Moving Forward??

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CountryCallingCodes.com - Get Your Own Country Calling Code Tool - It's Free!

CountryCallingCodes.com - Get Your Own Country Calling Code Tool - It's Free!

The Hon Michael Kirby on the future of HIV/AIDS and the Commonwealth - News and Events - University of Sydney

The Hon Michael Kirby on the future of HIV/AIDS and the Commonwealth - News and Events - University of Sydney

Roche ushers in a new era for pharma on the social web

Roche ushers in a new era for pharma on the social web

Is health promotion always healthy?

I have been thinking more about the notion and practice of 'health promotion'(HP). When thinking about health promotion do we need to be mindful that the 'good' in HP sits within a spectrum (all  be it a wide spectrum) and there are limits beyond which HP becomes a risk to health? I was discussing HP with students yesterday and one of  talked about a recent clinical event which caused me to ponder this idea of limits. Within the last month two teenagers had presented to the student's (Mental Health) unit - both suicidal and both citing the extreme demands of maintaining a healthy lifestyle and body. I know that this is a much more complex issue than the inference I am alluding to but i think that it relevant. How difficult (and sometimes for some people read stressful) is it to find time to fit in a visit to the gym 5 days a week for 30-60 minutes or to fit in walking 10,000 steps, or even to try and measure 10,000 steps? What impact does it have if you can't afford or source five vegetables a day and two fruit? Is it a paradox to undertake major and potentially high risk surgery as a  health promotion activity? Recently a study revealed that loneliness is one of the greatest risks to health - are the social implications of the non acceptability of smoking  implicated? I wonder if  Talcott Parson's rights and responsibilities of the sick role underpin some of our societal beliefs about HP and by this I mean; to have the right to be a member of society do people have a responsibility to seek and pursue HP activities? In other words, are smokers, drinkers and couch potatoes deviants?
I am being devil's advocate here and, of course am cognisant of the the evidence and various strengths of evidence linking environment, lifestyle and disease and death but I think that we must remain open to question and critique blanket assumptions that can glaze over the complex detail.

Reconsidering the "art of nursing" through the lens of health promotion

Florrie (& you know who I mean), in 1893, proposed that there are two kinds of nursing. One  is "the art of nursing the sick. We shall call that art nursing proper" and the other kind, health nursing, was not so much a priority in her tented world at that time. I came across this idea as i was critiquing our notions of health promotion and it's  basis in the 17th century liberal ideologies of individual responsibility, itself based upon the assumptions that individualism, rationalism and egoism are  good. The health promotion movement, built on  public health and health education work, really began in the USA in the 1940s and Maslow's theory of 'self actualisation' (1943) really entrenched the notions of the individual responsibility as a member of society  and the demand to overcome lower level needs and achieve, achieve, achieve. Talcott Parson's classic sick role theory in 1951 emphasised this individual responsibility by outline the rights and responsibilities of the sick person. Since then health promotion models have been built on these basic assumptions within a bio-medical paradigm. Health promotion tends to make claims; one that HP (as an entity) knows what constitutes health behaviour ;and two, HP knows the best way to go about it. This sits, as a separate practice to sick nursing. Health promotion is becoming/is a separate discipline.
However, if we reconsider the notion of health nursing as part and parcel of clinical practice - an approach rather than a discrete task, it may shift the idea that HP is something else and separate to being about the way that we practice not what we do. I think of  HP as being a component of every therapeutic interaction as it is related to how we practice not what we practice. I think that we do/can/maybe could do more practice through the lens of HP.
I guess what I am also saying is that the models of HP and the world, national and local programmes (macro, meso and micro levels of interventions) are only one part of the picture. Health nursing as a holsitic, relational, collaborative and situational approach to nursing where priorities, interventions and understandings are worked through together with the participant everyday rather than a more top down approach dominated by health care professionals, focused on disease and something seperate.

Sitting in Dubbo

Well, here we are, in a motel in Dubbo. The scene here looks beautiful, indeed it was a serene, delightful bush camp on the banks of the Barcoo River ( across the river from this shot) close to Tambo. All was blissful, except the zero temperature and the heavy frost on the tent and on the inside of the hatch that we had left open to breath that clean fresh country air! Having broken the ice on the pull out kitchen and prised the frozen chair from its resting place on the table we set off for a roadhouse brekkie! The next night in Bourke was above zero - by a degree or two and we are enjoying our last night on the road in 'luxury' in a Dubbo motel - with Fox Sports of course.

The previous night we pulled into the Kynuna Roadhouse having driven from Karumba that day. Kynuna consists of a raodhouse, a hotel and the now closed Waltzing Matilda Centre. Banjo Patterson lived around here when he wrote the words to Waltzing Matilda, which has some differences to the version we now know. We had spent a longish day on the road which included a minor mechanical problem experienced as we were overtaking a caravan miday along a 300 odd km stretch of road between places - halfway past the van there was a pop followed by a whistling noise and a loss of power. We limped on to a rest area and lifted the bonnet - seemed appropriate!! A nearby guy came over to assist as men tend to when they spy the missing gender in our vehicle and proceeded to take the turbo hat off, locate the detatched hose and put it back together - so thank you Bert. We were back on the road in no time and very pleased it was nothing serious nor expensive. Anyhow - about Kynuna - we were greeted by Helen who described herself as a traveller and the resident entertainer, informing us there would be live entertaintment on this very night. Picture it - a roadhouse in a settlement with a population of 12 hundreds of kms from anywhere, a caravn park/field with a portoloo and live entertainment - all for $10. Well, Helen was great. She sung with both melody and gusto and somehow got P & I up with her - I hesitate to say on stage as this was a in a roadhouse among the burgers and spare parts for sale - helping out with a little caberet for the 12 or so folks who were fortunate to call in to rest a while in this little place oozing history and character beneath the roar of passing roadtrains and the dust kicked up into the setting sun.