CommunityPublic health Nursing Bevel Up Movie

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Community/Public health NursingBevel Up Movie

• N205 2009

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Community health

• The pessimist complains about the wind.
• The optimist expects it to change.
• The realist adjust the sail.
• (William Arthur Ward)

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Definition of Community Health Nursing

• Canadian Public health association
• Community health/public health nursing is an art
  and a science that synthesis knowledge from the
  public health sciences and professional nursing
  theories. Goal is to promote and preserve the
  health of populations and is directed to
  communities, groups, families and individuals
  across their life span, in a continuous rather
  than episodic process .
• Potter Perry CHN frequently work with
  vulnerable (risk) populations. Ex street nurses

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Community Health Nursing ..Historical Roots

• Prior to mid 19 century CHN extension of
  domestic duties of home family provided
  primarily by female family members women of
  religious sisterhoods (Stewart, 1995
• Late 19 Early 20 century CHN emerged as a
  distinct specialty
• Majority nurses self employed private duty,
  considered among the professions elite, required
  additional skills/post-diploma training
• Majority female white Canadian/British
• Offered prospect for financial independence
• Visiting nurses/ home nursing/ VON

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VON Victorian Order of Nurses

• In 1897 the VON was founded
• It provided visiting and public health nursing
  across Canada
• Lady Aberdeen was cofounder
• Local branches were set up
• Bursaries were established
• Community-based nursing/home visiting

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Public health nursing

• Emerged in early 20 century
• 1902 Lillian Wald coined the term public
• health nursing (Buhler-Wilkerson,1993)
• Original mandate was health education,
• TB control, child hygiene programs,
• school inspection programs (combat
• disease death)

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History of Public Health Nurses

• First hired by hospitals/school boards
  eventually transferred to Departments of Health
• PHNs appointed to single, specific programs
  rather than to a generalist practice
• In response to confusing mix programs inability
  for needed programs to be sustained PHN assumed
  responsibilities role evolved to generalist
  model
• Blurring of boundaries continued to occur in
  rural areas amongst VN. Share my experience
  working with Dept. of Health.
• Originally, health was an individual
  responsibility presently government
  responsibility
• Community/public health nursing

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Roles/functions

• Direct care providers
• Educators
• Consultants
• Facilitators
• Researchers
• coordinator

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Settings

• Provincial Departments of Health
• Home care
• Schools
• Clinics
• Occupational health
• Street nurses

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CHN Today

• Development of National Community Health Nursing
  Standards 2003 updated 2008
• (CHNAC, 2008 http//www.communityhealthnursescanad
  a.ca

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Two distinct Practices Community health Nurses
Association of Canada (CHNAC) 2008

• Home Health Nurse (HHN) focus is on the client
  or family, and provide care in clients home,
  school or workplace.
• Public Health Nurse (PHN)focus is on population
  health promotion, health determinants all 12.

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Population health approach

• Looks at the range of factors that influence
  health of a population, health determinants (all
  inter-related).
• Develops programs and policies to address the
  entire populations health.
• Goal is to improve and or maintain the health of
  the population.
• Examples from movie re team meeting addressing
  increasing rates for STIs in the community

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Disease Prevention

• Primary disease prevention Risk avoidance ex
  immunization
• Secondary Risk reduction Ex needle exchange
  and screening
• Teritay rehabilitation

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Barriers to population-focused practice

• Public perception of the role of a nurse
• Socialization of nurses within the organizations
  that they work is not congruent with a
  population-focused approach.
• Educational preparation is lacking.

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Challenges for nurses in the movie

• Safety
• Timelines with clients
• Finding clients
• Establishing trust
• The nature of the work and being able to leave
  the work at the end of the day

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Challenges for the clients

• Disrespect by others
• Dealing with addictions
• Lack of social networks
• Unsafe living conditions
• Lack of resources
• Risking living conditions and practices, using
  drugs, sharing needles, sex trade
• Establishing trust with the nurses