B. Frischknecht - Formarsi per comprendere la realtà complessa della cura territoriale
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Brian is Director of the Association for Assistance and Home Care of Mendrisiotto and Basso Ceresio; he collaborates with SUPSI in the training of home care nurses, bringing the experience of the association he heads.
What do you do professionally?
I am the Director of one of the six public-interest domiciliary care services in the Canton of Ticino. I deal with strategic and operational management with a view to optimising the organisational structure and resources (human, financial or technical). I am accompanied and supervised in the strategic dimension by the Association Committee, which acts as the Board of Directors. Having a mandate of territorial public interest to coordinate services to the user to whom I am accountable, I am called upon by the region, institutions and bodies for synergies or projects.
As Director of the Association for Assistance and Home Care of Mendrisiotto and Basso Ceresio, why do you consider it important for home care nurses to participate in the DAS? What skills are acquired?
For several reasons; first of all because the nursing world is faced with a great challenge and opportunity. The emergence and impact of chronic diseases (such as diabetes, heart or respiratory diseases, etc.) leads nurses to greater professional autonomy and skills in therapeutic education. From the technicality of performing an act or a service there is a move towards communication, organisation and leadership skills. The nurse will have to gather information about people's lives, perhaps even touching on sensitive ontological topics such as life, death or how the patient experiences illness in relation to their individual values. He or she will have to motivate people to follow prescriptions, adapt their habits and lifestyles, share support with the family member(s), and so on. All these elements call for being with an 'Other' or 'Others' and the DAS offers the opportunity to deal with all these fields of the profession.
Without forgetting that chronic diseases and an ageing population imply having to respond to multiple needs. Identifying them from the outset in a comprehensive manner, and maintaining a high level of attention to changes over time, is at the heart of care, but it is not always easy; responding to them often requires an inter-professional and team approach. Activating the network requires the organisational skills of project management that are introduced and explored in the training.
Finally, nurses will play an important role with respect to the phenomenon of longer life expectancy. The great challenge for society will be to enable people to live longer, healthily. This will be possible through health promotion policies, group or individualised pathways and by making people more resilient and motivated. Nurses will also be at the centre of this flow.
What are the benefits of training clinical specialists with expertise in primary and home care?
It will take time to see substantial changes, because it is a question of a cultural and mindset change in the nursing world itself, which is still strongly anchored to medical specialisations (pathways in oncology, psychiatry, wound care, anaesthesia, etc.) or grappling with the legacy of a certain 'vocationalism'. In the people who have attended SUPSI training, I have caught the reflection and awareness of the complexity of home care. In addition to technical and physiopathological skills, the students were confronted with the interdependence of social, educational and clinical needs in taking charge and with the responsibility of following it up. In order to be able to do this, they realised that the nurse is personally at the centre of a care network of which they must act as guarantor and define the delegations. It is a task of great responsibility that can be extremely fascinating from a professional point of view provided the nurse gives himself his own planning and working method shared with other stakeholders, colleagues, the institution and the patient themselves. It is no coincidence that the world of home care will be one of the first sectors to benefit from the self-prescription of its resources without having to go through the legitimation of the doctor. The DAS Family and Community Nurse provides precisely the tools to read this complex reality and the opportunity to give oneself planning and working methods.