Maintaining appropriate boundaries with patients | Nursing Review
You can search services by DHB region (eg Auckland Central, Waitemata, Lakes ). You can find the DHB region location boundaries here. You can also search. of Health, the Laboratory provides access to the most up to date expertise for the practical deployment of .. Map of DHB boundaries and NASC boundaries. The sheer number of DHBs in New Zealand leads to duplication of to reduce the number of PHOs and map these to new DHB boundaries.
In recognition of the importance of maintaining appropriate clinical boundaries, the Nursing Council issued further guidance in June with the release of its Guidelines: That guide clearly notes that a sexual relationship with a current patient or one of their family members is inappropriate. The use of the word may indicate that there are some circumstances when such a relationship is deemed inappropriate and others when it is not.How To Have Boundaries In Relationships
An appearance before the tribunal, by its very nature, is not a pleasant experience and the best way to avoid this happening to you is to recognise the signs of becoming inappropriately involved with a patient or one of their family members see over-involvement sidebar. What should a nurse do if a person in their care or a family member is attracted to them?
Sometimes a nurse will find that a person that they are caring for, or their family member, is attracted to them and displays sexualised behaviour, perhaps flirting in the first instance. When this occurs, the nurse should firstly advise a colleague and consider contacting their professional body to seek advice on the most appropriate step to take. The nurse may decide to speak with the patient or family member displaying the attraction, gently explaining what they have noticed and then outlining the professional boundaries that they as a nurse are required to maintain.
This conversation is not an easy one for the nurse and the individual to have, and the individual should be reassured that the matter is being treated with the appropriate degree of confidentiality. However, despite the best efforts of the nurse, it may be that the result is that the clinical relationship cannot be re-established.
District health board - Wikipedia
What if a colleague is becoming over-involved? Unfortunately, sometimes a nurse will not recognise that their relationship with a patient or a member of their family is becoming intimate. If you think that colleague is in danger of failing to keep appropriate professional boundaries, you have a duty to do something about it.
If you witness such behaviour by a colleague, you cannot ignore it. At the same time, Downs recommends that "Treasury and the Ministry of Health should undertake a rigorous and data-driven review of primary care funding".
It may be that out of that review there is a case for a single national purchaser of primary care services. DHBs have every reason at present to focus on their hospitals, almost certainly to the detriment of primary care services.
We can do better with primary care in such areas as prevention, reducing some hospitalisations, improving access to care, reducing inequities, and better use of the primary care workforce.
NZ District Health Boards (2012)
I agree that "separating DHBs' dual functions as a provider and funder needs an extensive and objective review". At present, subsidies are paid to practices based on how many patients they have enrolled and whether they have high numbers of disadvantaged people.
The effect is that some disadvantaged people do not receive higher subsidies to help get access to general practice and some wealthy people receive subsidies they do not need.
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This is unfair and we need to rectify it. Although health outcomes in our region are generally better than the New Zealand average, these are variable across our Region. Some variation is seen in amenable mortality, cancer and CVD mortality, as well as cancer survival rates. The NRLTIP identifies options for reducing the inequities that currently exist in our system, by working across DHB boundaries, integrating and sharing resources, assets and services so that our investment path optimises health gain for all our communities.
Our diverse Region has: We anticipate that the demand for healthcare associated with our growing, ageing and changing population will quickly outstrip our ability to deliver healthcare under our current models of care and require significant investment.
Migrant and Refugee Services | eCALD
The NRLTIP quantifies the significant increase in capacity that is required to meet future growth, particularly in our hospitals where there are already capacity constraints. Many of our community based services are also reaching the limits of their ability to meet demand. If we simply multiply current activity by expected population growth, in 20 years the Region will need to support: The plan identifies that we will need approximately 1, extra hospital beds in Northland and Auckland in the next 20 years and outlines options for increasing hospital capacity.
These include investing in further development of our current hospital sites, building a new bed hospital south of central Auckland, and planning for a new hospital site to the north of Auckland.