Roles and Functions of the Community and Public Health Nurse

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Roles and Functions of the Community and Public
Health Nurse
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Upon mastery of this chapter, you should be able
to

• ? Identify the three core public health functions
  basic to communityhealth nursing.
• ? Describe and differentiate among seven
  different roles of the community health nurse.
• ? Discuss the seven roles within the framework of
  public health nursing functions.
• ? Explain the importance of each role for
  influencing peoples health.
• ? Identify and discuss factors that affect a
  nurses selection and practice of each role.
• ? Describe seven settings in which community
  health nurses practice.
• ? Discuss the nature of community health nursing,
  and the common threads basic to its practice,
  woven throughout all roles and settings.
• ? Identify principles of sound nursing practice
  in the community.

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Three primary functions of public health

• The various roles and settings for practice hinge
  on three primary functions of public health
• assessment,
• policy development,
• and assurance.
• They are foundational to all roles assumed by the
  community health nurse and are applied at three
  levels of service
• to individuals,
• to families,
• and to communities

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Assessment

• An essential first function in public health
• the community health nurse must gather and
  analyze information that will affect the health
  of the people to be serve
• health needs,
• health risks,
• environmental conditions,
• political agendas,
• and financial and other resources

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Policy Development

• is enhanced by the synthesis and analysis of
  information obtained during assessment.
• At the community level, the nurse provides
  leadership in convening and facilitating
  community groups to evaluate health concerns and
  develop a plan to address the concerns.
• Typically, the nurse recommends specific training
  and programs to meet identified health needs of
  target populations.

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Assurance

• Assurance activitiesactivities that make certain
  that services are providedoften consume most of
  the community health nurses time.
• Community health nurses perform the assurance
  function at the community level when they
• provide service to target populations,
• improve quality assurance activities,
• and maintain safe levels of communicable disease
  surveillance and outbreak control.

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Standards for Community Nursing

• Individuals should receive nursing services based
  on standards developed by the American Nurses
  Association (ANA), such as
• the Code for Nurses With Interpretive Statements
  (1985),
• Nursings Social Policy Statement (1995),
• Standards of Clinical Nursing Practice (2nd
  edition) (1998a),
• The Scope and Standards of Public Health Nursing
  Practice (1999).

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Clinician Role

• The most familiar role of the community health
  nurse is that of clinician or care provider
• means that the nurse ensures that health services
  are provided not just to individuals and
  families, but also to groups and populations.
• Three clinician emphases, in particular, are
  useful to consider here
• holism,
• health promotion,
• and skill expansion.

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Holistic Practice

• In community health a holistic approach means
  considering the broad range of interacting needs
  that affect the collective health of the client
  as a larger system
• Holistic nursing care encompasses the
  comprehensive and total care of the client in all
  areas, such as physical, emotional, social,
  spiritual, and economic.

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Health promotion

• The clinician role in community health also is
  characterized by its focus on promoting wellness.
• Examples include immunization of preschoolers,
  family planning programs, cholesterol screening,
  and prevention of behavioral problems in
  adolescents.
• Protecting and promoting the health of vulnerable
  populations is an important component of the
  clinician role

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Expanded Skills

• With time, skills in observation, listening,
  communication, and counseling became integral to
  the clinician role as it grew to encompass an
  increased emphasis on psychological and
  sociocultural factors.
• Recently, environmental and community-wide
  considerations, such as problems caused by
• pollution,
• Violence and crime,
• drug abuse,
• unemployment, poverty, homelessness,
• and limited funding for health programs
• have created a need for stronger skills in
  assessing the needs of groups and populations and
  intervening at the community level.

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Role of the Public Health Nurse

• To Provide input to interdisciplinary programs
  that monitor, anticipate and respond to health
  problems in population groups for all diseases or
  public health threats including bioterrorism
• To Evaluate health trends and risk factors of
  population groups to help determine priorities
  forming targeted interventions

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Role of the Public Health Nurse

• To
• Work with the community or specific population
  groups to develop targeted health promotion and
  disease prevention activities
• To Evaluate health care services
• To Provide health education, care, management
  and primary care to individuals and families who
  are members of vulnerable populations and high
  risk groups

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Public health nurses integrate community
involvement and knowledge of the entire
population with the personal clinical
understandings of health and illness gleaned from
the experiences of individuals and families
within the population.
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The nurse working in public health should
be a voice for members of the community to voice
problems and desires
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The public health nurse can apply her knowledge
of strategies to choose the intervention(s) that
meets the needs of a particular community, family
or individual
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The nurse is the agent who translates and applies
the knowledge of health and social sciences to
individuals and population groups through
specific interventions, programs and advocacy
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He or she also articulates and translates health
and illness experiences of diverse, often
vulnerable, individuals and families to the
health planners and policy makers
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Standards of practice have been established by
the American Nurses Association
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The Quad Council, made up of four public health
nursing organizations, has established core
competencies
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These competencies reflect an agreement by the
Quad Council that the public health nurse
requires preparation at the baccalaureate level.
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However, in many states nurses doing public
health work are not baccalaureate graduates.
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Even early on, the shortage of nurses affected
the hiring of BSN or MSN prepared nurses. Public
health departments could not compete with
hospital systems.
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The specialist level competencies require
preparation at the Masters level in community
and /or public health nursing.
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