagnosis [mental health and alcohol and drug problems]. Nurses provide education to clients and other professional groups and opportunities are available for ongoing research and clinical trials.

Acute In-Home & Post Acute Nursing
Nurses working in post acute and acute in home services assist clients and their carers in assuming self care for an acute health issue. The health issue may have necessitated a hospital admission or the admission may have been prevented or have been reduced in duration through the provision of services to the clients in their own home. Services frequently include intravenous antibiotics and wound management. Nurses work closely with the acute care sector, the clients General Practitioner and the multidisciplinary health care team to provide optimal service delivery.

Child Health & School Based Youth Health Nursing
Child Health nurses assist parents in focusing on the health, development and wellbeing of families and their children from birth to the age of 18. This is achieved by working in partnership with parents, children GPs and carers to prevent and detect health problems in the early stages and provide support for all aspects of the parenting role.

Hospital/Liaison Nursing
Liaison nurses assist in the smooth transition of clients from the acute setting to their homes. Nurses arrange appropriate community based services to enable clients to receive care in their own homes. Liaison Nurses provide key resources in regard to discharge planning and are a central contact point with community based service providers. This service also assists in the prevention of inappropriate hospital admissions or re admissions by ensuring adequate community based support services.

How do I become a community Nurse?
Nurses considering a career in community nursing can choose from a variety of postgraduate courses. These courses range from general community health, alcohol and drug , sexual health, HIV/AIDS, public health, nurse immuniser, maternal and child health, indigenous studies, mental health studies, aged care, health education, health promotion and advancement, continence management, diabetes nurse educator and accreditation, rehabilitation, women’s health, men’s health, cultural and indigenous awareness, management and administration, teaching and health education, and leadership. For more information on postgraduate course availability in this area, click here to go to the further education section.

What opportunities are available for community nurses?
There is a national shift in directing more health care into the community as the costs of hospitalisation continue to increase. This will occur in conjunction with a more integrated approach to delivering and managing health care services overall. Thus the future will see people with chronic disease and those with the conditions of aging being case managed by community health nurses. There will be a need for community nurses to liaise with hospitals, GPs and community based organisations, to manage the transition from home-hospital-home in the pre and post acute nursing care delivery. Community nursing in the speciality areas such as sexual health, alcohol and drug, women’s health, child health and diabetes will continue to need community nurses. Nurses experienced in population health and/or indigenous health will have scope in clinical delivery in primary health care centres, and there will always be opportunities for experienced nurses in research and teaching positions in the tertiary sector and at local, State and Federal health government levels.
Areas Available with Community Nursing.

• Community Health Nurse
• Alcohol and Drug Nurse
• Sexual Health Nurse
• Child Health Nurse
• School-based Nurse
• Women’s Health Nurse
• Family Health Nurse
• Acute In-Home Nurse
• Post-Acute Nurse
• Immunisation Nurse
• Public Health Nurse
• Council Nurse
• Aged Care Nurse
• Dementia Nurse
• Continence Nurse
• Hosp/Community Liaison Nurse
• Indigenous Health Nurse
• Community Nurse Educator
• Sexual Health Nurse Educator
• Alcohol & Drug Nurse Educator
• Diabetes Nurse Educator
• Continence Nurse Adviser
• Community Nurse Manager
• Community Nursing Director
• Director of Nursing, Community
• Community Mental Health Nurse see Mental Health nursing

Where can I get more information on community nursing?
For more information on community nursing, you can contact:

Community Nurse Educators,The Prince Charles Hospital Health Service District
Community Nurse Educator - 3350 8122
Sexual Health Nurse Educator - 3227 8666
Alcohol & Drug Nurse Educator - 3238 4070

Community Services, QEII Hospital Health Service District
Nursing Director - 3275 6700

Community Child Health, Royal Children’s Hospital Health District
Nursing Director - 3250 8555

Redcliffe-Caboolture Hospital Health Service District
Community Services Nurse Practice Coordinator - 3883 7300

Community Services, Royal Brisbane Hospital
Director of Nursing - 3336 1453

West Moreton Health District Community Services - 3817 2400

Public Health Units
Brisbane Northside - 3250 8555
Brisbane Southside - 3000 9148
Cairns - 4050 3600
Darling Downs - 4631 9888
Mackay - 4968 3858
Mt Isa - 4744 4404