Understanding organisational culture in the community health setting

Nurses work across a variety of settings, including the community. With an increasing ageing population, the associated growth in chronic health conditions and the current focus of government health policies targeting primary healthcare, nurses will be at the forefront of providing support and care to a growing number of people in the community. The organisational culture of community health settings is ever changing in response to the health needs of people in the community. Nurses require an understanding of ways in which the provision of community health services (CHSs) are structured in order to practise effectively and in collaboration with other health professionals and service providers. It is from this understanding that the healthcare needs of people in the community can be most effectively assessed, planned for and responded to by community nurses.
The organisational structure of CHSs in Australia and New Zealand is complex. With this in mind, the intent of this chapter is to provide an overview of organisational culture and to explore the organisational culture of community nursing, its history, governance and funding. In this chapter, particular emphasis is placed on exploring the importance of the role of primary healthcare and health promotion for the culture and organisation of community nursing. The chapter concludes with a discussion of the roles of community nurses.