Community and Public Health
NSG/450 Epidemiology and Global Health
April 12, 2017
Community and Public Health
Community and public health nursing focus on health promotion among individuals, families, and within the community (Nies and McEwen, 2015). Monitoring trends of diseases in society and maintaining interventions are not the only tasks of public health nurses. Instead, nurses focus on identifying populations that are at risk and finding aid in resources that assist in reaching solutions (Nies and McEwen, 2015).
The practical issue is that patients return to their livelihood with the same unhealthy lifestyle and choices they made after being treated at the hospital. Often, they have no resources in health maintenance due to education, income, and occupation (Nies and McEwen, 2015). Nursing is involved in considering all aspects the patient is currently having difficulties, and assist in finding resources as well as alternative solutions for health maintenance. For instance, a 70-year-old patient is unable to drive himself to go to the hospital for a follow-up appointment after a stroke. The home health nurse may assist him at home for health promotion of proper nutrition, encouraging exercise, and assessing patient’s health (Nies and McEwen, 2015). The community/public health nurse may consult with social service with financial issues. The social service provides the patient information that he can qualify for Medicare as long as he is guided which paperwork he needs to provide (While, 2014). But not all health cases are the same. The United States have an increased rate of patients who have hypertension, diabetes, and obesity (While, 2014). Nurses face current issues ethically when patients choose not to change their lifestyle after being diagnosed. Nurses also face a dilemma on finding ways for the patient to understand health maintenance based on trust between nurse and patient.
Health promotion has different levels of prevention. Level 1 is primary prevention activities. The activities are general health promotion and specific protection by preventing problems before it occurs. Influenza vaccinations and water purifications are specific protection by reducing and eliminating risk factors (Nies and McEwen, 2015). Level 2 is secondary prevention activities. The prevention is implemented after a problem has begun but before signs and symptoms appear and target populations that have risk factors (Nies and McEwen, 2015). Patients who have multiple sex partners needs HIV testing with possible sexual transmitted diseases (Nies and McEwen, 2015). Lastly, level 3 is tertiary prevention activities. The level reduces effects of disease and injury while restoring the optimal level of functioning. Examples are teaching insulin administration at home or explaining skin care for incontinent patients (Nies and McEwen, 2015).
The main issue community/public health nurses face cooperation. Cooperation is based on trust. Many patients have difficulty in cooperating due to issues in their daily life. Perhaps patients do not have a safe environment where he or she can rely on someone in providing education, income, or a safe shelter (Scott, 2013). Nurses must find a common denominator with the patient to connect and provide health promotion and maintenance. The rising rate of diseases are alarming, and help is needed now more than ever. The role and responsibilities of the community/public health nurses intertwine with social justice. Society’s responsibility is to meet basic needs of the people (Nies and McEwen, 2015). This includes living arrangements, work/school environment, and other factors that affect health and well-being (Nies and McEwen, 2015). The nurse’s role is to be a positive influence on health that can be seen in the individuals as well as the community’s lifestyle changes (Nies and McEwen, 2015).
Ethically, the nurse cannot tell the patient was it right or wrong. The nurse can only encourage on lifestyle changes such as walking every day for at least 30 minutes. When an Asian male has Diabetes Mellitus Type 2 due to his lifestyle changes, how likely will he change his diet? Asian Americans are noted in eating heavily in starch such as noodles and rice (Scott, 2013). An alternative may be difficult especially if the male patient is the head of the household who has pride in making decisions for his household. Obstacles of lifestyle changes due to cultural beliefs and traditional foods are challenging for the community/public health nurses to overcome.
In conclusion, public health nurses must identify social, political, environmental, and economic factors that lead to poor health options for both individuals and populations (Nies and McEwen, 2015). A nurses competency skills are based on analytic assessment, policy development/program planning skills, communication skills, cultural competency skills, community dimensions of practice skills, public health sciences skills, financial planning and management skills, and leadership and system thinking skills (Nies and McEwen, 2015). As a community, we hold ourselves together to support each other in our endeavors. This can also be seen by the community/health public nurses. The nurses are seen in supporting the community with providing knowledge and resources in maintaining the health of the community as a whole while supporting individuals that needs help (Nies and McEwen, 2015). The nursing process does not care only for individuals but the individual’s families and groups where they live, work or go to school or as they move through the health care system (Nies and McEwen, 2015).
Nies, M., & McEwen, M. (2015). Community/Public Health Nursing (6th ed.). St. Louis, MO: Elsevier Inc..
Scott, G. (2013). Nurses' public health role is underestimated. Nursing Standard (through 2013), 27(42), 1. Retrieved from https://search.proquest.com/docview/1399690601?accountid
While, A. E. (2014). Guest Editorial. Are nurses fit for their public health role?. International Journal Of Nursing Studies, 51(9), 1191-1194. doi:10.1016/j.ijnurstu.2014.01.008
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