Community Health Nursing Roles



Community Health Nursing Roles

Temple Brooke Robinson

Ferris State University

Abstract

Many people have said “I want to be nurse when I grow up”. However there are many different roles a nurse can play. This paper will discuss two of those roles; the community based nursing care of an individual and the nursing care of communities and aggregates as clients. After reading this paper it should be clear how these two roles are similar and how they are different.

Community Health Nursing Roles

There are many different roles for the nurse; many of these roles are in hospital or physician’s office. There are also nursing roles in the individual client’s home and in the community. The role of the community health nurse is similar to the role of community-based nurse caring for individual clients, but there are differences too.

The community-based nursing care of individual clients is the same care received in a traditional care facility, almost any care provided in the hospital, doctor’s office, clinic or rehabilitation facility is available, except the care is given in the home. An example of community-based nursing care is a Genesys Home and Hospice Care nurse. These nurses care for clients recovering from acute illness, trauma or surgery after they have been discharged from the hospital (Genesys Home and Hospice Care, n.d.). The nurse “coordinates patients’ overall care with physicians to provide continuing services in their homes” (Genesys Home and Hospice Care, n.d., para. 3). Community-based nursing care of the individual will have services which are adjusted to meet the changing needs of the patient, and incorporating these services into the family’s daily routine, minimizing disruption of the client and family’s lifestyle while promoting client and family independence (Genesys Home and Hospice Care, n.d.).

“Community/public health nursing is the care provided by educated nurses in a particular place and time and directed toward promoting, restoring, and preserving the health of the total population or community” (Maurer & Smith, 2009, p. 6). According to the American Public Health Association (APHA) community/public health nursing can be a collaboration of several community/public health nurses or one community/public health nurse working within a community or aggregate (American Public Health Association [APHA], 2010). An example of community/public health nursing care would be teaching infant and child care to teen-mothers. The community/public health nurse would evaluate the needs and the education level of the young mothers to whom the teaching would be directed. Once the teaching has been completed to community/public health nurse will re-assess the needs of the teen-mothers to see if further education of assistance is needed.

The roles and responsibilities of the community-based nurse are caregiver, case manager, change agent, client advocate, collaborator, counselor, and educator. The nurse needs to be able to perform accurate assessments and provide individual interventions as needed. Educating the client on health promotion and prevention is also part of the responsibilities of the community-based nurse.

A nurse caring for communities and aggregates also has roles and responsibilities; these are the same as the community-based nurse. The only difference is the nurse caring for the community and/or aggregate is not focused on one person or one family. This nurse must be able to assess an entire community and/or aggregate and be able to plan, implement, and evaluate programs focused on that population’s healthcare (Maurer & Smith, 2009). A nurse caring for a community also is involved politically, this nurse helps to advocated for important things such as adequate housing, stands of living, healthcare services and healthcare resources (Maurer & Smith, 2009).

The educational preparation for a community-based nurse is generally an associate degree in nursing (ADN) or a bachelor of science in nursing (BSN). ADN programs are generally offered at colleges and at some universities. This degree is usually obtained in two to three years (“When I grow up I want to be a nurse“, 2003). The BSN is offered by four year colleges and universities. The program is usually takes four years to complete. The BSN program can also be entered into by nurse with an ADN to help prepare the nurse for a broader scope of practice (“When I grow up I want to be a nurse“, 2003). Once a nurse has successfully completed either a BSN program or an ADN program the nurse must then pass the National Council Licensure Examination.

“It is not the place of employment that determines whether a nurse is a community/public health nurse, however. Instead, community/public health nurses are distinguished by their education and by their community/population focus of their practice” (Maurer & Smith, 2009, table 1-2). The preferred educational background for nursing care of a community or aggregate is a “master’s degree in community health nursing/public health nursing from a school of public health or a master’s degree in public health from a school of public health” (Maurer & Smith, 2009, p. 24). “Nurses with a master’s degree or a more advanced degree in nursing with a specialization in community/public health nursing and baccalaureate-prepared nurses who also have a master’s degree in Public Health with a specialization in nursing are eligible to take an advanced examination. These nurse specialists can become certified as an advanced public health nurse board certified” (Maurer & Smith, 2009, p. 25).

Community-based nursing care of the individual client focuses on the client and the family members who are the primary caregivers of the client. The level of care can range from daily dressing changes to complete care at the end of the client’s life. Some clients require a nurse to visit every day to help set up antibiotic infusions, evaluate a patient for congestive heart failure, or to perform dressing changes the family or client is unable to do them. Some clients leave the hospital so they are able to pass away in peace at their own home. In situations like this hospice nurses usually see the client every day or every few days. The hospice nurse works with family to keep the patient comfortable and pain free in the little time they have left.

The focus of nursing care of communities and aggregates is based on the needs of the community or aggregate. These nurses are expected to work with a community or aggregate with little to no supervision and collaborate with others to assess the population and the aggregates within a geopolitical community (Maurer & Smith, 2009, p. 24). The level of care given by the nurse varies depending on the assessed needs of the community/aggregate.

Typical care setting for community-based nursing care of the individual client is usually in the client’s home. The funding for this service us usually covered by private insurance or by Medicare/Medicaid. Though with advances such as telehealth, the nurse and client enter into a virtual environment of care where the nurse can monitor a client’s blood pressure, pulse rate, respiratory rate, weight, and arterial oxygen saturation, allowing the nurse to detect health issues quickly and call for an ambulance if needed (Maurer & Smith, 2009).

Typical settings for the nursing care of communities and aggregates are schools, rural communities, community mental health, and state and/or local health departments. Funding for care of the client’s in these settings are tight many of the school nursing programs have been cut or reduced in schools because the funding of these programs was diverted to programs such as “No child left behind”(Maurer & Smith, 2009). While there are accessible programs for rural communities such as Federally Qualified Health Centers and Rural Heal Clinics these programs have been receiving less funding from the government (Maurer & Smith, 2009). The funding by both federal and state government has decreased for the mental health community. It has become the responsibility of many of the communities to support any community mental health programs (Maurer & Smith, 2009).

While there are many differences between these two nursing roles, it is their similarities that make them interesting and challenging. It is the challenges which will keep community/public health nursing growing in the future. Most of all it is the interest in their communities which will keep nurses in community nursing.

References

American Public Health Association. (2010). About public health nursing. Retrieved from

Genesys Home and Hospice Care. (n.d.). Home and Hospice Care. Retrieved from

Maurer, F. A., & Smith, C. M. (2009). Community/ Public Health Nursing Practice (4th ed.). St. Louis, Missouri: Saunders Elsevier.

When I grow up I want to be a nurse. (2003). Retrieved from

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