CHN 1 RLE

Area of Exposure: Community Health Nursing 1 RLE Exposure

Location of Community: Zone 2 Hacienda. Carmen, Barangay Granada, Bacolod City
Require Hours to Render: 51 hours
Student-Client Ratio: 1 student: 1 household

Pre-requisites: Must have taken concepts on:

1. Family Nurse Contact
2. Public Health Nursing
3. Family Nursing Process
4. National Health Programs

Equipment Needed:

1. CHN Bag (to include BP apparatus)

2. CHN Forms (Home Visit Record, Health Teaching Plan, ARAS, Community Health Profile
Worksheet)
3. Complete RLE Paraphernalia
4. CHN Notebook

Brief Description of the Community:

Barangay Granada is a constituent barangay of Bacolod City which is located in the easternmost part of
the City. A 9-kilometer bus ride from USLS, Barangay Villamonte to the community site which is Zone
2, Hacienda Carmen, a privately owned property which has a population of more than 100 households.
A close-knit community with most members is related to each other by blood or by affinity. Most
concerns in the community are attended by the person in charge assigned by the landowners or more
popularly known as ‘Encargado”. The community is not congested as the houses have their own
backyard wherein, they plant fruit bearing trees. A small chapel is situated in the center of the
community, along with a basketball court and a baseball field to serve the recreational needs of the
community. A day care center is available for toddlers’ group and 2 local high schools, Emiliano Lizares
National High School and Generoso Villanueva Sr. National High School and 2 local elementary schools,
Asuncion L. Lizares Elementary School and Father Gratian Murray, AFSC Integrated School served the
primary and secondary educational needs of the nearby communities including Hacienda Carmen. Most
common type of transportation utilized by the community members are the local jeepney, tricycles and
private motorcycles.

Communication is made possible through the use of mobile phones, television (TV) and most common
among thee household is the use of radio. People don’t normally buy newspaper for news as they view
this as an additional expense but looks into the news through social media and local news delivered
through TV and radio. Internet connections are available to some households who can afford them. The
terrain going into the community is a mixture of rough road and scattered cemented pavement. A steel
bridge would have to be crossed before you can reach Zone 2. According to some residents, the stream
under the bridge would overflow in times of heavy rain.
The community is located along several sugarcane fields wherein most of the people in the community
works as laborers for the fields or commonly known as “Sacada”. They start very early in the morning
and goes home around lunch time and return immediately to the fields to attend to the plantation.

Case Scenario:

Student nurse, Mary Ann Noble was one of those who were assigned in Zone 2 Hacienda
Carmen, Barangay Granada. She was assigned to the family of Marissa Torres, a 33-year-old married
mother of 3 children namely Edison, 15 years old and a Grade 9 student, Alyssa 13 years old and a Grade
7 student and who is diagnosed with bronchial asthma, and Eric 8 years old and a Grade 2 student. She
has been a resident in the community since for 33 years as her parents are also laborers in the sugarcane
fields. She finished second year high school. They were able to put up their home but the land belongs to
their employer and they are allowed to live in the community for free. They are Roman Catholic and they
go to church every Sunday. The family has a good relationship with each other.

Marissa has also been working as a laborer in the sugarcane field and sometimes accept laundry
services at the barangay proper to augment the family’s income. Marissa’s husband, Elmer 36 years old
is an elementary graduate, is also a laborer in the hacienda. According to the Marissa, their monthly
earning is around P4,000 – 5,000. He is the breadwinner and he make the decision when it comes to their
expenses. He is out of the house most of the time due to the nature of his work. Marissa is quite worried
since her husband drinks alcoholic beverages every night with his fellow farmworkers. They have a good
relationship with their neighbors. The biggest percentage of their expenses goes to food which is about
P3,000 per month. Other expenses include utilities like electricity, water and other important things that
may arise. They cook their food using a clay pot (kalan) and wood. Meals usually include the following:
rice and viand (fish, meat or vegetables) and vegetable soup. They are able to eat three times a day but
most of the time there are no snacks in between meals. Marissa added that her 3 rd child Eric is a picky
eater and prefers to eat junk foods and noodles. Upon assessment by the student nurse he has a large
abdomen which is not proportion to his body. He goes around the community on his barefoot. Their
source of drinking water comes from the purified water which they purchase in the community and uses
the deep well for bathing and other household chores. The family share their drinking glasses. They
store water and food in covered containers. The client claims that there are flies, mosquitoes,
cockroaches, rats and ants in their house. They have a closed pit privy for their toilet. They use a plastic
bag for their garbage and throw it in a communal pit. They have a small canal at the back of their house
where the water from their kitchen flows. They have a dog which stays inside the house most of the time.
They also raise some chicken which they have for personal consumption. The sleep 6 to 7 hours a day.

Student Nurse Mary Ann observed that even if the house is small with only one room, the mother
has been able to maintain the cleanliness of the house. The house is made up predominantly light
materials and some nails and wires are not properly secured. The floor is made up of soil. The room
serves as their living room, dining room, kitchen and bedroom. They have a bed where they all sleep.
They use mosquito net to protect them from insect bites. They have a plastic table and chairs which they
use when they eat. They go to sleep at around 9 in the evening and the parents wakes up at around five am
to start their day. The older children are well kept and she reported that they experience occasional
medical conditions such as cough, fever, stomach ache and diarrhea, which she manages on her own since
going to the doctor is quite costly. She added that it is very seldom that she avails of the health services
in the Barangay Health Station since no doctor is around most of the time although she avails of the free
immunization (EPI) for her children which is up to date. For minor ailments, they seek the services of a
traditional healer, “manug-luy-a” as they believe that symptoms such as muscle pain or “kibit” can be
relieved. She delivered her children in Lying-In Center of Bacolod City. She gives her children over the
counter medications to relieve the symptoms as what she can see in the television or hear in the radio of
her neighbors. If there is a major ailment they go to the Barangay Health Center for check-up or to get a
referral slip for them to bring to the San Miguel Brewery Clinic where consultation and medications (if
available) are free.

Marissa described her community as generally peaceful as it is very seldom that conflicts occur in
their area. When things can’t be managed among themselves or neighbors, they would usually seek the
help of the “Encargado” or in some instances the Barangay Captain. They have a good relationship with
their neighbor.

SUGGESTED VIDEO FOR THE EXPOSURE:

Day 1
 Scene depicting a pre-conference in a classroom prior to the exposure.
 Scene depicting, CI and student doing a courtesy call in the Barangay. Hall (Barangay Captain,
Health Center etc.)
 Scene showing the student and CI walking towards the house of the client.
 Scene showing the CI talking to the client, asking permission if she consents to the visit.
 Scene showing the student, establishing a nurse-patient interaction, assessing the client and
family members present, observing the client’s environment (Initial Assessment)
 Scene showing the student asking permission and contract setting for the next visit.

Day 2
 Scene showing the student nurse returning for the next visit.
 Scene depicting the student performing bag technique.
 Scene showing the student conducting health teaching with visual aids.

Additional Videos that can created by the Faculty:

Demonstration videos on:

1. Bag Technique
2. Ameloi Making
3. Oresol Making
4. Alay Linis, Herbal Planting, etc.