Stretching district nursing services to meet rural needs

This article evaluates the adequacy of District Nursing Service (DNS) provision in the Goulburn Murray region in Victoria. It draws on a survey of the region's DNS and communication with several community health agencies in response to problems identified by service providers. The results suggest that these rural health services face problems not experienced in urban areas. District nurses in rural areas have to travel far and wide to accommodate their clients and they put in extra unpaid hours if necessary. Their travel time, management and communication skills are not sufficiently recognised in the current funding formula. Although this includes some weighting for rurality, it is insufficient for District Nursing Services catering for smaller, more dispersed populations. Current and future demand pressures on home and community-based nursing services highlight the importance of redressing this deficiency. Several issues raised in this article may reflect problems that are common in rural regions, including funding inadequacies, unpaid additional work, access and equity difficulties and boundary issues. As a result, recommendations to improve service delivery may have broader applicability.