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Community Health Nursing Roles

Angela M. Baird

Ferris State University

Abstract

Community-based nursing care and community as client care are both areas of community/public health. This paper will review both types of care and provide important roles and responsibilities, a comparison and contrast of the two types of care, educational preparation, specializations, and certifications of the professional staff. The focus of client care, level of care, typical settings and sources of funding will be explored also.

Community Health Nursing Roles

Many nursing professionals starting a career in nursing have the desire of obtaining a job as a registered nurse in a hospital setting. Some individuals never start the path to becoming a nurse because they have little education on the numerous career opportunities available for the nursing professional. Acute care, a branch of nursing where patients are treated for a short time with an illness, injury, or recovering from surgery is obtained through an inpatient hospital stay, emergency room, ambulatory care clinic, or any other short stay facility. These patients are usually treated until they are considered well enough to go home and are given appropriate discharge instructions. Another branch of nursing that has more than 360,000 registered nurses employed is community health nursing. In the United States this constitutes 15% of all employed nurses. From 1980 through 2000 the number of nurses employed in community health increased by 155% compared with an increase of 55% of nurses working in hospitals (Maurer & Smith, 2009). CHN (community health nursing) alone has many roles and responsibilities for the nursing professional to choose from. For this paper community-based nursing care and community as client care will be reviewed. CHN has multiple definitions depending on the association, but promoting health and preventing illness of populations is emphasized (Maurer & Smith, 2009). CHN professionals take care of individual patients with the same approach as a nurse working in an acute or long term care setting. Obvious differences are in the place and acuity of the patients. Some CHN professionals never see an individual patient but have roles that develop programs to assist an identified population with controlling and prevention of an illness. Both of these nurses may focus on the same health risks, promotion of healthy living, and prevention of disease.

Definition of community-based nursing care

CBN (community-based nursing) care is a philosophy of nursing, not a specialty. Care is provided to individuals, families, and groups. This includes where they live, work, play, or go to school. CBN characteristics are individual and family centered and has an appreciation on the values of the community. The goal of CBN is managing an acute or chronic condition with promotion of self care of the individual and family (Zotti, Brown & Stotts, 1996). Nurses that work in a noninstitutional setting and have obtained a diploma or associate-degree in nursing earn the name of community health nurse and practice community-based nursing (Maurer & Smith, 2009).

Examples of community-based nursing care

Hospice care registered nurses make home visits in the community to individuals and their families with an incurable or terminal illness. The RN (registered nurse) coordinates the services available to the individual in their home to promote a peaceful and dignified end of life. Visits are routinely made in the patient’s homes but can also be made in an inpatient hospice facility, hospital, or long term care facility.

Faith Community Nurse or Parish Nurse is a name that is receiving recognition as a specialty in the nursing profession by the American Nursing Association. “Faith community nursing is the specialized practice of professional nursing that focuses on the intentional care of the spirit as part of the process of promoting wholistic health and preventing or minimizing illness in a faith community.”(What is Parish Nursing, no author). Some of the roles of a Parish Nurse include provider of spiritual care, health advocate, health educator, and trainer of volunteers. The Parish nurse may provide education or facilitate education to individuals and groups to make the best choices to maintain health, lower health risks, prevent disease and maintain and manage diseases already present (Roles of a Parish Nurse).

Wound, ostomy, and incontinence nurses provide care through a community home health agency. Home health visits are made in the community by these nurses to assess new wounds, colostomies, and incontinence issues. Ostomy nurses use the nursing process to care for new and existing skin problems and make recommendations to the PCP (primary care physician) for any changes in treatment.

Definition of community as client care

Community as client care provides care to benefit the community as a whole. Care can be at the local, state, federal or international level and places an emphasis on nursing care that promotes, restores, and preserves the health of the total population of the community. Community client care seeks to promote individuals, families, groups and community organizations to participate in the creation of a health community (Maurer & Smith, 2009).

Examples of community as client care

Occupational health nurses are viewed as a subspecialty of community/public health nursing because of preventing environmental disease and injuries. Their main practice is for aggregate workers in occupational settings across the United States. Special skills include training of safety hazards, disaster planning, being familiar with safety equipment, and the ability to develop health education programs. Special knowledge of safety, toxicology, epidemiology, environmental health, and industrial hygiene are required (Maurer & Smith, 2009)

School nursing professionals are providers of basic health services to the school population. They are health screeners and a referral source; they promote health and healthy school environments, and are a liaison between school personnel, family, community, and health care providers. Activities of the school nurse ultimately have an effect on mortality and morbidity of children and adolescents and through the nurses interventions they can assist to reduce high risk behavior and promote a healthy life style (Maurer & Smith, 2009).

Similarities

Similarities of community based nursing and community as client care are that staffed professionals have obtained a basic education in nursing and work in noninstitutional settings. Education is given to individuals, families, and groups to promote a healthy community and enhance individual and family self care (Maurer & Smith, 2009). These two types of community care are provided with home visits to the young and old, acutely ill and high risk individual within local communities (Zotti, Brown & Stotts, 1996).

Differences

Community based nursing and community as client care have differences also. Community as client care is given at local, state, federal, and international communities. Nurses staffed within community based nursing have completed a diploma or associate degree in nursing and no formal preparation in public health nursing. Community as client nurses usually are baccalaureate prepared nurses and may even have master’s degrees that focus practices on communities, entire populations, and multiple aggregates. Professional certification is only available to those nurses who have a baccalaureate or master’s degree with advanced education in community health (Maurer & Smith, 2009).

Funding

Healthcare services are provided by private or public sectors. Private sectors are those individuals who can pay either out of pocket or through third party payers, like private health insurance. Public sectors are funds that come from governmental agencies (Maurer & Smith, 2009). Health departments would be an example of a governmental agency that receives funding through governmental agencies. Health departments offer many programs for free or based on an individual’s income.

Conclusion

In conclusion, community based nursing and community as client care are important aspects of community/public health nursing. With both types of care available to all individuals nurses will educate and promote healthy lifestyles, and ultimately help our communities to be productive and healthier too.

References

Bell, S. 2003. Community health nursing, wound care, and (horizontal ellipsis) ethics? Journal of Wound, Ostomy and Continence Nursing, 30 (5), 259-65.

Maurer, F. & Smith, C. 2009. Responsibilities for care in community/public health nursing. Community/Public Health Nursing Practice. (4th ed.). Missouri: Saunder & Elsevier.

Maurer, F. & Smith, C. 2009. Origins and future of community/public health nursing. Community/Public Health Nursing Practice. (4th ed.). Missouri: Saunder & Elsevier.

Maurer, F. & Smith, C. 2009. School health. Community/Public Health Nursing Practice. (4th ed.). Missouri: Saunder & Elsevier.

Roles of a parish nurse. Center for Community Health Ministry.

Types of hospice care. .

What is parish nursing? Center for Community Health Ministry. .

Zotti, M., Brown, P. & Stotts, C. 1996. Community-based nursing versus community health nursing: what does it all mean? Nursing Outlook, 44 (5), 211-17.

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