Title: Nurse Settings for Community Health Nursing.
1Nurse Settings for Community Health Nursing.
2Lecture objectives
- Upon finishing this lecture, you should be able
to - Describe seven settings in which community health
nurses practice. - Discuss the nature of community health nursing,
and the common threads basic to its practice,
woven throughout all roles and settings. - Identify principles of sound nursing practice in
the community.
3Community Health Nurse Practice
- Is focussed on wellness not sickness.
- Is focussed on prevention not just treatment of
problems. - Is focussed on assisting people and communities
make their own decisions regarding health care. - Is focussed on assisting those with existing
health conditions to maximise their potential and
prevent deterioration if possible.
4Community Health Nurse Practice
- Is based in the community in a range of settings,
wherever there is a need for support, information
and education. - Responds to public health needs in relation to
communicable diseases.
5Community Health Nurse Practice
- Has the whole community as their client, as well
as groups, families and individuals. - Recognises the impact of life course and social
determinants of health and works in partnership
with the community to address these.
6Community Health Nurse Practice
- Utilises the primary health care philosophy to
guide practice. - Has a specialised body of knowledge which
reflects current research and evidence based
practice.
7Community Health Nurse Practice
- Community health nurses recognise health as a
state of complete physical, mental and social
well-being and not merely the absence of disease
and infirmity W.H.O. - Community health nurses deal with clients in a
holistic manner, working with them wherever they
are on the health illness continuum.
8(No Transcript)
9What is different about practice of community
health nurse
- Community health nurse practice, by the nature of
the work setting, requires autonomy,
self-direction and use of a high level of
professional judgement.
10(No Transcript)
11Work settings for community health nurses
- The types of places in which community health
nurses practice are increasingly varied and
include a growing number of nontraditional
settings and partnerships with nonhealth groups. - Employers of community health nurses range from
state and local health departments and home
health agencies to managed care organizations,
industries, and nonprofit organizations.
12Work settings for community health nurses
- These settings are grouped into seven categories
- (1) homes,
- (2) ambulatory service settings,
- (3) schools,
- (4) occupational health settings,
- (5) residential institutions,
- (6) parishes,
- (7) the community at large.
13What is different about practice of community
health nurse
- Community health nurses interact with a wide
range of both professional and non professional
people within the community and must have a
variety of interpersonal skills.
14(No Transcript)
15Homes
- For a long time, the most frequently used setting
for community - health nursing practice was the home.
- In the home, all of the community health nursing
roles are performed - Clients who are discharged from acute care
institutions, such as hospitals or mental health
facilities, are regularly referred to community
health nurses for continued care and follow-up. - Here, the community health nurse can see clients
in a family and environmental context. - Service can be tailored to the clients unique
needs.
16Homes Health promotion
- Many community health nursing visits focus on
assisting families to understand and practice
healthier living behaviors - Nurses may, for example, instruct clients on
parenting, infant care, child discipline, - diet, exercise,
- coping with stress,
- or managing grief and loss.
17Homes The diversity
- The character of the home setting is as varied as
the clients served by the community health nurse.
- In one day, the nurse may visit
- a well-to-do widow in her luxurious home,
- a middle-income family in their modest bungalow,
- an elderly transient man in his one-room
fifth-story walk-up apartment, - and a teen mother and her infant living in a
group foster home. - In each situation, the nurse can view the clients
in perspective and, therefore, better understand
their limitations, capitalize on their resources,
and tailor health services to meet their needs.
18Home visits
- anxiety for the nurse.
- nurses first experience outside the acute care,
long-term care, or clinic setting. - visiting families in unfamiliar neighborhoods.
- fear of the unknown.
- collaboration with various types of home care
providers, including hospitals, other nurses,
physicians, rehabilitation therapists, and
durable medical equipment companies
19Ambulatory service settings
- include a variety of venues for community health
nursing practice in which clients come for day or
evening services that do not include overnight
stays. - Community health centers
- Multiple clinics offering comprehensive services
- Family planning clinics or a well-child clinics
- Day care centers, such as those for physically
disabled or emotionally disturbed adults - Offices (for example, a community health nurse
associated with a health maintenance organization
sees clients in the office and undertakes
screening, referrals, counseling, health
education, and group work.
20Ambulatory service settings cont
- Independent nursing agencies that practice by
seeing clients in community nursing centers as
well as making home visits. - Another type of ambulatory service setting
includes places where services are offered to
selected groups. - community health nurses practice in migrant
camps, - through churches as parish nurses,
- in remote mountain and coal-mining communities.
21Schools
- Schools of all levels make up a major group of
settings for community health nursing practice. - Nurses from community health nursing agencies
frequently serve private schools at elementary
and intermediate levels. - Public schools are served by the same agencies or
by community health nurses hired through the
public school system. - The community health nurse may work with groups
of students in preschool settings as well as in
vocational or technical schools, junior colleges,
and college and university settings. - Specialized schools, such as those for the
developmentally disabled, are another setting for
community health nursing practice.
22Occupational Health Settings
- Business and industry provide another group of
settings for community health nursing practice. - Community health nurses in occupational health
settings practice a variety of roles - The clinician role was primary for many years, as
nurses continued to care for sick or injured
employees at work. - However, recognition of the need to protect
employees safety and, later, to prevent their
illness led to the inclusion of health education
in the occupational health nurse role. - Occupational health nurses also act as employee
advocates, assuring appropriate job assignments
for workers and adequate treatment for
job-related illness or injury.
23Residential Institutions
- Any facility where clients reside can be a
setting in which community health nursing is
practiced. - Residential institutions can include
- a halfway house in which clients live temporarily
while recovering from drug addiction, - an inpatient hospice program in which terminally
ill clients live. - Some residential settings, such as hospitals,
exist solely to provide health care - others provide other services and support.
24Residential Institutions cont
- A continuing care centers
- In this setting, residents usually are elderly
some live quite independently, whereas others
become increasingly more dependent and have many
chronic health problems. - The community health nurse functions as advocate
and collaborator to improve services.
25Residential Institutions cont
- Residential institutions provide unique settings
for the community health nurse to practice health
promotion. - Clients are a captive audience whose needs can
be readily assessed and whose interests can be
stimulated. - These settings offer the opportunity to generate
an environment of caring and optimal-quality
health care provided by community health nursing
services.
26Parishes
- Parish nursing finds its beginnings in an ancient
tradition. - In parish nursing today, the practice focal point
remains the faith community and the religious
belief system provided by the philosophical
framework - Parish nursing may take different names, such as
- church-based health promotion (CBHP),
- faith community nursing, or
- primary care parish nursing practice (PCPNP).
27Parish nursing
- Involves a large-scale effort by the church
community to improve the health of its members
through education, screening, referral,
treatment, and group support.
28(No Transcript)
29Community at Large
- Unlike the six settings already discussed, the
seventh setting for community health nursing
practice is not confined to a specific
philosophy, location, or building. When working
with groups, populations, or the total community,
the nurse may practice in many different places.
30Community at Large
- For example,
- A community health nurse, as clinician and health
educator, may work with a parenting group in a
church or town hall. - Another nurse, as client advocate, leader, and
researcher, may study the health needs of a
neighborhoods elderly population by collecting
data throughout the area and meeting with
resource people in many places. - A nurse may work with community-based
organizations such as an AIDS organization or a
support group for parents experiencing the
violent death of a child.
31Tasks for practical
- Search the Internet or go to the library and find
two sources of health-related information for
consumers. Was the information accurate? - Search the Internet or go to the library and find
two research articles on community health
nursing. In what settings did the research take
place? Did the nursing authors collaborate with
interdisciplinary team members on this research?
If so, how do you think this collaboration
helped the research? If you were to conduct
research in the community, would you conduct it
with only nurses on the team, or would your team
be interdisciplinary? Why? What would be the
benefits or limits of each approach?