Concepts Basic to Community Health Nursing
The concepts addressed in Section 1, Units 1, 2, 3, and 4 may represent new material for some learners while being a review for others. Whether new learning or review, it is important to develop or increase one’s understanding of the concepts that form the foundations of community health nursing in order to apply the concepts to community health nursing practice. A quiz, comprising 20% of the overall course composite grade, occurs upon completion of Section 1.
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Learning Outcomes | Focusing | Practicing | Activity 1 | Activity 2 | Activity 3 | Activity 4 | Reflecting | References
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Unit 1: Community Health Nursing
“Key to all community practice is the principle of “doing with” not “to” or “for” the people served”
(Vollman, Anderson, & McFarlane, 2012, p. 3).
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Learning Outcomes
By completing this unit, you will be able to
• discuss the historical underpinnings of community health nursing.
• describe the various roles of the community health nurse in relation to the focus of client.
• identify current health care issues and trends of particular importance to community health nurses.
• discuss the role of professional associations in relation to community health nursing.
• identify the ethical issues particular to community health nursing.
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Focusing
Where do community health nurses work? What are the values and beliefs of community health nurses? What do community health nurses do?
Take a few moments to write your answers to these questions in your course notes. There are no incorrect responses; just list your ideas.
You may wish to consult the website at www.chnac.ca to determine how similar or different your ideas are to those outlined by the Community Health Nurses Association of Canada (2003).
The Community Health Nursing Standards of Practice (2003) are also found as an Appendix in the Stamler and Yiu (2012) text. You will be directed to consult these standards of practice often as you work through this course.
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Practicing
Activity 1: Who is the Community Health Nurse?
List the major differences between the CARNA Standards of Practice (2013) located at Practice Standards for Regulated Members with CNA Code of Ethics for Registered Nurses
http://www.nurses.ab.ca/content/dam/carna/pdfs/DocumentList/Standards/PracticeStandards_CNA_Ethics_2008.pdf
and the Canadian Community Health Nursing Standards of Practice (2011) located at http://www.chnc.ca/documents/CHNC-ProfessionalPracticeModel-EN/index.html
Discuss one example of how nursing practice might differ depending on which standards are being utilized to guide nursing practice. If you like, record your thoughts in your course notes, or post your ideas to the Unit 1 Conference. Feel free to read the postings of other learners and engage in discussion with your peers who have posted their ideas to the Conference.
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Activity 2: Who is the client or recipient of care and what are the common settings of community health nursing practice?
Flash is required for this activity. Flash Player can be downloaded for free from www.adobe.com.
Try the flash cards exercise by clicking here.
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Activity 3: How is community health nursing affected by societal and health care trends?
Beyond consulting the course texts, you might find the following websites of interest:
http://www.von.ca/en/about/history.aspx Victorian Order of Nurses for Canada.
www.capnm.ca/core_competencies¬_standards_print.doc The Canadian Association for Parish Nursing Ministry
http://www.who.int/healthpromotion/en/ World Health Organization.
Test your knowledge of community health nursing history by completing the following statements. To see the answer, drag your mouse (hold the left button down as you move the mouse) over the blank space in the sentence between the arrows.
1) The best known, early community health nurses, called district or visiting nurses were the -> Victorian Order of Nurses (VON)<-, founded in 1897.
2) In 1948 the federal government, through a National Grant Program, matched provincial spending for designated health programs dollar for dollar. By 1957 the -> Hospital Insurance and Diagnostic Services Act <- was passed, and in 1968 the -> Medical Care Insurance Act<- made publicly funded medical care available to all Canadians. The emergence of publicly funded health care brought dramatic changes to the roles of district or visiting nurses.
3) Through 1950 to 1970, hospitals were built in abundance however, by the early 1970’s, it was becoming evident that increasing hospital costs would not be sustainable. The 1974, the -> Lalonde Report <- presented the first vision for health promotion services.
4) A landmark document entitled the -> Declaration of Alma Ata (WHO) <- arose from an International Conference on Primary Health Care in 1978.
5) As diagnostic and hospital costs continued to increase, extra-billing by physicians and user fees by provincial institutions posed a serious threat to Medicare. The -> Canada Health Act <- was passed in April 1984 and provided the federal government with the legal authority to penalize provinces that permitted practices such as extra-billing for insured services.
6) The Epp (1986) framework, entitled -> Achieving Health for All: A Framework for Health Promotion <- expanded on Lalonde’s work and formed the basis for the -> Ottawa Charter for Health Promotion (1986) <-.
7) More recent documents such as Hamilton and Bhatti’s (1996) -> Population Health Promotion Model <- have clearly influenced today’s community health nursing as evidenced by the Community Health Nursing Practice Model (2003).
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Activity 4: Do Community Health Nurses face different ethical issues?
In your course notes provide definitions for the following ethical principles. Drag your mouse below the term, between the arrows, to see the suggested response:
Beneficence
->Requires that potential benefits to individuals and to society be maximized, and that potential harms be minimized” (Coughlin, Soskolne, & Goodman [1997] as cited in Vollman et. al., 2004, p.107).<-
Nonmaleficence
->“Requires that harmful acts not be committed – Primum non nocere – first, do no harm” (Vollman et. al., 2004, p.107).<-
Justice
->“Requires the equitable distribution of potential benefits and burdens” (Vollman et.al., 2004, p. 107).<-
Autonomy
->“Is focused on the right of self-determination that grants importance to individual freedom” (Vollman et. al., 2004, p. 108).<-
Do you believe the nurse-client relationship is different for nurses who work in hospitals and for those who work in the community? Write your response with brief rationale in your course notes.
The following CARNA website may assist you in answering the preceding question and should be of interest to you. Go to Professional Boundaries for Registered Nurses: Guidelines for the Nurse-Client Relationship (May 2011) athttp://www.nurses.ab.ca/content/dam/carna/pdfs/DocumentList/Guidelines/RN_ProfessionalBoundaries_May2011.pdf
You might also find the following article by Jos, Perlmutteer, and Marshall (2003) Substance abuse during pregnancy: Clinical and public health approaches a stimulus for further thinking in relation to community health nursing practice.
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