District nursing in Dominica.

District nurses constitute the basis of the primary health care services in Dominica. All encounters of three district nurses were registered using the international classification of primary care. Information on other aspects of district nursing was collected by participating observation and the use of a questionnaire. Check-ups for hypertension, diabetes, pregnancy and immunisations constituted 40% of all reasons for encounter. The district nurses dealt with 80% of all contacts; only 20% of all patients were referred to the district medical officer. There are several discouragements to the motivation of the nurses. In addition to being a nurse, all have their family and other obligations. Postgraduate training with diversified certification and upgrading of wages could contribute to a continued high motivation and increased job satisfaction.

District nurses in Dominica - abstract

The aims of this study was to assess the work and workload of the district nurses, and to study other aspects relatd to the profession of a district nurse. The study was conducted from June to October 1995. All encounters of three district nurses were registered during periods of four weeks, using the Internatonal Classification of Primary Care. Information on other aspects of district nursing was collected by observation and the use of a questionnaire. In the study period, 411 clients were attended to in 495 encounters. Check-ups for hypertension, diabetes, pregnancy and immunizations were among the most common reasons for encounter. Together they constitute 40 percent of all reasons for encounter. "No disease" was the most frequent diagnosis, followed by hypertension, diabetes, pregnancy, fever and skin conditions. Partial medical examinations were conducted at almost all encounters. The ranking of the treatment given was medication, education and dressing. Prevention was the most frequent activity. The district nurses effectively dealt with 80 percent of all contacts; only 20 percent of patients were referred to the district medical officer. There were several factors that negatively affected nurses' motivation. On average, the nurses worked 43 hours a week. The long walking to do household visits and being on call were considered to be the most demanding aspects. In addition to being a nurse, each has her family and other obligations. Finally, career mobility is limited. Postgraduate training with diversified certification and upgrading of wages could contribute to a continued high motivation and job satisfaction. (AU)