Health care system reform and the scope of independence in decision making by environmental/family nurses. II. Evaluation of preparation of nurses for a modern model of environmental care.

Changes biased towards the autonomy of the nursing occupation originated by formal regulations do not yet designate the actual independence of nurses. This independence is determined by the modern method of work-nursing process and application in practice of a selected theory of nursing. The question pertaining to the knowledge and practical usefulness of nursing theories was justified by an anticipated positive effect of these theories on the working process. They not only indicate the goals of care, but also the scope of tasks and their type. The study was conducted by the method of a diagnostic survey with the use of questionnaire forms, and covered environmental/family nurses employed in public health care units (n=60), and non-public units (n=50). The data obtained and the results of statistical analyses allowed us to presume that environmental/family nurses do not apply the method of the nursing process, and in the majority of cases did not keep the required records. The respondents had no knowledge of international concepts of nursing. People employed in new organizational forms significantly more often referred to the theory by D. Orem, compared to those working in traditional structures.