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INTRODUCTION TO COMMUNITY HEALTH NURSING (CHN)

NANCY NADEAU RN, BSN, MSN NURSING FACULTY FALL 2011

CHAP 1: PRESENT, PAST AND FUTURE Healthcare changes in the 21st century Characteristics of community and public health nursing Public health nursing roots Challenges for practice in the 21st century

OPPORTUNITIES
Callen et al. Essentials of Baccalaureate Nursing Education for Entry-Level Community Public Health Nursing Public Health Nursing Vol.27 No.4 pp. 371-382.
Historical foundations Core professional Values
Community/population as client Prevention Partnership Healthy environment Diversity

OPPORTUNITIES
Core knowledge and basic competencies
Communication Epidemiology and biostatistics Community/population assessment Community/population planning Policy development Assurance Health promotion and risk reduction

OPPORTUNITIES
Illness and disease management Information and health care technology Environmental Health Global Health Human Diversity Ethics and Social Justice Coordinator and manager Emergency preparedness, response, recovery

OPPORTUNITIES
Education Issues
Integration C/PHN essentials in the course Teachers: sufficient educational and experiential preparation Teaching/learning methods and technologies Learning experiences appropriate for understanding Education-service collaboration and mentoring Interdisciplinary learning and collaboration

OLDEST SPECIALTY NURSING PRACTICES


Entering this field will encounter the complex challenge of working with populations rather than just individual client Carry on the heritage of early public health nursing efforts with the benefit of modern sensibilities Focus from the individual and family to encompass communities and the opportunity to affect the health status of populations
www.youtube.com http://www.youtube.com/watch?v=oIj9CFGETcw

YOU ARE BEING ASKED TO LEAVE THE FAMILIARITY


Use the non tangible skills of listening, assessing, planning, teaching, coordinating, evaluating, and referring Draw on the skills you have learned. Need to combine creativity, ingenuity, intuition, and resourcefulness Work holistically with clients of all ages, at all stages of illness and wellness Use of your critical-thinking skills
A study of Community health competency among public health nurses Journal of Nursing Research Vol.16, No 4. 2008 pp. 286-296.

CHANGES IN THE 21ST CENTURY


Great public health achievements in USA? New concepts:
Social determinants of health Health disparities

Is the following statement True or False? Health care disparities are social conditions in which people live and work.
Role of government Pt/client-centered care Technology Personal responsibility for health

PERSONAL RESPONSIBILITY
The patient should be made to understand that he or she must take charge of his won life. Dont take your body to the doctor as if he were a repair shop.
Regestein, psychiatrist, Harvard University p.7

HEALTH AND HUMAN SERVICES WWW.HEALTHYPEOPLE.GOV/2020

HEALTHY PEOPLE 2010 US DEPARTMENT OF

There are used in measuring the health of the US population


Increase the quality and years of healthy life Eliminate health disparities

28 focus area 467 objectives stated in measurable terms that specify targeted incidence and prevalence changes and address age, gender, and culturally vulnerable groups along with improvement in public health systems Can you name some?

HEALTHY PEOPLE GOALS


2010 It provides a framework for prioritizing and addressing specific health needs in designated communities 2020 To provide a framework to address risk factors and determinants of health and the diseases and disorders that affects our communities

2020
1. Eliminate preventable disease, disability, injury, and premature death 2. Achieve health equity, eliminate disparities, and improve the health of all groups 3. Create social and physical environments that promote good health for all 4. Promote healthy development and healthy behaviors across every state of life

IS THERE A DIFFERENCE?
Community-based nursingminor acute and chronic care that is comprehensive and coordinated where people work, live or attend school; illness care provided outside the acute care setting Community health nursinguse of systematic processes to deliver care to individuals, families and community groups with a focus on promoting, preserving, protecting, and maintaining health

DO COLLECTIVELY TO ASSURE THE CONDITIONS IN WHICH PEOPLE CAN BE HEALTHY

Public health nursingpopulation-based practice, defined as a synthesis of nursing and public health within the context of preventing disease and disability and promoting and protecting the health of the entire community

8 DOMAINS OF PUBLIC HEALTH NURSING PRACTICE


Analytic assessment skills Policy development and program planning skills Communication skills Cultural competency skills Community dimensions of practice skills Basic public health science skills Financial planning and management skills Leadership and systems thinking skills
From: ANA 2007. Public health Nursing: Scope and Standards of Practice.

COMMUNITY AND PUBLIC HEALTH NURSING TODAY


Scope and Standards of Practice Educationentry into community and public health nursing practice as a generalist requires a baccalaureate degree CompetenciesQuad Council of Public Health Nursing Organizations has set competencies for both generalist and advanced practice nurses in public health Certification for specialty practice

ROLES & RESPONSIBILITIES


Direct Services
Caregiver, Case manager, advocate, educator, counselor, collaborator, information broker

Population-Based Services
Coalition builder, change agent, policy advocate/political activist, case finder, researcher

CAN I REALLY DO SOMETHING TO MAKE A DIFFERENCE IN THE LIVES OF MY CLIENTS?


Feel shocked and discouraged by the crushing poverty and overwhelming sense of helplessness many of your clients experience By the continual recurrence of substance abuse, domestic violence, job failure, and criminal activity