S.TRUEMAN PhD THESIS 2016
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options for referral, but only nurses commented specifically on limited resources generally, to care for mental health patients. Two nurse participants stated, ‘it all comes down to resources’ (rural nurse participant) and ‘obviously the metro are far better staffed to have greater resources than the rural do’ (rural nurse participant). Jelinek et al.’s study is consistent with the attitude of remote nurses who know and simply accept that to work remotely necessarily involves working in an environment of reduced resources. One response to the lack of available resources is remote nurses’ extended or advanced practice roles (Bushy, 2002; Hanna, 2001; Lowe, Plummer, O’Brien & Boyd, 2012). The lack of access to trained mental health staff, including to specialist mental health advice is a reoccurring issue. Remote nurses, unlike their metropolitan counterparts, do not have ready access to summons assistance from a mental health nurse or mental health consult-liaison nurse. This necessarily means that any care has to be delivered by the remote nurse; this is the same for any type of patient presentation. ‘The nurses provide the first point of contact for a range of primary-care functions normally provided by medical practitioners and allied health professionals in urban and large regional centres. Remote area nurses act as sole providers of primary and urgent healthcare, and frequently extend their skills due to community demand and a lack of any other form of health professional support.’ (Burley & Greene, 2007, p. 3) This results in the remote nurse having to undertake an extended practice role to meet the needs of the community (Kenny & Duckett, 2003; Wilson-Barnett, Barriball, Reynolds, Jowett & Ryrie, 2000). ‘[Remote nurses] specialty area of practice is being ‘an expert generalist’’ (Bushy, 2002, p. 109). The nurse delivers care, which if based in a
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