TUTORIAL ACTIVITY- WEEK 4 – 10 /06/21

TUTORIAL OBJECTIVES:

At the end of the session, students should be able to:

 Discuss the roles of a community health nurse

 Discuss the approaches of Community Health Nursing

 Describe the 3 levels of care

Students Tutorial Activity

1. Differentiate between community health nursing, public health nursing and home

based care nursing

- Community health nursing - is a synthesis of nursing and public health practice

used to promote and protect population health. It integrates all of the

fundamental components of professional, clinical nursing with public health and

community practice. It includes nursing programs' skills for health promotion,

improving conditions in the social and physical environment, preventing illness

and disability, and rehabilitation.

- Public health nursing - is the branch of nursing concerned with providing nursing

care and health guidance to individuals, families, and other population groups in

settings such as the home, school, workplace, and other community settings

such as medical and health centers.

of all ages with varying needs. Having home health care performed is a cost-

effective means of giving care while the patient is in the comfort of their own

home.

2. Describe the roles and functions of a community health nurse.

- Care giver - The clinician position of the community health nurse include

providing health care services not only to individuals and families, but also to

community groups and populations. The clinician role for community health

nurses has a distinct emphasis than basic nursing, namely - holism, health

promotion, and skill extension.

- Educator role - Nurses are educators because they give individuals with

knowledge on a certain disease or sickness, and the focus is on illness

prevention and promotion throughout the health education process, which

enables learning in order to change one's health behavior for the better.

- Manager - The CHN is responsible for coordinating client care, overseeing

auxiliary employees, managing caseloads, and running clinics as a case

manager. As well as evaluating and carrying out community health projects.

- Leadership role - the CHN focuses on effecting change, the nurse becomes a

change agent. As leaders, CHN strives to effect positive change in people's

health. Empowering and inspiring people, guiding activities, managing

disagreements, coordinating plans-bringing people and activities together so

they function in harmony while pursuing their goals are the leading functions of a

leadership job.
3. Identify the different health settings for practice for a community health nurse.

(Identify and state the activity/programs that can be done in these settings)

- Home - The home is a setting for health promotion – many CHN’s visits focus on

assisting families to understand and practice healthier living behaviors e.g.

educating parents/individual on topics like parenting, child care, proper diet,

exercise, and coping with stress. Nurses see clients with their own individual

problems in their own homes, so a better understanding on their limitation,

capitalize on their resources and tailor health services to meet their health needs. In

the home, clients are in their own ‘turf’- they feel comfortable and secure in familiar

surroundings and are better able to understand and apply health information.

- Ambulatory service settings - Include a range of locations for CHN practice, such as

community health centers, where clients can come for day or evening services that

do not require an overnight stay. Another form of ambulatory care setting is areas

where services are provided to specific populations, such as a day care center in a

correctional facility, faith communities, or distant mining villages.

- Schools - Schools at all levels make up a large collection of places where CHN can

be practiced. CHN primarily serves primary, middle school students and special

schools, such as those for developmentally handicapped children. CHNs are

teaching, interprofessional collaboration, and advocacy.

- Occupational health settings - Another group of environments for CHN practice is

business and industry. Companies are moving beyond typical health benefits to

assist health promotion activities because they recognize the importance of healthy

employees. CHNs primarily serve as clinicians, caring for sick and injured

personnel and major change to health educator position, emphasizing the

importance of proper job assignment and treatment for work-related illness or injury.

4 Describe the three levels of care

- Primary prevention - Preventative actions are taken in order to avoid disease or harm.

It is employed in a normally healthy population and happens prior to disease or

dysfunction. Offering children vaccines, for example, and urging the elderly to install and

use fall-prevention devices such as grab bars for bathtubs and hand rails for steps and

walkways.

- Secondary prevention - When diseases or impairments are already present, every

effort is made to discover and treat them as soon as possible. Community-based

hypertension and cholesterol screening aids in the identification of high-risk patients and

promotes early treatment to prevent heart attacks and strokes.

- Tertiary prevention - Attempts to decrease the degree and severity of a health problem

in order to limit disability, restore, and retain function, for example, treatment and

rehabilitation of a client following a stroke to lessen impairment and after mastectomy

exercise program to recover functioning.

- Persuasive approach – implies convincing people through dialogue and

educates them to change or modify their health behavior. CHN make use of this

approach in all types of nursing interventions related to health promotion and

specific protection, early recognition, diagnosis and treatment and disability

limitation and rehabilitation. It is through education that self-care competencies

of individual, family and community can be developed which is essential to

achieve the goal of health for all.

- Enforcement – implies the use of more coercive measures such as use of

legislation e.g. prohibition of drug abuse, child abuse, immunization as a

condition of school admission, etc. Use of authority for example, giving strict

instructions or orders to do certain things especially when it is a question of life

and death during emergency situations such as child labor, acute

bronchopneumonia, etc. Community health nurses make use of such

measures in life threatening emergency situation.

- Team approach – community health is a problem solving process and team

approach is very necessary to deal with varies and complex health needs and

problems at large. Community health nurses along with auxiliary nurses and

female health supervisors help to meet nursing needs of the community as a

whole. Other members of the team who are usually included are the

physicians, clinical specialists, public health engineers, social workers, health

educationalists and many more. CHN working in the community health settings
 needs to identify the health teams and their roles, functions and team

dynamics so as to participate effectively in providing compressive health care

services to people in the community and accomplish community health goals

and aims.

- Community involvement – community involvement and participation is

recognized as one of the crucial supportive approach for successful

implementation of community health care services. Therefore, community

health nurses working with individuals, families, groups within the community

as a whole for community health nursing services need to mobilize,

encourage, organize and prepare them to take greater interest and

responsibilities to develop self-reliance for their own health matters.

- Intersectorial approach – health of people at large cannot be attained by health

sector alone because there are many factors which affect people’s health but

they are not under the purview of the health sector e.g. food production and

distribution, water, sanitation, housing, environmental protection and

education, etc. Each one is dealt by separate sector and socio-economic

development and health. It is felt necessary to have proper coordination

between the health and all other sectors concerned at all levels.