COMMUNITY HEALTH NURSING ROLES 10
Community Health Nursing Roles
Kristina Swann
Ferris State University
Abstract
Community health nurses work with individuals and communities to provide care and promote health. They work in conjunction with case management and community partners to provide home follow up care, immunizations for homebound patients, health education and referral of clients to appropriate resources for assistance. Services offered by a community health nurse include but are not limited to preventative health screening, community education to schools churches and health fairs, follow up care for missed appointments, illness education, nursing or home assessment, and assist with forming a plan of care for individuals and communities to promote health and prevent disease.
Community Health Nursing Roles
Now that more emphasis is being placed on health promotion and illness prevention, more and more nurses are finding themselves working in the community with individuals rather than in the acute care setting of the hospital.Community health nurses have various roles all important to the welfare of the individual’s they care for. Community health nurses work with individual clients, their families, groups, aggregates, and the community to promote health and prevent injury.
Community Based Care of Individual Clients
Some community health nurses work as a direct care provider to individuals in their home.They work with clients checking their vital signs, changing dressings, or inserting catheters.This is an important role of a community health nurse.The care they provide to these individuals may determine whether or not the individual recovers from their illness or whether the individual needs to be hospitalized again (Maurer & Smith, 1995). Individuals are able to recover at home in their own environment due to the care the community health nurse is able to provide.A community health nurse also acts as a counselor, not only to the client but also to their families.They are able to help with questions and concerns that may arise, able to provide treatment options available and also able to provide support and reassurance throughout the recovery of an individual (American Nurses Association (ANA), 2007). A community health nurse working who provides the client and their family with accurate and resourceful information may prevent unnecessary phone calls to the client’s primary care physician, and also may prevent unnecessary visits to the emergency room.A community health nurse also works as an advocate.As an advocate, they work with individuals who are children, disabled, or elderly and not able to access the appropriate resources for the care they need.Community health nurses work with clients to ensure they are receiving the care and services that are needed (Maurer & Smith, 2009). The role of a community health nurse as an advocate for their clients is vital.A community health nurse may notice when caring for their elderly client that no family is available to help care for the client and that the client is no longer able to perform activities of daily living.The community health nurse would then pull together resources as an advocate for this client to ensure his needs are being met.
Community Based Care of Communities and Aggregates
The nurse working with the community and with aggregates works to maintain a healthy and safe environment. They work in the community such as at a school to help control communicable diseases, promote sanitation, and work at early detection of physical problems such as vision or hearing problems. The community nurse may also work with churches to enhance the quality of life for all members of a congregation (Maurer & Smith, 2009). The community health nurse would organize and facilitate support groups, provide referrals to community resources, and provide health education and counseling. Community health nurses may also work with the correctional facilities to provide health screening, teaching and counseling, and assisting individuals in assuming responsibility of their own health. The focus of care in the correctional facilities for a community health nurse is health education, suicide prevention, communicable disease control, and alcohol and drug rehabilitation (ANA, 2007). Health care at all levels is becoming increasingly community based, and as a result nurses must be prepared to provide care in very diverse settings. Community health nurses working in the community or with aggregates as clients may work as a direct care provider, providing health screenings and physical assessments. They may also work as a collaborator, working with families and others pulling together resources to promote the health of a community. A community health nurse also works as a leader taking responsibility for the population they are serving and trying to promote their health and well being. Another role of a community health nurse is as a researcher. This is an important role of a community health nurse. This is how the needs of a community are identified and plans implemented to help promote health.
Roles and Responsibilities
The roles and responsibilities of a community health nurse working with individual clients or a community are similar in some ways. Whether working with individual clients or a community as a whole, the goal is to maintain a healthy environment. Teaching about health promotion and injury prevention is done individually and also can be done in a community setting such as a health fair. Needs are identified in both groups and proper referral is made to promote the health and well being of the individual or community. Community health nurses work as advocates for the individual client and also for the community seeing where there are needs to improve standards of living or advocating for health care services (Maurer & Smith, 2009). Community health nurses collaborate with others to ensure that quality nursing care is being provided. The roles and responsibilities of a community health nurse working with individual clients or a community also differ in some ways. A community health nurse may work with an individual client in their home with one on one type care, or a community health nurse may work with a community as a whole such as helping a community recover from a natural disaster (Maurer & Smith, 2009). An individual client may have unmet needs indentified by the community health nurse such as transportation issues to and from doctors appointments. The nurse can then refer the client to a program or provide the individual with resources for transportation. In a community setting, a nurse may work together with the health clinics to provide care for certain underserved population. A community health nurse working with an individual client in their home has the responsibility to ensure a safe home environment is being maintained whereas a nurse working with the community has the responsibility to observe and report environmental and health hazards (ANA, 2007).
Educational Preparation
Community based nursing care of an individual client or in a community is typically provided with a baccalaureate degree in nursing. These nurses are expected to be able to apply the nursing process with individuals, families, and groups to promote health and wellness. A community nurse generalist is a nurse who has a baccalaureate degree in nursing and can provide community based nursing care with individuals, families, groups, and in the community. All community health nurses have the opportunity to become a specialist by taking specific classes to expand their knowledge in a specialized area of nursing such as community health (Maurer & Smith, 2009). These nurses usually have a master’s degree and are proficient in assessing, planning, implementing, and evaluating population focused health programs. A nurse specialist may work at developing and evaluating policies, health programs, research, and theory (Maurer & Smith, 2009). Nurses with a master’s degree or a specialization in community/public health are eligible to take an advanced exam and become certified as an advanced public health nurse board certified. Certification expires every 5 years and the nurse needs to practice at least 1000 hours during these 5 years in order to become recertified (Maurer & Smith, 2009). Community nurses are expected to follow certain standards of professional performance in order to maintain quality effective nursing care. A community health nurse generalist may participate in research activities such as identifying questions for investigation or participating in data collection. A community nurse specialist works with nurse generalists in interpreting and applying the research findings in their nursing practice. A community nurse working with an individual client may research family care giving or cost effective health interventions whereas a community nurse working with a community may research what works with different populations and what needs are not being met in the various communities. A community based nurse working with individual clients or with a community may have a bachelor’s degree, a master’s degree, or be an advance public health nurse. However, the focus is different for community nurses working with individuals versus working with a community as a whole. A community nurse working with individual clients may do in house home care with a bachelor’s in nursing, manage a home care facility with a master’s in nursing, or work as a researcher finding ways to better provide and promote health in the home care setting with an advanced practice degree in community/public health nursing. On the other hand a community nurse working with communities may work at a free clinic providing blood pressure screenings with a bachelor’s degree in nursing, work as a manager of a health department with a master’s degree in nursing trying to provide the community with general health and well being, or working on research of a community as a whole with an advanced practice degree in community and public health finding ways to better serve the community (ANA, 2007).
Focus of Care
A community health nurse working with individual clients has a family focus. The nurse must think of each family member in the home and how they contribute to each other’s general health and well being. The focus of care for individuals in community based nursing is to promote support systems that are adequate and effective, to encourage normal growth and development of family members, to educate the family about health promotion and injury prevention, and to overall promote a healthy environment (Maurer & Smith, 2009). On the other hand, a community nurse working with a community has a broader focus. They look at the entire community as a whole and are focused on maximizing the well being of members, promoting survival, and meeting the needs of the community members (Maurer & Smith, 2009). Whether a community health nurse is working with individual clients or with a community their main focus is to promote health. A community health nurse working with individuals or communities provided different levels of care depending on the client, family, group, or community. Working with individuals, a community health nurse may have to provide a routine in home follow up visit with a postpartum mom and her baby. They may also have to provide a higher level of care such as caring for a child at home on a ventilator. This is the same working in a community. A nurse may provide blood pressure screenings at a health fair or may have to provide a higher level of care such as working with the AIDS/HIV population and preventing the spread of their disease. The level of care whether it is in a community or with individuals varies from person to person and community to community. A similarity between providing care for individuals or a community and the level of care they needs is that preventative care can be done in either setting. Also, caring for individuals or communities can be done after illness or disease is already prevalent.
Typical Settings and Sources of Funding
The typical setting for nurses working with individual clients is in their home environment. This home environment may vary depending on the person. It may be a house, a group home, or a place where the elderly live. The setting for a nurse working in a community varies. They typically work with vulnerable populations such as the poor, uninsured, homeless, or in the prisons. They may work in schools, churches, or a common place such as a park. According to the United States Department of Health and Human Services (2000), the financial cost of caring for an individual in a hospital or institution is greater than the cost of providing support services in the home or community. As a result the government and insurance payers are expanding their coverage of community support services. Individual client community based care can be financed by a variety of ways such as self pay, health insurance, Medicare, and Medicaid. Nursing care of communities may be funded by donations, fundraisers, volunteer services, or by the government. Both individual and community based care costs a great amount of money. Home health care and community based care is generally supported through the government in some way.
Community health nurse are vital to the well being of our communities. More and more care is being done outside of the hospital setting. There are so many job opportunities for a community health nurse depending on whether they want to work one on one with clients or whether they want to work with groups or in a community. A community health nurse not only serves as a health care provider, but also as an advocate, leader, role model and collaborator.
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